29 Janani Chimaladinne

A 65yr old male patient masion by occupation resident of nalgonda came to old with  Chief complaints of  -fever-4 days  -pain abdomen -4 days  -decreased urine output -6 days -burning micturition-6 days  History of present illness : Patient was apparently asymptomatic 1 week ago then he developed decreased urine output since 6 days which is insidious in onset and gradually progressive,he also developed abdominal pain in right side of the abdomen since 4 days which is insidious in onset gradually progressive, episodic and sharp type radiating from right upper quadrant to epigastric region which is associated with back pain ,no aggravating factora but relieved on medication. History of fever since 4 days which is low grade and intermittent. H/o burning micturition present Constipation since 6 months  History of past illness:  N/k/c/o diabetes, hypertension,asthma,tuberculosis ,epilepsy No past medical history Personal history: Diet : mixed Appetite:normal Sleep : adequate Bowel and blad

This is is an online E log book to discuss our patient's deidentified health data shared after taking his/her/guardian's signed in formed 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 protfolio and your valuable inputs on comment box is welcome A 30 yr old male who is a student resident of suryapet came to general medicine OPD with chief complaints of involuntary stiffening of left upper and lower limbs sence 18 yrs. HISTORY OF PRESENTING ILLNESS:           Patient was apparently asymptomatic 18 yrs back then he started developing involuntary movements and stiffening of left upper and lower limbs associated with up rolling of eyes,froathing, headache,loss of language,fear, anxiety, apnea,stertoreus breathing,vocaliz