A. Rishi koundinya

 "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 58 year old male, labourer by occupation, came to the OPD with the chief complaints of Shortness of breath since 15 days, worsened 3 days back, facial puffiness since 1 week. History of Presenting illness -   Patient was apparently asymptomatic 4 years ago 4 years ago - pt complained of giddiness, went to a local hospital and was diagnosed as Hypertensive, on regular medication since then T. Nicardia 10mg, T. Arkamine 0.1mg sos 2 years back Pt developed B/L pedal edema, prog

  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 CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUT . A 86 year old male patient came to the opd with cheif complaints of 1.Excessive sleepiness since 1 week 2.contraction of all four limbs since 1week 3.slurring of speech since 1 week 4.fever since 4 days. HOPI: Patient was apparently asymptomatic 3months back then he dveloped blackish discolouration of right 4th toe and developed ulcer which is incidious in onset and gradually progressive and toe amputation was suggested.there was decreased intake of food and loss of appetite and unable to identify his family members. 20 days back then he developed bilateral swelling of knee joint then he was taken to the n