Concluded Case

BILATERAL NEPHROLIATHIASIS Č GBS

A female patient , complaining with pain abdo č nausea č vomiting, burning sensation and pain during urination č weakness too much. Patient is hypotensive č anematic and constipated. H/O Two months before hysterectomy done due to abnormal bleeding č bulky uterus . O/E BP 90/ 50mmHg Pulse 110bpm CVS s1 & s2 P Abdo. distended R/R 18bpm Chest B/L clear Hb% 6.7 gm/ dl

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USG reports A. Cholecystitis with cholelithiasis Bilateral small kidney stones Pt is having pain abdomen with distension of andomen. Pt's vitals also below average asBP low Hb% low and having burning sensation during micturation may be due to UTI Urine for culture and sensitivity test and give aprropriate antibiotic to contrlol UzTI Now start with broad spectrum antibiotic to treat cholecystis also In this condition go for conservative treatment with IV infusion Antibiotic as you started before Blood transfusion two unit to improve haemoglobim If everything goes well and pt gets stable Plan for cholecystectomy Regarding bil kidney stone as small stone in kidney keep watch of size of stone and any symtomps like haematuria etc think for lithotripsy and removal.

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Multiple cholelithiasis with cholecystitis Nephrolithiasis Present complaints can be managed with iv fluids and inj ondestron and inj antispasmodics Inj Ceftriaxozone Once clinically pt improves think of managing renal calculi Supportive treatment for anaemia

Thanx dr Basavaraj Dodamani
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USG reports A. Cholecystitis with cholelithiasis Bilateral small kidney stones Pt is having pain abdomen with distension of andomen. Pt's vitals also below average asBP low Hb% low and having burning sensation during micturation may be due to UTI Urine for culture and sensitivity test and give aprropriate antibiotic to contrlol UzTI Now start with broad spectrum antibiotic to treat cholecystis also In this condition go for conservative treatment with IV infusion Antibiotic as you started before Blood transfusion two unit to improve haemoglobim If everything goes well and pt gets stable Plan for cholecystectomy Regarding bil kidney stone as small stone in kidney keep watch of size of stone and any symtomps like haematuria etc think for lithotripsy and removal.

Thanks Dr Gyanendra Bath Tripathy
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As per USG cholecystitis with Cholelithias and bilateral renal calculi less than 6mm.For GALLSTONES ask for Laparoscopic cholecystectomy and for renal stone give Cap Tamfil 0.4mg one daily, Tab Neeri one tds, Syrup K-Mac B6 active two tsf tds

Cholecystectomy for cholylithasis Nephrolithotomy for nephrolithasis

Tnx Dr Maqusud Ansari
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Cholecystitis 1.bhumiaml ch + kutaki ch + dhatri lauha 2.liv 52 ds Nephrolithiasis/kidney stone make 1/8 th kashaya withPashana bhedi churan + gokshura churn + varun chal churan BID dose. Hazrul Yahood Bhasma 200 mg BID with honey,and gokshuradi guggulu 2 bid.

UTI B/L kidney stone. Cause. Nephrolithiasis Suggest. Tab. Niftas 100 mg Bd. For 7 days Tab. Pan 40. Od. Tab. Cystone Forte. 1 tid. For 1 month Syp. Citralka. 10 ml in 1/2 g water. Tid 3 liter water daily.

I agree with @ Dr. Mrinal Kantil Pal....

Thanks Dr. Pushker Bhomia
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