Greetings to one and all,
I am SRIVATSA GONWAR of FINAL YEAR MBBS(9th semester) at KAMINENI INSTITUTE OF MEDICAL SCIENCES, NARKETPALLY, INDIA.
Growing up, the following lines have inspired me to make them the very motto of my professional career. They are:
‘Antar bahischa tatsarvam vyapya narayana sthitah’
(Narayana is present within and all around)
As a part of Case Base Blended Learning Ecosystems and PaJR I got this opportunity of sharing my experience not only at this very beginning of my journey as a medical practitioner but for a life time.
I strongly feel, this way of utilisation of technology by medical professionals will result in greater reach of healthcare and its standards, thereby making our nation "Swasth Bhaarat".
CBBLE PAJR PARTICIPATORY LEARNING ACTION RESEARCH DISCLAIMER
NOTE: THIS IS AN ONLINE E LOGBOOK 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 A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT.
MY FIRST PATIENT INTERACTION:
My first patient interaction was when I was in 3rd year MBBS. I was assigned a case in my 3rd year of MBBS which showed clinical symptoms of bilateral pedal edema with low urine output along with knee and lower back ache since 2 months this gave rise to many thoughts of what the diagnosis could be but once I had look at the RFT I came to a conclusive diagnosis that it is CKD. I monitored the patient over a course of 10 day hospital stay, the patient was discharged on the 11th day with significant increase in his urine output. It was a beautiful opportunity to apply my theoretical knowledge in clinical setting.
https://srivatsagonwarrollno48.blogspot.com/2022/07/49-years-old-male-with-chronic-kidney.html?m=1
60year old female with neck pain:
60 year old female patient with neck pain and headache.
Patient presentation: Patient now presented with increased severity of headache and neck pain which is radiating to right shoulder. It is associated with difficulty in moving head from side to side, pain on moving head and there is presence of heaviness in head.There is no history of fall, fever, vomiting and shortness of breath.
Patient gave a history of back pain which is insidious in onset and gradually progressive. There are no aggravating or relieving factors. She then developed a head injury due to a heavy object (bottle gourd) falling on her head.
5 years ago she developed fever which was associated with pain in multiple joints and was diagnosed with Chikungunya. Following the episode the joint pains persisted and the patient complained of pain in multiple joints which started in the fingers and wrist and progressed to all the joints. The pain in the joints is greater when she wakes up and is associated with stiffness. The stiffness is relieved on activity.
Her neck pain also started around 5 years ago and is associated with pain in the right nuchal and occipital region and the right shoulder. The pain is temporarily relieved on using topical and oral analgesics.
2 years ago she visited the hospital due to an episode of fever and was incidentally diagnosed with Diabetes. She also complained of weight loss in the last 2 years around 10 to15kg.
1 year back she couldn’t raise her right arm and had increased severity of back pain for which she was advised MRI and she was informed about spine degeneration. Due to limitation of movement she was given injection to her right shoulder joint and after 10 days followed by injection to knee joint.
79year male with Recurrent CVA:
A 79 year old male presented to our op with cough, fever and difficulty in swallowing along with altered sensorium.
patient have a history of cough from 20 days insidious in onset and gradually progressive. PRODUCTIVE but patient is not able to spit it out. Pt also has Difficulty in swallowing,
H/o cough on intake of liquids.,
While interacting further with the pt i found out that he also has a
H/o change of voice since 20 days, insidious, hoarse in character and and h/o SLURRING OF SPEECH
No h/o difficulty in breathing, breathlessness, hemoptysis
The Fever since 10 days -high grade. O/e Chills and rigours were present
Patient gave a history severe headache along with vomiting 7 years ago for which after 3 days he became left sided hemiplegic with 3 infarcts in MRI report. During this period he was in hospital for 40 days and then got discharged without any improvement.
6 years ago he developed vomiting along with fever and diagnosed with UTI for which he had on antibiotic medication.
3 years ago he got COVID 2 times with in a span of 1 year
1 year back he got seizures for 5 mins for which he is now on anti epileptics.
Provisional diagnosis: Based on the patient's symptoms, history, and physical findings, I considered several potential diagnoses. The most likely condition in this scenario is Recurrent CVA with Hypertension, T2 ,DM, seizures disorder.
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