CASE DETAILS:

14 YEAR OLD BOY WAS BROUGHT BY HIS PARENTS TO IN PATIENT DEPARTMENT OF SHREE MUMBADEVI HOMOEOPATHIC HOSPITAL IN DROWSY STATE IN NIGHT AT 12:40 AM.PATIENT HAD SMALL BOUTS OF VOMITTING.PT WAS LOOKING COMPLETELY DEHYDRATED AND KEPT ON MUTTERING IN DROWSINESS.....

PATIENT WAS ATTENDED IMMEDIATELY AND IV ACCESS WAS TAKEN,BLOOD WITHDRAWN AND WAS SENT FOR SERUM ELECTROLYTES AND ROUTINE BLOOD INVESTIGATION ALONG WITH SERUM CREATININE AND URINE WAS TESTED FOR KETONES.....

BY THE TIME HISTORY GIVEN BY FAMILY MEMBER WAS THAT ON 28TH JAN i.e. 2 DAYS PRIOR GOT HIS RESULT AND FAILED IN SCIENCE SUBJECT.HE GOT 5 MARKS BUT TOLD HIS FATHER THAT HE SCORED 11 AND FAILED BY 1 TO 2 MARKS.HIS FATHER IN ANGER SHOUTED AND REACTED VIOLENTLY AND HIT HIM ON LEGS AND HANDSTHE DAY ENDED AND HE SLEPT NEXT DAY IN EVENINGVOMITTING HAPPENED IN SMALL QUANTITIESPROSTRATION 3+ AND DROWSINESS 3+....THOUGH VOMITTING HAPPENED ONLY TWICE BUT THERE IS SO MUCH PROSTRATION...PT WAS CLINGING TO HIS MOTHER AND CONSTANTLY WANTTED HER NEAR HIM AND AT THE SAME TIME HAD AVERSION TO ANY OTHER PERSON...HE HAD LOT OF FEAR OF DAD...FRIGHT AND GRIEF AFTER THE INCIDENCE AND DID NOT TALK TO FAMILY MEMBERS FOR 2 DAYS...IN DROWSINESS PATIENT WAS SAYING THAT HE IS SCARED OF HIS DAD AND DAD MAY HIT HIM....

WANTED TO SLEEP AND LIE DOWN....DIFFICULT TO AROUSE

THERMAL STATE:CHILLY PATIENT

O/E:

PULSE:70/MIN

BP-110/70 mmHg

RR-20/MIN

TEMP-AFEBRILE-98 F

SYSTEMIC EXAMINATION:

HIGHER FUNCTIONS:STUPORUS-STUPOR RETURNING IMMEDIATELY AFTER AROUSAL

IRRELEVANT RESPONSE TO VERBAL COMMANDS

RESPONDING TO PAINFUL STIMULI

NO NECK RIGIDITY

INVESTIGATIONS:

CBC-

HB-13.7 gm%

RBC-503000 cumm

WBC-9800 cumm

PLATELETS-3 LACK 17 THOUSAND

MCV-39.3

RANDOM BLOOD SUGAR-90

SERUM. CALCIUM-10.4

UREA-21.5

S. CREATINIE-0.7

URINE KETONE-PRESENT

S.ELECTROLYTES-

NA+ 141.2

K+ 4.33

Cl 106.2

CHEST X-RAY- NORMAL

TOTALITY OF SYMPTOMS:

1)AILMENTS FROM-BEING REPRAMINDED

2)PROSTRATION-VOMITTING AFTER

3)VOMITTING –SMALL QUANTITY

4)DROWSINESS

5)AVERSE TO COMPANY

6)CHILLY PT.

REMEDY SELECTION-ACID PHOS200 SINGLE DOSE AND SOS REPETITION

FOLLOW UP CRITERIA:
 

FOLLOW UP:

1/10/2016 1 AM
 

Dr rakesh gupta md(hom)mba(hcs)/dr namrata pandey dr surabhi chaturvedi/alice chettiar/hemangi mishra

CASE DETAILS:

72 year old male k/c/o gall stones & right ear glomus tympanicus tumor; got admitted at shree mumbadevi homeopathic hospital with sudden abdominal pain, worse jarring, better by warmth and lying on painful side, distension of abdomen, vomiting and obstipation (not passed stools and flatus since last 24 hours) on 30-7-15 at 5 am. H/o –eating chicken a day prior. P/h pancreatitis 6months ago. O/e- febrile, git- abdomen distended, dull note with shifting dullness, abdomen tenderness & guarding, abdominal girth-89.5 cm , bowel sounds absent.

Investigations (30-7-15) : - cbc - wbc – 19500, serum potassium -3.2meq/l, s.amylase-636, s.lipase-686, s.calcium-7.3mg/dl. Usg s/o pancreatitis with peri pancreatic fluid & bulky pancreas. Ascites, distended loops with sluggish bowel movements.

Diagnosis- acute relapsing pancreatitis with ascites with cholelithiasis with paralytic illeus leading to intestinal obstruction with hypocalcaemia with hypokalemia

Management : Maintain hydration/electrolyte correction; Gastric decompression: - ryles tube aspiration; Homoeopathic treatment bryonia 200 -> 1m

Treatment summary:- there was increase in abdominal girth from 89.5 cm  94 cm even after receiving antibiotic injections. patient was started on homeopathic medicine bryonia 200 every 2 hourly  1m initially diluted 2 hrly followed by whole dose 2 hrly. After the start of homeopathic medicine abdominal pain, fever disappeared, stool and flatus was passed. Abdominal girth reduced from 94 cm  81 cm, pleural effusion also disappeared. Wbc was also normal.

on 3-8-15 s.lipase: 48 normal s.amylase – 73 normal