[03-02-2025 09:02] PPM 1: [03/02, 08:48] Patient Advocate Diabetes 44F WB: Sir ekta kotha ,apnake bolechilam amr patient aer bes onk bochor dhorei urine infection hoche , antibiotic khay kichudin thik thake but abr hoy .r vison bad smell ...
[03/02, 08:49] Patient Advocate Diabetes 44F WB: Pressure r nerve r medicine nen .age 74 years.Apni ektu unar byapare bhabben?tahole ja bolben sei sob prescription apnake pathate pari ba jodi kono test korte bolen
[03/02, 08:53] Patient Advocate Diabetes 44F WB: Ekhon mone hoche abr o kono infection hoyeche ..
[03/02, 08:56] Patient Advocate Diabetes 44F WB: Pl bolben uni ei matro bathroom guzar jol gorom hoyeche kina dekhte giye hate futonto jol pore jole jache...?
[03/02, 08:57] Patient Advocate Diabetes 44F WB: Paste lagieche ,ki korbo ice dichi?
[03-02-2025 09:04] PPM 1: [03/02, 08:57] pm: Prescription noi... detailed history ebong clinical examination dorkar
[03/02, 08:57] Patient Advocate Diabetes 44F WB: Acha ..pathabo .
[03/02, 08:58] pm: Unar PaJR group toiri kore dicchi
[03/02, 08:58] Patient Advocate Diabetes 44F WB: Clinical examination Mane?
[03/02, 09:00]pm: Daktar er chokh diye patient ke dekha
[03-02-2025 09:05] PPM 1: @PPM3 amader team member. Uni Chinsurah te thaken. Unar chokh diye dekhte parle bhalo hoto
[03-02-2025 12:40] PPM 3: Ekdom
[03-02-2025 16:06] PPM 1: History: @CR
At present rastay cholle mone hoy pa balance kom , stepping thik porena.Rater dike 3_4 ber toilet jay,prochur hoy .
[03-02-2025 16:09] PPM 1: @~PA
রোগীর অ্যাডভোকেটের জন্য প্রশ্ন;
অনুগ্রহ করে আপনার রোগীর ঘটনাগুলির ক্রম বর্ণনা করুন যা বর্তমান সমস্যার দিকে পরিচালিত করেছে। আপনার রোগীর একেবারে কোন সমস্যা না হওয়ার সময় থেকে ঘটনাগুলির ক্রম শুরু করুন।
অনুগ্রহ করে আপনার রোগীর 24 ঘন্টা ধরে তার প্রতি ঘন্টার রুটিন বর্ণনা করুন যখন সে পুরোপুরি ঠিক ছিল
এর পরে অনুগ্রহ করে বর্ণনা করুন যে একবার রোগটি তার জীবন ধরে নেওয়ার পরে তার প্রতি ঘন্টা 24 ঘন্টার রুটিনে কী ঘটেছিল
রোগীর প্রতি ঘণ্টার রুটিনের কোন অংশটি ব্যাহত হয়েছে তা বিশেষভাবে উল্লেখ করুন
আমাদের কাছ থেকে রোগীর বর্তমান প্রয়োজনীয়তাগুলি কী যেমন আমরা যদি তাকে একটি ওষুধ দিতে হয় তবে তারা কোন সমস্যাটি সমাধান করতে পছন্দ করবে?
অনুগ্রহ করে রোগীর পেট এবং বাহুর পেশীর ক্লিনিকাল ফটো পোস্ট করুন যেমনটি নীচের ছবিতে দেখানো হয়েছে:
https://userdrivenhealthcare.blogspot.com/2024/08/template-for-pajr-user-driven-history.html?m=0
[03-02-2025 16:16] PPM 1: @CR will you be making this case report?
[03-02-2025 16:27] PA: 2015 sept. ekber stroke hoy.Left side weak hoy jay.Kotha jorie jay,Mri of brain nd CT scan report- grey brain.
[03-02-2025 16:29] PPM 1: Tar aage ekdom bhalo chilen?
[03-02-2025 16:29] PA: Long time bhugechen.
[03-02-2025 16:30] PA: Onk bochor dhorei kichu na kichu hotei thake
[03-02-2025 16:30] PPM 1: Ekdum prothom ta diye shuru kora jaak
[03-02-2025 16:30] PA: 1998 Mastoid bone operation hoy
[03-02-2025 16:31] PA: Kaner porda futo hoye gechilo,then operation hoy but bochor khaneker modhey I abr whole dekha jay
[03-02-2025 16:31] PPM 1: Tar aage ki koshto chilo jar jonye operation korte hoi
[03-02-2025 16:31] PPM 1: Unar tokhon prothom symptoms ki chilo?
[03-02-2025 16:32] PPM 1: 1998 er aage sompoorno shushtho chilen?
[03-02-2025 16:34] PA: That time1998 rate ghumonor somoy hathath i dekhe balis vije geche kan theke jol porche .terpor dr .dekhano hoy porda futo hoye jay .then operation hoy
[03-02-2025 16:35] PA: Ter age 1990 vison bleeding hoy, anemia hoy ,3 months bed ridden chilen Then Typhoid hoy.
[03-02-2025 16:39] PA: 1992 hathath i puja korte bose r darate paren na.duto knee lock hoye jay .then orthopedic, medicine dr.dekhanor por colonoscopy advice koren .colon e ulcer dhora pore.
[03-02-2025 16:39] PA: Long treatment choleche
[03-02-2025 16:40] PA: Er majhe gestric, indigestion hotoi.
[03-02-2025 16:41] PA: 1996 theke sanghatik mental pressure ase family te.
[03-02-2025 16:41] PPM 1: Knee lock theke colonoscopy?
