General medicine case

This is 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 patients clinical problems with collective current best evidence based inputsThis e-log book also reflects my patient centered online learning portfolio and your valuable inputs on comment box is welcome A 50 year old male patient farmer by occupation came to the opd with the chief complaints of abdominal pain since 1 month HISTORY OF PRESENT ILLNESS : Patient was apparently asympomatic 1 month back, then he developed abdominal pain after consumption of food  in epigastric region and right iliac region Pain: Squeezing type of pain , increases after food consumption and after lifting heavy weights andnon radiating type relieves on its own.  Pain lasts for 30 minutes during the episode. N

This is 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 patients clinical problems with collective current best evidence based inputsThis e-log book also reflects my patient centered online learning portfolio and your valuable inputs on comment box is welcome A 78 years male patient occupation by farmer came to opd with chief complaints of Bilateral pedal edema and shortness of breath, PND since 2 months HISTORY OF PRESENT ILLNESS : He was asymptomatic 1year back then he noticed decreased urine output , developed edema (upto knees) and shortness of breath (grade 3 NYHA classification) for which he went to a local hospital and diagnosed with renal failure and started on conservative management. Then from 2 months back he again developed bilat