Covid



This is an online E log book to discuss our patient\"s de-identified health data shared after taking his/her/guardian\"s signed informed consent. Here we discuss our individual patient\"s problems through series of inputs from available global online community of experts with an aim to solve those patient\"s clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment



A 63 yr old man came with the cheif complaints of 

fever since 1 wk 

cough since 1 wk 

dyspnea since 4 days 

History of presenting illness : 

Patient was apparently asymptomatic 1 week back then he developed high gradefever which is continous type one week back associated with chills 

then he developed cough since one week which is productive with scanty mucoid

then he developed dyspnea at rest4 days back 

he tested RAT positive at COVID opd 

Past history :

Has a history of pulmonary kochs several years back for which she took ATT for 6 months 

k/c/o type II DM since 7 yrs and he is on METFORMIN 500mg 

k/c/o CKD since 2 yrs and on conservative treatment 

k/c/o bronchial asthma 

in 2019 he was admitted with b/l pneumonia 

Treatment history : 

Patient is on METFORMIN 500mg since 7 yrs 

Personal history :

Appetite normal  

diet mixed 

bowel and bladder regular 

sleep adequate 

Micturition normal 

No addictions 

Family history :

Not significant 

General examination : 

Pt is conscious coherent cooperative moderately built and well nourished 

no pallor icterus cyanosis clubbing lymphadenopathy Oedma of feet 

vitals :

       PR 101 bpm 

      RR  22 cpm 

      bp 110/70 mmhg

     Afebrile 

systemic examination:

RS:  respiratory rate : 22cpm

        position of trachea is central 

        Vesicular breath sounds  are present

CVS : 

        s1 and s2 heard 

        No added  thrills and no murmurs 

Abdominal examination :soft non tender , no organomegaly

CNS :intact 

Provisional diagnosis: 

Viral pneumonia secondary to Covid 19 infection with k/c/o CKD and DM since 7yrs with old case of pulmonary kochs 

Investigations:

 ECG
CXR-PA
CBP
CUE
RFT
LFT
d-DIMER
CRP
LDH
ABG
FBS
PLBS
HbA1C
RT PCR 


Treatment 

1)head end elevation 
2) O2 supplementation -15L/min
3)Inj DEXAMETHASONE 8mg iv TID 
4)inj ENOXAPARIN 60mg( sc /OD )
5) TAB DOLO 650 (po/ sos)
6)TAB LIMCEE (po/od)
7)TAB METFORMIN 500mg (po/od)
8)inj PANTOP 40mg (iv/od)
9) monitor vitals 
10) temperature charting 4th hrly 
11) GRBS charting 6th hrly 
12)TAB NODODSIS 500mg (po/bi)
13)TAB LASIX 40mg (po)














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