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COSTOCHONDRITIS ?TREACHER COLLINS SYNDROME ? DOWNS SYNDROME LARGE ASD

  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
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  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
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  50 Y/M with c/o chest pain and Dyspnoea February 05, 2024  A 50 year old male resident of khasanaguda tailor by occupation came with chief complaints 1)chest pain since 3 years  2) shortness of breath since  3 years 3) cough since 1 week  Patient was apparently asymptomatic 5 years ago . March 2019  He had c/o fever , high-grade , not associated with child and rigors since 4 days , redness , pain and swelling in rt lower limb since  3 days . Initially it started as a bleb and  it progressed to swelling of limb  associated with pain . He was examined, investigated and diagnosed as Rt lower limb cellulitis with  ulcer over rt dorsum of foot. S/P - Split Skin Graft  Stayed at hospital for 3 months and got discharged  2022  He went to hospital with c/o dyspnea ( grade 2 mmrc ) since 1 month . No h/o chest pain, palpitations, sweating, pedal edema , pnd , orthopnea . He was started on medication 1) T.Aspirin 75 mg  2) T.Atorvastatin 20 mg  3) T.Met xl  15 mg  4) T Lasix 40mg  He was on re
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  65 Y Female July 17, 2022 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 CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUT  Chief Complaints : A 65 Years Old Toddy Seller came with C/O Chest Pain Since 5 days  Increased Pedal Edema Since 10 days HOPI :  Pt was Apparently asymptomatic Till 7 Years back  In 2015 she Developed Pain in Chest for which she went to Hospital and ? Inferior Wall MI was diagnosed & PTCA Was Done. At the Same Time She was diagnosed with DENOVO  DM2 & HTN for which She was Prescribed Medication. In  2019 She Developed SOB on Exertion ; Pedal Edema & Anasarca for which she went to Hospital and Diagnosed with CCF with Anemia for Which PRBC Transfusion was Done & Discha
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  A 45 year old male with chest pain February 03, 2024 Patient came with chief complaints of chest pain 1 episode 6 days back Patient was apparently alright 10 to 12 years when he developed increased drowsiness for which he consulted a doctor and was diagnosed to have hypothyroidism for which he used medication for 2 to 3 years and stopped it.he developed generalised body pains more on the neck and back insidious in onset, intermittent aggravated on working and relevied on taking rest.  Then 1 week back after his dinner (non veg) he started feeling tightness in his chest(like acidity in patients words) and started feeling hot and his breath became heavy for which he tried to on the fan and became unconscious as he got up. The pain was localised non radiating. When he got unconscious his family members observed that he was profusely sweating and pass urine involuntarily following which his family members took him to the hospital for which treatment was done for coronary artery disease,
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