Medicine daily log

This is an online Elog book to discuss our patient's de-identified health data shared afterwards his guardian signed informed consent Hereafter 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 . This Elog book also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome A 20 year old milk supplier from eklur nalgonda who is a known case of retroviral disease diagnosed 1 year back came to the casualty with altered sensorium. He had 2episodes of seizures with generalised tonic clinic movements with 5min  gap in between each episode lasting for 5mins. It is associated with involuntary micturition , and has postictal confusion .Not associated with uprolling  of eyeballs, tongue bite. He was previously admitted in the hospital with complaints of headache , vomiting

A 55 year old lady from Nalgonda presented to the medical OPD with complaints of distension of abdomen and swelling of lower limbs since 3 months. Self admittedly, a proud mother of 4, the patient was absolutely normal 15 years ago  when one summer's afternoon turned eventful for her, having developed cough with dyspnea and mild expectoration. The cough was occasional but present throughout the day, associated with very little colorless sputum. At the same time she also had dyspnoea and her husband intervened and reported wheeze also. She denies a seasonal or diurnal variation in cough and dyspnea. She also denied chest pain and hemoptysis at any point. The husband however says he noticed her wheezing early in the morning but it never woke her up from her sleep. Interjecting at this point, I ask if there was any exposure to biomass fuel usage and the patient nodded in affirmative, with an exposure to wood smoke for 50 years (until 5 years ago). She denies active or passive smoking.