Days of life in medicine

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848627/ Both T2DM and TD are chronic diseases that require lifelong treatment and have a long-lasting effect on cardiovascular health. According to the International Diabetes Federation (IDF), in the year 2017, approximately 425 million adults worldwide were living with diabetes. The total prevalence of diabetes is increasing and is expected to be 629 million by 2045. As per a large European meta-analysis, TD is present in 3.82% of the general population. Its prevalence among those with T2DM is significantly higher, ranging from 9.9 to 48%  A little light on thyroid effect on Diabetes and Vice versa Excess circulating thyroid hormones in hyperthyroidism is associated with poor glycaemic control. When normal individuals develop hyperthyroidism, nearly 2–3% of them develop overt diabetes. Nearly 50% of those with Graves’ disease have some degree of glucose intolerance. Diabetic patients with hyperthyroidism experience worsened glycaemic

On 2/12/2021 A 21 year old girland she has been feeling lonely and has been experiencing this feeling of being isolated since she was 13 years old. Around the same age, her grandmother was diagnosed with Alzheimer’s disease and her prognosis kept detoriating over time. Currently she is in a vegetative stage. The student tells me that her grandmother was very close to her so this caused her feeling even more depressed and lonely. She even consumed a bottle full of iron tablets, in order to end her life. She did visit counselling back then but never initiated medication or spoke to her family regarding these issues she's been facing  1 year back she confronted her mom and she told her how she was feeling and her mother took her to a psychiatrist and that's when she was started on medications 2 months she was diagnosed even with bipolar disorder. She tells that she feels anxious for small things. She then started to experience since 2 months tremors of Bilateral upper limbs and st

Currently in ward, yesterdays admission  A 65 year old man, working as a maestri at Nakrekal presented yesterday to our OPD with the complaints of  Neck pain since 15 days Bilateral lower limb weakness since 15 days  Unable to hold objects with bilateral hands since 12 days Numbness in all the four limbs (UL>LL) A 65 year old man, works as a maestri by occupation and is a father to 5 children gives a history of left femur fracture for which he used splint and other ayurvedic medications. 6 months back he started to experience giddiness after which he was diagnosed to be a diabetic after he was taken to a local hospital and he was initially started on Tab Metformin 500mg OD, he was later started on Tab Glimi M1 OD a month later. Since the past 6 months the patients grandson tells us that he has been developing itchy, hyperpigmented lesions on and off after consuming chicken, or fish. 20 days back after consuming fish he developed scaly itchy hyperpigmented lesions over his lower abdo

 

 

  I've learnt a couple of  life saving procedural skills during my residency program which would help me further in evaluating and save the life of patients, among which some of the nameful skills are performing intubations, 2dechos, usg abdomen and also I've placed a number of central venous lines both for femoral and IJV since the number of visiting CKD patients are more at our rural heath set up. I've also perfomed a couple of lumbar punctures along with pleural taps, ascitic tap along with pericardiocentesis ,Lung biopsy, Liver Biopsy LUNG BIOPSY: LUMBAR PUNCTURE: 2ECHO OF A MYXEDEMA COMA PATIENT WITH PERICARDIAL EFFUSION ADMITTED WITH US ANKLE JERK IN 15 YEAR OLD BOY WITH PARAPARESIS KNEE JERK IN 15 YEAR OLD BOY WITH PARAPARESIS FEMORAL CENTRAL LINE PLACEMENT IJV LINE PLACEMENT DEMONSTRATION OF DEEP TENDON REFLEXES TO MY JUNIORS INVERSION OF BICEPS

A 35 year old man, working at a store for printing wedding cards, from Suryapet presented to the casualty at 8pm with the  complaints of  Fever since 2 months Generalized weakness since 2 months  Dyspnea on exertion since 2 months  Pain abdomen since 20 days Right sided chest pain since 20 days Vomiting since 20 days  Dark coloured stools since 20 days He works at a store that prints wedding cards at Suryapet. He has 2 daughters. Since the past 15 years he has been consuming alcohol everyday, he consumes around 360ml of whiskey per day and his last alcohol intake was yesterday. Since 15 years he has been smoking, he says he only smokes occasionally.  Since the past 2 years he started to experience  loss of appetite. He also tells us that he started consuming less food and started to consume larger amounts of alcohol. He also tells us that he started to experience recurrent episodes of pain abdomen along with recurrent episodes of vomiting every alternate day and he has visited hospital

