AMC 60yrs old male daily wage worker

bed 3 60yr/M A 60 yr old male daily wage labourer by occupation b came to the casualty with chief complaints of fever with chills since 10 days c/o dry cough since 10 days c/o burning micturition since 10 days patient was apparently alright 10 days ago and then developed high fever which was intermittent , associated with chills ,relieved with medication/o dry cough not associated with sputum since 10 days,SOB since 10 days which was intermittent C/o burning micturition since 10 days no c/o of vomitings, loose stools history of pulmonary kochs 3 yrs ago used ATT for 6 months , (coughassociated with sputum and low gade fever) past history not a known case oc HTN,DM,CAD ,CVA appetite- normal bowel movements- regular micturition- normal no addictions no significant family history general examination no pallor,icterus, cyanosis, lymphadenopathy and edema pulse rate: 104bpm BP: 110/80 mmHg respiration: 29/min spo2 : 98%at RA CVS s1,s2 heard RS : BAE + ,NVBS,right inframammary and infra axillary crepts + Abdomen: soft,non tender CNS: NAD provisional diagnosis PULMONARY KOCHS Treatment 1) IVF 2 pint NS 2 pint RL 1 pint DNS @100 mp/hr 2) Tab.Dolo 650 mg po/Qid 3)Neb.Duolin 12th hrly Budecort 12 th hrly 4)inj.neomol 1 gm IV /sos ( if temp > 101F) 6)inj.pantop 40 mg IV/OD 7) vitals monitoring 4th hrly 8) plenty of fluids (4 lit /day) 9) syp.Grillinctus 10 ml /po/BD
RICU 60yr/M S- High grade with chills yesterday evening O- Pt is c/c/c temp-101F PR-72 bpm BP-90/60 mmHg CVS- S1, S2 heard R.S - BAE+ ,IMA,IAA crepts + P/A- soft,non tender, CNS-Hmf intact ,no FN A- PULMONARY KOCHS p- 1)IVF @ 100ml/ht Treatment 1) IVF 2 pint NS 2 pint RL 1 pint DNS @100 mp/hr 2) Tab.Dolo 650 mg po/Qid 3)Neb.Duolin 12th hrly Budecort 12 th hrly 4)inj.neomol 1 gm IV /sos ( if temp > 101F) 6)inj.pantop 40 mg IV/OD 7) vitals monitoring 4th hrly 8) syp.grillinctus 10 ml/po/BD 9)inj.monocef 1 gm IV/BD 10)plenty of oral fluids 11)ATT drugs*3times

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