๐๐ข๐ฆ๐จ๐ง๐ญ๐ก๐ฅ๐ฒ ๐š๐ฌ๐ฌ๐ž๐ฌ๐ฌ๐ฆ๐ž๐ง๐ญ- ๐€๐ฎ๐ ๐ฎ๐ฌ๐ญ

๐†๐„๐๐„๐‘๐€๐‹ ๐Œ๐„๐ƒ๐ˆ๐‚๐ˆ๐๐„ -๐๐ˆ๐Œ๐Ž๐๐“๐‡๐‹๐˜ ๐€๐’๐’๐„๐’๐’๐Œ๐„๐๐“ -๐€๐”๐†๐”๐’๐“

๐™ฝ๐™ฐ๐™ผ๐™ด:-๐™Ž๐™๐™„๐™‰๐˜ผ๐™„๐™‰๐™„

๐š๐™พ๐™ป๐™ป ๐™ฝ๐™พ:-33

๐™ฑ๐™ฐ๐šƒ๐™ฒ๐™ท:-2019

We have been given 5 questions as an assignment  to analyze,asess , understand and write the preview of the given cases.


  ๐1.
๐‹๐จ๐ง๐  ๐œ๐š๐ฌ๐ž๐ฌ

๐‚๐š๐ฌ๐ž 1 ๐ฅ๐ข๐ง๐ค-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006003-case-presentations.html?m=1


๐‚๐š๐ฌ๐ž ๐ข๐ง ๐›๐ซ๐ข๐ž๐Ÿ- A 44 year old man presented to OPD  with a 3-day history of bilaterally symmetrical rapidly progressive generalized edema.

๐‘ฐ๐’๐’”๐’Š๐’ˆ๐’‰๐’•๐’”- The case was taken in a very elaborative and instructive manner.
Each and every symptom of the patient was clearly mentioned being it the present or medical and personal history. An elaborative  analyzing of the case has  been done on the basis of all the symptoms and treatment was given appropriately.

And the questions which were asked regarding the case were very pertinent and answers were presented with tables and were collected from various articles.


๐‘ช๐’‚๐’”๐’† 2 ๐’๐’Š๐’๐’Œ-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006001-case-presentations.html

๐‘ช๐’‚๐’”๐’† ๐’Š๐’ ๐’ƒ๐’“๐’Š๐’†๐’‡-A 47 year male patient resident of Nalgonda came with chief complaints of abdominal distension and swelling of bilateral lower limbs since 6 months which is gradually increasing since 10 days and fluid discharge from the umbilical area since 2 days and fever since 2 days.

๐‘ฐ๐’๐’”๐’Š๐’ˆ๐’‰๐’•๐’”-
The scenario of the case was clearly presented. And also all the investigation reports were updated regularly. It would have been even better if the treatment is updated regularly.


๐‘ช๐’‚๐’”๐’† 3 ๐’๐’Š๐’๐’Œ-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006004-case-presentations.html


๐‘ช๐’‚๐’”๐’† ๐’Š๐’ ๐’ƒ๐’“๐’Š๐’†๐’‡-
26 year old male, construction worker by occupation presented to the casualty with the chief complaints of :-Fever since 3 months ,Cough with expectoration since 2 months ,Dyspnea on exertion since 2 months, Vomiting since 2 months, Decreased appetite and weight loss over last 2 months ,Dark coloured stools since 2 weeks. 



