Shravani Reddy

 33 year old P1L1 with previous NVD came to emergency with Acute abdomen since 1 day not relieving on medications radiating to back and associated with vomitings . Known case of hypothyroidism since 3 mnths on T.thyronorm 25 mcg  History of appendicectomy 13 years ago  Menstrual history: Irregular cycles, 3 months once  LMP 19/5/2024 LCB 6 years ago Per abdomen:  Soft, Tenderness present in Right lumbar region  Appendectomy scar + Bimanual examination:  Uterus 8 weeks size ,AV,soft uterus , Fornices free, No tenderness  UPT negative on admission  CA 125 - 9 U/ml S.TSH 3.2 uIU/ml USG Pelvis : Ut 76 x 32x 47 mm AV  ET 5mm Ovaries: Right ovary: 60x32x58mm bulky with peripherally arranged follicles and echogenic centre with no colour uptake on Doppler.Mildfluid noted in POD adjacent to right ovary suggestive of Right ovarian torsion. Left ovary normal  Mild free fluid noted in POD  Planned for Right ovarian Detorsion with right oophoropexy with right ovarian cyst aspiration Intraoperative

 46 year old female P3L3 with previous 3 NVDs with tubectomized came with c/o heavy menstrual bleeding since 6 months . History of 3 pint PRBC transfusion  Menstrual history previously regular cycles 4-5/30 days , no pain , no clots  On examination: Per abdomen :Soft  Per speculum: Fibroid polyp with thick stalk extending from cervix (5 x 6 cms) Bimanual examination: Fibroid polyp felt  Uterus size 6-8 wks size , AV, mobile, Fornices free , No tenderness  PAP SMEAR:  Negative for intraepithelial lesion or malignancy Before surgery USG report :  MRI report: before surgery  Planned for laparoscopic vaginal hysterectomy  Cervical fibroid : Intraop findings: 

21 year old patient G3P1L1A1 with Previous Lscs with 38wks 4 days Period of gestation with Hypothyroidism with Bilateral Ovarian cysts. Wife of Mr.X belongs to low socioeconomic class residing in Hyderabad. Menstrual history: Attained menses at the age of 13 years. Irregular menses , 3-4 days flow per 60-70 days , during periods no pain and no clots. Obstetric history: First pregnancy:  Spontaneous conception / Full term/ LSCS I/v/o transverse lie / female baby/ Birth weight 3 kg/ Alive and healthy / now 3 years of age .(2020) Second Pregnancy:  Spontaneous conception / spontaneous Abortion at 5 weeks period of gestation (2022) Third pregnancy: Spontaneous conception/Present pregnancy LMP: 13/7/2023 EDD: 20/4/2024 Past history: K/c/o Hypothyroidism on Tablet Thyronorm 25mcg per oral ; once a day since 8th of pregnancy  Not a known case of Diabetes, hypertension,Asthma ,Epilespy,Tuberculosis  Personal history: Appetite normal  Bowel and bladder movements regular  Sleep adequate  No addi

"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 best evidence based inputs.This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment" 40 yr old female came for follow up .No fresh complaints. HOPI: Pt was apparently asymptomatic 1 mnth back then pt has developed lack of appetite, generalized weakness and difficulty in breathing and decreased urine output. She went to hsptl outside and diagnosed as Renal disease and on managed outside hsptl. Pt came here for further treatment. Past history: K/c/o T2 DM since 10 yrs. K/c/o HTN since 1 yr. Diagnosis: CRF ?Diabetic nephropathy

"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 best evidence based inputs.This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment" A 52 yr old female with c/o swelling over the left retroauricular and angle of mandible since 3 days. C/o swelling associated with increase in local temperature of left leg since 2 weeks. History of present illness: Pt was apparently asymptomatic 2 wks back then she developed progressive swelling of the left leg associated with local rise of temp since 2 wks.swelling over the angle of mandible which was preceded by a swelling and pain over the mastoid region. H/O cutaneous fung