PARDHU ROLL NO 79

  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 Chief complaints: 75 years old male came to OPD with cc of pedal edema since 1month,shortness of breath since 20days,vomitings since 10days  History of present illeness: patient was apparently asymptomatic 1month back Than he developed bilateral pedal edema which is insidious in onset gradual in progression upto the knee and pitting type edema no aggrevating and no relieving factors . Patient also complains of shortness of breath since 20days which is sudden in onset gradual in progression ,aggrevating on doing work, walking and temporarily relived on medication and also he had history of vomitings which is su

 

 History  An 80 year old male, a resident of Chityal was brought   to the casualty in an unresponsive state at around 6:00am.  The patient was apparently alright few hours back. The day before he ate at 5 pm and went to sleep.He woke up and then couldn't sleep again at night. He tried sleeping but suddenly got up and then experienced a fall. Went to sleep again without eating anything. He woke up at around 1:00am to have some food (a glass of milk and rice). He then slept back. At around 4:00 am he felt uneasy and tried to wake up his wife by tapping her. She didn't respond initially. Later, she saw that he was sweating profusely, had raised body temperature and was unable to see or unable to talk even though there was movement of the neck muscles.  He was taken to the nearby hospital in Ramanapet where they noticed that his pupils are asymmetric and non- reactive to light.There was increased effort of breathing and fall in BP. He was treated with IV DNS and O2 supplementation.