KANDRU CHERISH ROLL NO 68

 A 25 year old male who is a resident of Choutuppal and a driver by occupation came with CC of  Pain and Redspots on the tips, pulp and nailbed of fingers (Rt hand) since 4 days ✓HOPI- The patient was apparently asymptomatic one and a half month back then he had burning sensation in the epigastric region aggravated on having heavy and spicy food. Associated with bloating after intake of food and abdominal tightness. For which he got treated by a local doctor ( Pantop-D for 6 days) Then 4 days back he had dragging type of pain which was sudden in onset and aggravated on doing work and relieved on rest. No H/o trauma. There are Redspots on the tips,pulp,nailbed of fingers of Right UL. ✓Past History - N/k/c/o DM, HTN, TB, Asthma, Epilepsy ✓Personal History- Appetite - Reduced Diet- Mixed Bowel and Bladder-Regular Sleep- Adequate Addictions - Nil ✓Family History - Not Significant ✓On Examination- Patient is conscious and coherent. Thin built and well nourished. Vitals Temp- Afebrile  PR- 9

A 46 year old male presented with CC of  ✓ Vomitings Since 10 days ✓ Fever since 10 days  ✓ Generalised weakness and drowsiness since 10 days  HOPI- Patient was apparently asymptomatic 1 year back then he had vomitings 1 to 5 episodes/day, non bilious, non projectile, non blood tinged for which he went to a government hospital & got treated. Prior to vomitings patient had 360 ml of alcohol. Then after 2 days he had involuntary movements of both upper & lower Limbs - 1episode, which is associated with froathing, tongue bite. Patient was unconscious during this episode. He was taken to a private hospital & managed conservatively. 10 days back patient had vomitings 2-3 episodes per day, non projectile, non-bilious,  food particles as contents and not associated with pain in the abdomen. Patient had fever associated with evening rise of temperature, chills, which is intermittent and relieved on medication. Generalized weakness and Drowsiness since 10 days. Past History - Not a

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 WITH AN AIM TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT. A 50 year old female presented with CC of Nausea and Vomitings since 3 days, heavy menstrual bleeding since 18 months. ✓HOPI- Patient was apparently asymptomatic 18 months back then she started having heavy menstrual bleeding(7/20; 4 pads per day) associated with clots. Not associated with allpain.She went to a local RMP and got an injection for it. The symptoms subsided for a month. Then she had the same complaints in the next month. H/o weight loss since 1year. She lost around 15kgs (present weight- 32kgs; 1 year back she was 48kgs). There is no history of chronic cough, loss of appetite. H/o Vomitings sin