Saturday, May 31, 2025

52M GB Abscess WB PaJR


20-01-2023

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS 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.

PATIENT HISTORY: Patient is a 52yr old male doing business supplying small machine parts.
At the age of 12yrs, he c/o anorexia, incomplete evacuation of stool, and acidity. He was taken to a local doctor who detected hepatomegaly and prescribed medications, taking which resolved his symptoms within a few days.
At the age of 13, he c/o high fever (103-104F), headache, and general body weakness lasting for 3-4 days, resolved with medications. 2 yrs later it happened again.
In 2020, one day when he went to a function, where he ate lot of fries, chicken and sweets. After returning home at night he started c/o localised intense pain in the right upper quadrant. The pain was increasing as the night progressed and taking medication for gas did not help. The next day his pain became unbearable and got admitted in a hospital, wherein he was injected with medication to relieve the pain. His pain reduced slowly. USG was done which detected Gallstone.
He went to a doctor who did a Laparoscopic Cholecystectomy. He had no complaints after that.
In 2022 he c/o localised mild pain inupper right quadrant. Initially the pain would occur at any time of the day 1-2 times daily and would last 10-15 mins. Mostly after dinner when he went to sleep and in a supine position. On tossing and turning to either side slowly the pain would disappear after 10-15 mins. For the past few weeks the pain occured 4-5 times a week. Doctor prescribed paraetamol which reduced pain temporarily. Then USG and CT abdomen were done which revealed a liver abscess. Doctor performed USG guided Percutaneous drainage, but during a follow up, doctor told there had been not much improvement and he would need a laparoscopic drainage of liver abscess. He didn't go for any further consultation.
Patient reported for the past few months he is passing brown greasy stools.
For the past 15-20 days, he is experiencing incomplete evacuation of stools.
After being diagnosed with a liver abscess he lost 4-5 kgs of weight which he regained in the past few months.
Patient denied any history of HTN or DM.

Friday, May 30, 2025

30F Autoimmune CKD Hypertensive Encephalopathy PRES Syn Telangana PaJR

 

30-05-2025

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.

[30-05-2025 22.02] PPM 1:  @PPM4 @PPM5 please share the patient's history and updates in her BP chart since admission.






[31-05-2025 14:21] PPM 3: Excellent — let’s go through *all 4 parts* in detail. Here is the breakdown for the case titled:

62M Alcohol Induced Vascular Neurogenerative Brain Disorder Visual Disturbances Telangana PaJR

 


30-05-2025 

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS 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.

[30-05-2025 13.20] PPM 1: OPD: Meanwhile today's 62M patient of suspected CSVD causing features of dementia and visual disturbances since one month.



[30-05-2025 13:29] PPM 3: The image you've shared is a clinical snippet from a WhatsApp message thread involving a case of *Cerebral Small Vessel Disease (CSVD)*. Here's a structured clinical annotation of the case based on the visible content:

53M OPLL Bipedal Edema Telangana PaJR

 


30-05-2025

THIS ISAN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS 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.

[30-05-2025 13.24] PPM 1: Another 53M patient today with fascinating OPLL which presented since one year back when he developed gradual onset of paralysis and stiffness and was bed ridden for a month before our neurosurgery team did a laminectomy for him following which he is walking but currently presented with bi pedal edema.

Thursday, May 29, 2025

16F With Left Hemiparesis Hyper Reflexia Telangana PaJR

 

28-05-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HER GUARDIAN'S 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.

[28-05-2025 12.10] PPM 1: 16F with left hemiparesis without facial involvement since birth with delayed milestones (walked at 3 years of age) and currently on examination has hyper reflexia on left upper and lower limbs with planter extensor on the same side but with sluggish left ankle reflex in comparison to the normal right ankle reflex. Mild contracture noted in left ankle.

https://youtu.be/4JPERKO7uz0?si=lWrztq4m8K7diSEn

Wednesday, May 28, 2025

65M Metabolic Syn 20 yrs CAD Prostatism 1 year WB PaJR

 


16-04-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS 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.


