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Diabetic ketoacidosis secondary to insulin abstinence with k/c/O type 1 DM since 5 years back with k/c/O pulm TB since 6 years back.

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 A 36 M Came to hospital on 20/3/21 at 10:35 pm with Pain abdomen since morning, vomiting since morning (7episodes) , altered sensorium since evening. Patient was apparently asymptomatic 5 years back, then developed increased frequency of urination, for which the patient went to the yashoda hospital and got diagnosed with diabetes mellitus, two days back, patient skipped the dose of the insulin and frm today morning, patient had pain abdomen with vomitings upto 7 episodes for which he went to the local RMP, took medication and did not got subsided and patient wife had given insulin, in the evening followed which the patient went in to altered sensorium and was brought to kims for further evaluation.  K/C/O DM TYPE 1 Since 5 years and on inj. INSULIN.  K/C/O PULM TB, SINCE 6 YEARS AND USED ATT FOR 6 MONTHS.  Vitals on admissiion 20/3/21  Pr 115 Bp 100/60 Grbs high  Strict NBM till
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Bimonthly assessment for the month of MARCH

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Bimonthly assessment for the month of March 2021 This is my submission for the Bimonthly internal assessment for the month of March. The questions to the cases being discussed can be viewed in the following link :  https://medicinedepartment.blogspot.com/2021/03/medicine-paper-for-march-2021-bimonthly.html?m=1 1Q.  Link to the following question :  https://ashakiran923.blogspot.com/2021/03/60-years-old-male-fever-under-evaluation.html?m=1 A)   What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings?How specific is his dilated superficial Abdominal vein in making diagnosis? Problem presentation :  • Fever since 15 days - not ass. with chills and rigor, intermittent type, taken medication which got relieved. • Shortness of breath since 3 days, progressed from grade 2 to grade 4.  • Burning micturition + (duration - not given ) • No h/o palpitations, chest pain, orthopnoea, PND, pedal Edema .  No h/o
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70/ M with HYPONATREMIA - EUVOLEMIC? SIADH? TB K/C/O HTN

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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.  Here is a case I have seen.  INTERNS  juveria  Swarna  Nikhil  Divya Dr. Arjun. (ASSIS PROF)  PGs Dr. Manasa PGY1 Dr. RADHA PGY3 This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. 70 / M , rice mill worker by profession , complains of vomiting : 6 to 7 episodes /day immediately after food , non bilious.  Cough with sputum since 10 to 15 years on and off  Decreases urine output with decreased stream.  No H/ O burning misturation  No other complaints of chest pain , pedal edema , facial puffiness  No H/O fever, loose stoo
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50 /F HYPOGLYCEMIA SECONDARY TO OHA ASSOCIATED WITH CKD STAGE (|||B)

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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.  INTERNS  juveria  Swarna  Nikhil  Manivarma Divya Dr. Arjun. (ASSIS PROF)  PGs Dr. Manasa PGY1 Dr. RADHA PGY3 50 year female came to casualty in semi conscious state, patient was apparently asymptomatic 8 years back then she had low grade fever went to hospital on routine blood investigation and examination diagnosed as hypertensive and diabetes 2 since 8 years on treatment with Atenolol 50 mg amlodipine 5 mg glimepiride 2mg p o o d 4 months ba
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45/F with anaemia? IDA.

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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.  INTERNS  juveria  Swarna  Nikhil  Manivarma Divya PGs Dr. HAREEN (SR)  Dr. Radha PGY3 Dr. Vaishnavi PGY2 Dr. Vinay PGY1.   Patient was apparently asymptomatic one and half year back then she complain of pedal edema one and half year back which is pitting type ,not aggrivated or relieved on medication.  Complain of SOB grade 3 on walking some distance and relieved on medication at hospital.  Also complain of facial puffiness and relieved on medi
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Bimonthly assessment for the month of Feb

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Submission of bimonthly assessment for the month of Feb 2021. Questions: Q.1) Please go through the patient data in the links below and answer the following questions: 50 year man, he presented with the complaints of Frequently walking into objects along with frequent falls since 1.5 years....  Drooping of eyelids since 1.5 years...  Involuntary movements of hands since 1.5 years ....  Talking to self since 1.5 years More here: https://archanareddy07.blogspot.com/2021/02/50m-with-parkinsonism.html?m=1 Case presentation links:  https://youtu.be/kMrD662wRIQ a). What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical finding.  Localisation of lesion:   Drooping of eyelid is called as ptosis and our patient has Bilateral ptosis, which is because of weakness in levator palpebrae superioris or Muller muscle  ➡ muscle involvement  ➡Nucleus -centre caudal nucleus of occulomotor complex ...  ➡Nerve involvement( 3rd
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