May 07, 2023
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 WITH 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.
24/F Chronic anemia 2` dietary iron deficiency
A 24 year old woman Ms.A a student by occupation and a resident of west bengal came to the medicine opd with c/o
-Nausea and dizziness since 4 months
History of presenting illness
patient was apparently asymptomatic 7 years ago , when she developed nausea and dizziness it was aggravated on walking and relieved on taking rest , she also noticed hair fall and dry skin , after a routine blood investigation it was discovered that her Hb was 7.2 gm/dl for which she was treated by giving iron injections over the course of one week , patient has been asymptomatic since then , 4 months ago she gave history of similar complains associated with SOB grade 3 according to NYDA classification .
History of past illness
k/c/o Diabetes Mellitus sibce 1 year
n/k/c/o HTN, TB, asthma
surgical history
h/o cholecystectomy 4 months back due to cholithiasis
Treatment history
Metformin tablets once a day since one year
-before breakfast: lipoglobin -HP
-after breakfast Diapride M1
-before dinner: lipoglobin -HP
-after dinner: vildagliptin tablets OP and folvite
Menstrual history
Age at menarch : 11 years
Regular cycles 5/30, 3 pads per day associated with clots 1cm * 0.5cm associated with pain
LMP: 3/05/2023
-IRREGULAR PERIODS SINCE 2 MONTHS; hypomenorrhea, oligomenorhhea
Family history
Mother is a known case of hypothyroid
Personal history
Diet: mixed
Appetite: loss of appetite since
Sleep: adequate
Bowel and bladder: normal and regular
Occasionally consumes alcohol
No known allergies
GENERAL EXAMINATION
Patient was c/c/c oriented to space, time and person
Weight: 52kg
Height: 5 feet
months
A 25yr old female came with chief complaints of SOB Grade II - III since 6 months.
History of present illness:-
Patient was apparently asymptomatic until 2016 then developed headache, occipital region more, insidious in onset, gradually progressive, prominent with nausea and occasional vomitings, associated with photophobia, phonophobia, no lacrimation, no aggravating factors and relieved with medication.
She also had difficulty in writing (associated with pain at tips) and on investigation was found to have low hemoglobin (also had SOB, grade I - III) jaundice and so, reports - Hb electrophoresis S/o HbE and mild iron deficiency anemia and was treated accordingly
In dec 2022, patient had right hypochondriac region pain, and on USG abdomen --> gallstones present and was operated for it.
Laproscopy cholecystectomy done.
In Feb 2022, patient experienced polyphagia, polydipsia, nocturia present (3-4 times) and went for dental checkup, and on investigation, was found to have high sugars and was diagnosed to have diabetes, and since then she was on regular medication, presently using Tab. Lipoglobin HP BD and Tab. Vildamne 50 2 tabs (night).
Now SOB grade II - III increased since 6 months
Past history:
Known case of diabetes mellitus since 1yr on medication Tab.Lipoglobin HP BD and Tab. Vildamne 50 2 tabs (night).
Not a known case of thyroid disorders, HTN, asthma
No chest pain and no orthopnea
Personal history:
Diet- eggetarian
Appetite - decreased
Sleep - adequate
Bowel and bladder- regular
No allergies
Addiction - teetotaler
Tobacco - snuff
Family history:
Grandfather has diabetes mellitus II
Menstrual history:
Aom- 13yrs
Menstrual cycle - 7/30-35days
General examination:
Patient is conscious, coherent, co operative
Pallor present
No icterus, cyanosis, clubbing, lympadenopathy, edema
Vitals:
Temp: 98f
Pr- 96bpm
Rr- 16cpm
Bp- 120/80mm hg
Spo2- 96%
Grbs- 309 mg/dl
Systemic examination:
Cvs- S1S2 heard, no murmurs
Rs- BAE present, NVBS present
P/A - soft, non tender
CNS- NAD
Investigation:-
FBS- 191mg/dl
PLBs:- 241mg/dl
HBA1C: 6.7
HEMOGLOBIN:- 6gm/dl
TLC- 7,800
PLT- 92,000
Provisional diagnosis:-
Metabolic syndrome with diabetes HbE thalassemia
Treatment:-
Tab.Lipoglobin HP BD
Tab. Vildamne 50
Tab. GLIMIPERIDE 0.5mg PO/BD
Tab. Metformin 1000mg PO/OD
Tab.folic acid 5mg PO/BD
Tab. Orofer XT PO/OD
Discharge Summary
25 year old female with Diabetes mellitus
June 01, 2023
A 25 year old female student, resident of coochbehar (West Bengal) came to GM OPD with chief complaints: -
✓ swelling in right and left lower limbs since 2017
✓ Headache since 2017
History of presenting Illness:-
Patient was apparently asymptomatic 6 years ago.On one fine day after she woke up , she noticed swellings in the both limbs below knee level. It was insidious in onset, progressive, has no aggravating factors, relieved on massage. It is not associated with pain.
H/o headache since 2017 in the back of head (occipital region) which is intermittent in nature, associated with nausea, photophobia and phonophobia. When she was asleep and suddenly wakes up then she will experience severe headache but then temporarily relieves on its own.
Later, she consulted a general physician after thorough examination she was diagnosed with migraine. Later, she went through few routine blood investigations and was diagnosed with Anemia. When she was found anemic, they adviced her to get Hb electrophoresis, result shown that her Hb E levels are high.
In April 2023
Serum iron: 47.62 g/dL
TIBC: 401.13 g/dL
She was prescribed with GRENIL for headache and Folic Acid tablets for anemia .
She complained of pain while writing since 2016 which used to start after writing a paragraph (20-30 lines) relieved on rest. It is non radiating, intermittent in nature.(Type - cramp like pain?)
Past history:-
In the year of 2022, around June- July She had severe tooth pain, consulted a dentist, after routine investigations she got to know about high blood sugar levels. So, dentist treated her conservatively until blood sugars are normal and treated her accordingly. (RCT)
In the month of Aug, She had pain in left upper quadrant, consulted a physician, after thorough investigations, she was diagnosed with gall bladder stones on USG. She got treated conservatively, on pioglitazone for diabetes. Later she underwent laparoscopic cholecystectomy in December 2022.
Daily routine:-
Previously patient wakes up around 7-8 am in the morning, goes for walking occasionally for an hour, returns home drinks tea and eat biscuit s and eats breakfast after an hour.
Present - She couldn't go for walk, because she became weak (because of anemia??) . At a times she also feels dizzy while walking.
After brisk walking for a while, she will have difficulty in breathing, palpitations and sweating which relieved on taking rest. (6 months)
Previously, at 11 am goes to college and returns home by 3 for lunch, takes rest for sometime while watching or TV or phone. Around 6 pm, she will have snacks and do her work. Around 8-9 pm she will have her dinner have a chat with family, goes to sleep while using her phone by 12 pm.
Present - Since 3 months she gets tired easily unable to do her work, sleeps a lot than her usual time.
Patient's Medication; Diapride M1 Forte (Metformin Hydrochloride Prolonged and Glimepiride Tabs
Vildagliptin 50 Tablets.
General Examination:
Patient was conscious coherent co-operative
Pallor - present
No icterus, cyanosis, clubbing, lymphadenopathy, edema.
FBS - 191 mg/dl
PLBS - 241 mg/dl
Personal History:-
Diet - Mixed
Sleep - Adequate
Appetite - normal
B&B - regular
No addictions.
Menstrual history:-
Menarche - 13 years
5/30 - 3 pads/day
Family history:-
Her paternal grandfather has diabetes mellitus
Treatment History:-
Tab.Lipoglobin HP
Tab.DIAPRIDE M1 Forte
Tab.VALDIMAC 50
Tab.FOLIC ACID 5 mg
Conservative treatment for Gall stones -
ZERODOL SP
Systemic examination:
CVS: S1 S2 heard, no murmurs
RS: BAE present, NVBS heard
CNS: No focal neurological deficits found
P/A: Non tender, no organomegaly
PROVISIONAL DIAGNOSIS :-
Metabolic syndrome with Diabetes and HbE thalassemia.
Prev USG report:-
Investigations
HbA1c - 6.7%
Complete Blood picture - 
On 4/6/2023
Serum ferritin - 4.3 ng/mL
Discharge Summary
25 year old female resident of coochbehar, West Bengal came with chief complaints of swelling in both lower limbs, headache since 2017(as with nausea and dizziness) difficulty in breathing (6 months). Patient is severe anemic since 2017, diagnosed with diabetes mellitus 1 year ago, had laparoscopic cholecystectomy (6months ago).
FBS - 191 mg/dl
PLBS - 241 mg/dl
HbA1c - 6.7%
Hemoglobin - 6 %
MCV, MCH, MCHC - decreased
Serum ferritin - 4.3 ng/mL
Treatment advised:-
Tab. Glimepiride 1.5mg before breakfast
Tab. metformin 1000mg after breakfast
Tab. Glimepiride O.5mg before food @8pm
Tab. OROFER XT PO/OD
Saturday, December 9, 2023
PaJR patient link with daily energy inputs (food plates) and energy outputs (activities) young type 2 Diabetes with HbE hemoglobinopathy chronic anemia.
This is an updated blog done by taking reference from the case report links on this patient's PaJR description box :
25 YEAR OLD WOMAN WITH CHIEF COMPLAINT OF HEADACHE SINCE 6 YRS
25 year old female student by occupation resident of west bengal came to opd with Chief complaints of
1. Swelling in both limbs since 6 years
2. Headache on backside since 6 years
HOPI:-
Patient was apparently asymptomatic 6 years ago.On one day after she wakes up in the morning she noticed swelling in both limbs below knee level mainly at the level of foot which is insidious in onset progressive with no aggravating factors and relieved on massage and not associated with pain. The swelling is more when she was sleeping
H/o headache since 6 years in the occipital region and associated with photophobia and phonophobia and no history of lacrimation.
Headache is more when she gets up in the morning and relieved immediately after few hours on its own for which she went to hospital and after examination she was diagnosed with migraine.
Later, she went through few routine blood investigations and was diagnosed with Anemia. When she was found anemic, they advised her to get Hb electrophoresis result shown that her Hb E levels are high.
History of pain while writing since 7 years which used to start after writing a paragraph (20-30 lines) relieved on rest. It is non radiating, intermittent in nature.
Past history:-
----One year back, around June- July She had severe tooth pain, consulted a dentist and there she got to know about high blood sugar levels and then she was treated her conservatively until blood sugars are normal and treated her accordingly. She used
Lipoglobin HD bd
Vildamac 50mg in the night
-----In the month of August, She had pain in left upper quadrant, consulted a physician, she was diagnosed with gall stones on USG and underwent laparoscopic cholecystectomy in December 2022.
------ No history of hypertension, asthma, TB
Personal History:-
Diet - Mixed
Sleep - Adequate
Appetite - normal
B&B - regular
No addictions.
