Vamsi Roll no 23

 Chief complaints Right lower limb swelling since 10 days, fever since 5 days History of presenting illness Patient was apparently asymptomatic 10 years back then he developed progressive swelling of right lower limb and diagnosed with filariasis for which he was prescribed medicines by a local doctor 10 year back he was diagnosed with diabetes mellitus and hypertension and since then using antihypertensives( nifedipine) and anti diabetics( glizide) - 3 years back he developed pedal oedema and went for further evaluation and diagnosed to have chronic renal failure ? - 2 years back he suffered from COVID-19 following which he had shortness of breath at rest (grade 4) and chest pain for which he went to co-operate hospital in Hyderabad and diagnosed to have inferior wall myocardial infarction, So he was treated with streptokinase. At that time coronary angiogram was not done in the view of high serum creatinine levels - After 1 month cononory angiogram was done to recanalized the right c

 70 yrs old female bought to the casuality in unresponsive sate with cheif complaints of  Slurring of since 1 day ( 07-07-2022 )  Altered sensorium since 1 day (07-07-2022) HOPI :  Patient was apparently asymptomatic 1 day back and on thursday morning she developed slurring of speech and giddiness then they went to a hospital in miryalguda , they found increased levels of sugars ( >500 mg/dl ) and thought giddiness was due to increased sugar levels and given treatment to reduce sugars, despite of which symptoms doesn’t relieved , on thursday night patient was bought to our hospital in unresponsive state.  Blood in the stools 2 days back  HCV +ve Daily routine:  Wake up - 8:00 am  Completes her daily household activities  Tiffin - 9:00am  Lunch - 12:30 pm Dinner-8:30 pm Sleep - 9:30 pm Past history :  K/C/O - hypertension since 10 yrs ( on medication TELMA 20 mg )  K/C/O- Asthma  Diabetes- diagnosed 1 day back ( 07-07-22)  No history of epilepsy, thyroid,Tb .  Personal history :  Die

A 62 year old male came to casuality with chief complaints of  Generalized body swelling since 15 days  Facial puffiness since 15 days  Scrotal swelling since 15 days  HISTORY OF PRESENTING ILLNESS Patient was apparently asymptomatic 2years ( July 2021)  back, then developed weakness of right upper and lower limb associated with slurring of speech and deviation of mouth for which he was taken to hospital and diagnosed as right hemiparesis . 10 months back developed B/l  lower limb edema ( pitting type), upper limb edema and facial puffiness for which was managed conservately .  15 days back again developed generalized body swelling, facial puffiness,sob and scrotal swelling .   PAST HISTORY  K/c/o hypertension since 1 yr and on T. Clinidipine 10 mg and furosemide 40mg . K/c/o CVA with right hemiparesis 2 yrs back.   Not a k/c/o DM . PERSONAL HISTORY  Diet - Mixed Appetite- normal Sleep- Adequate  Bowel and bladder- regular  Habits/Addiction: chronic alochol and smoker for 40 yrs  FAMIL

  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.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome.” This is a case of a 41 year old male with complaints of left leg pain since 4 years. History of presenting illness Patient was apparently asymptomatic 4yrs ago but developed joint pain in  left pubic area which was radiating towards the whole left leg(from hip joint to ankle joint) upon movement and resting for period of 10-20 mins  Associated with fever of temp 100-101°F which subsided upon resting. He also experienced numbness in the left leg for a period of 20-30