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1) Complications of diabetes mellitus Chronic hyperglycaemia causes irreversible damage over time to a number of tissues: particularly the small blood vessels of the retina (retinopathy), the glomerulus (nephropathy) and peripheral nerves (peripheral neuropathy). These are the microvascular complications. They are strongly linked to long term elevated blood glucose.  Macro vascular complications are further divided into coronary circulation ( angina, acute coronary syndrome or myocardial infarction), cerebral circulation (transient ischaemic attack, stroke), peripheral circulation ( foot diseases).  other complications are - infections, rheumatological complications, skin complications.  2. Diabetic neuropathy  symptoms include paraesthesia in the feet, sharp pain in lower limbs ( worse at night and felt mainly on the anterior aspect of the leg), burning sensation in the soles of feet and cutaneous hyperaesthesia. As the condition advances, structural changes appear in the foot leading
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60 M WITH TYPE 2 DIABETES MELLITUS AND HYPERTENSION

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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. Ihave 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 60 year old man, resident of suryapet, labourer by occupation, came to the ophthalmology op with complaints of diminution of vision in the right eye and was referred to the general medicine department because
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48 M with pain abdomen and lower back pain since 1 week

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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. 48 M resident of suryapet, farmer by occupation came to the opd with c/c of lower back pain and pain abdomen since 1 week  HOPI patient was apparently asymptomatic 1 week ago and then he developed pain abdomen
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