O slideshow foi denunciado.
Utilizamos seu perfil e dados de atividades no LinkedIn para personalizar e exibir anúncios mais relevantes. Altere suas preferências de anúncios quando desejar.

Case on emphysema....shahnawaz

216 visualizações

Publicada em

this case i have taken in Shri Mahant Indresh Hospital dehradun, India

Publicada em: Saúde e medicina
  • Login to see the comments

Case on emphysema....shahnawaz

  1. 1. Presented by- Shahnawaz Ahmad Teli M.Pharm 2nd Semester (clinical pharmacy) CASE PRESENTATION ON emphysema
  2. 2.  Patient ID: 35726/16  Patient name: XYZ  Age: 5 years  Gender: Male  Date of admission: 17/10/16  Date of discharge: 3/11/16 Patient details
  3. 3. Patient Complaints  Fever and Chest pain since 30 days.  Breathlessness  Fever was gradual on onset , not associated with chills Physical Examination- General condition -- sick CNS -- Conscious, well oriented CVS – S1 and S2 sounds heard. Abdomen -- Non-tender, Non- distended (Normal). Vital signs- B.P- 118/80 mmHg P.R- 80/Min Resp.- 16/min Temp.- 99.4 F Spo2 --- 92%
  4. 4. PAST MEDICAL HISTORY :- ICD Insertion Past Medication History :- Nil Family History :- Nil Past History ICD insertion– An Implantable Cardiovascular defibrillator (ICD) insertion of an electronic device just below the collar bone is used to help regulate potentially life threatening heart rhythms .
  5. 5. HAEMATOLOGI CAL DATA Investigations Value Normal range Haemoglobin(Hb) 7.7 (L) 10-14g/dl Monocytes 16% (H) 2-10% ESR 120 (H) < 15mm/hr MCH 23.1 (L) 24-30 pg MCHC 30.3 (L) 31- 37 g/dl RBC 2.24 (L) 3.1-5.3millions/cmm TLC 27500 (H) 4000-11000/cmm Scr. 0.3 (L) 0.8- 1.5 mg/dl
  6. 6.  USG :  Organized debris in right pleural cavity & few thick septa, which suggests of emphysema.  Collapse /consolidation of right lung.  Culture Report: Technique- Zeil-Neelson Staining Result- No acid fast bacilli seen. Gram staining – No microorganism seen. Other Investigations
  7. 7.  On the basis of Laboratory investigations and Radio imaging, the patient was diagnosed as Emphysema. Final Diagnosis
  8. 8. Surgery  Surgery was done to remove damaged area of the lung and also Pleural fluid was drained out.
  9. 9. MEDICATION CHART Name, strength, route, frequency Date started Date stopped Inj.Teicoplanin 140 mg ( iv) 17/10/16 20/10/16 Inj.Tazomac (Tazobactum+Piperacillin) 1.4gm(iv) TDS 20/10/16 Till discharge Inj.Metrogyl (Metronidazole) 100mg (iv) TDS 17/10/16 29/11/16 Syp. Zincovit( multivitamin and minerals) BD 17/10/16 TILL discharge Syp. Combiflame( Ibuprofen+paracetamol) 325+400mg/5ml SOS 20/10/16 Syp. Broncorex (Bromohexine+terbutaline+Guaifenesin) 2 tsp. BD 29/10/16 TILL discharge Susp. Lizomac Ds (Linezolid 30ml) TDS 2/11/16
  10. 10. DISCHARGE SUMMARY  Susp. Linezolid 7.5ml TDS X 10 DAYS  Syp. Zincovit 5ml BD  Steam inhalation 3-5 times/day  Syp. Broncorex 2 tsf  Review after 7 days
  11. 11. CLINICAL JUSTIFICATION The treatment given was satisfactory almost as the condition of the patient was improving, apart from this there were some suggestions-  First line treatment for emphysema are antibiotics ( Beta lactum antibiotics, Aminoglycosides and Macrolides) .  supplement (Syp. Zincovit) was given for low hemoglobin.  Metrogyl and linzolid was given for surgical prophylaxis.
  12. 12. Patient Counselling  Try to do some regular exercise or physical activity that helps to improve breathing, ease symptoms and have a better quality of life.  Try to avoid triggering factors like extreme hot or cold weather.  Try to remain away from second hand smoking exposure.  Adhere to the medications.  Maintain hygienic conditions.
  13. 13. REFERNCE  Micromedexsolutions.com