Rishi Dandaboiena

This is an online E log book to discuss our patient's d-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 is welcome. Here is a case i have seen:  A 68 year old female presented to ophthalmology opd with complaints of diminished vision since 6 months,diagnosed with right eye SMC admitted for cataract surgery referred to medicine opd in view of high bp recordings Bp 220/120 mm of hg No ℅ Headache vomitings dizziness  neck pain is present occasionally  No pedal edema  shortness of breath on exertion present  palpitations absent She is using dexamethasone  and acyclofenac for body pains a

  Patient was apparently asymptomatic 10 years ago then she had met with RTA and had history of left forearm fracture , from then onwards she had ℅ weakness of left upper limb Head injury unknown  Then 10 days back she had H/o fall while going to washroom,unconsciously  ℅ weakness of right upper limb and lower limb and deviation of mouth to left side She also had ℅ seizures at time of fall She also had similar episodes 7-8 times since then No ℅ head ache,nausea,vomiting She is able to recognise faces Decreased appetite,significant weight loss present No ℅ fever ,cold,cough Speech slurred No h/o Htn,dm,epilepsy,asthma,tb,cva,cad GCS-15/15 Tobacco chewer since 50 years Alcoholic occasional since 50 years  General Examintaion: Temperature:afebrile Pr:92bpm Bp:120/80mm hg SpO2:98 at room air Rr:18cpm Cvs:s1s2 heard  Rs:bae+,nvbs Per abdomen :soft ,non tender Cns:alert, Speech slurred Reflexes:                Biceps triceps supinator knee ankle Right.    ++.        ++.           ++.       +

This is an online E log book to discuss our patient's d-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 is welcome. Here is a case i have seen:   A 63  year old woman presented with a 1 week history of gradually progressive altered mental status.  A cheerful lady, active in preparation for her grand daughter's marriage, the attendants - her daughter, an allied care staff here in KIMS and her son - reported that developed an unusual fatigue 1 week ago, when she felt weak and was unable to function independently. She then started vomiting whatever food she took. The attendants init