[03-02-2025 16:42] PA: Ha
[03-02-2025 16:42] PA: Gastric issues chilo .
[03-02-2025 16:42] PA: Oh sorry miss kore gechi ..
[03-02-2025 16:42] PPM 1: Colonoscopy generally paikhanai kono problem hole korano hoi
[03-02-2025 16:44] PA: Ekdin hathath dupure electric shock khan just 2 din por thekei stool r sathe raw blood aste thake
[03-02-2025 16:44] PA: Terpor i lower abdomen pain hoy .then dr . colonoscopy advice koren
[03-02-2025 16:45] PA: Ebhabei cholchilo . constant treatment e chilo
[03-02-2025 16:46] PPM 1: 1992?
[03-02-2025 16:46] PPM 1: Bochore ek dur jor ba pet kharap ,ombol esob hoto otherwise serokom kono problem chilona
[03-02-2025 16:46] PPM 1: Ki medicines kheten? Aekhono khaan?
[03-02-2025 16:47] PPM 1: Ekhon pressure r nerve r medicine nen .uric acid high .
[03-02-2025 16:49] PA: Oi somoy antibiotic kheyechilo prochur r injection ,bes choto thakay oto details thik bola chaper
[03-02-2025 16:49] PPM 1: Raw blood er jonye ki oshudh kheten? Koto din khete hoyechilo?
[03-02-2025 16:50] PA: Na 1992 noy ,At the year of 2000
[03-02-2025 16:51] PA: 1992 e knee lock hoye jay ,uris acid vison high thake r gastric hoy.
[03-02-2025 16:52] PA: Otherwise kono problem chilona
[03-02-2025 16:54] PA: Ekdom bolte parbona, injection cholto r antibiotic,antacid kheten
[03-02-2025 16:54] PPM 1: Kotodin cholchilo?
[03-02-2025 16:54] PA: Gastro dr .dekhten seta jani
[03-02-2025 16:55] PA: Pray3 mas medicine kheyechilen pray 1bochor puro sustho hote time legechilo
[03-02-2025 16:58] PA: Ebhabei cholchilo.tuk tak kichu holeo samle jeten.
[03-02-2025 17:02] PA: 2004 train kolkata Jaber somoy bunk theke bhari suitcase pore jay mathar opor ..then porerdin thekei komore pain start hoy.Orthopedic dekhano hoy x-ray report e dekha jay komore nerve chepe geche .pray almost bed ridden hoye poren .soja hoye darate ,hatte parten na .
[03-02-2025 17:03] PA: Oi somoy vitamin injection ,D3 kheyechilen pray 3 months
[03-02-2025 17:04] PA: Terpor theke bhari kaj korte ba matite bosle uthte osubidha hoto
[03-02-2025 17:07] PA: Ebhabe pray 2005 obdhi bes kosto peyechilen
[03-02-2025 17:13] PA: Erpor 2010 hathath i rastay beriechilen , er kta bus aschilo side dite giye pa mochke jay but pore jan ni .pa soja korte perchilen na then ekjon help niye jokhon bari dhukte jan thik tokhon i r ekta pa mochke jay ..r soja darate perena .kono rokom e barir lokerder sahajye ghore ese sue poren .porer din Orthopedic dekhano hoy x_tay dekha jay 2 pa eksathe i goralir kache bhenge geche .ekekta pa plastering hoy r ekta crepe bandage chilo pray 2 weeks
[03-02-2025 17:14] PA: Normal hatachola y aste pray 1 bochor lege jay
[03-02-2025 17:16] PA: Erpor thekei dekha jay ektu jore dhakka lagle ,ba hochot kheleo kokhon o hater angul ,kokhon o ba payer angul ekadhik ber bhenge geche
[03-02-2025 17:16] PA: Ei somoy urine infection hoy ,uric acid high hoy abr o
[03-02-2025 17:17] PA: Vit D3, calcium, tab kheten
[03-02-2025 18:42] PA: Erpor thekei uni ber ber urine infection e bhogen .halka jor ,ga hat e byatha ,kash ,golar voice change hote thake .knee pain ,pa fola esob choltei thakto ..
[03-02-2025 18:45] PA: Abr 2015 sept. Stroke,left side weak hoye jay , vomiting tendency, vertigo,high pressure etc...
[03-02-2025 18:50] PA: Pray 6 months legechilo normal life aste ,but bhagyer porihase 2016 oct. Husband mara jan.vison bhabe imbalance life ..ojotha bhul bhal boka,bhule jaoa ,jed,khaberchure fele deya, etc berte thake ..
[03-02-2025 18:52] PA: 2017 march abr mild stroke with same symptoms.
[03-02-2025 18:52] PA: Erpor theke constant kichu na kichu legei thake
[03-02-2025 18:54] PA: Aste aste hatacholay goti komte thake ,pa fele daralei kanpte thake,hat mutho korte osubidha hoy ,jor payna r vison byatha
[03-02-2025 19:00] PA: 2019 r por sarir aste aste bhange thake .2020 Covid r somoy vison jor full symptoms high fever, tana 7 days for charena,sange kashi,gola byatha,mathar jontrona,buke sordi,chest infection blood test report Typhoid ase but Covid report not properly checked ase.
[03-02-2025 19:00] PA: Onkdin bhugte hoyechilo oi somoy.
[03-02-2025 19:06] PA: Then 2021 ,month of July middle hathath ekdin majh rat theke loose motion start hoy more than 34 times, then hospital e admit kora hoy, saline r kichu antibiotic 2 din cholar por o kono improve na hoyay bond sign kore onno nurshing home admit kora hoy
[03-02-2025 19:07] PA: At a time oi period e Md medicine,Gastro, Nephrology, neurology nd ent dr dekhen.
