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60M COMA WITH POSSIBLE ALCOHOLIC DELIRIUM TREMENS ON MECHANICAL VENTILATION 4 DAYS

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60yr Old male who is an farmer & shepherd . Married at age of 18yrs (3sons). Daily routines  Wakes up @ 4am 4am-8am goes to cattle farm and draw milk from buffaloes. 8am drinks some tea and goes to farm and returns back to home around 10am 10am eats rice and takes cattle to field . 2pm eats rice in the filed ,which he carries from home. 2pm to 5pm does some farm work and look after the cattle. 6pm returns back to home along with his cattle. 6pm to 8pm talks with his friends, drinks alcohol and have some smoke. 8pm eats rice and goes to sleep at 9pm. ADDICTIONS: Started smoking at the age of 18yrs(10-15 beedis /day).  Drinks alcohol occasionally from the age of 18 years  but from past 20 years he is taking alcohol regularly 90ml/day (after his childern got married and settled he started taking alcohol regularly ) HOPI:  Pt was apparently asymptomatic 1yr back then gradually developed pain and swelling in left inguinal region ( *reducible* hernia) ,and used to have pain abdomen on
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INJ THIAMINE 100MG IV IN 100ML NS TAB UDILIV 300MG PO/TID HEPAMERZ 2 SACHETS WITH CUP OF WATER  TAB RIFAGUT 550 MG PO/BD SYP DUPHALAC 15ML PO/HS TAB OXAZEPAM 15MG NICOGUMS 2MG ACUTE ON CHRONIC LIVER DISEASE WITH LOW GRADE ESOPHAGEAL VARIES? ALCOHOLIC HEPATITIS COAGULOPATHY CALCULOUS COLECYSTITIS PANCYTOPENIA ALCOHOL AND TOBACCO DEPENDENCE SYNDROME USG ABDOMEN CALCULUS COLECYSTITIS MILD SPENOMEGALY IRREGULAR BLADDER WALL
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A 60 YEAR OLD FEMALE WITH AKI SECONDARY TO CONSUMPTION OF UNKNOWN COMPOUND

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This is an a 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 welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan CHIEF COMPLIANTS vomitings since evening 4hrs - 3episodes  Loose stools 2 episodes HOPI Patient was apparently asymptomatic 4hours back then developed vomitings 3 episodes food as content non bilious non blood
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79 y/o male with Recurrent CVA and left hemiplegia with Aspiration pneumonia and seizures disorder

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This is an a 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 welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan COMPLAINTS AND DURATION: A 79 y/o male was brought to casuality with c/o cough since 20 days ,  fever since 10 days difficulty in swallowing and h/o Aspiration pneumonia since one month C/o altered sensorium s
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pre final paper 2

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