LEFT_BELLS_PALSY,HYPERTENSION-NEERAJ_(1)[1][1].pptx

Case presentation of left bells palsy

1. LEFT BELLS PALSY,HYPERTENSION NEERAJ S.J 2 nd PHARM D 2022 BATCH

2. DEMOGRAPHIC DETAILS NAME :MRS X AGE :40 GENDER :FEMALE MRD NO :J000032830 DEPARTMENT :NEUROLOGY DOA :20/01/24 DOD :22/01/24 NO OF HOSPITAL STAY :3

3. REASON FOR ADMISSION C/O Deviation of angle of mouth to right side with left facial palsy. . SOCIAL HISTORY : NIL . FAMILY HISTORY : NIL . PERSONAL HISTORY : HYPERTENSION

4. CLINICAL EXAMINATION GENERAL : Conscious and Oriented CVS : S1 S2+ GIT : Soft and non tender LUNGS : B/L Clear NEUROLOGY : Left facial palsy ,All limbs moving

5. VITALS ON ADMISSION TEMPERATURE : Afebrile BP : 130/80mmHg PULSE : 85 beats/min RR : 20 beats/min SPO2 : 98%

6. PROVISIONAL DIAGNOSIS ? Left Bells Palsy

7. VITALS MONITORING CHART VITALS 20/01 21/01 22/01 NORMAL VALUES BP 130/80 130/80 130/80 120/80mmHg PULSE 85 83 80 60-100 beats/min RR 20 22 22 20 Breaths/ min TEM 98.6 98.6 98.6 98.6 F SPO2 98% 98% 98% 95-100%

8. LABORATORY INVESTIGATION REPORT

9. HAEMATOLOGY PARAMETERS 20/01 NORMAL VALUE Hb 13.8 14-18 gm/dl WBC 13000 4500-11000 cells/ cumm Polymorphs 77.9 50-80% Lymphocytes 17.5 20-40% Eosinophils 0.7 Less than 5 Monocytes 3.6 2-10% ESR 30 0-20mm/hr Platelet Count 3.85 1.5-5.0 Lakhs HbA1C 5.1 Less than 6%

10. URINE ROUTINE PARAMETERS 20/01 21/01 NORMAL VALUE ALBUMIN <30 mg/dl SUGAR Nil 0-0.8 mm/dl PUS CELLS 14-16 1-5 cells/ hpf RBCs 12-14 1-5 cells/ hpf EPITHELIAL 10-12

11. RENAL FUNCTION TEST PARAMETERS 20/01 NORMAL VALUE UREA 16 20-40 mg/dl CREATININE 0.6 0.7-1.3 mg/dl PARAMETERS 20/01 NORMAL VALUE CRP 3.2 0.3-1.0 mg/dl

12. ELECROLYTES PARAMETERS 20/01 NORMAL VALUE Na 139 136-144 mg/dl K 3.9 3.7-5.1 mmol/L

13. LIVER FUNCTION TEST PARAMETERS 20/01 NORMAL VALUE Total bilirubin 0.65 0.20-1.30mg/dl Direct bilirubin 0.30 0.00-0.40 mg/dl Indirect bilirubin 0.35 0-1 mg/dl ALT 26 <50 U/L AST 23 15-37 U/L Alk.phosphatase 66.0 50.0-136.0 U/L Serum albumin 4.8 3.4-5 gm/dl Serum globulin 4.4 1.8-3.5 gm/dl Total protein 9.2 6.0-8.3 gm/dl

14. FINAL DIAGNOSIS LEFT BELLS PALSY HYPERTENSION

15. TREATMENT CHART SL NO BRAND NAME GENERIC NAME DOSE ROA FREQUE-NCY 20/01 21/01 22/01 1 TAB AMLO AMLODIPINE 5mg P/O 1-0-1 + + + 2 TAB METHYLPRED METHYLPREDNIS-ONE 8mg P/O 1-0-1 + + + 3 TAB ARKAMINE CLONIDINE 0.1mg P/O 1-0-1 + + + 4 INJ VIATRAN CEFAPERAZONE & SILBACTUM 1.5mg P/O BD - + + 5 INJ PANTOP PANTOPRAZOLE 40mg IV OD - + + 6 TAB PREDMET METHYLPREDNIS-OLONE 16mg P/O 1-0-1 - - + 7 TAB PANTOP PANTOPRAZOLE 40mg P/O 1-0-1 - - + 8 TAB NIFTAZ NITROFURANTOIN 100mg P/O 1-0-1 - - +