[03-02-2025 19:09] PA: Somosto reports oi somoy imbalance chilo . pancreatitis, urine infection, Enlarged liver, etc detect hoy ..total organ imbalance chilo
[03-02-2025 19:13] PA: Discharge r por onkdin catheter chilo,er por ,odbhut bhabe oi somoy continuous medication thaka soteyo urine stop hoye jay pray 4 hours por white ball typer kichu ber hoy urine r sathe
[03-02-2025 19:15] PA: Vison critical condition chilo
[03-02-2025 19:18] PA: Then urologist consult kora hoy ,abr hospital e admit korano hoy 10 days admit thake, high infection of urine, amylase, lipase level was so high. Then hystoscopy kora hoy
[03-02-2025 19:50] PA: Terpor pray 1 year sustho hoye uthte time lage.kintu sei thekei kichudin por por urine infection hoche.
[03-02-2025 20:02] PPM 1: Last urine culture kabe koriyechen ebong last urine a asubidhe kabe feel korechen?
[03-02-2025 21:54] PA: 4-5months age hoyeche .
[03-02-2025 21:55] PA: Pus cell chilo 10-12.
[03-02-2025 21:55] PA: Ter 1 month age chilo 32-36
[03-02-2025 21:56] PA: Amikacin injection diyechilen tokhon
[03-02-2025 21:58] PPM 1: Urine culture sensitivity ki chilo ebong patient er koshto ki chilo
[03-02-2025 21:58] PA: Urine r osubidha pray 2019 theke bochore 1-2ber hoto ,kintu ekhon last 3-4years yearly pray 3-4mas ontor hoche . antibiotic cholche terpor hoyto 2_3months thik thake ..
[03-02-2025 22:00] PA: Ha sensitivity chilo (.32-36).clear hotona ,lower abdomen nd back pain hoto r sombhob bad smell
[03-02-2025 22:00] PA: Mild temperatures thakto
[03-02-2025 22:01] PPM 1: Urine culture sensitivity test korano hoini tokhon?
[03-02-2025 22:01] PA: Terpor jokhon pus cell 10-12chilo tokhon kono sensitivity paoa jayni
[03-02-2025 22:02] PA: Ha hoyechilo r sensitivity chilo
[03-02-2025 22:02] PA: Amoxicillin
[03-02-2025 22:04] PA: Ekhon o sei ager moto smell hoche,hat pa kmn kanpche ,r vison payer cheto jala kore ,rater dike 3_4times bathroom jete hoche..
[03-02-2025 22:39] PPM 1: Tahole ekta urine for pus cells ebong urine culture sensitivity kore dekha jete pare kintu antibiotics start nao korte hote pare
[03-02-2025 22:40] PA: Acha
[03-02-2025 22:45] PA: Age tahole routine test kora hobe pus cell koto ache dekhe culture sensitivity test hobe?
[04-02-2025 16:22] PPM 1: Hain
[04-02-2025 16:24] PPM 1: Tahole urine problem bortomane shudhu smell ta? Baki shobi anyo problem?
Blood sugar unar fasting ebong proti khawar du ghonta baade last kobe kora hoyechilo?
[04-02-2025 16:37] PA: Proti khaber 2 hours por hoyni konodin.Normal fasting r vat khaber 2 hours por hoyechilo .
[04-02-2025 16:37] PA: 3 months ago
[04-02-2025 16:44] PA: Na, urine pele r dhore rakhte paren na rate bes 4 ber jete hoy , bad smell achei. prochur jol khan r mukh dry hoye jay..pa mainly jala kore r kanpe daralei ...hater finger tips jor nei, gripping e problem.
[04-02-2025 16:44] PA: Saradin tuk tuk kore khide pay bole kichu na kichu kheye jan.
[04-02-2025 16:45] PA: kono blood test proyojon ache ki?uric acid high r constipation ..
[04-02-2025 17:01] PPM 1: Glucometer fasting and two hours after every meal for one day
[04-02-2025 18:43] PA: Ok
[05-02-2025 08:43] PA: Fasting blood sugar 107.
[05-02-2025 08:44] PA: BP 142/67, pulse 87
[05-02-2025 14:05] PA: After 2 hours of lunch sugar 138
[05-02-2025 14:28] PPM 1: Goto kaal shara dine koto liter jol kheyechen ebong koto liter urine beriyechhe.
Eta goto kaal na holeo kalke theke ektu mepe janaben
[05-02-2025 15:02] PA: Acha kal bolbo tahole
[05-02-2025 15:02] PA: Saradin prochur jol khan
[05-02-2025 16:23] PPM 1: Proti ta amount mepe 24 ghontai koto daracche sheta jana dorkar. Koto ta nicchen ebong koto ta beruchhe dutoi alhada bhabe mepe janaben
[05-02-2025 16:23] PA: Ha ,sure kal obossoi
[05-02-2025 16:24] PA: Urinal e measure korte bolbo ..
[05-02-2025 16:48] PPM 1: Ekta 1 liter er marking dewa measuring pot a urine ta dhele measure kora jete pare
[05-02-2025 17:10] PA: After 2hours later of taking breakfast sugar level is 143
[05-02-2025 17:11] PA: Acha
[05-02-2025 22:25] +91 91638 78286: After2 hours of dinner sugar level is 144
[06-02-2025 07:56] PPM 1: Pre diabetic range So not that bad
[06-02-2025 08:22] PA: Urine routine test aj hobe .,
[06-02-2025 08:23] PA: Sugar r jonno kono medicine nen na.just nerve , pressure r high uric acid r medicine khan
[06-02-2025 22:16] PA: The patient intake 2.5 lit water till now nd urine korechen ekhono porjonto 1.7lit
[06-02-2025 22:17] PA: Hate o paye vison byatha grip korte perchena na r vison mukh dry hoye jache o hat bes fuleche
[06-02-2025 22:37] PA: Ekhon r ekber toilet holo 400ml
[07-02-2025 09:03] PA: Pa o hat bes fuleche..
