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Br.Raju 35yrs/M 06/09/10

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Provisional Diagnosis-Congenital Rubella syndrome Post Viral Demyelination Hypothyroidism/Thyroiditis T2DM Iron def anemia/Vit D def state
Final Diagnosis-Post viral demyelination/Hashimottos Encephalopathy Hypothyroidism/Thyroiditis T2DM Iron & Vit D Def state
History and Findings-Photocopy machine work with amma in Vallikavu H/o Chr cough,scanty sputum DOE class II last 6months snoring ++ Day sleepiness ++ for yrs Deaf & dumb from birth(congenital rubella syndrome), Speech improved on therapy.H/o PDA closure at 9yrs of age.Organic psychosis Nov/Dec 2008.H/o Hypothyroidism off Rx
Investigation-Previous Inv:09/07/04-CT Brain-Demyelinating disease ?Glyomatous cerebral/SSPE.MRI Brain 12/07/04-Viral induced demyelination ?Rubella encephalitis,MRI brain 20/2/07-Viral demyelination,MRI Brain Nov 2009- lesions status quo,B/L symetric white matter hyperintensities.13/09/04 TSH-7.98,20/03/07-TSH-4.60,25/11/08-TSH-6.88,ATg-45.92,ESR-16,Hb-12.2 Present inv:Hb-10.3,MCV MCH low.ESR-22,P.Smear-Microcytic hypochromic anemia,FBS-118,GRBS-196,HBA1c-8.6%,Blood urea-18.2,S.creat-0.7mg,uric-6.1,A/g-4.27/3.3g,ALP-103,GGT-65,Ca-8.5,P-3.6,LFT-N,Ck-81.5,CK MB-8.5,LDH-293,IgE-60.67,CRP-5.01,TSH-14.86,FT4-0.95,TPO-1656.7,25(OH)vit D-5.66ng,C1 INH-17mg (N-11-26),Na-136,K-4.4,S.Iron-24.4,Fe-8.17,TIBC-432.3,ANA-Neg (0.27),ds DNA-22.1,stool fat +ve,OB Neg,ECG-Sinus tachycardia,Cxr-Cardiomegaly,Echo-No RWMA,mild MR/TR,EF-55%,urine RE-Nil
Treatment-Diabetic diet. Tab.Thyronorm 75mcg 1-0-0,Cap.Fefol z 0-0-1,Tab.Rantac 150mg 1-0-1,Cap.GLA 120mg 1-0-0, Cap.Neuracetam 800mg 1/2-0-1/2,Glycomet SR 0.5g 1-0-0,Cap.Evion 400mg od
Follow Up-Pt improving steadily with more mental alertness & able to work without break.Intellectual works better,attention & speech better,day time sleepiness markedly improved 23/06/11-TPO-769.92,Hb-15.3 15/10/11-HBA1c-7.1,TSH-3.62
doctor bhaskaaran

doctor bhaskaaran

wkfvcepdupscibtlbsbo, http://www.lmyhjkaety.com iaroburchp

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