A 29-year-old female presented with severe frontal headache, vomiting, and neck stiffness for one week. A lumbar puncture revealed cryptococcal meningitis. She was started on amphotericin B and fluconazole for induction and consolidation therapy. Monitoring showed worsening anemia and kidney injury from the amphotericin B treatment. The patient's symptoms improved but serial lumbar punctures and cultures were needed to ensure sterilization of the cerebrospinal fluid and check for potential drug resistance before completing the full antifungal treatment course.
Stroke is the 2nd leading death associated disorder. It is also known as cerebrovascular disorder mainly caused by high blood cholesterol levels or rupture of cerebral arteries.
3. a case study on plasmodium falciparum with thrombocytopenia with viral hep...Dr. Ajita Sadhukhan
A 20-year old male patient was admitted to the male medicine ward with complaints of fever with chills since 1 week, headache, abdominal pain, nausea, vomiting, yellowish sclera, yellowish urine, anorexia, general weakness since 10 days.
A 50-year-old male was admitted with swelling of the lower limbs, fever, chills, vomiting, and diarrhea. He has a history of chronic kidney disease and malaria. On examination, he was febrile and had pallor, icterus, and tenderness in the abdomen. Laboratory tests showed decreased hemoglobin and kidney function. He was diagnosed with chronic kidney disease exacerbation and malaria and treated with IV fluids, antibiotics, antimalarials, and other medications. His condition improved and he was discharged on medications including antibiotics and supplements with counseling on diet, lifestyle and medication adherence.
A 29-year-old female presented with severe frontal headache, vomiting, and neck stiffness for one week. A lumbar puncture revealed cryptococcal meningitis. She was started on amphotericin B and fluconazole for induction and consolidation therapy. Monitoring showed worsening anemia and kidney injury from the amphotericin B treatment. The patient's symptoms improved but serial lumbar punctures and cultures were needed to ensure sterilization of the cerebrospinal fluid and check for potential drug resistance before completing the full antifungal treatment course.
Stroke is the 2nd leading death associated disorder. It is also known as cerebrovascular disorder mainly caused by high blood cholesterol levels or rupture of cerebral arteries.
3. a case study on plasmodium falciparum with thrombocytopenia with viral hep...Dr. Ajita Sadhukhan
A 20-year old male patient was admitted to the male medicine ward with complaints of fever with chills since 1 week, headache, abdominal pain, nausea, vomiting, yellowish sclera, yellowish urine, anorexia, general weakness since 10 days.
A 50-year-old male was admitted with swelling of the lower limbs, fever, chills, vomiting, and diarrhea. He has a history of chronic kidney disease and malaria. On examination, he was febrile and had pallor, icterus, and tenderness in the abdomen. Laboratory tests showed decreased hemoglobin and kidney function. He was diagnosed with chronic kidney disease exacerbation and malaria and treated with IV fluids, antibiotics, antimalarials, and other medications. His condition improved and he was discharged on medications including antibiotics and supplements with counseling on diet, lifestyle and medication adherence.
13. a case study on convulsions in a kco epilepsy with lactational amenorrhoeaDr. Ajita Sadhukhan
A 25 year old female patient was admitted to the female medicine ward with complaints of 2 and a half month amenorrhoea, epileptic fit convulsions at home, vertigo, generalised weakness and 1 episode of epileptic fit today evening.
This document presents the case of a 12-year-old male patient admitted with nephrotic syndrome. On examination, the patient had edema, elevated cholesterol, and urine analysis showed albumin and epithelial cells. Based on these findings, the patient was diagnosed with nephrotic syndrome. He was started on medications including prednisolone and furosemide. Over five days of treatment, his symptoms improved as seen in decreasing blood pressure and resolution of edema. He was counseled on diet and medication compliance and asked to follow up in one week.
