Victor's Medical Diary

Monday 28/11/2022 Adarsha Hospital,Kundapura  Had night duty today. Patients were less, the night was going good. Then a patient came to casuality reffered to Dr.Adarsh by Dr.Nagesh for admission. I went to casuality to see the patient. The patient was Mr.Narayana, middle aged man k/c/o T2DM came with c/o ulcer over his right greater toe with right lower limb swelling and fever since 3 days.  On examination he had a 2x2 cm ulcer over his 1st toe of right lower limb. He had done a Arterial and venous Dopler study of Right lower limb which said that he had decreased arterial flow below ankle and he had Thromboangiitis obliterans. He was admitted to ward and reffered to Dr.Adarsh (Surgeon) for further management. Dr. Nagesh was planning to start Inj Alprostadil after discussing with Dr Adarsh to increase the blood flow over there. Some details about  Thromboangiitis obliterans Thromboangiitis obliterans (TAO), an inflammatory vasculopathy also kn...

Wednesday 30/11/2022 Adarsha Hospital,Kundapura  Had a pretty good day today. Finished rounds and OPD with Dr.Adarsh. During the evening around 3:30pm a patient was brought to casualty in a unconscious state. I rushed to casuality to see him. The patient was Mr.Shankar, a middle aged man k/c/o T2DM,HTN,IHD with a recent h/o hospitalisation for CVA left hemiparesis. He was in a unconscious state with a GCS of E1V1M1 with profuse sweating. He had tremors on his left hand. He had multiple episodes of vomiting and had Nausea since 1 day. His Vitals were stable and GRBS was 127mg/dl. He had a Temp of 100.1 degree F. On Examination his pupils were reactive. CNS was unconscious and not oriented. Chest was clear. ECG was done and was normal. Electrolytes were norrmal. As my time was up I came to my house. Will review the patient tomorrow and update on his condition.

Sunday 27/11/22 Adarsha Hospital,Kundapura I had night duty today, So didn't see much patients. But in the evening there was an interesting patient. The patient was Mrs.Sudha, 26 year old female with no premorbid illness presented with c/o deviation of right side of mouth with right upper limb weakness. She also had drooping of right eyelid. She was admitted to ward and was advised for blood investigations,ECG,CXR and CT Brain. Her blood tests were normal except slight rise in total counts of WBC, ECG,CXR abd CT Brain were normal. She was reffered to Physician Dr.Nagesh.  When Dr.Nagesh saw the patient he immediately diagnosed her as Bell's Palsy and nothing else. He was 100% confident. He advised the following treatment and said that it will take one week to recover and there is no need to worry. His treatment was as following: 1. Inj MOCEF 1gm IV ATD 1-0-1 2.Inj EMESET 4mg IV 1-1-1 3.Inj PANTOP 40mg IV 0-0-1 4.Inj NERVIJEN PLUS IV 0-0-1 5.Tab SUPRADYN P/O 1-0-1 6.Tab WYLOSONE...

Saturday 26/11/22 Adarsha Hospital,Kundapura A patient 24 year old male presented with c/o difficulty in micturition since 2 years and sudden loss of micturition (Urinary Retention) since 2 days. He had undergone USG Abdomen and Pelvis which stated that he had Mild Calculus in the Urinary bladder. He was reffered to Urologist and he advised him surgery named Cystolithotrity. Bladder Stones  - Causes,Symptoms,Risks,Complications,   Diagnosis and Treatment

Thursday 24/11/22 Adarsha Hospital, Kundapura More details about TURBT Transurethral resection of a bladder tumor (TURBT) can involve both biopsy and tumor removal (resection). Because the procedure goes through the urethra, no incisions are necessary. The surgery can prevent cancer from invading the muscle wall.

Friday 25/11/22 Adarsha Hospital,Kundapura The day was boring as I had evening duty today. I was sitting in the OPD when a call came from 2nd floor ward. It was about decreased urine output about a patient named Sri Devi.  I had seen this patient few days back. Sri Devi was a middle aged woman, k/c/o T2DM,HTN,CKD,IHD came with c/o breathlessness, lower limb swelling and abdomen distension since 5-6 months. She was admitted to ward for further management. Her breathlessness and lower limb swelling had decreased but abdomen distension was still significant. We went to see her at approx 4:00pm to asses her condition. She had passed urine today morning at 6:00 am and since then she had not passed urine. On examination she had some tenderness at lower abdomen, but she didn't had the urge to pass urine. We advised for hot water compression over the bladder region and wait for few hours. Because she was a k/c/o CKD and she had limit of 1 and half litres of water per day. At 5:30 pm We got...

