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Biweekly exam

                                                  1)Anatomical diagnosis -? Glomerulosclerosis                                                                        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.  IV)  acidosis: acidification of urine is lost.                                       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 NaHC
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16 year old female with headache

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 This is an online elog book to discuss our patients de identified health data shared after taking his/her guardian signed informed consent. Here we discuss our individual patient's problems through series of inputs from avialable global online community of experts with an aim to solve those patients 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 in comments below. A 16 year old female who is a student by occupation came to the old with complaints of headache since 3 months on left temporal region pulsating type radiating to parietal and occipital region,progressive type Patient was apparently asymptomatic 1 month back and then she developed headache in left temporal region and radiating to occipital region .Headache is not associated with fever,cold,cough,associated with decreased appetite and headache relieved on medication. Patient now presented with complai
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A 35 year old male with bilateral pedal edema

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This is an online elog book to discuss our patients de identified health data shared after taking his/her guardian signed informed consent. Here we discuss our individual patient's problems through series of inputs from avialable global online community of experts with an aim to solve those patients 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 in comments below. A 35 year old male patient who is a daily wage labourer by occupation came to the opd with complaints of bilateral pedal edema since 2 months with was aggrevated from 20 days,abdominal distension from 20 days,and dry cough from 20 days ,facial puffiness from 3 days Patient was apparently asymptomatic 2 months back then he developed edema of feet which was on and off .From 20 days the edema gradually progressed till knee,which relieves on elevation of limb.From 20 days he was having abdominal distensio
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THE UNSOLVED PERIPHERAL NERVE MYSTERY OF 20M

A 20 year old man presented with the chief complaint of weakness in all 4 limbs. In early November, while settling down for a grand dinner with his family, the patient reported to have had a heartful meal and when he was finished he noticed that he had some difficult in getting up from a seated position on the floor. When we where interviewing him and at this point we asked if this was the first time he ever felt weak and he recollected that he felt weakness in his toes earlier than this event and he reported that his footwear was slipping off from his feet. Reasoning it to his allegedly poor diet, he ignored this symptom, however on the day he couldn't get up from the floor, he realised  his weakness wasn't improving inspite of taking an improved diet and that led him to consult a doctor in Hyderabad. At that point he had some difficulty in walking, getting up from seated positions and a difficulty in playing cricket which led him to abandon the sport. He did not report any di
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