135 U.Akanksha: a 65 year male with vomitings

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Chief complaints:-

Vomiting since 4 days

Fever since 4 days not associated with chills

Loose stools since 3 days not associated with blood.

History of presenting illness:-

The patient started developing these symptoms 5 days ago. He was at home when he got up from his bed and started vomiting (projectile) with the vomit comprising food or water, depending on what he consumed. He came to the hospital on the same day (6.10.2022) with complaints of projectile vomiting. He had 4-5 such episodes in one day. Even after vomiting everything that he consumed (in an episode), he still retched afterwards 3-4 times with no vomit. He then passed watery, greenish stools 4 times that day which was associated with squeezing type of pain in the epigastric region and developed a high grade fever. He also had associated shortness of breath. He came to this hospital on the same day, was medicated for it and discharged the next day.

The symptoms, however, did not subside and the patient was rushed to the ICU at 4pm on 9.10.2022 with complaints of vomiting and not being able to consume anything without vomiting. He hasn't been passing any stools till 9:30am yesterday.

Daily routine:-

He usually gets up early in the morning at 5am.Then he does his daily activites.He will have his breakfast at 7-8am.Then if he has any works he will go out otherwise he will stay at home.He will come home by 6pm and fresh up and have dinner by 8pm.He usually eats rice or chapatti or jowar roti.he usually sleeps by 9pm.

Past history:-

Known case of

Hypertension since 8 yrs

Diabetis mellitus type 2 since 8 yrs

Asthma since 6 months

Not known case of

Tuberculosis,leprosy, Cardiovascular diseases,chornic kidney disease and any other chronic illness.

He has been having joint pains since 10 years and has been going to the hospital repeatedly for his pains. He took painkillers and continued to work everyday till 4 days ago.

From 3 years ago, the patient has been getting scaly, itchy rashes with peeling of skin on his arms and legs. He was told this was due to diabetes.

Surgical history:- not significant

Drug history:-

For diabetes-

Tab.BAMILODIPINE 5mg+ATEMOLOL 50mg

For Hypertension -

Tab.METFORMIN 500mg

For asthma-?

Personal history:-

Diet-mixed

Built-well built (obese)

Appetite -decreased