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 A 70 year old male came to the casualty with c/o pedal edema since 1 n half month. which is progressive, pitting type, bilateral associated with facial puffiness. no h/o SOB, Oliguria, abdominal distension. pt complains he has HICCUPS since 15 days. C/O VOMITING 10 days back, food particles as content, non projectile, bilious. He usually have episode of Vomiting when he is travelling on bike or any other mode of transport. H/O B/L pedal edema 2 years back, used medication for it and the edema subsided. pt is a k/c/o HTN since 1 and half year. not a k/c/o DM,CAD, ASTHMA, TB. Appetite: Normal Diet: Mixed  Bowel movements: Regular. Micturition: Urinary hesitancy + dribbling of urine+ no increased frequency of urine. Sleep: Adequate. Habits: Alcohol- 90 ml occasionally. Tobacco: 1 Chutta/ day, stopped since 3 years. No significant family history. O/ E Oedema of feet: B/L grade 2 pitting type. Temp: Afebrile. PR: 78bpm. RR: 23 cpm. BP: 200/100 mm hg  SPO2: 98% on RA . Systemic Examination

A 75 year old came to the casualty with c/o  fever, cold, cough since 4 days. patient was apparently asymptomatic till 2003 , then patient had B/L knee pain which gradually aggravated, then patient was started on NSAID'S daily for 3 years. Then in 2006- one day pt had continuous episodes of loose stools, 12-14 episodes per day with ? Anuria.  In view of anuria he went to nephrologist > ? AKI > Advised dialysis > patient underwent 1 session of hemodialysis. 2 YEARS BACK : pt experienced Polyuria , polydypsia for 2 days for which he visited nearby RMP and was diagnosed as DIABETIC and started on OHA. At present since 10 DAYS , patient had decrease of appetite, generalised weakness> took OHA and didn't take any food. Then Patient experienced 1 episode of hypoglycemia GRBS: 18 mg/dl ( frothing and uprolling of eyes). Then his attender gave him sugar water and 25 D Infusion in ambulance- Recovered. Had similar episode 2 days back. decrease in Appetite since 10 days. k/c/

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. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan. A 35 year old female r/o athmakuru came to the casualty for follow up i/v/o high bp. FIRST VISIT on 13/9/21 pt came with c/o fever a/w chills,cold,cough since 3 days( for which she consulted a local RMP, som