KMC IS ALSO IN DUWAKOT. It also contains a medical college in Duwakot.

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KATHMANDU MEDICAL COLLEGE& TEACHING HOSPITAL
Sinamangal, Kathmandu, Nepal
: 4476152, 4469064*
DISCHARGE
DEPARTMENT OF INTERNAL MEDICINE
Name of the patient: RAM SARAN WAGLE
Age/Sex: 50YRS/ MALE
IP no: 165521
Address: KATHAMNDU
Bed no: 137
Date of Admission: 2079/06/24
Date of Discharge: 2079/06/27
Case Summary
Patient was in his usual state of health 7 days back when he developed fever which was acute in onset, Tmax recorded
was 103F associated with chills and rigor, relieved on taking oral medications.
he also complained of SOB for 7 days, insidious in onset, gradually progressive, more on exertion, relieved on rest,
a/w cough, dry in nature.
No history of bleeding of gum and nose, black tarry stool.
No history of abnormal body movement, LOC, frothing from mouth, up-rolling of eyes.
No history of loose stool, abdominal pain, burning micturition.
Past history:
No history of COPD, ASTHMA, PTB, THYROID DISORDER.
Personal history:
Consumes tobacco, chronic alcoholic and Nonsmoker.
EXAMINATION AT THE TIME OF ADMISSION:
On examination:
S/E:
Chest: right sided crepitations present
CVS: S1S2M0
P/A: Soft, non-tender , non-distended.
CNS: GROSSLY INTACT
INVESTIGATIONS 2079/06/24 2079/06/26 2079/06/27
HB/PCV 11.4 11.5/33
TC 7200 5200
DC(N-L) 70-25 55-40
PLATELETS 80000 92000
RBS 119
UREA/CR 119/27
NA/K 133/3.6
SGPT/SGOT/ALP 74/95/184
BT/BD 0.9/0.3
DENGUE IGM POSITIVE
RK39
SCUB TYPHUS IgG POSITIVE
SCUB TYPHUS IgM NEGATIVE
BRUCELLA MELITENSIS NEGATIVE
BRUCELL ABORTUS NEGATIVE
MALARIA AG NEGATIVE
G/C – ill looking
PILCCOD- NIL
VITALS:
Temp: 103 F
Pulse: 128 pm
RR- 35/min
BP- 100/60mm of Hg
SPO2-86% in RA
DIAGNOSIS: DENGUE FEVER (DENGUE FEVER IgM POSITIVE)
VIRAL MYOCARDITIS
DEPARTMENT OF INTERNAL MEDICINE
PROF DR. MATHURA KC
ASST. PROF. DR. SUBASH PANT
DR. ALOK DHUNGEL
DR. ANANTA ARYAL
DR. SUNIL ACHARYA
DR. ABISHKAR ACHARYA

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CPK MB/ TROP-I 12/NEGATIVE
ECHO(2079/06/25):NORMAL CHAMBERS
MILD MR
MILD TR WITH MILD PHT (28+5=33MM OF HG)
GLOBAL HYPOKINESIA
SINGLE WAVE MIP
NO INTRACARDIAC MASS, THROMBUS, OR PERICARDIAL EFFUSION
MILD LV SYSTOLIC DYSFUNCTION (EF 45%)
USG(2079/06/24): -HEPATOMEGALY WITH HETEROGENOUS ECHOTEXTURE.
-TWO HYPERECHOIC FOCUS IN RIGHT LOBE OF LIVER
D/D: HEMANGIOMA
-SPLENOMEGALY
Treatment in the Hospital:
Patient presented to ER and was admitted to general medicine ward and where he was evaluated and managed with, IV FLUIDS,
INJXONE, INJ DOXY, INJ PANTOCID, INJ THERMODOL, INJ ONDEM, and other supportive management. he is being discharged
after hIS vitals are stable.
CONDITION AT DISCHARGE:
VITALS:
Pulse: 80bpm
RR: 20min
Temp: 98.7F
BP: 110/80mm of Hg
SpO2: 94% in RA
TREATMENT AT DISCHARGE
1. TAB
2. TAB
ADVICE:
FOLLOW UP IN MEDICINE OPD IN 2 DAYS/SOS
____________________
SIGNATURE OF RESIDENT
DR. LAXMAN KHATI
NMC NO : 26732
G/C: Fair
PILCCOD –B/L LIMB SWELLING
S/E:
P/A: Soft, non-tender, bowel sound present.
RS: right sided creps present
CVS: S1S2M0
CNS: Grossly intact

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