patient came with shortness of breath, altered sensorium, Grbs HI and urine ketones positive.


this is an online E log book to discuss our patient\"s de -identified health data shared after taking his/her/guardian\"s signed informed consent. Here we discuss our individual patient\"s problems through series of inputs from available global online community of experts with an aim to solve those patient\"s clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs in the  log.

 Chief complaints;-

A 51 year old female patient, is a known case of diabetes mellitus since 20 yrs, and she is initially on OHA and 
since 3 years she is on insulin 20 units in the morning and 10 units in evening.

 Now she ...Came with cheif complaints of..  
Pain in right hypochondrium and epigastrium since 4 days.

No h/o blood in vomitus.
Patient has loss of appetite since 2 days.

Patient didn't take her  Regular dose of insulin , As she didn't eat anything.

 No h/o  fever, pain abdomen , loose stools, no h/o cough.
N/o yellow discoloration of eyes, pedal edema, chest pain, palpitations.

She has C/o  altered sensorium , on 12/06/2021 early morning.

Past history:- 
H/o hysterectomy 20 yrs back.
No H/o hypertension,asthma, epilepsy, TB.

 Personal history:-
Her diet is mixed, 
Appetite decreased since 2 days
Bowel and bladder - regular .
no  addictions.

 Vitals:-
Bp:-150/100
PR:-134
RR:-32
TEMP:- AFEBRILE
SPO2 :-100% on room air
GRBS:- HIGH (>500) AT ADMISSION.

On examination:-
Patient is conscious, coherent , cooperative.

Abdominal examination:-
Tenderness in Right hypochondrium and epigastrium.
No palpable mass.
 
Cvs:- 
S1 S2 heard,
No thrills , no murmurs.

Respiratory system:-
BAE:- present 
           Nvbs.
 CNS :- intact.

  Investigations:-









ECG:-



Treatment:-
1. IV fluids 
2. Insulin infusion

Discharge summary:-



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