Vineeth kumar bandi

 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. Here is a case i have seen: CASE DISCUSSION A 56 year old female patient came to the op with complaints of shortness of breath since 2 months HISTORY OF PRESENTING ILLNESS Patient was apparently alright 2months ago then she developed Shortness of Breath which was insidious in onset , aggravated on exertion like walking . Relieved on taking rest , associated with seasonal variation , not associated with diurnal variation .  No orthopnea , pedal edema , Paroxysmal noctur

 Question 1) pain in the epigastric region differentials Inferior wall MI(normal ecg and echo) Acute pancreatitis(radiation to the back)-usg finding and elevated serum amylase level Perforated peptic ulcer  Causes of acute pancreatitis- harrison pg no 2348 Gall stones : https://gi.org/topics/gallstone-pancreatitis/ This occurs at the level of the sphincter of Oddi, a round muscle located at the opening of the bile duct into the small intestine. If a stone from the gallbladder should travel down the common bile duct and get stuck at the sphincter, it blocks outflow of all material from the liver and pancreas. This results in inflammation of the pancreas that can be quite severe. 2)sob- acidosis due to renal failure          ? Ards secondary to sepsis/pancreatitis           Pleural effusion due to acute pancreatitis            3)decreased urine output-pre renal Aki secondary to volume loss(oliguric) 3rd space loss due to pancreatitis Sepsis induced aki 4) abdominal distention with consti

  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. Here is a case i have seen: A 28 year old female who is a daily wage labourer came to casuality with complaints of fever since 10days, bilateral pedal edema since 7days, burning micturition since 3days and shortness of breath since 1day  Patient was apparently alright till 10days back, then she had fever, which was low grade, not associated with any chills and rigors, relieves on taling medication, no aggrevating or relieving factors. From 7days she was having insidiou