SANJAY BANDARU 121

Learning points- 1.The importance of history taking  2.The importance of past history which might be the cause for the present condition   3.The effect of rat poisoning on the kidney 4.The types of rat poisoning that are commonly available   5.The importance of building proper relationship between the patient and the doctor  OSCE- Mechanisum of ascitis- It is associated with profound changes in the splanchnic and systemic circulation and with renal abnormalities. The development of ascites is related to the existence of severe sinusoidal portal hypertension that causes marked splanchnic arterial vasodilation and a forward increase in the splanchnic production of lymph. Splanchnic arterial vasodilation also produces arterial vascular underfilling, arterial hypotension, compensatory activation of the RAAS, SNS, and AVP, and a continuous sodium and water retention, leading to ascites formation. Now, therefore, the splanchnic arterial circulation, rather than the venous portal system, is b

 This is an 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 patient problem through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evidence input. This E blog also reflect my patient centered online learning portfolia and your valuable inputs on the comment box is welcome.                   I have been given this case to solve in attempts to understand the topic of patient clinical data analysis to develop my compentency in reading and comphrending clinical data including history , clinical finding , investigation and come up with diagnosis and treatment plan.... A 29 year old male from Miryalaguda ,a agricultural woker by occupation came to opd with complaints of Bilateral pain in lower limbs upto knee since 22 days History of Presenting Illness:-    Patient was apparently