๐‘ฐ๐’๐’”๐’Š๐’ˆ๐’‰๐’•๐’”-
๐‘‡โ„Ž๐‘’ โ„Ž๐‘–๐‘ ๐‘ก๐‘œ๐‘Ÿ๐‘ฆ ๐‘œ๐‘“ ๐‘๐‘Ÿ๐‘’๐‘ ๐‘’๐‘›๐‘ก๐‘–๐‘›๐‘” ๐‘–๐‘™๐‘™๐‘›๐‘’๐‘ ๐‘  ๐‘ค๐‘Ž๐‘  ๐‘Ž๐‘๐‘๐‘ข๐‘Ÿ๐‘Ž๐‘ก๐‘’๐‘™๐‘ฆ ๐‘ค๐‘Ÿ๐‘–๐‘ก๐‘ก๐‘’๐‘› ๐‘ค๐‘–๐‘กโ„Ž ๐‘œ๐‘›๐‘ ๐‘’๐‘ก๐‘  ๐‘Ž๐‘›๐‘‘ ๐‘กโ„Ž๐‘’ ๐‘Ÿ๐‘’๐‘๐‘œ๐‘Ÿ๐‘ก๐‘  ๐‘ค๐‘’๐‘Ÿ๐‘’ ๐‘Ž๐‘™๐‘ ๐‘œ ๐‘ข๐‘๐‘‘๐‘Ž๐‘ก๐‘’๐‘‘ ๐‘œ๐‘› ๐‘Ž ๐‘Ÿ๐‘’๐‘”๐‘ข๐‘™๐‘Ž๐‘Ÿ ๐‘๐‘Ž๐‘ ๐‘–๐‘  .๐‘‡โ„Ž๐‘’ ๐‘–๐‘š๐‘Ž๐‘”๐‘’๐‘  ๐‘œ๐‘“ ๐‘กโ„Ž๐‘’ ๐‘”๐‘’๐‘›๐‘’๐‘Ÿ๐‘Ž๐‘™ ๐‘’๐‘ฅ๐‘Ž๐‘š๐‘–๐‘›๐‘Ž๐‘ก๐‘–๐‘œ๐‘› ๐‘ค๐‘Ž๐‘  ๐‘Ž๐‘™๐‘ ๐‘œ ๐‘Ž๐‘ก๐‘ก๐‘Ž๐‘โ„Ž๐‘’๐‘‘ ๐‘คโ„Ž๐‘–๐‘โ„Ž ๐‘ค๐‘–๐‘™๐‘™ ๐‘š๐‘Ž๐‘˜๐‘’ ๐‘กโ„Ž๐‘’ ๐‘๐‘Ž๐‘ ๐‘’ ๐‘š๐‘œ๐‘Ÿ๐‘’ ๐‘‘๐‘’๐‘๐‘–๐‘๐‘ก๐‘–๐‘ฃ๐‘’.๐ด๐‘›๐‘‘ ๐‘Ž๐‘™๐‘™ ๐‘กโ„Ž๐‘’ ๐‘–๐‘›๐‘ฃ๐‘’๐‘ ๐‘ก๐‘–๐‘”๐‘Ž๐‘ก๐‘–๐‘œ๐‘› ๐‘Ÿ๐‘’๐‘๐‘œ๐‘Ÿ๐‘ก๐‘  ๐‘ค๐‘’๐‘Ÿ๐‘’ ๐‘๐‘Ÿ๐‘’๐‘ ๐‘’๐‘›๐‘ก๐‘’๐‘‘ ๐‘–๐‘› ๐‘Ž ๐‘โ„Ž๐‘Ÿ๐‘œ๐‘›๐‘œ๐‘™๐‘œ๐‘”๐‘–๐‘๐‘Ž๐‘™ ๐‘š๐‘Ž๐‘›๐‘›๐‘’๐‘Ÿ.

๐’๐ก๐จ๐ซ๐ญ ๐‚๐š๐ฌ๐ž๐ฌ

๐‘ช๐’‚๐’”๐’† 1 ๐’๐’Š๐’๐’Œ-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006001-case-presentations.html

๐‘ช๐’‚๐’”๐’† ๐’Š๐’ ๐’ƒ๐’“๐’Š๐’†๐’‡-
A 45 year old female patient farmer by occupation resident of Nalgonda came to casuality with complaints of vomitings and abdominal pain since 4 days ,she was bitten by snake on her right lateral foot.

