10 year FEMALE PATIENT PRESENT WITH pain ABDOMEN , vomiting , FEVER, CONVULSION SINCE 3- 4 days . USG ABDOMEN AND STRAIGHT XRAY ABDOMEN ERECT POSTURE REPORT ATTACHED. BLOOD REPORT SUGGESTIVE OF NEUTROPHILIC LEUCOCYTOSIS. BLOOD SUGAR, SGPT, SERUM CREATININE, POTASSIUM, CALCIUM, CHLORIDE, MALARIA TEST, QBC IS WITHIN NORMAL LIMIT. SODIUMIS 128, SRUM BILIRUBIN IS 2.46 TOTAL , DIRECT 1.60, INDIRECT 0.86, SERUM AMYLASE IS 264, SERUM LIPASE IS 123, CRP IS 56. PLATELET COUNT IS NORMAL. PROVISIONAL DIAGNOSIS AND TREATMENT. USG REPORT IS BILATERAL MINIMAL ECHOGENIC KIDNEYS, CONTRACTED AND THICK EDEMATOUS GALL BLADDER, MILD ASCITES AND MINIMAL FLUID IN BILATERAL PLEURAL CAVITY, MILDLY DILATED MAIN PANCREATIC DUCT AND MILDLY DILATED CBD AT PORTA, FEW BORDERLINE DILATED GUT LOOPS IN ABDOMEN.

A male of 36 yrs having tense Ascitis due to hepatitis non specific.He is non alcoholic no other addiction .Received treatment from so called multispeciality hospital from super consultant .He needs taping every 5to 6 days about 6 ltr fluid .Taping done about 5-6 times.No family history or no h/o hepatitis in past.please suggest Rx.

Patient Age 40 Yrs Old With History of Chronic Alcoholic With Complaint Absent of Urination & Pain Abdomen.Previously History Of Diagnosis With DM & TB.Here Is I Am Attaching Some Of Reports. Please Suggest Further Management. Thank You.

Sepsis is just as urgent as heart attack, says NICE. NICE wants people who show signs of sepsis to be treated with the same urgency given to those with suspected heart attacks. In the  new guideline, NICE (National Institute for Health and Care Excellence) says all health professionals, no matter where they work in the NHS, need to think about the possibility of sepsis in all patients who may have an infection. “Anyone can succumb to sepsis. It can come on as the result of a minor injury or infection that the body is trying to recover from and the immune system goes into overdrive. Sepsis can be difficult to diagnose with certainty.” Professor Faust  stressed that the only way clinicians could ensure that a diagnosis wasn’t missed was to start asking “could this be sepsis?” earlier on so they rule it out or get people on treatment as soon as possible. https://www.nice.org.uk/news/article/sepsis-is-just-as-urgent-as-heart-attack-says-nice

55/male /labor worker,chronic alchoholic c/o Distention of abdomen Vomiting Nasuea Fever Yallow colour urine Total bilirubin 10.8 Sgpt127 CBC as shown in report. Platelets r too low. What to do? Refuse for admission.