[07-02-2025 09:03] PA: Photote bojha jachena
[07-02-2025 09:04] PA: Pa fele darate bes lagche
[07-02-2025 09:05] PA: Kaal Sandher por theke urine r poriman kom hoyeche..
[07-02-2025 09:05] PA: Eta observe kore dekha geche urine clear hole abr pa hat fola kome jay ..long time ei symptoms cholche
[07-02-2025 09:07] PA: Ei somoy Mukh o fule jay r alkasol khele abr clear hoy ..ei ber obossoi r alkasol deya hoyni
[07-02-2025 09:07] PA: Wait for ur opinion
[07-02-2025 09:11] PA: Last few days she takes green peas, moong daal, cabbage, palak, beetroot, carrot, potato, chana, nuts ektu besi porimanei.
[07-02-2025 16:55] PPM 1: It needs to be measured from 8:00AM to 8:00AM. Is 2.5 liters since today 8:00AM?
[07-02-2025 16:56] PPM 1: The food plates need to be shared at those times
[07-02-2025 16:56] PPM 1: Does she have any difficulty in breathing?
[07-02-2025 16:57] PPM 1: 1.7 liters ta kota theke kota obdhi?
Normal 24 hours urine is supposed to be 1-2 liters
[07-02-2025 17:55] PA: Tomorrow I will measure from 8Am to 8Am
[07-02-2025 18:00] PA: Na serokom kichu noy ,tobe ektu kaj korlei gheme jan r hanpie jay
[07-02-2025 18:01] PA: Sokal 7 ta theke rat 8 ta obdhi
[07-02-2025 18:02] PA: Regular ja jokhon khan ter photo pathabo tai to?
[07-02-2025 21:02] PPM 1: Hain
[08-02-2025 09:26] PA: Morning Tea with chocolate biscuit.
[08-02-2025 09:28] Rakesh Biswas Sir: Avoid biscuits! Nuts are healthier
[08-02-2025 09:29] PA: Ha
[08-02-2025 09:30] PPM 1: Check out how this other PaJR patient changed from tea biscuits to healthier nuts 👇
https://pajrcasereporter.blogspot.com/2025/01/33f-with-post-traumatic-headache.html?m=1
[08-02-2025 09:31] PA: This is not black tea ,she has started to take nutrition drinks since last 3 months
[08-02-2025 09:34] PA: Absolutely right sir ..100 percent right i already nije experience korchi...feeling very light..
[08-02-2025 09:48] PPM 1: Nutrition drinks can be even more dangerous!
Most of them are full of sugar
[08-02-2025 21:56] PA: She took rice with butter,veg sabji..
[08-02-2025 21:56] PA: Sweet dohi
[09-02-2025 08:02] PA: Morning 8 am to 8 am Urine hoyeche [800+450+250+400+500+1700]=Total 4100 ml.
[09-02-2025 08:07] PA: Water intake from 8am to 8am. almost 4.5lit.
[09-02-2025 08:09] PA: Ber ber gola sukie jache ,bes onkta kore jol khete hoche at a time
[09-02-2025 08:32] PA: Morning Tea with puffed rice.
[09-02-2025 08:34] PA: She takes it every day in 3 times
[09-02-2025 10.10] PA: 164/86 PR 74
[09-02-2025 13:17] PPM 1: Has her increased water intake and increased urination started after she started taking this?
[09-02-2025 13:18] PPM 1: Since when?
[09-02-2025 13:21] PPM 1: 👆Need to see the details written on top here
[09-02-2025 13:22] PPM 1: Has she ever had any fever?
[09-02-2025 13:25] PPM 1: Please share a picture of all the medicines she is currently taking
[09-02-2025 13:25] PPM 1: Does she have any problem during passing urine?
[09-02-2025 13:32] PA: Her current prescription
[09-02-2025 14:23] PPM 1: What is the date of this prescription?
Please share the medicine pictures that the patient has been taking ever since she was experiencing her current priority symptoms of dry mouth and excessive water drinking.
[09-02-2025 14:24] PPM 1: 👆 since when is she taking this?
[09-02-2025 15:13] PA: No, she has no problem during passing urine but can't hold.
[09-02-2025 15:16] PA: From last 3 months she takes this syrup. In the morning and evening.
[09-02-2025 15:19] PPM 1: She is drinking too much water! That's the reason it's difficult for her to hold. She needs to reduce her intake from 4 liters to 1-2 liters max
[09-02-2025 15:19] ppm 1: Please ask her to stop taking this
[09-02-2025 15:20] PA: After passing Urine she feels very tired
[09-02-2025 15:21] PA: Ok sir ,i will tell.
[09-02-2025 15:21] PPM 1: Anyone who has to pass 4 liters of urine will feel tired
[09-02-2025 15:22] PA: Yes.
[09-02-2025 15:25] PA: Once in a week
[09-02-2025 15:26] PA: Shen takes loxof when she had urine infection.
[09-02-2025 15:28] PA: 1/2tab at night. Amlodipine
[09-02-2025 15:46] PA: Any advice in this case?
[09-02-2025 15:47] PA: Ebhabe 2_3months difference kno ber ber urine infection hoche?
[09-02-2025 15:48] PA: Ei medicine gulo cholbe na kichu change korben?
[09-02-2025 15:55] PA: 2times daily
[09-02-2025 15:58] PPM 1: When was this last taken? Since when has she started taking it?
How many times did she start taking it and took it for how many days?
