Vaibhavi Vishwanath

  This is an online e-log book to discuss our patient's de-identified health data shared after taking his/her/guardian's 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.   A 51 yr old male patient presented to Opd with chief complaints of pedal edema and facial puffiness and fever since 2 months   History of present illness :       Patient was apparently asymptomatic 4 yrs back then he developed pedal edema for which he visited hospital and diagnosed as renal dysfunction and he was on medication and dialysis also done once. In our hospital he was admitted on 31st October 2021 he had complaints of pedal edema since 1 week and shortness of breath since 2 days decreased urine output and was discharged from our hospital on 24th November 2021     But pedal edema not subsided on

  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 A 60 yr old female presented to opd with chief complaints of vomiting since 20 days fever since 2 - 3 days abdominal pain since 2- 3days HISTORY OF PRESENT ILLNESS Patient was apparently asymptomatic 20 days back then she had 4-5 episodes of vomiting which is non projectile and non bilious non blood tinged and had fever 2-3 days back and abdominal pain since 2 -3 days  Patient also gives history of joint pains she is unable to walk HISTORY OF PAST ILLNESS Patient gives the history of pedal edema went to local hospital 4 months back where she was diagnosed as Acute kidney injury which relieved on med

1.  Anatomical and etiologic localisation for harmiparesis and further management (9 marks) Clinical Significance Examination of the motor system of a limb includes checking for muscle bulk and fasciculation, muscle tone at joints, the power of muscle groups, deep tendon reflexes, clonus, plantar response, and coordination. In cases of a lower motor neuron type weakness, there is early muscle wasting, fasciculations, hypotonia, hyporeflexia, and a normal plantar response. On the other hand, the upper motor neuron type of weakness is characterized by normal muscle bulk, hypertonia, hyperreflexia, clonus, and an extensor plantar response (positive Babinski’s sign). Furthermore, the preservation of deep tendon reflexes distinguishes myopathy from neuropathy. Lower motor neuron type weakness can result from any pathology of anterior horn cells, spinal nerve roots, plexus, or peripheral nerves. An upper motor neuron paraplegia can result from myelopathy involving the thoracic spinal cord, w