K. Manasa

DISSERTATION PLAN ACTIVITY TITLE : Factors influencing clinical decision making around therapeutic interventions for critically ill renal failure patients in a rural medical college  PROBLEM STATEMENT:   Most of the renal failure patients present with sob pedal adema Tachypnea due to which they are requiring early dialysis  Aim: To study various events related to and influencing treatment decisions around patients with critically ill renal failure  Objectives : 1) Document the events and symptoms leading to the patient presenting with renal failure  2) Study the associations between the events and certain symptoms influencing the therapeutic decision taken  3) Document the patient outcomes resulting from the therapeutic decisions over two years of follow up  Methodology: Qualitative observational study  Inclusion criteria  a) All patients of renal failure defined by biochemical azotemia and radiological indicators  b) All patients with substantial diagnostic and therapeutic dilemma in

CASE 1: 57 year old man with jaundice, pedal edema and abdominal distension since three years and bleeding gums since three days" https://swathibogari158.blogspot.com/2020/09/chronic-decompensated-liver-disease.html 1) What is the reason for this patient's ascites? A) Chronic liver disease ( chronic alcoholic since 40 yes) Truncal obesity leading to fatty liver changes in echotecture of liver leads to increase hydrostatic pressure and increase portal hypertension leads to ascitis  2) Why did the patient develop bipedal lymphedema? What was the reason for the recurrent blebs and ulcerations and cellulitis in his lower limbs? A) Biletral pedal odema is due to decrease albumin( synthetic activity of liver has affected) leads to decrease oncotic pressure further causes pitting type of pedal odema blebs and bursting of blebs and leading to ulceration is due to coagulation activity of liver has affected i.e explained by increased INR trends leading to bleeding manifestations and ble