Menstrual history:
Age at menarche: 11 years
Regular cycles 5/30, 3 pads per day associated with clots 1cm * 0.5cm associated with pain
LMP: 3/05/2023
-IRREGULAR PERIODS SINCE 2 MONTHS; hypomenorrhea, oligomenorrhea
Family history
History of diabetes for her grandfather
Treatment history
Tab.VALDiMAC 50
Tab.FOLIC ACID 5 mg
General examination:-
Patient is conscious, coherent, co operative well oriented to time place and person
Pallor present +
No icterus,
No cyanosis,
No clubbing,
No Lymphadenopathy,
No edema
Vitals:-
Temp:- 98f
Pr- 96bpm
Rr- 16cpm
Bp- 120/80mm hg
Spo2- 96%
Fasting blood sugar -191 mg/dl
Post prandial blood sugar -241mg/dl
Systemic examination:-
Cvs- S1 S2 heard, no murmurs
Rs- BAE present, NVBS present
P/A - soft, non tender
CNS- No neurological deficits
Provision diagnosis:-
Diabetes and anemia under evaluation
Investigations
2022
USG
Present Hb - 6mg/dl
Complete blood picture
PaJR Group Daily updates: GRBS monitoring:
Meals on 14/7/23:
Meals on 4/12/23:
Discussion:
[6/13, 14:38] PA: Sir ami notun osudh gulo ki suru korbo
[6/13, 16:23] PPM 1: Aekhon Ki Ki oshudh khacchen shegunor chobi with time diye share korun
[6/13, 16:23] PA: Ok
[6/13, 16:29] PPM 1: Aajke kheye chilen?
[6/13, 16:29] PA: Haaa
[6/13, 16:30] PPM 1: Notun oshudh guno ache? Chobi share korte parben?
[6/13, 16:30] PA: Ha korchi
[6/13, 16:43] PPM 1: Eta breakfast are dinner aer por neben
[6/13, 16:44] PPM 1: Eta breakfast er aage neben. Eta newar du ghonta baade blood sugar ta janaben
[6/13, 16:44] PPM 1r: Eta lunch aer por neben
[6/13, 16:46] PPM 1: Eta breakfast er aage ebong du ghonta baade blood sugar test er result dekhe janabo kokhon koto nite habe
[6/13, 16:54] PA: Achaa
[6/13, 16:57] PA: Fruits kalo jam, mosombi, aam
[6/13, 22:10] PA: Roti sabji dal salads
[6/14, 09:15] PA: Sir eita ki ardhek ta Nebo Bharat sir bolechilo ardhek ta nite
[6/14, 09:16] PA: Eitao ardhekta r ktha boleche
[6/14, 10:32] PA: Glimepiride tablets IP 1MG ardhek
[6/14, 10:35] PA: Glimepiride tablets IP 0.5 MG ardhek
[6/14, 10:41] PA: Sobji dal diye daliya salads
[6/14, 16:12] PA: Dal sabji salads roti boiled egg
[6/14, 16:15] PPM 1: Before breakfast er ta korenni?
[6/14, 16:16] PA: Korechilam 170
[6/14, 16:17] PPM 1: 0.5 mg
[6/14, 16:17] PPM 1: 0.25mg
[6/14, 16:18] PA: Agulo ki thik achhe khaya ta
[6/14, 16:19] PPM 1: Duto ordhek nile dose ta 0.75 mg hoi
Aer aage apni gotokal obdhio 1mg nicchilen
[6/14, 16:20] PPM 1: Eta lunch aer por niyechilen?
[6/14, 16:22] PA: Haa
[6/14, 16:30] PA: Sir eita to breakfast er por bolechilen r dinner er por
[6/14, 16:30] PA: Lunch er por to ata bolechilen
[6/14, 16:40] PPM 1: Hain thik tai
[6/14, 16:40] PPM 1: Shothik
[6/14, 16:41] PPM 1: 👆Eta breakfast aer por niyechilen?
[6/14, 16:44] PPM 1: When we save the patient's phone number, make sure that patient identifiers are not saved. Please delete this share here as it contains patient identifiers. Please change the contact save in your phone such as 24F DM2 HbE WB and then again copy paste the same information here
[6/14, 16:44] PPM 3: Ok sir
[6/14, 16:48] PA: Haa sir
[6/14, 16:50] PPM 3: আপনি কি আপনার বাড়িতে পৌঁছেছেন?অনুগ্রহ করে আমাদের দ্বারা লিখিত নতুন ট্যাবলেট ফটো পাঠান
[6/7, 9:54 PM] PA: Sir ajk e ashechi barite bikale
[6/7, 9:54 PM] PA: Kalk osudh kine apnak photo pathabo
[6/7, 10:19 PM] PPM 3: ঠিক আছে ধন্যবাদ
[6/7, 10:19 PM] PPM 3: 👍🏻
[6/9, 9:40 AM] Dr.Bharath kumar MD(Gen.Medicine): আপনি কি ট্যাবলেট কিনেছেন?
[6/9, 12:12 PM] PA: Haa 2 to pachinaa order diyechi
[6/9, 12:12 PM] PA: 2 to charai ki osudh khaya suru korbo
[6/9, 12:12 PM] PA: Kalk j 2 to paini ota asbe
[6/9, 12:12 PM] PA: Naki ak bare suru korbo sb
[6/10, 5:14 PM] PPM 3: আপনি এখন পর্যন্ত যা কিনেছেন তার ট্যাবলেটের ছবি পাঠান
[6/10, 6:57 PM] PA: Sob paya geche
[6/10, 6:58 PM] PPM 3: 👍🏻👍🏻
[6/10, 7:00 PM] PPM 3: Morning glimipride 1mg + glimipride 0.5mg before food
[6/10, 7:01 PM] PPM 3: Metformin 1000mg after breakfast
[6/10, 7:02 PM] PPM 3: Afternoon Orofer XT after food @ 2pm
[6/10, 7:02 PM] PA: Sir sugar test korar machine ta akhono asheni
[6/10, 7:03 PM] PA: Tahole ki osudh suru korbo
[6/10, 7:05 PM] PA: Sir eita osudh ta ki bandho korbo
[6/10, 7:06 PM] PA: Ei 3 ta osudh ki bandho kore dibo
[6/10, 7:07 PM] PPM 3: হ্যাঁ 3টি ওষুধ বন্ধ করুন
[6/10, 7:09 PM] PA: Achaa
[6/10, 7:11 PM] PPM 3: আপনি কি বুঝতে পেরেছেন কিভাবে ওষুধ খেতে হয়
[6/10, 7:13 PM] PA: Ha sir
[6/10, 7:13 PM] PA: Eitao ki bandho korbo
[6/10, 7:15 PM] PA: Sir bolchi j ashar somy bolechilen j akta osudh 4 bhag kore 1 bhag khete
[6/10, 7:15 PM] PA: Ota kon osudh ta
[6/10, 7:15 PM] PPM 3: হ্যাঁ
[6/10, 7:15 PM] PA: Acha
[6/10, 7:18 PM] PA: ???
[6/10, 7:19 PM] PPM 3: আমাকে স্রাবের সারাংশ শেষ পৃষ্ঠার ছবি পাঠান
[6/10, 7:19 PM] PPM 3: Discharge photo
[6/10, 7:29 PM] PPM 3: Glimipride 0.25mg @ 8 pm
[6/10, 7:30 PM] PPM 3: 0.25 mg half tablet
[6/10, 7:30 PM] PPM 3: Night
[6/10, 7:30 PM] PA: Okk
[6/11, 11:11 PM] PA: Sir
[6/11, 11:11 PM] PA: Ata to asheni akhono
[6/11, 11:12 PM] PA: Osudh gulo ki suru korbo
[6/12, 6:14 PM] PA: ???
[6/14, 18:50] PPM 1: Kalke theke breakfast er aage Glimeperide 1 mg puro neben
[6/14, 18:55] PA: Achaa
[6/14, 18:57] PPM 1: Kalke abar fasting, 2 hour post breakfast, 2 hour post lunch ta janaben
[6/14, 19:05] PA: Acha
[6/14, 19:05] PA: Sir ajk dinner ta janabo??
[6/14, 19:33] PPM 1: Hain. Khub bhalo hoi
[6/14, 20:15] PA: Achaa
[6/14, 21:50] PA: Dal sabji roti salad
[6/15, 06:30] PPM 1: Raate 0.5 mg Glimeperide er half tablet neben aajke theke
Sokale Glimeperide 1 mg aajke theke
[6/15, 09:14] PA: Achaa
[6/15, 09:14] PA: Tahole sokal a r 0.5 mg glimepiride ta nibo naa
[6/15, 09:17] PA: Badam
[6/15, 10:12] PPM 1r: Hain
[6/15, 10:13] PPM 1: Goto kaal raate Glimeperide 0.5 mg er half niyechilen Ki?
[6/15, 10:19] PA: Naaa
[6/15, 10:21] PA: Sir bolchi j ami ki karola r juice kore theke pari
[6/15, 10:49] PA: Roti sabji begun vaja egg salads
[6/15, 14:24] PPM 1: Sobji hishebe khete paren. Oshudh hishebe noi
[6/15, 14:36] PA: Asole juice kore khete vlo lage
[6/15, 14:36] PA: Acha sobji koire khabo
[6/15, 15:52] PA: Dal paneer bejun vaja gajor alu vaja salad
[6/15, 16:31] PPM 1: 👍
[6/15, 18:03] PA: Sir ei biscuit ta khaya jabe
[6/15, 19:37] PPM 1: Shob rokom biscuit hi moida. Avoid korte parle bhalo
[6/15, 19:52] PA: Achaa
[6/15, 22:07] PA: Ata beson diye ruti sobji salad suji misti chara
[6/16, 00:32] PA: Sir ajk sobji j misti Alu chilo oi jonne ki sugar ta barlo??
[6/16, 07:37] PPM 1r: Na
Dinner aer aage Glimeperide 0.25 mg niyechilen?
[6/16, 07:38] PPM 1: Aer aage 1mg niyechilen naki 1.5 mg?
[6/16, 07:39] PPM 1r: 👆Aei biscuit ta tokhon kheyechilen?
[6/16, 08:45] PA Evening a cha diya 2 to
[6/16, 08:46] PA Haaa
[6/16, 08:46] PA: 1mg
[6/16, 08:47] PA: Sir 1.5 to nei 0.5mg
[6/16, 08:48] PPM 1: 1+0.5=1.5
[6/16, 08:50] PPM 1: Take 1.5 mg
One tablet of 1mg and another tablet 0.5mg
Let us know the blood sugar after two hours of breakfast
[6/16, 08:50] PA: Sir breakfast er age kalk sudhu 1 mg kheyechilam
[6/16, 08:51] PA: Ookk
[6/16, 08:52] PPM 1: Tahole ajke 1.25 mg neen
1mg + half of 0.5 mg
[6/16, 08:52] PA: Achaa
[6/16, 08:52] PA: R ate ki khabo 0.5 mg ta ??
[6/16, 09:47] PPM 1: Ota aajker sugar dekhe bola jabe
[6/16, 10:19] PA: Vat dal dim sedho salad
[6/16, 10:19] PA: Acha
[6/16, 14:26] PPM 1: 1.25 mg niyechilen?
Also 1000mg metformin o niyechilen?
[6/16, 14:37] PA: Haa
[6/16, 14:37] PA: Niyechi
[6/16, 14:46] PA: Vat dal sobji mach vaja mach er jhol salad
[6/16, 17:07] PA: Fruits Aam r kalo jam
[6/16, 19:33] PA: Mishti chara cha muri
[6/16, 20:37] PA: Sir rat re ki 0.5mg khabo???
[6/16, 22:23] PA: Vat dal sabji egg
[6/16, 23:04] PPM 1: Hain
[6/16, 23:14] PA: Sir dinner to hoye geche khaini
[6/17, 10:07] PPM 1: Goto kaal raate 0.25 mg niyechilen?
