NITISH DAMPURU ROLL NO 33

 Hello, This is Nitish Dampuru, a medical undergraduate studying in India. I'd like to share some of the interesting cases that helped me to learn more about medicine. I'd also like to thank my seniors and my professors for guiding, teaching me, enhancing my respect for the art of medicine and finally make me better as a person. NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS/HER GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT. What is the greatest achievement for a doctor? To be the reason for their patient's smile. Isn't it ?? Alright let's get to the details of my first encounter with a patient. She was a 45 year old daily wage worker whose chief complaints were vomiting (4-5 ep

      This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan. A 65 year old female came to casuality with chief complaints involuntary movements of B/L upper limbs and lower limbs. HOPI:-  A 65 years old female came to casualty with  C/C of headache since 4 hours In

 Chief complaints:-  C/o B/L knee pains since 4 years  Lower back ache since 1 year B/L UL and LL muscle pains and multiple joint pains since 4 months  B/L pedal edema since 3 months  Difficulty in swallowing since 3 months  Hopi : Patient was apparently asymptomatic 4 years ago, then she developed B/l knee pain insidious in onset and gradually progressive which gets aggrevated on doing and relieved on rest  Patient had h/o fall in 1 year ago due to slippage in the bathroom, sustained injuries to the lower back , she was on conservative management. 4 months ago she had a swelling and pain in all the joints of B/L upper limbs and lower limbs and developed fever for 3 days , lower grade rest a/w chills and rigors  B/L pedal edema since 3 months upto ankle jt and non pitting type  Occassional H/o difficulty in swallowing more to solids  H/o constipation ( passes stools once in 3 days after taking syrup. General Examination: Patient is conscious coherent and cooperative  pallor - present 

 This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan Cheif compliants:- A 65 year old presented with  1)cough since 4 months 2)Fever since 10 days  Hopi:-  Patient was apparently asymptomatic 4 months back then developed cough a/w sputum , which is whitish in colour, thick, moderate amount, more during nights. H/o fever since 10 days, high grade a/w chills and rigor , internittent, no evening rise of temperature  No h/o cold, SOB, chest pain, palpitations, excessive sweating, burning micturition, pedal edema, decreased urine output H/o increased exposure to dust  Past history :-  similar complaints in the past 20 years ago , an