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CHAPPED LIPS

A 15 year old male patient resident of poddichedu presented to the opd with chief complaints of  1) chapping of corner of lips since 3 months  2) inflammation of lower lip since 3 months HISTORY OF PRESENTING ILLNESS:- Patient was apparently asymptomatic 3 months ago and then he developed chapping of the corner of the lips which was insidious in onset and he is intolerable to spicy food and is aggravated by cold weather .  HISTORY OF PAST ILLNESS:- Not a K/C/O of DM , HTN , epilepsy , asthma .  TREATMENT HISTORY:-  PERSONAL HISTORY:-   Diet - mixed  Appetite - reduced  Sleep - normal  Bowel and bladder - regular  Patient wakes up around 7 am in the morning and has a good amount of breakfast fil FAMILY HISTORY:-    Not significant  O/E:- PT is conscious coherent co-operative  BP: 100/70 MMHg  PR :84 BPM RR: 18 CPM SPO2: 98% AT ROOM TEMP NO SIGNS OF PALLOR ICTERUS CLUBBING CYANOSIS LYMPHADENOPATHY S/E:- CVS: S12 PRESENT CNS: NAD RS: NVBS HEARD PROVISIONAL DIAGNOSIS:- Angular cheilitis PH
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DIABETIC KETOACIDOSIS SECONDARY TO NON-COMPLIANCE

A 50 yr old female came to GM OPD with chief complaints of fever, vomiting, difficulty in breathing. HISTORY OF PRESENTING ILLNESS: - patient was apparently asymptomatic 2 weeks back then she developed fever of low grade with vomiting 4 episodes per day which is non-bilious, non-projectile. HISTORY OF PAST ILLNESS:- K/C/O- DM since 20yrs K/C/O- HTN since 20yrs. Not a K/C/O of TB, ASTHMA, EPILEPSY TREATMENT HISTORY:- METFORMIN since 20yrs TELMISARTAN since 20yrs PERSONAL HISTORY:- Diet- mixed Appetite- normal Bowel and bladder habits- regular Burning micturition No addiction FAMILY HISTORY:- Not significant PHYSICAL EXAMINATION:- # GENERAL :- No pallor No icterus No cyanosis No clubbing No lymphadenopathy Vitals:- B.p- 140/90mmHg Pulse-  Temp- Afebrile Respiratory rate- 18/min # Systemic examination:- CVS- S1,S2 heard           No cardiac murmurs           No thrills Respiratory system - dyspnoea present                                       No wheeze                                    
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DIMINUTION OF VISION IN THE EYES

A male patient of age 77 years old resident of vangamurthy presented to the opd with chief complaints of  1) diminution of vision in both eyes since 2 years  HISTORY OF PRESENTING ILLNESS:- Patient was apparently asymptomatic 2 months ago and he developed diminution of vision which was insidious in onset and gradually progressive in nature .  It was not associated with watering , photophobia , redness or itching .  HISTORY OF PAST ILLNESS:- There was a history of surgery related to CHD 1 year ago  There was a history of auditory and visual hallucinations since 1 year and was diagnosed 1 month ago . K/C/O of DM 2 since months  Not K/C/O of asthma , epilepsy , Tb  TREATMENT HISTORY:- 1)  Metformin 500 mg  2) risperidone 2 mg  PERSONAL HISTORY:- Sleep : inadequate  Appetite : loss of appetite  Bladder and bowel : regular  Drug allergies : no  Addictions : no  FAMILY HISTORY:- Not significant PHYSICAL EXAMINATION:-   1)  general examination:  Height -  Weight -  Icterus - no  Cyanosis - no
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  CASE SCENARIO:- *A 28 yrs old female came to opd chief complaints of pain at right hypochondrium, pain in the left flank, shortness of breath, tiredness(since 2 years). HISTORY OF PRESENT ILLNESS :- *Patient was apparently asymptomatic 15yrs ( i.e in 2007 ) she had complaints of loss of weight and appetite for which she was diagnosed as pulmonary tuberculosis and on started on anti tubercular therapy .But she discontinued the treatment and she was kept of 8 months ATT and in 2020 she developed low back ache for which she was diagnosed as renal calculi.now she came to our hospital with c/o left flank pain , dyspnoea grade 2,one episode of hematuria. HISTORY OF PAST ILLNESS:- *TB in 2007 *Hematuria on 25th May 2022 TREATMENT HISTORY:- *Homeopathy for SOB. PERSONAL HISTORY:- *Diet is mixed. *Appetite is normal. *Bowel movement is regular. *Bladder movement is normal. *Micturition normal. *No known allergies. *No addiction to alcohol and smoking. FAMILY HISTORY:- *No H/O of HTN, DM. *Fat
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  CASES IN GENERAL MEDICINE A 57 yr male agriculture by occupation came to follow up for dialysis. CHIEF COMPLAINTS :- * Abdominal distension  *Burning micturition since 3 days *Vomiting since 3 days HISTORY OF PRESENT ILLNESS:- *Patient was apparently asymptomatic 5 years back, had complaints of polyuria and polydipsia. *1 year back had H/O of left Hemiplegia. *10 days back he had H/O of bilateral pedal edema, SOB  and abdominal distension.  PAST HISTORY :- *k/c/o HTN, DM-2 since 5 years *Had CVA 1 year back *He had 2 dialysis before coming here TREATMENT HISTORY :- * He was on medication for DM and HTN since 5 years *He was on antiplatelet and physiotherapy for Left Hemiplegia  PERSONAL HISTORY  :- *He is a vegetarian, stopped Non-veg 1 year back *Bowel movement is Regular *No H/O of alcohol and smoking but occasionally he used to drink Toddy FAMILY HISTORY:- *No familial History GENERAL EXAMINATION:- *Patient was in a conscious state *Pallor-Mild *Icterus present *No cyanosis and cl
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A 45 YEAR  FEMALE WITH FEVER, VOMITING AND SHORTNESS OF BREATH 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.” I've been given this case to solve in an attempt to understand the topic of "patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan. A 45year female Presented with  C/O Fever since 5 days C/O Vomiting since 4 days C/O Headache since 4 days C/O Shortn
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