[6/17, 10:37] PA: Naa sir amr to agei dinner hoyegechili
[6/17, 15:20] PA: Vat dal kathal ki sabji soya chunks er rosha
[6/17, 15:34] PPM 1: 1.5 mg er por?
[6/17, 15:39] PA: Haaa
[6/17, 17:29] PPM 1: Gotokaal raate Glimeperide newa hoini tahole?
[6/17, 17:32] PA: Naa
[6/17, 17:32] PA: Neya hoyni
[6/17, 17:33] PA: I.P 1000 mg ta dinner er por kheyechilam
[6/17, 17:35] PPM 4: What I feel is we need to let the pt tell us about the 24hrs sugar level along with the medicines taking in pen and paper format... Then after that we can titre the medicine as required...
[6/17, 17:43] PPM 1: What's the advantage of pen and paper format?
[6/17, 17:46] PPM 4: No advantage just for 24hr record sir... Because in message sometimes we miss Or due delay reply pt might not take exact dose after titre
[6/17, 17:49] PPM 1: The 24 hour record and graph can be done prospectively by any of us PaJR volunteers here either as a handwritten paper image or excel file @PPM5 @PPM6 @PPM3
However the communication problem and time lag will be similar in both as far as dose titration is concerned?
[6/17, 17:53] PPM 4: Suppose we tell our pt to give her 24hrs(today's) sugar level tomorrow morning.. Then after seeing today's data we advice her the medicines..
Then again day after tomorrow we tell her same to see the effect of our dose titration.. We can do this for maximum 3days..then we will have the idea and exact dose required... After that we may continue like the way we are doing today...
Just this sir...
[6/17, 17:57] PPM 1: We are doing the same thing but instead of waiting for 24 hours to see the entire day's report retrospectively we are titrating and adjusting our doses in advance.
Which approach looks better?
[6/17, 18:03] PPM 4: Sir one thing I would like share from my daily inpatient rounds... When we start insulin for a particular pts we at first start with sliding scale to begin with... Then it goes on for 1 to 2days...after that we make a fixed dose(bolus)... And for fixing that dose we get a massive help from the sliding scale which we started earlier.. Sliding scale also helps to understand a what time cbg is more and when cbg is less.....
What I meant is we are seeing this pt for 4to 5days with cbg... But I think we didn't get a desire result maybe because of exact dose... So if we try for 24hrs formula I think we can get the exact dose earlier...
Rest your decisions sir😊
[6/17, 18:13] PPM 1: Yes the sliding scale has been there with us for about last more than fifty years right after insulin was first used perhaps but if you look at it from another angle you may realize that all dose titrations for any kind of drug be it Insulin or OHAs or even non diabetic drugs are always based on a sliding scale where the drug dose titration is dependent on the patient's response to the drug (intervention).
We can choose to fix a particular dose of insulin after seeing the dose adjustments made over a day depending on the patient's response but even that fixed basal bolus regime will still continue to slide up or down (by + or -2 units) depending on how the patient's sugar responds to the so called fixed insulin regime. But one must remember everything is always essentially sliding! 🙂
[6/17, 21:49] PA: Sir ajk ki 0.5 mg ta khabo
[6/17, 21:52] PPM 1: 0.25 mg
[6/17, 21:53] PPM 1: 0.5 mg aer half
[6/17, 21:53] PA: Kivabe khabo
[6/17, 21:53] PAt: Achaaa
[6/17, 23:09] PA: Khichuri sobji
[6/18, 06:59] PPM 1: Aer aage 0.25 mg niyechilen?
[6/18, 07:00] PPM 1: Goto kaal breakfast aer aage 1.5 mg niyechilen to?
[6/18, 09:36] PA: Haaa
[6/18, 10:27] PA: Sir sugar mapar kit ta kal rate ses hoye geche ajk bikale nahole kalk sokal a asbe
[6/18, 10:28] PA: Ajk tai update dite parchina sugar er
[6/18, 12:01] PA: Vat dal karkol vaja salad
[6/18, 16:36] PA: Ruti egg salad
[6/18, 20:06] PA: Chana
[6/18, 20:12] PPM 1: 👍
[6/18, 23:03] PA: Ruti kathal ki sabji
[6/19, 17:40] PA: Fruits
[6/19, 17:49] PPM 1: 👆This is after 0.25 mg yesterday night?
[6/19, 17:49] PPM 1: This is after 1.5mg before breakfast?
[6/19, 17:53] PA: Haa
[6/19, 17:53] PA: Hm
[6/19, 22:29] PA: Ruti suji salad
[6/20, 08:06] PPM 1: Tar aage 0.25 mg?
[6/20, 09:32] PA: Hmm
[6/20, 11:24] PPM 1: Tablet koto? 1.5 mg?
[6/20, 11:27] PA: Naa
[6/20, 11:27] PA: Khayar agei
[6/20, 11:59] PPM 1: Koto jiggesh korechilaam. Kokhon noi 🙂
[6/20, 12:07] PA: Oo sorry
[6/20, 12:07] PA: 1.25
[6/20, 12:07] PA: 1.25 mg
[6/20, 14:31] PA: Vat dal potol baja alu sedho salad
[6/21, 10:48] PA: Sir kalk balance ses hoye giyechilo tai update korte parini
[6/21, 10:57] PPM 1: Goto kaal raate 0.25 mg niyechilen?
[6/21, 11:46] PA: Haaa
[6/21, 17:02] PPM 1: 1.25 mg khawar por?
[6/21, 17:05] PA Haa
[6/21, 17:08] PA: Dal vat kochu sag tarkari mach
[6/22, 00:37] PA: Fry dal paneer
[6/22, 05:36] PPM 1: 0.25 mg potato chips aer saathe palla dite parbena! 🙂
[6/22, 08:09] PA: Achaa
[6/22, 08:09] PA: Khabo na r tahole
[6/22, 08:09] PA: 🥺
[6/22, 13:38] PA: Roti chalkumro ghanto paneer
[6/22, 18:06] PA: Vat potol vaja kathalbichi vaja chalkumro ghonto paneer
[6/22, 18:07] PA: Salad
[6/22, 18:08] PA: Lunch er 2hr por
[6/23, 01:59] PA: Khichuri egg
[6/23, 02:01] PA: Dinner er 2hr por
[6/23, 09:21] PPM 1: After 0.25mg?
[6/23, 10:19] PA: Haa
[6/23, 21:44] PA: Vat Dal pepe sedho karkol vaja chhanar Bora
[6/23, 21:45] PA: Sir college chilo tai ajk sugar test kora hoyni
[6/23, 21:45] PA: Rate update dete dibo
[6/23, 22:07] PPM 1: College a ajke Ki topics alochona hoyeche?
[6/23, 22:11] PA: Sir xm er from fill up chilo
[6/23, 22:11] PPM 4: What is your subject?
[6/23, 22:12] PA: Political science
[6/23, 22:12] PPM 4: Okay
[6/24, 08:23] PPM 1: 0 25 mg?
[6/24, 09:26] PA: Na sir kal khaya hoyni ses hoye geche
[6/24, 09:26] PA: Order doyechi
[6/24, 09:26] PA: Ajk asbe
[6/24, 09:26] PA: Kalke ashar kotha chilo
[6/24, 10:56] PA: Sir ajk na sorir ta kharap lagche
[6/24, 10:56] PA: Matha r pechon dik ta var var lagche
[6/24, 10:56] PA: Sorir a jor pachina
[6/24, 10:57] PPM 1: Chintar karon nei
Ekhane ghontai ghontai unar shob somosya guno janate thakben
[6/24, 10:58] PPM 1: Ghontai ghontai uni Ki korchen ebong Kokhon Kotokkhon somosya ta thakche janaben
[6/24, 10:59] PA: Sir uni mne k
[6/24, 10:59] PA: Amr sorir kharap lagche to
[6/24, 11:01] PPM 1: Uni mane 24F patient jaake niye aei group a amra alochona Kori ebong sob somoi cheshta Kori jaate unar goponiyota ebong privacy confidentiality akkhoto thake
[6/24, 11:03] PA: Milk oats kaju badam 4 ta almond 3 ta alpo modhu
[6/24, 11:04] PA: Acha
[6/24, 11:12] PPM 1: 👍
[6/24, 14:14] PPM 1: 1.25 mg?
[6/24, 14:23] PA: Ha
[6/24, 14:23] PA: Kheyechi
[6/24, 14:32] PA: Sir ajk sokal theke kei pet ta kmn jolche
[6/24, 14:33] PA: Mne jola pora moto
[6/24, 16:25] PA: Vat musur dal pepe sedho soyabin sedho
[6/24, 17:57] PA: Mango
[6/24, 23:10] PA: Tok doi chira mango
[6/25, 18:04] PA: Egg paneer dal vat
[6/25, 18:05] PA: Breakfast er 2 hr por
[6/25, 18:05] PA: Vat muri ghanto mutton salad
[6/25, 18:25] PPM 1: 1.25 mg newar por?
Kaal theke 1.5 mg newa jete pare 👍
[6/25, 18:36] PA: Acha mne full tablet khabo
[6/25, 19:13] PPM 1: 👍
[6/26, 13:58] PA: Kal rate vat r mutton
[6/26, 13:58] PA: Sir kal ghumiye porechilam tai sugar test kora hoyni
[6/26, 13:59] PA: Chitoi pithe r khir mishti chara
[6/26, 14:33] PPM 1: Chitoi pithe ta Ki diye toiri kora hoi?
[6/26, 14:57] PA: Chal er gulo
[6/26, 17:25] PA: Vat dal pepe sedho paneer potol vaja lebu
[6/27, 02:16] PA: Dal sedho vat ghee
[6/27, 09:40] PPM 1: 1.25 mg?
[6/27, 09:43] PA: Ha
[6/27, 09:43] PA: Sir
[6/27, 09:43] PA: Brown bread khaya jabe??
[6/27, 09:50] PPM 1: Na
Bhalo multigrain ruti holo ekmatro brown bread jeta nijer haathe peeshe banate hoi, bajare pawa jai na
[6/27, 09:51] PA: Achaa
[6/27, 13:55] PA: Breakfast chitoi pithe mango
[6/27, 14:20] PPM 1: 1.25?
[6/27, 15:36] PA: Haa
[6/27, 17:41] PA: Vat dal sobji dal er Bora rosha achar
[6/27, 19:24] PPM 1: The rosha achar appears sweet?
[6/27, 22:03] PA: Naa na
[6/27, 22:03] PA: Kono kichu tei misti nei
[6/28, 02:11] PA: Vat dal sobji
[6/28, 02:13] PA: Fruits kheyechilam lunch lunch er 2 hr por
[6/28, 07:38] PPM 1: After 0.25?
[6/28, 08:14] PA: Hnm
[6/28, 11:51] PA: Oats milk banana almond 5 ta
[6/28, 14:27] PPM 1: 👍1.25?
[6/28, 14:34] PA: Na 1.5 mg
[6/28, 22:46] PA: Lunch vai dal uche vaja chicken
[6/28, 22:47] PA: Dinner vai dal chicken
[6/29, 07:39] PPM 1: 1.5?
[6/29, 07:39] PPM 1: 0.25?