๐‘ฐ๐’๐’”๐’Š๐’ˆ๐’‰๐’•๐’”-
๐‘‡โ„Ž๐‘’ ๐‘๐‘Ž๐‘ ๐‘’  ๐‘ค๐‘Ž๐‘  ๐‘ค๐‘Ÿ๐‘–๐‘ก๐‘ก๐‘’๐‘›  ๐‘Ž๐‘‘๐‘’๐‘ž๐‘ข๐‘Ž๐‘ก๐‘’๐‘™๐‘ฆ  ๐‘Ž๐‘›๐‘‘ ๐‘๐‘œ๐‘š๐‘๐‘Ž๐‘๐‘ก๐‘™๐‘ฆ . ๐‘‡โ„Ž๐‘’ โ„Ž๐‘–๐‘ ๐‘ก๐‘œ๐‘Ÿ๐‘ฆ ๐‘œ๐‘“ ๐‘–๐‘™๐‘™๐‘›๐‘’๐‘ ๐‘  ๐‘ค๐‘Ž๐‘  ๐‘‘๐‘’๐‘ ๐‘๐‘Ÿ๐‘–๐‘๐‘’๐‘‘ ๐‘๐‘Ÿ๐‘’๐‘๐‘–๐‘ ๐‘’๐‘™๐‘ฆ .๐‘‡โ„Ž๐‘’ ๐‘ ๐‘–๐‘ก๐‘’ ๐‘œ๐‘“ ๐‘ ๐‘›๐‘Ž๐‘˜๐‘’  ๐‘๐‘–๐‘ก๐‘’ ๐‘ค๐‘Ž๐‘  ๐‘Ž๐‘™๐‘ ๐‘œ ๐‘Ž๐‘ก๐‘ก๐‘Ž๐‘โ„Ž๐‘’๐‘‘  ๐‘Ž๐‘™๐‘œ๐‘›๐‘” ๐‘ค๐‘–๐‘กโ„Ž ๐‘กโ„Ž๐‘’ ๐‘–๐‘›๐‘ฃ๐‘’๐‘ ๐‘ก๐‘–๐‘”๐‘Ž๐‘ก๐‘–๐‘œ๐‘› ๐‘Ÿ๐‘’๐‘๐‘œ๐‘Ÿ๐‘ก๐‘ .
๐ด๐‘›๐‘‘ ๐‘Ž ๐‘™๐‘–๐‘›๐‘˜ ๐‘ก๐‘œ โ„Ž๐‘–๐‘”โ„Ž ๐‘ฃ๐‘  ๐‘™๐‘œ๐‘ค ๐‘‘๐‘œ๐‘ ๐‘’ ๐‘Ž๐‘›๐‘ก๐‘–๐‘ ๐‘›๐‘Ž๐‘˜๐‘’ ๐‘ฃ๐‘’๐‘›๐‘œ๐‘š ๐‘ค๐‘Ž๐‘  ๐‘๐‘Ÿ๐‘œ๐‘ฃ๐‘–๐‘‘๐‘’๐‘‘ ๐‘คโ„Ž๐‘–๐‘โ„Ž ๐‘ค๐‘Ž๐‘  ๐‘ฃ๐‘’๐‘Ÿ๐‘ฆ ๐‘–๐‘›๐‘“๐‘œ๐‘Ÿ๐‘š๐‘Ž๐‘ก๐‘–๐‘ฃ๐‘’.

๐‘ช๐’‚๐’”๐’† 2 ๐’๐’Š๐’๐’Œ-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006003-case-presentations.html

๐‘ช๐’‚๐’”๐’† ๐’Š๐’ ๐’ƒ๐’“๐’Š๐’†๐’‡-
A 19 year old male resident of Nalgonda and currently studying intermediate ,came to opd with complaints of :
-Itchy Ring leisons over arms ,abdomen ,thigh and groin since 1 and half year ,Purple stretch marks all over abdomen ,lower back ,upper limbs ,thighs since 1 year ,Abdominal distension and facial puffiness since 6 months, Pedal edema since 3 months , Low back ache since 3 months .

๐‘ฐ๐’๐’”๐’Š๐’ˆ๐’‰๐’•๐’”-
The case is presented in a chronological order.The CNS examination was report was presented elaboratively and all the investigation reports are also provided.
The images of the purple striae were also attached and updated regularly.


๐‘ช๐’‚๐’”๐’† 3 ๐’๐’Š๐’๐’Œ-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006002-case-presentations.html

๐‘ช๐’‚๐’”๐’† ๐’Š๐’ ๐’ƒ๐’“๐’Š๐’†๐’‡-
35 year old man working as a food caterer  presented to our OPD with the chief complains of  :-Dyspnea at rest since 5 days ,Cough with expectoration since 5 days ,Bilateral pedal edema since 4 days ,
Abdominal distension since 3 days.