The document discusses guidelines for diagnosing and treating systemic lupus erythematosus (SLE) and lupus nephritis. It provides details on classifying lupus nephritis based on the ISN/RPS system and describes the patient's biopsy results of class IV diffuse lupus nephritis with active and chronic features. Treatment guidelines and monitoring of SLE and lupus nephritis are also reviewed.
Sinus Bradicardia on grade II dengue hemorragic fever.pptxSyahrulAdzim
This case report describes a 37-year-old man diagnosed with Grade II dengue hemorrhagic fever who presented with sinus bradycardia. Laboratory tests confirmed dengue infection and showed thrombocytopenia and elevated liver enzymes. Chest X-ray found left pleural effusion. The patient was treated conservatively with IV fluids, antiemetics, and analgesics. Dengue virus can cause myocardial inflammation and arrhythmias like bradycardia through direct viral invasion or immune mediated mechanisms. This case emphasizes that bradycardia is a common finding in dengue that results from the cardiac effects of the viral infection.
SAI DEEPAK CASE STUDY ON CHRONIC KIDNEY DISEASESaiDeepakS1
A 35-year old female patient presented with chest pain, breathlessness, body pain and lack of appetite. Laboratory investigations revealed severe anemia and renal dysfunction. She was diagnosed with pneumonia and chronic kidney disease. She was started on medications including sodium bicarbonate, folic acid, nifedipine, carvedilol, atorvastatin and calcitrol. She was counselled about her disease, medications, lifestyle modifications including diet, exercise and stress reduction.
The document summarizes the case of an 8-year-old girl admitted to the hospital with tea-colored urine. She was diagnosed with acute glomerulonephritis based on lab tests showing hematuria, proteinuria, and low complement levels. Her symptoms improved over her hospital stay with IV fluids and medications. She was discharged after 6 days with medications and advised to follow up in 2 weeks and longer term to monitor resolution of her symptoms.
This case report describes a 38-year-old man admitted to the hospital with black stools for 20 days and shortness of breath for 5 days. Examination found pallor and bruises. Tests showed severe anemia, elevated coagulation times, and a positive HCV antibody test. Upper endoscopy revealed stomach and duodenal erosions with oozing blood. The patient was diagnosed with type 1 von Willebrand disease based on a low von Willebrand factor level. He received transfusions, cryoprecipitates, factor replacement therapy, and endoscopic coagulation to treat his gastrointestinal bleeding.
This case report describes a 38-year-old man admitted to the hospital with black stools for 20 days and shortness of breath for 5 days. Examination found pallor and bruises. Tests showed severe anemia, elevated coagulation times, and a positive HCV antibody test. Upper endoscopy revealed stomach and duodenal erosions with oozing blood. The patient was diagnosed with type 1 von Willebrand disease based on a low von Willebrand factor level. He received transfusions, cryoprecipitates, factor replacement therapy, and endoscopic coagulation to treat his gastrointestinal bleeding.
Case Presentation Dr. Hosam Fouda Supervised by Dr. Tarek TantawyAhmed Albeyaly
This document presents the case of a 48-year-old male patient with a history of membranous nephropathy who presented with shortness of breath and swelling of the face and lower limbs. Various tests were performed which showed nephrotic syndrome. The patient was previously treated with steroids and cyclosporine, achieving remission. The document discusses the diagnosis of membranous nephropathy, treatment options including conservative management and immunosuppressive drugs, risks and benefits of treatment, and contraindications to immunosuppressive therapy.
1) A 45-year-old male soldier presented with 8 days of fever and 2 days of a maculopapular rash. Initial investigations showed thrombocytopenia. NS1 and IgM tests were positive for dengue.
2) Differential diagnoses included dengue, chikungunya, malaria, and other viral fevers. The patient was managed as a case of dengue hemorrhagic fever with platelet transfusions and IV fluids.
3) Over subsequent days, the patient's platelet count and other investigations improved. He recovered well and was discharged on day 10 with a platelet count of 170,000. The final diagnosis was dengue hemorrhagic fever.
