1. CASE PRESENTATION
S.Navya
Pharm-D 4th
year
HT.NO:13117D1007
Vaagdevi College of
Pharmacy,Hanamkonda.

2. CASE PROFILE
• A male patient of age 28 years was admitted in
general medicine male ward of MGMH with
ip.no:21301 on 13/6/16.
• The patient case profile was explained in soap
format.
SUBJECTIVE FINDINGS:
• Severe pain in both upper and
lower limbs since four days
• Pain in both knee joints since
four days.

3. • Fever of low grade associated with chills and
rigours since four days.
• Bone pain(osteolgia) since five days.
PAST MEDICAL AND MEDICATION
HISTORY:
• Patient is a known case of sickle cell
anemia since two years.
• NO PAST SOCIAL AND
FAMILY HISTORY WAS
FOUND.

4. OBJECTIVE FINDINGS
COMPLETE BLOOD PICTURE:17/6
Haemoglobin:7.3gm%
Total RBC:3.2million cells/mm
Total WBC :12,3000cells/cmm
Neutrophils:76% Eosinophils:9%
Lymphocytes:12% monocytes:3%
Pcv:23%, mcv:71%,mch:21pg,mchc:30gm/dl
impression:microcytic hypochromic eosinophilia.

5. • 16/6 LIVER FUNCTION TESTS:
Total bilirubin:9.65mg/dl
Direct bilirubin:5.46mg/dl
SGOT:69.4U/L Alkaline phosphate:160U/L
SGPT:47.1U/L
15/6 SERUM CALCIUM:5.8mg/dl
16/6 Ultrasound of abdomen:
impression:mild hepatosplenomegaly
13/6 BLOOD UREA:45mg%

6. • PHYSICAL EXAMINATION:
• On examination patient was
conscious and coherent.
 Generalized weakness.
Pallor+
Icterus+

7. PROVISIONAL DIAGNOSIS:
• Based on chief complaints,
past medical history the patient was diagnosed
with
ABOUT DISEASE;Sickle cell
anemia is a hereditary disease in
which a mutated form of haemoglobin
Distorts the red blood cells into a
cresent shape at low oxygen levels.
‘SICKLE CELL ANEMIA’

8. • Etiology:genetic inheritence called
autosomal recessive inheritence;a variant of
sickle cell anemia have HbS.HbS has valine
substituent for glutamic acid as the sixth
amino acid in the beta polypeptide compared
with normal hemoglobin.
• Symptoms:Chest pain,pale skin,swelling in
hands and feet,severe pain of joints and
bones,severe infections etc.

9. Assessment of standard treatment

10. PLAN
s.n
o
Drugs Dose
ROA
Freq Category
1. IVF 3 pint NS,1 pint RL Electrolyte replinesher
2. Inj.Ceftriaxone 1amp/IM BD 3rd
gen cephalosporin
3. Inj.Diclofenac 1 amp/IM BD analgesic
4. Tab.Hydroxyurea 200mg/PO BD Antimetabolite
5. Tab.Pantoprazole 40mg/PO OD Proton pump inhibitor
6. Tab.Paracetamol 500mg/PO TID Antipyretic
7. Tab.Calcium 500mg/PO OD Calcium supplement
8. Tab.Ursodeoxycholic acid 300mg/PO OD Liver protective
9. Inj.Ketorolac 1amp/IM BD NSAID

11. Lifestyle modifications
• Take folic acid supplements daily, and
choose a healthy diet.
• Drink plenty of water.
• Avoid temperature extremes. Exposure to
extreme heat or cold can increase your risk of a
sickle cell crisis.
• Exercise regularly, but don't overdo it.