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 34yr old man , as a working driver presented  with difficulty in swallowing since 5am   Weakness in Right UL and LL since 5am   Deviation of mouth to left since 5 am  Slurred speech since 6am .  Pt developed sudden onset of  difficulty in swallowing while he tried drinking water followed by he suddenly developed weakness of rt upper limb and rt lower limb .  His attendant later observed deviation of mouth towards left side and slurring of speech.  H/o 1episode of GTCS 3years back though wt on treatment.  He has been an occasionally  alcoholic since 20years .  Not a k/c/o Htn ,Dm type2, Thyroid disorder,  Asthama.  No h/o any past surgeries.   On examination:  Patient was conscious coherent and cooperative.   Vitals:    Pulse : 108 bpm  Respiratort rate: 18 cpm  Temperature: 98.6 F  Blood pressure: 170/100 mm hg  Grbs-153 mg/dl  Spo2: 98% at room air  CVS: S1, S2 heard  Respiratory system: Bilateral air entry present, normal vesicular breath sounds heard, no added sounds heard  Per abd
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26 year old woman with c/o seizures since 5 days

 26 year old woman resident of Lingotom who is unmarried came with c/o involuntary movements of both upper limb and lower limb since 5 days ,drooling of saliva present  No urinary incontinence, no tongue bite Patient earlier recalled events dates back when she was 12 years old presented with GTCS (no documentation) She was having on and off seizure episodes and did not subside for 2 years, she visited many hospitals in that period and later she was taken to hyderabad and was put on antiepileptics and was seizure free for 2 years and then again developed seizures  She gives a history that she was conscious at the time of seizure episodes and was able to recall the events with no post ictal confusion but sometimes preceeded by aura with involuntary movements of both hands and legs with post ictal confusion lasting for 1-2 min with drooling of saliva She gives a h/o preceeding fever before seizure episodes  From the age 16-24 she was having on and off seizure episodes and were not subside
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58 yr old man

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 58 year old man from mandepally presented with c/o B/L pedal edema since 3 months ,abdominal distention since 2 months ,facial puffiness since 2 months dyspnea on exertion since 1 month,frothy urine since 1 month ,cough with expectoration since 5 days and fever since 1 day  Patient works as a farmer at mandepally and has been having B/L knee joint pains since 5 months for which he has been taking medications and B/L pedal edema extending upto knees since 3 months followed by abdominal distention and then facial puffiness and the dyspnea on exertion and also frothy urine since 1 month  He has been complaining of cough with mild sputum expectoration associated with hemoptysis, non foul smelling and high grade  fever since 1 day  No c/o hematuria,loin pain, pain abdomen, reduced urine output No c/o chest pain,palpitations, dizziness, sweating  He is alcoholic since 20 years 90 ml whiskey 3 times a week his last intake was 1 year back O/E patient is conscious, coherent and cooperative  Vi
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bimonthly assessment january

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1.26 year old woman with complaints of altered sensorium since day,headache since 8 days,fever and vomitings since 4 days https://harikachindam7.blogspot.com/2020/12/26-year-old-female-with-complaints-of.html a. A 26 year old woman with complaints of Headache since 8 days Fever since 4 days Vomitings since 4 days Altered sensorium since 1 day 28 year old woman with 1. Hyponatremia secondary to SIADH 2. Tubercular meningitis 3. Acute infarct in the left thalamic region 4. SLE with multiple joint pains              b.      Hyponatremia Tb meningitis SLE  Sequence of events Tubercular   meningitis (TBM) is a rare condition in patients with systemic lupus erythematosus (SLE). The aim of this study is to describe the clinical characteristics, possible risk factors, and outcomes of SLE patients with TBM. On systematically reviewing medical records from10 SLE patients with TBM admitted to a hospital from December 2008 to December 2018. A total of 100 cases in the same period were randomly se
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15 yr boy with Paraplegia and a history of Fever

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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 box is welcome. Here is a case i have seen: A 15 year old boy presented to the Opd at 2pm with the complaints of Slippage of footwear since 6 months Difficulty in walking since 6 months  Difficulty to get up from bed since 6 months Patient is in his 8th grade at a government school at a local village.  His parents work as Masons at a local village. He has an elder brother who is studying degree and a younger sister who is in her 10th grade. He was apparently completely alright 6 years
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