Soumya Goud

 A  50 year old female patient a resident of Nalgonda, home maker came to the OPD with chief complaints of pain and stiffness in several joints since 1 year. History of present illness : She was apparently asymptomatic 10 years ago, then she developed a dull aching type of pain and stiffness in her finger joints(MCP joints) of right hand with limitations of movements at the joints.  Then within 6 months of onset the disease progressed to involve other joints of the right hand and left hand as well(wrist joint and elbow joint)  Within 4 years of onset she started feeling pain in the joints of the feet and ankle joint.  Since 3 months the pain became unbearable limiting  her activities The pain was insidious in onset, slowly progressive dull aching type of pain, non radiating, associated with swelling, stiffness and limitations of movements in the involved joints. Stiffness and pain was more in the first 1 hour of waking up and gradually improved on movement. There are few exacerbations

  This is 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 patients clinical problems with collective current best evidence based inputsThis e-log book also reflects my patient centered online learning portfolio and your valuable inputs on comment box is welcome August 15, 2021 A 44YEAR OLD MALE PATIENT WITH JAUNDICE  A 44year Old male patient,engineer by occupation came to the opd with the chief complaints of  -bilateral pedal Edema since 20 days extending upto the knees -yellowish discolouration of sclera and skin since 20days -vomitings since 1week for about 2-3 episodes a day  History of presenting illness- Patient  was apparently asymptomatic 20 days back and then gradually developed  Bilateral pedal edema putting type extending upto kne