[19-04-2025 08.20] PA: Morning A Cha muri 8 am

[20-04-2025 22:11] PA: Daktar Babu Amar Bukay Abong petay Halka Akta Batha hoay ke korbo Janaben
[20-04-2025 22:11] PA: Daktar Aponi tho kono Osud delan na

















[21-04-2025 06.58] PPM 1: I didn't see his blood sugar reports earlier
Please share his glucometer fasting,
Two hours post breakfast
Two hours post lunch
Two hours post dinner today ASAP
Continue the tablet Tamsulosin 0.4 mg once at night
[21-04-2025 06:58] PPM 1: Please don't share any patient identifiers so that we can protect the patient's privacy and confidentiality
[26-04-2025 12:39] PA: Ok

[28-05-2025 15:49] PPM 1: Sokal theke raat obdhi patient ghontai ghontai ki koren ebong kone ghontai ki korar somoi byatha ta anubhob koren sheta janaben
[28-05-2025 15:52] PPM 1: 👆unake amra aer aageo barite blood sugar fasting ebong two hours after breakfast, lunch and dinner kore janate bolechilam @PA 
[28-05-2025 15:53] PA: Akhon ke korbo
[28-05-2025 15:56] PA: Sokal 8 am A Gum thakay Uthi
[28-05-2025 15:56] PA: 1 hours Hata hati kori
[28-05-2025 15:57] PA: 10 Am A Latrin A jai
[28-05-2025 15:58] PA: Kentu Latrin poriskar hoay na
[28-05-2025 15:58] PPM 1: Apnar 65M patient er signed informed consent ta share korun taratari
[28-05-2025 16:00] PPM 1: 👆unake amra aer aageo barite blood sugar fasting ebong two hours after breakfast, lunch and dinner kore janate bolechilam @PA
[28-05-2025 16:01] PPM 1: 👆 unar ekta sugar value ekhane sanghatik high dekhacchilo
[28-05-2025 16:10] PA: Akhon Amar  Buk batha tar jono ke korbo
[28-05-2025 16:11] PPM 1: Aage unar blood sugar ta aajke theke janan. Ajke lunch kotai korchen uni?
[28-05-2025 16:13] PPM 1: Goto kal 10AM-11:00AM ki korechilen?
Tarpor 11:00AM-12:00PM ki korechilen?
Buk byatha ta unar kokhon hoyechilo ebong oi somoi ta uni ki korchilen?
[28-05-2025 16:14] PA: Gumiya takla hoya
[28-05-2025 16:15] PPM 1: Goto kaal uni kotar somoi ghumiye theke ter peyechilen?
[28-05-2025 16:16] PA: Ratay Jokhon gumai thokhon  halka batha hoay
[28-05-2025 16:18] PA: Morning A Jokhon Uti  Thokhon Batha ta Bashi Ainuvob hoay
[28-05-2025 16:19] PA: Saradin Komay Abong bashi hoay
[28-05-2025 16:21] PA: Jokhon Jagna pai Tik Thokhon  bujthay pari Ja batha hochay
[28-05-2025 16:22] PA: Khathay Ischa ta Akdom kom
[28-05-2025 16:23] PA: Latrin ta poriskar hoay na
[28-05-2025 16.47] PPM 1: Local daktarer saathe alochona kore ekta ECG koran ebong ekhane share korun
Unar khawar du ghonta baade lunch, dinner breakfast ebong kalker khali peter sugar ta janaben siggiri
[28-05-2025 21:10] PA: Ok
[31-05-2025 08.46] PA: Fasting blood sugar 269mg/dl
[31-05-2025 09:00] PPM 1: Please also share two hours post breakfast, post lunch and dinner and then we shall suggest his medicines for the newly detected diabetes
[31-05-2025 12:48] PA: 31.05.25, 12.40 pm -- 453(pp)
[01-06-2025 10:42] PPM 1: After discussing with the patient's local doctor he should start
Tablet Glimiperide 1 mg once daily before breakfast
Tablet Metformin 500mg after breakfast, lunch and dinner
[07-06-2025 11.14] PA: 




[07-06-2025 11:24] PA: Dakther Babu Osud  Charai  Sugar ta komar dekay  Khayoa, 
Control korche, 2 km Hata Hate korche,  Bayam korchi 
Akhon ke Osud ta khaytha Suru korbo Janaben
[07-06-2025 11:28] PA: Bortho manay kono kosto nai Sudhu hatu nechay Je je koray Ar mathar pechonay Chap deya thakay, Chest A Chap deya mazay modhay  Bake Sob Tik Achay
[07-06-2025 12:05] PPM 1: @PPM2 @44F PA @PPM4 He's feeling his sugars are kind of coming down with diet and exercise alone from when he started at 453 pp on 31/5/25 to fasting 291and 321 pp today!
He's a fantastically motivated patient who was albeit in denial for quite sometime as he was asymptomatic!
[07-06-2025 12:55] PA: Osud ta ke Suru korbo Akhon
[07-06-2025 12:59] PPM 1: Aro kichudin cheshta kore dekhte paren tabe hoito kichu maash lagbe
[07-06-2025 13:07] PA: Akhon Suru korbo Dakthar babu
[07-06-2025 17.06] PPM 2: Yes and the insulin resistance phenotype is apparent.
[07-06-2025 20:05] PA: Osud khala hobay na
[07-06-2025 20:07] PA: Insulin ke  Netha hobay
[08-06-2025 11:08] PPM 1: Oahudh khelei habe. Insulin nite hobena.
Patient oshudh shuru korar saathe saathe jeno rojkar khali peter fasting sugar ebong proti ti khawar du ghonta baader sugar test guno glucometer a dekhe share koren
[08-06-2025 15:18] PA: Tik Achay

Tuesday, May 27, 2025

38M CKD LVF HTN Polyneuropathy Paraplegia Telangana PaJR

 



27-05-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS 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.

EMR SUMMARY

 Age/Gender: 38 Years/Male
Address:
Discharge Type: Relieved
Admission Date: 15/10/2024 05:05 PM
Name of Treating Faculty
(ASSOC PROFF)
(ASST PROFF)
[PGY2]
[PGY1]
Diagnosis
CHRONIC RENAL FAILURE
HYPERTENSIVE URGENCY(RESOLVED)
DENOVO HTN

63F With Polyneuropathy Telangana PaJR

 


27-05-2025

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.

[27-05-2025 12.52] PPM 1: OPD now
63F with Inability to walk and loss of sensation over all extremities in the glove and stockings distribution since 8 years
No history of Diabetes 
Admitted by @PPM3 who will share further her sensory findings

66M With Metabolic Syn DM2 30yrs Telangana PaJR

 

27-05-2025 

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS 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.

[27-05-2025 11.51] PPM 1: OPD now:
66M with metabolic syn diabetes 30 years.
Used to be a cutting master tailor but over last one year his customers have reduced as he's unable to cut properly!
On examination:
Glove and stocking anesthesia with loss of joint position sense 
Impaired tandem walking
Broad based gait 
Lives with wife. Son died recently. Unable to even afford their meals properly. Can't afford to get any further testing.

68M Metabolic Syn HFPEF, Pulmonary Edema Telangana PaJR

 

27-05-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS 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.

[27-05-2025 15.44] PPM 1: Operative scar from 30 years for perforation and 4 years back for adhesions


24/5/25


26/5/25


[27-05-2025 16.27] PPM 1: Afternoon session:

Three heart failure and one altered senso PaJRed

One of them imaged here 👇

https://youtube.com/shorts/Ek5oQEDGNLY?feature=shared

55F Altered Sensorium after HYPOGLYCEMIA 27mg 1 mth DM2 12yrs Telangan PaJR


 27-05-2025

THIS IS AAN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HER SIGND 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.

[27-05-2025 14.53] PPM 1: Small vessel changes

[27-05-2025 15:19] PPM 3: GPT did figure it out from the image - 

I can help analyze the images based on what I see.