hirschsprung disease.pptx
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This document presents a case report of a 2-year-old boy named Kowshik Alom who was admitted with chronic constipation since birth and gradual abdominal distention. His symptoms did not improve with various laxatives and medications. On examination, his abdomen was distended but otherwise normal. Investigations including barium enema x-ray showed features suggestive of Hirschsprung's disease. He underwent transverse colostomy with biopsy but unfortunately died on the second postoperative day likely due to aspiration and cardiorespiratory failure.
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hirschsprung disease.pptx
This case presentation describes a 2-year-old boy named Kowshik Alom who was admitted with chronic constipation since birth and gradual abdominal distention. He had difficulty passing stool and required suppositories. Examination found abdominal distention but no other abnormalities. Tests including barium enema x-ray were performed. He was diagnosed with Hirschsprung disease and underwent transverse colostomy with biopsy. Unfortunately, the patient died on the second postoperative day likely due to aspiration and cardiorespiratory failure.
Juvenile Colonic Polyp
The document describes the case of a 31⁄2 year old boy who was admitted with a 1 year history of painless rectal bleeding after bowel movements. On examination, he appeared well with no abnormalities found. A colonoscopy revealed a pedunculated polyp 20cm from the anal verge, which was removed via colonoscopic polypectomy.
Neonatal Cholestasis
Ishrat, a 5-month old female infant, presented with right cheek swelling for 11 days along with jaundice and intermittent pale stool since birth. Examination found hepatosplenomegaly and the swelling was diagnosed as an abscess. Laboratory tests revealed elevated liver enzymes consistent with neonatal hepatitis. She was diagnosed with neonatal cholestasis due to neonatal hepatitis syndrome with an abscess on her right cheek and treated supportively.
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This document presents a case study of a 22-year-old pregnant woman, Rupa Serung, who is 38 weeks pregnant and was admitted to the hospital with bleeding per vagina. On examination, she was found to have a grade II placenta previa. Tests showed signs of anemia. An ultrasound confirmed a single fetus in longitudinal lie and cephalic presentation with a low-lying placenta. The diagnosis was grade II placenta previa. The options for management include either expectant management with bed rest or immediate termination of the pregnancy depending on the status of the mother and fetus.
Constipation
- A 3 year 5 month old child presented with constipation since 6 months of age, which was diagnosed as functional constipation. Examination found a loaded colon on x-ray but no other abnormalities.
- Functional constipation is usually caused by painful bowel movements that cause voluntary withholding of stool. It is commonly treated with lifestyle changes like diet and behavior modifications, disimpaction if needed, and maintenance therapy using laxatives.
- Younger infants require more evaluation to rule out organic causes for constipation like Hirschsprung's disease. Older children may need further testing if constipation is intractable or there are red flags for underlying conditions.
Molar pregnancy ( Case Presentation)
A 25-year-old woman presented with irregular vaginal bleeding following evacuation of a molar pregnancy 6 weeks prior. On examination, she was anemic and her uterus was enlarged to 16 weeks size. Ultrasound and beta-hCG levels confirmed incomplete evacuation of molar tissue. She underwent a second suction and evacuation procedure where a large amount of molar tissue was removed. She was advised follow up monitoring of beta-hCG levels and contraceptive use, and warned to report any symptoms like bleeding or vision changes during recovery.
Meckels Diverticulum
A 2-year old boy presented with rectal bleeding and abdominal pain. Initial investigations showed anemia. Ultrasound was unremarkable but a Meckel's scan showed evidence of heterotopic gastric mucosa in the abdomen, indicating Meckel's diverticulum. During laparotomy, Meckel's diverticulum was found and resected along with reduction of two intussusceptions. Meckel's diverticulum is a remnant of the embryonic yolk sac that fails to obliterate, located on the ileum. It most commonly presents in children under 2 years old with rectal bleeding. Surgical resection is usually required for symptomatic cases.
