2020-2022 TITLE : Factors influencing clinical decision making around therapeutic interventions for critically ill renal failure patients in a rural medical college NEED FOR STUDY : Renal failure is increasingly recognized as a global public health problem. The clinical decision to continue conservative medical management vs dialysis in a patient with acute on chronic renal failure (particularly in low resource settings), is dependent on factors that have not be characterized well in the global literature although there are absolute and relative indications for dialysis, there are many clinical grey areas around them. Aim: To study various events related to and influencing treatment decisions around patients with critically ill renal failure Objectives : 1) Document the events and symptoms leading to the patient presenting with renal failure 2) Study the associations between the events and certain symptoms influencing the therapeutic decision taken 3) Document the patient outcom
1) PG integrated meet - autoimmune vasculitis 2)Aug 3rd (2021) - mortality meet : infective endocarditis 3) Dec 15 th integrated PG meet 2021( stress and heart diseases - DCMP) https://youtu.be/0DhbPzGuQVk 4) Dec 28 th mortality meet ( septic shock and MODS ) 5)Jan 11 th Mortality meet ( DKA with shizoprenia and hbs ag positive) - https://youtu.be/9k4JibwfvdE 6) efficacy of steroids ( COVID central meet) https://youtu.be/R6DH9b1EfUU 7)COVID: prevention of health care associated infections https://youtu.be/so0E-lJldmo 8) Mortality meet on Feb 1st 2022 41/M with left emphysematous pyelonephritis with sepsis with ARDS with alcoholic liver disease with AKI secondary to sepsis with type 2 respiratory failure with alcohol and tobacco dependence syndrome 9) Integrated meet Central vertigo : 23rd feb https://youtu.be/tI6uoD3wErY 10)Advances in covid management( interns ) : 16 th feb and 22nd feb 2022 11) Mortality meet : 9th July 2022 : 70/F with Cardiogenic shock secondary to ACS (
LONG CASE : 34 year old male patient resident of Nalgonda came to the hospital with CHIEF COMPLAINTS: Involuntary movements of upper limbs since 4 years Stiffness of all 4 limbs since 4 years Slowness of movements since 4 years Involuntary movements of lower limbs since 3 years HISTORY OF PRESENTING ILLNESS: Patient was apparently asymptomatic 4 years back then he developed involuntary movements which developed in right upper limb since 4 years and after 6 months of initiation of right side developed to Left upper limb which was gradual in onset, occurs at rest since 3 years developed in lower limbs also which were subsided by voluntary movements and also subsides during sleep as told by family members. Involuntary movements not decreased with levodopa medication. He has history of difficulty in initiation of movements , to start there is clumsiness of movements and now difficulty to perform his day to day activities like mixing of food , brushing teeth Difficulty to start
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