Nithin Chakravarthy

  A 19 YR OLD FEMALE CAME WITH C/O RIGHT SIDED CHEST PAIN SINCE EVENING HOPI- PT WAS APPARENTLY ASYMPTOMATIC 1 DAY BACK LATER SHE DEVELOPED CHEST PAIN RIGHT SIDED, INSIDIOUS IN ONSET, TENDERNESS+, PAIN IS NON RADIATING, SHARP TYPE OF PAIN. NO H/O HEAVY WEIGHT LIFTING AND WORKING NO H/O TRAUMA, PALPITATIONS, SWEATING, SOB NO H/O FEVER, COLD, COUGH, NAUSEA, VOMITINGS NO H/O BURNING MICTURITION, CONSTIPATION, PEDAL EDEMA, DECREASED URINE OUTPUT, ABDOMINAL PAIN. PAST HISTORY- NOT A K/C/O HTN, DM, CVA, CAD, TB, ASTHMA NO H/O SIMILAR COMPLAINTS IN THE PAST H/O DELAYED MILESTONES + COURSE IN HOSPITAL: PT WAS ADMITTED I/V/O CHEST PAIN ON FURTHER EVALUATION,GENERAL EXAMINATION,SHE HAS ANTIMONGOLOID PALPEBRAL FISSURE,MICROTIA,MICROGNATHIA,LOW SET EARS,ADONTOTIA?PARTIAL CLEFT LIP,HIGH ARCHED PALATE,SANDAL GAP,NAIL DYSTROPHY IN ALL FINGERS AND TOES. SHE HAS DELAYED MILESTONES IN INFANCY 2D ECHO SHOWED LARGE ASD BASED ON ABOVE FINDINGS SHE IS SUSPECTED TO HAVE ? TREACHER COLLINS  SYNDROME,? DOWNS S

  75 year old female patient presented with fever since 2 days and sob since 4 days This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input.. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is  CHEIF COMPLAINTS. Patient came with cheif complaints of fever since 2 days , shortness of breath since 4 days ,burning micturation since 4 days  HOPI  patient was apparently asymptomatic 4 days  back then she developed Shortness of breath since 4 days which was insidious in onset, gradually progressive( from grade 3 to 4) aggrevated on exposure to cold/early morning and relieved on medications Patient also complains bur