March monthly assessment

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Final practical examination- long case

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CBBLE UDHC SIMILAR CASES   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.  Informant - Daughter in law  A 85 year old man from Narketpally, who used to work as a merchant in a local market, came with chief complaints of uprolling of eyes, frothing from mouth,and clenching of both fists at 3:30 pm on Saturday. History of presenting illness   Patient was apparently asymptomatic on Saturday morning, had his lunch in the afternoon , sat on his bed, when he suddenly fell on the bed and developed clenching of his hands, uprolling of eyes and moving head to right side associated with frothing from mouth,  lasting for about 3 - 4 minutes. No ...
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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/14760...
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Thesis

 SERUM URIC ACID LEVELS IN TYPE 2 DIABETES MELLITUS AND ITS ASSOCIATION WITH CARDIOVASCULAR RISK FACTORS  Aim :  To study the effect of serum uric acid levels in type 2 diabetes mellitus and its association with cardiovascular risk factors.  Objectives :  To compare serum uric acid levels with other CVD risk factors (hypertension,dyslipidemia,obesity,smoking)among type 2 diabetic subjects.  To compare duration of diabetes and serum uric acid levels Sample size :140 Inclusion criteria : Patients with type 2 diabetes mellitus (irrespective of their glycemic status and duration of diabetes).  Patient’s age > 40 years.  Both sexes were included Exclusion criteria : Patients with the following conditions were excluded from the study   Age <40 yrs Renal failure.  On long term diuretics and steroids.  Chronic Alcohol consumers.  On antimetabolite and chemotherapy drugs.  Hepatic disorders.  Renal transplant pati...
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