70 M Born in 1954 in tamil nadu moved to Andhra pradesh (suryapet ) at the age if 14 yrs (1968) and started doing biscuit business since then. Non alcoholic,Chronic smoker- stopped 20 yrs ago as he developed wheeze ,dyspnea on exertion exposure to dust ,cold weather and uses some unknown tablet for it once daily at night time .wheeze and sob subsided 2 years ago
Patient has no other comorbidities
In August 2022
He developed sudden onset retention of urine with associated symptoms of abdominal distension,chest pain , profuse sweating
Taken to general physician - diagnosed with diabetes mellitus and hypertension - Started on medication since then
Later on after 10 days patient advocate noticed involuntary movements of right upper limb at rest
Since then started Tab syndopa plus
Foleys catheterization was done for urinary retention and used to change foleys once in 15 days
Patient was referred to urologist where CT scan was done -and noticed rapid increase in size of prostate in 30 days
So referred to yashoda hospitals for further evaluation
Where pet ct ,biopsy were done
Showed prostate adenocarcinoma with metastasis to L4 vertebra
Advised for b/l orchidectomy but attenders denied for surgery due to unavailability of nursing staff at home post surgery
So no treatment was started for prostate cancer then
In December 2023 there was obstruction in foleys and was advised cystotomy
Then came to KIMS hospital for further management
And started on Tab BICALUTAMIDE since then and TAB RELUGOLIX since 1 week
In 1st week of December there was hematuria for which frequent bladder irrigation was done and it resolved
On 9/12/24 patient was found unresponsive early in the morning
And brought to hospital
PAST ILLNESS HISTORY
H/o bradykinesia +nt
no h/o constipation
No h/o orthostatic hypotension
No h/o frequent falls
TREATMENT HISTORY
TAB BICALUTAMUDE 50 MG PO BD
TAB RELOGOLIX 120 MG
ON DAY 1 3 TABLETS PO OD
F/B 1 TABLET PER DAY ( PRESCRIBED BUT NOT STARTED TAKING THEM)
TAB TELMA AM 40/5 PO OD
TAB SITAGLIPTIN+METFORMIN 50/500 1/2 PO BD
TAB SYNDOPA PLUS 100+25 PO 1-1-1
TAB SYDOPA CONTROLLED RELEASE TABLET AT NIGHT
TAB OFLOXACIJ 200MG PO BD FOR 6 MONTHS
TAB NITROFURANTOIN 100 MG PO BD FOR 1 WEEK
At presentation
Gcs - E2V1M4
