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Showing posts from February, 2022

33 yr old male with epigastric pain

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Patient came to casuality wih c/o epigastric pain since 2pm of 27/2/22. Nausea and vomitings are present since 4pm yesterday.  HOPI:  Patient is a chronic alcoholic since 20yrs. Due to issues with his wife, he is consuming alcohol since 1yr. For the last 7days he is drinking wihout having food. C/o epigastric pain since yesterday  Burning type, radiating to back gradually progressive.  Nausea present, vomitings present of dark black colored. Non bilious, non projectile. C/o Burning sensation in throat Similar episode of binge drinking 2 eisodes in last 1yr. K/C/O HTN since 5yrs , on medication - irregular.  N/K/C/O: DM, TB, asthma. O/E: Pt is C/C/C. Afebrile. Bp: Pr: Rs: BAE+ CVS: S1S2 + CNS: NAD. Abdomen Provisional diagnosis: ? Acute Pancreatitis? Acute Gastritis. 

65yr old Female with fever

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65yr Female Patient came to the casuality with c/o fever since 1week Patient was apparently asymptomatic 5yrs back . Later diagnosed with HTN 5yrs back on visiting hospital for knee pain. On medications tab.Telmisartan-40mg OD Patient was diagnosed with DM 4yrs back on visiting hospital for regular check up On medication tab .Metformin Stopped medication since 6 months for the low sugar levels. 6 months back patient went to hospital for pedal edema since 1month. Patient was daignosed with CKD 6months back. Patient went to the hospital 2months back for the frothy urine. Now Patient came to the casuality with c/o fever since 1week. High grade fever associated with chills and generalised weakness O/E: Pt is lethargic. Febrile Pr: 102bpm Bp:  150/70mmhg Spo2:  99@ RA GRBS: 96mg/dl RR: 14cpm. RS: BAE+ CVS: S1 S2+ Cns: patient is lethargic GCS: E3V1M6 Pupils: NSRL Power: Moving all limbs. Tone: normal Reflexes      B   T   S   A   K   P R:                 2+   + 

70YR OLD FEMALE WITH DECREASED SENSORIUM

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CBBLE UDHC SIMILAR CASES This is an online E log book to discuss our patient's 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 available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. 70 YR OLD FEMALE CAME TO CASULITY WITH C/O DECREASED APPETITE SINCE 5DAYS. IRRELEVANT TALK SINCE 1DAY. HOPI: PATIENT WAS APPARENTLY ASYMPTOMATIC 15YRS BACK, HAD H/O GIDDINESS AND DIAGNOSED AS HTN ON MEDICATION T.TELMA 20MG OD, DM-II ON T. GLICAZIDE 60MG OD SINCE THEN. H/O DIZZINESS  2YRS BACK - CT BRAIN DONE WHICH SHOWED AGE RELATED ATROPHIC CHANGES. STARTED MEDICATION. REPEATED CT AFTER 1 YEAR ,WHICH SHOWED THE SAME AGE RELATED ATROPHIC CHANGES. 6 MONTHS BACK HAD H/O FALL IN A FAMILY FIGHT AND HAD SUSTAINED INJURY TO RIGHT HIP , BUT NO ABSOLUTE FRA

19 YR OLD MALE WITH PAIN ABDOMEN

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19YR OLD MALE  C/O PAIN ABDOMEN SINCE 3DAYS C/O VOMITINGS 2 EPISODES SINCE 3 DAYS C/O LOOSE STOOLS SINCE 3DAYS , 5 TO 6 EPISODES PER DAY. HOPI: PATIENT WAS APPARENTLY ASYMPTOMATIC 3 DAYS BACK, THEN HE DEVELOPED LOWER ABDOMINAL PAIN, SUDDEN IN ONSET, CONTINOUS, COLICKY IN NATURE AND RADIATING TO LEFT LOWER ABDOMEN, AGGRAVATING PAIN BEFORE DEFECATION,  ASSOCIATED WITH VOMITING 2 EPISODES, NON BILIOUS,  NON PROJECTILE,  FOOD AS content,  H/O LOOSE STOOLS SINCE 3DAYS 5 TO 6 EPISODES PER DAY, WATERY STOOLS. H/O FEVER 1 EPISODE ASS. WITH CHILLS AND RIGOR , AFTER WHICH PATIENT WENT TO LOCAL HOSPITAL FOR ABOVE COMPLAINTS,  WHERE CONSERVATIVE MANAGEMENT DONE. H/O INTAKE OF MUTTON IN THE FUNCTION 3DAYS BACK. NO H/O SIMILAR COMPLAINTS IN THE PAST. G/E; PT C/C/C. PR: 115BPM BP: 110/ 70MMHG P/A: OBESE ABDOMEN , MILD TENDERNESS AT LEFT ILIAC FOSSA. CBP RFT ECG LFT PROVISIONAL DIAGNOSIS: ACUTE GE ? VIRAL HEPATITIS. TREATMENT: 1.

60yr old female with fever and loss of appetite .

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ICU BED 1 60year old female who is home maker by occupation was diagnosed with diabetes since 10 years , intially used Oha and later shifted to insulin due to uncontrolled sugars. Last year MARCH -2021 - H/o trauma , cellulitis and amputation was done in view of diabetic foot . Last year May 2021- H/o ?CVA - Left hemiparesis with bowel and bladder incontinence. Pt is on Foley's since then. Every 15 days they used to change it. She got admitted in our hospital only during that time(documentation not available) and her weakness improved over 1 month and she was able to hodl things. But bladder incontinence still persisted .So she was on Foley's/diaper since then. Cause could be -? aca territory infarct  Pt is bedridden since amputation and CVA .  No difficulty in speech or swallowing. She used to be active as per attenders. She is not using her regular insulin since post CVA . She dint use any other medications since 8 months. Stopped antiplatelets also . H/o fever 3 days ago- on