B.SHIVAPAL REDDY ROLL NO.15

 This is an online E logbook to discuss our patients' 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 the available global online community of experts intending to solve those patients' clinical problems with the 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 are 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, and investigations, and come up with a diagnosis and treatment plan. CASE PRESENTATION 27 yr old male came with complaints of Generalised weakness since 10 days Difficulty in breathing since 10 days Easy fatigability since 10 days HOPI: pa

  48 year Male came to the medicine OPD with chief complaints of  Difficulty in breathing since 2 days  decreased urinary output since 2 days Swelling of lower limbs on and off since 1 year HISTORY OF PRESENTING ILLNESS Patient was apparently asymptomatic then he developed bilateral pedal edema on and off in nature since 1 year from knee to ankle region, and was on conservative treatment. He went to local hospital and was diagnosed with hypertension and started using medication (drug-Telmisartan dosage-40mg)since 1 year. 2 days ago at night patient developed sob sudden in onset and gradually progressive, class 3, associated with orthopnea. associated with PND urine output was narrow streamlined urine history of intermittent fever not associated with chills and rigor  not associated with chest pain  not associated with sweating  no history of burning micturition DAILY ROUTINE  patient wakes up at 530 in the morning and does his household chores and goes to work daily work for 5 hours an