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...
I) 45 yr old lady who is a housewife and had DM 2 since 5yrs and HTN since 1yr. She was apparently normal 6months back,used to develop pedal edema on and off aggravates on walking and relieves on taking rest for which she was taken to nalgonda hospital and the doctor had advised her to decrease the fluid intake and gave some medications.It was associated with shortness of breath grade 3. 5days back she had developed pedal edema which got progressed and developed abdominal distension,facial puffiness associated with decreased urine output,sob even at rest and chest pain on right side, non radiating with intermittent palpitations. More here: https://alekyatummala.blogspot.com/2020/09/45-yr-female-with-anasarca.html?m=1 1) What is your complete anatomic and etiologic diagnosis from the data available in the patient's online record linked above? (ignore the provisional diagnosis on admission mentioned in the case report) ANS :- DIABETIC NEPHROPATHY with NEPHROTIC RAN...
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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