A 38 YR OLD FEMALE CAME TO OPD WITH FEVER, VOMITING AND NOT BEING ABLE TO WALK

 A 38 yr old female patient, sweeper in a fertiliser company by occupation was brought to casualty with fever, vomitings and hypersalivation. She had low grade, intermittent fever which relieves on medication not associated with chills and rigors.

HOPI: She had 5 episodes of vomitings for 2 days which contained food particles, non projectile and non foul smelling. She needed support for walking.

Fever since 3 days, vomitings 5 episodes(12th & 13th June 2022), unable to walk since 2 days

Negative history: no history of shortness of breath, cough, loose stools


Past illness- known hypertensive since 2 years (using medication)

NOT a known case of DM, asthma, tuberculosis, diabetes, asthma, epilepsy, CAD


Personal History: Mixed diet

Bowel And Bladder-Regular 

Sleep Adequate 

No Allergies And Addictions.


Family History: not significant 


General Examination: 

Patient is Conscious, coherent and cooperative.

Moderately Built and Nourished.

Pallor Absent

Icterus Absent

Clubbing Absent

Cyanosis Absent

Lymphadenopathy Absent

Edema Absent 


Vitals : 

Temperature - afebrile 

Pulse:  114/min

B.P: 140/80mmHg

SpO2: 98% on RA

GRBS: high


Systemic examination:

ABDOMEN: Palpable liver, no tenderness, distended abdomen.






Lab diagnosis:
























Pa

Treatment history:


13/6/22



*IVF NS@100ml 



*Inj Monocef@1 gm x IV x BD



*Inj Human Actrapid (1ml+39ml NS)@6ml/hr







14/6/22



*IVF 20NS@100ml/hr



D-1 *Injection monocef 2gm×IV×BD



*Injection human actrapid insulin



                  1ml +39ml NS @ 6ml/hr



*Injection zofer 4mg IV BD



*Injection pan 40mg IV BD



*GRBS 1hourly



*Monitor vitals hourly








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