  The different medical complications observed in a rural medical hospital from  excessive alcohol indulgence and the importance of alcohol abstinence Abstract: Introduction: Alcohol consumption has been identified as an important risk factor for illness, disability, and mortality (Rehm et al. 2009 b ). In this study we discuss the various medical conditions we've come across at a rural medical hospital caused by alcohol and conditions where in alcohol plays a role of a contributing factor and the importance of alcohol abstinence. Materials and methods: This is a prospective study conducted at Kamineni Insitute of Medical Scineces, Narketpally including 70 inpatients after taking their informed consent. Results: The most common disease categories observed during this study entirely or partly caused by alcohol consumption were  liver and pancreatic diseases (49%), neuropsychiatric diseases ( 31%), cardiovascular diseases(13%), diabetes (4%), 3% presenting with multiorgan dys

I've conducted a retrospective study on covid 19 patients evaluating their clinical course and risk factors for mortality. The following is the abstract of the paper I'm currently working on. A retrospective analysis of the clinical course and the risk factors for mortality in covid 19 patients in a rural health center Abstract: Introduction: In December, 2019, Wuhan city, China, became the centre of an outbreak for pneumonia of unknown cause. By January, 2020, Chinese scientists had isolated a novel coronavirus, severe acute respiratory syndrome coronavirus, from these patients with virus-infected pneumonia, which was later designated coronavirus disease 2019 (COVID-19) in February, 2020, by WHO. In this study we discuss the various clinical presentations and the risk factors for mortality observed in  covid 19 patients. Materials and methods: This is a retrospective study conducted at Kamineni Insitute of Medical Scineces, Narketpally including 34 inpatients who were te

In reference to the patient mentioned in the blog here 👇 http://gm-elogbook-anudeep-98.blogspot.com/2021/11/30yr-old-male-with-urinary-retention.html To perform a prospective, placebo-controlled study to examine the long-term efficacy of alfuzosin compared with placebo and standard therapy in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) P - One hundred twenty consecutive men diagnosed with CP/CPPS I - 17 in the alfuzosin C - 20 in the placebo 29 in the control/standard group O -  At the end of 6 months of active therapy, the alfuzosin group had had a statistically significant decrease in total NIH-CPSI score compared with the placebo and control/standard groups (9.9, 3.8, and 4.3 decrease, respectively, P = 0.01). A statistically significant improvement occurred in the pain score in the alfuzosin group at 6 months compared with the placebo and control/standard groups (P = 0.01), but not in the voiding or quality-of-life score among the three groups. Of the

A 15 year old girl presented to the opd today with the complaints of Bilateral lower limb swelling since 15 days Reduced urine output since 10 days  Abdominal distension since 5 days Facial puffiness since 3 days Dyspnea at rest since 3 days Non productive cough since 3 days  Fever since 1 day She was born out of a 3rd degree consanguinous marriage. She has 2 healthy  siblings. Her father expired when she was 10 years old, he was a chronic alcoholic,  according to her mother who is unsure regarding the cause of his death, she attributes it to ? Respiratory Failure and Liver failure .  According to her mother, her father's elder sister had a kidney disease due to which she expired.  When she was 6 years old - she experienced cough along with dyspnea and low grade fever after which she was diagnosed to have pulmonary kochs for which she used ATT for 6 months.  Her mother works as a daily wage laborer. She finished her 8th grade, she as well is currently working as a daily wage labore

