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 I am Dr.Anahita Behara from KIMS,Nkp and today I shall demonstrate the benefits of a case based learning ecosystem (CCBLE) , as a budding medical student full of curiosity ,  i was fascinated by the revelling mystery of the numerous diseases encountered during my study . I was deeply disturbed  by my inability to make a change . I had such big dreams but no way of achieveing them , until I was introduced to the concept of Case-based learning or  Patient-centric learning , following up on patients even after they were discharged and monitoring their lifestyle habits , gave us a window to view not only the "dis-ease" but the "ease" as well , linking all the domains of health .  It humanises the patient and forces us to look at the bigger picture.

Case report of Acetamiprid poisoning with Turquoise vomitus

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Introduction  Acetamiprid belongs to a new systemic neonicotinoid insecticide that is effectively used for crop protection and flea control in agricultural works [ 1 ]. It has low toxicity in mammals, but ingestion of large amounts can cause severe toxicity. It is described in a case report that a buffalo exhibited severe gastrointestinal symptoms and respiratory distress following accidental ingestion of acetamiprid in India [ 2 ]. Here we describe a case of a 34 year old male with diabetic ketoacidosis and acetamiprid ingestion  Case Report  This is the case of a 34 year old male who is a resident of Nalgonda m, Telangana , who is a farmer by occupation , was brought to the casuality at 6:00am with history of Acetamipride 20% (insecticide) ingestion  approximately 50gm powder in 2 glasses of water , he presented with 3 episodes of turquoise colored vomitus and shortness of breath since 1:00am   There is n/h/o pain abdomen , giddiness , nausea , chest pain , palpitations , incontinenc

FEVER PROJR 202407866

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 Fungal 

Fever unclassified 55/M 202410905

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 Admission Date: 07/03/2024 01:00 PM Discharge Date Date:21/04/2024 Discharge Type: Relieved Diagnosis CKD ON MHD Case History and Clinical Findings C/O PEDAL EDEMA SINCE 1 WEEK C/O DECREASED URINE OUTPUT SINCE 1 WEEK PT WAS APPARENTLY ASYMPTOMATIC 1 WEEK AGO THEN HE DEVELOPED PEDALEDEMA SINCE 1WEEK , WHICH WAS INSIDIOUS IN ONSET AND GRADUALLY PROGRESIVE IN NATURE ALSO C/O DECREASED URINE OUTPUT SINCE 1 WEEK N/K/C/O HTN , CVA , CAD , ASTHMA O/E: NO PALLOR ICTERUS CYANOSIS CLUBBING AND GENERALIZED LYMPHADENOPATHY PEDAL EDEMA PRESENT TEMPERATURE 97.8 PR- 79BPM RR-18CPM BP- 140/90 GRBS 112 SPO2- 98% AT RA CVS- SI S2HEARD NO THRILLS AND MURMURS RS- B/LAE NVBS HEARD P/A- SOFT AND NON TENDER NO PALPABLE MASS CNS - NFND CRANIAL NERVES INTACT SENSORY AND MOTOR SYSTEM NORMAL Investigation LIVER FUNCTION TEST (LFT) 06-03-2024 12:55:PM Total Bilurubin0.77 mg/dlDirect Bilurubin0.20 mg/dlSGOT(AST)10 IU/LSGPT(ALT)10 IU/LALKALINE PHOSPHATASE473 IU/LTOTAL PROTEINS7.4 gm/dlALBUMIN3.68 gm/dlA/G RATIO0.9

Fever projr unclassified

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  CASE :   DIAGNOSIS :  diagnosis  RTA , TRAUMATIC BRAIN INJURY(20/3/23) WITH INTRAVENTRICULAR HEMORRHAGE(RESOLVED) WITH ASPIRATION PNEUMONIA(RESOLVED) FRONTAL BONE FRACTURE s/p -RIGHT FRONTAL LACERATION SOFT TISSUE REPAIR WITH DEBRIDEMENT WAS DONE ON 21/3/23.HFMEF (EF-50%)  SUDDEN CARDIAC ARREST-? HIE ON MECHANICAL VENTILATION DAY-5 (25/3/23) POST CPR STATUS(2CYCLES) ON (25/3/23 ) ANTERIOR WALL MI (EVOLVED)  S/P TRACHEOSTOMY (29/3/23) RECURRENT HYPOKALEMIA WITH GRADE 2 BED SORE (DAY2) ?SEPSIS with LEFT MIDDLE LOBE CONSOLIDATION ? ventilator associated pneumonia  COURSE IN HOSPITAL  25 YEAR OLD MALE PATIENT BROUGHT TO CASUALTY WITH H/O FALL FROM BIKE UNDER ALCOHOL INFLUENCE AT 9:30 PM NEAR HALIYA,NALGONDA ON 20/03/23. AND THEN TAKEN TO HOSPITAL FOR FURTHER MANAGEMENT.PATIENT IS INVESTIGATED AND DIAGNOSED TO HAVE RTA , TRAUMATIC BRAIN INJURY,WITH INTRAVENTRICULAR HEMORRHAGE WITH FRONTAL BONE FRACTURE WITH ASPIRATION PNEUMONIA AND RIGHT FRONTAL LACERATION SOFT TISSUE REPAIR WITH DEBRIDEM

