A 45 year female pt c/o Alternate day vomiting since 2 months Mild abdominal pain side of rt lumber region radiate to back side since 1 month Loss of appetite since 2 months Burping ( belching) since 1 year Gen weakness Tingling sensation both hand & toes Distanted abdomen since 15 days DM - T2 since 18 years HTN since 5 years UTI since 1 years Past h/o: - pulmonary Koch's 15 years ago Hyponatreamia 2 years ago Dec2018: -BP 140/80 mmHg Nov 2018: -BP 130/90mmHg Oct 2018: -BP 140/90 mmHg 26 Dec 2018 : - sr. Creatinine 1.4 mg/dl 15 Dec 2018 : -sr. Creatinine 2.0 mg/ dl Nov 2018: - sr. Creatinine 1.6 mg/dl HbA1c: - 6.7 BSF: - 110 PP: -205 Sgot: -49 Sgpt: -40 Protein: - 6.2 Albumin 3.1 Globulin: - 3.1 Total Bilirubin 0.6 Direct Bilirubin 0.4 Indirect Bilirubin 0.2 MBG 145.5 Few Bacteria +ve in urine please suggest Rx & diagnosis

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FEMALE AFFECTIONS OF. VOMITTING. RELAPSE OR REOCCURENCE. LUMBER BACK. DIRECTION RT. DIRECTION BACKWARD. APPETITE LOST WANTING. ERRUCRATIONS. WEAKNESS. ANAEMIA. HYPERTENSION. DIABETES MALLITUS. UTI. ABDOMEN DISTENSION. TUBERCULOSIS... CONSUMPTION. PULSE IS THE REMEDY DR.

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HISTIRY T2 DM HTN PAST PTB PRESENT PROBLEMS& POSSIBLE CAUSE VOMITING LOSS OF APPETITE FULLNESS OF ABDOMEN BELCHING = DIABETIC GASTROPARASIS TINGLING HANDS TOES= DIABETIC NEUROPATHY PAIN RT LUMBER RADIATING TO BACK = MAY BE RT RENAL STONE LONG UTI = DUE DM POSSIBLY RENAL STONE SHE HAS CKD =CAUSE HTN DM SLIGHT LOW SERUM ALBUMIN DUE TO LOW INTAKE + RENAL LOSS WEAKNESS = DM CKD LOW FOOD INTAKE SHE HAD HYPONATRAEMIA CAUSES .= LOW INTAKE MAY BE DRUG INDUCED IF DIURETIC IS CHOSEN AS ANTIHYPERTENSIVE DRUG SALT LOOSING NEPHROPATHY RECOMMANDATIONS URINE = C& S CULTURE FOR AFB 24 HOURS URINARY Na + Serum Na is not true representation of total body Na + CXR = EXCLUDE REACTIVATION OF PAST PTB USG = KUB GB LIVER PANCREAS UGI ENDOSCOPY = SOS PRESENT MEDICAL LIST NEEDED FOR RX

Jaundice Tab -cefixime 200 BD Syrup-Liv-52 DS 5 ML TDS Cap- PantopDSR BBF Use of boil water Avoid Fatty, oily, junk food and non veg take light food ( Less salt less mirch)

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Provisional diagnosis: DM type2 with stage first HTN with UTI with ? renal medical disease, ? hepatomegaly, ? ascites,. ? Lymphadenopathy. Do USG abd and pelvis to R/O renal medical disease, hepatomegaly, Continue treatment for DM and hypertension Tab ceficime200 1bd for 5 days for UTI, Tab cyclomeff for abd pain Tab nurokind LC 1od Cap rabeprazole+ domperidone 1od Tab febrex500 for fever. Sharbat bazuri motadil 1l BD

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Dr for Female Patient . 1.Joundice.2.Blood Sugar.3.Kidney Infection. C/OVomiting &mild Abdomen pain . RX 1.Arsenic Alb 30 xbd. 2.Chelidonnium O potancy.10dropsx bd. 3.Shygium Jambolium O.10dropsxbd. Before Meal times daily. DrRanjit Priya. Homeopathy.

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Hi doctor the case seem to be complicated since there is loss of appetite and vomiting every alternate day kindly go in for further diagnostic tests like usg abdomen and pelvis and look for hepatitis or liver failure symptoms and also verify the pancreas and gallbladder. The createnin levels may be high due to renal issues as as complication of htn and dm At the present stage i would suggest rest to the liver by giving katuki and pippali churnas with honey tid will be better warm water intake and saltless fatfree soft diet willbe beneficial. Intake of fruits will be good. Other medicines ie alopathic medicine doses should be little studied verified and given. Other few drugs like gokshrua and guduchi choornas with warm water or kashayas before food is suggestive. Kindly post your opinions.

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Adv USG KUB COULD BE A CASE OF RENAL CALCULI?

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Pain abdomen a/w vomiting and radiculopathy to back s/o renal calculus advise her to drink plenty of fluid which will cure uti and other renal functions, further more these medicines will definitely help in other symptoms. More medicine if needed can be added symptomatically 1. Virataryadi kashayam (diluted) - 60 ml With punarnavadi manduram - 1 (7 am & 5 pm) 2. Amritmehari churnam - 5 gm with mahadhanwantaram gulika - 2 (before lunch & dinner) 3. Indukantam ghritam - 5 ml (with lunch) 4. Ayaskriti - 30 ml with chandraprabha vatika - 1 (after lunch and dinner) 5. Sarambu bhavit kanmad bhasma capsules - 2 with chyavanprash - 5 grams (bed time) with goat's milk Virechan (purgations must be avoided in such cases)

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रोगी यकृतशोथ से पीड़ित है रोगी को मधुमेह भी है चिकित्सा संबंधी योग मूत्रल कषाय पाषाणभेद मकोय पंचांग शाहतरा कासनी बीज पुनर्नवा गिलोय का काढ़ा बनाकर उसमें 2 ग्राम हजरलयहुद भस्म मिलाकर सुबह-शाम सेवन कराएं यकृत दारी लौह 4 रत्ती ताप्तयादि लौह 4 रत्ती शहद मिलाकर सुबह-शाम सेवन कराएं त्रिफला चूर्ण 10 ग्राम रात को सोते समय दूध के साथ दे निश्चित रूप से लाभ होगा योग परिक्षित है पिछले 40 वर्ष से प्रयोग कर रहा हूं

Plz suggest patient to USG of abdomen .start majoon dawedulward 5 gm bd with sarbat bajoori motadil 10 ml bd. Jawarish anarain for vomiting

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