16 yr old girl with c/o pelvic pain

 NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS / HER /GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT. 

PATIENT HISTORY: Pt is a 16 yr old school-going girl.

Since birth pt's hands are always very sweaty and warm.

When in class 3 injured rt hand due to an electric shock. Took 1 month to recover. During the same time got bitten by a dog, anti-rabies vaccine was given,

Since 6 yrs old, pt used to go dancing school. When dancing for long or doing hard moves she c/o intense stabbing pain in her left lower abd which lasted for 2-3 hrs. Later pain used to occur even without dancing. Till class 9 did not receive any treatment as such. 

While in class 9, pt also started c/o diffused abd pain after a meal or if had not eaten for 4 - 5 hrs. Dr. prescribed USG and gave her Pan 40 along with other medications which reduced her pain temporarily. She did not seek further treatment. 

For the past 1 yr, c/o a sharp chest pain starting from the left and spreading to whole chest, lasting for 10-15 mins. 2-3 times per year.

Last 3 months she c/o intense pain which is moving all around her abdomen lasting for 2-3 hours. The pain generally begins in the evening and then gradually intensifies. Most intense around dinner time. Pain mostly goes away on sleeping.

3 months ago, while her parents were away from home for a wk or two,  c/o reduced appetite and also c/o a weird odor from whatever food was served to her, so she used to skip meals. Sometimes also c/o of feverish feeling and abd pain, subsiding on its own. After eating forcefully would c/o nausea and vomiting. The stool was normal. After her parents return home, she was taken to a Dr. did a USG (mild fatty liver and POD noted) who prescribed medications taking which resolved her symptoms. Stopped medications after 2 wks.

No H/O HTN OR DM

HISTORY OF PERIODS: 

Menarche at the age of 12. After a few menstrual cycles, she c/o dysmenorrhea, and menorrhagia. Menstrual bleeding used to happen for 5-6 days. At present, no c/o dysmenorrhea or menorrhagia, resolved on its own with time

But for the past 4 yrs, the menstrual cycle is happening 10 days prior to or later than the expected date. And every year one month is completely missed i,e 11 cycles each year instead of 12.

CHIEF COMPLAINT AND Pt REQ.:

For the past 3-4 days c/o nausea, light pelvic pain especially in the evening which increases as night progresses. On sleeping pain goes away.

For 1 wk extreme headaches reduce somewhat by drinking tea or with sleep.

PERSONAL DETAILS:

Pt does free hand exercises since class 10 for 1 hr each morning.

Pt loves to drink tea (prefers milk tea) at least 3 times a day.

Pt eats an excess amount of chicken pakora, golgappa, ice cream, and sometimes biriyani from outside.

FAMILY HISTORY:

Father - H/o asthma 20 yrs ago, currently not using any medications. Arthroscopic partial meniscectomy was done 1 yr ago. c/o intense pain on standing still for a min or so starting in the gluteal region and descending to calf muscles. 

Mother - no c/o any health issues.

REPORTS: 





















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