March monthly assessment

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Internal assessment

 1 .AKI secondary to ?Nephrotic syndrome secondary to uncontrolled diabetes mellitus, hypertension with Anemia https://www.ncbi.nlm.nih.gov/books/NBK538145/  2. Azotemia due to worsening of third spacing from intravascular depletion (pedal edema , ascites) and poorly controlled diabetes and hypertension  Anemia due to decreased levels of erythropoeitin which is produced in kidney  Hypoalbuminemia due to damage to glomerulus which increases albumin loss in urine. Chronic diseases like hypertension and diabetes also lead to albuminuria  Acidosis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5648741/  Acidosis due to decreased tubular reabsorption of bicarbonate and its decreased production in relation to amount of acid synthesized   3. Sodium bicarbonate to correct acidosis  Kcl to correct hypokalemia . Actrapid insulin for management of diabetes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341062/ https://pubmed.ncbi.nlm.nih.gov/14760875/  Lasix to increase urine output and red
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36 year old man with yellowish discoloration of eyes and urine since 3months

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A 36 year old male who is a master cook by occupation came to opd with complaints of yellowish discoloration of eyes and urine since 3 months HOPI: patient was apparently normal 1 year back ,then he developed lower back ache ,diagnosed with renal calculi and was operated. C/o fever since 3 months         Insidious in onset         Gradually progressive         Subsides on its own         More during nights C/o nausea since 3 months C/o vomitings ( 4 -5 episodes) food particles as content H/o weight loss since 1month C/o pain abdomen intermittently and was admitted in an hospital thrice till now and diagnosed with chronic pancreatitis H/o usage of Herbal medicine 1 month back ,6 times/day for a week H/o pedal edema and abdominal distension 1 month back , used medication for this in Nalgonda PAST HISTORY: Alcoholic and tobacco chewer since 20 years H/o Renal caliculi and was operated for that . PERSONAL HISTORY : Thin built Appetite lost Regular alcoholic and tobacco chewer, stopped 3 mo
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cp

50 yr old female, resident of choutuppal , sweeper by occupation presented to casualty with complaints of  altered sensorium since 1 hr . Pt was apparently asymptomatic 2 days back ,then she started complaining of chest pain which is , transient in the retrosternal area, lasting for 20-30 minutes and then subsided, no h/o radiation ,palpitations, sweating,giddiness. She started complaining of chest pain at 12pm today ,associated with profuse sweating ,giddiness, fell on ground and had involuntary movements in rt upper and lower limb ,after which she was unconscious for 30 min, was taken to govt. hospital 
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