E- LOGS OF MEDICINE

  Case History and Clinical Findings 17 YEAR OLD MALE WITH C/O ALTERED SENSORIUM SINCE 7:30 PM ON 8/8/23 C/O 2-3 EPISODES OF VOMITING SINCE 7:30PM PATIENT WAS APPARENTLY ASYMPTOMATIC TILL TODAY MORNING PATIENT HAD CONSUMED ALCOHOL (5 BEERS) AND PATIENT WAS ALTERED SENSORIUM SINCE 7:30 PM IN THE NIGHT PAST HISTORY: N/K/C/O DM-II,HTN,CVA,CAD,TB,ASTHMA,EPILEPSY GENERAL EXAMINATION PATIENT WAS UNCONCIOUS AT PRESENTATION. GCS SCORE E1V1M4 NO PALLOR,ICTERUS,CYANOSIS,LYMPHADENOPATHY,CLUBBING,PEDAL EDEMA VITALS: TEMP:AFEBRILE PR : 96 BPM RR 18 CPM BP 60/40 MM HG SPO2 99 GRBS 119 MG/DL PSYCHIATRY OPINION WAS TAKEN AND PATIENT IS COUNSELLED AND PSYCHOTHERAPY IS DONE. AND HARMFUL EFFECTS OF ALCOHOL IS EXPLAINED Investigation ABG PH 7.297 PCO2 40.5 PO2 113 HCO3 19.2 RFT UREA 19 CREATININE 0.8 URIC ACID 6.8 NA 132 K 3.3 CL 102 CA 9.8 HEMOGRAM HB 13.9 TLC 14300 N/L/E/M/B 86/10/1/3/O PCV 41.1 MCV 75.3 MCH 25.6 MCHC 33.9 RBC 5.45 PLT 2.73 FBS 95 Diagnosis ALTERED SENSORIUM S...

  A 30 year old male patient resident of Gudipally came to the casualty on 23/11/22 of altered behaviour since yesterday Involuntary micturition since yesterdayGiddiness since morningHOPI.Patient was apparently asymptomatic till 12 am last night then he started behaving abnormally which was sudden in onset in terms of not .responding when spoken to,irrelevant talk which is repetitive and self talking.patient is irritable every few minutes and abuses family members at times.Patient had history of alcohol consumption since 10 years currently 6 to 10 units daily throughout day,reports craving for alcohol, sweating and trembling when he doesn't consume alcohol.patient stopped consumption for the past 10 days till yesterday but was given 3 units I/v/o tremors@ 10:30 am which subsided after consumption . patient.also reported double images and slurring of speech and memory disturbances since 10 days.patient reports consumption of tobacco in the form of smoking(10 cigarettes per day). PAS...

  Case History and Clinical Findings 62 YEAR OLD MALE Patient came with the complaints of pedal edema and scrotal swelling since 2 monthsshortness of breath since 2 monthsPatient was apparently alright 1 year ago, then he developed weakness of right upper and lower Limb and deviation of mouth to right side and started talking irrelevantlyMRI brain imaging was done which showed infarcts.Pt . used allopathic as well as herbal medication and weakness gradually improved by 6 months. patient has fluctuating sensorium since then which has worsened since 2 months. complain of pedal edema and scrotal swelling since 2 months insidious onset gradually progressive in nature up to nice fitting type continuous and nature know their regional variation with shortness of breath with incidence in launching on set manually progressive signature on ordinary activity great to grade 2orthopnea present pnd presentNot complain of chest pain, palpitations ,fever vomiting loose stoolsPt is a known case o...

