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76 years old MALE WITH CARDIOGENIC SHOCK, ATRIAL FIBRILLATION, HFREF (17%) PRE RENAL AKI ON CKD, RIGHR UPPER LOAB FIBROSIS (post TB sequelae)

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76 years old MALE patient came with complaints of DIFFICULTY IN BREATHING since 1 month HOPI :  Patient was apparently alright before 1 month then he devoloped DIFFICULTY IN BREATHING insidious in onset and gradually progressive from grade -1 to grade -2 then to grade -4 (mmrc)  No h/o cough No h/o chest pain, chest tightness  No h/o sweating / giddiness No h/o vomitings /diarrhoea No h/o bleeding manifestations PAST HISTORY : K/C/O PULMONARY TUBERCULOSIS took medication for 6 months 2years ago and also took the same medication for 6 months 4 years ago. Not a K/C/O HTN /DM / ASTHAMA /EPILEPSY/CAD PERSONAL HISTORY : Diet - mixed,  Appetite -decreased Bladder - Normal Bowel - constipation ADDICTIONS : Regular Alcoholic took 1 bottle of toddy/day since 40years , stopped 2 months ago Smokes 4-6 chuttas /day since 40 years, stopped 2  months ago.  FAMILY HISTORY : No history of similar complaints in the family.  No history of DM/HTN/TB/ASTHAMA/EPILEPSY/CAD ...
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50 THESIS CASES

CASE NO -1 77 years / MALE D. O. A : 03/03/2024 D. O. D : 13/03/2024  Diagnosis 1.CARDIOGENIC SHOCK(RESOLVED) SECONDARY TO ACS [NSTEMI EVOLVED IN LCX ,RCA TERRITORY ] WITH ATRIAL FIBRILLATION WITH FAST VENTRICULAR RATE(RESOLVING) 2.HEART FAILURE WITH REDUCED EJECTION FRACTION [EF -20 %] 3.? CARDIO RENAL SYNDROME TYPE 1 4.? PRE RENAL AKI ON ? CKD [RESOLVING] 5. RIGHT UPPER LOBE FIBROSIS POST TB SEQUELAE Case History and Clinical Findings C/O DIFFICULTY IN BREATHING SINCE 1 MONTH HOPI PATIENT WAS APPARENTLY ALRIGH 1 MONTH BACK THEN DEVELOPED DIFFICULTY IN BREATHING INSIDIOUS ONSET GRADUALLY PROGRESSIVE FROM GRADE 1 TO GRADE 2 TO GRADE 4 .NOW MMRC NO H/O BLEEDING MANIFESTATIONS NO H/O SWEATING ,GIDDINESS NO H/O BURNING MICTURATION ,SKIN CHANGES ARROUND UMBILICUS NO H/O FEVER ,COLD ,COUGH NO CHEST PAIN , PALPITATIONS ,ORTHOPNEA K/C/O TB 2 YEARS AND 4 YERAS AGO -O MEDICATION FOR 6 MONTHS EACH TIME N/K/C/O DM , HYPERTENSION, TB, ASTHMA, EPILEPSY. SMOKES 2-5 CHUTTAS /DAY STOPPED 2 MONTHS ...
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DR VENKANNA'S THESIS

TITLE CLINICAL PROFILE, COMORBIDITIES AND OUTCOMES IN PATIENT WITH CARDIAC ARRHYTHMIAS PROBLEM STATEMENT : Arrhythmias are a common dilemma confront- ing the intensivist. They represent a major source of morbidity, and they lengthen hospital stay. Arrhythmias are most likely to occur in patients with structural heart disease. The inciting factor for an arrhythmia in a given patient may be an insult such as hypoxia, infection, cardiac ischemia, catecholamine excess (endogenous or exogenous), or an electrolyte abnormality. Management includes correction of these imbalances as well as medical therapy directed at the arrhythmia itself. The physiological impact of arrhythmias depends on ventricular response rate and duration as well as on the underlying cardiac function. Bradyarrhythmias may decrease cardiac output due to heart rate alone in patients with relatively fixed stroke volumes, and loss of an atrial kick may cause a dramatic increase in pulmonary pressures in patients with diastol...
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