45 year old female with Acute gastroenteritis with HBsAg postive


45 year old female Patient complains of vomitings since 2 days (10 episodes)
and had h/o fever since 1 week ,
loose stools since 1 day (2 episodes )
Patient was apparently asymptomatic 1 week back later she developed fever which is continuous not relieved with medications and complaints of vomitings 10 episodes since 2 days non bilious containing food particles. C/0 loose stools 10 hrs back 1 episode
No h/o cold,cough, palpitations,tachycardia 
H/o typhoid fever 1 year back
Not a k/c/o TB,Asthma, HTN, Epilepsy,DM.
General examination:
Patient conscious, coherent, cooperative 
Temp:101 F
PR:94 bpm
BP:130/80 mmhg
Spo2 : 99%
GRBS :140 mg%
CVS: S1,S2 heard ,no murmurs 
RS: BLAE +
P/A: 
Abdomen is obese 
Soft,non tender ,no bruits heard 
No free fluid,palpable masses
No organomegaly
CNS : NAD
Provisional Diagnosis:
Acute gastroenteritis denovo detected HbsAg positive. 
Treatment:
-On the day of adimission
1.IVF RL @50 ml/ hr
2.inj.zofer 4 mg iv TID
3.inj.Pan 40 mg IV OD
4.ORS sachet in 200 ml pot water after every episode of vomitin
-Day 1
1.IVF RL @50 ml/ hr
2.inj.zofer 4 mg iv TID
3.inj.Pan 40 mg IV OD
4.ORS sachet in 200 ml pot water after every episode of vomitin
-Day 2 
1.IVF RL @50 ml/ hr
2.inj.zofer 4 mg iv TID
3.inj.Cipro 200 mg in 100 ml IV OD
4.inj.Pan 40 mg IV OD
5.inj.metrogyl in 100 ml NS IV BD
6.ORS sachet in 200 ml pot water after every episode of vomitin
-Day 3 
1.IVF RL @50 ml/ hr
2.inj.zofer 4 mg iv TID
3.inj.Cipro 200 mg in 100 ml IV OD
4.inj.Pan 40 mg IV OD
5.inj.metrogyl in 100 ml NS IV BD
6.ORS sachet in 200 ml pot water after every episode of vomitin
UDG REPORT 
FEVER CHART
INVESTIGATION 

Popular posts from this blog

46 yr old male with HFrEF with type 4 cardi renal symdrom with DCMP with ischemic Hepatits

Image
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.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. Team: Interns- M Supriya Mohitha K Sowmya Sanjay Amrutha Dr.Druga Krishna PGY1 Dr.Ajith Kumar PGY2 Dr.Laxma Reddy PGY3 Dr.Manasa PGY3 Dr.Vijaya Lakshmi (Ast.Prof.) 46 years old old male patient came with  c/o abdominal distension since 20 days   c/o shortness of breath since 20 days and c/o  pedal edema since 20  days Patient was apparently asymptomatic 6 years back then had  throne pricking on the left foot followed which he developed swelling ...
Read more

75 YRS OLD FEMALE WITH CVA

Image
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.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. Team: Interns- M Supriya Mohitha K Sowmya Sanjay Amrutha Dr.Druga Krishna PGY1 Dr.Ajith Kumar PGY2 Dr.Laxma Reddy PGY3 Dr.Manasa PGY3 Dr.Vijaya Lakshmi (Ast.Prof.) C / o altered sensorium  Unable to speak Unable to move her upper and lower Limbs since  6 o'clock in the evening yesterday Patient had history of toddy intake in the afternoon yesterday after which she unable to move her right upper limb and lower Limbs ⁶6ťshe unable to speak ok or response two daughters...
Read more

50 yrs old male k/c/o HbsAg +ve with cirrhosis

Image
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.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. Team: Interns- M Supriya Mohitha K Sowmya Sanjay Amrutha Dr.Druga Krishna PGY1 Dr.Ajith Kumar PGY2 Dr.Laxma Reddy PGY3 Dr.Manasa PGY3 Dr.Vijaya Lakshmi (Ast.Prof.) A 50 year old male came with c/o distention of abdomen since 7 months,B/L pedal edema since 7 months,  pt was apparently asymptomatic 7 months back then he developed  low grade fever with yellowish discolouration of eyes followed by pedal edema  which is gradually progressive and pitting type -no aggr...
Read more