10-12-2024
This is an Online E Log Book to discuss our patient's de-identified health data shared after taking her signed informed consent . Here we discuss our patient's problems through series of inputs from available global online community experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.
Long distance patient evaluated now in OPD
Diabetes 6 years
370mg post prandial on screening in Bhuvaneshwar medical college.
Was on life style modification for 6 months. Repeat pp 170 mg
Started on medicines Tablet Metformin 500mg twice daily
Later since 1 year added glimiperide 2 mg at night
Last FBS 96
PPBS 150 one month back
Also complains of intermittent erythema and hyperpigmentation in lower limbs
On liquid paraffin
She works in subdivision hospital and needs to get her Hba1c done outside and can't trust the local labs. Last Hba1c was done one year back and she's trying to search her mobile phone to retrieve that! Says it was apparently in the normal range.
She's one patient who didn't buy into our PaJR system and we don't have a good case report/record of her ever since we first met her in 2014!
Due to this informational discontinuity we couldn't even optimise her medications properly because she had a habit of suddenly popping up into our WhatsApp text and we would again have to retrieve her information from scratch with many holes as she wouldn't have been able to share them again in sequence and our own irritation with her not getting her data sequentially in one place!10-12-2024
PPM 1 - GRBS
400pm -163
8.00pm - 144
10pm - 139
2.00am - 124
7.00am - 115
Metformin 500mg two times after lunch and dinner.
PPM 1 - Alright. Continue to take that way. 
PPM 1 - @PPM3 please update the blood sugar profile values
PA - Sir Kunal hasn't seen the orthopedic surgeon yet.
PPM 1 - @PPM3 please check if the Orthopedic people saw this patient's son today?
PPM 3 - Okay sir.
PPM 3 - Okay sir.
PPM 1 - Also please share the three discharges.
They are all three planned to be discharged in the morning tomorrow as they have a train to catch.
PPM 3 - Ok sir.
PPM 3 - GRBS
8.00am - 115
10 am - 140
1 pm - 135
3 pm - 115
8pm - 122
10pm - 152
2 am - 103
8 am - 62
10am - 223
1 pm - 220
3 pm - 173
PPM 1 - 👍
12-12-2024
PPM 1 - Discharge done for all three?
What about the son's final orthopedic resolution?
PA - No sir.
PPM 1 - I'll try to request the Orthopedic Professor to visit your patient at 10 am as soon as our current 9 - 10 am meeting is over.
PA - Ok sir.
PPM 1 - GRBS
8 am - 62
10 am - 223
1 pm - 220
3 pm - 173
8 pm - 84
10 pm - 190
2 am - 250
8 am - 146.
The above sugar values are from 8 am on 11-12-2024 to 8 am on 12-12-2024.
PPM 3 - All discharges are ready sir, waiting for signatures sir.
PPM 1 - Share the de-identified summary here now for 52F and her son and I shall sign as soon as the clinical meeting is over.
PPM 3 - Ok sir.
PPM 1 - The diagnosis needed to have been changed. It's suspected right shoulder joint ligament tear.
PA - Now what should the patient do sir.
PPM 1 - Keep updating the patient's details here regularly at least once a week.
PPM 1 - The case reporter will inform you further.
PA - Ok sir.
[6:58 pm, 21/01/2026] PA: Amar sugar RBS 87 at 9 pm
[6:58 pm, 21/01/2026] PA: BP 140/72 pulse 72
[7:00 pm, 21/01/2026] PA: Metformin
Gp2
Nexovasxt
[7:10 pm, 21/01/2026] PPM 1: Please share the images of the medicines she's taking
[7:12 pm, 21/01/2026] PPM 1: I find that some of the information in this patient's case report is overlapping with another younger patient with shoulder pain and hypertrophied latissimus dorsi for who the case report may not have been made but the latissimus dorsi image may be available in the NKP CBBLE links
[7:14 pm, 21/01/2026] PA Metformin
[7:14 pm, 21/01/2026] PA: Nexovas t
[7:25 pm, 21/01/2026] PPM 1: How many times?
[7:26 pm, 21/01/2026] PPM 1: 👆This is being taken by the patient once in the morning?
[7:27 pm, 21/01/2026] PPM 1: The patient needs to share her fasting and two hour post breakfast, two hour post lunch, two hour post dinner on any Sunday
[7:27 pm, 21/01/2026] PA: This medicine one time before dinner
👆
[7:28 pm, 21/01/2026] PPM 1: Which medicine?
[7:28 pm, 21/01/2026] PPM 1: Metformin?
[7:29 pm, 21/01/2026] PPM 1: 👆 Taken before breakfast?
[7:30 pm, 21/01/2026] PA: No sir Metformine take two times after lunch &dinner
[7:30 pm, 21/01/2026] PPM 1: And glimiperide?
[7:30 pm, 21/01/2026] PA: Before dinner
[9.16 pm, 25/01/2026] PPM 1: Today's update:
[25/01, 16:38] Patient Advocate 53F Diabetes 6yrs WB Diabetic Dermopathy:
Today's sugar level
FBS 121
AFTER BREAKFAST 263
AFTER LUNCH 291
WITHOUT MEDICINE
[25/01, 18:05] Global doctor 2 GD2:
Medicine khacchen na keno?
[25/01, 19:12] Patient Advocate 53F Diabetes 6yrs WB Diabetic Dermopathy:
RBS only 87 chhilo
[25/01, 19:12] Patient Advocate 53F Diabetes 6yrs WB Diabetic Dermopathy:
Akhon dose ta ki hobe
[25/01, 19:34]GD2:
RBS dekhe blood sugar control bojha jai na. Ota shudhu matro hypoglycemia suspect korle dekha dorkar
[25/01, 19:35]GD2: Abar aager moton Tablet Glimiperide 2 mg breakfast er aage niye breakfast ebong lunch ebong dinner er du ghonta baade ebong porer din fasting sugar kore janaben
[25/01, 19:44] Patient Advocate 53F Diabetes 6yrs WB Diabetic Dermopathy: Ok
No comments:
Post a Comment