[09-02-2025 16:00] PPM 1: She may not be having any urine infection this time
[09-02-2025 16:03] PA: 5-6days ago dr.prescribe this medicine
[09-02-2025 16:05] PA: Tahole ki oner urine infection hoyni? loxof off kore deben?
[09-02-2025 16:05] PA: R baki medicine gulo?
[09-02-2025 18:15] PA: Ekhon koronio ki?kno emn hoche ?
[09-02-2025 22:20] PPM 1: Then it's possible that the urine bacterial count may have subsided because of the loxoff (levofloxacin) taken since then. Her count from whatever is visible in the report shared appears to be insignificant in teams of numbers but then to call a patient UTI it's the clinical findings including symptoms that are equally important in terms of overall evaluation.
From what is being shared here about the patient she appears to be clinically not having an active UTI but her current priority issues are different such as dryness of mouth causing more water intake and urination (4.5 litres), which in turn is causing inability to hold the urine
[10-02-2025 09:02] PA: Morning Tea
[11-02-2025 11:43] PPM 1: Hourly activities?
[11-02-2025 11:49] PA: Very weak almost rest tuktak kaj korchen
[11-02-2025 11:53] PPM 1: Please let us know exactly hourly
[11-02-2025 12:10] PA: But how? pl guide me
[11-02-2025 13.14] PPM 1: Every hour just let us know what the patient is doing. As illustrated here👇
আপনি কি আপনার রোগীর প্রতিদিনের ঘন্টার ক্রিয়াকলাপগুলি নীচের স্লটের মতো করে ভাগ করতে পারেন? 👇
08.02.2024 আপডেট
8.30 AM - ঘুম থেকে ওঠার সময়
8.30-9 AM - ফ্রেশআপ
9.30 AM - প্রাতঃরাশ (6 ভাদা + চাটনি) + এক কাপ কফি
10 AM - 1 PM - ক্লায়েন্ট কল
1.45 PM- দুপুরের খাবার (3 কাপ ভাত + চিকেন কারি প্রায় 300 গ্রাম)
2.15-5.30 PM - ক্লায়েন্টের কাজ চলতে থাকে
6 PM - 2 মাফিন + এক কাপ চা
6. PM- 9PM- সিস্টেমে ক্লায়েন্টের কাজ
9.30 PM - রাতের খাবার (2 কাপ ভাত + চিকেন কারি প্রায় 200 গ্রাম)
https://userdrivenhealthcare.blogspot.com/2024/02/pajr-telugu-guidelines-for-sharing.html?m=1
[11-02-2025 15:27] PA: Acha..
[11-02-2025 20:03] PA: She had dinner with roti and sabji
[11-02-2025 20:03] PA: She completed dinner at 8 pm
[12-02-2025 00:02] PA: She went to bed at 12 o clock at night
[12-02-2025 08:57] PA: Morning 6.30 ghum bhengeche .
[12-02-2025 09:11] PA: Motamuti pray ghum theke uthte 1 chinter opor time lege jay sokale bichana theke uthte
[12-02-2025 09:11] PA: 8am fresh hoy
[12-02-2025 09:12] PA: 8.30 drinks with chola vaja nen
[12-02-2025 11:56] PA: Patient took her lunch with this plate at 11.30 am
[12-02-2025 14:00] PA: Vat khaber 1ghonta r modhei ghumie poren o pray 20 25 mint deep ghum hoyeche..
[12-02-2025 19:26] PA: Patient took her dinner with 3pic roti nd 1 bowl ghugni
[13-02-2025 11:26] PA: She took lunch at 11.15 am with this plate
[14-02-2025 10:21] PA: She wake up in 7.30am.
[14-02-2025 10:22] PA: After 1 hours later she takes black tea nd chola vaja
[14-02-2025 10:33] PPM 1: 👆 other than sleeping what are her hourly activities?
[14-02-2025 13:08] PA: She took her lunch at 12.30pm with this
[14-02-2025 13:30] PA: 12.30 pm
[15-02-2025 07:58] PA: Morning Tea
[15-02-2025 15:21] PA: She took her tiffin at 3.15pm
[29-03-2025 13:03] PPM 1: @PPM 4 @PPM 5 this patient is the mother of our current patient admitted from WB in special ward. 2021 she had severe strangury and discharged two hard fleshy particles from her urethra and was consequently cystoscoped. The only finding was a large volume bladder and incidentally at the same time she also was found to have pancreatitis with high lipase etc. Can both of you prepare her case report after further collecting the images etc from @~PA
[29-03-2025 13:17] PPM 4: Okay sir!
[29-03-2025 13:18] PPM 5: Yes, sir
[29-03-2025 14:41] PPM 1: 👍
[08-04-2025 06:31] PA: Fasting blood sugar level is 129
[08-04-2025 06:32] PA: 1st time BP 135/65
[08-04-2025 07:13] PPM 1: 👍
[08-04-2025 09:34] PPM 1: @~PPM 6 need your inputs on this patient's ideal footwear to cure her corn! Will share the updates below
[08-04-2025 09:37] PPM 6: P&O nearby?
[08-04-2025 09:37] PPM 6: Which town?
[08-04-2025 09:38] PPM 1: West Bengal, Chuchura
[08-04-2025 09:39] PPM 1: @PPM 4 @~PA need a Bengali volunteer to translate the conversation to English. AI is also welcome
[08-04-2025 09:40] PPM 6: I will understand🙏🏻
[08-04-2025 09:41] PPM 6: Small dig in the insole and put MCR pad
[08-04-2025 09:55] PPM 1: Can you share an image to illustrate?
[08-04-2025 10:04] PA: Chinsurah, West Bengal. Pin 712101
[08-04-2025 10:13] PA: Ok. Will try.
[08-04-2025 10:14] PA: What is MCR pad nd how to use?
