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.
[27-06-2025 15.49] PPM 1: 3rd long distance patient 39M
One day 2 years back, he found all of a sudden a catch in his back while shifting a heavy machine in his ration shop.
Since then he is having severe whole body stiffness since early mornings everyday and has to rub his lower limb planter areas for half an hour before getting out of bed.
Also showed in AIG since last two months for throat and abdominal tightness diagnosed as globus in AIG
He also complains of assymetric nail changes in his feet.
[27-06-2025 15.49] PPM 1: Evaluated by PPM3.
[30-06-2025 11.56] PPM 1: @PPM3 update on this patient?
We are reviewing him again in the OPD now.
What other test had we discussed on Saturday which you promised to do?
[30-06-2025 11:57] PPM 3: Sir MRI spine Venkat sir is not accepting sir
[30-06-2025 11:57] PPM 3: So we did not do MRI brain
[30-06-2025 11:57] PPM 3: We are more interested in the clinical findings
What is our localisation? Where are we expecting to find the lesion in MRI
[30-06-2025 11:59] PPM 3: Hemogram creatinine
[30-06-2025 12:00] PPM 1: Can you help us by examining his shoebers test here in OPD?
[30-06-2025 12:01] PPM 3: Ok sir I am coming
[30-06-2025 12:06] PPM 3: Sir patient went outside I will get him to ICU at 2 o clock sir
[30-06-2025 12:16] PPM 1: Patient is waiting with us in OPD!
[30-06-2025 12:23] PPM 3: Ok sir I am coming
[30-06-2025 13:07] PPM 1: Chest expansion is 3-4 cm and shoebers test is 19 cm suggesting objective evidence for reduced spinal flexibility due to ligamental fibrosis.
Chief complaint is inability to bend down and lift objects due to pain that aggravates while doing so
@PPM3 please share his deidentified x-rays and orthopedic notes and ask them to review the patient
[30-06-2025 13:07] PPM 3: Ok sir
[30-06-2025 17:03] PPM 1: Please share his x-rays and the Orthopedic note
[30-06-2025 17:06] PPM 3: Ok sir
[30-06-2025 17:41] PPM 3: Ortho refferal sir
[30-06-2025 17:41] PPM 3: Review ortho refferal.
[30-06-2025 21:37] PPM 1: Tell them they have come from 2000 kms away and can't come back in 3 weeks and they have taken all these pain killers since 2 years
[30-06-2025 21:37] PPM 3: Ok sir
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