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Mr. Harshal Pangar, a 16-year-old male, presented with a 3-month history of a lump on his left arm that increased in size and caused pressing pain, worsened by lifting heavy weights or long writing. Examination found a round, movable lump without discoloration. Investigations including biopsy confirmed a diagnosis of lipoma. Analysis of the case found key symptoms of desiring spicy non-veg food, aversion to milk and spinach, and thermally being chilly. Belladonna 200 potency was prescribed twice daily for 7 days based on the susceptibility of the patient and characteristic symptoms matching the remedy.
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intern case.pdf
- 1. Surgery case Pornima Mungankar (intern) Winter (2021)
- 2. PEILIMINARY DATA ● Name - Mr Harshal Pangar ● Age - 16 ● Sex - male ● Address - pimpri ● Religion - Hindu ● Marrital status - Unmarried
- 3. Chief complaint - Lump on left Arm since 3 months Location sensation. Modalities. Concomitant Lower pressing type of < while lifting heavy Limb. Pain specially when. weight, while Lifting heavy wtwt. writing for long bWhile writing for . > At rest Long time
- 4. ODP- Patient was apparently healthy 3 months back then he started suffering from from lump on his posterior side of left forarm which was initially small and has increase in size with pressing type of pain
- 5. Patient as as person - average built , whitish complexion Personal h/o -. Diet -. Mixed Likes - spicy, non veg Dislike - milk , spinach Thirst - 4-5 glass / day Stool - satisfactory,no complaints Urine - 4-5 times / day satisfactory Perspiration - on forehead, &neck Sleep - sound Dreams - not specific
- 6. Thermals Season - summer Covering - as per season Food - as served Bath - warm Prefer - open air
- 7. Family history - Father- healthy Mother - healthy Brother - healthy Past history - Dengue at age of 12 yrs No h/o of any surgery or major illness
- 9. Systemic Examination RESPIRATORY SYSTEM- INSPECTION- SHAPE- BILLATERALLY SYMMETRICAL MEDIASTINUM- CENTRALLY PLACED NORMAL RESPIRATORY MOVEMENTS PALPITATION- CHEST MOVEMENT- NORMAL TACTILE-VOCAL-FERMITUS – NORMAL TENDERNESS- NO TENDERNESS PERCUSSION- RESONANT NOTE AUSCULTATION- NORMAL BREATH SOUND
- 10. Cardiovascular system INSPECTION- NO SHAPE DEFORMITY APEX IMPULSE- NORMAL NO DILATED VEINS PALPATION - APEX BEAT- NORMAL NO THRILLS PERCUSSION- DULL NOTE AUSCULTATION- HEART SOUND- S1S2 NO MURMER
- 11. Abdominal Examination INSPECTION- SHAPE- SCAPHOID UMBILICUS- INVERTEDND, CENTRALLY SITUATED PULSATION- NOT VISIBLE ABDOMINAL MOVEMENT- NORAML SKIN- NORMAL PALPATION- SOFT NON TENDER PERCUSSION- DULL NOTE AUSCULTATION- PERISTALSIS- NORMAL
- 12. CNS Examination HIGHER FUNCTION- CONSCIOUS WELL ORIENTED CRANIAL NERVES- NORMAL MOTOR SYSTEM- NORMAL SENSORY SYSTEM- NORMAL RFELEXEX- NORM
- 13. LOCAL EXAMINATION Normal appearance of skin No discoloration Slightly moveable Round in shape
- 14. INVESTIGATION - Biopsy , ct scan Provisional Diagnosis - 1) Lipoma 2) Sebacious cyst Final diagnosis - lipoma
- 15. Analysis Symptoms classification Mentals –Gets angry easily but can't control characteristics Control his anger - Demand respect. common - Friendly nature. common - Extrovert. Characteristic
- 16. Physical generals - Desire spicy, non veg characteristic - Aversion to milk , spinach characteristic - Thermally chilly. Characteristic - Thirsty. Characteristic - Perspiration on neack and head. Common ● Particulars Lumps over posterior part of forarm characteristic Pressing type of pain< while lifting Heavy wt ,writing for long time>rest
- 17. Evaluation - Gets angry easily but can't control anger - Extrovert - Desire spicy & non veg - Aversion Milk & spinach - Thermally chilly - Thirsty - Lump over posterior forarm of left hand with pressing pain < lifting heavy wt, writing for long time > rest
- 18. Probable remidies - Belladonna - Sulphur - Calcarea carb FINAL REMIDY - BELLADONNA
- 19. Susceptibility Age - 16 yrs Sex- male Pathology - reversible Onset - slow Nature - chronic No of characteristic symp - more Immune response - good POSOLOGY - 200 potency Hight susceptibility BD x 7 days
- 20. PRESCRIPTION For , Mr Harshal Pangar 16 yr , male Rx Belladonna 200 BD x 7 days Follow up after 7days Reg no sign