Tuesday 22/11/22 Adarsha Hospital, Kundapura The day started at 11 am due to temporary shift changes. I finished Dr.Adarsh sir OPD and went to casuality with sir for dressing. At that time, he called Dr.Krathika to say something. He said write the full form of OCD (Obsessive compulsive disorder) otherwise the insurance people may not sanction the amount. I wondered what it might be at first as I was unaware of the term OCD. Then I found out that the patient diagnosed with OCD was Mr.Ganesh. I had seen him two days before when he came for admission to our hospital. He had unusual complaints like he had lust for girls etc. But my duty was about to finish that day and the next day I was on leave, So I missed to see him. Then I looked at his Case sheet,Mr. Ganesh, a 24 year old boy had c/o bad dreams with unwanted thoughts in day and night. He would feel lust to any girl he sees and he is also ashamed of his thoughts. He consulted Psychiatrist Dr.Nithin and he had advised a...

Monday 21/11/22 Dcosta Mansion, C.S.Road, Kundapura I didn't go to hospital today as I took leave. Today I'm going to talk about why am I working in a Allopathic hospital being an Ayurvedic doctor.  I didn't have practical exposure in Ayurveda during my UG days. So when I joined allopathic hospital, the patient flow was immense. This helped me to learn lot of things very quickly. It's very hard to find a job in the field of Ayurveda, and even if you get one the pay is very less or there is no pay. You have to work for free. The pay at Allopathic hospitals are atleast manageable. There are very few cases in ayurvedic hospitals and we don't get exposed to different cases. The use of modern technologies in Diagnosis is less in  Ayurveda. In Allopathic hospitals,we get to learn lot of new and updated concepts to diagnose a disease and treat them accordingly . Sometimes due to our wrong diagnosis the patient might lose his life. There is no scientific explana...

Sunday 20/11/22 Adarsha Hospital,Kundapura Duty on Sundays is always boring. Started my day good I met my old neighbour and childhood teacher Pushpa aunty. She came with c/o weakness and during blood test her Hb was low and treated accordingly. Also met my Childhood Kannada teacher Nagaraj sir. He came to show his mother for regular checkup. But the day was boring since no good and interesting cases came. But a patient who visited on OPD basis was little interesting. The Patient was Mrs. Bibi Hannisa, middle aged women k/c/o HTN,T2DM,CKD,COPD presented with c/o Fever with chills, generalised weakness since 3 days. She is Obese and had been admitted previously for similar condition in our hospital. She always gets repeated LRTI. On examination, She had B/L Rhonchi+. Sir ordered some blood tests,CXR and ECG. When her lab reports came, it shower that she has severe infection. Her WBC was 23,000 u/L with raised nuetrophil levels (80,000u/L). Her RFT was slightly raised Sr. Crea...

Saturday , Adarsha Hospital,Kundapura The day started well with an RTA skid and fall case which was then reffered to KMC,Manipal. Then finished Dr. Adarsh Sir rounds and followed by his OPD.  In the evening almost at 4:00PM a case came to casuality reffered by a local doctor. The patient was Mr.Channayya Poojari , middle aged man k/c/o HTN  came with c/o Black tarry stools since 3 days with generalised weakness,myalgia. He was having multiple episodes of loose stools since 3 days. He is a chronic smoker and Old Alcoholic (Left 10-15 years back). He had Haemorroids few years back and had undergone haemorroidectomy two years back.He had Icteus+ . On examination his vitals and systems were normal. On P/R examination some blood was seen which looked like recent bleed. source : Osmosis.org We sent some lab investigations like CBC,RBS,RFT,LFT,Serum Electolytes till sir had to come. Had thought of sending for stool for occult blood once sir examined the patient. Primary ...