16. DISCHARGE MEDICATIONS SLNO BRAND NAME GENERIC NAME DOSE ROA FREQUENCY DURATION 1 TAB AMLO AMLODIPINE 5mg 1-0-1 5 days 2 TAB ARKAMINE CLONIDINE 0.1mg 1-0-1 5 days 3 TAB PREDMET METHYL PREDNISOLONE 4mg 1-0-1 1-0-0 3 days 2 days 4 TAB PANTOCIP PANTOPRAZOLE 40mg 1-0-1 5 days 5 TAB NIFTAZ NITROFURANTOIN 100mg 1-0-1 5 days

17. REVIEW : Review in Neurology OPD after 1 week .

18. SOAP ANALYSIS SUBJECTIVE EVIDENCE A 40 yrs old female patient was admitted in neurology department on 20/01/24 with c/o left bells palsy and hypertension and was discharged on 22/01/24.

19. OBJECTIVE EVIDENCE ELEVATED PARAMETERS WBC ESR RBCs PUS CELLS EPITHELIAL TOTAL PROTEIN CHOLESTEROL

20. ASSESSMENT According to the subjective and objective evidence the case was diagnosed as left bells palsy

21. PHARMACEUTICAL CARE PLAN 1 . TAB AMLO . Generic Name : AMLODIPINE . Dose :5mg . MOA : Used to treat Hypertension . Side effect : Headache, fatigue, nausea, abdominal pain, 2. TAB.METHYL PREP . Generic Name : METHYL PREDNISOLONE . Dose : 5mg . MOA : Used to treat Allergic conditions . Side effect : Mood change, Weight gain

22. 3. TAB ARKAMIN Generic Name : CLONIDINE Dose : 0.1mg MOA : Used to treat Hypertension Side effect : Dry mouth, fatigue, dizziness, headache, nausea 4. INJ. VIATRAN Generic Name : CEFOPERAZONE + SOLBACIUM Dose : 1.3mg MOA : To treat bacterial infection Side effects : nausea, vomiting, diarrhoea, indigestion

23. 5. INJ. PANTOP Generic Name : PANTAPRAZOLE Dose : 40mg MOA : Proton pump inhibitor Side effects : nausea, vomiting, 6. TAB NIFTAZ Generic Name : NITROFURANTOIN Dose : 100mg MOA : Antibiotic Side effects : nausea, vomiting,diarrhoea

24. PATIENT COUNSELLING DISEASE BASED LEFT BELLS PALSY : A condition that causes sudden weakness in the muscle on one side the face. Symptoms : Disordered movements of the muscle that control facial expression such as Smiling, Blinking of eyelid. HYPERTENSION : A condition in which the force of the blood against the artery walls is too high.

25. DRUG BASED COUNSELLING 1. TAB AMLO Used to treat high BP and prevent angina. Take with or without food. Take medicines as long as prescribed , if you stop taking your condition may get worse. 2. TAB ARKAMINE To treat Hypertension. It lowers the BP and prevent angina by decreasing heart rate. Take drug with or without food.

26. 3. TAB NIFTAZ It is an antibiotic. To treat bacterial infection. Take with food to avoid nausea.

27. DIET AND LIFESTYLE MODIFICATION DASH DIET [Dietary Approach to step Hypertension] Diet should include plenty of whole grains, fresh fruits and vegetables, low fat diary products, lean meats, healthy fats. Avoid food that are high in fat, sugar, refined flows, sodium and cholesterol. Do stress management like Yoga. Mild exercise like walking. Monitor the mental health by seeking counselling or connecting with friends and family.

28. REFERENCE . http://www.pharmeasy.in . http://www.netmeds.com

29. THANK YOU