This 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.



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. 
 

A 41 year old male admitted to pyschiatry ( de-addiction centre) 
As he has h/o alcohol consumption since 10 years,
Tobacco chewing since 10 years.
HOPI: patient consumes intially 90ml of whiskey with his friends, this gradually increased to 180ml as he would have a physically exhausting days at work. 10 years back, patient lost his wife and hence he started drinking more frequently, consumes ~12 units/day everyday and experiences sleep disturbances, tremors , if he doesn't consume alcohol and not going to work. Patient chews 1 pack of tobacco per day, experiences headache if he doesn't consume alcohol
Yesterday afternoon he had one episode of involuntary movements of B/L upper limb &lower limb, not associated with involuntary micturation/defecation, associated with tongue bite + ,aura + , not associated with uprolling of eyelids, no postictal confusion ; so he was shifted to GENERAL MEDICINE department.
Past illness: ? alcohol withdrawal seizures(1episode) 5 months back
K/c/o HTN , since 1 -1/2year on amlong-5mg/po/od (on irregular medication)
Not a k/c/o DM, CAD,Asthma, TB
No significant family history
VITALS-
PT is C/C/C
Afebrile,Bp-120/80 mm hg, pr-84bpm , GRBS-192mg/dl, CVS- S1S2+ , RS- Bae+, NVBS,
Provisional diagnosis-
Alcohol withdrawal seizures
Alcohol dependence syndrome.
Tobacco dependence syndrome.

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