Gm blog series -(26/4/23)

This is an online elog documenting de-identified patient health data after taking his signed consent to enforce a greater patient centered learning. 

DEIDENTIFICATION - 
The privacy of the patient is being entirely conserved. No identifiers shall be revealed through out the piece of work whatsoever.

CASE DISCUSSION 

CHIEF COMPLAINTS AND HOPI:

A 56 year old male patient who is a resident of koilagudem (nalgonda district)who is a daily wage labourer by occupation brought to the casualty in unresponsive state at 1:30 Am .patient was found drowsy from 1 pm on 25/04/2023 And suddenly developed seizure like activity associated with slurring of speech,uprolling of eyeballs,stiffness of all four limbs,

Associated with involuntary defecation and micturition and found unresponsive. 

No h/o fever ,cough.

No h/o neck stiffness and projectile vomitings. 

No h/o generalised weakness ,tingling,numbness.

No h/o head trauma.

Cheif complaints of swellings with discharge not associated with pain on the left forearm. History of similar swellings with discharge on and off from past 6 months. 



PAST HISTORY:

No history of similar complaints in the past. 

Known case of Diabetes type 2 since 1 month.on glimiperide 1mg and metfromin 500mg.

known case of asthma since 30 years. 

Not a known case of Diabetes,HTN,Epilepsy,CAD,TB.
FAMILY HISTORY:

No similar complaints in the family.





PERSONAL HISTORY: 

DIET : MIXED 

APPETITE: ADEQUATE 

SLEEP:NORMAL 

BOWEL AND BLADDER :REGULAR 

ADDICTIONS: NO ADDICTIONS. 



TREATMENT HISTORY:
   Medications for cough and pains.

GENERAL EXAMINATION:

Patient is unresponsive. 

Pupils dilated sluggishly reactive.

Poorly built and poorly nourished. 

Vitals: Pulse rate during admission 52 bpm on atropine 98bpm.

Respiratory rate:32cpm.

Spo2 :98%@RA.

Bp:120/90MMHG 

Temp:afebrile. 
SYSTEMIC EXAMINATION:

CVS:S1,S2 HEARD,NO MURMURS. 

RS:BAE+,NVBS.

P/A: SOFT ,NON TENDER. 



CNS: Patient is unresponsive at first. 



HMF:INTACT

MOTOR EXAMINATION 

  TONE: rt lt

      UL: N. N

      LL:N N

REFLEXES:

      B:2+ 2+

      T:2+ 2+

      S:2+ 2+

      K:2+ 2+

      A2+ 2+

      P:2+ 2+
      INVESTIGATIONS AND CLINICAL IMAGES:


PROVISIONAL DIAGNOSIS:

ALTERED SENSORIUM SECONDARY TO ?HYPOGLYCEMIA.

Treatment:

1IVF NS @@ 50ml/hr.

2.Inj:25%DEXTROSE INFUSION @10ml/hr 

Increase/decrease according to GRBS.

3.INJ:PIPTAZ 4.5 g/Iv/TID

4.Inj.CLINDAMYCIN TID

5.TAB.DOLO 650 mg/po/(

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