Henoch–Schönlein purpura
Dr. Maimuna Sayeed presented the case of 2 year old Diya who presented with rashes on her body for 2 months along with swelling all over her body for 5 days and decreased urination. Her physical exam showed purpuric rashes, edema, and joint tenderness. Tests showed mild anemia, proteinuria, and normal electrolytes. Her ultrasound was normal. The provisional diagnosis was Henoch-Schönlein purpura with nephritis based on her rash, joint pain, abdominal pain, edema, and proteinuria. She was started on medications but had worsening symptoms on follow-up, so additional medications and a renal biopsy were planned.
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hirschsprung disease.pptx
This case presentation describes a 2-year-old boy named Kowshik Alom who was admitted with chronic constipation since birth and gradual abdominal distention. He had difficulty passing stool and required suppositories. Examination found abdominal distention but no other abnormalities. Tests including barium enema x-ray were performed. He was diagnosed with Hirschsprung disease and underwent transverse colostomy with biopsy. Unfortunately, the patient died on the second postoperative day likely due to aspiration and cardiorespiratory failure.
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The document describes the case of a 31⁄2 year old boy who was admitted with a 1 year history of painless rectal bleeding after bowel movements. On examination, he appeared well with no abnormalities found. A colonoscopy revealed a pedunculated polyp 20cm from the anal verge, which was removed via colonoscopic polypectomy.
Neonatal Cholestasis
Ishrat, a 5-month old female infant, presented with right cheek swelling for 11 days along with jaundice and intermittent pale stool since birth. Examination found hepatosplenomegaly and the swelling was diagnosed as an abscess. Laboratory tests revealed elevated liver enzymes consistent with neonatal hepatitis. She was diagnosed with neonatal cholestasis due to neonatal hepatitis syndrome with an abscess on her right cheek and treated supportively.
OBS AND GYNAE APH case presentation
This document presents a case study of a 22-year-old pregnant woman, Rupa Serung, who is 38 weeks pregnant and was admitted to the hospital with bleeding per vagina. On examination, she was found to have a grade II placenta previa. Tests showed signs of anemia. An ultrasound confirmed a single fetus in longitudinal lie and cephalic presentation with a low-lying placenta. The diagnosis was grade II placenta previa. The options for management include either expectant management with bed rest or immediate termination of the pregnancy depending on the status of the mother and fetus.
Constipation
- A 3 year 5 month old child presented with constipation since 6 months of age, which was diagnosed as functional constipation. Examination found a loaded colon on x-ray but no other abnormalities.
- Functional constipation is usually caused by painful bowel movements that cause voluntary withholding of stool. It is commonly treated with lifestyle changes like diet and behavior modifications, disimpaction if needed, and maintenance therapy using laxatives.
- Younger infants require more evaluation to rule out organic causes for constipation like Hirschsprung's disease. Older children may need further testing if constipation is intractable or there are red flags for underlying conditions.
Molar pregnancy ( Case Presentation)
A 25-year-old woman presented with irregular vaginal bleeding following evacuation of a molar pregnancy 6 weeks prior. On examination, she was anemic and her uterus was enlarged to 16 weeks size. Ultrasound and beta-hCG levels confirmed incomplete evacuation of molar tissue. She underwent a second suction and evacuation procedure where a large amount of molar tissue was removed. She was advised follow up monitoring of beta-hCG levels and contraceptive use, and warned to report any symptoms like bleeding or vision changes during recovery.
Meckels Diverticulum
A 2-year old boy presented with rectal bleeding and abdominal pain. Initial investigations showed anemia. Ultrasound was unremarkable but a Meckel's scan showed evidence of heterotopic gastric mucosa in the abdomen, indicating Meckel's diverticulum. During laparotomy, Meckel's diverticulum was found and resected along with reduction of two intussusceptions. Meckel's diverticulum is a remnant of the embryonic yolk sac that fails to obliterate, located on the ileum. It most commonly presents in children under 2 years old with rectal bleeding. Surgical resection is usually required for symptomatic cases.
