Pati

entdetails
I
nformant-Mot herRel i
able
Kavya.P
3year2mont holdf emalechild
Address-D/ OPr akasham, Pi
ler
u,Chitt
oorDt
Chi
efCompl aint
s
C/0Notgai ningwei ghtsince6mont hs
C/oRecur r
entepi sodesofl oosest
ools
Associatedwi thfeversince6mont hs

Hist
oryofpresenti
ngil
lness;
Chil
dwasappar entl
ynormal6monthsbackmot hergradual
ly
noti
cedchil
ldnotgaini
ngweightandhadlostt
hepr ev
iousy
att
ainedweight

Loosest ools,7-8ep/ dayl oosewat erygreenishfoulsmell

ing,not
mi xedwi thbloodormucus.Pr esentepisodei ssince5day sc/o
Fev erhighgr adeinter mit
t entreli
evestempor ari
lywithmedi cation
si
nce3day s.
h/osi milarcompl aintspr esentf r
equentlyoncei na2mont hs
H/ ol et
har gydecr easedact i
vit
ynoti nt
erestedinsur r
oundings
presentsi nce4mont hs
h/ol ossofappet i
tepr esent
h/or estri
ctionoff eedspr esentdur ingtheill
nessi nviewoff ever
H/ oabdomi naldistension.
Nohi storysuggest i
veofv it
ami nandmi neraldefici
encies
PastHi story
historyofsi milarepisodespr esentoncei neverymont hsince6
mont hs
Ant enatalHistory
Mot hermar ri
edatt heageof19y earssheconcei vedthischildat
ageof23y rsMot herwasdi agnosedwi t
hpr egnancybyUPTand
conf i
rmedbyUSG

HadregularANC'
SandTTpr
opy
laxi
sMot
hernotusedI
FAi
nvi
ew
ofvomit
ings

1STand2NDTr
imest
ers-Ni
lsi
gni
fi
cant

Qui
ckeni
ngf
eltat20weeksofgest
ati
on3r
dTr
imest
er-Mot
her
hadanemi
aforwhi
chshewast
ransf
usedwi
thpackedRBC

Diet
aryHist
ory
Babywasex cl
usiv
elybreastfedti
ll1yearofagelat
erst
art
ed
gi
v i
ngcow'smilki
nv i
ewofi nadequat
emi l
kproducti
onbythe
mother.

Cowsmi l
kwasgivenin1:2dil
uti
on,100mlperev er
yfeed6to8
feedsperday2atnight.
Shegaveonlydil
utedmilkt
il
l10mont hsofage.
Shestart
edgiv
ingidli
,bi
scui
tsandsnacksfrom 13months
onwards

Cowsmi
lkwasgi
venoncei
nev
ery4hour
sar
ound100ml

Babywasst
art
edgivi
ngbiscui
tsandsmashedf
rui
tsbananaat
ar
ound14monthsofage.

Rightnowpriort
othei
ll
nesschil
dwasf
edwi
thBr
eakf
astmi
lk
200ml,i
dli2,
Banana1medium si
ze
LunchRice-1/2cupDhal-3tsp

Ev
eni
ngsnacksBi
scui
ts3,
mil
k250ml

Ni
ghtRi
ce-½cupMi
lk200ml

Devel
opment
alHi
stor
y
Grossmot
or

Rol
lsoverby6months.
Standswi
thsuppor
tby12mont
hsSt
ands
wit
houtsuppor
tby14mont hs

Runni
ngat
tai
nedby3y
ear
s.Notabl
etocl
imbst
air
s

Immunisat
ionHistory
Immunisedaccordingtonati
onali
mmuni
sat
ionschedul
e
Famil
yHistor
y:ni
lsignif
icant
Soci
o-EconomicHi stor
y
Lowsoci oeconomicstatusaccor
dingtomodi
fi
edkuppuswamy
scal
e
GeneralExaminati
on
Chil
di scomfort
ablysi
tti
nginmot her
'sl
ap.
Aler
tPl ay
fuli
nter
acti
ve
Anthropometry

Wei
ght8.
2kgHei
ght80cm,
Headci
rcumf
erence47cm

Chestci
rcumf erence40cm MAC10cm
Vital
s
PR-112/minregul arnor
malinvol
umeandcharact
erno
radif
emoraldelayandallper
ipher
alpul
sesf
elt

RR-28/minregul
arabdominot
horaci
cty
peBP-90/
60mm ofHg
i
nri
ghtuperl
imbinsupineposi
ti
on

Temperatur
e-97.4*F
HeadtotoeExaminati
on
Skul
l-shapenor
mal,AFadmi
tst
ipofl
it
tl
efi
ngerPFcl
osed

Hai
r-Hy popi
gmented,
thi
nbr
itt
lel
ust
rel
essFace-Ey
es-pal
lor
pr
esentNoict
erus,
Nopuff
yeyel
ids

Ear
sandNose-Nor
mal
;

Or
alcav
ity-St
omat
it
ispr
esent
,Teet
h-Nor
mal

ski
n,-Dr
yandwrinkl
ed,Nai
ls-normal
,li
mbs-wasti
ngpresent
,BCGScarpr
esentChest
-Normal.Abdomen-di
stended

Genit
alsnor
mal
Syst
emi cExaminat
ion
Abdomen-Di st
endedabdomen,
Skinoverabdomen-nor mal

Ev
ert
edumbi
li
cussl
ight
lypusheddown

Li
verispalpabl
e3cm underr
ightcost
almargi
nsof
tin
consi
stencyroundedmargi
nsmoot hsur
facenont
enderl
iver
span7cm

Nof
reef
lui
d

Bowelsoundspr
esentandnor
malNobr
uit
s