Sreeja Boga

  CASE 1 https://swathibogari158.blogspot.com/2020/09/chronic-decompensated-liver-disease.html Q1  Reason for this patients ascites  a)Chronic alcoholism since 40 years  causes portal hypertension increased hydrostatic pressure causing fluid accumulation hence Ascites  2) Why did the patient develop bipedal lymphedema? What was the reason for the recurrent blebs and ulcerations and cellulitis in his lower limbs?   Ans: Bilateral pedal oedema which is of pitting type is due to decrease in the albumin level trends due to course of the disease and long standing cirrhosis causing decrease in the production of proteins causing decrease in the oncotic pressure leading to accumulation of fluid. 3) What was the reason for his asterixis and constructional apraxia and what was done by the treating team to address that?   A3 The increased levels of ammonia in liver failure patients causes damage to the neurons causing hepatic encephalopathy the reason for asterixis in this patient  The treatment

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 is welcome.  Case presentation: A 23 year old male who is a food supplier,  CAME WITH C/O COUGH SINCE 1 WEEK AND SHORTNESS OF BREATH SINCE 4 DAYS PATIENT WAS APPARENTLY ASYMPTOMATIC 1 MONTH BACK AND  THEN HE DEVELOPED COUGH WITH EXPECTORATION AND SHORTNESS OF BREATH WAS TESTED POSITIVE FOR COVID 19 AND TOOK TREATMENT AND TESTED NEGATIVE AFTER 20 DAYS.LATER HE PRESENTED WITH SIMILAR COMPLAINTS SINCE 1 WEEK COUGH ASSOCIATED WITH EXPECTORATION WHITISH IN COLOR ASSOCIATED WITH CHEST PA

 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 is welcome.  Case presentation: A 48Y male, Church father by occupation resident of Nakrekal,presented with chief complaints of vomitings since 3 days Patient was apparently asymptomatic 3 yrs back In 2017 ,he had an injury to his left lower limb for which he was diagnosed as tendon rupture and he went to Orthopaedician and used PCM and pain killers for 2 months  Later after few months he developed Burning micturation and easy fatigability for which he consulted doctor at Nalgonda