Case history-2

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A 36 year old female house wife came to the hospital with complaints of 

Fever since 5 days

Abdominal pain since 5 days 

Nausea since 5 days 

 patient was apparently asymptomatic 5 days back. Then she complained of fever which is high grade , continuous ; not associated with chills and rigors . Relieved with medication .

No complaints of cold and cough . patient complaints of generalised weakness .

Patient complaints of nausea, vomiting 2- 3 episodes per day associated with food particles , non bilious , non blood tinged. 

Patient complaints of abdominal pain in the umbilical region  , which is squeezing type and relieved after vomiting . No complaints of loose stools or constipation . No c/o pedal edema, Facial puffiness . No c/o burning micturition .

No c/o chest pain, palpitations , syncopaal attacks . C/o sob grade 2. orthopnea and pnd absent. 

C/o frontal headache which got subsided on medication. No c/o bleeding manifestations . she was a known case of hypothyroid on thyronorm 50 microgram po / od

Past History: No H/O of  Diabetes  , Hypertension, CAD, Asthma, Tuberculosis

Personal History: 

Diet :Mixed

Appetite: lost

Sleep: adequate 

Bowel and bladder habits : Regular 

Addiction:No addictions 

On examination: 

Vitals:

PR: 100 bpm 

Bp: 100/70 mm of hg 

Spo2: 96% at RA

Grbs: 144 mg%

No pallor, Icterus, Cyanosis, Clubbing, lymphadenopathy, edema

Systemic examination: 

Cvs: 

S1 S2 present 

No murmurs, no thrills

Rs: 

Normal vesicular breath sounds heard

Abdomen: 

Shape: scaphoid 

Tenderness present in umbilical region, No palpable masses

Cns: NAD

 Provisional diagnosis:

Dengue ( Ns1, IgG positive with Thrombocytopenia (resolving) with viral hepatitis 

Investigations:

On 12/ 08/ 21: 

Hemogram:

On 14/08/21:

Obg referral for PV clots: 

On 15/8/21:

On 16/8/21:

Ophthalmology referral for blackish discoloration of left eye:

On 17/8/21:

Fever chart:

A 36 year old female house wife came to the hospital with complaints of Fever since 5 daysAbdominal pain since 5 days Nausea since 5 days 
 patient was apparently asymptomatic 5 days back. Then she complained of fever which is high grade , continuous ; not associated with chills and rigors . Relieved with medication .No complaints of cold and cough . patient complaints of generalised weakness .Patient complaints of nausea, vomiting 2- 3 episodes per day associated with food particles , non bilious , non blood tinged. Patient complaints of abdominal pain in the umbilical region , which is squeezing type and relieved after vomiting . No complaints of loose stools or constipation . No c/o pedal edema, Facial puffiness . No c/o burning micturition .No c/o chest pain, palpitations , syncopaal attacks . C/o sob grade 2. orthopnea and pnd absent. C/o frontal headache which got subsided on medication. No c/o bleeding manifestations . she was a known case of hypothyroid on thyronorm 50 microgram po / odPast History: No H/O of Diabetes , Hypertension, CAD, Asthma, Tuberculosis
Personal History: Diet :MixedAppetite: lostSleep: adequate Bowel and bladder habits : Regular Addiction:No addictions 
On examination: 
Vitals:PR: 100 bpm Bp: 100/70 mm of hg Spo2: 96% at RAGrbs: 144 mg%
No pallor, Icterus, Cyanosis, Clubbing, lymphadenopathy, edema
Systemic examination: Cvs: S1 S2 present No murmurs, no thrills
Rs: Normal vesicular breath sounds heard
Abdomen: Shape: scaphoid Tenderness present in umbilical region, No palpable masses
Cns: NAD
 Provisional diagnosis:Dengue ( Ns1, IgG positive with Thrombocytopenia (resolving) with viral hepatitis 
Investigations:
On 12/ 08/ 21: 
Hemogram:

























On 14/08/21:




Obg referral for PV clots: 




On 15/8/21:



On 16/8/21:


Ophthalmology referral for blackish discoloration of left eye:



On 17/8/21:




Fever chart: