TOPIC: PREDICTORS OF OUTCOMES IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION AND HEART FAILURE ADMITTED TO A RURAL TERTIARY CARE HOSPITAL PROBLEM STATEMENT: HEART FAILURE is one of the leading cause of death at present all over the world. Inspite of the recent advances and extensive research being done in medical field we are unable to find the exact etiology and predictors of mortality and morbidity in many of the patients with HEART FAILURE and the current mode of treatment is only symptomatic. In a rural setup with limited resources: How far we can eliminate the diagnostic and therapeutic uncertainties that persist in a patient with heart failure and what best we can do to improve their outcomes. INTRODUCTION: Inspite of having advancement in field which helps in diagnosing pulmonary hypertension, it remains the disease that takes lot of time for diagnosis from the presence of first symptom, many patients are diagnosed only in advanced stage of disease. 1 Normal pressure in pulmon...
26/M btech,completed 3yrs back non alcoholic and a non smoker , developed vomitings 4-5episodes on23rd December: yellow colored,non bilious,non blood stained contained foodparticles/water. Thenafter patient used to have vomitings every day 2-3episodes or at times multiple episodes for one &half month i.e till feb 11th After 15days of onset of vomitings i.e in January patient went to Suryapet hospital and there for the first time he was said to have high bp-170mmhg and brain imaging was done .Used anti hypertensive drugs for 10days and stopped On February 12th he presented with : 1-multiple episodes of vomitings a day before,2-he noticed decreased urine output since January 3- intermittent shortness of breath on walking for long distance 4-spasm of both calves since 5-6yrs monthly twice/thrice only night times due to which he used to get up from his sleep His creatinine was 15mg/dl On February 13th he was referred to NIMS i/v/o renal biopsy.There his sh...
36 year male presented to casualty at around 8.00pm yesterday with complaints of chest pain and epigastric pain radiating to back since 4.00 pm, associated with profuse sweating. No h/o SOB/palpitations/syncope No h/o vomitings/loose stools No h/o fever/cold/cough No other complaints K/c/o CAD 3 yrs back - s/p PTCA K/c/o HTN since 3 yrs and on treatment (unknown) Not a k/c/o DM/ Asthma/ Epilepsy/ TB Chronic alcoholic & smoker since 15 yrs O/E: pt c/c/c Temp: afebrile PR: 68bpm , irregularly irregular BP: 160/120mmhg RR: 32cpm Spo2: 99% on RA CVS: S1S2 heard , No murmurs RS: BAE + , NVBS P/A: soft , NT CNS: NFND INVESTIGATIONS TROP-I : Negative S.Amylase : 71 S.Lipase : 18 DIAGNOSIS: Proximal LAD STEMI TREATMENT: Inj.Enoxaparin 60mg IV/ stat Inj.Pan 40mg IV/ stat Inj.Zofer 4mg IV/ stat Inj.Tramadol 1 amp in 100 ml NS IV/ over 20 min Tab.Aspirin 325mg stat Tab.Clopidogrel 300mg stat Tab.Atorva 80mg stat Tab.Met-xl 25mg stat No symptomatic relief with these medications Pai...
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