๐‘ฐ๐’๐’”๐’Š๐’ˆ๐’‰๐’•๐’”- The examination images were provided along with the investigation reports and videos. And treatment protocol is also updated regularly.

๐2.
๐‹๐จ๐ง๐  ๐œ๐š๐ฌ๐ž๐ฌ-
๐‚๐š๐ฌ๐ž 1 ๐ฅ๐ข๐ง๐ค-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006003-case-presentations.html?m=1

๐‚๐ก๐ž๐ข๐Ÿ ๐œ๐จ๐ฆ๐ฉ๐ฅ๐š๐ข๐ง๐ญ๐ฌ-
• bilaterally symmetrical rapidly progressive generalized
• Severe joint pains
• Limitation of movements in his hands,wrists and feet.
• Burning eyes since 3days
• Subcutaneous swelling
• Involuntary weight loss and loss of appetite since 1yr.

๐‘ซ๐’Š๐’‚๐’ˆ๐’๐’๐’”๐’Š๐’”
• Acute Glomerulonephritis, likely due to Secondary Amyloidosis due to Chronic Poorly Treated Seronegative Erosive Rheumatoid Arthritis.
• Dilutional Hyponatremia secondary to Anasarca due to Glomerulonephritis.
• Hyperuricemia likely due to decreased Uric Acid Excretion Precipitating Gouty Arthritis
• Anemia of Chronic Disease secondary to Poorly Treated Rheumatoid Arthritis.

๐‘ป๐’“๐’†๐’‚๐’•๐’Ž๐’†๐’๐’• ๐’‘๐’๐’‚๐’
• Free water restriction for Hyponatremia

• Tab. PREDNISOLONE P/O 20 mg OD

• Tab FEBUXOSTAT P/O 80 mg OD

• Haemodialysis for worsening renal dysfunction

๐‘ช๐’‚๐’”๐’† 2 ๐’๐’Š๐’๐’Œ-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006001-case-presentations.html

๐‘ช๐’‰๐’†๐’Š๐’‡ ๐’„๐’๐’Ž๐’‘๐’๐’‚๐’Š๐’๐’•๐’”-

• Abdominal distension
• Swelling of bilateral lower limbs since 6 months which is gradually increasing since 10 days
•  Fluid discharge from the umbilical area since 2 days and fever since 2 days.
• High grade fever, intermittent in nature  not associated with chills, since 2 days.
• H/0 of anorexia, fatigue and generalized weakness since 3 months.
• H/0 of itching present since 3 months.
• H/0 of disturbed sleep since one month.

๐‘ซ๐’Š๐’‚๐’ˆ๐’๐’๐’”๐’Š๐’”
Decompensated chronic liver disease
Etiology -  chronic ethanol related
 Ascites , SBP,  Hepatic encephalopathy 
? Hepatorenal syndrome.

