General medicine

  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. Here is a case i have seen: Pt presented to opd with c/o Generalized weakness. A 44 yr old female who was apparently asymptomatic 1 yr back then developed pain in the legs(dragging type) ,which is a/w generalized weakness and shortness of breath. The pain in the legs were aggravated during the last 2 months ,at the same time patient developed sudden diminision of vision in left eye,where they visited the local ophthalmologist treated with topical drugs.patient was ref

1)Anatomical diagnosis -? Glomerulus of kidney                                                                    Etiological diagnosis -  ?? Nephrotic syndrome secondary to the diabetic nephropathy or CKD.      2)Reasons for I) Azotemia : impaired renal excretion of urea and creatinine secondary to CKD.  II) Anemia : decreased erythropoietin.  III) Hypoalbunemia: capillary basement membrane and podocytes damage.kidney cannot filter protein                                 Acidosis-accumulation of H+ and loss of HCO3 3) Rationale : syp potchlor was given because of the hypokalemia.. Inj. NaHCO3 was given because of metabolic acidosis ..Insulin and antihypertensives are given because known case of DM and HTN. Orofer XT was given because of anemia.. Inj. Lasix was given to decrease her volume overload. Spironolactone was given it was a potassium sparing diuretic.Calcium was given to the patient  because of hypocalcemia secondary to CKD. Indications of NaHCO3:metabolic acidosis in cardiac

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. Here is a case i have seen: A 55 yr old male patient who was a toddy tree climber by occupation  came to opd with complaint of pain in multiple joints associated with restriction of movement   Patient was apparently asymptomatic 10 yrs back .Then he felt pain in bilateral knee joints which is associated with swelling.for which he used medication (proper records not available about medication)which gave him mild symptomatic relief but not completely cured his pain. Patie