Case Study 5

 October 18 ,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."

October 18 , 2021

A 45 year old male presented to OPD for SOB and

 burning sensation in the stomach.


HISTORY OF PRESENT ILLNESS 


Patient was apparently asymptomatic 6 months back

 and then developed SOB and burning sensation in the 

stomach then he visited KIMS and got treatment and

then again he developed SOB , burning sensation in the

stomach with repeated burps and he got admitted in 

the hospital 2 days back.


He has a history of seizures since childhood and due to 

which he stays at home . The patient said that seizures

occur when he is cold and may occur at any time

randomly and he's taking phenytoin for seizures. 


PAST HISTORY 


No history of Diabetes mellitus and Hypertension. 

No history of Asthma, Tuberculosis 


PERSONAL HISTORY 


Appetite - Normal 

Bowel and bladder movement - Regular 

Diet - Mixed 

Sleep - Adequate 

Habits - He consumes alcohol occasionally 

No known allergies 


FAMILY HISTORY 


No significant family history 


ON GENERAL EXAMINATION 


She was conscious, coherent and cooperative 

Temperature - 98.4 °F

Pulse rate - 108 bpm

Blood pressure - 110/70 mmHg 

SpO2 - 

Respiratory Rate  - 

No Pallor

No icterus 

No cyanosis 

No clubbing of fingers 

No lymphadenopathy 

No pedal edema 

No malnutrition 


SYSTEMIC EXAMINATION 


CVS:


S1 and S2 heard 

No murmurs 


RESPIRATORY SYSTEM:


Normal Vesicular breath sounds heard 

Bronchial artery embolism 


PER ABDOMEN:


Soft 

Non tender 


CNS:


Oriented to time , place and person


PROVISIONAL DIAGNOSIS 


Seizures 


REPORTS 











HEMOGRAM


Hb - 11.6 gm/dl

TL - 5200 cells/cumm

Platelets - 3.25 lakh/cumm

PCV - 31.9

RBC - 88 mg/dl

Serology - Negative

Blood urea - 31 mg/dl

S. Creatinine - 1.1 mg/dl


S.electrolytes :

Na+ - 132 meq/L

K+ - 3.1 meq/L

Cl - 98 meq/L


LFT


TB - 0.54 mg/dl

DB - 0.19 mg/dl

AST - 11 Iu/L

ALT - 10 Iu/L

ALP - 155 Iu/L

TP - 5.7 gm/dl

ALB - 2.9 gm/dl

A/G - 1.0 


TREATMENT 


Inj PAN 40 mg/IV/OD

Inj Zofer 4 mg/IV/OD

Inj Optineuron in 500 ml NS/IV/OD

T.Eptoin 100 mg T/D

Carbamazapine 300 mg/BD

GRBS 6th hourly 

Temp , BP , SpO2 , PR monitoring 

Zytce gel for L/A









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