76.V.Vasavi

60 year old male patient , 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 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 defecation 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.  •

This is an online E log book 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 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 log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box. CHIEF COMPLAINTS: Pt complains of fever,decreased appetite since 1 month, Breathlessness since 1 week,vomitings and loose stools since 3 days .  HOPI: Patient was apparently asymptomatic 3 months back. Then she had multiple swellings in front of the left ear, for which she developed fever which was lowgrade, intermittent, no evening rise of temp, ass with decreased appetite since 1 month. She then had vomitings which was non bilious and non projectile, containing food particles. She

This is an online E log book 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 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 log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment . CHIEF COMPLAINT  :- Patient complaints of cough, soreness of throat and tingling sensation of lower limbs since 10 days.  HISTORY OF PRESENT ILLNESS  :- Patient was apparently asymptomatic 10 days back. Later he developed shortness of breath, cough which was insidious in onset with whitish colour sputum, non blood stained. He also developed tingling sensation in lower limbsand burning sensation of palms and soles.  HISTORY OF PAST ILLNESS  :- No history of HTM/DM No history of asthma