  Case History and Clinical Findings 60 YEAR OLD FEMALE PATIENT WAS BROUGHT TO CASUALITY WITH C/O PAIN ABDOMEN SINCE LAST MIGHT, DECREASED URINE OUTPUT SINCE LAST NIGHT HISTORY OF PRESENT ILLNESS:- PATIENT WAS APPARENTLY NORMAL 1 DAY BACK THEN DEVELOPED PAIN ABDOMEN DRAGGING TYPE NON RADIATING LOCALISED TO UMBILICAL REGION ASSOCIATED WITH 2 EPISODES OF VOMITINGS WATERY NON BILIOUS NON PRTOJECTILE WITH FOOD PARTICLES AS CONTENTS C/O DECREASED URINE OUTPUT SINCE LAST NIGHT H/O FEVER 3 DAYS BACK HIGH GRADE INTERMITTENT ASSOCIATED WITH CHILLS AND RIGORS RELIEVED BY MEDICATION C/O PAIN IN LEFT LOWER LIMB, SWELLING PRESENT, PITTING TYPE, EXTENDING UPTO THE KNEE, TENDERNESS PRESENT C/O SHORTNESS OF BREATH SINCE LAST NIGHT NO C/O CHESTPAIN,PALPITATIONS, ORTHOPNEA, PND, LOOSE STOOLS AND FACIAL PUFFINESS PAST HISTORY:- PATIENT IS A K/C/O HYPERTENSION SINCE 5 YEARS USING TAB.ATENOLOL 50MG OD N/K/C/O DM, TB, EPILEPSY, CVA, CAD, THYROID DISORDERS PERSONAL HISTORY: APPETITE - NORMAL BOWELS -...

  Case History and Clinical Findings PRESENTING COMPLAINTS: Fever since 12 days. Burning micturition since 12 days. HOPI A 65 year male, apparently asymptomatic 12 days back then he had gradual onset of fever since 12 days initially high grade fever associated with chills, history of burning micturition on day 3 of illness. Patient sought for consultation at local Rmp and treated with oral medication. On day 4 of illness, the patient was brought to another local hospital for further management, there he was treated with iv Fluids for 3days. As fever didn't subside, patient was shifted to another hospital; there he was treated with IV antibiotics and 1 unit of platelet transfusion was done in view of low platelet count. During the transfusion of platelet patient had chills. From next day of transfusion patient developed slurred speech and was reffered to our hospital in view of hemodialysis. Now admitted for further evaluation and management. Past history:History of CAD 6yrs agoHis...

  Case History and Clinical Findings 80 YEAR OLD MALE PATIENT CAME WITH C/O FEVER SINCE 1 DAY HOPI: PATIENT WAS APPARENTLY ALRIGHT 1 DAY BACK AFTER WHICH SHE STARTED HAVING FEVER ,HIGH GRADE,ASSOCIATED WITH GENERALISED WEAKNESS PATIENT WAS UNABLE TO GET UP FROM BED SINCE MORNING H/O INVOLUNTARY PASSAGE OF STOOLS AND URINE TODAY MORNING NO H/O NECK STIFFNES,NECK PAIN NO H/O COUGH,COLD,BURNING MICTURATION NO H/O ALTERED SENSORIUM IN THE PAST NO H/O HEADACHE ,VOMITINGS H/O SIMILAR COMPLAINTS 3 YEARS BACK AND GOT HOSPITALISED K/C/O ?CKD SINCE 15 YEARS(ON CONSERVATIVE MEDICINE) H/O ?CVA 4 YEARS BACK K/C/O DM 2 SINCE 20 YEARS (ON OHA'S TAB-GLIMIPERIDE 1MG + METFORMIN 500MG) COURSE IN HOSPITALA 80 YEAR MALE CAME TO OPD WITH C/O FEVER SINCE 1 DAY,NECESSARY INVESTIGATIONS WERE DONE AND DIAGNOSED AS LOWER RESPIRATORY TRACT INFECTION CHRONIC OBSTRUCTIVE PULMONARY DISEASE CHRONIC KIDNEY DISEASE (STAGE IIIB) UMBILICAL HERNIA K/C/O DM 2 SINCE 20 YEARS .CONSERVATIVELY MANAGED, SYMPTOMS SUBSIDED. ...