Adobe Scan May 17, 2023

Download as pdf or txt
Download as pdf or txt
You are on page 1of 2

Coll:94411 84226

TANVI HOSPITAL
Plat No. 15, Road No. 1, Hudasainagar Kaman, Vanasthalipuram,
97053 27113

Hyderabad, Rangareddy - 500070.

DEPARTMENT OF ORTHO
DISCHARGE SUMMARY

Admission IPNo.01602 Age/Sex :45Yrs/Male


Patient Name: Mr. S. VIJAYAKUMAR Ward Name : Room -09
DOA :09-02-2022 DOD : 18-02--2022
Consultant :Dr. M. V. PRASAD DNBORTHO Department : ORTHO

CONSULTANT NAMES :Dr. M. V. PRASAD DNB ORTHO


ConsultantOrtho Surgeon

FINAL DIAGNOSIS 1). *Fracture Left leg Neck of Femur Surgery on 10-02-2022

CHIEF COMPLAINTS :A4 5years old male patient admitted with C/o Alleged to have met with RTA
.On 09.02.22 at 12.30 pm swelling/ pain both thigh with deformity unable to stand and walk.

HISTORY OFPRESENT ILLNESS A45years old male patient admitted with C/o Alleged tohave met with
RTA.On09.02.22 at 12.30 pm 2wheeler vs 2wheeler, patient is ciding 2wheeler sustained injury after
getting hit to anther 2wheeler coming from right side near ozone hospital corner. Not under influence of
Alcohol. H/o multipleinjuries. No H/o Alcoholic and drug abuse. No H/o DM and HTN

PAST HISTORY : Nil particular No DM° /CAD /HTN°.


No past history of similar complaints.

PERSONAL HISTORY : No Past particulars.

ON EXAMINATION :Patient Conscious/Coherent


Temp -98.2° F,
BP - 130/80mm/Hg,
HOSA
PR- 126/min, PlotNo. 15,
P/A -Soft. (Vanasthalipuram
Hyderabad
CVS- S1+ S2+.
SPO2 - 92% on RA.
uda Sel Nagat

SISTEMICEXAMINATION: X-Ray Pelvis with both hips fracture neck of femur.

INVESTIGATIONS :Reports Enclosed.


Cell :94411 84226
ETOLO
TANVIHOSPITAL
Plat No. 15, Road No. 1, Hudasainagar Kaman, Vanasthalipuram,
97053 27113

KCOLO Hyderabad, Rangareddy - 500070.

CASE DISCUSSION
:A 45 yrs old male patient presented with above mentioned complaintsgot
admitted in our hospital under the care of ortho and was evaluated accordingly all necessary
investigations were done wherein X-Ray Pelvis with both hips fracture neck of femur. Patient was
initially treated with IV Antibiotics, IV PP>'s, IV Analgesics, IV Antipyretics, Oxygen inhalations and other
supportive medications.ORIF of lift femur Under GA on 10-02-2022 with titania implants Patient
responded well. Patient was gradually improved; hence he is shifted out from ICU to ward. Patients
responded well to the above measures and have improved clinically, hence he is being discharged in
hemodynamically stable condition with further medications and regular follow-up with general
physician.

TREATMENT ADVISED :
1) Tab. Levoflox - 750mg Once daily x 5 days
2) Tab. Pantop-40mg Once daily x5days
3) Tab. Zerodol-P Twice daily x 5 days
4) Tab. Ceftum 500mg Twice daily x Sdays
5) Tab. Limcee Once daily x 5 days
6) Tab. Montek LC Once daily x 5 days
7) SypGrillinctus 2 tsf Twice daily x Sdays
8)SypDuphalac Once daily 30ml.

REVIEW: After Five Days OPD or SOS if any Emergency.

R.M.O RESIDENT
OSPIA
Plot Nó,15,
| Vanastlalpuram
HyeRISULTANT
Sai Naga

You might also like