๐‘ป๐’“๐’†๐’‚๐’•๐’Ž๐’†๐’๐’• ๐’‘๐’๐’‚๐’-
1.Tab PAN 40 MG OD
2. TAB . RIFAGUT 550 mg po BD
3. SYP.HEPAMERZ 10 ml Bd
4. SYP. Lactulose 10 ml H/ S
5. Tab udiliv 300 mg po  BD.
6. Inj . Ciprofloxacin 500mg iv Bd
7. Daily abdominal girth .
๐ด๐‘›๐‘‘ ๐‘ ๐‘Ž๐‘™๐‘ก ๐‘Ÿ๐‘’๐‘ ๐‘ก๐‘Ÿ๐‘–๐‘๐‘ก๐‘’๐‘‘ ๐‘‘๐‘–๐‘’๐‘ก ๐‘–๐‘  ๐‘”๐‘–๐‘ฃ๐‘’๐‘› ๐‘ก๐‘œ ๐‘Ÿ๐‘’๐‘‘๐‘ข๐‘๐‘’ ๐‘กโ„Ž๐‘’ ๐‘Ž๐‘๐‘‘๐‘œ๐‘š๐‘–๐‘›๐‘Ž๐‘™ ๐‘‘๐‘–๐‘ ๐‘ก๐‘’๐‘›๐‘ ๐‘–๐‘œ๐‘› ๐‘Ž๐‘  ๐‘Ÿ๐‘’๐‘ก๐‘Ž๐‘–๐‘›๐‘–๐‘›๐‘” ๐‘œ๐‘“ ๐‘กโ„Ž๐‘’ ๐‘“๐‘™๐‘ข๐‘–๐‘‘ ๐‘–๐‘  ๐‘Ÿ๐‘’๐‘‘๐‘ข๐‘๐‘’๐‘‘ ๐‘๐‘ฆ ๐‘๐‘Ÿ๐‘œ๐‘ฃ๐‘–๐‘‘๐‘–๐‘›๐‘” ๐‘Ž ๐‘ ๐‘œ๐‘‘๐‘–๐‘ข๐‘š ๐‘Ÿ๐‘’๐‘ ๐‘ก๐‘Ÿ๐‘–๐‘๐‘ก๐‘’๐‘‘ ๐‘‘๐‘–๐‘’๐‘ก.

๐‘ช๐’‚๐’”๐’† 3 ๐’๐’Š๐’๐’Œ-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006004-case-presentations.html

๐‘ช๐’‰๐’†๐’Š๐’‡ ๐’„๐’๐’Ž๐’‘๐’๐’‚๐’Š๐’๐’•๐’”
• Fever since 3 months 
• Cough with expectoration since 2 months 
• Dyspnea on exertion since 2 months 
• Vomiting since 2 months 
• Decreased appetite and weight loss over last 2 months 
• Dark coloured stools since 2 weeks. 

๐‘ซ๐’Š๐’‚๐’ˆ๐’๐’๐’”๐’Š๐’”
Amoebic liver abscess with rupturing into pleural cavity with Right lung basal consolidation. 

๐‘ป๐’“๐’†๐’‚๐’•๐’Ž๐’†๐’๐’• ๐’‘๐’๐’‚๐’-
1.Inj. Metronidazole 750mg/iv/Tid
2.inj.Ceftriaxone 1gm/iv/bd
3.Inj.pantoprazole 40mg/iv/OD
4.inj paracetamol 1gm/Iv/sos
5.Tab.paromomycin 500mg/Tid
6.syp.Ambrolyte 5ml/Tid
7.Temperature/Respiratory rate /blood pressure/SpO2monitoring. 

๐‘บ๐’‰๐’๐’“๐’• ๐’„๐’‚๐’”๐’†๐’”
๐‘ช๐’‚๐’”๐’† 4 ๐’๐’Š๐’๐’Œ-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006001-case-presentations.html

๐‘ช๐’‰๐’†๐’Š๐’‡ ๐’„๐’๐’Ž๐’‘๐’๐’‚๐’Š๐’๐’•๐’”-
• Vomitings
• Abdominal pain since 4days
• Swelling of right foot non pitting type
• Anorexia,myalgia,fatigue and anasarca since 5days

๐‘ซ๐’Š๐’‚๐’ˆ๐’๐’๐’”๐’Š๐’”
Acute kidney injury , secondary to acute tubular necrosis , due to snake bite . 



๐‘ป๐’“๐’†๐’‚๐’•๐’Ž๐’†๐’๐’• ๐’‘๐’๐’‚๐’

1. 4 sessions of haemodialysis
2. Inj zofer 4 mg TID
3. Inj pan 40 mg Od
4. Strict input / output    charting.

๐‘ช๐’‚๐’”๐’† 5 ๐’๐’Š๐’๐’Œ-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006003-case-presentations.html

๐‘ช๐’‰๐’Š๐’†๐’‡ ๐’„๐’๐’Ž๐’‘๐’๐’‚๐’Š๐’๐’•๐’”-
• Itchy Ring leisons over arms ,abdomen ,thigh and groin since 1 and half year
•  Purple stretch marks all over abdomen ,lower back ,upper limbs ,thighs since 1 year
•  Abdominal distension
•  Facial puffiness since 6 months
•  Pedal edema since 3 months
• Low back ache since 3 months .

