Scribd
Upload
6K views26 pages

Case PPT DM

1) Jagat Ram, a 53-year-old businessman from Ambala City, Haryana, presented with a 15-day history of fever and right upper quadrant abdominal pain. 2) He had a 5-year history of type 2 diabetes mellitus managed with oral hypoglycemics. 3) Investigations showed hepatomegaly with a liver abscess. He was diagnosed with type 2 diabetes mellitus complicated by a liver abscess.

Uploaded by

Garima Kamboj Mirok
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
6K views26 pages

Case PPT DM

1) Jagat Ram, a 53-year-old businessman from Ambala City, Haryana, presented with a 15-day history of fever and right upper quadrant abdominal pain. 2) He had a 5-year history of type 2 diabetes mellitus managed with oral hypoglycemics. 3) Investigations showed hepatomegaly with a liver abscess. He was diagnosed with type 2 diabetes mellitus complicated by a liver abscess.

Uploaded by

Garima Kamboj Mirok
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
You are on page 1/ 26

CASE Presentation Diabetes Mellitus

RESOURCE PERSON: Dr. Abhiruchi Galhotra PRESENTED BY: Dr. Dinesh Mirok

Presenting

the case of Jagat Ram, 53

year old male


Married Businessman Religion: Address:

Hindu s/o Brij Lal resident of

Ambala City, Haryana.

Presenting Complaints:
Fever since 15 days, pain in upper abdomen since 15 days and K/C/O Diabetes since 5 years

History of present illness:

The patient was apparently well 15 days back


when he started complaining of fever. It was sudden in onset, continuous in nature and accompanied with rigors and chills. There were no complaint of rashes.

He was also having pain in the right upper


quadrant (RUQ) involving rt. Hypochondriac

and Epigastrium regions of the abdomen.

The pain was severe in intensity, continuous and non radiating in nature.

The patient took some analgesic + antipyretic from some local practioner for the same and got relieved for some time only.

After that the patient went to the trauma centre,


Ambala and from where he was referred to

GMCH, Chandigarh

He was admitted in GMCH on 24th August where his investigations showed following results:
Hb: 11.5 g/dl

TLC: 21000

Platelet count: 2.5 lakh


DLC: 85/08/01/01

Na+: 139 mEq/ dl K+ : 4 mEq/dl Urea: 38 mg/dl

Creatinine: 1.2 mg/ dl


SGOT: 71.9 IU/L

SGPT: 105.7 IU/ L


ALP: 631.7 IU/ L

S. Bilirubin: 12.6 mg/dl FBS: 230 mg/dl USG abdomen showed hepatomegaly with

liver abcess

The patient is also a k/c/o Diabetes Mellitus


His chief complaints prior to diagnosis were

polydipsia , polyuria and weakness in the legs.

He went to a private doctor in Ambala for checkup, who told him to get his random blood sugar level which was reported as 400mg/dl.

He was then diagnosed as case of T2DM for

which he was taking oral hypoglycemics


( Glimperide + Metformin).

According to the patient his sugar level was


completely fine throughout after he started

the medicine although he is not carrying


any authentic proof for the same.

No h/o HTN No h/o Peripheral Neuropathy No h/o Nephropathy (as told by the patient) No h/o any visual disturbance

Past history: No significant history of any other long term illness like hypertension, TB, any similar

episode or any other chronic illness in the


past Family History: No family h/o hypertension ,TB , Endocrinopathies or any other chronic disease in family.

Personal History :

Non Vegetarian,
Non Smoker Non-alcoholic Bladder, bowel habits are normal Sleep : normal for 8-10 hours day The patient goes for a morning walk daily that is 2- 3 Km (as told by the patient)

Socio Economic status: Education : Graduation Occupation :Businessman Income: Approx. Rupees 30000 per month from all sources Per capita income: Rupees 5000 Score: Occupation : 5 Education : 6 Income : 6 Total : 17 Social Class: II (Upper Middle)

Environmental History (as told by the

patient)

Lives in Pucca house, floor cemented, roof

is present

Number of floors: 2 No of rooms per floor:2, patient lives on top floor with wife No of doors in house: 5

No of windows: 6

Cross ventilation: Present Personal toilet is present Water Supply: Tap Water ,storage tank present in house Filtered Drinking Water facility is available in the house Cooking: Uses Gas, Smoke vent is present No pets at home Rodents ,Mosquitoes present Uses repellants for Mosquitoes

Dietary History (Before Hospitalization):


Breakfast : 1 Prantha + 1 glass milk + 2 eggs (boiled) Lunch : Rice (2 katori )+ 4 katori veg + 4 chapati Evening : 1 cup tea without sugar Night : 4 chapati + I katori Dal +1 glass milk

Total calorie and protein intake:


Energy Proteins

Intake (past 24 hours)

1910 Kcal

60gm

Required intake

Total intake (in 24 hours )


1200 Kcal 710 Kcal

25gm

Excess

35gm

Daily Intake in Hospital:


Early Morning: 1 Cup Milk without sugar Breakfast : 1 Katori Dalia +1 Cup Tea Lunch : 1 Katori Dal + 2 Chapattis + 1 Katori Curd + Green Salad with lime Evening : 1 Cup Milk (without sugar)with 2 Bread Slices

Night : Katori Khichdi + 1 Katori Curd + Green Salad with lime


Energy Proteins

Intake (past 24 hours)

1175 Kcal

25gm

Total intake (in 24 hours )


1200 Kcal 25gm

Required intake

Deficit

25 Kcal

Treatment history :

Taking OHD for T2 DM General physical examination:

Patient was calm, cooperative, conscious and well oriented to time, place and person Built :Well built Height : 171cms

Weight : 89 kg
BMI : 30.4

Pulse :100/min ,regular, no radio-femoral


delay, all peripheral pulses are palpable

Blood pressure :
1st reading-------130/84mm Hg

2nd reading ------130/80mm Hg (after


2 mins)

Respiratory Rate :24/min

Pallor : +
Icterus: +++ Clubbing : Koilonychia : Lymphadenopathy : + Edema : + Thyroid: normal

SYSTEMIC EXAMINATION : Abdominal examination :

Tenderness present

Hepatomegaly
No other abdominal mass felt

Bowel sounds heard

Eye examination :

Visual examination : WNL

CVS :

S1,S2 Heard
No parasternal heave, No murmurs Normal vesicular breath sounds No adventitious sounds Trachea midline No neurological deficit present Reflexes normal No facial asymmetry

Respiratory system:

Nervous system examination :


Provisional diagnosis: T2DM with Liver abscess


Investigations and Follow up: FBC: Hb, TLC, DLC LFT Culture liver abscess CECT abdomen

Comprehensive diagnosis : Jagat Ram, 53 year old male upper middle(II) socioeconomic status, nonsmoker, non-alcoholic is suffering from T2DM with Liver abscess

Treatment being given to the patient:


Inj.

Insulin 4U TDS, Inj. Tramadol 100mg

SOS, Inj. Metrogyl 400mg BD, Inj. Rantac 150mg BD, Inj. Ceftrixone BD, Inj. Vit K
Low

calorie diet as told by the dietician

Thank You

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy