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.

Comments

Day 49 : To find out the cause of Black tarry stools (Melena)

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 ...

Day 52 : OCD and lustful thoughts of Ganesh

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...

Day 53: The Bladder cancer and TURBT

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.

Victor's Medical Diary

Search This Blog