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55 F WITH LOW BACK ACHE SINCE 15 YEARS

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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."  CHIEF COMPLAINTS  55 year old female from Assam came with the CHIEF COMPLAINTS of lower back ache since 15 years . HISTORY OF  PRESENTING ILLNESS  Patient is a resident of Assam married at the age of 18 years ,started working in farms 4 years after her marriage ,her work many consisted of  ploughing and sowing ,transplanting the sampling requiring her to bend forward and lean for several hours (5-10hrs/day) She gave birth to her first child 2 years after marriage
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49 yrs old male with HF and CKD

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 Chief complaints Right lower limb swelling since 10 days, fever since 5 days History of presenting illness Patient was apparently asymptomatic 10 years back then he developed progressive swelling of right lower limb and diagnosed with filariasis for which he was prescribed medicines by a local doctor 10 year back he was diagnosed with diabetes mellitus and hypertension and since then using antihypertensives( nifedipine) and anti diabetics( glizide) - 3 years back he developed pedal oedema and went for further evaluation and diagnosed to have chronic renal failure ? - 2 years back he suffered from COVID-19 following which he had shortness of breath at rest (grade 4) and chest pain for which he went to co-operate hospital in Hyderabad and diagnosed to have inferior wall myocardial infarction, So he was treated with streptokinase. At that time coronary angiogram was not done in the view of high serum creatinine levels - After 1 month coronary angiogram was done to recanalized the right c
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39 year old male patient presents to casualty with complaints of shortness of breath

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A 39 year old male came to the casualty around 10 pm with  Chief complaints of sob since 3 days.  Fever since 10 days Cough since 10 days Chest pain since 10 days Pain abdomen since 10 days HOPI :  Patient was apparently asymptomatic 10 days back, then he developed fever associated with chills and body pains, headache, sore throat. Patient had cough which was productive with white coloured sputum. Then patient got tested positive for Widal after 4 days of onset of fever. He used symptomatic medication for a week. Then, he developed SOB since 3 days for which he got admitted in Nalgonda. SOB was insidious in onset, gradually progressed from grade 2 to grade 4 since past 10 days, SOB was more in sitting position and relieved on lying down, as his SOB aggravated, patient got shifted from that hospital and presented to our casualty. Patient also used to complain of intermittent chest pain, pain abdomen since 15 days Past History : Admitted to a hospital for pain abdomen for 4 days Not a k/
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