[08-04-2025 10:20] PA: Which type of shoes will be best for her mom's? Her foots r very highly sensitive for stepping. Most of the time she feels something has fallen on the floor like sand. She can't walk steadily. In the year 2012 her both feet were broken and after that's why she feels discomfort.
[08-04-2025 10:23] PA: In the year of 2015 the patient had a stroke after that the balance of leg decreased.
[08-04-2025 10:25] PA: She can't walk with sandles, and never wore thick sole shoes.
[08-04-2025 10:27] PA: Most of the time she walks with bare foot. Now due to corn in her foot she can't walk and feels pain
[08-04-2025 10:28] PA: Pl suggest which type of shoes she can wear?
[08-04-2025 10:30] PPM 3: Pincode looks like mine
[08-04-2025 10.30] PA: Is it right to walk in bare foot inside the house? Most of the time when she walks she feels burning sensation and redness.
[08-04-2025 11:56] PPM 3: That is lost proprioceptive feedback. Physiotherapist will demonstrate PNF exercise for that
[08-04-2025 11:56] PPM 6: Better physiotherapy techniques are required
[08-04-2025 11:56] PPM 6: Chappal/Sandal whatever convenient
[08-04-2025 11:58] PPM 6: Ni. Use slippers- MCR
[08-04-2025 11:59] PPM 6: Didn't find after trial on G
[08-04-2025 12:08] PPM 1: You are their local doctor!
@~PA you can also meet our best student Dr Aadipta who lives nearby and visits his house once a week!
[08-04-2025 12:09] PA: Ok.
[08-04-2025 12:09] PPM 1: Erythromelalgia!
@Meta AI what are the possible causes of erythromelalgia in a 74 year old woman with metabolic syndrome?
[08-04-2025 12:10] Meta AI: Erythromelalgia in a 74-year-old woman with metabolic syndrome could be triggered by several factors. Metabolic syndrome, characterized by abdominal obesity, dyslipidemia, glucose intolerance, and hypertension, increases the risk of developing conditions that may contribute to erythromelalgia.
Possible Causes:
- Medications: Certain medications, such as vasodilators and calcium channel blockers, used to manage hypertension and other cardiovascular conditions, may cause erythromelalgia as a side effect.
- Neuropathy: Diabetic neuropathy, a common complication of diabetes, can cause nerve damage, leading to erythromelalgia symptoms.
- Vascular Issues: Poor blood circulation and vascular problems, more common in people with metabolic syndrome, may contribute to erythromelalgia.
- Hormonal Changes: Hormonal fluctuations during menopause, which often coincide with metabolic syndrome, may also play a role in developing erythromelalgia.
- Underlying Conditions: Certain conditions, such as polycystic ovary syndrome (PCOS), can increase the risk of developing metabolic syndrome and potentially erythromelalgia.¹
What to Do:
To manage erythromelalgia symptoms, consider the following:
- Consult with a healthcare provider to review medications and adjust as needed.
- Practice good blood sugar control and manage diabetes, if applicable.
- Engage in regular exercise and maintain a healthy weight to improve circulation.
- Avoid triggers like heat, stress, and certain foods that may exacerbate symptoms.
It's essential to consult a healthcare professional for personalized guidance and treatment. They can help determine the underlying cause of erythromelalgia and develop a plan to manage symptoms and address related health issues.
[08-04-2025 12:20] PPM 3: I am not the best but I can try to help her
[08-04-2025 12:21] PA: Just few minutes ago,i spoke with Aadipta Ghosh. He told that he will talk to me at night.
[08-04-2025 PA: BP 124/55, PR 101 124/54, PR 104
[08-04-2025 12:54] PA: Yesterday she took BP medicine Amlodipine 5mg in 1/2 tab
[08-04-2025 15:05] PA: After 2 hours of lunch sugar level is 202mg/dl
[08-04-2025 15:08] PA: Same menu +extra quantity of boiled rice nd farmented rice with water
[08-04-2025 15:10] PA: (Fermented rice nd water means_ In Bengali called panta vat)
[08-04-2025 15:11] PA: Forgot the pic of the food plate
[08-04-2025 15:13] PA: She doesn't take any sugar medicine
[08-04-2025 16:10] PA: BP 153/63 PR 122, 3 mints after standing BP is 131/63
[08-04-2025 18:33] PA: 2 hours after tiffin sugar level is 254mg/dl
[08-04-2025 23:45] PA: BP is 147/67 Sugar level is 91mg/dl post dinner
[12-04-2025 09:26] PPM 1: Sharing the meticulous details of the PaJR informed consent process above because @~PA is going to need it when she connects to more and more patients
[12-04-2025 15:01] PA: Patient has chronic UTI problem. She has to go toilet 3-4times at night, mouth dryness and muscle cramp in legs
[12-04-2025 15:08] PA: Every 2_3months alternate she takes antibiotic medicine for urine infection. Now she takes BP medicine and pregabilin 75 at night.
[12-04-2025 15:30] PA: At present she has a severe foot pain due to corn ,most of the times she feels burning sensation under the foot and when she walks on the floor feels that sand r spearding on the floor ..she likes to walk in bare foot.she can't hold any sandle nd can't grip with hand.
[12-04-2025 15:41] PA: Now she has high uric acid, Hba1c more than 7.5, cough and cold
[12-04-2025 15:48] PA: Activities: Wakes up around 7.am. after gets up she needs to take time for daily work because that time she feels dizziness in hand and leg both, 7.30 am Taking black tea with biscuit/nuts. after that she needs rest for sometime.
[12-04-2025 15:52] PA: 8.30 9am drinks chatur sorbot then she Cleans her bed room. 9.30 am she take bath. after that doing puja meditation .11.30 _complete her lunch
[12-04-2025 15:53] PA: Then she takes rest for 1hour .1pm _ She attend Online Gita class.