Henoch–Schönlein purpura
Dr. Maimuna Sayeed presented the case of 2 year old Diya who presented with rashes on her body for 2 months along with swelling all over her body for 5 days and decreased urination. Her physical exam showed purpuric rashes, edema, and joint tenderness. Tests showed mild anemia, proteinuria, and normal electrolytes. Her ultrasound was normal. The provisional diagnosis was Henoch-Schönlein purpura with nephritis based on her rash, joint pain, abdominal pain, edema, and proteinuria. She was started on medications but had worsening symptoms on follow-up, so additional medications and a renal biopsy were planned.
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This document provides information about a 6 year and 4 month old male Chinese patient named Jackson Tea Jia Sheng who was admitted to the hospital due to vomiting and diarrhea for the past 2 days. The patient's medical history including past illness, family history, birth details, development, and immunization status are documented. The physical examination findings show the patient is alert and interacting well without signs of dehydration, and vital signs are normal. The system examinations including respiratory, cardiovascular, and gastrointestinal systems are unremarkable.
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Manmohan Memorial Institute Of health Sciences
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This document presents the case of a 3 month old male infant referred to the Children's Emergency Room with complaints of vomiting since birth, swelling on the left forearm, fever, watery stools, and coughing/catarrh. On examination, the infant was found to be small for age but otherwise healthy. Initial workup revealed malaria parasites. The infant's condition improved with treatment, and further tests found no abnormalities. He was ultimately diagnosed with gastroesophageal reflux disease and discharged upon gaining weight and reducing vomiting with feeding adjustments. Follow up visits showed continued improvement.
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Pediatric PORTFOLIO.pptx
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CAH FINAL.pptx
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2) On examination, she was found to be severely dehydrated, hypotensive, and had ambiguous genitalia. Laboratory tests confirmed congenital adrenal hyperplasia.
3) She was treated for shock and started on hydrocortisone and fludrocortisone. Long term management will include lifelong steroid replacement therapy and potential surgical correction of genitalia.
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choledochal cyst.pptx
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12SOAP Note Patient with UTIUnited State
1
2
SOAP Note Patient with UTI
United State University
FNP xxx: Common Illness Across the Lifespan -Clinical Practicum
Dr. xxxx
SOAP Note Patient with UTI
ID: L.U. a female patient presented to the clinic accompany by self, patient is a reliable historian.
Client’s Initials: L.U
Age :65 years.
Race: African American
Gender: Female
Date of Birth: 08
Insurance: BlueCross BlueShield .
Marital Status: Married
Subjective: “ I have been having pain and burning during urination for two weeks now and the pain goes to my lower abdomen, and I have been unable to hold urine, I now urinate on myself because I can no longer hold it until I get to the bathroom”.
CC: Pain and burning during urination.
HPI:
Patient stated symptoms began within the past two weeks and have worsened over the past seven days. The patient complains of severe pain and burning sensation during urination that radiates to lower abdomen, with urgency. The urine is cloudy and has a foul smell odor. After attempting to pass urine, the pain subsides for a little while, yet it reoccurs. Patient states that she has been sexually active only with the same partner for the past 15 years. On assessment patient reports pain of 8 /10 on pain scale. Patient denies having blood in urine, fever, headache, shortness of breath or chest pain at the moment.
ROS
Constitutional: Patient states she is in good state of health she denies headache , chest pain weakness fever chills, weight loss or gain.
Eyes: Denies double vision, change in vision factors, or blurry vision.
Ears/Nose/Mouth/Throat: denies sore throat, hearing issues, or nose congestion.
Cardiovascular: denies any kind of orthopnea, rapid heart rate, palpitations, or chest pain.
Pulmonary: Denies
Gastrointestinal: c/o moderate to severe pain in the abdominal area.
Genitourinary: acknowledged presence of increase in urgency and frequency of urination. Major pain while urinating for the past ten days.
