A 19 yr old male complains of vomitings..

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 I have been given this case to solve in an attempt to understand the topic of “patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations, and come up with diagnosis and treatment plan

D.Santhosh (Internee)


Cheif complaints :
A 19 yr old male presented with complaints of...
- Vomitings since yesterday,
- Diarrhoea since yesterday
- Headache since morning

History of presenting Illness :
- Patient was apparently asymptomatic 1 day back then after consumption of outside food; he developed .....

- Vomitings - 5 episodes, contains food particles, non bilious, non projectile, 
- Diarrhoea - 11 episodes , not associated with stomach pain.
- Headache - frontal region, non radiating, no photophobia
-  No H/o burning micturition.
-  No H/o fever, hemetemesis.

Past history :
Not a known case of HTN, DM, TB, Asthma Epilepsy.

Personal history :
Diet - mixed,
Appetite - Decreased
Sleep - Adequate
Bowel movements - Increased

Family history :
Insignificant

General examination :
Patient is conscious, coherent  cooperative and well oriented to time, place and person.
No signs of pallor, icterus, cyanosis ,clubbing, lymphadenopathy and edema

VITALS
Temp - afebrile
PR - 100
BP - 120/80 mm hg
Spo2 - 99 at RA
RR - 16CPM.

Systemic examination :

Cvs :
S1 and S2 heard; no murmurs.

RS :
BAE+ , NVBS present.

P/A :
Soft and non tender

CNS : NO Abnormality detected

INVESTIGATIONS 

Hemogram on 11/01/23,
Hb - 17.4 mg/dl
TLC - 9200 /mm3
PLT - 2.6 lakh 

on 14/01/23,
Hb - 15.9 mg/dl
TLC - 5200 /mm3
PLT - 1.7 lakh


ECG : Normal sinus rhythm

USG ABDOMEN : Mild central IHBRD


TREATMENT GIVEN :

- Tab TAZIM 200 mg PO/BD
- Tab METROGYL 400 mg PO/TID
- Tab PAN 40mg/BD
- Tab ZOFER 4mg IV/SOS
- Tab BECOZINC PO/OD
- ORS Sachets + 200 ml of water after every episode of vomiting
- Plenty of water intake

PROVISIONAL DIAGNOSIS :

Acute gastroenteritis toxin mediated? anaerobic bacterial?

Follow up
- Tab METROGYL 400mg PO/TID for 2 days
- Tab TAXIM 200mg PO/BD  for 2 days
- Tab PAN 40mg PO/BD for 5 days
- Tab BECOZINC PO/OD for 7 days
- Plenty of water intake






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