[12-04-2025 15:59] PA: 2.30 pm _she makes roti for tiffin ..3.30 pm taking rest or works depends on her energy
[12-04-2025 16:01] PA: 5.30 pm _Goes to temple within walking 5 mints distance. 7 pm She returns back her home. then she takes tea or anything ..8.30_9.30 pm Dinner Time
[12-04-2025 16:13] PA: Most of the time she keeps doing some works or others as long as her health permits.
[12-04-2025 16:40] PPM 1: Do we have any recent urine culture report? Also how much urine volume does she pass each time at night? Is it small volume or normal volume? What is her 24 hour intake of water and 24 hour output of urine. Please share if possible by measuring these on a holiday.
Also on a given day can you share the last fasting and two hour post meal sugar after breakfast, lunch and dinner?
[12-04-2025 16:50] PPM 1: @Meta AI is there an association between erythromelalgia in this 74 year old woman with recent exacerbation of Diabetes and sensation of sand beneath her feet?
[12-04-2025 16:50] Meta AI: An interesting combination of symptoms. Considering the recent exacerbation of diabetes and erythromelalgia, the sensation of sand beneath her feet could be related to several factors:
- Diabetic neuropathy: High blood sugar levels can damage nerve endings, leading to abnormal sensations like burning, tingling, or feeling like there's sand beneath her feet.
- Peripheral neuropathy: This condition, often associated with diabetes, can cause numbness, tingling, and pain in the feet, which might be described as feeling like sand.
- Dry skin or skin conditions: Certain skin conditions, like eczema or dry skin (xerosis), can cause sensations of roughness or grittiness on the skin, similar to feeling sand beneath her feet.
- Medication side effects: Some medications used to manage diabetes or other related conditions might cause sensations like numbness, tingling, or paresthesia (abnormal sensations like pins and needles).
Given the complexity of her symptoms, it's crucial to consult a healthcare professional for a thorough evaluation. They can assess her diabetes management plan, examine her feet for any signs of skin conditions or neuropathy, and review her medications to determine the best course of action.
[12-04-2025 16:55] PPM 1: Low colony count. What was the date of this test?
[12-04-2025 16:57] PA: Now she intakes 2-3lit water per day.nd out put of urine is 2 lit .
[12-04-2025 16:58] PA: 8th of Feb
[12-04-2025 16:58] PA: Mostly 8 th of Feb
[12-04-2025 17:00] PPM 2: Incredible history taking 👍🏼
[12-04-2025 17:01] PPM 2: For how many years has the patient been a diabetic?
[12-04-2025 17:03] PPM 2: All her features are consistent with small fiber neuropathy (damage to the small nerves) which are supplying the heart, bladder and bowels and also the nerves in the hands and legs (which is why she feels like walking in sand)
[12-04-2025 17:06] PA: In the year 2023 her fasting nd PP was just crossed the border line ,but Hba1c was 6.5 that's why she didn't take any sugar medicine
[12-04-2025 17:07] PPM 2: Okay. Can we go back to 2023? When was she absolutely well in herself and when did she start having any symptoms at all
[12-04-2025 17:08] PA: But 2015 when she had brain stroke after that she feels imbalance when she walks and feels sand beneath her feet
[12-04-2025 17:09] PPM 2: So before 2015, she was fairly well in herself?
[12-04-2025 17:09] PPM 2: What symptoms did the stroke cause in her?
[12-04-2025 17:10] PA: Yes, almost 2015 she was fairly well
[12-04-2025 17:10] PA: Sorry before 2015
[12-04-2025 17:13] PPM 2: Yes got it. And what symptoms did she have in 2015?
[12-04-2025 17:13] PA: That time suddenly she felt giddiness in the night.
[12-04-2025 17:17] PA: Then she tried to go to bathroom but couldn't. But 1-2hours after she went to toilet and then she felt same. after that she realised due to vertigo she felt giddiness.
[12-04-2025 17:18] PA: Then reported to local doctor,. checked BP that time it was 170.
[12-04-2025 17:19] PA: Normally her BP is low.
[12-04-2025 17:23] PA: That time she couldn't stand properly, leg sensation (key ringtesting) redness of tongue and slightly her mouth was unshaped.
[12-04-2025 17:23] PPM 2: Which side was she unable to stand properly?
[12-04-2025 17:24] PA: Left side.
[12-04-2025 17:24] Aditya: Okay
[12-04-2025 17:24] Aditya: Did she have any speech disturbance at the time?
[12-04-2025 17:27] +91 91638 78286: One more thing that I forgot to mention that is in the year her left ears mastoid bone operation done
[12-04-2025 17:27] PA: Yes,sir
[12-04-2025 17:52] PPM 2: Okay. What was the problem?
[12-04-2025 17:52] PPM 2: Please can you describe it further.
[12-04-2025 18:23] PA: After operation she was absolutely fine.
[12-04-2025 18:35] PA: Year of 2001 she found that her stool was full of raw fresh blood. That time she felt uneasiness in her lower abdomen but no pain or any other symptoms
[12-04-2025 18:37] PA: 2 -3 days was continued with her stool ,no other time .
[12-04-2025 18:39] PA: Before that time she was very irregular to her taking food.most of the time she skipped her breakfast .
[12-04-2025 18:44] PA: After that dr.adviced to do colonoscopy and then ulcer in colon detection detected .Then she was under treatment .she has a gastric problem.suddenly she felt that she was unable to stand nd bend her knee.
[12-04-2025 17:24] PPM 2: Okay
[12-04-2025 17:24] PPM 2: Did she have any speech disturbance at the time?
[12-04-2025 17:27] PA: One more thing that I forgot to mention that is in the year her left ears mastoid bone operation done
[12-04-2025 17:27] PA: Yes,sir
[12-04-2025 17:52] PPM 2: Okay. What was the problem?
