Online archived Ward rounds from 2013 Bhopal

 Date: Sun, Feb 24, 2013, 3:39 PM

Reviewed 23/f(malabsorption syndrome with Rickets and weakness):

I had shown her to Dr HR and he felt we can also put her on Inj Arachitol (considering that she is having malabsorption). Here is a good study that supports its usage in Vitamin D deficiency:https://www.mja.com.au/journal/2005/183/1/annual-intramuscular-injection-megadose-cholecalciferol-treatment-vitamin-d

Arachitol (3 lac) - Injection, manufactured by Solvay Pharma India Pvt Ltd contains Generic Medicine Vit D3- 300000 iu.
Arachitol (3 lac)- Vit D3- Injection costs about Rs.19.25 per 1 ml in India as of date.
Duracal (3 lac) - Injection, manufactured by Ultramark Healthcare Pvt Ltd. contains Generic Medicine Vit D3- 300000 iu.
Duracal (3 lac)- Vit D3- Injection costs about Rs.18 per 1 ml in India as of date.
Systa D3 (3 lac) - Injection, manufactured by Systacare Remedies contains Generic Medicine Vit D3- 300000 iu.
Systa D3 (3 lac)- Vit D3- Injection costs about Rs.13.25 per 1 ml in India as of date.http://thedu.in/compare_prices/index.php/medicines-s/article/83723-systa-d3-3-lac-vit-d3-injection

I am not sure if we could carry out all the stool tests for malabsorption that we planned yesterday. Prof Ramakantan from KEM, Mumbai feels the X-rays are consistent with Osteomalacia and Hyperparathyroidism.

Ela, Anshul, Kartikeya, Please upload the images (clinical 'jar of pickles,' bowed bones and x rays) to tabula rasa so that it can be discussed there further.

Tue, Feb 19, 2013 at 10:54 PM

ICU 35M CKD What is his Kidney size? Any RBCs in his urine? If his Kidney size is normal we can plan for a biopsy.

For 23/f(malabsorption syndrome with Rickets and weakness):
Check history of current menstruation.
Get X ray Knees bilateral and X ay wrists bilateral (if affording). Collect patient's previous biopsy from Dr Virendra Chowdhury and help them to meet him tomorrow.

Tue, Feb 19, 2013 at 9:16 PM

ICU
42/m(myxodema coma) still in icu bleed from nose, BP-140/90,T-97.4,rbs-148,t3t4tsh report awaited

35/m(CKD)pt is irritable , no fresh complaints
U/C-106/9.10,Ur/m- albumin 3+, sugar trace , pus cell 15-20/HPF bacteria 3+
WBC- 9.3*10*9/l, hb-2.9,plt-66*10*9//l, PT-20 second , INR -1.31
LFT s.protein a-2.9,g-1.7,a/g-1.7,s.bilirubin T-0.39 d-0.27 I-0.12,sgot-19,sgpt-18.3,sap-68

33/m(TB peritonitis & ald) no fresh complaints , Ur/m- albumin -nil, sugar-nil , U/C-57.3/1.75, LFT- s.protein T-5.0,a-1.5,g-3.5,a/g-0.4 s.bilirubin T-1.5,d0.77,i-0.73 sgot-117,sgpt-21.3,sap-259
Peritoneal biopsy - suggestive of chronic granulomatous infiltration (?tubercular)

62/m(tbm) no fresh complaints ,
Na/k-122/5.34
Ct- sub acut infarct in bilateral frontal region in ACA territory in left capsular thalamic region tributaries of PCA, peri ventricular ischemic changes

65/m(cva) c/o pt is unconscious and shift to icu.

FMW

27/f(5month anc with viral hepatitis) no fresh complaints ,
U/C-5.4/0.31 ,sgot-1110,sgpt-844,sap-175,albumin-2.5,PT-30 second , INR 2.1 ,aptt-38 second , hb -9.7, Na/k-131/2.8 shift to fmw

50/f(foreign body sensation in neck) no fresh complaints , U/C-37.3/0.63

60/m(t2dm) no fresh complaints , hba1c-9.80,rbs -281

23/f(malabsorption syndrome with Rickets and weakness)

MMW

60/m(k/c/o HTN ) rbs-93,u/c-44/2.18,hb-9,adv - 2d echo

42/m(rt hemiperesis with facial paralysis ) report awaited , adv - c.ecosprin av

60/m(k/c/o t2dm with htn) no fresh complaints fbs/ppbs-123/268

40/m(pTB) no fresh complaints att cat 1 started

80/m c/o chest pain , neurophysician ref due

50/m(cml) no fresh complaints report awaited

65/m(?ald) c/o swelling over both legs , ascites, jaundice report awaited

18/m c/o pain in abdomen plan for usg guided fnac for lymph node
FHDU

45/f(CAD with post MI with CHF) no fresh complaints , wbc-7.4*10*9/l,hb -11, Na/k-140/3.2,U/C-27.4/0.76

47/f(old pTB with b/l fibrosed lungs ) no frsh complaints and pt is on intermitent oxygen

65/f c/o- echymosis all over the body chest pain *1day

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