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Showing posts from March, 2021

Bimonthly assessment march 2021

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 1) Please go through the patient data in the links below and answer the following questions: https://ashakiran923.blogspot.com/2021/03/60-years-old-male-fever-under-evaluation.html?m=1 a). What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings?How specific is his dilated superficial Abdominal vein in making diagnosis ? Ans: 60 year old male chronic smoker & alcoholic non diabetic & non hypertensive c/o fever since 15 days associated with burning micturition, on & off facial puffiness , abdominal distention , SOB Grade -2 which progressed to Grade -4 , aphthous ulcers & dysphagia. O/E: Distended abdomen with dilated superficial abdominal vein Shifting dullness + Localization: Cirrhosis of liver with portal hypertension UTI AKI on CKD Specificity of dilated abdominal veins :98%, sensitivity 42% in diagnosing hepatocellular disease. b) What is the etiology of the current probl...

33year old male with uncontrolled sugars

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33year old male diabetic since 7years used OHAs for 6years and was started on inj.mixtard insulin as his sugars were uncontrolled on OHAs pt is now on Inj.Human mixtard 20-15 Day before yesterday night pt had alcohol binge and did not eat ,so he did not take his insulin dosage following which since yesterday mrng pt is having vomitings,3-4episodes yesterday,food as content associated with generalised weakness ,giddiness since yesterday.so he did not take his insulin yesterday also Since yesterday 3pm no futher episodes of vomitings but he is still feeling weak so they had brought him to casualty No h/o fever,loose stools,pain abdomen N/o cold, cough,shortness of breath k/c/ o DM II since 7years on Mixtard insulin  Not a klc/O HTN,CVA,CAD Occasional alcoholic (take alcohol during festivals) 10years Occasional smoker since 1month O/E Pt C/C BP 110/60 PR 120/min, regular GRBS 417mg/dl Spo2 98% at RA CVs s1s2+,No mumurs RS BAE +,NVBS Diagnosis: Uncontrolled sugars Treatment IVF NS @100...

52year old male with ascites

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 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.  E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. Here is the case i have seen, 52 year old male farmer and daily wage labourer by occupation came with complaints of abdominal distension since 2 months and indigestion weight loss and shortness of breath(grade 2) Constipation(since 1month) Patient was apparently asymptomatic 2 months back then patient observed abdominal distension,insidious in onset, gradually progressive h/o weight loss of about 5-6kgs over 2months h/o constipation on and off since 1 month SOB grade 2 sinc...

THESIS

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 TITLE OF THE THESIS CLINICAL PROFILE,EVALUATION,DIAGNOSIS AND THERAPEUTIC OUTCOMES IN PATIENTS WITH ASCITES  NEED FOR STUDY 1)Ascites is a major complication of cirrhosis, occurring in 50% of patients over 10 years of follow up The development of ascites is an important landmark in the natural history of cirrhosis as it is associated with a 50% mortality over two years, and signifies the need to consider liver transplantation as a therapeutic option. The majority (75%) of patients who present with ascites have underlying cirrhosis, with the remainder being due to malignancy (10%), heart failure (3%), tuberculosis (2%), pancreatitis (1%), and other rare causes.(1) 2)Ascites is one of the most common complications of liver cirrhosis along with variceal bleeding and hepatic encephalopathy. It is often the first sign of decompensated cirrhosis with portal hypertension. Patients with compensated cirrhosis progress to decompensated cirrhosis at a rate of 5-7% per year, and about 50...

17year old female with recurrent Respiratory tract infections,anemia,growth retardation

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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.  E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. Unit 1 Dr. Charan PGY1 Dr. Chandana PGY1 Dr. Sushmitha PGY2 Dr. Adithya PGY3 Dr. Praneeth PGY3 Dr.Hareen (SR MD gen med) Dr. ARJUN (Asst. Prof.gen med) Dr. RAKESH BISWAS HOD Here is a case I've seen: Admission under Unit 1 on 8/03/2021 History taken by Dr.Chandana Vishwanatham Dr. Sai charan  Dr.Susmitha 15year old female who is the first child of a consanguinous married couple her mother expired during the birth of 3rd child She has 2 younger brothers who are apparentl...