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CASE DISCUSSIONS

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45YR old male, real-estate business man, came to OPD with cheif complaints of 1.VOMITINGS , 2-3 episodes per day since 1week. 2. HEMETEMESIS , 2episodes , 10-15ml , 1week back. 3. MELENA since 2days. No H/O fever, pain abdomen, diarrhoea. Not a K/C/O DM, ASTHMA,TB. PAST HISTORY: 2yrs back, when he was at home around  11-12pm , he had INVOLUNTARY MOVEMENTS OF LEFT UL,LL    DROOLING+    DEVIATION OF MOUTH+    ROLLING OF EYE BALLS + then he fell down. INVOLUNTARY MOVEMENTS LASTED FOR ABOUT 5MIN. He was in POST ICTERAL CONFUSION STATE FOR ABOUT HALF HOUR. Then he was taken to hospital, where his BP WAS HIGH. started on ANTI HYPERTENSIVES and  ANTI EPILEPTICS. ANTI HYPERTENSIVE - NOT DOCUMENTED. ANTI EPILEPTICS:     LEVIPIL 500MG /BD He continued to use these medications for almost one and half yr , and stopped using anti epileptic medication 1mon back. Now these acute complaints since 1week. LAST BINGE OF ALCOHOL 3DAYS BACK. no significant family history PERSONAL HISTORY: Takes mi
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GM CASE DISCUSSIONS.

40 year old male came to casualty  with c/o fever, cough with blood tinged sputum(1 episode),red coloured urine associated with B/L loin pain.  HISTORY OF PRESENT ILLNESS : Patient was apparently asymptomatic 1week back then he developed  fever, insidious in onset, no diurnal variation, subsided on taking medication for 2-3 hrs.H/o burning micturition since 2-3 days.H/o passage of red coloured urine after taking medication (?suggested COVID tablets).  H/o cough with blood tinged sputum since yesterday.H/o  B/L loin pain,non radiating.  PAST HISTORY : Not a k/c/o DM/HTN/ASTHMA/EPILEPSY/TB PERSONAL HISTORY : appetite-normal Sleep-adequate Bowel and bladder-burning micturition Addictions-1bidi/day since 30 years.  No significant family and treatment history.  GENERAL EXAMINATION : pt. is c/c/c TEMP:Afebrile BP:110/80 mm Hg PR :78 bpm Nopallor,icterus,cyanosis,clubbing,lymphadenopathy,edema. SYSTEMIC EXAMINATION : CVS:S1,S2 heard RS:BAE +  P/A: soft, non tender CNS: NFND PROVISIONAL DIAGNO
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GENERAL MEDICINE CASE DISCUSSIONS

17 year old female came to casualty with chief complaints of fever, headache, low back ache since yesterday. HISTORY OF PRESENT ILLNESS : Patient was apparently asymptomatic till yesterday, then developed which is insidious on onset, gradually progressive, not associated with chills and rigor, no diurnal variation, no sweating.  C/o headache(diffuse type) not associated with nausea/vomiting. C/o low back ache(diffuse type) not radiating. No c/o cough, sob.  PAST HISTORY : not a k/c/o DM/HTN/TB/Epilepsy. PERSONAL HISTORY : appetite-normal Sleep-adequate Bowel and bladder-regular No any addiction  TREATMENT HISTORY : No significant treatment history  FAMILY HISTORY : NO significant family history.  GENERAL EXAMINATION : Patient is conscious coherent and co-operative Temp:Afebrile Bp:100/60 mm hg Pr:93/min Spo2:100% at RA GRBS:115 mg/dl No pallor, icterus,cyanosis clubbing,edema,lymphadenopathy. SYSTEMIC EXAMINATION : cvs:S1,S2 heard RS:NVBS heard Abdomen:soft,non tender CNS:NFND PROVISIO
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GENERAL MEDICINE CASE DISCUSSIONS

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65 year old male, farmer by occupation resident of nalgonda, stopped working 6 months ago, in view of generalized weakness,presented to the opd with chief complaints of fever since 5 days(low grade, intermittant and associated with chills). C/O weakness of right upperlimb and left lower limv since 4 days. B/L knee pain. C/O Abdominal distension and facial puffiness ,B/L pedal edema since 4 days.  No sob, chest pain, palpitations, orthopnea.  C/O giddiness and loss of appetite. H/O loose stools 3 days ago(10-12 episodes /day for 2 days, black coloured stools) whhich subsided now associated with pain abdomen in umbilicus.  No vomitings, headache, cough. No decreased urine output.C/O burning micturition. No h/o trauma,seizures. PAST HISTORY : NO H/O DM, HTN, TB, Asthma, CVA, CAD.  NO H/O previous renal issues.  H/o covid pneumonia 8 months ago, subsided with in 2 days.  H/o fall 2 years back on right hand, implant placed.  H/o typhoid and liver issues which subsided with medication.  PERS
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GENERAL MEDICINE CASE DISCUSSIONS

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A 21 year old woman, hailing from Nalgonda, Telangana presented with the cheif complaints of  Vomiting since 4 days Weakness in all her four limbs since 4pm since day  before yesterday  Patient studied till 10th grade at  Nalgonda government school. She was alright until 1 year back, after which she started finding it hard to control her urine, she started wetting her clothes frequently and her mother would always find her bed wet. She was brought to our hospital where in her mother was told that her right kidney was entirely damaged so they had to place a pipe into her left kidney. She had a gross right hydroureteronephrosis and a moderate left hydroureteronephrosis. A left nephrostomy was done for her along with bladder biopsy, she was on the drain for 6 months after which it was removed. Her bladder biopsy revealed granulomatous picture suspicious of TB.  The patient was diagnosed with Genitourinary TB and Thimble bladder. She was started on ATT and  ureterosigmoidostomy was perform
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General medicine case discussions.

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70YR OLD WITH ALTERED SENSORIUM 13/9/21 A 70 year old female  Came to casuality with complaints of fever since 10 days and generalized weakness(Patient stopped going to work)-Patient was active and does her regular activities History of present illness:- C/0 fever since 10 days,high grade,intermittent, not associated with chills and rigors Patient went to local rmp and took medication for fever,but still fever was persistent,yesterday evening Patient went to local hospital and one pint of NS was given and sent home,yesterday night pt became drowsy and not responding to commands  so today morning pt visited local Hospital and few investigations were done and referred here for further evaluation  On presentation to casuality, pt was drowsy(Gcs-e3,v1,m4) and had 2 episodes of absence seizures.  Arousable  on deep painful stimulus  No h/oheadache,involuntary movements,head trauma or weakness No h/0 cough,cold, pedal edema, SOB,pain abdomen,loose stools,vomitings Past history: H/o previous
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General medicine case

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This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input.  CHIEF COMPLAINTS: A 70 year old female patient resident of Aliya who stays at home came to the OPD with chief complaints of: - Fever since 1 week  -Right buttock pain since 3  days -H/o loose stools and vomiting 5 days ago which were subsided.  HISTORY OF PRESENT ILLNESS: - patient was apparently asymptomatic  2 years  ago then due  to loss of appetite and generalized weakness patient visited local Hospital and was diagnosed with type 2 diabetes milletus. Since then she was on Oral hyperglycemic agents (unknown). - 2 months ego patient experienced 1 episode of sudden onset of giddiness and generalized weakness which re
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