36 YEAR OLD FARMER BY OCCUPATION CAME WITH COMPLAINTS OF VOMITINGS SINCE MORNING AND GENERALISED WEAKNESS 

PATIENT WAS APPARENTLY ASYMPTOMATIC TILL YESTERDAY THEN HE HAD 

VOMITINGS (10-20 EPISODES SINCE MORNING) CONTAINS FOOD PARTICLES , NON

BILIOUS, NON PROJECTILE , ASSOCIATED WITH STOMACH PAIN DIFFUSE TYPE.

NO COMPLAINTS OF FEVER, CHEST PAIN, COLD, COUGH, SOB ,BURNING MICTURITION ,

CONSTIPATION, WEIGHT LOSS, HEAD ACHE, EGIGASTRIC PAIN, BLURRING OF VISION, 

PALPITATIONS, LOOSE STOOLS

NOT A K/C/O HYPERTENSIVE AND DIABETES 

K/C/O ALCOHOLIC SINCE 10 YEARS ( WHISKEY 90ML)

CHEWS TOBACCO SINCE 10 YEARS 

NO SIMILAR COMPLAINTS IN THE PAST.


ON EXAMINATION :

PATIENT IS C/C/C ,  MODERATELY DEHYDRATED.

AFEBRILE , NO PALLOR , CYANOSIS , CLUBBING, LYMPHADENOPATHY, EDEMA

ICTERUS +

BP:110/80 mmhg 

PR: 80bpm /regular 

P/A : SOFT, NO TENDERNESS PRESNT 


INVESTIGATIONS:

RFT:

UREA: 29

CREATININE: 1.2

CALCIUM: 10.2

PHOSPHORUS: 3.9

SODIUM: 141

POTASSIUM: 3.0

CHLORIDE: 94

SERUM LIPASE: 26IU/L

SERUM AMYLASE: 64IU/L

LFT:

TOTAL BILIRUBIN: 3.97

DIRECT BILIRUBIN: 1.18

SGOT: 43

SGPT: 29

ALKALINE PHOSPHATE :196

TOTAL PROTEINS:8.3

ALBUMIN: 4.8

A/G RATIO: 1.38

USG SUGGESTIVE OF GRADE 2 FATTY LIVER 

HB - 15.5 

TLC : 14,200

NEUTROPHILS : 88

LYMPHOCYTES : 05

EOSINOPHILS : 03 

MONOCYTES : 04

PLATELETS : 1.95


PROVISIONAL DIAGNOSIS: ALCOHOLIC LIVER DISEASE WITH ACUTE GASTRITIS WITH  HYPOKALEMIA AND ALCOHOL DEPENDENCE.

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