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 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
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A 35yr old male with slurring of speech and difficulty in walking

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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. A 35yr old male came to the hospital with chief complaints of: 1. slurred speech since yesterday night, 2. Tingling sensation of bilateral upoer and lower limbs since yesterday night . 3. Difficulty in walking associated with diplopia since yesterday night  History of fall from bed yesterday night at 3am and was hit to a hard object from then he developed slurred speech and difficulty in walking.  He was apparently asymptomatic since yesterday when he had a history of
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65yr/M with sudden painful diminision of vison along with generalized weakness in all the limbs since 2days of presentation.

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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. 65yrs /M,farmer(not doing any work from6-7yrs).patient complaints of 1. sudden painful diminision of vision in both eyes (left>right)associated with headache 2. generalized weakness of both U/L &L/L 3.slurring of speech. since 2days             He was taken to the local hospital but there was no relieving of symptoms.pt was apparently asymptomatic 2days back then he suddenly developed all these symptoms.No complaints of diplopia, redness of eyes, ocular pain, t
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Seizures case

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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 DISCUSSION: 20yrs male ,butcher by occupation studied till class 7th.In2011 he had right focal seizures of 1episode and was admitted to the hospital for 1week and used antiepileptic medication for about 2years.In 2014 he had his 2nd episode of rt focal seizures.      ?NCC on MRI and was on albendazole and steroids  used antiepileptic drugs for 1year and also used herbal medications. In 2018 he had acute onset of SOB, abdominal tightness and constipation he was ad
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