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Biweekly examination

 1)Anatomical diagnosis -? Glomerulosclerosis                                                                        Etiological diagnosis -  ?? Nephrotic syndrome secondary to the diabetic nephropathy or CKD.      2)Reasons for I) Azotemia : impaired renal excretion of urea and creatinine secondary to CKD.  II) Anemia : decreased erythropoietin.  III) Hypoalbunemia: capillary basement membrane and podocytes damage.  IV)  acidosis: acidification of urine is lost.                                       3) Rationale : syp potchlor was given because of the hypokalemia.. Inj. NaHCO3 was given because of metabolic acidosis ..Insulin and antihypertensives are given because known case of DM and HTN. Orofer XT was given because of anemia.. Inj. Lasix was given to decrease her volume overload. Spironolactone was given it was a potassium sparing diuretic.Calcium was given to the patient  because of hypocalcemia secondary to CKD. Indications of NaHCO3:metabolic acidosis in cardiac arrest, Tricycli

55 year old man with ? Viral pneumonia in uremic encephalopathy and acute Pyelonephritis secondary to UTI with AKI and ? Viral Myocarditis

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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: 55 year old man, working as a Maestri at Sukanapally presented to casualty at 8pm with the complains of Reduced urine output since 12days High colored urine since 12 days Pain abdomen radiating to back since 12 days Dyspnea at rest since 8 days Cough with expectoration since 7 days  Fever since 7 days Drowsy and irritable since morning  He works as a Maestri at Sukanapally near chityal. H