?OBSTRUCTIVE SLEEP APNOEA ?RHF ?ANEMIA 2° TO MENORRHAGIA
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USG ABDOMEN:
A 23yr old woman, daily labourer by occupation came to the OPD with chief complaints of
SOB on exertion since 5 days
Generalized weakness since 5 days
Nocturnal Dyspnea since 5 days
HISTORY OF PRESENT ILLNESS:
Patient was apparently asymptomatic 5 years back then she developed oligomenorrhoea
[3-4cycles/year] and it gradually progressed to amenorrhea after 3 years.
After getting married in 2020 patient started having regular menstrual cycles, but after 1 year, i.e., from 2021 March, patient started complaining of excessive menstrual bleeding for 20days/30 days cycle, for which she visited our hospital and had regular checkups for 3 months and was advised lifestyle modification I/V/O obesity. Patient used to change 3-4 pads for the first 7 days of the cycle and 2 pads for the rest 13 days of the cycle.
Patient had developed SOB GRADE - III 5 days back which was sudden in onset, not associated with fever or chestpain
H/O Orthopnea present
H/O Paroxysmal Nocturnal Dyspnea present, not associated with cough
PAST HISTORY:
K/C/O Type-II DM was on regular medication until 8 months back, then discontinued.
Not a K/C/O HTN, Asthma, COPD, CAD
PERSONAL HISTORY:
Diet - Mixed
Appetite - Normal
Bowel & Bladder - Regular
Micturition - Normal
Addictions - No Addictions present
FAMILY HISTORY:
NOT SIGNIFICANT
GENERAL EXAMINATION:
Patient is conscious, coherent and cooperative, oriented to time, place and person.
Pallor - Present
No Icterus
No Cyanosis
No Clubbing
No Lymphadenopathy
No Edema
VITALS:
BP: 160/100mmHg
PR: 97bpm
RR: 21cpm
Spo2: 98%@RA
SYSTEMIC EXAMINATION:
CVS: S1, S2 heard, No murmurs
RS: BAE present, NVBS heard
P/A: Soft, Non-Tender, Bowel sounds present
CNS: NAD
INVESTIGATIONS:
HEMOGRAM:
ABG:
LFT:
RFT:
RBS:
CUE:
USG ABDOMEN:
ECG:
PROVISIONAL DIAGNOSIS:
? OBSTRUCTIVE SLEEP APNOEA
? RIGHT HEART FAILURE with Type-II DM
? ANEMIA 2° TO MENORRHAGIA
TREATMENT GIVEN:
1) DIABETIC DIET
2) TAB. METFORMIN 500MG PO/OD
3) GRBS 7-POINT PROFILE:
7am : Before Breakfast - 124mg/dl
9am : After Breakfast - 190mg/dl
1pm : Before Lunch -
3pm : After Lunch -
7pm : Before Dinner -
9pm : After Dinner -
2am : Midnight - 189mg/dl
4) TAB. OROFER-XT PO/OD
5) SpO2 Monitoring
