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80/M with AKI on CKD

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80yr old male came to casualty with the complaints of  -pedal edema since 1 yr - shortness of breath  since 1 yr -decreased urine output since 15 days -history of injury to left foot 10 days back  Patient was apparently asymptomatic 10 years back then he developed B/L knee joint pains,for which patient used NSAID's from the local medical shop since 1 yr and then patient started developing pedal edema which was gradual and progressive a/w shortness of breath on exertion.  Following which patient was normal for 10 days. Then 10 days back Patient has injury to the left foot ,following which pedal edema aggravated on left side associated with blebs formation  He referred to KIMS for further evaluation  No history of HTN,DM,ASTHMA,TB,EPILEPSY, CAD. For shortness of breath patient was using BETAMETHASONE 0.5 and salbutamol capsules.  On examination  Vitals: Bp:100/70 mm of hg  PR:100 bpm RR:22 cpm Spo2: 98% at room air  Systemic examination:  Cvs:s1s2 + RS: BAE+ GIT: normal CNS: normal 
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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
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50/M with seizures under evaluation

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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. Interns: Dr Archana Dr Jeeharika Dr Sreeja Dr Harsha Dr Kalyan Dr Raveen PGY1 Dr Aashitha PGY2 Dr Aravind PGY3 Dr Vamshi PGY3 Dr Hareen SR Dr Praveen Naik Ass Prof DR. RAKESH BISWAS HOD Here is a case i have seen: Admission under unit 3 on 04/03/2021 50/F was brought to casualty with c/o: Seizures (? GTCS) 3-4 episodes, starting around 6:00pm  HOPI:  Patient was apparently asymptomatic till yesterday evening, she had seizures (?GTCS) 3-4 episodes, yesterday evening. 
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