CLINICAL MEET 21 ST DECEMBER Department of Medicine Chaired by Dr. - PowerPoint PPT Presentation

CLINICAL MEET 21 ST DECEMBER Department of Medicine Chaired by Dr. Rakesh Biswas Professor of General medicine

Dr. Sarat

EVENTS BEFORE HOSPITALIZATION 50Y Abdominal distension 46Y (2017) Diabetes 45Y (2014) EVENTS OF LIFE Menopause (2013) 41Y Schizophrenia 28 to diagnosed (2009) 38Y Worked at HYD 26Y (1997- Divorce 2007) (1994) 25Y Marriage (1993) Birth AGE AND YEARS 1968 Dr. Azra

Dr. Spandana

Dr. Spandana

Dr. Spandana

Dr. Spandana

Risk of malignancy indices(RMI) in preoperative evaluation of adnexal masses Dr. Sahithi

Dr. Sahithi

GENERAL PHYSICIAN CALL FOR HYPOTENSION ON DAY 4 OF ADMISSION DAY 1 ADMISSION BP – 90/60 mmHg DAY 4 ADMISSION BP- 70/50mmHg. Complaints of diarrhea Signs of dehydration present ? HYPOVOLEMIA TREATMENT: INTRAVENOUS FLUIDS GIVEN Dr. Siphora

• PRE OPERATIVE BP - 90/60mmHg • INTRA OPERATIVE BP - fell down to 60/40 mm Hg • Inotropes- nor adrenaline and central line was secured and 1 unit of whole blood was transfused • POSTOPERATIVE DAY - 1 BP -120/70 mmHg on inotropes • Inotropes was weaned off on pod-2 • CVP not mentioned Dr. Siphora

GENERAL PHYSICIAN CALL FOR HYPOTENSION WITH BP 80/50 mmHg POD 3 • CENTRAL VENOUS PRESSURE WAS 4CM OF WATER • TREATED AS HYPOVOLEMIA : INTRAVENOUS FLUIDS GIVEN WITH CVP MONITORING • PATIENT DISCHARGED WITH BP -100/60 mmHg Dr. Siphora

PATIENT SECOND VISIT AFTER 2 MONTHS FOR TOTAL HYSTERECTOMY WITH SALPINGO- OOPHORECTOMY TO SURGERY DEPARTMENT • C/O Weight loss and loss of appetite • With BP-70/50mmHg and was put on central line. Fluids and inotropes were started Dr. Siphora

GENERAL PHYSICIAN CALL FOR HYPOTENSION DAY 2 • Inotropes were weaned off • CVP -3cm of water and IVC diameter 1.3cm • Continuous CVP monitoring and IV FLUIDS accordingly given. • Patient was taken up for surgery with BP – 90/60 mmHg Dr. Siphora

• INTRA OPERATIVE BP -90/60mm Hg was maintained with IV fluids. • POST OPERATIVE BP – 90/60 mmHg • PATIENT DISCHARGED BP – 100/60 mmHg Dr. Siphora

Dr. Babji

Dr. Babji

Dr. Shweta

Dr. Shweta

5453/1 7 Dr. Shweta

How does body react to stress? • Behavioural sensitization to stress. • Biological mechanisms : 1.HPA axis dysregulation 2.Dopamine dysregulation Dr. Afeen

MANAGEMENT OF OVARIAN TUMOR STAGE 1 A [CLEAR CELL CA OF OVARY] TAH + BSO NO NEED OF CHEMOTHERAPY MONITORING WITH CA125 VALUES Dr. Sahithi