Kshithi ambati

 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. Case presentation: A 70year old male patient who is a farmer by occupation came with chief complaints of involuntary movements in the left upper and lower limb from two days. HOPI: Patient was apparently asymptomatic two days back then developed involuntary movements in left upper and lower limb.the movements were seen for every 5 to 10mins . H/o frothing, up rolling of eyes and drowsiness present  H/o post ictal confusion present  H/o generalised pitting type of edema

 CASE 1 a)Anatomical locations are  kidneys for decreased urine output Heart or lungs for sob Git for constipation and abdominal pain Outcomes: Decreased urine output ,vomitings and pedal edema and patient is taken for dialysis for five times His aki progressed to ckd. b)fluid replacement  Antibiotics  Tramadol Zofer Pantop Lasix Nebulization Non pharmacological: ryles tube and nbm  CASE 2 a)anatomical locations Haematological causes for anemia Bone marrow  Kidneys Lungs Outcome - Pharmacological:antibiotics  Prbc transfusion  ATT Febuxostat CASE 3 a)anatomical locations Heart Cns b)non pharmacological:salt and fluid restriction  Pharmacological: Lasix Metoprolol  Enalapril Human actrapid insulin CASE 4 a) anatomical locations: Heart failure  Polyneuropathy B)pharmacological: Thiamine  Lasix  Telmisartan Non pharmacological:salt and fluid restriction.