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65 years old came with chief complaints of pedal edama and SOB

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  This is an online E log book to discuss our patient'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 solveb 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. 65 years old male came to old with chief complaints of decreased urine output since 6 months Bilateral swelling of legs since 6 months Shorthness of breath since 6 months HOPI Patient was apparently asymptomatic 6 months back then he had H/o swelling in both limbs (below knee) since 5  months which was insidious in onset and gradually progressive in nature .It was pitting type.It aggrevated while working  It relieved after dialysis. H/O nocturia H/o decreased urinary out...
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70 year old female came with chief complaints of shortness of breath since 5 days

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  C/o shortness of breath since 1 week C/o generalised weakness since 1 week  Pt was apparently asymptomatic 1 week back then she developed shortness of breath , grade 2, aggregated on exertion , gradually progressed to grade 4 . H/ o orthopnea present , no PND.No seasonal variation,no diurnal variation.No h/o fever,cold,cough.no weight loss.no pedal edema. Past history: K/c/o HTN  K/c/o HFrEF Not a k/c/o Dm2,CVA,CAD,epilepsy Personal history: Diet: vegetarian  Apetite: decreased Bowel and bladder: regular Sleep: disturbed  GENERAL EXAMINATION: Patient is conscious,coherent and cooperative, moderately built and malnourished Pallor: absent Icterus: absent Cyanosis: absent Clubbing: absent Lymphadenopathy: absent Pedal edema: present VITALS: Temperature: 98 .2F Pulse: 124beats/minute Blood pressure:120/80mm Hg Respiratory rate:20cpm Systemic examination  CVS - S1 S2 heard R/S -  No wheeze  Diffuse crepts present no palpable mass, Trachea- central Ve...
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32 year old male with pleura effusion secondary to tuberculosis.

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Chief complaints: Fever since 1 week  Stomach pain at right side since 1 week HOPI Patient was apparently asymptomatic 1 week back then he developed fever which is sudden in onset ,continous,gradually progressive associated with chills and rigors,evening rise of temperature was present with night sweats.no aggregating factors ,temporarily relieved by medication  Patient also complained of abdpmen pain since 1 week in right hypochondriac,rt.lumbar,umbilicus region aggrevated on inspiration and relieved by rest H/O cough since 3 days ,insidious in onset,non productive type,non blood stained,non foul smelling No h/o post nasal drip,cold,hoarseness of voice,noseblock No h/o dyspnea,chestpain,palpitations No h/0 PND,orthopnoea No h/o nausea vomiting,abdominal distension,constipation,loose stools Past history  H/o admission in hospital due to same complaints  Not a K/C/O DM,HTN,TB,asthma,CAD,thyroid disorder  PERSONAL HISTORY: Mixed diet Adequate sleep Regular bowel a...
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