40 yr old with sob ,orthopnea and fever

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 seenComplaints of sob ( grade 2 -grade 3) according to NYHA classification since 1 week 
Pt was apparently asymptomatic 1 week back then he developed  shortness of breath ( grade 2-grade3) according to NYHA classification which is associated with orthopnea , pnd .
K/c/o bronchial asthma since 10 years 
C/o loose stools (2-3episodes)watery consistency
H/o fever 1 week back associated with chills and rigors subsided on  taking medication
K/c/o bronchial asthma (on nebulisation with formonide 0.5 mg and glycipyorium 25 mcg ) 
K/c/o dm and htn since 10 years kn glimi -m2 and telmikind-h
K/c/o smiker ( 10 packs per day) , non alcoholic
Provisional diagnosis - bronchial astmal
Treatment
1.oxygen inhalation 4 to 6 lit per min 
2.AVIL 2CC/IB /STAT
3.INJ.HYDROCORTISONE 100MG /IV /TID 
4.INJ MONOCEF 1GM /IV/BD 
5. NEBULISATION WITH DUOLIN 6 TH HOURLY 
NEB WITH BUDECORT 12 TH HOURLY
6.TAB AZITHROMYCIN 5OOMG /PO/OD 
7.TAB .MONTAC -CC/PO/HS
8.TAB PAN 40MG PO/OD
9. SYP .ASCORYL / 2 TSP /PO/TID 
10 .BP /PR/SPO2 MONITORING HOURLY

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