DAY ONE,20th July 2009
8.30 am
Report myself to the Human Resources Department.Got my name tag.Being informed the name of the doctor incharged and being showed around the area of hospital by authorized person.I was sent to the clinic of the incharged doctor.

9.30 am-12.00pm
Clinic session
Patient one.
Male,around 60 years old.Symptoms of redness,swelling,tenderness but without pain in both legs.According to doctor,this is unilateral legs swelling in case of Deep Vein Thrombosis (DVT).Patient also has cellulitis.

Doctor asked about DVT, and explained the diagnosis method,which includes: renogram method,where radioactive dye is injected into vein to determine location of deep thrombosis.Next,Doppler’s Ultrasound, the flow test compatability method.This test can determine the velocity of blood flow in veins.

Patient two
Female,around 60 years old.Complained pain in back joints that cause difficulty in moving.Being prescribed to do physiotherapy to maintain posture.Patient has spondylitis and taking Nirontin to ease neuritic pain.

Doctor prescribed Calcium diet for healthy bones by asking patient to drink milk.Patient is also given supplement Caltric D.

Patient three
Male,52 years old.Complained continous numbness and tingling sensation on left feet.Later that sensation is felt on right feet too.Next to both hands.Due to this,patient can’t walk and using wheelchair to move.Patient has a rare disease,called Churg-Strauss Syndrome.

Doctor examined the patient’s motor strenght.Hand grip power, 3 over 5.Both waist extension and flexion,4 over 5.Foot extension and flexion againts gravity, 3 over 5.Medication such as Prednisolone,Nirontine,Cyclophosphamide,Bactrim,Naxonate and Vitamin D is prescribed.

Patient four
Female,around 60 years old with history of previous stroke attack.Patient can’t come for check-up.Represented by family members to conclude the present conditon to doctor.According to them,patient complained on the back at the vertebra area.This cause difficulty to walk.Showing the latest X-ray on vertebrae,the doctor concluded that there was some small fracture in the vertebrae.Looking in the kidney test result,the function is a little bit impaired.All other system function is normal.

Doctor prescribed MRI to identify any other area of thrombus or artheroslerosis in brain to prevent next attack.Ultrasound for kidney to identify any underlying stone.For the small fracture doctor said that that it can heal itself.Medication include pain killer.

Patient five.
Female,65 years old.Pain in joints(hands and upper limbs).Maybe in case of osteoarthritis.
Doctor checked the patient retina.He also tapped the patient wrist.Patient complained pain on right wrist.

Patient six
Female.Around 50-60 years old.Pain on foot.Vitamin D prescribed.

Patient seven
Female.Around 50-60 years old.Pain and swelling in lower legs for the past 2 month.This patient has osteoarthritis.

Doctor conducted intrarticular steroid injection.Aseptic method,local anaesthetic(xylocaine) is used.Aspiration of knee joint fluid to asses colour and any pus.If pus content is minumum,injection of steroid is being proceed.Classical sign of OS include,crepitation of bone during joint examination.

Patient eight.
Male.28 years old.Pain in upper quadrant of stomach.Pain in the Th-10 in front and irradiated to L9.Patient is admitted to ward for further investigtion.Maybe there is some prroblem with the gallstone.

12.00pm-1.00pm
Casualty department

Patient one
Female.Around 20.Complained acute pain in the epigastric area.Kidne striking test is performed and the result is positive.Patient is admitted to the ward for further investigation.
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Assignment of investigation and history taking is given to me about the patient with Churg-Strauss Syndrome.