Day 47 : A boring day with the return of Mrs. Celine and Sildenafil

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.

She was admitted to ward with 3% NaCl with 20ml/he and to continue all her old meds. Tab Spiromide was only stopped from her old meds. Have to see her improvement as the days go on.

Also learned about Sildenafil.

A patient who was k/c/o COPD with HTN was on Tab Sildenafil 20mg.

So I asked why is he on Sildenafil which is normally given in Erectile dysfunction cases.

So, Dr Adarsh smiled and said that it is also suggested in Pulmonary Arterial Hypertension as it acts a Vaso dilator. It dilates the blood vessels that supply the lungs and relieves breathlessness. It also improves exercise capacity in men and women.

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Day 57 : Right toe ulcer with TAO ( Buerger's Disease)

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Day 48 : A large right lower limb swellling with cellulitis , Filariasis

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.

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