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Chief complaints: C/o of vomitings since 3 days C/o pain abdomen since yesterday morning History of present illness: Patient was apparently asymptomatic 3days ,back,then developed vomitings since 3 days,5-6episodes per day,content being whatever she ate and drank,yellowish in colour,non projectile,non foul smelling. Pain abdomen since yesterday,at the umbilicus,sudden in onset,not progressive,not radiating, pain aggravated after vomiting episode,relieved with medication. H/O nausea is present No H/O constipation, diarrhoea, burning micturition is present H/O 1 episode of black stools yesterday Past history: Patient is not a k/c/o htn , dm , asthma, epilepsy, thyroid disease  H/O blood transfusion 15 yrs back Diet :mixed  appetite: normal Bladder and bowel :normal . Sleep:adequate.  addictions: none vitals: temp:afebrile BP:130/70 mm of hg PR:72bpm RR:18cpm General examination : pt is conscious,coherent and cooperative pallor present  No icterus   cyanosis,clubbing,edema or lymphadenop

 is an 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 patient's clinical problems with collective current best evidence based inputs.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. Case presentation: 47 yrs old male patient came to casualty with complaints C/O burning micturition since 15 days C/O fever , since 10 days  vomitings since 3 days  C/O pain abdomen, since yesterday ,in right hypochondrium,epigastric  and right lumbar region  History of present illness: Pt was apparently asymptomatic 15 days back,then complains C/O burning micturition since 15 days,no pain during micturition, C/O fever ,high grade since 10 days associated with chills, reli

1) A 55 year old man with Recurrent Focal Seizures Detailed patient case report here: http://ushaindurthi.blogspot.com/2020/11/55-year-old-male-with-complaints-of.html 1. What is the problem representation of this patient and what could be the anatomical site of lesion ? A 55 year old male , with Type 2 Diabetes mellitus who is a chronic alcoholic & smoker came with c/o weakness of right upper limb with involuntary movements of both right upper and lower limbs . The anatomical site of lesion may be internal capsule(left sided) as it is the most common site for lacunar infarcts,also presents as hemiparesis. 2. Why are subcortical internal capsular infarcts more common that cortical infarcts? subcortical infarcts are more common as the penetrating artery supplying this region are prone to occlusion because of its small diameter.They usually arise from a large cerebral artery, most commonly from the Circle of Willis. These penetrating arteries arise at sharp angles from major vessels