"This 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 based inputs.

A 27 year old male patient , a resident of Bhuvanagiri , a farmer by occupation came to the casualty with chief complaints of shortness of breath since morning (13/02/2022)

History of Present illness
Patient was apparently normal two days back. He attended a wedding on 11/02/2022.On 12/02/2022 evening he took alcohol (180ml) following which he had 4 episodes of loose diarrhea and 3 episodes of vomiting .On 13/02/2022 morning he developed shortness of breath of sudden onset while he was in bed itself .It was not associated with cough,headache, chest pain, abdominal pain ,fever, vomiting of blood .There was no history of trauma. Patient is a chronic alcoholic (takes 180 ml of alcohol everyday for the last 10 years).He is regular tobacco chewer. 

Past History 
No History of similar complaints in the past and hospitalizations. 
Not a known case of Diabetes, Hypertension, Tuberculosis, Asthma

Family history 
Not significant 

Personal history 
Patient is married for 6 years and is blessed with two daughters
He doesn't take food wherever he drinks
Sleep adequate,Bowel and bladder regular
Alcoholic for 10 years and a regular tobacco chewer 

General Examination
Patient has a GCS of E3 ,V(ET), M4
Moderately built and poorly nourished
No Palor 
No Icterus
No Cyanosis
No Clubbing 
No Pedal edema 
No Regional lymphadenopathy
No Significant lymphadenopathy

Vitals
Heart rate- 84bpm
Respiratory rate - 22cpm
Fever subsiding with antipyretics
Blood pressure- 116/76 mm Hg
Maintaining a SpO2 of 99% with FiO2 of 60% and is on SIMV mode on the ventilator 

Respiratory System Examination

INSPECTION:

Chest is symmetrical

Trachea – midline

No Drooping of shoulders, supraclavicular/infraclavicular hollowing, intercostal fullness/indrawing/retraction/widening, crowding of ribs, rickety/scorbutic rosary, Harrison’s sulcus, Pectus carinatum/excavatum

No Kyphoscoliosis, winging of scapula, prominence of the medial border of scapula

No Sinuses, scars, dilated veins, nodules

PALPATION:

Trachea – midline

No Intercostal widening/crowding of ribs, rickety/scorbutic rosary, Intercostal tenderness, subcutaneous emphysema

No Kyphoscoliosis,

No dilated veins 

PERCUSSION:

Normal Resonance

No abnormalities found 

AUSCULTATION:

Breath sounds -Normal Vesicular Breath sounds

CARDIOVASCULAR SYSTEM:

S1 and S2 heard

No raise in JVP


ABDOMEN:

NO Hepatosplenomegaly, Ascites


https://youtu.be/vtQ5M3uGvEA

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