HTN/T2DM/ENTERIC FEVER/DLP

A 50 YEAR OLD FEMALE CAME ON ED C/O NUMBNESS OF BOTH LOWER LIMB, SOB+ DURING SLEEPING, JOINT PAIN, INTERMITANT ON AND OFF FEVER, PMH - HTN,CKD,T2DM Taking tab. Janumet 50/500 BBF, RBS - 498 mg/dl, BP - 140/80 MM/HG, R/R - 24 BRTH/MIN, TEMP. AFEBRILE, SPO2 - 96%, CVS -S1S2, CNS - COUNCIOUS, R/S - BL CLEAR, OTHER - NAD, Following report are attached SUGGEST YOUR VALUABLE OPINION

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? UNCONTROLLED DIABETES..WITH.. DIBETIC NEUROPATHY..AND.. PRE ENTERIC FEVER.. ENTERIC FEVER.. MANAGEMENT.. STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. GABAPENTIN WITH NEUROTROPHIC VITAMINS X NEUROPATHY.. ENTERIC FEVER.. IV..FLUIDS.. INJECTION CEFTRIAXONE 1GM.. MVI .. SYMPTOMATIC T/T.. REST AND FOLLOW UP..

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Typhoid fever Hypertriglyceridemia Reduce carbohydrate intake. ... Eat the right carbohydrates. ... Choose low glycemic index foods

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Pt has developed diabetic peripheral neuropathy Strict control of diabetes B 12 tab orally

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Acute febrile illness with uncontrolled diabetes mellitus Rx inj Monocef 2gm bd Tab azee 500 mg od On discharge tab zifi o bd*10 days Inj hai with hgt chart Inj lantus with hgt chart Tab glycomet gp1 bd Tab era Hb od*20 days Adv hba1c,creat,urine r/m,bsl fasting and pp

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Entric fever Hypercholestrimia Hypertriglyseride Hyperglycemia Check fbs ppbs Start insulin short acting

50/F..investigation report suggestive of : typhoid positive with hyperlipidaemia with hyperglycaemia with anaemia. distal sensory Neuropathy cause to r/o either diabetic,vit B12 def.,uraemic or radiculopathy. O antigen titres r high. watch for urinary output,ketone bodies.electrolytes.. in treatment:supportive and symptomatic therapy in view of ckd.dosage to be in reduced state. start on EPO.

Perip. diabetic Neuropathy with entric fever. Kco-Dm-2,CkD,HTN Rx- As adviced by many of our colleagues I will just add that need to check for other diabetic related complication like retinopathy, cardiomyopathy etc and patients renal clearance if not on dialysis then need to adjust antibiotics doses acc. to creatinine clearance.

Diabetic Need HbA1c with Antidiabetic Manegement Diabetic Neuropathy Tab.praga M 1HS Do ABI test Fever Inj.xone Iv fluid with multivitamins

Control of Diabetes T.Isryl M2 forte 1 0 1 T.Lipikind 0 0 1 C Livogen 1 0 0 Gabapentin or Amitriptyline HS for peripheral neuropathy B12 injection

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POSSIBLY PERIPHERAL NEUROPATHY

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