07.Ram subhash

    This is an online e-log book to discuss our patient's de-identified health data shared after taking his/her/guardian's 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 blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan.  Date of admission:04/02/2022. A 45yrs old female ,farmer by occupation came to casuality with the Chief complaints Of   Fever and body pains, not associated with chills since 10days. HISTORY

 1) Define heart failure? Etiology and clinical feature of heart failure. How do we diagnose heart failure. Physical examination and various modalities and diagnosis of heart failure. Write a note on treatment of heart failure?  A)  2) Define cirrhosis of liver? Etiopathogenesis of cirrhosis of liver? Write a note on clinical feature, diagnosis, and treatment of cirrhosis of liver?  A)  3) clinical feature and diagnosis modalities of renal claculi?  A)  4) Etiology of pleural effusion? Diagnostic criteria of pleural effusion?  A)  5) Diagnosis and treatment of dengue fever?  A)  6) Clinical feature and treatment of peptic ulcer?  A)  7) Treatment of acute polynephritis?  A) --- 8) Treatment of abdominal tuberculosis?  A)  9) Etiology and treatment of pneumonia?  A)  10) Complications of dialysis?  A)  11Q) Ascitic fluid analysis?  A)  12) proton pump inhibitors?  A)  13) Afterload reducing agents in heart failure?  A) --- 14) Treatment of urinary tract infections?  A)  15) Diffenrial d

 A 60 year old man, who works as a daily wage worker hailing from Palem presented to the hospital with- • reduced micturition and defecation since 2 months. • burning sensation on micturition since 2 months. HISTORY OF PRESENT ILLNESS • Patient was apparently asymptomatic 2 month  back. • The patient is a retired coolie who does nothing work in the day. • He wakes up at 6am, roams around his village,  and he take rest at around 10pm. • 2 weeks after Dusshera (2 months back), patient suffered with a dizziness and cough which he attributes to "cold". • Patient was taken to an ENT specialist who ruled him clear of any problem. • The same day, the patient noticed an acute decrease in his urination and micturition. • When patient was taken to the hospital in Nakrekal where he was diagnosed with Renal failure.  • He was put on Maintainance Hemodialysis since then. • Patient recollects that after 5 days of dialysis, patient's micturition and defecation was somewhat restored.  •