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doctor bhaskaaran

doctor bhaskaaran

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  Provisional Diagnosis - Raynaud's Lt UL ?Thoracic outlelt obstruction yndrome ?Vasculitis Liver Dysfn ?Auto immune
  Final Diagnosis - Cryoglobulin induced Raynaud's LUL HCV infection
  History and Findings - Shock like pain Lt UL paroxysmal in nature s/o Raynaud's x 12yrs.H/o jaundice 3 epidodes in ths past & also in the family.Premarietal sex+,non alcoholic.MRI LS spine 5/4/11 diffuse annular disc bulge L4 L5,L5 S1 MRI Cervical spine 5/5/11 normal,MRI Brain normal
  Investigation - Hb-16.2,ESR-14,platelet-349.0,CRP-2.26,Creat-1mg,uric-6.3,ca-9.7,P-4.24,GGT-153.1,SGPT-120.6,SGOT-47.5,A/g-4.64/3.4,ALP-84,Ck-350.3,TSH-1.88,ATg-0.91,TPO-1,26,HbA1c-5.8%, ANA-neg,ceruloplasmin-38.12(normal)Fe-173.89,HBSAg,anti HCV,HIV screen neg,VDRL NR,TPHA neg,Doppler neck vessel normal,Doppler Lt UL arteries normal,USG neck normal,Cryoglobulins +ve,ECG-Wnl,cxr-Normal,anti HCV ELISA Neg,HCV RNA PCR qualitative+ve,HCV viral load quantitative < 15 +ve
  Treatment - Ecospirin/UDCA/Silymarin
  Follow Up - Pt asymptomatic/LFT improving


Provisional Diagnosis-Obesity/DLP/Hyperuricemia ?Insulinoma ?Diabetes Insipidus
Final Diagnosis-Psychogenic Polydypsia vit D def
History and Findings-Polyurea,Polydypsia,increased appettite,burning abdominal pain,Sleep disturbance,lethargy,snoring 11yrs duration Wt-89kg BMI-31,acanthosis nigricans+
Investigation-Hb-15.6,ESR-22,HbA1c-5.8%,A/g-4.57/3.44,ALP-69,FBS-83.9,Total Insulin-22.7,serum PTH-90.1(15-68 normal),Serum.Gastrin-162(normal upto 100),Serum.Amylase-56,Lipase-29,urine amylase-88,Creatinine-1.1,Ca-1.4,P-3.8,PSA-2.924,TSH-2.17,25(OH)Vit D-15.54,S.Osmolality-335,urine osmolality-547,Na-141.K-4.3,ECG-Wnl,Cxr-N,MRI Brain-15/09/11-No mass lesion in pituitary region
Treatment-Doxepin/Metformin/Calcirol sachets
Follow Up-


Provisional Diagnosis-Reactive Hypoglycemia Dyslipidemia Hydradenitis suppurativa GERD
Final Diagnosis-Coeliac disease Reactive Hypoglycemia Hiatus Hernia Hydradenitis suppurativa
History and Findings-Recurrent Hydradenitis axilla,Reactive Hypoglycemia ,Recurrent oral aphthi,High uric acid,reflux symptoms-Chronic OGD 10/05/09-Duodenitis,CLO Neg Colonoscopy 12/06/09-Internal Hemorrhoids
Investigation-Hypertryglyceridemia(481.8)/Hyperuricemia/HbA1c-5.4%,LFT normal,FBS-97.7,Total insulin-9.7 normal 3-35,GRBS 3hr 60mg/dl with hypoglycemic symptoms repeat OGD scopy 19/09/11-hiatus hernia D2 biopsy report 20/09/11-Mild increase in Intra epithelial Lymphocytes 25-30/100 tTg- IgA-11.3+ve (normal < 8) Diagnostic of Coeliac disease
Treatment-Gluten free diet,Acrbose,Mega 3 capsule,Liposem
Follow Up-


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