Case history-10






A 48 yr Male  ,came to opd with Acute History of Poisoning near godavarigudem , nalgonda

History of present illness:


The patient was apparently asymptomatic 12 days ago ( i.e on 23 /11/21 ) He is works as farmer ,he started consuming alcohol from 20 years .

-On 20/11/2021 he started drinking alcohol which he didn’t stopped drinking for 2 days..

-on 22/11/2921 morning . In altered stage he consumed profenofos ( 100-150ml ) - An Insecticide. He was taken to local hospital immediately by his wife. 

He had 3-4 episodes of  vomitings .He was given gastric lavage. Pralidoxime and Atropine were administered . 

-He was then shifted to navya hospital  on 23/11/21 where he went into respiratory failure . He was ET intubated on 24/11/21 @4 pm

-Due to financial concerns he was shifted to our hospital on 25/11/21 insedated stage on mechanical ventilator . Patient was intubated as was diagnosed with  Type 2 Respiratory failure along with Intermediate syndrome  (  Muscle weakness and paralysis)

ET tube was changed and tracheostomy was done .


Past history:


Patient had history of high grade fever , vomitings and increased secretions

Patient had history of trauma to his LEFT EAR 

1 and 1/2 yr back. 

No history of chest pain ,Hypertension palpitations , 

no history of diabetes,epilepsy,TB,tyroid disorder.

-patient has undergone 4 units of blood transfusion.


 Personal history:


Diet-mixed

Appetite- None 

Bowel and bladder- Regular

Sleep-normal 

Addictions - Alcohol - Every day and smoking (2-3 packs per day)


Family history:

No history of DM/HTN/TB/ asthma/ thyroid 

No similar complaints in the family previously .


General examination:


No pallor or cyanosis Or icterus or clubbing 

No lymphadenopathy 

No Dehydration or odema 


Vitals:


Temp -101 C/F

Pulse rate -120 bpm

Resp ratec-22 cpm

Bp-120/90mm hg



Systemic examination:

1.cvs-inspection-chest wall is bilateral systemically 

Palpation -normal 

Auscultation-normal with regular heart beat

S1 S2 heard

No murmurs 


2.abdomen 


Shape of abdomen is scaphoid

No tenderness 

No palpable mass

Liver is palpable 

Bowel sounds are heard

Investigation:












    


   

Treatment:



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