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OSCE and learning points

  Study on IV and oral paracetamol efficacy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783910/#:~:text=Patients%20who%20received%20intravenous%20paracetamol%20had%20a%20higher%20mean%20first,SD%201.76%2C%20p%20%3D%200.1593 https://scholar.unair.ac.id/en/publications/efficacy-and-tolerability-of-intravenous-paracetamol-compared-to-#:~:text=Normal%20temperature%20achievement%20were%20higher,in%20reducing%20fever%20in%20children Inference Both the studies say that IV paracetamol takes lesser time to reduce the symptoms but also the adverse effects similar with the both IV and oral treatment  Mortality due to  dengue haemorrhage  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3862602/ Study done on deaths in dengue patients between 2009 and 2010 - autopsy findings in 6 patients out of 12 deaths among 1032 dengue patients revealed that death is due to multiorgan dysfunction secondary to bleeding diathesis and hypotension IV fluid management in dengue fever. https://www.google.com/url?sa=t&
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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 clinical problems with collective current best evidence based inputs 25 yr old female patient resident of miryalguda,housewife by occupation came to OPD with chief complaints of fever since 5 days and giddiness since 5 days. History of presenting illness: Patient was apparently asymptomatic 5 days back the she developed fever  which is sudden in onset, continuous ,high grade fever, associated with chills and rigors relieved on medication . Fever is associated with headache,retro orbital pain. History of generalized weakness, body pains. History of nausea and vomitings(non bilious) 3 to 4 times a day projectile History of cough (non productive) History of abdominal pain, burning mict
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2nd internal answersheet

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 A  65 year old female  came to the OPD with complaints of  lower back pain radiating to the lower limbs . Chief Complaints:  A 65 year old female home maker, resident of  Tummalaguda came to the OPD with complaints of  Severe lower back pain radiating to the legs since 6 days, fever since 1 week and shortness of breath. History of presenting illness: The patient was apparently asymptomatic 1 week ago when she felt pain in the lower back which was insidious in onset, gradually progressive, radiating to the lower limbs upto her knees and of stabbing type. She also had low grade fever since a week that was intermittent and not associated with chills and rigor. It was relieved on medication. She also has shortness of breath (grade II). She has constipation since 4 days. Past history:  History of  HTN since 10 years for which she was on medication. Osteoarthritis since 10 years. N/K/C/O DM, TB, asthma, thyroid disorders, epilepsy, CAD or CVA Personal history: Diet: mixed Appetite : decreas
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76 year male with bilateral pedal edema

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 76 yr male patient came with the complaints of Bilateral pedal edema and unable to walk since 20 days  History of present illness  Patient was apparently asymptomatic 20 days back then he developed bilateral lower limbs edema upto knee which is insidious in onset gradually progressive and aggravated on standing and walking ,relived on lying down . Complains of pain in the legs since 20 days which is aggravated on walking and relived on lying down.History of burning sensation in the legs since 20 days.History of Shortness of Breath since  No History of headache. Giddiness, Patient is a farmer 4 years back ,then he stopped farming  due to generalized weakness.He wakes up by 6am ,by 9am he completes his breakfast containing jowar roti and curry then he will have a cup of tea with sugar.He takes lunch at around 2:30pm ( rice with curry and milk).At around 5:00 pm he again drinks tea with sugar and biscuits .He completes his dinner by 8:00pm and sleeps by 9:30pm. Past illness  He is a know
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 A 42 year old female came to the hospital with chief complaints of pedal edema, shortness of breath and decreased urine output since 6 months. HISTORY OF PRESENT ILLNESS:- The patient was apparently asymptomatic 6 months ago and then she developed pedal edema, which was gradual in onset, progressive along with shortness of breath (grade III-IV) along with decreased urine output. She then came to this hospital for further evaluation. HISTORY OF PAST ILLNESS:- She is not a known case of diabetes mellitus, CVA, TB, asthma. She had hypertension since 6 months. TREATMENT HISTORY:- The patient had a blood transfusion in the past. She is also regularly taking medicines for her symptoms. She had a C-Section surgery 20 years ago. PERSONAL HISTORY:- Diet: Mixed, but ever since the onset of her symptoms, she stopped consuming non-vegetarian food. Appetite: decreased Bowels: irregular Micturition: decreased FAMILY HISTORY:- No history of diabetes, hypertension, heart disease or stroke, tuberculos
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