HYPOGLYCEMIA

This is 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 patients clinical problems with collective current best evidence based inputsThis e-log book also reflects my patient centered online learning portfolio and your valuable inputs on comment box is welcome

A 64 years old male patient came to opd with the chief complaint of sudden loss of consciousness

History of present illness:
Patient was apparently asymptomatic 15days ago. then he developed high sugars for which he went to hospital  and advised to use gliclazide 60mg &  Metformin 500mg OD. Patient was normal untill morning  then he took Gliclazide 60mg & Metformin 500mg in the morning assuming his sugars to be digh. From then he was unconcious, and his GRBS was 21mg/dl. His last meal was yesterday afternoon
HISTORY OF PAST ILLNESS :

 H/o DM since 1year, 
H/o HTN since 1yr, 
No H/o Asthma , epilepsy, TB . 

TREATMENT HISTORY :
NO history of previous medication 


PERSONAL HISTORY :
Married 
Mixed diet 
appetite normal
bowel regular
Normal micturation
No addictions

FAMILY HISTORY :
NO H/O :-HTN,DM ,EPILEPSY ,TB


GENERAL EXAMINATION :

NO pallor 
No .icterus 
 No cynosis 
 No lymphadenopathy 
 No clubbing 
No bilateral pedal edema

PHYSICAL EXAMINATION-:

.temperature-:afibrile 
.pulse rate -:87/min
.resp rate -:18/min 
.Bp -:110/60


 SYSTEMIC EXAMINATION :

CVS-; 
        S1,S2 HEARD 
        NO MURMERS 

RESPIRATORY SYSTEM-:
         No dyspnea 
          No wheeze 
          Position of trachea -;central 
ABDOMEN-:
          Shape scaphoid 
          No  Tenderness
          No palpable mass 
           No palpable spleen and liver 

CNS-:
         Consious, coherent ,cooperative 
         Speech normal
         No neck stiffness
         
SENSORY SYSTEM :
        Able to percieve-:pain , temp.

 PROVISIONAL DIAGNOSIS :
 Hypoglycemia 2° to oral hypoglycemic drugs
 
INVESTIGATIONS:
Complete blood picture
ECG, 
Complete urine examination  
RBS
HbA1c
RFT
LFT, 
USGAbdomen
2D ECHO

TREATMENT:
Glucose replacement
Octreotide


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