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Dka

  A 29 yr old male presented to casuality with left sided chest pain since 10 days worsening since yesterday night    HOPI :   Pt was apparently asymptomatic 15 days then he developed fever after spraying pesticides in field ,associated with cough with expectoration  Pt was taken to a local doctor and treated symptomatically , but symptoms not relieved  Pt developed left sided chest pain 10 days back ,non radiating ,diffuse pain ,pain increased on inspiration   Not a/w sweating, palpitations pt was refered to our hospital in view of persistent fever ,cough with chest pain  PAST HISTORY :   No h/o HTN,epilepsy,TB,asthma  PERSONAL HISTORY :  Appetite -normal  Diet mixed  Bowel and bladder- regular  Sleep adequate  Addictions -  FAMILY HISTORY  Not significant  GENERAL EXAMINATION   O/E pt is c,c,c  Moderately built No pallor ,icterus, cyanosis, clubbing, lymphadenopathy ,edema of feet    Vitals : Temp :  Bp : PR:  Rr:  Spo2:  RS : Inspection : shape of chest : normal  ⁃ Symmetry of c
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Pneumothorax

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 A 58 yr old male pt came with cheif complaints of  Cough since 15 days  Sob since 1 day  Chest pain since 1 day  HOPI  Pt was apparently asymptomatic 15 days back after which he developed dry coughwhich was insidious in onset , progressive in nature , no postural /diurnal/seasonal variation  Complaints of SOB Since 1 day , acute in onset , progressive in nature ,grade II -III , increased on exertion  C/o chest pain since one day , acute in onset , increased during cough , non radiating , not associated with palpitations, sweating No c/o fever , chest tightness,wheez, decreased urine output,orthopnea, pND,loss of weight, loss of appetite  Past history  H/o TB 1 yr back ( took ATT for 1 month ) N/k/c/o DM,HTN chronic smoker for 40 yrs ( 1 pack beedies / day) Chronic alcoholic for 40 yrs ( occational)  Treatment history  Took ATT for 1 month 1 yr back  Personal history  Occupation: farmer  Appetite -normal  Diet mixed  BowelAnd bladder regular  Sleep adequate  Addictions :smoker since 40
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Dengue 2

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A 14 yr old male student came with chief complaints of    Fever since 5 days  Vomitings since 3 days   Pain abdomen since 3 days  HOPI: pt is apparently asymptomatic 5 days back then he developed fever lowgrade,intermittent, not associated with chills and rigors ,rash, loose stools,relieved on taking medication  -Vomitings since 3 days non projectile, non bilious, food as content    , 1-2 episodes per day  -Pain abdomen since 3 days relieved on sleeping and aggrevating by sitting  - He went to local hospital yesterday and tested NS1 positive and referred to our hospital in view of    platelet count 52,000 and moderate ascites PAST HISTORY :  No past medical history  PERSONAL HISTORY: mixed diet , decreased appetite,regular bowel and bladder, sleep adequate no addictions  FAMILY HISTORY:not significant  GENERAL EXAMINATION:  Pt is c,c,c  Afebrile  Bp : supine 90/60            Standing 80/60  PR :72  Rr:20  PA : tenderness present in periumblical region           Shifting dullness presen
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Dengue

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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   A 26 year old male came with chief complaints of fever since 20 days   HOPI : pt was apparently asymptomatic 20 days back then he had low grade fever ,intermittent, not associated with chills and rigors ,relieved by taking medication  From 4 days pt is having continous fever , not relieving on taking medication , not associated with chills and rigors  -no diurnal variation  No vomitings,loose stools,pain abdomen,malena ,bleeding gums   -He went to a local hospital 4 days back
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