2. Proforma
• Hospital Name : Sub district hospital ,Kalwan
• Consultant Name: Dr .Khaire
• PATIENTS DETAL: O.P.D.Card no.
• I.P.D.No.
• Name: Dhanesh Yogesh Kothawade
• Age: 9 yrs sex: Male
• Marital status:Unmarried
• Address and Phone number: At .post Kalwan
•
3. • Occupation:
• Educational qualification of patient: Primary Education
• Social history: Vegeterian ,Non smoker, Non alcoholic
• FAMILY HISTORY:None
• Date of chake up:21 OCT 2015
• Present Complints: Vommiting, Nausea ,Weakness, Loss of apetite
• Yellowish skin.
• On Examination: Blood Pressure(B.P): 120/90 mmHg
4. • Pulse: 72 /Min
• Height: 130 cm. Weight: 20 kg
• BMI:11.83
• Category of patient:
Underweight normal Overweight Obese
Below 18.5 18.5-24.9 25-29.9 30.O& Above
5. • Investigation:
Test Obeserved value Normal value
Urine examination
Albumin Nil
Suger Nil (70-140mg/dl)
Bile Salt Absent
Bile pigment Absent
S. Bilirubin
Total
0.89mg/di (0.2-1.1mg/dl)
S.G.O.T. 25U/L 2-20U/L
S.G.P.T. 33U/L 2-15U/L
6. Sr .No. Medication Dose Frequency Route Duration Cost
1 Tab.Taxime 200mg b.d oral 7 day
2 Inj. Rantac 1 AMP b.d IV 7 day
3 Inj. Amicin 500mg b.d IV 5 day
4 Inj. Ondem 1AMP b.d IV 7 day
5 Monocef 1g. b.d Iv 7 day
7. • Any other lab test: Sonography
• DIAGNOSIS:Hepatomegaly with jaundice
• ASSOCIATED DIESEASES:
• Past Medical History:No
• Past Medication History:NO
• MEDICATION DETIAL :
8. • DISCUSSION..
• Drug interaction: No drug interaction
•
• Drug food interaction: No
• Side Effects: Ranitidin Headach, diziness, rashes,gi disterbance
• Amikacin Ototoxicity, Nephrotoxicity
• Any Alternative treatment: sugercain juice
• Any exercise: No
• Ptinent counselling: avoid oily food