General Medicine

Patient came with c/o : Fever since 1 day Headache since 1 day Fever - high grade , intermittent , relieves on taking medication , not associated with chills and rigors. Headache - present in the frontal region, no aggreavating or relieving factors , not associated with any postural variation . HOPI : 15 days back pt has c/o nasal congestion as pt symptoms of nose blockage increased since 4 days for which pt was using nasal decongestion tablets . Pt is having excessive anger since 2 days which he was attributing that occur after taking the medications . At age of 12 yrs pt was admitted in KIMS ( 14/10/2016 ) with c/o fever , vomitins , seizures ( 4 episodes ) and headache diagnosed as hypertensive encephalopathy secondary ? PSGN , discharges on ( 28/10/2016 ) and used tab phenytoin for 7 months and stopped on advise of doctors . N/K/C/O DM , HTN , TB , ASTHMA , EPILEPSY PERSONAL HISTORY : Diet- mixed Appetite- normal Sleep- adequate Bowel and bladder movements- regular No known allergi

  GIDDINESS UNDER EVALUATION SECONDARY TO A) HTN ? B)AUTONOMIC NEUROPATHY ? WITH DENOVO HTN WITH HYPERTERNSIVE RETINOPATHY WITH K/C/O DM-2 WITH DIABETIC NEUROPATHY . 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. A 45yr old male patient resident of pedhakaparthy came to the casualty with  c/o giddiness since 2days , non rotational , duration-10min, aggravated on standing , relieved by supine. HOPI -  Patient was apparently asymptomatic 2days back and had an episode of giddiness , where he went to the local RMP and was found to have increased BP and patient had given TAB .AMLONG , TAB .ATENOLOL and didn't have any episode of giddiness . From y

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 COMM 80 years male who is a farmer by occupation came to casuality with chief complaints of vomiting 2 episodes since morning and giddiness since morning. HOPI: - Patient was apparently asymptomatic 4 years back and on road in village health checkup he was diagnosed to have hypertension and he was put on tablet atenolol 50 mg since 4 years. - Today morning, he woke up and ate food and after 2 1/2 hours, he went to his work in field, while working in the field he had sudden onset of giddiness follo

13 year old boy who is studying 6 th class came with chief complaints of Fever ( since 1 day ). Patient was apparently alright till one day back he had high grade fever, which relieved on taking medication, not associated with any vomitings , loose stools , pain abdomen, not associated with any night sweats , cough , no h/o any ear pain / ear discharge . 5 months back patient got admitted in our hospital for c/o SOB ( treated conservatively for 5 days and discharged ) . PAST HISTORY : Not known case of DM2 , Hypertension , Asthma , TB , Epilepsy . PERSONAL HISTORY : Diet- mixed Appetite- normal Sleep- adequate Bowel and bladder movements- regular Occasional alcohol intake + No known allergies FAMILY HISTORY:  Not significant GENERAL EXAMINATION: No Pallor  No icterus, cyanosis, clubbing, koilonychia, lymphadenopathy, edema. VITALS AT ADMISSION : Temp - 99 F PR- 72 bpm RR- 22 cpm BP- 110/70 mmHg SpO2- 98% RA GRBS- 126 mg/dl SYSTEMIC EXAMINATION: CVS: S1S2 heard, no murmurs RS: BAE+ NVB

Chief complaints Fever ( 10 days ) Lethargy ( 4 days ) Blood in saliva ( 3 days ) SOB ( 2 days ) Patient was apparently alright 10 days ago back he had fever low grade , intermittent , relieved on taking medication . Not associated with chills and rigor and doing his routine works , from 4 days as patient was lethargic brought to local hospital found out to be Dengue NS 1 reactive and platelet count was  44000 ( 1/3/22 )  22000 ( 2/3/22 ) one SDP transfusion 33000 ( 3/3/22 ) From 3 days patient notices blood in saliva and while during coughing associated with Black coloured stools from 2 days patient is having Grade 2 to Grade 4 ( NYHA ) N/K/C/O DM , HTN , TB , ASTHMA , EPILEPSY PERSONAL HISTORY : Diet- mixed Appetite- normal Sleep- adequate Bowel and bladder movements- regular Occasional alcohol intake + No known allergies FAMILY HISTORY:  Not significant GENERAL EXAMINATION: No Pallor  No icterus, cyanosis, clubbing, koilonychia, lymphadenopathy, edema No neck stiffness Kernig and Br