Case Presentation on Venous Thromboembolism.pptxJoel M Johns
This is a case presentation for Pharm. D students.
Disclaimer:
This presentation is purely for educational purpose only.
The patient described in this case does not resemble anyone in reality, living or dead.
Any resemblance is considered as co-incidential.
14. a case study on diabetes mellitus type 1 with diabetic ketoacidosis cp in...Dr. Ajita Sadhukhan
A 26 year old male patient was admitted to the male medicine ward with complaints of nausea, vomiting, generalised weakness, anxiety, decreased appetite, headache since noon.
This case involves a 30-year old woman presenting with a wide range of symptoms over 12 months including fatigue, arthritis, rashes, oral ulcers, hair loss, and kidney problems. Physical exam and lab tests confirmed she meets enough criteria for a diagnosis of systemic lupus erythematosus (SLE) with class IV lupus nephritis. Her treatment plan includes cyclophosphamide, steroids, ACE inhibitors, and later azathioprine to control her SLE and protect her kidneys. Her response is being monitored through disease markers and renal function.
This document presents a case report of an 88-year-old male admitted to the hospital with community-acquired pneumonia. He presented with a cough, expectoration, fever and shortness of breath. He has a past medical history of diabetes and heart disease. Examination findings and investigations confirmed left lower lobe pneumonia with sepsis. He was treated with antibiotics, antipyretics, PPI and antivirals. His symptoms improved over 4 days and he was discharged on medications including clarithromycin and oseltamivir for 5 more days. Pharmacist interventions addressed drug interactions and monitoring parameters were discussed.
The document summarizes a patient's medical report during hemodialysis treatment. It includes information on the patient's medical history, physical examination findings, lab results, dialysis monitoring, diagnosis of end stage renal disease due to diabetes and hypertension, and treatment plan to address issues like intradialytic hypotension and anemia management through diet, medication, and ensuring adequate dialysis.
Acute glomerulonephritis is an acute inflammation of the renal glomeruli characterized by sudden onset of oliguria, hematuria, hypertension and edema. It is commonly caused by a streptococcal infection and results in the deposition of immune complexes in the glomeruli. On pathology, glomeruli appear enlarged and infiltrated by polymorphs with epithelial crescents. Immunofluorescence shows "lumpy-bumpy" deposits of immunoglobulin and complement. Management involves controlling hypertension and edema with diuretics, treating any underlying infection, and managing complications such as acute renal failure. The prognosis is generally good with complete recovery in most cases.
Inpatient Case Presentation. Kyle CriscoKyle Crisco
Kyle Crisco is a 37-year-old male with cerebral palsy and seizures who was admitted for sepsis. He developed systemic inflammatory response syndrome with respiratory failure and was started on broad-spectrum antibiotics. Imaging showed consolidation in his right lung base consistent with healthcare-associated pneumonia. Blood cultures grew methicillin-resistant Staphylococcus aureus. The patient was treated with vancomycin, piperacillin-tazobactam, and other supportive medications. After 5 days of antibiotics and becoming afebrile and clinically stable, vancomycin was stopped. The patient's prolonged hospital stay was complicated by intermittent emesis from a feeding tube, which resolved after tube replacement.
A Drug Utilization Evaluation of Bronchodilators Using a Defined Daily Dose M...Dr. Afreen Nasir
Nasir A, Ghosh K. A Drug Utilization Evaluation of Bronchodilators Using a Defined Daily Dose. International Journal for Multidisciplinary Research [Internet]. 2023;5(6):1–11. Available from: 10.36948/ijfmr.2023.v05i06.11517
13. a case study on convulsions in a kco epilepsy with lactational amenorrhoeaDr. Ajita Sadhukhan
A 25 year old female patient was admitted to the female medicine ward with complaints of 2 and a half month amenorrhoea, epileptic fit convulsions at home, vertigo, generalised weakness and 1 episode of epileptic fit today evening.
