A 34 year old male with vomiting , generalised weakness and hiccups

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to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan. 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 patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input

P.bharath Kumar

Roll no 108

Cheif Complaints-

34 year old male lorry driver by occupation resident of chitiyal came to opd with chief complaints of

Vomiting since 3 days

Hiccups since 3 days

Cough since 3 days

Loose stools for 1 day 3 days back

HOPI- patient was apparently asymptomatic 3 days back then he had vomiting which was sudden in onset, 10-15 episodes per day,non bilious,non projectile,food and water as the contents

Vomiting is present immediately after food water and alcohol intake which is associated with generalised weakness for which he went to local hospital in chityala and he was under saline infusion.

Loose stools- 4 episodes lasted for 1 day 3 days back

Non blood stained,large volume not associated with pain abdomen and fever, black coloured stools

Hiccups Since 3 days continuously, associated with mild difficulty in swallowing

Cough- dry since 3 days not associated with fever sore throat cold.

Past history:

H/o yellow discolouration of eyes associated with vomitings 5-6 episodes per day non bilious containing food particals 3 months back for which he went to local hospital and diagnosed as jaundice and treated for it.

Not a known case of HTN, DM, TB, Asthma, Epilepsy, CAD

No h/o any previous surgeries

No known allergies

Personal History

Diet- mixed

Appetite- decreased

Bowel and bladder- regular

Sleep- regular

Addictions- chronic alcoholic since 16years (minimum 90ml per day) ,3 months back he has stopped Consuming alcohol as he was diagnosed with jaundice, but 5-10days back he again started consuming alcohol.

Increased consumption during night after dinner

Occasional toddy consumer

And also consumes tobacco in the form of gutka (betel quid). At first he used to take 1 packet per day now he is taking 10 packet per day

Family history

Not significant

General physical examination-

Patient is conscious coherent cooperative well oriented to time place and person moderately built and nourished

Pallor -absent

Icterus- present (mild)

Cyanosis- absent

Clubbing absent

Lymphadenopathy-absent