35F ?allergic dermatitis METHOTREXATE TOXICITY

This is an online Elog book to discuss our patient deidentified health data shared after taking his/ her guardians sign informed consent

Here we discuss our individual patient problems through series of inputs from available Global online community of experts with n aim to solve those patient clinical problem with collect current best evidence based input

This Elog also reflects my patient centered online learning portfolio.

I have been given this case to solve in an attempt to understand the topic of " Patient clinical data analysis" to develop my competancy in reading and comprehending clinical data including history, clinical finding, investigations and come up with a diagnosis and treatment plan

35 year old female, farmer by occupation resident of aakaram. wakes up at 5 am does household chores till 9am goes to farm and comes back by evening 5pm, cooks food, have dinner and go to bed by 9pm.

The patient is apparently asymptomatic until 5 days ago then she had sudden onset of low grade fever without chills at night time . Not associated with sweating, dizziness, fatigue and body pains.

Second day after onset of fever she went to farm for work and injured her left toe with ?sand while spraying fertilizers. From third day she noticed progressive painful lesions appearing on both lower limbs and upper limbs chest and neck associated with local rise in temperature and swelling . Not associated with loss of sensation, itching, joint pains.

No complaints of headache, burning micturition, giddiness, chest pain, shortness of breath, palpitations, cough ,insomnia, loose stools, loss of appetite.

History of usage of semecarpus anacardium for one day. Tab deflazocort 6mg for five days itraconazole tofloxacin, orividazole, clobetalol propionate, and megaheal ointment for five days

History of psoriasis vulgaris? From 2 years for which she used tab methotrexate 7.5mg OD for one month and capsule itraconazole 100mg OD for one month which she stopped 15 days back

Day 1

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Cases 1-16

Case 1 https://himajav.blogspot.com/2023/08/53f-metabolic-syndrome.html 53 year old female housewife by occupation resident of coochbihar admitted with complains of generalised weakness since 6 years The patient's medical history reveals that she was asymptomatic until six years ago when she presented with weight loss, xerostomia, and anorexia. She sought medical attention at a local medical facility, where she was diagnosed with Diabetes mellitus and subsequently initiated on oral hypoglycemic agents. Around four years ago, the patient began experiencing generalized asthenia and easy fatigability, leading to the diagnosis of both Hypertension and hypothyroidism. Approximately four years ago, the patient complained of cervical discomfort, prompting a diagnostic consideration of cervical spondylosis. This condition was managed with a course of physiotherapy. Currently, the patient reports intermittent occurrences of generalized asthenia, easy fatigability, and xerostomia. She also...

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A 30-year-old male presented with a history of progressive weight loss over the past year. Symptoms commenced in November 2022 with severe abdominal pain and vomiting, initially attributed to roadside food consumption. Recurrent monthly episodes of abdominal pain, bloating, and vomiting/loose stools persisted until April. Diagnostic workup, including abdominal scan, CBP, ESR, CRP, TTG antibody, LFT, RFT, sputum for AFB, chest X-ray, Quantiferon Gold for TB, and Montoux test, yielded normal results except for elevated CRP. Ayurvedic treatment resulted in symptom improvement, but weight loss persisted. From November 2022 to April 2023, he lost 10 kgs and maintained stability at 48 kgs thereafter. CRP levels correlated with symptom exacerbations, decreasing post-treatment. Presently, he experiences diminished appetite, eating only twice daily, despite previously consuming 4-5 meals. Daily schedule and eating patterns outlined. . [27/11/23, 10:31:59] ~ A: ‎~ A created this group ‎[28...

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NOTE: THIS IS AN ONLINE E LOGBOOK 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 A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT. DIAGNOSIS : ACUTE GASTRITIS WITH LOWER ESOPHAGEAL SPHINCTER 49 year old female born by natural delivery on 05-06-1973. Born and bought up in coochbihar North Bengal. Milestones achieved normal. Childhood was pleasant. Went to school by walk 1.5kms near to home. Comes back home and played games like coco, jumping,running, finishes homework and goes to bed. She lives with her family - 9 siblings,parents and grandparents all live together At age 11 she lost her father due to heart stroke secondary to hypertension. She is very close to her younger brother during her childhood but the same relatio...

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