๐‘ซ๐’Š๐’‚๐’ˆ๐’๐’๐’”๐’Š๐’”
Iatrogenic cushings syndrome
Tinea Corporis
Denovo HTN

๐‘ป๐‘น๐‘ฌ๐‘จ๐‘ป๐‘ด๐‘ฌ๐‘ต๐‘ป ๐‘ท๐‘ณ๐‘จ๐‘ต
Ointment AMLORFINE 
• FUSIDIC ACID CREAM.
• SALINE COMPRESS OVER LEISONS.

This was the treatment given for tinea corporis.
• Tab. Telma 20 mg OD-for left ventricular hypertrophy
• Tab.Hizone 15mg TID-as there was suppresion of HPA Axis.

25/6/21
• Dose of tab. Hizone was reduced to 10mg.
• Tab. Shelcal 500mg OD
• Tab.Vitamin D3 OD
• Tab. Ultracet SOS

6/8/21
• Telma dose increased to 40mg OD
• Tab Itraconazole 100 mg BD
• lulifin cream
• Tab levocitrixine 5mg od.
• Ultracet tab.is continued


๐‘ช๐’‚๐’”๐’† 6 ๐’๐’Š๐’๐’Œ-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006002-case-presentations.html

๐‘ช๐’‰๐’Š๐’†๐’‡ ๐’„๐’๐’Ž๐’‘๐’๐’‚๐’Š๐’๐’•๐’”-
• Fever since 3 months 
• Cough with expectoration since 2 months 
• Dyspnea on exertion since 2 months 
• Vomiting since 2 months
• Decreased appetite
• weight loss over last 2 months 
• Dark coloured stools since 2 weeks. 

๐ƒ๐ข๐š๐ ๐ง๐จ๐ฌ๐ข๐ฌ
Heart failure with reduced ejection fraction-27%
Type 2 diabetes mellitus

๐“๐ซ๐ž๐š๐ญ๐ฆ๐ž๐ง๐ญ ๐ฉ๐ฅ๐š๐ง
• Tab Lasix 80mg in the morning, 40mg in the afternoon and evening 
•  Tab Isosorbide mononitrate 10mg twice a day 
• Tab Hydralazine 25mg  
• Tab Telma 40mg 
• Tab Metformin 500mg once a day 

He was advised to take  fluids  less than 1 litre and salt restriction of less than 2grams/day to avoid retention of fluid in the abdomen.


๐3.

๐‹๐จ๐ง๐  ๐œ๐š๐ฌ๐ž

๐‚๐š๐ฌ๐ž ๐ฅ๐ข๐ง๐ค-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006003-case-presentations.html?m=1

A 44 year old man presented to OPD  with a 3-day history of bilaterally symmetrical rapidly progressive generalized edema.

The symptomatology of the case was accurately presented . All the positive findings of acute glomerulopathy and chronic problem were clearly discussed along with the favouring features of inflammatory pathology  were elaboratively diacussed before coming into the final diagnosis which is acute glomerulonephritis secondary to Amyloidosis, anaemia of chronic disease secondary to poorly treated rheumatoid arthritis.


Short cases-

Case link-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006003-case-presentations.html

A 19 year old male resident of Nalgonda and currently studying intermediate ,came to opd with complaints of :
-Itchy Ring leisons over arms ,abdomen ,thigh and groin since 1 and half year ,Purple stretch marks all over abdomen ,lower back ,upper limbs ,thighs since 1 year ,Abdominal distension and facial puffiness since 6 months, Pedal edema since 3 months , Low back ache since 3 months .

The case was presented in chronological order , he was diagnosed with Iatrogenic cushings syndrome which means raised cortisol levels due to over use of Clobetasol which is a corticosteroid.
The patient was also referred to dermatologist for the treatment of tinea corporis and also to the opthalmologist .
The patient has also lost his self esteem and was also referred to psychiatry department.