Musculoskeletal: Denies any kind of pain
Integumentary & breast: Denies issues
Neurological: Denies issues
Psychiatric: Denies any kind of depression or mood swing
Endocrine: Denies having any problem
Hematologic/Lymphatic: Denies
Allergic/Immunologic: No Known allergy
Past Medical History:
· Medical problem list: patient denies having any major illnesses and only reports headaches and sometimes common seasonal allergy or cold.
· Denies history of chronic medical problems with father or mother.
· Preventative care: None indicated
· Surgeries: Denies
· Hospitalizations: Denies
· LMP: Patient states she do have a 28 days menstrual cycle and the last cycle was 2 weeks ago. She has had three pregnancies and three cesarean section.
Allergies: No known food or drug allergy
· Medications: Patient takes only Centrum vitamins and sometimes Tylenol for headache. Family History: Patient’s mother has hypertension that she manages by taking daily medication and exercising. The patient’s father has hypertension too a ...
12SOAP Note Patient with UTIUnited State
1
2
SOAP Note Patient with UTI
United State University
FNP xxx: Common Illness Across the Lifespan -Clinical Practicum
Dr. xxxx
SOAP Note Patient with UTI
ID: L.U. a female patient presented to the clinic accompany by self, patient is a reliable historian.
Client’s Initials: L.U
Age :65 years.
Race: African American
Gender: Female
Date of Birth: 08
Insurance: BlueCross BlueShield .
Marital Status: Married
Subjective: “ I have been having pain and burning during urination for two weeks now and the pain goes to my lower abdomen, and I have been unable to hold urine, I now urinate on myself because I can no longer hold it until I get to the bathroom”.
CC: Pain and burning during urination.
HPI:
Patient stated symptoms began within the past two weeks and have worsened over the past seven days. The patient complains of severe pain and burning sensation during urination that radiates to lower abdomen, with urgency. The urine is cloudy and has a foul smell odor. After attempting to pass urine, the pain subsides for a little while, yet it reoccurs. Patient states that she has been sexually active only with the same partner for the past 15 years. On assessment patient reports pain of 8 /10 on pain scale. Patient denies having blood in urine, fever, headache, shortness of breath or chest pain at the moment.
ROS
Constitutional: Patient states she is in good state of health she denies headache , chest pain weakness fever chills, weight loss or gain.
Eyes: Denies double vision, change in vision factors, or blurry vision.
Ears/Nose/Mouth/Throat: denies sore throat, hearing issues, or nose congestion.
Cardiovascular: denies any kind of orthopnea, rapid heart rate, palpitations, or chest pain.
Pulmonary: Denies
Gastrointestinal: c/o moderate to severe pain in the abdominal area.
Genitourinary: acknowledged presence of increase in urgency and frequency of urination. Major pain while urinating for the past ten days.
Musculoskeletal: Denies any kind of pain
Integumentary & breast: Denies issues
Neurological: Denies issues
Psychiatric: Denies any kind of depression or mood swing
Endocrine: Denies having any problem
Hematologic/Lymphatic: Denies
Allergic/Immunologic: No Known allergy
Past Medical History:
· Medical problem list: patient denies having any major illnesses and only reports headaches and sometimes common seasonal allergy or cold.
· Denies history of chronic medical problems with father or mother.
· Preventative care: None indicated
· Surgeries: Denies
· Hospitalizations: Denies
· LMP: Patient states she do have a 28 days menstrual cycle and the last cycle was 2 weeks ago. She has had three pregnancies and three cesarean section.
Allergies: No known food or drug allergy
· Medications: Patient takes only Centrum vitamins and sometimes Tylenol for headache. Family History: Patient’s mother has hypertension that she manages by taking daily medication and exercising. The patient’s father has hypertension too a ...
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This clinical meeting summarizes the case of 1 year and 6 month old Nusrat who presented with multiple reddish and blackish spots over her body for 1 month. Her history revealed low grade fever and cough 2 weeks prior. On examination, she had multiple echymoses of varying sizes over her chest and abdomen with mild pallor. Laboratory tests found thrombocytopenia. The provisional diagnosis was immune thrombocytopenic purpura (ITP), which was confirmed as the final diagnosis. She was started on prednisolone therapy.