18/11/22 Friday Adarsha Hospital, Kundapura The day began good with patients in casuality in the morning followed by Dr Adarsh Sir rounds and then his OPD. While in his OPD, A patient came with Large right lower limb swelling. The patient was Mr.Rajashekhar, middle aged man k/c/o Filariasis since 12 years.  He had swelling over his right lower limb with cellulitis since 10 days. He was Febrile with 99.5 degree F fever. He had severe pain and swelling. Just by seeing the severity of the leg he was advised to go to higher center for management. But patient refused and insisted to get treated in our hospital. He was then taken to minor OT for Incision and drainage. As Dr. Adarsh incised few areas over his right lower limb the patient was shouting in pain. He had tears in his eyes due to excruciating pain. Dr Adarsh released the pressure that was built in the swelling. Then he was dressed and shifted to ward.

17/11/2022 Thursday Adarsha Hospital, Kundapura  The day started with Dr.Adarsh sir rounds and followed by OPD. The day was dull and I was helping sir in his OPD. Suddenly Nayana sister from the casuality came inside OPD and said that Pt.Celine has come to casuality with weakness.We rushed to Casuality to review the patient.  The Patient was Mrs. Celine D'Souza, 79 year old female k/c/o T2DM,HTN,CKD,COPD with BA on Rx. She was admitted many times before in our hospital and her recent visit was during my night duty last month. Now she presented with generalised weakness and breathlessness. Her Vitals were good and GRBS was 177mg/dl. Dr Adarsh sir examined her and she had B/L Rhonchi with pitting pedal edema. He immediately ordered some blood tests, ECG,CXR. Her lab tests included CBC, RFT, LFT, Serum Electrolytes. After few minutes, her lab reports came and she had low Na+ - 118 cucm. She was diagnosed as Hyponatremia with other premorbid illness. ...

16/11/2022 Wednesday Adarsha Hospital, Kundapura I was sitting idle in the casuality in the morning when a patient came with c/o right sided chest pain. I went to him immediately to examine him. The Patient was Mr. Nerambally Narayana , middle aged man k/c/o Hypertension on Rx with c/o Right sided chest pain on and off since one week . He had decreased sleep.  On Examination,  he had tenderness over right lumbar region with mild icterus. So, when I asked more about this I found out that he is chronic alcoholic with previous history of acute liver injury.  So I ordered some lab tests - CBC,RBS,LFT.RFT,ECG and CXR,USG abdomen. Since USG had to be done outside the hospital, It got late. All his blood reports,ECG,CXR was normal. We had to wait for USG for final diagnosis. When USG report came, it was mentioned that he had B/L Renal calculi with Ileoclotis . And the calculi was not significantly large to get operated.  Guess what was hid final diagnosis....

 15/11/2022, Tuesday, Adarsha Hospital, Kundapura The day began boring as I finished rounds with Dr. Adarsha Hebbar, then I went to his OPD to see his patients. The patients were usual and there was no interesting case. He said me to remove suture of a RTA patient discharged a week back. I removed sutures. Adarsh sir visited casualty to see a patient who had difficulty in walking.  The patient was Mr.Suresh Shetty, Midlle aged man who was a k/c/o HTN . He presented with c/o swelling, reddness and pain over right thigh which made him difficult to walk. While examining him, he had urticaria like symptoms over his right thigh. He also had pitting pedal edema. He also had a h/o fever a week back. The condition of his leg looked bad. He also had murmurs (abnormal heart sounds). He needed higher antibiotics to stop the spread of the infection. He was advised for admission. His treatmennt plan was as following  1. INJ SINIBEC 4.5MG IV 1-1-1-1 2. INJ XOLID 600MG IV 1-1-1 3. INJ...

November 14, 2022 Monday  Adarsha Hospital, Kundapura During the rounds of Dr. Adarsha Hebbar in the morning, we saw Pt. Manjunath Naik, who was admitted on 12/11/22 for gangrenous 4th right toe (ring toe). He is k/c/o T2DM,HTN.PVD and his 5th toe (little toe ) was amputated in our hospital few days back. We had done arterial and venous doppler of right lower limb which showed decreased blood supply to lower part of the lower limb. The 4th toe had turned black and looked very bad. The patient and his attenders were not reluctant for the amputation of the 4th toe. They requested the doctor to save his 4th toe by any means. At that time Dr. Adarsha Hebbar suggested inj.Prostal ( Alprostadil) 500mcg. He said we will try inj Prostal for 5 days. Even after this injection if there is no improvement,then we have to amputate the 4th toe to save others nearby toes in the future. Gangrenous toe  Some details about Inj Prostal (Alprostadil 500mcg) Prostal Injection is used to treat paten...