HYPER OSMOLAR NON KETOTIC DIABETIC COMA WITH UTI

Clinical case Chief Complaints A 70 yr old lady is suffering from fever frequency of micturition and feeling unwell for 10 days She is hospitalized because of confusion drowsiness followed by unconsciousness. History Not a DM HTN No ho drug intake Vitals BP 90/60 Pulse 110/min low volume Temp 39.2 Physical Examination Pt is semiconscious response to painful stimulus Tongue dry Skin turgor reduced Neck rigidity slightly present Plantar extensor on both sides. Lower abdomen very tender. Investigations Hb 11.2 Wbc 17000 Poly 85% Lympho 15% Platelet 210000 ESR 12 mm 1st hour Electrolytes Na 158 cl 110 K 4.6 bicarb 19 Bilirubin 18 micromol per litre normal 2 to 17 SGPT 29 IU/L Alkaline phoaphatase 90 IU/L S creatinine 1.4 S. Urea 38 Urine plenty of pus cells albumin ++ glucose +++ Chest xray normal CT Brain diffuse age related cerebral atrophy Diagnosis What is the likely diagnosis? Management What immediate therapeutic measures would you start?

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SUGGESTIVE. OF SEPTICEMIA BACTERIAL. UTI HYPOTENSION ELEVATED. URINE. SUGAR. LEVELS

Leucocytosis Hypernatremia Jaundice Serum creatinine raised Ratio of lymphocyte to nutrophil 1 to 4 Rt PCR

proteinuria and high uric acid/Albumin in Urine Allovera juice 1 liter nashader thekri 100 gram kalmisora 100 gam in tamaam ko agg par khushk kar lee lakin hilate rahe ta ki yeh jal na jaye yeh zard rang [ yellow color ] me tayer hoge iss me 100 gram sudh shilajeet dal kar 500 mg ki goli bana le iss ko teen time milk se de contra indication ;;;;;; iss ko chronic or acute renal failure men na de or gout [ vatrakat ] ke patient ko na de in albuminuria good result

Urine ketone...? ? Ketoacidosis.. ? Urosepsis.. Adv urine c/s. USG abdomen and pelvis Inj piptaz 4.5 mg TDs Inj metro 100 cc TDs Inj pan emeset... Tab levoflox 500 mg od Iv 100 cc/hrs

UTI Rx Punarnavashtak qwath BD Galo ghan tab 1bd Neeri tab 2bd

UTI Adv imperial antibiotics Culture and sensitivity. Evaluate for any bladder outlet obstruction. Also uremic encephalopathy and meningitis in mind. Sos csf analysis.

? PYREXIA..WITH.. UTI.. DM .. ATROPHIC CEREBRAL CHANGES WITH ASSOCIATED COMPLICATIONS.. NEED'S.. URINE C AND S..EXAMINATION.. USG..ABDOMEN.. ANEMIA PROFILE.. BSR..HBA1C..

Tnx Dr Anil Gangani
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UTI . With. DM .. urine sugar +++ .

U T I Senile dementia

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