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A 12-year-old girl presented with a 3-month history of right lumbar pain and swelling. Examination revealed a ballotable cystic swelling in the right lumbar region. Imaging studies including ultrasound and IVU showed bilateral renal stones with right-sided hydronephrosis. The final diagnosis was bilateral renal stones causing right-sided hydronephrosis.
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Siyam, an 8-year-old boy, presented with continuous dribbling of urine since birth and constant soiling and passing of stool for 6 years. He was born with absence of anal opening and underwent various procedures for ARM including pelvic colostomy, abdominal anorectoplasty, and inverted V-Y anoplasty. Currently, he has fecal and urinary incontinence. On examination, his perianal region was soiled with stool and he had loss of anal tone, grip, and sensation. The provisional diagnosis is all staged complete ARM with fecal and urinary incontinence.
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This document provides an overview of burn management. It discusses that burns affect over 11 million people annually, with most occurring in poor countries and among children. After initial management at the site of injury, patients may require admission based on factors like partial thickness burns over 15% of total body surface area for adults or 10% for children. For severe burns, management involves airway control, ventilation, intravenous access, fluid resuscitation, and assessing burn depth and area.
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This document provides information about a 6 year and 4 month old male Chinese patient named Jackson Tea Jia Sheng who was admitted to the hospital due to vomiting and diarrhea for the past 2 days. The patient's medical history including past illness, family history, birth details, development, and immunization status are documented. The physical examination findings show the patient is alert and interacting well without signs of dehydration, and vital signs are normal. The system examinations including respiratory, cardiovascular, and gastrointestinal systems are unremarkable.
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it is a case study report on PIH and Severe Pre eclampsia
I did when I was posted on Kist Medical TEaching Hospital for Midwifery Practicum
Prepared by:
Rashmi Regmi
B Sc Nursing
Manmohan Memorial Institute Of health Sciences
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This document presents the case of a 3 month old male infant referred to the Children's Emergency Room with complaints of vomiting since birth, swelling on the left forearm, fever, watery stools, and coughing/catarrh. On examination, the infant was found to be small for age but otherwise healthy. Initial workup revealed malaria parasites. The infant's condition improved with treatment, and further tests found no abnormalities. He was ultimately diagnosed with gastroesophageal reflux disease and discharged upon gaining weight and reducing vomiting with feeding adjustments. Follow up visits showed continued improvement.
Diarrhoea, A socio-clinical case presentation.
This document presents a case study of a 3-year-old female child named Ritu Das who presented with acute diarrhea and some dehydration. She had a history of 8-10 watery stools per day for the past 2 days along with 2 vomiting episodes the previous night. The child lives in a joint, lower middle class family in a kuchha-pucca house with unhygienic practices. On examination, she was restless with a pulse of 110/min and dry tongue. She was diagnosed with acute diarrhea with some dehydration and prescribed ORS, zinc, and advice on feeding and hygiene.
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This document discusses the diagnosis and management of abdominal pain in pediatric patients through a series of case studies and discussions. It begins with an introduction on abdominal pain in children and objectives. It then presents 5 case studies of children presenting with abdominal pain and asks the reader to make a diagnosis. Following this, it discusses the causes, history, examination, investigations and management of abdominal pain in children at different ages. It provides details on recognizing red flag signs, systemic causes, and approaching the diagnosis of acute abdominal pain.
Case presentation: rif lump.pptx
A 23-year-old female presented with 4 days of right lower abdominal pain shifting from peri-umbilical to the right lower abdomen, accompanied by 3 days of nausea, vomiting and fever. On examination, a tender, firm lump was found in the right iliac fossa. The provisional diagnosis was a right iliac fossa lump due to acute appendicitis. Differential diagnoses included ileo-caecal TB, carcinoma of the caecum, right ovarian cyst, mesenteric lymphadenopathy, and intussusception.
