Kandhada Tejaswini Rollno :66

  THIS IS AN ONLINE E LOGBOOK 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 A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS WITH AN AIM TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT    Chief complaints : A 45 year old male who is a resident of Nalgonda and Sheperd  by occupation presented to the opd with chief complaints of   shortness of breath and  cough since 6 years  abdominal distention , facial puffiness , pedal edema since 3 years. HOPI patient was apparently asymptomatic 6 year back and then he developed shortness of breath which is insidious in onset gradually progressive which is initially grade 2 then progressed to grade 3 . Then he developed cough which is productive with sputum which is yellow in colour and non blood stained  There is history of abdominal distention since

   A 75 year old male, farmer by occupation and a resident of Miryalaguda presented with chief complaint of lower backache, increased urine output and yellow coloured urine. HOPI- The patient was apparently asymptomatic 5 years back then he had joint pains of both the knees and low back ache with difficulty in walking for 3 to 4 months with right knee joint swelling. Right knee joint was aspirated.  6 days back he had Pain in lower back which is shooting type continuous and radiating to lower limbs(Pain was severe that he couldn't sit, so they went to a local hospital and got treated). Pain was followed by fever which is Intermittent, and temperature increased at night and fever subsides by morning. Fever relieved on medication (Dolo). There is also increased frequency of micturition around 15times in a day(18 times in one night), yellow coloured urine. No H/o Nausea, vomiting, diarrhoea, headache, dizziness. Past History - k/c/o DM and HTN since 5 years. Not a known case of TB, As

  A 36 year old male patient farmer by occupation came to general medicine OPD with chief compliants of   D ecreased   appetite   since   1 year. Nausea   and  V omiting   since   6   months. Loose stools  since  6 months. Tingling sensation in his both Upper Limbs and Lower Limbs  since  10 days. HOPI  Patient was apparently alright 1 year back then initially he had decreased appatite associated with nausea which was gradually progresed to complete loss of appatite with in 5-6 months but able to still manage his daily routine activities. Then patient developed vomitings, 4-5 episodes per day , greenish , immediately after food intake. With food particles as contents. Not a/w blood in vomiting. Since 6 months patients had loose stools now increased in frequency since 2 months. 5-6 episodes per day, Watery consistency, large quantity, associated with greenish mucous with No blood in stools.  Then problem of passing loose stools has  worsened  in  past 2 months. There is a  significant d