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/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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60 year old man with shortness of breath since 3 months

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 A 60 yr old man ,daily laborer, resident of nakrekal ,came with chief complaints of shortness of breath since 3 months History of presenting illness Patient was apparently asymptomatic 4 years back .He used to go to work in the fields in the day and had one litter of toddy every day after work. 4yrs back- pt had frequent episodes of giddiness ,1-2 episodes, every 2-3 days, each episode lasting for around 5-10 minutes, not associated with nausea,vomiting,tinnitus, and relieved spontaneously on rest. Pt went to a local hospital after one month, where he was diagnosed to have hypertension and started on medication. He was asymptomatic for 1 year ,continued his daily field work, then he noticed having swelling of both lower limbs,which was insidious in onset and gradually progressive, upto knee, painless and pitting type, associated with generalized weakness. Went to  hospital after one month and found out to have kidney failure requiring dialysis. In 2019,pt visited our hospital...
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