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A Middle aged Male with CKD, CLD, ?Ascites, ?Sob .

        A 46 year old male who is a farmer presented to the casualty in the midnight with complaints of shortness of breath since 1 day which started in the early morning around 4:00am which woke him from his sleep , abdominal distention with decreased urine output since 3 days ,was taken to the outside hospital and referred to our center. He complained that , this “ayasam” didn’t let him rest for a second .  He gave a history of similar complaints in the past with intermittent attacks of shortness of breath ,fever associated with chills and was rushed to the hospital during midnights , those episodes lasts for 1-2 days got subsided with treatment , was told that his hb :9.5 gm/dl causing his sob. He gave a clear history that every episode made him very uncomfortable to sleep , he used to go near the windows /out of the house to catch the fresh air.  He gave a history of abdominal discomfort with abdominal distention and decreased appetite since 3 days ,didn’t pass stools since 3 days,
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"The Darting Tongue in Sydenham's Chorea."

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 Hello everyone, This is R Preethi  an intern in the medicine department,  An internship is a hands -on way to learn new skills. Completing an internship can expose you to the workplace, letting you know what really goes on . One of the important terms of getting the internship  completion  is to complete my log book by documenting the cases I saw, along with my daily log .  The case  presentation:  A 17 year old lady from jaggayapet, presented with a 1 week history of "shaking". Hailing from an impoverished family,  she was apparently asymptomatic 2 years ago, when she first developed  wheezing and breathlessness on a cold winter night at 1am which woke her up from her sleep. The mother reported that it resolved spontaneously over a short period of time . At this point ,she denied a history  of sweating or palpitations.  She also  denied a prior history of chest tightness and exertional dyspnea.   5 days later she  started developing cough and breathlessness with very little
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Hello everyone! Iam an intern in the medicine department one of the important terms of getting the internship completion is to complete my log book with my daily log what i learn during the course of my duties. Case presentation:       A 23 year old male autodriver by occupation came with cheif complaint of muscle pain of both biceps and calves after lifting heavy weights since 1month. HOPI: Patient was apparently asymptomatic 1month back , then he developed muscle pain after lifting heavy weights  , which is of dragging type and associated with tingling sensation of both upper limbs. and lower limbs extending upto midarm , migthigh and slightly above the umbilicus. -Difficulty in carring heavy weights for long distance due to pain. -Difficulty culty in getting up from squatting and sitting position. -Pain on lifting the arms above the shoulders. -Headache intermittently on exposure to the sunlight  for long time. -Slippage of footwear and taking more time in wearing slip
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Daily log

  R .PREETHI    INTERN   ATTENDENCE FROM    25 -05-20 to 8-06-20 Medical leave-0 Causal leave -0 23- 5-20 :  Case discussion  on Acute para paresis symmetrical bilateral                    Lower limbs weakness with sensory deficit and case related queries.    24:5-20 : Rotational sunday, studied about heart failure . 25-5-20 : case discussion on atypical presentation of progressive Right hemiparesis                  With ataxia and UMN , and queries , facial palsy types. 26-5-20 : studied about DKA . 27-5-20 : Went with patient for ophthalmology examination and radiology for CT scan. 28-5-20:   Amc work and went for typing discharge summary. 29-5-20 : OPD ; ECG of MI patient discussion. 30-5-20: Amc work, perfomed CNS examination. 31-5-20: studied about Renal failure . 1-6-20: Case discussion on peripheral neuropathy , case related queries             and recording the session . 2-6-20: Studied about peripheral neuropathy and GBS. 3-6-20: Learned topic on
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