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July 28, 2022 CKD This is 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 patients clinical problems with collective current best evidence based inputs  Chief complaints :    A 60 yr old male Pt came with cheif compliants of : * History of decreased urine output since 2 months. * shortness of breath since 2 months * Bilateral pedal edema. History of present illness: * patient was apparently asymptomatic 2months back. * Then he developed decreased urine output and shortness of breath which is gradually progressive from grade 1 to grade 3  * History of pedal edema ,bilateral and progressive gradually ,pitting type with facial puffiness, aggrevated by walking and relieved by sitting  History of past illness: * Hypertension- using medication since 4 years.

July  27, 202 2 HYPERTENSIVE EMERGENCY WITH GRADE 1 HYPERTENSIVE RETINOPATHY   HYPERTENSIVE EMERGENCY WITH GRADE 1 HYPERTENSIVE RETINOPATHY   This is 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 patients clinical problems with collective current best evidence based inputs. Introduction:A 40year old female patient who is labourer came to OPD with  CHIEF COMPLAINTS : of 1.Cough ass c̅ sputum 2.Fever (on and off)  3.SOB @REST 4.Pedal odema   Since 15 days  HOPI: The patient was asymptomatic 8 months back She  had sudden onset of Cough-which is productive and in scanty amounts,not associated with fever,sob, she wnt to local Rmp and got treated . after receiving IV fluids for 1 week near rmp ,patient developed sob (grade 2-3) and also cough didnt subside

July 24 2022 A CASE OF 50 YR OLD MALE WITH CHRONIC PANCREATITIS WITH ACUTE GASTRITIS  A 50 YR OLD MALE CAME TO OPD WITH  C/O PAIN ABDOMEN AND NAUSEA SINCE 4 DAYS .  PATIENT WAS APPARENTLY ASYMPTOMATIC 8 YRS BACK AND THEN HAD COMPLAINTS OF POLYURIA WHEN HE DIAGNOSED AS DM 2 AND 5 YRS BACK HE DAIGNOSED AS HYPERTENSIVE WHEN HE WENT FOR GENERAL CHECKUP FOR HIS DIABETES  3 YRS BACK , HE HAD PAIN ABDOMEN AFTER INTAKE OF ALCOHOL ,RYLES ASPIRATION , IV FLUIDS GIVEN ? PANCREATITIS .  1 YR BACK , HE ADMITTED IN OUR HOSPITAL FOR UNCONTROLLED SUGARS WITH FUNDOSCOPY SHOWING NON PROLIFERATIVE DIABETIC RETINOPATHY,  RIGHT SIDED DIABETIC FOOT ASSOCIATED WITH POST GILLES AMPUTATION ,FOREFOOT AMPUTATION 10 MONTHS BACK .  ON 20/6/21 C/O PAIN ABDOMEN AFTER ALCOHOL INTAKE AND DIAGNOSED AS ACUTE PANCREATITIS LAST BINGE 4 DAYS BACK i.e., ON 20/7/21  ON 21/7/21 PAIN ABDOMEN TREATED SYMPTOMATICALLY BUT PAIN NOT SUBSIDED .  ON 24/7/21 .HE CAME AGAIN WITH PAIN ABDOMEN , SQUEEZING TYPE , NON RADIATING , GRADUALLY

July 18 2022 TB MENINGITIS A 45 yr old male  chronic alcoholic since 20 yrs carpenter by occupation was brought to causality with  CHIEF COMPLAINTS  •difficulty in walking&decreased appetite since 15 days •constipation since 5 days •fever and pedal edema since 3 days •vomiting since 2 days HISTORY OF PRESENT ILLNESS •patient was apparently asymptomatic 6 months back then  he had b/l pedal edema  and for which he taken herbal medicine for 15 days and the edema relieved then they went to hospital in chityala and he was  diagnosed with hypothyroidism and taking T.thyronorm 25mcg since then. •1.5 month back he had history of fever,dry cough&weight loss from then •20days  back he had tingling&numbness in b/l lower limbs till ankle and got admitted in our hospital and diagnosed as peripheral neuropathy and given symptomatic treatment and discharged after four days then from the next day patient had difficulty in walking and decreased appetite since then •H/o constipation since 5