DINESH PERAM ROLL NO 162

This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan Patient came to causality with complaints of Fever since 5 days SOB since 5 days Vomiting for 3 days The patient was apparently asymptomatic 5 days back then he developed fever, high grade, not relieved with medication , associated with chills and rigors. SOB since 5 days, grade III , no orthopnea , pnd. Also presents with vomitings since 3 days, non bilious, non blood stained , watery, 2-3 episodes. Ulcer over left foot,since 4 months, associated with edema of foot,  H/o abscess drainage??? New bleb notes since 2 days. K/C/O DM II since 14 years, on Metformin 500 mg and Glimi

60 /Female with slowness of movement/ Long case   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." Chief compliants :  1) Slowness of movements since 1 year . 2) Involuntary movements of the Left upper limb. 3) Slowness in speech since 1 year. History of present illness :  60 year old female,who is a mother of 3 children (  1 son and 2 daughters ), labour by occupation ( goes to agriculture field ) was apparently asymptomatic 1 year back, then developed Slowness of movements which was insidious onset, gradually p