A 50M with C/o Bilateral Pedal Edema

A 50Y M Came with C/o Pedal Edema since 1 week

HOPI:-

Patient was apparently asymptomatic 1 Year back then he developed back pain for which he went to local hospital and diagnosed to have CKD. He was on Conservative management, 3 months back he had Pedal edema and started on hemodialysis since May 25 which was his last follow up.

Pedal edema is present

Blood transfusion of PRBC done on 02/09/23

Dialysis was done on:-

21/8/2023

24/8/2023

30/8/2023

02/9/2023

04/9/2023

23/9/2023

27/9/2023

30/9/2023

02/10/2023

07/10/2023

Past History:

K/C/O CKD since March 2023

K/C/O DM2 since 4 years on Insulin ( Irregular Medication)

K/C/O HTN, CVA, CAD, Epilepsy

Surgical history:-

4 years back 2nd right toe amputation done (Diabetic)

In March RIGHT IJV was placed and removed in May.

On Examination:-

Patient was conscious, coherent and cooperative

No signs of Pallor, Icterus, Cyanosis, Clubbing, Lymphadenopathy

Vitals:-

Temp- 98.4F

PR- 96 BPM

RR- 18 CPM

BP- 130/80 MM HG

SpO2- 96% at Room Atmosphere

Systemic examination:-

CVS- S1 S2 +, no murmurs

CNS- NFND

RS- BAE+, NVBS

P/A- Soft , Non Tender, No organomegaly

Investigations-

LFT Done on 18-08-2023

RFT Done on 18-08-2023

CBP- done on 18-08-2023

HbsAg- Done on 19-08-2023

Anti HCV antibodies - done on 19-08-2023

CBP- done on 31-08-2023

RFT Done on 31-08-2023

CBP- done on 03-09-2023

Treatment Adviced-

1. FluidRestriction < 1.5L/day

2. Salt Restriction < 2g/day

3. INJ. EPO 4000 IU/SC/Twice weekly

4. INJ. Iron sucrose 100 mg in 100 ml NS Once Weekly

5. Tab. Nodosis 500mg PO/BD

6. Tab. Orofer XT PO/BD

7. Tab. Shelcal 500mg PO/OD

8. INJ. Piptaz 2.5g IV/TID for 3 days

Comments

43F Patient came to opd with c/o Bilateral pedal edema

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. 43F Patient came to opd with c/o Bilateral pedal edema since 1 month. Patient was apparently asymptomatic till 1 month ago then she developed c/o B/L pedal edema (pitting type, extending upto the knee) and chest discomfort (now subsided) now patient has c/o tingling of Rt. Upper limb. Pt has come for regular checkup of HTN& DM Had H/o UTI 1 month ago Numbness in Rt upper limb and Rt lower limb since 1 month. PAST HISTORY:k/c/o Diabetes since 10 yrs and is on Insulin HAI 15U- 20U- 25U. k/c/o hypothyroidism since 6 yrs and is on Tab. Thyroxine 125mg PO/OD k/c/o Hypertension since 2

A 70 YR OLD MALE WITH ALTERED SENSORIUM AND HYPONATREMIA.

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. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome." CASE: A 70 year old male came with chief complaints of : 1) Altered behaviour since afternoon. 2) Involuntary movements of the both upper limbs and lower limbs since 4pm along with loss of speech and involuntary movements of the mouth. HOPI: Patient was a security guard by occupation in Hyderabad 20 years back and there sons brought him to their village 20 years back and was doing nothing since then. He was normal till 1 month back and started developing decr

171 MK Farhan, E Log Cases

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