This document presents the case of a 12-year-old male patient admitted with nephrotic syndrome. On examination, the patient had edema, elevated cholesterol, and urine analysis showed albumin and epithelial cells. Based on these findings, the patient was diagnosed with nephrotic syndrome. He was started on medications including prednisolone and furosemide. Over five days of treatment, his symptoms improved as seen in decreasing blood pressure and resolution of edema. He was counseled on diet and medication compliance and asked to follow up in one week.
The document discusses guidelines for diagnosing and treating systemic lupus erythematosus (SLE) and lupus nephritis. It provides details on classifying lupus nephritis based on the ISN/RPS system and describes the patient's biopsy results of class IV diffuse lupus nephritis with active and chronic features. Treatment guidelines and monitoring of SLE and lupus nephritis are also reviewed.
Sinus Bradicardia on grade II dengue hemorragic fever.pptxSyahrulAdzim
This case report describes a 37-year-old man diagnosed with Grade II dengue hemorrhagic fever who presented with sinus bradycardia. Laboratory tests confirmed dengue infection and showed thrombocytopenia and elevated liver enzymes. Chest X-ray found left pleural effusion. The patient was treated conservatively with IV fluids, antiemetics, and analgesics. Dengue virus can cause myocardial inflammation and arrhythmias like bradycardia through direct viral invasion or immune mediated mechanisms. This case emphasizes that bradycardia is a common finding in dengue that results from the cardiac effects of the viral infection.
SAI DEEPAK CASE STUDY ON CHRONIC KIDNEY DISEASESaiDeepakS1
A 35-year old female patient presented with chest pain, breathlessness, body pain and lack of appetite. Laboratory investigations revealed severe anemia and renal dysfunction. She was diagnosed with pneumonia and chronic kidney disease. She was started on medications including sodium bicarbonate, folic acid, nifedipine, carvedilol, atorvastatin and calcitrol. She was counselled about her disease, medications, lifestyle modifications including diet, exercise and stress reduction.
The document summarizes the case of an 8-year-old girl admitted to the hospital with tea-colored urine. She was diagnosed with acute glomerulonephritis based on lab tests showing hematuria, proteinuria, and low complement levels. Her symptoms improved over her hospital stay with IV fluids and medications. She was discharged after 6 days with medications and advised to follow up in 2 weeks and longer term to monitor resolution of her symptoms.
This case report describes a 38-year-old man admitted to the hospital with black stools for 20 days and shortness of breath for 5 days. Examination found pallor and bruises. Tests showed severe anemia, elevated coagulation times, and a positive HCV antibody test. Upper endoscopy revealed stomach and duodenal erosions with oozing blood. The patient was diagnosed with type 1 von Willebrand disease based on a low von Willebrand factor level. He received transfusions, cryoprecipitates, factor replacement therapy, and endoscopic coagulation to treat his gastrointestinal bleeding.
This case report describes a 38-year-old man admitted to the hospital with black stools for 20 days and shortness of breath for 5 days. Examination found pallor and bruises. Tests showed severe anemia, elevated coagulation times, and a positive HCV antibody test. Upper endoscopy revealed stomach and duodenal erosions with oozing blood. The patient was diagnosed with type 1 von Willebrand disease based on a low von Willebrand factor level. He received transfusions, cryoprecipitates, factor replacement therapy, and endoscopic coagulation to treat his gastrointestinal bleeding.
Case Presentation Dr. Hosam Fouda Supervised by Dr. Tarek TantawyAhmed Albeyaly
This document presents the case of a 48-year-old male patient with a history of membranous nephropathy who presented with shortness of breath and swelling of the face and lower limbs. Various tests were performed which showed nephrotic syndrome. The patient was previously treated with steroids and cyclosporine, achieving remission. The document discusses the diagnosis of membranous nephropathy, treatment options including conservative management and immunosuppressive drugs, risks and benefits of treatment, and contraindications to immunosuppressive therapy.
