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NSAIDS INDUCED NEPHROPATHY WITH METABOLIC ACIDOSIS WITH CKD WITH HTN(1MONTH).

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65 year old male patient came to OPD with  C/o of shortness of breath grade 2 to grade 3 according to a NYHA classification since 15 days C/o bilateral pedal edema(on and off since 2 yrs) and complain of decreased urine output since 2 months  C/o decreased appetite 65 year old male who is farmer by occupation   was apparently asymptomatic 14 years back doing all his routine activities and then he met with an RTA and sustain low back ache for which he was conservatively treated for six days and then discharged which is followed by recurrent back ache for which he took NSAIDS for 10 years in nearby hospital followed by herbal medication . Two years back he noticed bilateral pedal edema and went to local hospital and treated conservatively and then pedal edema is on and off. 2months back he noticed decreased urine output Since 15 days he complain of shortness of breath grade 2 to grade 3 K/c/o Hypertension since 1month ( on tab atenolol 10mg,irregular medication) Not a k/c/o di
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Alcoholic acidosis? wet beri beri? Acute pancreatitis? AKI secondary to dehydration

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35 YR OLD MALE PATIENT CAME TO CAUSALITY WITH  C/o shortness of breath since morning C/o pain abdomen since Monday (3-4days) C/o chest pain ( left sided since 4 days ) C/o decreased urine output since 2 days C/o hematuria since morning C/o vomitings since morning Patient was apparently asymptomatic 4 days back then he developed shortness of breath ( grade III- grade IV ) h/o binge drinking of alcohol since 10days without eating food. C/o pain abdomen ( diffuse type of pain ) associated with vomitings ( food particles as content ), non projectile C/o chest pain left sided not associated with sweating ,palpitations, orthopnea , PND C/o hematuria since morning C/o decreased urine output since 2 days Not a Known case of DM,HTN Alcoholic since 20 years ( 100ml/day) H/o visited RMP 3 days back I/v/o generalized weakness and vomitings Physical examination No signs of pallor,cyanosis,clubbing, lymphadenopathy,edema Icterus ++ Vitals - Temp: 98.5 F PR: 112 bpm RR : 22 cycles BP : not recordable
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70 yr old male with altered sensorium

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70 year old male farmer by occupation came to the casualty with sudden onset of a aphasia since yesterday night . patient was apparently asymptomatic till yesterday then he woke up from bed at 11 p.m. to go to washroom and fell from bed and his attenders  observed aphasia (sudden onset) and he is unable to wake up from the floor.  no history of trauma to the head, no involuntary micturition and defaecation. H/O fever 5 days back not associated with chills and rigors and not associated with nausea and vomiting,took treatment from local RMP. No H/o pedal edem,SOB,burning micturition.  H/o tingling sensation of bilateral upper limb and lower limb since 1 month    not a known case of asthma ,TB epilepsy   known case of diabetes since one year and hypertension since one year and on irregular medication   alcoholic occasionally(last drink 1week back) and smoking (1chutta/day) since 45yrs. Personal history :  Married  Diet - mixed  Appetite - normal Sleep - adequate  Bowel movements : regu
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CASE OF A 40 YEAR OLD WITH PEDAL EDEMA

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Internal Medicine Friday, 30 April 2021 CASE OF A 40 YEAR FEMALE WITH PEDAL EDEMA  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 IS THE CASE I HAVE BEEN GIVEN  : A 40 year old female patient, works at a construction site came to the opd with CHIEF COMPLAINTS OF : 1. Chest pain since 5 days 2. Shortness of breath since 5 days HISTORY OF PRESENT ILLNESS : The patient was apparently asymptomatic 5 days ago, the she developed chest pain, non radiating &  increased on taking deep inspiration. Shortness of breath on & off No h/o orthopnea, PND, fever, Cough PAST HISTORY  :   Not a k/c/o DM, HTN, CAD, Asthama, epilepsy and Tb PERSONAL HISTO
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PNEUMONIA WITH DIABETIC KETOSIS

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April 30, 20                                       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   40 year old male, labourer by occupation, low socioeconomic status from narketpalli came to opd with  Cheif complaints: Breathlessness since 1month Fever since 10 days Chest pain since 4 days History of present illness: Patient was apparently asymptomatic 1 month back, then developed Breathlessness which was insidious onset which used to be grade 2(MMRC)   and progressed to grade 4 since last 4 days with no postural or diurnal variatio
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