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1) Tayeba, a 1 month old female infant, was admitted with frequent vomiting, blackening of the skin, and atypical genitalia.
2) On examination, she was found to be severely dehydrated, hypotensive, and had ambiguous genitalia. Laboratory tests confirmed congenital adrenal hyperplasia.
3) She was treated for shock and started on hydrocortisone and fludrocortisone. Long term management will include lifelong steroid replacement therapy and potential surgical correction of genitalia.
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CASE STUDY
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A 3-month-old female child presented with vomiting, jaundice, and fever. On examination, she had mild jaundice and an abdominal mass. Laboratory results showed elevated bilirubin and alkaline phosphatase. Imaging found a cystic lesion in the porta hepatis. The provisional diagnosis was choledochal malformation. The plan was laparotomy to further evaluate the mass.
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12SOAP Note Patient with UTIUnited State
1
2
SOAP Note Patient with UTI
United State University
FNP xxx: Common Illness Across the Lifespan -Clinical Practicum
Dr. xxxx
SOAP Note Patient with UTI
ID: L.U. a female patient presented to the clinic accompany by self, patient is a reliable historian.
Client’s Initials: L.U
Age :65 years.
Race: African American
Gender: Female
Date of Birth: 08
Insurance: BlueCross BlueShield .
Marital Status: Married
Subjective: “ I have been having pain and burning during urination for two weeks now and the pain goes to my lower abdomen, and I have been unable to hold urine, I now urinate on myself because I can no longer hold it until I get to the bathroom”.
CC: Pain and burning during urination.
HPI:
Patient stated symptoms began within the past two weeks and have worsened over the past seven days. The patient complains of severe pain and burning sensation during urination that radiates to lower abdomen, with urgency. The urine is cloudy and has a foul smell odor. After attempting to pass urine, the pain subsides for a little while, yet it reoccurs. Patient states that she has been sexually active only with the same partner for the past 15 years. On assessment patient reports pain of 8 /10 on pain scale. Patient denies having blood in urine, fever, headache, shortness of breath or chest pain at the moment.
ROS
Constitutional: Patient states she is in good state of health she denies headache , chest pain weakness fever chills, weight loss or gain.
Eyes: Denies double vision, change in vision factors, or blurry vision.
Ears/Nose/Mouth/Throat: denies sore throat, hearing issues, or nose congestion.
Cardiovascular: denies any kind of orthopnea, rapid heart rate, palpitations, or chest pain.
Pulmonary: Denies
Gastrointestinal: c/o moderate to severe pain in the abdominal area.
Genitourinary: acknowledged presence of increase in urgency and frequency of urination. Major pain while urinating for the past ten days.
Musculoskeletal: Denies any kind of pain
Integumentary & breast: Denies issues
Neurological: Denies issues
Psychiatric: Denies any kind of depression or mood swing
Endocrine: Denies having any problem
Hematologic/Lymphatic: Denies
Allergic/Immunologic: No Known allergy
Past Medical History:
· Medical problem list: patient denies having any major illnesses and only reports headaches and sometimes common seasonal allergy or cold.
· Denies history of chronic medical problems with father or mother.
· Preventative care: None indicated
· Surgeries: Denies
· Hospitalizations: Denies
· LMP: Patient states she do have a 28 days menstrual cycle and the last cycle was 2 weeks ago. She has had three pregnancies and three cesarean section.
Allergies: No known food or drug allergy
· Medications: Patient takes only Centrum vitamins and sometimes Tylenol for headache. Family History: Patient’s mother has hypertension that she manages by taking daily medication and exercising. The patient’s father has hypertension too a ...
12SOAP Note Patient with UTIUnited State
1
2
SOAP Note Patient with UTI
United State University
FNP xxx: Common Illness Across the Lifespan -Clinical Practicum
Dr. xxxx
SOAP Note Patient with UTI
ID: L.U. a female patient presented to the clinic accompany by self, patient is a reliable historian.
