A 29year male patient with uremic seziures

 A 29 year male patient presented to opd with complaints of involuntary movements of upper limbs and lower limbs

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A 29 year old male presented to opd with Chief complaints of involuntary movements of upper and lower limbs since 3 days.

History of present illness:

Pt was apparently asymptomatic 10months back then he noticed weight loss and then went for testing then he came to know his creatinine levels were and high and suggested dialysis by a local doctor and he went to Mexcure hosptal in Hyderabad and was told he having kidney failure and then he visited global hospital in Hyderabad were he again suggeste  to forb kidney biopsy and couldn't do it due to insufficiency of money den suggested to visit KIMS for second opinion den he underwent investigation and suggested dialysis again then his dialysis treatement was started heree on 08/07/21 for every 2/3 days he continued it till 10/09/21(21times till dis date)

 then he stopped too visit KIMS two months back

Then he had 3 episodes of seizers since 4 days where they visited a doctor in NALGONDA and admitted for

 2 days and then discharged on 21/12/2021

The he had seizers 2 episodes

1,at 3am

2,at 11am 

Then on the way to hospital

Past history :

Pt is known to hypertensive since  4years where he neglected bro take medication and since he diagnosed to be renal failure he is using medication

 There is no history of similar complaints in the past 

Personal history :

Diet - mixed

Appetite - decreased

Bowel and bladder movements - regular 

Pt is alcoholic since 10/11 years and stopped 10months back 

And then he had alcohol for 2times after stopping alcohol

No smoking history

 General examination:

Patient is conscious , coherent, cooperative.

No pallor , icterus , cyanosis, lymphadenopathy, pedal edema.

Vitals :

Temperature-98.6°f

Respiratory rate-14cpm

Pulse rate-88bpm

Bp-160/100mmhg

Systemic examination:

CVS-

Inspection- chest wall is bilaterally symmetrical

No precordial bulge

No visible pulsations , engorged veins , scars ,sinuses.

Palpation- JVP is not seen 

Auscultation- S1 ,S2 heard , no murmurs

Rs- BAE normal , trachea position - central, no added sou ds

Per abdomen - soft , non tender 

Cns- 

Provisional Diagnosis-  uremic seizures

CKD on MHD

INVESTIGATIONS: 

Treatment:

Fluid restriction less than 2 per day 

Salt restriction:-less than 2 gm/day 

NEB with duolin 8th hrly

Tab.lasix 50mg

Tan.Nicardia 10mg

Tab.shelcal

Tab.OROFER.XD

Tab.nodosis 500MG

B.p charting 6th hourly temperature and respiratory rate-8th hrly