1) A 45-year-old male soldier presented with 8 days of fever and 2 days of a maculopapular rash. Initial investigations showed thrombocytopenia. NS1 and IgM tests were positive for dengue.
2) Differential diagnoses included dengue, chikungunya, malaria, and other viral fevers. The patient was managed as a case of dengue hemorrhagic fever with platelet transfusions and IV fluids.
3) Over subsequent days, the patient's platelet count and other investigations improved. He recovered well and was discharged on day 10 with a platelet count of 170,000. The final diagnosis was dengue hemorrhagic fever.
Case Presentation on Venous Thromboembolism.pptxJoel M Johns
This is a case presentation for Pharm. D students.
Disclaimer:
This presentation is purely for educational purpose only.
The patient described in this case does not resemble anyone in reality, living or dead.
Any resemblance is considered as co-incidential.
14. a case study on diabetes mellitus type 1 with diabetic ketoacidosis cp in...Dr. Ajita Sadhukhan
A 26 year old male patient was admitted to the male medicine ward with complaints of nausea, vomiting, generalised weakness, anxiety, decreased appetite, headache since noon.
This case involves a 30-year old woman presenting with a wide range of symptoms over 12 months including fatigue, arthritis, rashes, oral ulcers, hair loss, and kidney problems. Physical exam and lab tests confirmed she meets enough criteria for a diagnosis of systemic lupus erythematosus (SLE) with class IV lupus nephritis. Her treatment plan includes cyclophosphamide, steroids, ACE inhibitors, and later azathioprine to control her SLE and protect her kidneys. Her response is being monitored through disease markers and renal function.
This document presents a case report of an 88-year-old male admitted to the hospital with community-acquired pneumonia. He presented with a cough, expectoration, fever and shortness of breath. He has a past medical history of diabetes and heart disease. Examination findings and investigations confirmed left lower lobe pneumonia with sepsis. He was treated with antibiotics, antipyretics, PPI and antivirals. His symptoms improved over 4 days and he was discharged on medications including clarithromycin and oseltamivir for 5 more days. Pharmacist interventions addressed drug interactions and monitoring parameters were discussed.
The document summarizes a patient's medical report during hemodialysis treatment. It includes information on the patient's medical history, physical examination findings, lab results, dialysis monitoring, diagnosis of end stage renal disease due to diabetes and hypertension, and treatment plan to address issues like intradialytic hypotension and anemia management through diet, medication, and ensuring adequate dialysis.
Acute glomerulonephritis is an acute inflammation of the renal glomeruli characterized by sudden onset of oliguria, hematuria, hypertension and edema. It is commonly caused by a streptococcal infection and results in the deposition of immune complexes in the glomeruli. On pathology, glomeruli appear enlarged and infiltrated by polymorphs with epithelial crescents. Immunofluorescence shows "lumpy-bumpy" deposits of immunoglobulin and complement. Management involves controlling hypertension and edema with diuretics, treating any underlying infection, and managing complications such as acute renal failure. The prognosis is generally good with complete recovery in most cases.
Inpatient Case Presentation. Kyle CriscoKyle Crisco
Kyle Crisco is a 37-year-old male with cerebral palsy and seizures who was admitted for sepsis. He developed systemic inflammatory response syndrome with respiratory failure and was started on broad-spectrum antibiotics. Imaging showed consolidation in his right lung base consistent with healthcare-associated pneumonia. Blood cultures grew methicillin-resistant Staphylococcus aureus. The patient was treated with vancomycin, piperacillin-tazobactam, and other supportive medications. After 5 days of antibiotics and becoming afebrile and clinically stable, vancomycin was stopped. The patient's prolonged hospital stay was complicated by intermittent emesis from a feeding tube, which resolved after tube replacement.