[6/29, 11:18] PA: Ha
[6/29, 11:18] PA: Ha
[6/29, 15:37] PA: Oats
[6/29, 15:38] PA: Parota sobji salad
[6/29, 16:20] PPM 1: 1.5?
[6/29, 16:55] PA: Hmm
[6/30, 14:00] PA: Sir kalk rate ghumiye porechilam tai rat a test kora hoyni
[6/30, 14:01] PA: Oats
[6/30, 14:26] PPM 1: 👆breakfast?
[6/30, 14:48] PA: Haa
[6/30, 14:49] PA: Breakfast er 2 hr por
[6/30, 16:15] PPM 1: Sugarless?
[6/30, 16:19] PA: Haaa
[6/30, 16:19] PA: Banana half mango half
[6/30, 16:26] PPM 1: And milk?
All these ingredients appear to be calorie dense, which can explain the high 2 hour post breakfast inspite of 1.5
[6/30, 16:27] PA: Ha milk oats almond 4 ta
[6/30, 16:28] PA: Tahole ki banana mango bad dibo
[6/30, 16:57] PPM 1: Hain
[6/30, 16:58] PPM 1: Shudhu milk oats are almonds kheleo sompoorno vegetables, fruits, multi grains and pulses er proportion ta shothik habe na
[6/30, 17:03] PA: Achaa
[7/1, 00:16] PA: Lunch vat dal sobji
[7/1, 00:18] PA: Homemade biriyani
[7/1, 07:40] PPM 1: 👍
[7/1, 21:45] PA: Breakfast oats milk banana almond kaju badam
[7/1, 21:46] PA: Lunch vat dal paneer sabji chalkumro ghanto
[7/2, 07:18] PPM 1: Effect of 1.5?
[7/2, 07:19] PPM 1: Calorie dense
[7/2, 18:51] PA: Uche vaja vat
[7/2, 18:53] PA: Vat dal mach chicken salad
[7/3, 12:15] PA: Vat r chicken
[7/3, 17:46] PA: Breakfast vat uche vaja karkol vaja
[7/3, 17:48] PA: Khichuri mocha ghanto paneer karkol vaja salad
[7/3, 17:49] PA: Mango
[7/4, 13:14] PA: Dinner parota sobji paneer kuyash diye rosha
[7/4, 13:16] PA: Breakfast gola ruti badam chana mango lal cha
[7/4, 13:17] PA: Sir sugar test kora hoyni test strips ta ses
[7/4, 13:17] PA: Kalk asbe
[7/4, 21:05] PA: Lunch khichuri chalkumro ghnto sobji salad
[7/4, 21:06] PA: Sir 2 ,3 din theke sorir kharap lagche
[7/4, 21:06] PA: Sorir ta durbol durbol
[7/4, 21:06] PA: Lagche
[7/4, 21:06] PA: Hatte parchina
[7/4, 21:06] PA: Hatle r o sorir kharap lagche
[7/4, 21:07] PA: Pa pechon dike tane
[7/4, 21:07] PA: Matha ta var var
[7/4, 21:09] PPM 1: Goto kaal sokal theke sondhe ghontai ghontai Ki Ki korechilen ebong kone ghontai asubidhe ta ter peyechilen ebong sheta kotokkhon chilo ebong taate Ki Ki kaaj byaghat hoyechilo?
[7/4, 21:11] PA: Kalk sokal thekei sorir ta durbol durbol
[7/4, 21:14] PA: Kalk sokal a uthe breakfast kore osudh kheye maa sathe alpo ranna korechi tar por dufure snan kore kheye suya chilam bikel er dike chal kheye hatte giye e bujhechi sorir ta beshi kharap hatte parini takhon o ato ta guruto deini
[7/4, 21:14] PA: Tate bari ache nun jol kheye chilam
[7/4, 21:14] PA: Tar pr olpo thik hoyechilo
[7/4, 21:15] PA: Tar pr rate khete suye porechi
[7/4, 21:15] PA: Ajk sokal theke e kono kaj e anarji nei
[7/4, 21:15] PA: Sorir khub durbol
[7/4, 21:17] PA: Ajk sokal theke suyae chilam
[7/4, 21:17] PA: Aktu age hatte giye abar sorir kharap lagchilo
[7/4, 21:17] PA: Hatte parchilam na
[7/4, 21:17] PA: Matha ta kmn jano korche
[7/4, 21:24] PPM 1: Blood sugar ta dekha dorkar habe. Oshudh kheye jacchen asha kori
Ki Ki oshudh kokhon kokhon khacchen ebong kaalke kheyechen sheta abar aekhon janan
[7/4, 21:41] PA: Ei 2 to breakfast er age
[7/5, 14:36] PA: Kalk dinner parota paneer chalkumro ghanto
[7/5, 14:37] PA: Breakfast parota dal salad
[7/5, 18:45] PA: Lunch vat dal kochu sag uche vaja sobji diye mach er jhol
[7/5, 21:26] PPM 1: 1.5?
[7/5, 21:26] PA: Homemade vegetable momo
[7/5, 21:27] PA: Suji diye baniyechi
[7/5, 21:27] PA: Haa
[7/6, 23:17] PA: Kalk rater dinner vat dal sobji diye mach salad
[7/6, 23:19] PA: Breakfast r lunch ajk ak sathe korechi vat dal sag paror
[7/6, 23:20] PA: Dinner roti dal sobji chana
[7/7, 06:30] PPM 1: 👍
[7/7, 06:35] PPM 1: Goto kaal sokal theke sondhe ghontai ghontai Ki Ki korechilen janaben.
Jodi kono ghontai Kono asubidhe ter peye thaken Shetao janaben tar saathe sheta kotokkhon chilo ebong taate Ki Ki kaaj byaghat hoyechilo shetao janaben
Asubidhe na hoye thakleo ghontai ghontai doinondin shorire energy ta kibhabe khoroch hocche sheta jana dorkar. Shorire energy Ki bhabe dhukche khabar er madhyome sheta apni roj share korchen
[7/7, 07:40] PA: Kal sokal a uthe olpo morning walk kore 4 ta almond kheyechilam tar pr 1 hr por cha kheyechilam tar pr kichu khon por amder dokan a boshe chilam tar breakfast r lunch ak sathe 12 tar dike korechilam tar pr abar dokan a e boshe chilam tar por 3 tar dike dokan a fruits kheyechilam tar por 6 tar dike 30 minit evening walk korechilam tar pr bari ayshe cha kheyechilam tar pr 10 tar dike dinner korechilam
[7/7, 07:40] PA: Kalk sara din kono subidhe hoyni
[7/7, 07:41] PA: Sudhu taratari hatle paa pechon dike tane
[7/7, 07:41] PA: Takhon kmn jano lage
[7/7, 07:41] PA: Sorir ta
[7/7, 07:47] PPM 1: Dokane Ki korechilen ghontai ghontai biboron dile bhalo hoi. Kiser dokan?
[7/7, 08:09] PA: Jama kapor er
[7/7, 08:10] PA: Boshe chilam customer asle jinis o dekhate hoy dokan a staff na thakle
[7/7, 08:15] PPM 1: Goto kaal jinis dekhate unar koto bar uthte hoyechilo? Kone kone somoi?
[7/7, 16:50] PA: Sir se gulo to mne nei
[7/7, 16:51] PA: Breakfast dariya sob rokom sobji diye salad
[7/7, 16:54] PA: Breakfast er age kheyechilam
[7/7, 16:56] PA: Lunch vat uche vaja sobji mach er jhol
[7/7, 20:32] PPM 1: 1.5?
[7/7, 20:46] PA: Ha
[7/8, 15:00] PA: Kalk biye bari te kheye aste anek rat hoyeche Tai rate test kora hoyno
[7/8, 15:02] PA: Kheyechi dal,kumro Bora, potol chingri, ilish paturi, mutton, ice cream alpo
[7/8, 15:04] PA: Breakfast parota paneer mango
[7/8, 16:17] PPM 1: 👍
[7/8, 18:04] PA: Lunch vat, kochu sag, potol vaja, gandho patila pata Bora, chana rosha salad
[7/8, 22:41] PPM 1: 👍
[7/9, 13:57] PA: Kalk dinner ruti sobji suji misti chara
[7/9, 13:58] PA: Vat dal misti kumro bora salad
[7/9, 14:04] PPM 1: 👍
[7/9, 14:04] PPM 1: 0.25?
[7/9, 14:04] PPM 1: 1.5?
[7/9, 15:05] PA: Haa
[7/9, 15:05] PA: Haa
[7/10, 00:53] PA: Lunch vat, karkor vaja, misti kumro vaja, macha vaja, mach er jhol,
[7/10, 00:55] PA: Dinner vat, dal, karkol vaja, mach er jhol
[7/10, 00:56] PA: Mango dinner er 2 hr por
[7/10, 00:57] PA: Olpo khide pachilo tai kheyechi
[7/10, 06:48] PPM 1: 0.25?
[7/10, 06:48] PPM 1: 1.5?
[7/10, 09:53] PA: Ha
[7/10, 09:53] PA: Haa
[7/10, 15:42] PA: Breakfast r lunch ak sathe korechi vat, chalkumro ghanto, paneer, salad
[7/11, 01:15] PA: Oats milk banana almond mango
[7/11, 06:29] PPM 1: Calorie dense
[7/11, 06:30] PPM 1: 👆Dinner vat, dal, karkol vaja, mach er jhol 160
[7/11, 06:31] PPM 1: 👆Oats milk banana almond mango 221
[7/11, 11:03] PA: Evening a akta barite cha kheyechilam misti chilo cha ta
[7/11, 11:03] PA: Haà
[7/11, 16:32] PA: Breakfast vat chana vaja pepe diye dal
[7/11, 16:32] PA: R mukhi vaja
[7/11, 16:33] PA: Lunch vat, chana rosha, salad, dim
[7/11, 19:44] PA: Lunch erbpor
[7/11, 21:28] PPM 1: 👍
[7/12, 14:03] PA: Dinner vat sobji sedho butter
[7/12, 14:08] PA: Poha salad
[7/12, 19:33] PPM 1: 👍
[7/12, 23:44] PA: Lunch vat dal sukto varali ghonto dim kosha
[7/12, 23:45] PA: Dinner vat dal dim curry
[7/13, 05:38] PPM 1: 👍
[7/13, 12:06] PA: Breakfast ruti cha
[7/13, 15:41] PA: Lunch dariya sobji diye ratkari r salad
[7/13, 16:28] PPM 1: 👍
[7/14, 08:58] PA: Dinner parota, dal, sobji, dim
[7/14, 09:35] PPM 1: 0.25?
[7/14, 09:44] PA: Hn
[7/14, 09:48] PPM 1: Aei duto reading dekhe mone hocche goto kaal 0.5 nile bhalo hoto kintu abar sugar ta khawa dawa ebong hourly activities aer upor depend kore. Apni apnar patient aer hourly activities roj share korchenna
[7/14, 10:23] PA: 15 din theke 24 hr e bishti hoche kombeshi
[7/14, 10:24] PA: Tai bari theke ber hoya hoche naa
[7/14, 10:24] PA: Hatta o hoche na
[7/14, 11:12] PPM 1: Barir bhitore haanthar jonye bina electricity te chole sherokom kaather treadmill banano jai kimba dokaneo kena jete pare
[7/14, 11:22] PA: Acha
[7/14, 15:56] PA: Breakfast vat dal sobji
[7/14, 15:58] PA: Lunch a mango kheyechi
[7/14, 16:15] PPM 1: 👍
[7/15, 10:41] PA: Dinner vat dim er curry salad
[7/15, 10:41] PA: Test strips ta ses tai sugar ta dekha hoyni
[7/15, 19:21] PA: Breakfast parota sobji salad mango
[7/15, 19:26] PA: Lunch vat dal chalkumro ghanto
[7/16, 08:30] PPM 1: 👍
[7/16, 12:41] PA: Breakfast oats
[7/16, 12:42] PPM 1: 1.5?
