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) Doc...
KHL postings : DAY 1 :Presented a case of 56 /F P3L2D1 with c/of lump of right breast since 6 months .. on examination 5 *3*3 cm lump present in right upper outer quadrant .. with no other findings like nipple discharge, distruction, paued orange or lymphnodes . FNAC done outside shows ? invasive carcinoma advised true cut biopsy and mammography . Other follow up cases of carcinoma of breast and cervix DAY 2: Approch to thrombocytosis DAY 3: carcinoma of pancreas DAY 4: Carcinoma of stomach DAY 5: Carcinoma of rectum DAY 6 : Carcinoma of cervix DAY 7 : Recurrent carcinoma of breast DAY 8: 26/F P2L1 missed abortion done D and C outside twice but due to uncomfortable bleeding during 2 nd D and C emergency TAH + BSO done and HPE of the specimen of uterus showing invasive mole ( outside hospital ) ..so referred here to our hospital for further management .. on presentation patient was stable , only one beta hcg values available which was...
Case 1: https://tejasree25.blogspot.com/2022/04/nephrotic-syndrome-with-type-i-dm.html This is a case of 22 year young married female with DM 1 since 11 years and Hypertension since 6 months 1st presentation : April 2022 Presenting complaints of B/L pedal edema since 1 months •Shortness of breath (grade 2-3 ) since 1 months,which is insidious on onset gradually progressive not associated with orthopnea /PND •Decreased urine output since 10 days •Swelling of lips since 3 days On examination Anasarca +, Pallor + Her baseline creatinine at time of admission was 4.7 , urea 82, serum albumin :2.8 , hb:7.8, Chest xray showing b/L moderate pleural effusion 2D echo : EF :60, good LV systolic function With severe metabolic acidosis ( anion gap :21 at admission , 8.2 at time of discharge ) Microvascular complications of diabeties + in this patient such as albuminuria, diabetic retinopathy changes 24 hours urinary prot...
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