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Hello everyone..  I am an intern in Medicine and i am making this log so that I can share the cases I have been seeing during my posting at medicine department.And as a hope that some will share their new ideas and thoughts.

Details of this patient was given by my colleague intern, Anugna.I am thankful for that

CASE :

A 18YEAR OLD MALE PATIENT CAME TO OPD WITH CHIEF COMPLAINT OF WEAKNESS OF B/L LOWERLIMBS SINCE 20 DAYS

THE WEAKNESS STARTED IN PROXIMAL REGION 2 YEARS BACK WHICH IS INSIDIOUS IN ONSET GRADUALLY PROGRESSIVE LATER PROGRESSED TO B/L DISTAL REGION

H/O B/L EDEMA OF LL NON PITTING TYPE

H/O DIFFICULTY IN SQUATTING POSITION AND GETTING UP FROM SQUATTING POSITION

H/O DIFFICULTY IN WEARING AND HOLDING CHAPPALS

NO H/O DIFFICULTY IN COMBING HAIR , BUTTONING AND UNBUTTONING SHIRT

NO H/O CRANIAL NERVE INVOLVEMENT

PAST HISTORY

NOT A K/C/O HTN,DM,CVA, EPILEPSY,CAD,TB,THYROID

PERSONAL HISTORY-

diet-mixed

appetite-normal

sleep-adequate

B&B-regular

FAMILY HISTORY- 

not significant

-no known food or drug allergies

GENERAL EXAMINATION-

-patient was conscious, coherent and coperative

-moderately built and nourished.

-no signs of pallor, icterus, clubbing, cyanosis, lymphadenopathy, edema

-VITALS

1.temperature-AFEBRILE

2.pulse rate-92bpm

3.respiratory rate-18 cycles/min

4.BP-130/90mmhg

5.SpO2-96%

6.GRBS-142mg/dl

SYSTEMIC EXAMINATION

I.CVS-

S1 S2 heard

no added murmurs

2.RESPIRATORY SYSTEM-

-normal vesicular breath sounds heard

-bilateral air entry present

3.PER ABDOMEN-

shape=scaphoid

umbilicus=central and normal in position

all quadrants moving equally on respiration

no tenderness

no organomegaly

bowel sounds-heard

no bruit heard

4.CNS-

patient is conscious, coherent, coperative 

patient well oriented to time, place and person

higher mental functions= normal

Cranial nerves- intact

Motor system-

       tone - normal

       power -  4-/5 in both lower limbs

        reflexes absent in both lower limbs

sensory system-normal

No meningeal signs

No cerebellar signs

Based on the above complaints patients blood samples were sent for 

1.CBP

2.serology

3.RFT

4.ECG

5.CUE

6 MUSCLE BIOPSY

                                                                                                                                                                        

DD - Muscular dystrophy

         Acute on CIDP

TREATMENT

     T Prednisolone 15mg po od

      T Pantop 40mg bbf

        T Met xl 12.5mg od

       Cap Becosules od

        T Chymerol forte od

        T Taxim 200mg bd

         T Vit c od

          T Ultracet sos

 

PROCEDURE:

Have seen muscle biopsy from right quadriceps femoris as investigation for  Becker disease (provisional diagnosis)

 

Here is the sample that has been taken yesterday 

details about this case are presented by our Pg mam and has been uploaded in YouTube here is the link : https://youtu.be/3VVH7w3rWSM.

18/05/2020:

Patient came today and we are planning for randomised control trail with placebo and deoxyribose.

               This is to check whether deoxyribose has effect on myopathy or not.