95

A 65 yr old male came to opd with HOPI He is a 60 yr old who was a toddy tree climber for 30 yrs.later on continued as daily wage labourer along with his wife.he stopped working since 4 yrs. His daily activities inude waking up at 8/9 in the morning, attending nature call, rice for breakfast going back to sleep around 9/9:30 AM, waking up again around 3/4 PM having lunch, going back to sleep around 8PM, having dinner or indulging in alcohol weekly once with his relatives who visits their house. On Friday .He had tingling sensation throughout the body starting from lower limbs denies H/O fall/trauma around in the evening as it was not subsiding went to local doctor and was given medication, not subsided. On Saturday morning, in his daily activity .He couldn't get up after going loo.He had to take support of the walls & slowly moved to door, opened the latch and had a fall,with no apparent injuries. He was taken to nakrekal for further management & was not subsided. By evenin...

HYPOKALEMIC PERIODIC PARALYSIS A 62 year old male presented with weakness in both lower limbs extending upto thigh unable to lift and walk. He is the eldest of 5 sons and owns  4 acres of land ,grows rice and owns and drives a tractor to plough the field. He is an alcoholic since 30 years , daily intake (90-180 ml whisky) and denies smoking 5 years ago ,On an occasion, he was made to drink herbal medication in order to make him quit drinking .He developed fever the same night with chills and was taken to hospital and he even recollects that his voice was getting low and starting from paralysis of lower limbs in an ascending manner and was referred to Kims,Nkp.He stayed for 3 days and was discharged on potassium supplementation. 6-10 days later he developed paralysis of lower limbs and was again brought to Kims ,Nkp, and was corrected and was symptom free for one month  He developed paralysis for third time later ,after 1-2 months ,he was taken to Gandhi hospital for the same a...

October 1st 2021, Admission under nephrology department. Under the guidance of Dr Pradeep sir 65 year old male came with complaints of B/l lower limb edema(pitting type) ,upper limb edema and facial puffiness since 5 days Hopi : patient was apparently alright 5 days back then he developed b/l pitting type of lower limb edema progressed to upper limb No history of facial puffiness ,vomitings,loose stools,orthopnea,PND K/c/o CVA since 2 months recovered within 1week  K/c/o hypertension since 5 months(on prazosin 5mg) H/o 2 sessions of hemodialysis in 2013 On examination :  Pt is c/c/c No signs of pallor, icterus, cyanosis, clubbing, lymphadenoapathy, edema Vitals: Afebrile PR: 70 bpm, regular RR: 24 cpm BP: 220/130 mmHg SPO2: AT ROOM AIR-98% Systemic examination :  CVS:S1,S2 heard  Apex beat:5th ICS Resp: BAE+ Nvbs heard Position of trachea- central P/A: soft, tenderness absent, bowel sounds heard Provisional diagnosis Hy...

This is an onlineE log book to discuss our patients de- identified health data shared after taking his / her guardian' s signed informed consent . Here we discuss our individual patients problems through series of inputs from available global online community of experts with with an aim to solve those patients clinical problems with collective current best evidence based inputs . This E log book also reflects my patient my patient- centered online learning portfolio and your inputs are welcome May 2 2021 SHORT CASE This is an online elogbook to discuss our patient's deidentified health data shared after taking her/guardian's informed consent. A 46 year old female agriculturer by occupation hailing from miryalaguda presented with chief complaints of  1. Shortness of breath since 5 days 2.Generalised swelling of the body since 5 days HISTORY OF PRESENTING ILLNESS The patient was apparently assymptomatic 5 days back and then she developed shortness of breath with was insidious...

This is an online E log book 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 series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. May 2, 2021 LONG CASE : A 50-YEAR-OLD LADY WITH LEFT-SIDED WEAKNESS OF THE BODY AND DEVIATION OF THE MOUTH TOWARDS THE RIGHT A 50-year-old lady, from Suryapet, who is a homemaker, came to the hospital on 20/04/2021 at 3 PM, and was examined on 24/04/2021 at 10 AM, with Chief Complaint s  of : 1) W eakness of the left upper and lower limbs since 5 days 2) Deviation of the angle of mouth towards the right since 5 days 3) Slurred speech since 5 days. History of Presenting illness  :  The patient was apparently asymptomatic  5 days ago , when  at around 9 AM in the morning, on 20/04/2021 : ...

KYASA SAI BRIGISHA  roll no 95 I've 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 a diagnosis and treatment Complaint of patient priority wise 1) bilateral lower limb weakness since 20 days Progressive weakness intially in the proximal muscles and at present distal muscles are involved 2) swelling of the lower limbs in calf region 3) difficulty in getting up from squatting position CNS examination patient is conscious, coherent, coperative  patient well oriented to time, place and person higher mental functions= normal Cranial nerves- intact Motor system-        tone - normal        power -  4-/5 in both lower limbs         reflexes absent in both lower limbs sensory system-normal No meningeal signs No cerebellar signs B...

I've 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 a diagnosis and treatment plan. Patient complaint: difficulty in walking since 1 month, Under evaluation:  distal and proximal muscle weakness and wasting of muscles present ,no sensory and anatomical involvement, hypotonia and decreased power in lower limbs and absent reflexes, no fasiculations  ANATOMICAL location: Peripheral neuropathy Axonal: chronic,distal to proximal, reflexes not affected,sensory more involved than motor, wasting minimal ,calf tenderness Demylinating: acute diffuse proximal and distal, reflexes are lost,motor more involved than sensory,wasting not seen, ncv decreased Anterior horn cell: wasting present fasiculations present distal affected more no autonomic and sensory  The ...