Case link-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006002-case-presentations.html

35 year old man working as a food caterer  presented to our OPD with the chief complains of  :-
Dyspnea at rest since 5 days 
Cough with expectoration since 5 days 
Bilateral pedal edema since 4 days 
Abdominal distension since 3 days

The symptomatology was clearly and compactly explained.Upon examining the abdomen through ultrasound grade 1 fatty liver as he was an alcoholic,mild ascites so was advised salt restricted diet  and right pleural effusion. On analyzing all the investigation reports and examinations he is diagnosed with Heart failure  with reduced ejection fraction  and denovo detected type 2 diabetes mellitus.


๐—ค4.๐—ง๐—ต๐—ถ๐˜€ ๐—ถ๐˜€ ๐˜๐—ต๐—ฒ ๐—น๐—ถ๐—ป๐—ธ ๐˜๐—ผ ๐—บ๐˜† ๐—ฐ๐—ฎ๐˜€๐—ฒ ๐˜„๐—ต๐—ถ๐—ฐ๐—ต ๐—ถ ๐˜„๐—ฎ๐˜€ ๐—ฎ๐˜€๐˜€๐—ถ๐—ด๐—ป๐—ฒ๐—ฑ ๐˜๐—ต๐—ถ๐˜€ ๐—บ๐—ผ๐—ป๐˜๐—ต.
๐—–๐—”๐—ฆ๐—˜ ๐—Ÿ๐—œ๐—ก๐—ž-http://srinaini25.blogspot.com/2021/08/genmedicine.html

๐—ค5.Reflective logging  of one's own experiences is a vital tool toward competency development in medical education and research. 