[7/16, 12:45] PA: Haa
[7/16, 21:51] PA: Lunch vat, dal, uche vaja, mutton, salad
[7/17, 11:16] PPM 1: Control bhalo 👏
[7/17, 11:19] PPM 1: Aekhon sugar ta soptahe ekbar korleo habe shudhu daily khawa dawa (shoktir adai) ebong ghontai ghontai shoktir khoroch (activities) ta jaate apnar patient roj janiye jan
[7/17, 11:32] PA: Achaa
[7/17, 11:35] PA: Kalker dinner dinner vat, dal sedho, mutton
[7/17, 15:54] PA: Breakfast vat,dal, karkol vaja
[7/17, 15:54] PA: Lunch vat, karkol vaja, dal er bora rosha
[7/17, 22:22] PPM 1: 👍
[7/17, 22:39] PA: Dinner oats, milk, mango
[7/18, 18:50] PA: Breakfast ruti, sobji
[7/18, 18:51] PA: Lunch vat,sobji,potol pepe diye rosha
[7/18, 22:25] PPM 1: 👍
[7/19, 10:29] PA: Dinner ruti, sobji,dim
[7/19, 10:36] PaA: Breakfast vat, varali ghonto, potol vaja salad
[7/19, 23:34] PA: Lunch vat, dal,varali ghonto, potol vaja, egg curry
[7/19, 23:34] PA: Suji parota sobji diye
[7/20, 09:42] PPM 1: Porotha ta sujir na hoye gom nijer haathe sheel nora diye peeshe aata diye korle bhalo hoto ebong shobji ta beshi hole bhalo hoto
[7/20, 11:06] PA: Achaaa
[7/20, 20:57] PA: Breakfast oats
[7/20, 20:58] PA: Lunch Vat, dal, potol vaja
[7/20, 21:50] PPM 1: 👍
[7/20, 23:47] PA: Dinner vat dal soyabin er rosha
[7/21, 20:45] PA: Breakfast vat,potol vaja, misti kumro ghonto, soyabin er torkari
[7/21, 20:45] PA: Lunch vat, sukto, dal, mach vaja
[7/22, 00:42] PA: Dinner vat,dal,dim, salad
[7/22, 23:09] PA: Breakfast oats
[7/22, 23:10] PA: Lunch vat,dal,sobji
[7/22, 23:11] PA: Dinner ruti,dal, sobji, salad
[7/23, 13:12] Patient: Breakfast oats, mango, milk
[7/23, 18:51] PA Lunch Homemade egg biryani salad
[7/24, 15:13] PA: Vat, dal, misti kumror bora, potol posto, pulao, paneer, salad
[7/24, 15:13] PA: Breakfast oats, mango
[7/24, 15:14] PA: Lunch vat, sobji sedho, salad
[7/24, 16:55] PPM 1: 👍Aei soptahe ekbar fasting ebong sokale khawar du ghonta baader ta janaben
BP thik ache?
Unar doinondin ghontai ghontai activities share korte parle bojha jeto je aei khabar aer madhyome jei shoktir aamdani hocche sheta koto ta khorcha hocche
[7/24, 18:10] PA: Achaa
[7/24, 18:10] PA: BP ta to dekha hoyna anek din
[7/24, 18:10] PA: Ratte janchi
[7/24, 18:24] PPM 1: Soptahe jekono eK din ontoto dosh bar dekhe janaben
[7/24, 18:58] PA: Acha
[7/24, 21:07] PPM 1: We would like to also know about your daily energy expenditure other than your energy intake 👍
[7/24, 23:21] PA: Okk
[7/25, 00:31] PA: BP 117/ 84
[7/25, 00:32] PA: Dinner roti sobji diye dal er bora rosha
[7/25, 00:32] PA: Mango dinner er po
[7/25, 13:44] PA: Oats, milk, banana, mango
[7/25, 22:25] PPM 1: 👍
[7/25, 23:03] PA: Lunch vat, pepe diye dal,kochu ghonto, uche vaja, kuyash diye potol diye rosha
[7/25, 23:05] PA: Paneer parota, doi
[7/26, 11:14] PA: Kalk ghum theke uthe morning walk korechi 30 minit bari te ashe maa r sathe olpo ranna korechi dufure olpo ghumiyechilam bikale abar evening walk korechi 30 minit er moto
[7/26, 22:47] PA: Breakfast parota,sobji, salad, doi
[7/26, 22:48] PA: Lunch a mango kheyechi
[7/26, 22:49] PA: Dinner roti,dal,sobji,egg curry
[7/27, 21:01] PA: Breakfast vat, dal, potol vaja, alu sedho
[7/27, 21:02] PA: Lunch vat,dal potol vaja, alu sedho, paneer er rosha
[7/27, 21:45] PPM 1: 👍
[7/27, 23:45] PA: Dinner ruti, dal, paneer er sobji, salad
[7/29, 10:56] PA: Kalk breakfast vat, dal, potol vaja,salad
[7/29, 10:56] PA: Lunch vat, uche vaja, mach er jhol
[7/29, 10:57] PA: Mango
[7/29, 10:58] PA: Dinner vat, mach er jhol
[7/29, 11:00] PPM 1: 👍
[7/29, 11:01] PA: Kalk phn a balance ses hoye gechilo
[7/29, 11:01] PA: Tai dite parini
[7/29, 11:01] PPM 1: @PPM4 Can we have the google sequencing of the above food plates?
[7/29, 14:41] PPM 4: Sure sir
[7/29, 16:46] PPM 1: Again the date and time would be desirable?
[7/29, 16:47] PPM 1: Can we just sort them out in day wise clusters?
[7/29, 16:50] PPM 4: Ok sir.. Will send soon.. Actually on duty now
[7/29, 23:25] PA: Breakfast oats
[7/29, 23:25] PA Lunch daliya sobji diye
[7/29, 23:25] PA: Dinner roti sobji
[7/30, 12:23] PPM 1: Off course definitely we should do all our volunteering only when we are free from our workplace 👍
[7/31, 19:23] PA: Kalker breakfast oats
[7/31, 19:25] PA: Vat dal sobji
[7/31, 19:27] PA: Dinner Khichuri dim vaja papor
[7/31, 19:27] PA: Ajk breakfast oats
[7/31, 19:28] PA: Lunch daliya khichuri
[7/31, 19:28] PA: Sobji diye
[7/31, 22:29] PPM 1: 👍
[8/1, 11:41] PA: Dinner vat,dal, chalkumro ghanto
[8/1, 11:41] PA: Breakfast oats
[8/1, 12:31] PPM 1: 👍
[8/1, 20:50] PA: Lunch vat, dal, uche vaja,chalkumro ghonto, sobji diye chhana rosha
[8/1, 21:03] PPM 1: 👍
[8/2, 19:19] PA: Kalk rate dinner roti dal r dim sedho maakha
[8/2, 19:20] PA: Breakfast oats
[8/2, 19:21] PA: Lunch homemade egg biriyani, salad, doi
[8/2, 22:17] PPM 1: 👍
[8/4, 00:28] PA: Breakfast Fruits
[8/4, 00:28] PA: Lunch vat, sag, chalkumro ghonto, dal, paneer er rosha
[8/4, 00:29] PA: Dinner vat, kochu ghonto, badhakofi ghonto, dal pepe diye
[8/4, 00:35] PA: DP 83/127
[8/4, 10:57] PPM 1: 👍
[8/4, 14:52] PA: Breakfast vat, kochu ghanto l, badhakofi ghonto
[8/4, 15:24] PPM 1: 👍
[8/4, 15:25] PPM 1: Glimeperide dose?
[8/4, 23:32] PA: Ha breakfast er age
[8/4, 23:33] PA: Lunch vat, dal,mach vaja, badhakofi ghonto, mach er jhol
[8/4, 23:35] PA: Dinner roti, sobji, egg
[8/5, 10:56] PPM 1: Glimeperide koto dose newa hoyechilo?
Shudhu dine ekbar?
[8/5, 11:19] PA: Na 2 bar
[8/5, 11:19] PA: Sokal a purota
[8/5, 11:20] PA: Ratte half
[8/5, 11:21] PPM 1: Koto dose!??
[8/5, 11:21] PA: 0.5
[8/5, 11:22] PPM 1: So before breakfast 0.5 mg and before dinner 0.25 mg?
[8/5, 11:23] PA: Haa
[8/5, 11:25] PPM 1: One issue in PaJR PHRs that are currently not autoupdated is that one can't look at the previous trail if one has cleared chat, which one is forced to often to maintain phone function! @PPM7
[8/5, 12:18] PPM 7: You could download the zip file till that point before clearing chat? But understand that it will be quite a mess managing the files.
Alternatively, let me experiment with a WhatsApp api based tool this weekend... It gets data via WhatsApp web. That may solve a lot of our PaJR archiving difficulties.
Will report back findings.
[8/5, 12:18] PPM 8: That'd be a great help.