Fever projr unclassified 29/F

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date of admission 3/5/2024  date of discharge 16/5/2024   Diagnosis RADIATION ENTERITIS WITH RIGHT HYDROURETERO NEPHROSIS KNOWN CASE OF CARCINOMA CERVIX POSTHYSTERECTOMY STATUS Case History and Clinical Findings C/O PAIN ABDOMEN SINCE 10 DAYS LOOSE STOOLS SINCE 6 DAYS HOPI:PATIENT WAS APPARENTLY ASYMPTOMATIC 10 DAYS BACK, THEN HE DEVELOPED PAIN PAIN ABDOMEN DIFFUSE INSIDUOUS ONSET GRADUALLY PROGRESSIVE AND SUBSIDED YESTERDAY EVENING .SQUEEZING IN NATURE AGGRAVATED ON TAKING FOOD AND RELIEVED ON PASSING TOOLS H/OLOOSE STOOLS SINCE 6 DAYS FOOD AS CONTENT10-12 EPISODES PER DAY H/O FEVER LOW GRADE INTERMITTENT DURING NIGHT RELIEVED ON TAKINGMEDICATION NOT ASSOCIATED WITH CHILLS AND RIGOR NO H/O VOMITING . PAST HISTORY: K/C/O HYPOTHYROIDISM AND ON CARBIMAZOLE 2.5 MG OD NO H/O SIMILAR COMPLAINTS IN THE PAST. N/K/C/O DM, HTN, TB , CKD ,CVA , ASTHMA,EPILEPSY ,THYROID. H/O OF CARCINOMA CERVIX 1 YEAR AGO FOR WHICH HYSTERECTOMY WAS DONE F/B RADIOTHERATY AND CHEMOTHERAPY FOR 3 MONTHS PATIENT IS CO

Fever projr dengue 202407401

 Diagnosis DENGUE PYREXIA (NS POSITIVE) CHRONIC KIDNEY DISEASE ON MAINTENANCE HEMODIALYSIS Case History and Clinical Findings PATIENT CAME WITH C/O FEVER SINCE 3DAYS, CHEST PAIN SINCE TODAY MORNING HOPI- PT WAS APPARENTLY ASYMPTOMATIC TILL TODY MORNING THEN SHE DVELOPED CHEST PAIN WHICH IS SUDDEN IN ONSET, GRADUALLY PROGRESSIVE(BURNING TYPE, LOCALISED, LEFT SIDED) ASSOCIATED WITH SOB GRADE III C/O PEDAL EDEMA, BILATERAL PITTING TYPE, GRADE II H/O FEVER 3 DAYS AGO WITH GENERALISED BODY PAINS TESTED NS POSITIVE 3 DAYS AGO WITH YESTERDAY PLATELETS 65OOO NO C/O BURNING MICTURITION, VOMITINGS, LOOSE STOOLS, BLEEDING GUMS, HEMATEMESIS, HEMOPTYSIS, PURPURA, RASHES, PALPITATIONS. PAST HISTORY- H/O LEFT PCNL + DJ STENTING DONE 3 MONTHS AGO WITH STENT REMOVAL DONE LEFT MULTIPLE CALCULI , B/L HUN WAS PRESENT L>R K/C/O CKD SINCE 3 MONTHS ON DIALYSIS SINCE 20 DAYS ,8 HD DONE. NOT A K/C/O DM, HTN, CAD,CVA, ASTHMA, THYROID DISORDERS. FAMILY HISTORY- INSIGNIFICANT MENTRUAL HISTORY- MENOPAUSE ATTAIN