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HussainA
Re: Re: Young Patient with acidotic breathing
quote:
He had family history of Diabetes.
Unfortunately, sometimes after finding a single point in the history or examination we consider it the ONLY key to a diagnosis and hence fall a prey to a misdiagnosis resulting in such a misfortune.
oooooooooooooo
TO WHOM IT MAY CONCERN
I seek refuge of Allah from the accursed one (Satan)……..
So far as the myth, wretchedness and absurdness of your posts and the vivid atrocity of yours are concerned, I do once again vehemently
disagree with you!
The link (http://www.emedicine.com/med/topic802.htm),
One of the References, was just to show only to the silly and illiterate people like you otherwise any knowledgeable one can open the latest relevant books/journals and the other related literature to see the references which SURELY do REJECT and REFUTE your mediaeval approach. In addition, the bibliography in the end of the article provides sufficient help regarding their sources (studies etc).
Verily, you have done your best to leave no stone unturned to defend your whimsical thoughts, assumptions, obsessions, heteroclites, serving your folly and
telling a lie one hundred times to conceal just one lie of yours but in vain. One must shudder to look at such stupidities and the blunders done on your part,
in the twenty first century, Alas!
In addition, besides your whimsical thinking, you have provided an enough valuable data for a psychotherapist to analyze for the subsequent management. I think, after thought insertion and thought broadcasting only the third diagnostic stage is pending. By the way, why there are several
contradictions between your own statements superadded by the flight of ideas and the grandiose delusions etc? See it yourself, if you are acquainted with these important parameters.
Remember, even if you have grey hair (everywhere); archus senilis in your eyes, your experience is no more than a big ZERO if not upto the mark and fulfilling all the prerequisite requirements. And also remember absolutely NO
technical one would pay any heed and no one is going to be enchanted and dazzled with such a cunningness and hierarchy of yours which are hereby certainly evident and revealed to everyone.
Furthermore there is no harm if such people (elderly) are vigilant on their PSA preceded by
the full clinical examination and more accordingly.
Having said like 2+2=5 and considering it nonesuch why don’t you dare to prove it…….?
Hence, summarizing, I do once again disagree vehemently with you and do put your whimsical and aberrant thinking, baseless assertion and the supposed exhibition deep into the abyss.
Remember, if you have NO evidence at all then do not be dogmatist and stop quoting your abhorrent and the trashy novel which proves to be no more than a useful tool for sarcasm.
Remember again, it is twenty first century. NO conjecture and NO illicit and inane thinking are admitted at all. So try to develop the proper connoisseurship, if you can.
Also remember, don’t try to beat about the bush and try to tell a lie one hundred times to conceal just one lie of yours.
quote:
Posted by: chameed on 19-12-2007
……………………..any clinical knowledge or experience in medicine …………………..
Produce the EVIDENCE which favours your baseless assertion, otherwise it is all RUBBISH what you are trying to proclaim. Till then, I vehemently disagree with you and your
supposed exhibitive attitude.
Do not PROCLAIM your stupidities and the corrupted knowledge if you have NONE of the evidence. And
don’t try to beat about the bush and try to tell a lie one hundred times to hide just one lie of yours.
Your baseless assertion, supposed exhibition as well as you are hereby put into the huge waste bin.
NO conjecture and NO illicit and inane thinking are admitted at all. So try to develop the proper connoisseurship, if you can.
If you have NO evidence at all then do not be dogmatist and
stop quoting your abhorrent and the trashy novel which proves to be no more than a useful tool for sarcasm.
[Edited by HussainA on 21-12-2007 at 10:17 AM GMT]
peece
Re: Young Patient with acidotic breathing
due to ph of 7 acidosis leading to anaerobic metabolism aggrevated by low b.p.and sympathetic activity increase .
docosama
Re: Young Patient with acidotic breathing
Sir
You are right that peritonitis as a cause of sepsis should be suspected in this patient. However, a patient with dehydration due to excessive vomiting and a family history of diabetes, DKA should be suspected; which was ruled out. He did have severe acidosis, but what was the cause, was not properly investigated. This unfortunate child had a short stay in the hospital. Abdomen initally was soft and non tender, but later on in the morning, it was tense, but bowel sounds were still present.
He was resuscitated on the standard ACLS protocols. This child was presented in an ER of a Govt hospital, where you know unfortunately all facilities are not avaiable as well, and the cause of such antibiotic cover.
icumicuccu
Re: Young Patient with acidotic breathing
A young pt who presents with hypotension, tachpnea and evidence of dehydration needs to be worked up expeditiously. His appearance and tachypnea with a tense abdomen and 4 day history suggested an abdominal catastrophe. After 3 L he should have been adequately hydrated. The fact that he became hypotensive again suggest sepsis. He may have a ruptured appendix with peritonitis and sepsis/peritonitis. His overwhelming sepsis and hypoperfusion can explain his lack of fever. Hypothermia is also a sign of fulminant sepsis. The antibiotic coverage was also not adequate. Based on resistance pattern amoxil is a useless drug. He was probably compensating for severe metabolic acidosis all through the night and went in to cardiac arrest from severe lactic acidosis. details of resusitation were not given. Surgical consult was not obtained. Abdominal xray atleast could have shown localized ilius prompting additional work up. Abgs should have done earlier in the course of the illness.
We have to learn to value human life and take vital signs seriously. It is unfortunate that this child died.
cardinal s
Re: Young Patient with acidotic breathing
he may be having gastritis leading to vomiting and dehydration