[12-04-2025 17:52] PPM 2: Please can you describe it further.
[12-04-2025 18:23] PA: After operation she was absolutely fine.
[12-04-2025 18:35] PA: Year of 2001 she found that her stool was full blood. That time she felt uneasiness in her lower abdomen but no pain or any other symptoms
[12-04-2025 18:37] PA: 2 -3 days was continued with her stool no other time.
[12-04-2025 18:39] PA: Before that time she was very irregular in taking food. Most of the time she skipped her breakfast.
[12-04-2025 18:44] PA: After that dr.adviced to do colonoscopy and then ulcer in colon detected. Then she was under treatment. she has a gastric problem. Suddenly she felt that she was unable to stand and bend her knee.
[12-04-2025 18:44] PA: X-ray was taken.
[12-04-2025 18:59] PA: That time she was more healthy about 70 kg. She had severe knee pain almost bed ridden. Doctor told that it was due to gastric, ulcer and defficiency of D3 and low Hb. But sir if u want any prescription regarding this she cannot submit because patient's daughter was unable to take responsibility. she was only 20 years old.
[12-04-2025 19:02] PA: Medication continued for long time and 2 months she was bed ridden.
[12-04-2025 19:04] PA: That time she was on strict diet which was prescribed by the doctor.
[12-04-2025 20:39] PPM 2: Absolutely no worries. As long as she is able to share the narrative that is good enough
[12-04-2025 20:39] PPM 2: And how did she start moving and stop becoming bed ridden?
[12-04-2025 20:50] PPM 1: The entire narrative was shared in 3/2/25 and is available here 👇
https://pajrcasereporter.blogspot.com/2025/04/74f-uti-metabolic-syn-stroke-acute.html?m=1
[16-04-2025 08:19] PA: Ma r 3 din age rastay honchot lege vison pain hochilo .Amr nijer o sei somoy sarir thik na thakay r x-ray korate parini .sange sange pray ghonta khanek ice pack r mukhe Arnica 10 drops kore diyechilam .1st angul narte perchilona , onkkhon borof deber por pain komechilo .
[16-04-2025 08:19] PA: Ma r ektutei samanno honchot I bhenge jay r kal shite pore jay .
[16-04-2025 08:19] PA: Hatte gele lagche olpo.
[16-04-2025 08:19] PA: Aj ki tahole duto angular majhe stick diye bendhe debo?
[16-04-2025 08:23] PA: Aj ki tahole duto angular majhe stick diye bendhe debo?
[16-04-2025 08:23] PA: Saturday jaoa ,thik bujhte perchina..ki korbo?pl ektu bole din
[16-04-2025 08:23] PA: Ei jaygay to plaster o hobena ,naki crepe bandage ?
[16-04-2025 08:23] PA: Fola khub ekta nei
[16-04-2025 08:23] PA: Olpo anguler dogata fola
[16-04-2025 08:23] PPM 1: Basic principle of orthopaedic is
Reduction
Splintage
Physiotherapy
Ideally an x-ray of foot to rule out fracture followed by splintage as planned above or with a professionally made splint for the purpose
[16-04-2025 08:36] PPM 1: [16/04, 08:23] Patient Advocate Diabetes 44F WB: Aj tahole xray korie nbo?
[16/04, 08:23] Patient Advocate Diabetes 44F WB: Erokom bohuber hoyeche ,
[16/04, 08:24] Patient Advocate Diabetes 44F WB: Ma r jonno j form r link diyechilen download kore print kora jachena ..tai sign korteo perchina
[16/04, 08:24]cm: Last x-ray kabe korano hoyechilo?
[16/04, 08:24] Patient Advocate Diabetes 44F WB: 2 bochor age
[16/04, 08:25] Patient Advocate Diabetes 44F WB: Ektu thokkor laglei emn chir ba bhenge jay hat ba payer angul
[16/04, 08:27]cm: Ota share korte parben?
[16/04, 08:27] Patient Advocate Diabetes 44F WB: Khub kom kore holeo ma 8 theke 10 ber erokom hat pa bhenge geche
[16/04, 08:27] Patient Advocate Diabetes 44F WB: Mainly angul gulo
[16/04, 08:30] cm: Bhenge jawar evidence hishebe X ray dekha dorkar
[16/04, 08:34] Patient Advocate Diabetes 44F WB: Dekhchi kothay rekhechi xray plate .
[16-04-2025 09:28] PPM 1: [16/04, 09:26] Patient Advocate Diabetes 44F WB: Ki x_ray korbo ektu prescribed kore din na ..meye jabe ma kiye .barir kachei clinic
[16/04, 09:27] Patient Advocate Diabetes 44F WB: Plate niye aslei apnak photo pathachi
[16/04, 09:28]cm: Xray of the feet ap view with the focus on 1st metatarsal web space
[16/04, 09:28] Patient Advocate Diabetes 44F WB: Acha
[16-04-2025 10:46] PA: What should we do?
[16-04-2025 16:31] PPM 1: Show her to a local Orthopaedic doctor
[16-04-2025 16:53] PA: Yes, sir. She went to orthopedic Dr. this afternoon. The patient has sent her prescription.The leg is quite swollen and painful. Dr.will see her again day after tomorrow. If swelling reduces, he will do strapping. Hope for the best
[16-04-2025 18:50] PPM 1: @~ would this splint be better for the patient?👇
https://www.amazon.com/Metatarsal-fixation-Orthosis-Fracture-Stabilizer/dp/B0D78CKPS9
[16-04-2025 19:00] PA: This item can't be delivered in our location
[16-04-2025 19:06] PPM 6: No
PPM 1: 👏
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