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A 65 year old female with bilateral knee pain,low back ache and Pedal edema

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Hello everyone .I am Sanya ,an intern posted in Medicine department and of the important terms of getting internship completion is to complete my log book with my online log of what I learn during the course of my duties  Here we discuss our individual patient 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. This E log book also reflects my patient - centered online learning portfolio and your valuable inputs on the comment box is welcome CASE HISTORY : A 65 yr old female patient who was farmer by occupation was apparently asymptomatic  2 years back ( She was able to perform all her activities , she used to go for labour work in addition to agriculture,and home based works with out any problem)  .Exactly 2 years back she noticed pain in the left knee joint, which was pricking type, which aggravated with standing, with and even without work.also.In
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56 year male with shortness of breath ,palpitation

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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.  A 56 yr old Male who is accountant was apparently asymptomatic 6 years back then he developed Shortness of breath, palpitation, Giddiness, buckling was present when he was going to home from his work.Then he came to our hospital , unknown medications were given,his symptoms were relieved.He developed  shortness of breath( Grade 2), pedal Edema till knee  which was dependent,giddiness and palpitations       1  1/2 year back for which he was brought to our hospital an
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Biweekly exam

  1)Anatomical diagnosis -? Glomerulosclerosis                                                                        Etiological diagnosis -  ?? Nephrotic syndrome secondary to the diabetic nephropathy or CKD.      2)Reasons for I) Azotemia : impaired renal excretion of urea and creatinine secondary to CKD.  II) Anemia : decreased erythropoietin.  III) Hypoalbunemia: capillary basement membrane and podocytes damage.  IV)  acidosis: acidification of urine is lost.                                       3) Rationale : syp potchlor was given because of the hypokalemia.. Inj. NaHCO3 was given because of metabolic acidosis ..Insulin and antihypertensives are given because known case of DM and HTN. Orofer XT was given because of anemia.. Inj. Lasix was given to decrease her volume overload. Spironolactone was given it was a potassium sparing diuretic.Calcium was given to the patient  because of hypocalcemia secondary to CKD. Indications of NaHCO3:metabolic acidosis in cardiac arrest, Tricycl
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65 yr old female with vomitings,decreased urine output

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This is an online E log book to discuss our patients deidentified health data shared after taking his/her/ guardian 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 problems with collective current best evidence based inputs. CASE DISCUSSION: A 65 yr old female who is a vegetable vendor was apparently a symptomatic 4 months back then she started developing oedema of left leg    Which extended till knee associated with pain,redness,blisters seen so patient went to local RMP for symptomatic cure,took tablets ( records not available?) pain got relieved,but the oedema was progressing.So patient went to local hospital where I.V antibiotics, fluids are given. Initially oedema was subsided but later on again it was progressively increasing.The patient went to another Hospital where it was diagnosed Diabetic foot ,? Left leg cellulitis where a knick
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56 year male with shortness of breath ,Palpitation

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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.  A 56 yr old Male who is accountant was apparently asymptomatic 6 years back then he developed Shortness of breath, palpitation, Giddiness, buckling was present when he was going to home from his work.Then he came to our hospital , unknown medications were given,his symptoms were relieved.He developed  shortness of breath( Grade 2), pedal Edema till knee  which was dependent,giddiness and palpitations       1  1/2 year back for which he was brought to our hospital and
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