Client’s Initials: L.U
Age :65 years.
Race: African American
Gender: Female
Date of Birth: 08
Insurance: BlueCross BlueShield .
Marital Status: Married
Subjective: “ I have been having pain and burning during urination for two weeks now and the pain goes to my lower abdomen, and I have been unable to hold urine, I now urinate on myself because I can no longer hold it until I get to the bathroom”.
CC: Pain and burning during urination.
HPI:
Patient stated symptoms began within the past two weeks and have worsened over the past seven days. The patient complains of severe pain and burning sensation during urination that radiates to lower abdomen, with urgency. The urine is cloudy and has a foul smell odor. After attempting to pass urine, the pain subsides for a little while, yet it reoccurs. Patient states that she has been sexually active only with the same partner for the past 15 years. On assessment patient reports pain of 8 /10 on pain scale. Patient denies having blood in urine, fever, headache, shortness of breath or chest pain at the moment.
ROS
Constitutional: Patient states she is in good state of health she denies headache , chest pain weakness fever chills, weight loss or gain.
Eyes: Denies double vision, change in vision factors, or blurry vision.
Ears/Nose/Mouth/Throat: denies sore throat, hearing issues, or nose congestion.
Cardiovascular: denies any kind of orthopnea, rapid heart rate, palpitations, or chest pain.
Pulmonary: Denies
Gastrointestinal: c/o moderate to severe pain in the abdominal area.
Genitourinary: acknowledged presence of increase in urgency and frequency of urination. Major pain while urinating for the past ten days.
Musculoskeletal: Denies any kind of pain
Integumentary & breast: Denies issues
Neurological: Denies issues
Psychiatric: Denies any kind of depression or mood swing
Endocrine: Denies having any problem
Hematologic/Lymphatic: Denies
Allergic/Immunologic: No Known allergy
Past Medical History:
· Medical problem list: patient denies having any major illnesses and only reports headaches and sometimes common seasonal allergy or cold.
· Denies history of chronic medical problems with father or mother.
· Preventative care: None indicated
· Surgeries: Denies
· Hospitalizations: Denies
· LMP: Patient states she do have a 28 days menstrual cycle and the last cycle was 2 weeks ago. She has had three pregnancies and three cesarean section.
Allergies: No known food or drug allergy
· Medications: Patient takes only Centrum vitamins and sometimes Tylenol for headache. Family History: Patient’s mother has hypertension that she manages by taking daily medication and exercising. The patient’s father has hypertension too a ...
Obs Case Presentation.pptx
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Itp.kanta
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acute gastroenteritis, case presentation < sabrina >
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2) Neonates have high total body water content, immature kidneys unable to concentrate urine, and poor thermoregulation placing them at risk for dehydration and hypothermia.
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1. Preoperative preparation aims to optimize the patient's condition for surgery and postoperative recovery through relevant medical assessments, investigations, and risk optimization within available time windows prior to surgery.
2. The preoperative evaluation involves a thorough patient history, clinical examination, risk assessment, and appropriate investigations to address any medical optimization needs and inform patient consent for surgery.
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1. Hypospadias is a birth defect where the opening of the urethra is on the underside of the penis rather than at the tip.
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hirschsprung disease.pptx
- 1. LONG CASE PRESENTATION (HIRSCHSPRUNG DISEASE) DR.RAGHU NATH KARMAKER PHASE B RESIDENT DEPT. OF PAEDIATRIC SURGERY MMCH
- 2. Particulars of the patient Name : Kowshik alom Age : 2 years Sex: Male Religion : Islam Address : Barhatta , netrokona Date of admission : 24/11/2022 Date of examination : 24/11/2022
- 3. Presenting complaints 1. Chronic constipation since birth. 2. Gradual abdominal distention and occasional vomiting for same duration .
