13. B.Harika

  October 27, 2021   This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input  A 40 year old male patient came to the casualty with chief complaint of Shortness of Breath worsening since 2 hours Grade 3-4 Palpitations + B/L pedal edema + , pitting type since 10-15days Abdominal distension and  Decreased urine output since 15days H/O fever 1 week back, it's subsided now  Patient was apparently asymptomatic 6 months ago  He then developed an episode of Sob to which he visited a local doctor and he was relieved of his symptoms and he was diagnosed to have  (? LIVER FAILURE ) with yellowish discoloration of eyes and was adviced medication He had intermittent episodes of Sob and

  This is an online elog book to discuss our patients de-identified health data shared after taking his /her/ guardian informed consent here we discuss our individual patients problems through series of input from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs. Date of admission: 21 October 2021 A 60 yr old male who is a farmer by occupation came to the OPD for the dialysis diagnosed as kidney failure 1 1/2 back . He went to local hospital and was diagnosed with renal failure( serum creatinine 3mg/dl) Chief complaint: patient complains of shortness of breath, sleeplessness, swelling of limbs. HISTORY OF PRESENT ILLNESS : •Pedal edema  • Anorexia  • Fever  • Dyspepsia  •  Insomnia  • Serum creatinine levels - increased (2 mg /dl)  • Decreased urine output  Presently on dialysis on MHD  HISTORY OF PAST ILLNESS :  On dialysis since 1 and half year  K/h/o Hypertension sice 6 years  No h/o