EMERGENCY CASE OF THE WEEK

DEPARTMENT OF CARDIOVASCULAR MEDICINE

A CASE OF MALIGNANT HYPERTENSION
(Updated 19.2.2013)
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Patient Name: ****** Gupta aged: 33 years, Female

Diagnosis: Malignant Hypertension

Emergency Crisis: High Blood Pressure 

Patient reported to our Cardiology OPD on 24.6.2011 (1.30 PM) in a
quiet uneasy condition with her work colleague (Bank) and while
entering the clinic, near reception, she vomited and fell while her
colleague was getting the registration slip for the patient.

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On Emergency call, patient was made lie down on chair and was managed as per the presentation.
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Case Presentation

Patient while entering the reception, suddenly vomited and fell on side without any known cause or complaint. The accompanying office colleague could interpret only that she complained of severe headache since morning and just 10 minutes back, she started complaining of nausea and was brought to us.

No symptoms (except headache), no past history and no drug history could be collected as patient was lying in painful condition and was unable to tell her symptoms.

Observation & Quick Clinical Examination was the only way out to make a diagnosis and to revive the patient.

Patient had severe headache since morning with nausea and now vomiting. There was profuse sweat on her forehead and body temperature was above normal. Patient was highly sensitive to light.

B.P. was 186/124 mmHg and Pulse was 94/m, full and hard with RR of 26/m and patient was unable to interpret her symptoms due to severe headache, nausea and dizziness. There were loud Heart sounds without any added sounds.

Not wasting much time, she was prescribed ADRENALINUM 0/1 (10 Drops – STAT) on tongue at interval of 5 minutes for next 15 minutes.
Patient felt comfortable within next 15 minutes and asked for water and initiated talk with attending consultant. She easily drank 2 glasses of water and within next 5 minutes interpreted the whole story that what actually happened to her in her own words.

B.P after 10 minutes noted was 170/120 mmHg and Pulse was 90/m.

Adrenalinum 0/1 was given after 10 minutes and B.P. could be noted (after 25 minutes from start) as 156/110 mmHg and patient was feeling much comfortable and was easily talking to her colleague and attending consultant.

After talking to her, it could be found that she is suffering from HTn since last 6 years and is regularly taking Allopathic Drug for Htn but still BP sometimes shoot up like this and she feels as if she would have brain hemorrhage.

She was kept under observation for next 30 minutes and blood pressure was monitored in final on discharge as 140/96 mmHg and patient went to her car walking with ease.
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Afterwards, she took treatment for same and was fully recovered from her HTn within 6 months and all allopathic drugs were tapered off within initial 20 days.



Link to websitepage: http://drbindras.wix.com/clc3795#!emergency-case-of-the-week/c9b1 

Emergency Case of the Week

EMERGENCY CASE OF THE WEEK

Homoeopathic Emergency Case Management where lives are saved within few minutes and hours..



A CASE OF ANURIA IN BENIGN PROSTATE HYPERTROPHY
DEPARTMENT OF UROLOGY
(Updated: 8.2.2013)

Patient Name: Ku****** Singh, aged: 67 years, Male

Diagnosis: Benign Prostate Hypertrophy (Grade III)

Emergency Crisis: Anuria (more than 48 hours)

Allopathic Urologist’s Advice: Immediate Surgical Intervention


Patient reported to our Urology OPD on 17.11.2012 (11.15 AM) in quite painful and critical condition as the patient had not passed urine for last 3 days and previously catheter was inserted for last 26 days (2 times) which caused localized inflammation and tenderness and had to be removed.

USG: Grade III Prostate enlargement (Volume 56 cm3) Residual volume: 500 ml
PSA: 11.82 ng/ml

Case Presentation

Patient suddenly stopped passing urine 1 month back and was taken to a urologist (allopathic) and on examination and USG it was reported that there is obstruction of urinary outflow due to enlarged prostate and was prescribed some medications for 2 days but with no help. After 2 days catheter was inserted to relive the patient and was advised to have a observation/wait for next 7 days.

No improvement after 9 days and patient approached a Homoeopath for help and he gave medicines for next 12 days but with no relief and finally patient was advised surgical intervention within next 2-3 days.

Patient approached our UROLOGY OPD with tearing pain in abdomen and anuria with nausea and loss of appetite. Patient was feeling drossy for last 2 days and there was raised blood pressure with palpitation.

On examination B.P. was 150/110 mmHg and HR was 94 bpm and ECG was done with findings of RBBB and RAD.

Taking into consideration the case presentation, Nux vomica 10M STAT (1 dose) followed by Pulsatilla 0/1 (1 hourly) was prescribed and patient was advised complete bed rest with diet restrictions.


Next morning patient’s attendant reported with joy that patient passed 450 ml urine since last noon (in 20 hours) and is feeling much relaxed and better now.

Pulsatilla 0/1 was continued 1 Hourly and was tapered to 2 hour/3 hour for next 2 days and after 4 days, a dose of Digitalis 1M was prescribed followed by Puls 0/2 and another USG & PSA was carried out on 31.12.2012 with marked improvement.

USG: Grade III Prostate enlargement (Volume 51 cm3) Residual volume: 150 ml
PSA: 4.63 ng/ml

The urine output was 700 ml/24 hour with intake of 1000-1200 ml/24 hour day by day.

This is how with 44 days of treatment, there is a remarkable improvement in lab reports and of course in patients condition.

The patient as of now is on cardiac/urology management and is comfortably performing his daily routine work with adequate diet and is symptom free.


Link to website: http://drbindras.wix.com/clc3795#!emergency-case-of-the-week/c9b1