Medicine log book by Pujitha Aparna

FINAL PRACTICAL EXAMINATION- LONG CASE  Feb 8,2022   "This is an online E log book to discuss our patient's de-identified health data shared after taking his / her guardians signed informed consent. Here we discuss our individual patient's problems through a series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs .This E log book reflects my patient centered online leading portfolio and your inputs on the comment box is welcomed." Chief complaints: A 60 year old male patient driver by occupation came to  causality with the chief complaints of;  Pedal oedema since 15 days.   Vomitings since 1 week SOB since 5 days.                                               Fever,cough since 5 days. Decreased urine output since 3 days He is a known case of chronic renal failure and he is on hemodialysis and he underwent (4) sessions of hemodialysis. HISTORY OF PRESENT

FINAL PRACTICAL EXAMINATION-SHORT CASE Feb 8,2022  "This is an online E log book to discuss our patient's de-identified health data shared after taking his / her guardians signed informed consent. Here we discuss our individual patient's problems through a series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs .This E log book reflects my patient centered online leading portfolio and your inputs on the comment box is welcomed." CHIEF COMPLAINTS: A 50 year male patient farmer by occupation brought  to casualty with h/o altered sensorium since 1 day H/o fever since 4 days. HISTORY OF PRESENTING ILLNESS - Patient was apparently asymptomatic 4 days ago,then he developed fever which is high grade,No diurnal variation, associated with chills. No h/o cough and GI symptoms.  Attenders tells h/o stoppage of  oral hypoglycemic agents for 3days, h/o decreased inta