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A 65 YEAR OLD MALE PATIENT FARMER BY OCCUPATION HAD BROUGHT TO CASUALITY IN ALTERED SENSORIUM SINCE 2HRS ON 27/11/2022 AT 8:00PM.

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  A 65 YEAR OLD MALE PATIENT FARMER BY OCCUPATION HAD BROUGHT TO CASUALITY IN ALTERED SENSORIUM SINCE 2HRS ON 27/11/2022 AT 8:00PM. HOPI:  PATIENT WAS APPARENTLY ALRIGHT 1 DAY BACK AND THEN WENT TO FIELD AFTER CONSUMPTION OF ALCOHOL. SINCE THEN HE WAS DROWSY AND WAS TAKEN TO RAMANNAPET GOVT HOSPITAL AND WAS TREATED THERE FOR HIS GRBS-79mg/dl. HE WAS STILL DROWSY AND BROUGHT TO CASUALITY WITH ALTERED SENSORIUM AT 8:00PM ON 27/11/2022. PAST HISTORY:  HE IS A K/C/O DM 2 SINCE 2 YEARS AND ON MEDICATION T. METFORMIN 500 MG, T. GLIMIPERIDE 1MG. HE IS A K/C/O HTN SINCE 2 YEARS AND ON MEDICATION TELMA 4OMG. HE HAD H/O SEIZURES 2 YEARS AGO. PERSONAL HISTORY : Diet - Mixed Appetite-Normal Sleep-Adequate Bowel and Bladder movements-Regular Addictions- He consumes alcohol 90ml/day since 40 years.  ON  EXAMINATION:  PATIENT IS CONSCIOUS, INCOHERENT.  Moderately built and moderately nourished. No pallor, icterus, cyanosis, clubbing, lymphadenopathy, edema. VITALS: BP-140/80MMHG PR-76BPM RR- 18CPM. G
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70 yr old female with altered sensorium under evaluation

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Icu bed no 3 : 70y old female shopkeeper by occupation came to tha casuality with complaints of fever since 2 days insidious in onset gradually progressive subsided on taking medication, not associated with chills and rigour. patient attenders have observed irrelevant talk since yesterday mrng she was taken to a local hospital where she was referred to our hsptl for further management  k/c/o HTN on telma 40 and DM on glimi M2 and antiplatelets PAST HISTORY: H/o similar episodes in the past 15 years back where she was admitted in guntur hospital for 15 days and an mri scan was done which revelaed ?lnfarct  in brain  O/E: Pt is consious , non coherent , non cooperative  Febrile :100.8 Bp :150/60 PR:79bpm Grbs:158 Sleep : good Appetite : decreased Bladder:irregular Bowel:irregular Alcoholic and tobacco chewer since when she is 16 yr old  Stopped toddy 10 years back  CNS EXAMINATION: Slurred speech  Pupils dilated :Rt -2-3mm                             Lt -2-3 mm  Tone :            Rt    
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70 year old female with altered sensorium under evaluation

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  Icu bed no 3 : 70y old female shopkeeper by occupation survived by 3 kids came to tha casuality with complaints of fever since 2 days insidious in onset gradually progressive subsided on taking medication, not associated with chills and rigour. patient attenders have observed irrelevant talk since yesterday mrng she was taken to a local hospital where she was referred to our hsptl for further management  k/c/o HTN on telma 40 and DM on glimi M2 and antiplatelets  O/E: Pt is consious , non coherent , non cooperative  Febrile :100.8 Bp :150/60 PR:79bpm Grbs:158 CNS EXAMINATION: Slurred speech  Pupils dilated :Rt -2-3mm                             Lt -2-3 mm  Tone :            Rt                     Lt             UL        Normal         Normal             LL         Normal         Normal Power:            Rt                     Lt            UL        5/5                   5/5            LL         5/5                   5/5 Relfex:                            Rt                    Lt  
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30 year old female with seizures under evaluation with fever with thrombocytopenia

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  A 30 year old female came to casuality with the chief complaints of    Fever since 10 days   Yesterday she had an episode of Involuntary movements of bilateral upper limb and lower limb    since yesterday evening  HISTORY OF PRESENT ILLNESS : Patient was apparently asymptomatic    10 days back then she developed fever which was insidious in onset , gradually progressive ,not associated with chills and rigour subsided on medication she was treated conservatively and then on further investigations she was diagnosed with NS1 Antigen positive and was on conservative management since then . Yesterday she had an episode of  involuntary movements of B/l UL and LL associated with uprolling of eyes woth drooling of saliva lasting for 2 mins , no involluntary micturition/defecation/tongue bite  No post ictal confusion No complaints of palpitations, shortness of breath , orthopnea , burning micturition  PAST HISTORY:  H/o seizures 5 years back in her first pregnancy and wasn’t on any medication
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52 year old female with Diabetic ketoacidosis secondary to GE

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CBBLE UDHC similar cases 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   52 year old female who is a farmer came to the casuality with complaints of   Shortness of breath since afternoon  Vomitings since afternoon Pain abdomen since afternoon Dyspepsia since afternoon HISTORY OF PRESENT ILLNESS : Patient was apparently asymptomatic shortness of breath    since afternoon( grade 2 to grade 3 ) according to NYHA classification  C/o vomitings ( 3 episodes food particle as content) , non bilious, non projectile  C/o pain abdomen ( di
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