We tried archiving chat exports,but as you mentioned,it's a mess
[8/5, 21:49] PA: Breakfast oats
[8/5, 21:50] PA: Lunch vat, Uche vaja, chalkumro ghanto, sobji
[8/7, 15:54] PA: Dinner radha pallabi,vat, chhola dal, potol posto, panner
[8/7, 15:55] PA: Breakfast oats
[8/7, 15:55] PA: Lunch vat, chal kumro ghonto, mutton curry
[8/7, 15:59] PA: Dinner Oats
[8/7, 15:59] PA: Ajk breakfast sobji sedho diye vat
[8/7, 15:59] PA: Lunch vat, pulao, paneer
[8/7, 22:21] PPM 1: Sudhu matro oats (kimba Jekono cereal) kono kichu vegetables fruits ebong daal chara na khawai bhalo
[8/7, 22:55] PA: Achaa
[8/7, 22:56] PA: Anarosh
[8/7, 22:56] PA: Dinner roti,chhola, panee, salad
[8/8, 08:50] PPM 1: 👍
[8/9, 10:55] PA: Milk
[8/9, 10:56] PA: Breakfast vat, dal, karkol vaja,potol vaja
[8/9, 10:58] PA: Lunch vat, chalkumro ghonto, karkol vaja, dal, chhana rosha, salad
[8/9, 10:59] PA: Dinner roti, chalkumro ghonto,dal, chhana rosha
[8/10, 15:23] PA: Breakfast oats mango badam
[8/10, 15:24] PA: Lunch vat, dal, uche vaja, din vaja, mach er jhol
[8/10, 15:24] PA: Dinner roti, sobji, mach er jhol
[8/10, 15:25] PA: Breakfast panta vat, sobji, dim sedho, alu pepe sedho
[8/10, 15:26] PA: Lunch vat, sag, dal, dim er curry
[8/10, 16:22] PPM 1: 👍
[8/12, 11:38] PA: Anarosh
[8/12, 11:39] PA: Dinner vat, dal, egg curry
[8/12, 11:39] PA: Breakfast vat,dal, badhakofi ghonto
[8/12, 11:40] PA: Lunch vat,dal, badhakofi ghonto, badhakofi r bosha, dim vaja
[8/12, 11:41] PA: Dinner roti,badhakofi ghonto
[8/12, 11:41] PA: Dinner er por milk
[8/12, 11:42] PA: Breakfast oats, milk, banana, almond
[8/13, 12:24] PPM 1: 👍
[8/13, 20:27] PA: Lunch sobji diye daliya r tarkari
[8/13, 20:27] PA: Anarosh
[8/13, 20:28] PA: Dinner roti sobji
[8/13, 20:28] PA: Vog er kichuri sobji diye r papor
[8/13, 21:04] PPM 1: 👍
[8/15, 10:35] PA: Dinner vat, badhakofi ghonto, niramish tarkari
[8/15, 10:36] PA: Breakfast vat r niramish tarkari
[8/15, 10:37] PA: Lunch vat, dal, sobji, chana bora rosha
[8/15, 10:37] PA: Salad
[8/15, 10:38] PA: Dinner roti, sobji, chara r borar rosha
[8/15, 11:10] PPM 1: 👍
[8/17, 18:46] PA: Lunch vat, Dal, badhakofi ghonto, uthe vaja,dal er bora, salad
[8/17, 18:46] PA: Breakfast Poha
[8/17, 18:47] PA: Rate sudhu coffee kheyechilam
[8/17, 18:47] PA: Jor asheche kichu khete parchinaa
[8/17, 18:48] PA: Sokal a sudhu cha
[8/17, 18:50] PA: Lunch vat r mach er jhol
[8/17, 18:51] PA: Dinner dudh diye suji
[8/17, 18:52] PA: Sokal a cha
[8/17, 18:52] PA: Lunch vat r niramish torkari
[8/17, 18:57] PA: BP 116/78
[8/17, 20:23] PPM 1: Proti 6 hours baade baade apnar patient aer temperature ta mepe ekhane janaben
[8/17, 21:39] PA: Achaa
[8/17, 21:40] PA: Jor to akhn nei
[8/17, 21:55] PA: 100 ache akhn
[8/17, 23:21] PA: Dinner vat, varali ghanto,din vaja, peyaj vaja
[8/18, 09:20] PPM 1: Proti 6 hours baade baade janaben
[8/18, 12:28] PA: 4 tar somy korechilam 101 chilo
[8/18, 12:29] PA: Abar 10 tay korechi 99
[8/18, 15:16] PPM 1: 👆Aei din prothom jor aeshchilo? Aandaj koto chilo aei din?
[8/18, 16:46] PA: 2 er kom chilo
[8/18, 16:46] PA: 1.6 nahole 1.7
[8/18, 16:46] PA: Sese bar atai dekhechilam
[8/18, 16:46] PA: Jor jakhon chilo
[8/18, 16:48] PA: Breakfast dudh, khoi, almond badam
[8/18, 16:48] PA: Lunch vat, pepe diye dal, papor
[8/18, 17:19] PA: Jor er somoy ei osudh ta kheyechi
[8/18, 22:12] PPM 1: 👍
[8/20, 10:58] PA: Breakfast vat r kochu ghonto
[8/20, 10:59] PA: Lunch vat dal er bora rosha
[8/20, 10:59] PA: Dinner vat r dal er bora rosha
[8/20, 19:38] PPM 1: 👍
[8/20, 19:38] PA: Ajk jor aschilo 5 tar dike
[8/20, 19:39] PA: 101
[8/20, 19:39] PA: Breakfast dudh, khoi,badam
[8/20, 19:40] PA: Lunch vat, dal, badhakofi ghonto,karkol vaja, dim sedho
[8/20, 20:20] PPM 1: Proti 6 ghonta baade baade mepe janate parĺe khub bhalo hoto
[8/20, 21:00] PA: Achaa
[8/21, 18:21] PA: Kalk 10 tar dike 99 chilo
[8/21, 18:21] PA: Ajk sara din 98
[8/21, 18:22] PA: Dinner parota sobji
[8/21, 18:23] PA: Breakfast vat r pepe alu sedho
[8/21, 22:17] PPM 1: 👍
[8/23, 23:47] PA: Lunch vat, dal, badhakofi ghonto, dal er bora rosha
[8/23, 23:48] PA: Dinner vat, dal sedho, pepe sedho
[8/23, 23:54] PA: Breakfast vat, karkol vaja, potol vaja
[8/23, 23:55] PA: Lunch khichuri labra papor
[8/23, 23:58] PA: Dinner oats milk banana almond
[8/24, 00:00] PA: Breakfast oats milk
[8/24, 00:02] PA: Lunch vat, dal, karkol vaja, Mach vaja
[8/24, 00:02] PA: Mach er jhol
[8/24, 00:17] PA: Dinner milk oats kaju badam
[8/24, 08:33] PPM 1r: 👍
[8/25, 17:22] PA: Breakfast vat, sag, potol bepe diye rosha
[8/25, 17:23] PA: Lunch vat,dal,sag, sobji, potol pepe diye rosha
[8/25, 17:25] PA: Dinner roti r rosha
[8/25, 17:25] PA: Breakfast vat, sobji
[8/25, 17:28] PA: Lunch vat, dal, sobji, egg curry
[8/25, 17:29] PA: Apple
[8/25, 22:42] PPM 1: 👍
[8/26, 13:07] PA: Dinner roti, sobji, egg curry
[8/26, 13:07] PA: Breakfast milk
[8/26, 13:07] PA: Almond
[8/26, 16:48] PPM 1: 👍
[8/26, 16:51] PA: Lunch vat, dal pepe diye,karkol vaja, potol posto,
[8/26, 21:22] PA: ডাব এর জল
[8/26, 21:22] PA: Apple r narkel
[8/27, 10:01] PPM 1: 👍
[8/27, 10:28] PA: Dinner roti sobji
[8/27, 21:30] PA: Breakfast vat, kochu ghonto
[8/27, 21:33] PA: Lunch daliya khichuri r sobji
[8/27, 21:57] PPM 1: 👍
[8/28, 17:18] PA: Dinner roti, sobji, dal
[8/28, 17:18] PA: Dinner er por dudh holud diye
[8/28, 17:21] PA: Breakfast vat, dal, karkol vaja
[8/28, 17:22] PA: Lunch vat, dal, uche vaja,kochu ghonto, pepe bothi, chanar bora
[8/28, 22:28] PPM 1: 👍
[8/29, 12:01] PA: Breakfast er age chhola
[8/29, 12:01] PA: Dinner chana r parota, sobji, doi
[8/29, 12:03] PPM 1: 👍
[8/30, 00:55] PA: Breakfast roti r chhola
[8/30, 00:56] PA: Lunch vat, dal, badhakofi ghonto, varali ghanto, karkol vaja,papor
[8/30, 00:56] PA: Banana
[8/30, 10:12] PPM 1: 👍
[8/31, 22:21] PA: Breakfast poha doi
[8/31, 22:22] PA: Lunch vat, dal, sobji, karkol vaja,potol posto, papor
[8/31, 22:25] PA: BP 120/83
[9/1, 00:05] PA: Dinner roti sobji,dal, doi
[9/1, 06:40] PPM 1: Eta ektu beshi bhaat prodhan hoye geche
[9/1, 06:41] PPM 1: 👆Eta ekdom thik ache
[9/1, 06:52] PA: Achaa
[9/3, 01:43] PA: Breakfast milk, almond, Banana
[9/3, 01:45] PA: Lunch vat, pepe sedho, dal, bharali ghonto, mach er jhol, doi, salad
[9/3, 01:45] PA: Dinner roti ghee diye r milk
[9/3, 01:47] PA: Lunch vat, dal pepe diye, sobji, potol vaja,papor, salad
[9/3, 01:48] PA: Lunch er por Apple, mosombi
[9/3, 01:51] PA: Dinner vat, badhakofi ghonto, soyabin fulkofi rosha, salad
[9/3, 01:51] PA: Ajk breakfast kora hoyni barite puja chilo
[9/4, 15:20] PA: Breakfast chhola, doi
[9/4, 15:21] PA: Lunch vat, dal pepe diye, mutton
[9/4, 15:21] PA: Salad
[9/4, 15:22] PA: Dinner vat, dal, badhakofi ghonto, mutton
[9/4, 15:22] PA: Salad
[9/4, 15:23] PA: Breakfast er age milk
[9/4, 15:23] PA: Breakfast roti, sobji
[9/4, 15:24] PA: Lunch vat,dal, badhakofi ghonto, alu vaja, chhana rosha
[9/4, 19:07] PPM 1: 👍
[9/5, 18:05] PA: Dinner polao, paneer,dal, papor
[9/5, 18:05] PA: Breakfast ruti, sobji, dim
[9/5, 18:07] PA: Lunch vat, chalkumro ghonto, sobji diye choto mach er jhol, katol Mach er kaliye, salad
[9/5, 20:01] PPM 1: 👍
[9/5, 22:25] PA: Dinner vat, dal,dim vaja
[9/6, 13:25] PA: Breakfast gola ruti, sobji, salad
[9/7, 18:58] PA: Lunch vat,dal, sobji, potol er rosha, salad
[9/7, 18:59] PA: Papor
[9/7, 18:59] PA: Dinner vat, dal, sobji, potol er rosha, alu sedho
[9/7, 19:00] PA: Ajk kichu khaya hoyni akhono
[9/7, 19:00] PA: Jonmastomii upash korechi
[9/7, 19:03] PPM 1: Oshudh?
[9/7, 19:11] PA: Khaya hoyni
[9/7, 19:11] PA: Rate kheye osudh khabo
[9/8, 12:53] PA: Sabu makha, malpoya, luchi, sujir dhokla, kolar bora, tal er khir
[9/8, 12:54] PA: Breakfast vat dal sobji diye
[9/10, 10:52] PA: Dinner vat, pepe potol sedho, sb sojbi diye tarkari
[9/10, 11:20] PA: Breakfast roti sobji
[9/10, 11:21] PA: Lunch vat, sag, varali ghonto, karkol vaja, dal, paneer er rosha
[9/10, 11:22] PA: Dinner vat, dal, paneer
[9/10, 11:23] PA: Breakfast chira, doi, almond, apple
[9/11, 23:11] PA: Lunch vat, dal, sobji, pepe sedho,dim er curry
[9/11, 23:11] PA: Dinner vat, dal, sobji, dim er curry
[9/11, 23:12] PA: Breakfast sujir parota,chana,doi
[9/11, 23:13] PA: Lunch daliya r khichuri, sobji
[9/11, 23:13] PA: Dinner roti, sobji
[9/12, 08:22] PPM 1: 👍
[9/12, 22:07] PA: Ajk vog er prosad kheyechi vat, sag, dal, sobji, potol vaja,uche vaja,misti komro vaja, vendi vaja, panna
[9/12, 22:07] PA: Sb diye kheyechi
[9/12, 22:08] PA: Ak bare mekhe kheyechi
[9/12, 22:08] PA: Photo tola hoyni setar
[9/12, 22:08] PA: Tai jonne atai dilam
[9/12, 22:08] PA: Breakfast kora hoyni
[9/12, 23:10] PA: Dinner vat, dal, sobji, soyabin rosha,parota
[9/14, 16:07] PA: Breakfast roti soybin er sobji
[9/14, 16:08] PA: Lunch vat,sag, badhakofi ghonto, mach er jhol data begun alu diye
[9/14, 16:09] PA: Dinner parota,badhakofi ghonto,dim vaja
[9/14, 16:10] PA: Breakfast vat, badhakofi ghonto,papor
[9/14, 16:10] PPM 1: Goto kaaler?
