32 /M HYPOGLYCEMIC SECONDARY TO ALCOHOL (RESOLVED )WITH ALCOHOL DEPENDANCE SYNDROME.

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 on the comment box is welcome.


Here is a case I have seen. 


INTERNS 
juveria 
Swarna 
Nikhil 
Manivarma
Divya

PGs
Dr. HAREEN (SR) 
Dr. Praneeth Y3
Dr. Vaishnavi Y2
Dr. Vinay Y1. 

32 /M who is a farmer presented with chief complaints of irrelevant talk, giddiness, Epigastric pain since 1 hour. 
HOPI:
patient was apparently asymptomatic 20 years back then he started consuming Alcohol around 90 ml, whiskey perday which slowly increased to 720 ml per hour -one full bottle. Then he has been consuming whiskey everyday since the last 10 years. Patient present to casualty with irrelevant talk since 1 hour, giddiness and epigastric pain, along with nausea. 
VITALS:
PR:100bpm
BP:130/80mmhg
RS:BAE+, clear, 
CVS:S1S2+
GRBS:444MG/DL.

Provisional diagnosis: HYPOGLYCEMIA,ALCOHOLIC LIVER DISEASE WITH ALCOHOLIC DEPENDANCE SYNDROME IN WITHDRAWAL. 

INVESTIGATION:
Treatment DAY 1:
1. IVF 2 UNITS NS, 1UNIT DNS @ 75ML/HR
2.INJ THAIMINE 1 AMPOULE IN 100 ML/ NS INTRAVENOUS \TID. 
3.INJ.PANTOP 40 MG IV /OD
 4.INJ ZOFER 4 MG IV/ SOS
 5.TAB. LOTAZEPAM 2 MG 1-1-2FOR 2 DAYS 
6.TAB. LIOFEN XL 20 MG TWICE A DAY FOR 4 DAYS. 
7.INJ LORAZEPAM 4MG I'M /SOS 
8.INJ 25% DEXTROSE IV IF GRBS LESS THAN 75MG/DL.
9.GRBS CHARTING HOURLY 
10.MONITOR VITALS. 
TREATMENT DAY 2:
1. IVF 2 UNITS NS, 1UNIT DNS @ 75ML/HR
2.INJ THAIMINE 1 AMPOULE IN 100 ML/ NS INTRAVENOUS \TID. 
3.INJ.PANTOP 40 MG IV /OD
 4.INJ ZOFER 4 MG IV/ SOS
 5.TAB. LOTAZEPAM 2 MG 1-1-2FOR 2 DAYS 
6.TAB. LIOFEN XL 20 MG TWICE A DAY FOR 4 DAYS. 
7.INJ LORAZEPAM 4MG I'M /SOS 
8.INJ 25% DEXTROSE IV IF GRBS LESS THAN 75MG/DL.
9.GRBS CHARTING HOURLY 
10.MONITOR VITALS. 

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