Case Study 2

 September 10, 2021

"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."

September 10, 2021

A 56 year old man driver by occupation presented to OPD with shortness of breath 

HISTORY OF PRESENT ILLNESS 

Patient was apparently asymptomatic 1 year back , then he had shortness of breath with chest pain 6 months back. He used medication for 3 months and then he discontinued later.

PAST HISTORY 

He was diagnosed to be hypertensive and diabetic 1 year back. 

He's on regular medication T.Glimi 500mg for diabetes and no regular medication for hypertension.

PERSONAL HISTORY 

Appetite is normal and on mixed diet with regular Bowel and bladder movement and adequate sleep.

He's also chronic smoker since 20 years and also occasional alcoholic.

FAMILY HISTORY 

No significant family history 

GENERAL EXAMINATION 

Patient was conscious, coherent and cooperative 

Pulse rate: 92 bpm 

Blood pressure: 120/70 mmHg

Respiratory Rate: 26 cpm

SpO2: At room air - 76% , 98% with 16L of O2

SYSTEMIC EXAMINATION 

CVS:

Apex beat : 5th ICS

RESPIRATORY: 

Dyspnea 

PER ABDOMEN:

Obese, tenderness absent, Bowel sounds heard 

CNS:

Normal 

PROVISIONAL DIAGNOSIS 

Acute Pulmonary edema 

INVESTIGATIONS 

ECG:







CHEST X RAY: 

 

 


CBP:

Hemoglobin - 15.9

TLC - 17,500

Platelets - 2.45

TREATMENT 

T.Nicardia 20 mg Po/ OD

T. Met-XL 25 mg PO TOD

T. GLIMI - M₂ PO/OD 

T. Ecospirin Av (75/70) Po/OD

T. clopitab 75mg PO OD

 T.Lasix 2omg Po/BD.

 Ini ceftriaxone 1gm IV/ BD

Syp Ascoril 10ml PO/TID




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