GENERAL MEDICINE E LOG BOOK BY PAWAN BHASIN ROLL NO. 115

70 year old female diabetic patient came for regular check up  K/c/o T2 DM since 10 years  K/c/o HTN on TAZLOC 40 mg ( telmisartan) since 3 years Weight loss present No polyuria , no nocturia Not a k/c/o- thyroid, asthma, CAD, CVA NO SIGNIFICANT PERSONAL AND FAMILY HISTORY O/E  PT IS C/C/C MODERATELY BUILD AND NOURISHED MILD PALLOR NO PEDAL EDEMA TEMP- 97.1°F PR-68BPM RR-21CPM BP-100/60MMHG SPO2 -99 % ON RA GRBS-  ON ADMISSION- 202 (11/11/21) GRBS AT 8 PM 154 MORNING 8 AM -105(12/11/21) SYSTEMATIC EXAMINATION CVS- S1S2 HEARD RS-BAE+ NVBS ABDOMEN - SOFT , NAD CNS- NAD TREATMENT TAB. TAZLOC 40 MG PO/OD GRBS MONITORING 8AM-2PM- 8PM INJ. HAI  Discharge summary

A 72 y old male patient general physician by profession came to opd with the c/o palpitations and shortness of breath on exertion since 6 years C/o insomnia since 10 years on alprazolam o.5 mg,  C/o dryness of mouth on taking medication No pedal edema, orthopnea, PND  *2015 - ACUTE LV FAILURE  EF20%  On cardivas , losartan  25mg , dabistar 110 mg No h/o DM, SMOKING, ALCOHOL ,TB K/C/O HTN since 6 yrs NO SIGNIFICANT PERSONAL AND FAMILY HISTORY O/E PT IS C/C/C MODERATELY BUILD AND NOURISHED TEMP-98.1°F PR-62BPM RR-24 CPM BP-140/90 MMHG SPO2 99 AT ROOM AIR SYSTEMATIC EXAMINATION CVS-S1S2 HEARD RS-BAE+ NVBS ABDOMEN - SOFT ,NAD CNS- NAD PROVISIONAL DIAGNOSIS HFrEF 2° TO CAD AF with  CVR TREATMENT Tab. Pan 40 mg po/od 7am Tab. Losar H 5p/12.5 mg po/od 8am Tab. Dapaniflozin (oxra 10 mg) - po/od Tab. Digoxin 0.25 mg po/oD Tab. Cardivas CR Po/oD Tab ALZOLAM O.5 po/oD Discharge summary

A 28 y old female patient came with c/o pain in  epigastrium and right hypochondrium  since 1 month  Pt was apparently asymptomatic 1 month ago and then she developed pain in epigastrium and rt hypochondrium aching type , non radiating, with no aggrevating or relieving factors  No c/o vomiting, belching ,fever ,  constipation ,  burning micturation , white discharge  PAST HISTORY :-  Seizure during pregnancy - was on medication till 2 years 2FTNVDS and tubectomised  Not a k/c/o DM, HTN, CAD, CKD , ASTHMA , TB , EPILEPSY  PERSONAL HISTORY - married housewife with normal appetite with non veg diet , regular bowels , normal micturation , no known allergies , NO ADDICTIONS . NO SIGNIFICANT FAMILY HISTORY MENSTRUAL HISTORY - AOM- 16 YEARS Menstrual cycle 28/3 LMP-15/10/21 OBSTETRICS FOMULA - G2P2L2 O/E pt is C/C/C MODERATELY BUILD AND NOURISHED  NO PALLOR , ICTERUS , CYANOSIS , CLUBBING, LYMPHADENOPATHY , EDEMA  Temperature -97.4°f PR-72BPM BP-110/70 mmhg RR-16CPM Spo2 at room air - 98%

DR.HUDA(INTERN) DR.RUTHWIK (INTERN) DR.PAWAN BHASIN (INTERN) DR.SHUBHASRI(INTERN) DR.DURGA(INTERN) DR.SHASHIKALA (PG-2) DR. DIVYA(PG-3) DR.RASHMITHA(PG-3) DR. HAREEN(SR) DR. ARJUN (AP) DR. RAKESH BISWAS (HOD)

A 44 year old male patient it came to casualty with  C/o shortness of breath (grade II) according to NYHA classification Not associated with orthopnea/PND. C/o B/L PEDAL EDEMA ( pitting type ) since 1 week  C/o decreased URINE OUTPUT since 1 week C/o FACIAL PUFFINESS since 1 week  Pt was apparently asymptomatic 1 week back then developed fever associated with chills and rigor, was diagnosed with typhoid and was treated outside in a private hospital  Pt also C/o loss of appetite, and 2 episodes of vomiting ( non bilious , non projectile ) not A/W nausea. Pt is a K/C/O  -CKD since 10 years on regular medication  - DM since 4-5 years  (on GLIMI M2 morning and GLIMI M1 night) -HTN since 1 year - on Tab TELMA-AM NO SIGNIFICANT FAMILY HISTORY PERSONAL HISTORY O/E- Pt is c/c/c obese , clubbing present TEMP+98.4°F BP-130/80MMHG PR-89 BPM RR- 20CPM SPO2-98% @ RA CVS-S1S2 HEARD NO MURMUR RS-NVBS + NO CRYPTS P/A-SOFT, NON TENDER CNS-HMF INTACT APEX BEAT- 6TH ICS LATERAL AND OUTWARD JVP-RAISED , E