- 4. History of present illness According to statement of informant mother , presenting complaint started since birth . The child did not pass meconium up to 3 days after birth and then passed meconium with the assistance of suppositories . Since then child defecates infrequently at 3-4 days interval with the help of suppositories , laxatives and sometimes spontaneously . Mother also complaints of gradual abdominal distantion since then which was accelarated in last 2 months.
- 5. There are also complaints of occasional non bilious projectile vomiting . For these complaints he was taken to local doctors and took antiemitics and laxatives in last 2 years for several times . There are no history of fever , diarrhoea , blood mixed stool or perineal soiling . As of no improvement of the condition the parents admitted their child in department of paediatric surgery of mymensing medical college hospital.
- 6. History of past illness No history of past illness.
- 7. Birth history Antenatal history : uneventful but the mother was not on regular checkup and was not on anti thyroid drugs . Natal history : He was delivered by NVD at term at home . Post natal history : uneventful except delayed passage of meconium
- 8. Feeding history : The child was on exclusive breast feeding and now on family diet . Developmental history : His milestone of development are normal . Immunization history : immunized as per EPI schedule Treatment history : Treated by laxatives and suppositories .
- 9. Family history The baby was 3rd issue of non consanguineous parents . Parents and other siblings are good health . No family history of same type of illness .
- 10. Socioeconomic history Belongs to lower class family .
- 11. General examination Appearance : well alert Anaemia : mild Jaundice : absent Edema : absent Cyanosis : absent Clubbing : absent Koilonychia : absent Lymph node : No accesible lymph node are found . Temperature : normal Pulse 100 beat /min Res rate : 24B/MIN
- 12. Systemic examination (GIT) Mouth and oral cavity : healthy Abdomen : Inspection : Abdomen was distended , umbilicus centrally placed and inverted , no visible peristalsis , no engorged vein or scar mark . Hernial orifice were intact . Palpation : Abdomen was soft and non tender no organomegaly , fecoloma or ascities were present
- 13. Systemic examination ( contd.) Percussion : Tympanic , shifting dullness absent Auscultation : bowel sound present . Perineal examination : No perineal soiling , anus is normally placed , no excoriation or fissure is noted . D/R/E : Rectal grip can be felt on inserted finger and index finger is snugly fitted to the rectum . Rectum was empty . After withdrawal of finger a gush of flatus and feces comes out .
- 14. Other systemic examination Reveals no abnormality .
- 15. Salient feature Kowshik alom , a 2 years old boy hailing from barhatta ,netrokona , got admitted with the complaints of chronic constipation since birth , gradual abdominal distention and occasional vomiting for same duration . The child did not pass meconium up to 3 days after birth and then passed meconium with the assistance of suppositories . Since then the child defecates infrequently at 3-4 days interval with the help of suppositories , laxatives and sometimes spontaneously .
- 16. Contd.... Patients also complaints of gradual abdominal distention since then which was accelarated in last 2 month . There are also complaints of occasional non projectile bilious vomiting . For these complaints he was taken to local physcian and took antiemitics , laxatives and suppositories in last 2 years for several times . There are no history of fever , diarrhoea , blood mixed stool or perineal soiling . His general survey is essentially normal except mild anaemia
- 17. Contd..... Abdomen is distended , umbillicus is centrally placed no visible peristalsis , organomegaly fecoloma or ascities .bowel sound is present . There is no perineal soiling , anus is normally placed . No excoriation or fissure is noted , index finger is snugly fitted to the rectum . Rectum was empty . After withdrawal of finger a gush of flatus and faeces comes out . Other systemic examination reveals normal .
- 20. Investigation CBC with Blood grouping s. createnine s. electrolytes T3,T4,TSH Barium enema x-ray in both A/P And L/V
- 22. Treatment: Initial management NPO TFO N-G SUCCTION I/V FLUID BROAD SPECTRUM ANTIBIOTICS RECTAL IRRIGATION
- 23. Surgical Transverse colostomy with labelling biopsy
- 24. Follow up On 2nd post operative day baby was die most probably due to aspiration followed by cardiorespiratory failure
- 25. Thank you