๐Œ๐จ๐ง๐ญ๐ก ๐›๐ฒ ๐ฆ๐จ๐ง๐ญ๐ก ๐ฐ๐ž ๐š๐ซ๐ž ๐ ๐ž๐ญ๐ญ๐ข๐ง๐  ๐š ๐ง๐ฎ๐ฆ๐›๐ž๐ซ ๐จ๐Ÿ ๐๐ข๐Ÿ๐Ÿ๐ž๐ซ๐ž๐ง๐ญ ๐จ๐ฉ๐ฉ๐ฎ๐ซ๐ญ๐ฎ๐ง๐ข๐ญ๐ข๐ž๐ฌ ๐ญ๐จ ๐ฅ๐ž๐š๐ซ๐ง ๐ญ๐ก๐ž ๐ฌ๐ฎ๐›๐ฃ๐ž๐œ๐ญ ๐›๐ž๐ญ๐ญ๐ž๐ซ.๐ˆ๐ง ๐ญ๐ก๐ž ๐ฌ๐ญ๐š๐ซ๐ญ๐ข๐ง๐  ๐จ๐Ÿ ๐ญ๐ก๐ž ๐ฆ๐จ๐ง๐ญ๐ก ๐ฐ๐ž ๐ฐ๐ž๐ซ๐ž ๐š ๐›๐ข๐ญ ๐๐ข๐ฌ๐š๐ฉ๐ฉ๐จ๐ข๐ง๐ญ๐ž๐ ๐ญ๐ก๐š๐ญ ๐ฐ๐ž ๐ฐ๐ž๐ซ๐ž ๐ง๐จ๐ญ ๐š๐›๐ฅ๐ž ๐ญ๐จ ๐š๐ญ๐ญ๐ž๐ง๐ ๐œ๐ฅ๐ข๐ง๐ข๐œ๐š๐ฅ ๐ฉ๐จ๐ฌ๐ญ๐ข๐ง๐ ๐ฌ ๐š๐ฅ๐ญ๐ก๐จ๐ฎ๐ ๐ก ๐ฐ๐ž ๐ฐ๐ž๐ซ๐ž ๐ข๐ง ๐ญ๐ก๐ž ๐œ๐จ๐ฅ๐ฅ๐ž๐ ๐ž,๐›๐ฎ๐ญ ๐ข ๐ซ๐ž๐š๐ฅ๐ฅ๐ฒ ๐ญ๐ก๐š๐ง๐ค ๐ญ๐ก๐ž ๐ ๐ž๐ง๐ž๐ซ๐š๐ฅ ๐ฆ๐ž๐๐ข๐œ๐ข๐ง๐ž ๐๐ž๐ฉ๐š๐ซ๐ญ๐ฆ๐ž๐ง๐ญ ๐Ÿ๐จ๐ซ ๐š๐ฅ๐ฅ๐จ๐ฐ๐ข๐ง๐  ๐ฎ๐ฌ ๐ญ๐จ ๐ญ๐š๐ค๐ž ๐ญ๐ก๐ž ๐ก๐ข๐ฌ๐ญ๐จ๐ซ๐ฒ ๐จ๐Ÿ ๐ญ๐ก๐ž ๐ฉ๐š๐ญ๐ข๐ž๐ง๐ญ ๐๐ข๐ซ๐ž๐œ๐ญ๐ฅ๐ฒ.๐ˆ๐ญ ๐ฐ๐š๐ฌ ๐š๐ง ๐ž๐ฑ๐œ๐ž๐ฉ๐ญ๐ข๐จ๐ง๐š๐ฅ ๐ž๐ฑ๐ฉ๐ž๐ซ๐ข๐ž๐ง๐œ๐ž ๐จ๐Ÿ ๐๐ข๐ซ๐ž๐œ๐ญ๐ฅ๐ฒ ๐ญ๐š๐ฅ๐ค๐ข๐ง๐  ๐ญ๐จ ๐š๐ง๐ ๐ฉ๐š๐ญ๐ข๐ž๐ง๐ญ ๐š๐ง๐ ๐ญ๐š๐ค๐ข๐ง๐  ๐ญ๐ก๐ž ๐ก๐ข๐ฌ๐ญ๐จ๐ซ๐ฒ!๐€๐ง๐ ,๐š๐ฅ๐ฌ๐จ ๐ญ๐ก๐ž ๐ž-๐ฅ๐จ๐ ๐ฌ ๐ฐ๐ก๐ข๐œ๐ก ๐ฐ๐ž ๐ก๐š๐ฏ๐ž ๐›๐ž๐ž๐ง ๐ ๐ข๐ฏ๐ž๐ง ๐ญ๐จ ๐ซ๐ž๐ฏ๐ข๐ž๐ฐ ๐ญ๐ก๐ข๐ฌ ๐ฆ๐จ๐ง๐ญ๐ก ๐ฐ๐ž๐ซ๐ž ๐ฏ๐ž๐ซ๐ฒ ๐ž๐ฅ๐š๐›๐จ๐ซ๐š๐ญ๐ข๐ฏ๐ž๐ฅ๐ฒ ๐ฉ๐ซ๐ž๐ฌ๐ž๐ง๐ญ๐ž๐ ,๐ฐ๐ž ๐ ๐จ๐ญ ๐ญ๐จ ๐ฅ๐ž๐š๐ซ๐ง ๐ก๐จ๐ฐ ๐›๐ซ๐ข๐ž๐Ÿ๐ฅ๐ฒ ๐ฐ๐ž ๐š๐ซ๐ž ๐ฌ๐ฎ๐ฉ๐ฉ๐จ๐ฌ๐ž๐ ๐ญ๐จ ๐ฉ๐ซ๐ž๐ฌ๐ž๐ง๐ญ ๐ญ๐ก๐ž ๐œ๐š๐ฌ๐ž ๐š๐ง๐ ๐ก๐จ๐ฐ ๐ฐ๐ž ๐š๐ซ๐ž ๐ฌ๐ฎ๐ฉ๐ฉ๐จ๐ฌ๐ž๐ ๐ญ๐จ ๐œ๐จ๐ฆ๐ž ๐ญ๐จ ๐ญ๐ก๐ž ๐Ÿ๐ข๐ง๐š๐ฅ ๐๐ข๐š๐ ๐ง๐จ๐ฌ๐ข๐ฌ.๐’๐จ,๐š๐ฅ๐ญ๐จ๐ ๐ž๐ญ๐ก๐ž๐ซ ๐ญ๐ก๐ข๐ฌ ๐ฆ๐จ๐ง๐ญ๐ก ๐ก๐š๐ฌ ๐›๐ž๐ž๐ง ๐ฏ๐ž๐ซ๐ฒ ๐ข๐ง๐ฌ๐ญ๐ซ๐ฎ๐œ๐ญ๐ข๐ฏ๐ž.












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