A 74 year old woman presented to the casualty yesterday In altered sensorium since morning 10am  She is an elderly woman, who studied till her 4th grade and has 6 children, 4 sons and 2 daughters. Her husband expired in 1982, according to her son the reason for his father's death  is not clearly known and it was suspected to be due to suicide because of family issues.   30 years back she underwent hysterectomy- secondary to ?fibroids  25 years back on routine check up she was diagnosed to be a Hypertension and diabetic.  She was started on Tab metxl 50mg along with Tab Galvusmet 50/500mg (vildagliptin along with metformin)  10 years back she consulted a local doctor for bilateral lower limb edema and was diagnosed with hypothyroid and was started on Tab thyronorm 100mcg which was later made to 50mcg. 6 years back she experienced chest pain along with dyspnea at rest after which she was diagnosed to have TVD and a CABG was performed. 6 years back - she complained of reduced vision i

History taken in April, 2021 when she got admitted with us A 21 year old woman, hailing from Nalgonda, Telangana presented with the cheif complaints of  Vomiting since 4 days Weakness in all her four limbs since 4pm since day  before yesterday  Patient studied till 10th grade at  Nalgonda government school. She was alright until 1 year back, after which she started finding it hard to control her urine, she started wetting her clothes frequently and her mother would always find her bed wet. She was brought to our hospital where in her mother was told that her right kidney was entirely damaged so they had to place a pipe into her left kidney. She had a gross right hydroureteronephrosis and a moderate left hydroureteronephrosis. A left nephrostomy was done for her along with bladder biopsy, she was on the drain for 6 months after which it was removed. Her bladder biopsy revealed granulomatous picture suspicious of TB.  The patient was diagnosed with Genitourinary TB and Thimble bladder. S

21 year old woman, working as a nurse in an outside hospital, residing at Nalgonda presented to casualty on 26/8/2021 with the chief complaints of  Fever since 4 months  Generalized weakness since 4 months Body pains along with multiple joint pains since 4 months Cough since 1 month  Vomiting 1 day back  Unable to walk since 1 day Unable to pass urine and stool since 1 day She was born out of a non consanguinous marriage. She cried immediately after birth.  At birth - she was in the hospital for 2 - 3 days for jaundice.  Her father works as a shop keeper and her mother works at a chaat bandi. She has 2 elder sisters, both of her sisters work as the nursing staff.  At 13 years of age, she had a history of fall following which she lost all her teeth. She was apparently alright until 1 year back when she noticed swelling in her neck after she went for a checkup to a local hospital where she got diagnosed to be hypothyroid. She was started on Tab thyronorm 100mcg once daily. Few months lat

A 65 year old from ********* presented with the complaints of  Bilateral lower limb swelling since 1 month  Dyspnea on exertion since 20 days Black coloured stools since 20 days  A 65 year old man, previously used to work as a farmer 6 years back, got married to his far relative and has been happily married with 3 children.  He has been an occasional alcoholic and a beedi smoker and smokes around 3 to 4 beedis per day. He smoked last 3 months back. 25 years back, his left index finger was amputated after it got hit by a tractor. 20 years back he got into a fight with his friends following which he had a trauma to his head following which he had one episode of seizure and he was put on antiepileptics, which he used for 3 years and stopped. Since 6 years - He has been experiencing bilateral knee joint pains so much that he stopped working. He paid a visit to our hospital and was advised for a total knee replacement. However, on further investigating him  he was told that he had a heart c

A 20 year old woman presented to our opd on 19/8/2021 with the complaints  Hyperpigmentation of her lips since 1 year Hyperpigmented patches on cheeks and upper limbs since 3 months  20 year old woman, who noticed a hypopigmented patch measuring 1cm into 1cm on her forehead 10 years back after which she consulted a doctor and was diagnosed with leprosy and has been on treatment since 10 years. Since 1 year she has been having hyperpigmentation of her lips. Since the past 3 months she has also noticed hyperpigmented patches on her face following which she developed similar patches on her chest and her bilateral upper limbs. She says these are aggravated post exposure to sun light.  She says these lesions are itchy and scrap on scratching. She was advised skin biopsy on 8/8/2021 and ANA levels by our dermatology department. SKIN BIOPSY REPORT: Serum ANA turned out to be 173 (raised) Her other routine investigations were normal except for he