[9/14, 16:11] PA: Lunch vat, badhakofi ghonto, pachmisali tarkari chana rosha
[9/14, 16:11] PA: Haa rater
[9/14, 16:12] PA: Goto kal rater dinner
[9/14, 16:13] PA: Badhakofi kalk ker ta kal e ses ajk abar kora hoyeche
[9/14, 16:16] PA: Sir sugar test korar kit ta ses hoye geche Oder diyechi 3,4 din er modhe ashe jabe tar pr janachi
[9/14, 16:23] PPM 1: Lab aeo fasting pp kora jete pare
[9/14, 17:23] PA: Acha
[9/14, 17:27] PA: Sir Hemoglobin tao ki korabo
[9/14, 19:26] PA: Last kabe koriyechilen ebong koto chilo?
[9/14, 20:12] PA: July a kora hoyechilo
[9/14, 20:13] PA: 7 chilo
[9/14, 20:14] PA: Report ta pachina
[9/14, 20:14] PA: Abar koriye nichi
[9/15, 09:22] PA: Dinner roti, paneer er sobji, tameto chatni
[9/15, 09:22] PA: Breakfast suji, almond
[9/15, 14:29] PPM 1: 👍
[9/15, 14:29] PPM 1: Sweet?
[9/15, 14:51] PA: Modhu deya olpo
[9/15, 14:52] PA: Khaya jabe na?
[9/15, 21:29] PPM 1: Na
[9/15, 22:03] PA: Achaa
[9/15, 22:28] PA: Lunch vat, dal,dim vaja
[9/15, 22:29] PA: Dinner chola, saasa, tameto
[9/15, 22:29] PPM 1: 👍
[9/17, 23:35] PA: Breakfast apple
[9/17, 23:36] PA: Lunch vat,dal, pepe kuyash er sobji, salad
[9/17, 23:37] PA: Dinner vat, dal sedho, sobji
[9/17, 23:37] PA: Breakfast chatu, dim sedho
[9/17, 23:40] PA: Lunch vat, dal pepe diye, sobji, Mach er jhol
[9/17, 23:41] PA: Dinner oats er Idli sambar
[9/18, 18:28] PPM 1: 👍
[9/18, 21:40] PA: Breakfast buter chatu
[9/18, 21:42] PA: Lunch vat, dal pepe diye, pepe kuyash er torkari
[9/18, 21:43] PA: Dinner chola sedho
[9/18, 21:43] PA: Thanda legeche kichu khete eche korena
[9/18, 21:45] PPM 1: Apnar patient shara din kokhon ki oshudh nicche bishesh kore diabetes aer jonye shetao roj janaben
[9/18, 21:45] PA: Acha
[9/18, 21:45] PA: Akhoni janabo sir
[9/18, 21:51] PPM 1: Aechara ekhane amader roj patient aer activity talika jeta jana dorkar roj ghontai ghontai ekta text aer madhyome jeta niche jemon sajano👇
5:00 AM to 6:00 AM
Tarpor
6: 00 AM to 7:00 A M
...............
Tarpor aei bhabe proti ta ghontai
....................
10:00 PM to 11:00 PM
Ghum aer aage last text obdhi
Jaani mushkil kintu parle khub bhalo habe
Ekhane niche bortoman ekjon patient aer doinondin lekha share korlam 👇
5:00 AM সাধারণভাবে পাঁচটা থেকে সাড়ে পাঁচটায় ঘুম থেকে উঠে পড়ি। তারপর ওয়াশরুম থেকে ফিরে নদীতে যাই অল্প কিছুক্ষণ সাঁতার ও স্নান করে ফিরে আসি।
Time? : তারপর সামান্য ব্রেকফাস্ট করে হাঁটতে চলে যাই এবং সেটা খোলা হাওয়ায় নদীর পাড় ধরে। ফিরে এসে বাজারে যাই। সেখান থেকে ফিরে এসে ভোরের কাগজ পরি।
10:00 AM দশটা নাগাদ দুপুরের খাবার খেয়ে নেই। তারপর একটু বিছানায় গড়িয়ে নেই। তারপর বাইরের কিছু কাজ থাকলে করি অথবা বন্ধুর উপন্যাসের অথবা কম্পিউটারে কিছু কাজ থাকলে করি।
3:00 PM আবার তিনটে নাগাদ নাগাদ কিছু স্ন্যাকস বা টিফিন জাতীয় খাবার খাই।
Time? : বিকালের দিকে কখনো কখনো আবার হাঁটতে যাই অবশ্য সেটা সঙ্গী সাথী পেলে। ফিরে এসে ফল খাই তারপর আবার বাইরের কাজ থাকলে করি অথবা কম্পিউটার বা অন্যান্য কিছু কাজ থাকলে সেগুলো করি।
10:00 PM তারপর দশটা নাগাদ রাতের খাবার খেয়ে নেই।
11:00 PM তারপর রাত এগারোটা থেকে বারোটার মধ্যে শুয়ে পড়ি এটাই দৈনন্দিন জীবন।
[9/18, 21:53] PPM 1: Breakfast aer aage 1.5 mg nicchen?
[9/18, 21:53] PA: Haa
[9/18, 21:57] PA: Ei vabe janate hbe sir
[9/22, 20:29] PA: Breakfast chatu
[9/22, 20:30] PA: Lunch kichuri, badhakofi ghonto, papor vaja
[9/22, 20:32] PA: Dinner chicken biriyani
[9/22, 20:32] PA: Breakfast vat, kochu ghonto,potol vaja Mach vaja
[9/22, 20:34] PA: Lunch vat, sag, kochu ghonto, badhakofi ghonto, dim vaja
[9/22, 20:34] PA: Apple
[9/22, 20:36] PA: Dinner. Gola ruti sobji
[9/22, 20:37] PA: Breakfast milk
[9/22, 20:38] PA: Lunch vat, dal, sobji
[9/22, 20:39] PA: Dinner ruti, sobji, dim vaja
[9/22, 20:39] PA: Breakfast milk, almond
[9/22, 20:39] PA: Lunch vat, sobji, dal er bora rosha
[9/22, 20:40] PA: 2 din theke jor
[9/22, 20:40] PA: Tai kichu dite parini
[9/22, 21:38] PPM 1: Fever charting proti char char ghontai jananor kotha chilo?
[9/22, 23:05] PA: Bule gechi
[9/22, 23:06] PA: 102 r mojhei chilo
[9/22, 23:06] PA: Akhono to er opore jayni
[9/23, 15:07] PPM 1: Amader proti char char ghontar temperature jana dorkar chilo
Tahole aekhon anuman korchi patient aer same problem are nei
[9/23, 23:54] PA: Ha
[9/23, 23:56] PA: Breakfast oats
[9/23, 23:57] PA: Lunch khichuri, labra, potol vaja,karkol vaja,alu vaja, apple
[9/23, 23:58] PA: Dinner Khichuri, labra
[9/24, 11:13] PPM 1: 👍
[9/24, 11:39] PA: Breakfast chatu
[9/24, 11:54] PA: Dim sedho
[9/24, 12:29] PPM 1: 👍
[9/25, 21:23] PA: Lunch vat, sobji, dim er curry
[9/25, 21:24] PA: Dinner ruti, sobji, dim er curry
[9/25, 21:25] PA: Breakfast vat, sobji, chana r bora, uche vaja
[9/25, 21:25] PA: Lunch vat, chana bora rosha, papor
[9/25, 21:37] PPM 1: Bhaat ta ektu beshi mone hocche!
[9/25, 21:38] PA: Ha khub khide peyechilo
[9/25, 23:38] PA: Dinner ruti, chana bora rosha
[9/26, 08:48] PPM 1: 👆
[9/26, 15:38] PA: Sokal a 6 ta 6:30 tar dike uche jol kheye hatte jai 1 ghonta r moto hete bari ashe almond khai 5 ta kono din milk. Tar pr porte boshi samnei xm ar pr 10 tar dike breakfast kori tar pr dokan a giye boshe thaki 2 ghonta r moto tar pr 2:30 dike lunch kori tar pr lunch er 30 minit pr kono kono din ghumiye pori 1 ghonta r jonne sandha bela abar hatte jai 1 ghonta hete asi tar pr kono kono din fruits ba chire vaja kheye kheye abar porte boshi abar kono din khichu na kheye boshi 10 tar dike dinner kori 12 ta 1 ta dike ghumiye pori
[9/26, 23:08] PA: Breakfast chatu
[9/26, 23:10] PA: Lunch vat,dal, uche vaja, photo vaja, karkol vaja, alu vaja,badhakofi ghonto, polao, mutton curry, papor
[9/26, 23:11] PA: Dinner vat, mutton, papor
[9/26, 23:28] PA: Ajk alpo payesh o khaya hoyeche
[9/26, 23:28] PA: R cake o
[9/26, 23:29] PPM 8: Which cake?
Chocolate?butterscotch?
