Diabetic foot ulcer with CKD
July 31,2022
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.
History of presenting illness
Patient was apparently asymptomatic 20days back then he developed pain in the right lower limb and for which he went to Near by hospital and treated with antibiotics and then he developed swelling in the lower limb which is insidious in onset ,gradually progressive ,pitting type initially at ankle ,extended till knee then he developed a bubble like thing in the dorsum of the right foot which bursted and developed into an ulcer
H/o fever since 1week which is intermittent associated with chills and rigors.
No h/o burning micturition decreased urine output
Patient developed shortness of breath 2yrs back and came to our hospital and diagnosed with heart disease (CAD)and renal disease and he was referred to Hyderabad kims and was treated and symptoms subsided
Daily routine
He wakes up in the morning 5'o clock goes to narketpalli and come back by 7am and have lunch and then go back to nky for site visit and come back by 5pm then at night he will have the dinner and go to sleep by 11pm
Past History
Diabetes since 12 yrs and using glimepiride
Hypertenstion since 12yrs for which he is using nifidipine
No History of asthma, Epilepsy, Tuberculosis
Had a History of dialysis
1st on 22/7/22
2nd on 24/7/22
3rd time on 27/7/22
4th time on on 29/7/22
Personal History
Diet-mixed
Appatite-normal
Sleep-adequate
Decreased urine output(3 to 4 times a day)
Normal Bowel movements
No addictions
No allergies
Family History
No significant
Treatment history
He is using ecosprin,furasemide,folic acid,bisprostol since 2 yrs
And glicazide since 12yrs for diabetes daily morning
General examination
The patient was consious, coherrent, cooperative Well oriented with time, place and person .well built and nourished
No pallor
No icterus 
No cyanosis
Pedal edema
Edema of left hand
Vitals
temp-afebrile(98.6)
Bp-120/90mm of Hg
PR-88bpm
RR-18cpm
Spo2-97%
GRBS-107mg/dl
Systamic examination
Clinical pictures
