Y.POOJITHA ROLLNO 177

 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 series of inputs from an available global online community of experts to solve those patients 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 are welcome. CHIEF COMPLAINTS  A 76yr old female resident of parvatipuram homemaker by occupation came yesterday with chief complaints of shortness of breath since 4months  and pain in the left side of the flank since 10days. HISTORY OF PRESENTING ILLNESS. Patient was apparently asymptomatic 5months back and then she developed shortness of breath that progressed from grade-2 to grade-3.  It was not associated with orthopnea or paroxysmal nocturnal dyspnea and no complaints of pedal edema.   lesions are seen

 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 series of inputs from an available global online community of experts to solve those patients 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 are welcome. A 75year old male labourer by occupation, resident of parda(Nalgonda), presented with the chief complaint of difficulty in breathing. HISTORY OF PRESENTING ILLNESS  Patient was apparently asymptomatic one day back and had difficulty in breathing and his relatives took him to a nearby rmp doctor where he was checked for the b.p which was 200/100mm of hg , and was kept on nebulization , telma 40mg  was given to him. Later as there was no improvement in the condition of the patient he was referred t