Shiva Shankar posham roll no 125

CASE 35 yrs old Male resident of LB nagar, occupation sugar dealer came to opd with chief complaints of blood in the stools ,SOB ,easy fatigability ,itching all over the body since 1mn.   HOPI : Patient was apparently asymptomatic 1mn back then he observed blood in the stools not associated with pain during defecation . He complaints of easy fatigability,SOB while doing work and lifting little weights also. History of itching all over the body ,due to itching there are small hyperpigmented patches on both upper and lower limbs since 1mn. PAST HISTORY : Similar complaints 1 yr back (blood in stools for 15 days) N/k/c/o Hypertension, diabetes,asthma, epilepsy,CAD DAILY ROUTINE : He wakes up at 5 am and does his daily routine ,eats breakfast at 8:30 and goes to work at 9am , afternoon he takes alcohol and comes home and eats lunch and sleeps until 5 or 6pm ,then again he goes out , drinks alcohol and comes home and does his dinner and goes to bed at 10 pm. PAST HISTORY: Similar complaints

 70 years with SOB from 10days  This is an online E logbook to discuss our patients' 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 the available global online community of experts intending to solve those patients' clinical problems with the 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 box are 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, and investigations, and come up with a diagnosis and treatment plan. CASE PRESENTATION Patient came to the casualty with the complaints of breathlessness since since 10 days  Complaints of swelling of both th