A Case of Multiple Bone Fractures in right Upper Extremity with Multiple Comorbidities still have High S. Creatinine &. Urea Postdialysis: Can We Consider Surgery for his Fracture?

A 74 years old male presented to emergency department with multiple fractures in his right upper extremity from train accident along with multiple co-morbidities. Subsequent biochemical evaluation reveals that his hemoglobin level is low and S. creatinine, S. Urea is also high with metabolic acidosis. Initially patients fracture was managed with plastering it. Dialysis was planned but because of his higher than normal S. Creatinine, S. Urea, mild metabolic acidosis even after post dialysis, put the decision process in dilemma of if there are any benefit from this surgery and it will outweigh the risk!!

Case Note, Xray & Blood reports:

Comments

Consent Forms

Hindi BMJ Consent form Bengali BMJ Consent form English BMJ Consent form Telegu BMJ Consent Form Telegu BMJ Consent Form UDHC Consent Form

55 years Old male with Bipolar affected disorder moving from depression to Manic to depression phase

Disclaimer:- This is a HIPAA de-identified open-online-patient-record with initial information in patient's voice, posted here December 2017 after collecting informed patient consent (form downloadable Click Here) This is a case of a 55 years old, diabetic, hypertensive patient who was diagnosed with Bipolar affected disorder since 1995. In 1995 due to financial loss he was attacked by this condition. He was seen by Dr. D. K Agarwala and diagnosed as BPAD-Depression phase and treated with lithium, sodium valporate, propranolol, Zeptol cr, Nitrosum - S. With the treatment he was reasonably well but every 6 months of interval he appeared to have some disturbance like didn't want to talk to anybody, forgot to smile etc. They went to the doctor and treated accordingly and was continuing the treatment. In the year of 2013, August he was diagnosed with BPAD-severe depression phase but, he was not responding well to the medications and then they went to NIMHANS for...

60 year old woman with hypothyroidism and SIADH

This patient is a 60 year old woman with recent vomiting, coma (sodium 107) and clinical features of dull apathy, skin coarsening, bradycardia, areflexia strongly suggesting hypothyroidism. Serum osmolality and urine sodium are suggesting SIADH. Thyroid profile: Our patient's current dose of sodium is 10ml per hour and she is having mild hypotension at times and in her blood sugar recordings hypoglycemia (attached below) was noted. In brain imaging, empty Sella is noted (attached below). Most of the data we have till now is suggesting hypopituitarism Online Discussion:

BMJ Elective Case Log

Search This Blog