Similar to Case Presentation: Cryptococcal meningitis (20)
A Drug Utilization Evaluation of Bronchodilators Using a Defined Daily Dose M...Dr. Afreen Nasir
Nasir A, Ghosh K. A Drug Utilization Evaluation of Bronchodilators Using a Defined Daily Dose. International Journal for Multidisciplinary Research [Internet]. 2023;5(6):1–11. Available from: 10.36948/ijfmr.2023.v05i06.11517
A study on drug utilisation evaluation of Bronchodilators using defined daily...Dr. Afreen Nasir
Conference proceeding: Nasir A. A study on drug utilisation evaluation of Bronchodilators using a defined daily dose method. Pharmacy Education Journal [Internet]. 2023 Aug;23(5):23–24. Available from: https://doi.org/10.46542/pe.2023.235.138
2024 HIPAA Compliance Training Guide to the Compliance OfficersConference Panel
Join us for a comprehensive 90-minute lesson designed specifically for Compliance Officers and Practice/Business Managers. This 2024 HIPAA Training session will guide you through the critical steps needed to ensure your practice is fully prepared for upcoming audits. Key updates and significant changes under the Omnibus Rule will be covered, along with the latest applicable updates for 2024.
Key Areas Covered:
Texting and Email Communication: Understand the compliance requirements for electronic communication.
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Medical Messaging and Voice Data: Ensure secure handling of sensitive information.
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Why Attend:
Expert Instructor: Brian Tuttle, with over 20 years in Health IT and Compliance Consulting, brings invaluable experience and knowledge, including insights from over 1000 risk assessments and direct dealings with Office of Civil Rights HIPAA auditors.
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https://conferencepanel.com/conference/hipaa-training-for-the-compliance-officer-2024-updates
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
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- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
MBC Support Group for Black Women – Insights in Genetic Testing.pdfbkling
Christina Spears, breast cancer genetic counselor at the Ohio State University Comprehensive Cancer Center, joined us for the MBC Support Group for Black Women to discuss the importance of genetic testing in communities of color and answer pressing questions.
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
Exploring the Benefits of Binaural Hearing: Why Two Hearing Aids Are Better T...Ear Solutions (ESPL)
Binaural hearing using two hearing aids instead of one offers numerous advantages, including improved sound localization, enhanced sound quality, better speech understanding in noise, reduced listening effort, and greater overall satisfaction. By leveraging the brain’s natural ability to process sound from both ears, binaural hearing aids provide a more balanced, clear, and comfortable hearing experience. If you or a loved one is considering hearing aids, consult with a hearing care professional at Ear Solutions hearing aid clinic in Mumbai to explore the benefits of binaural hearing and determine the best solution for your hearing needs. Embracing binaural hearing can lead to a richer, more engaging auditory experience and significantly improve your quality of life.
Can Allopathy and Homeopathy Be Used Together in India.pdfDharma Homoeopathy
This article explores the potential for combining allopathy and homeopathy in India, examining the benefits, challenges, and the emerging field of integrative medicine.
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardso...rightmanforbloodline
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
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This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
2. PATIENT DEMOGRAPHY
IP No. : 071900715 DOA : 6/12/19 DOD : 11/2/2020
Age : 47 YEARS Ward : 4th Department : Medicine
Sex : Female
3. SUBJECTIVE DATA
COMPLAINTS ON ADMISSION:
• C/o cough since 1month, fever since 15days, headache for 4 days, vomiting for
2 days, slurring of speech for 2 days.
HISTORY OF PRESENT ILLNESS :
• Patient was apparently well 1 month back, then she developed cough gradual
in onset & progressive, with scanty expectoration –mucoid, nonblood tinged,
fever –intermittent during evening with chills ,rigor, myalgia, headache-
holocranial throughout the day.
• H/O weight loss, vomiting (projectile, non bolus , contain food particles), chest
pain.
• No H/O bleeding manifestation and chest pain.
4. PATIENT HISTORY:
• Past medical History -
No H/O HTN , T2DM , COPD
K/C/O retroviral disease
Opportunistic infection – oral candidiasis
• Family History – Nothing significant
• Allergy - NKA
• Medication history - Nothing significant
• Social History -
Appetite: Reduce Sleep: disturb Bowel-Bladder: Normal ®ular
Diet: Mixed
• Past Menopausal – 2 yr
5. OBJECTIVE DATA
• VITAL SIGNS :(6/12/19)
BP : 140/80mmHg RR: 90 breaths /min SPO2=96%
• GENERAL EXAMINATION: Patient is moderately built , well nourished
PICCKLE : Pallor + ,Icterus / Cyanosis/ Clubbing/Koilonychia / Lymphadenopathy/Oedema – Absent
• SYSTEMIC EXAMINATION
HEENT – normal
CNS- conscious , well oriented to time /place/person ,HMF +
RS- normal breath sound
Par abdomen – soft
CVS- S1 S2 sound +, Tachycardia
Power- 5/5 5/5 Tone – N N Plantar - ↓
5/5 5/5 N N
Neck stiffness + Kernig's sign + Brudzinski's sign +
6. PROVISIONAL DIAGNOSIS:
• Δes PLHA ( person living HIV – AIDS) to rule out Opportunistic infection, oral
candidiasis
• Δes Retroviral disease +
14. ASSESSMENT
TREATMENT GOALS:
• Patient specific –
-Improve QOL
-Selecting cost effective medicine & minimizing side effects of medicines
• Disease specific –
- Eradication of microorganism causing infection , reducing sign – symptoms
- Prevention of neurologic sequelae like seizure , deafness, coma, death
- Identifying microbes in CSF & destroying them
17. CLINICAL PHARMACIST NOTES / INTERVENTION:
• Drug – drug interaction :
1) Serious – Fluconazole + ondansetron - ↑ QTc interval
2) Monitor closely-
Pan ↓ effect of ferrous sulphate by ↑ gastric pH
Fluconazole & Trimethoprim ↑ QTc interval
3) Minor-
Pan ↓ level of cyanocobalamin
Fluconazole ↑ level / effect of sulfamethoxazole
Fluconazole↑ level / effect of pan
18. PLAN
CONDITION ON DISCHARGE-
• Pallor +
• Power, tone, reflex –N
• BP- 140/80mmHg
• SPO₂ - 96%
• PR- 90 BPM
• CVS – S1S2 ,Tachycardia +
• RS- NVBS
• CNS – Conscious, Kernig's + , Brudzinski's + , Neck stiffness +
ADVICE TO DOCTOR-
Since the patient’s discharge condition is not stable as sign –symptoms of meningitis are still
present , and there is no discharge medicine prescribed for that, may be her conditions can
improve if C. FLUCONAZOLE 250 mg is included in her discharge medicine.
19. DISCHARGE MEDICATION :
Medicine prescribed Generic name Dose Frequency/ Duration Possible side effects
T. Septran DS TRIMETHOPRIM
(80mg)+
SULFAMETHOXAZOLE
(400mg)
1-0-0 × 1 week diarrhea , skin rashes, headache
T. PAN PANTOPRAZOLE 40mg 1-0-0 × 1 week vomit, constipation, gas formation in
stomach, loose motion, fast heart beat
T.PCT PARACETAMOL (
ACETAMINOPHEN)
500mg 0-0-1 × 1 week stomach pain , ulcer in mouth
T. Optineurin Vit – B 12,B5, B6,B2,
B3, B1
0-1-0 × 1 week Headache , sleepiness, upset stomach
T.Fe FERROUS SULPHATE 200mg 0-1-1 × 30 days constipation/ loose motion , dark color
stool
T. N . Acetylcysteine ACETYLCYSTEINE 600 mg 1-1-1 × 30 days Vomit, mouth sore