Vamsi Roll no 23

 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 CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUT This is a case of 32 yr old male resident of nagaram , housekeeper in a hospital in kachiguda came to general medicine OPD with  CC: patient came to OPD with cheif complaints of abdominal pain , vomiting, Sob since 5 days. HOPI : patient was apparently asymptomatic 10 days back then he developed fever without chills and rigor , with no diurnal variation , yellowish urine without burning micturition , b/l pedal edema upto ankle , facial puffiness , for which he has gone to rmp and diagnosed as jaundice, later on 24 th he took a herbal medicine, and on 25 he developed abdominal pain which is sudden in onset and g

 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 PUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS WITH AN AIM TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUT 75 yrs old male came to the OPD with CC:vomiting since 10 days ,Sob since 20 days Bilateral pedal oedema since 30 days .  HOPI:  Patient was apparently asymptomatic 30 days back then he developed  Bilateral pedal oedema which is insidious in  onset,  gradually progressive  , pitting type , extending from knee to foot , no agrrevating and relieving factors .  Sob which is insidious in onset gradually progressive, grade 4 , agrrevates on walking Vomiting - 4- 5 / day  , non bilious , non blood stained , immediately after taking water and food . PAST HISTORY  18 yrs back he developed tb for which he had take antit