[9/26, 23:30] PA: Both
[9/28, 10:46] PA: Breakfast chatu
[9/28, 10:47] PA: Lunch vat, Pepe ghonto, alu vaja
[9/28, 10:47] PA: Dinner ruti, pepe ghonto, dim sedho
[9/28, 10:48] PA: Breakfast dhoi chira almond
[9/30, 20:57] PA: Lunch vat, pepe ghonto, potol kuyash bothi, gajol alu vaja, chana rosha
[9/30, 20:58] PA: Dinner ruti, sobji, gajol alu vaja, chana rocha
[9/30, 20:59] PA: Breakfast milk, almond
[9/30, 20:59] PA: Lunch vat, soyabin er sobji
[9/30, 20:59] PA: Dinner ruti, soyabin er tarkari, dim vaja
[9/30, 21:00] PA: Breakfast ruti sobji pepe kuyash potol diye sobji
[9/30, 21:02] PA: Lunch vat, dal, sag, uche vaja, soyabin er rosha
[9/30, 21:04] PA: Dinner Khichuri, soyabin er rosha, papor
[10/1, 13:10] PA: Breakfast khichuri, papor
[10/1, 19:38] PA: Lunch vat, sag,uche vaja, mutton curry, dal chilo photo tulte bule gechi 2 jon er ta ak sathe chilo tai jonne
[10/1, 19:56] PPM 1: 👍
[10/2, 16:37] PA: Dinner ruti, mutton curry
[10/2, 16:38] PA: Breakfast milk, khoi, almond
[10/2, 16:39] PA: Lunch vat, dal sedho, pepe, gajor, potol sedho
[10/3, 20:19] PPM 1: 👍
[10/4, 11:45] PA: Dinner daliya khichuri, sobji
[10/4, 11:46] PA: Breakfast vat, sag, dim vaja
[10/4, 11:46] PA: Lunch vat, sobji, papor
[10/4, 11:46] PA: Dinner ruti, sobji
[10/4, 11:47] PA: Breakfast er age milk
[10/4, 11:47] PA: Breakfast khichuri
[10/4, 22:08] PPM 1: 👍
[10/5, 08:00] PPM 1: https://medicinedepartment.blogspot.com/2023/10/variety-of-diet-plates-shared-in-pajr.html?m=1
[10/5, 10:59] PA: Sir ami ki group gulo te join korbo
[10/5, 11:18] PA: Lunch vat, sag, chochori, mach er jhol, fried rice
[10/5, 11:19] PA: Dinner vat, chochori, fried rice, paneer er rosha
[10/5, 14:49] PPM 1: Paren
[10/5, 17:57] PA: Haa
[10/5, 17:58] PA: Breakfast vat, sag, soyabin pepe r sobji
[10/5, 17:59] PA: Lunch chira r narkel
[10/5, 19:39] PPM 1: 👍
[10/6, 14:54] PA: Dinner vat, dal sedho, soyabin er taratari, dim sedho
[10/6, 14:54] PA: Breakfast ruti, pepe ghonto
[10/6, 14:55] PA: Lunch vat, dal, uche vaja, pepe ghonto, potol vaja, dim er curry
[10/7, 23:12] PA: Dinner dal, dim sedho
[10/7, 23:13] PA: Breakfast vat,potol vaja pepe kuyash potol er rosha
[10/7, 23:13] PA Lunch vat, dal, pepe ghonto, dal, pepe kuyash potol er rosha
[10/7, 23:14] PA: Dinner ruti, pepe kuyash potol er rosha, milk
[10/8, 09:05] PPM 1: 👍
[10/8, 23:03] PA: Breakfast vat, sag, soyabin
[10/8, 23:03] PA: Lunch vat, soyabin er tarkari
[10/9, 00:49] PA: Dinner vat, dal sedho, sojbi sedho
[10/9, 19:25] PPM 1: Ekhane salads hole bhalo hoto
[10/9, 19:25] PA: Achaa
[10/9, 19:30] PPM 1: Bhat anek beshi
Also take vegetables in half of the plate like this👇
[10/12, 21:22] PA: Breakfast Roti,sobji, soyabin er tarkari, salad
[10/12, 21:23] PA: Lunch vat, pepe ghonto, dal sedho, soyabin er tarkari
[10/12, 21:24] PA: Dinner dhosa
[10/12, 21:25] PPM 1: 👍
[10/12, 21:26] PA: Breakfast milk, almond
[10/12, 21:27] PA: Lunch vat, dal, badhakofi ghonto, karkol vaja , misti kumro bora
[10/12, 21:27] PA: Dinner suji r tometo kajol erbparota
[10/12, 21:29] PA: Breakfast chatu
[10/12, 21:32] PA: Lunch vat, sag, uche vaja, begun vaja, potol vaja, sob rokom sobji diye tarkari,dal paneer er rosha
[10/12, 21:32] PA: Dinner er tai kheyechi
[10/12, 21:35] PA: Breakfast milk, almond
[10/12, 21:40] PA: Lunch vat,dal sedho, pepe ghonto, soyabin er tarkari
[10/12, 21:40] PA: Dinner, roti dal, badhakofi ghonto
[10/12, 21:42] PA: Breakfast chatu
[10/12, 21:42] PA: Lunch vat, dal, kochu sag, sobji, soyabin er rosha
[10/13, 14:11] PPM 1: 👍
[10/14, 07:39] PA: Dinner khichuri, soyabin er rosha
[10/14, 07:40] PA: Breakfast khichuri, Mach vaja, dim vaja, salad
[10/14, 07:41] PA: Lunch vat, chachori, mach er jhol, dim er curry, salad
[10/14, 07:42] PA: Ruti diye pizza kheyechi peyaj, tameto, chana diye
[10/16, 07:04] PPM 1: 👍
[10/16, 09:52] PPM 1: PaJR regular best food plates award👏👏👏
👇
[10/16, 10:30] PA: Sir ei group a join hobo?
[10/16, 10:31] PA: Breakfast vat, badhakofi ghonto
[10/16, 10:32] PA: Lunch vat, soyabin er tarkari
[10/16, 10:33] PA: Dinner vat, soyabin er tarkari
[10/16, 10:35] PA: Breakfast parota, sobji,badam tameto r chatni
[10/16, 10:36] PA: Lunch vat, Mach er jhol,salad
[10/16, 10:37] PA: Dinner vat, chicken curry, pulao, papor, salad
[10/16, 15:17] PA: Breakfast poha, salad
[10/16, 15:18] PA: Lunch vat, dal,pepe sedho, varali ghonto, badhakofi ghonto
[10/16, 21:43] PPM 1: 👍
[10/16, 21:43] PPM 1: Hote paren
[10/16, 22:05] PA: Hoyechi
[10/17, 01:13] PA: Dinner ruti, bharali ghonto, dal sedho, badam tameto chatni
[10/18, 11:20] PA: Breakfast chatu, milk
[10/18, 11:21] PA: Lunch vat,dal,sag,pepe sedho, kuyash bothi, soyabin er rosha, salad
[10/18, 11:22] PA: Dinner ruti, dal, soyabin er rosha
[10/18, 11:22] PA: Breakfast milk
[10/19, 16:09] PPM 1: 👍
[10/20, 16:57] PA: Lunch vat dal, pepe sedho , mach er jhol
[10/20, 16:58] PA: Dinner vat, badhakofi ghonto, egg curry, salad
[10/20, 16:59] PA: Breakfast ruti, badhakofi ghonto, egg curry salad
[10/20, 17:03] PA: Lunch Egg curry vat
[10/20, 17:04] PA: Dinner ruti, sobji, soyabin er tarkari
[10/20, 17:07] PA: Breakfast chatu, almond, milk
[10/20, 22:30] PPM 1: 👍
[10/27, 21:14] PA: Sir barite Durga Puja chilo tai ei ko din somy paini kichur
[10/27, 21:15] PA: Breakfast chatu, almond, banana
[10/27, 21:19] PA: Lunch vat,sag, kuyash bothi, misti alu vaja, soyabin diye 5 mishali tarkari
[10/27, 21:20] PA: Dinner suji Ata r patota, kuyash bothi
[10/29, 12:06] PA: Lunch khichuri, labra, badhakofi ghonto, papor
[10/29, 12:07] PA: Dinner Khichuri, labra, badhakofi ghonto, papor
[10/29, 12:08] PA: Breakfast vat, soyabin vaja, dal er bora
[10/29, 14:39] PPM 1: 👍
[10/30, 23:01] PA: Lunch vat, musti alu vaja, chachori, dal er bora rosha
[10/30, 23:02] PA: Dinner ruti,dal er bora rosha, salad
[10/30, 23:02] PA: Breakfast ruti, chachori, salad
[10/30, 23:03] PA: Lunch vat, uche vaja, pepe ghonto, chochori, dal
[10/30, 23:03] PA: Salad
[10/30, 23:03] PA: Dinner ruti, soyabin er rosha
[10/31, 05:30] PPM 1: 👍
[10/31, 19:23] PA: Breakfast vat, niramish sobji
[10/31, 19:24] PA: Lunch tandoori ruti, chola
[11/1, 13:24] PA: Dinner vat, dal sedho, sobji
[11/1, 13:25] PA: Breakfast er age milk
[11/1, 13:27] PA: Breakfast vat, chachori, badhakofi bora
[11/1, 14:50] PPM 1: 👍
[11/2, 00:35] PA: Lunch vat, dal,begun vaja, badhakofi bora, pepe ghonto
[11/2, 00:36] PA: Dinner paneer parota chola
[11/2, 06:49] PPM 1: 👍
[11/2, 22:58] PA: Breakfast ruti, sobji, salad
[11/2, 22:58] PA: Lunch vat, badhakofi ghonto, misti alu vaja, paneer, salad
[11/2, 22:59] PA: Dinner vat, dal sedho, badhakofi ghonto, paneer
[11/3, 15:53] PA: Breakfast paneer parota, begun vaja, salad, Apple
[11/3, 15:54] PA: Lunch vat, dal, chochori, misti alu vaja , salad
[11/8, 11:30] PA: Sir barite aktu asubidhe te chilam amr dadar chele accident mara geche
[11/8, 11:32] PA: Photo deyar moto obothay chilam na
[11/8, 11:33] PA: Friday theke kalk porjonto chatu kheye chilam sokal a ratte
[11/8, 11:33] PA: Lunch a sedho vat kheyechi
[11/8, 11:33] PA: R khuch khaya hoy i
[11/8, 11:33] PA: Hoyni
[11/8, 11:34] PA: Breakfast chhatu milke diye, almond
[11/8, 14:21] PPM 1: Asha korchi aaste aaste barir sobai aei boro bipoder theke beriye ashben
[11/8, 14:25] PA: 😞😞
[11/8, 14:26] Patient: Keu mene nite parche naa somy lagbe
[11/8, 14:32] PPM 1: Abosyoi lagbe
[11/8, 14:33] PA: Haa
[11/8, 18:14] PA: Lunch vat, potol vaja, soyabin er rosha
[11/8, 21:59] PA: Dinner ruti, sobji
[11/10, 00:54] PA: Breakfast milk, chhatu
[11/10, 00:56] PA: Lunch vat, chachori, mach
[11/10, 00:56] PA: Dinner ruti, sobji
[11/10, 14:19] PPM 1: 👍
[11/10, 23:44] PA: Breakfast vat, dal vorta
[11/10, 23:45] PA: Lunch vat, dal vorta misti kumro bora, dim er curry
[11/10, 23:45] PA: Dinner ruti, sobji
[11/11, 06:05] PPM 1: 👍
[11/12, 16:41] PA: Breakfast milk almond oats
[11/12, 16:43] PA: Lunch vat, dal alu sedho, dim er curry
[11/12, 16:44] PA: Dinner parota, sobji
[11/12, 16:44] PA: Breakfast milk chhatu
[11/12, 16:46] PA: Lunch khichuri, begun vaja, badhakofi
[11/12, 20:41] PPM 1: 👍
[11/13, 10:49] PA: Dinner chicken biriyani
[11/13, 10:49] PA: Sir
[11/13, 10:49] PA: Amr na khub gorom lage
[11/13, 10:49] PA: Thanda mota moti porei geche
[11/13, 10:50] PA: Maa baba r to fan lage na
[11/13, 10:50] PA: Amr e gorom lage
[11/13, 10:50] PA: R aka notun naa
[11/13, 10:50] PA: Ager thekei
[11/13, 15:14] PPM 1: Apnar patient Ghum theKe uthe proti ghontai ghontai Ki Ki koren ebong kone somoi ta uni koshto ta ter paan sheta janale bhalo hoto
[11/14, 22:32] PA: Sokal a 6:30 tay uthe hate asi 1 ghonta tar por lal cha khai porte boshi 10 tar dike brekfast kore dokan a boshe thaki 2 tar dike lunch kore bikal a lal cha kheye porte boshi 10 tar dike dinner kori
[11/14, 22:33] PA: Breakfast parota, dal, dim sedho begun vaja
[11/14, 22:33] PA: Lunch vat, dal, soyabin er rosha, dim vaja
[11/14, 22:34] PA: Dinner vat, soyabin er rosha
[11/14, 22:35] PA: Breakfast chhatu
[11/14, 22:37] PA: Lunch vat, pepe ghonto, chachori, paneer
[11/15, 11:33] PA: Dinner vat, Mach vaja, badhakofi ghonto, dim er curry
[11/15, 11:34] PA: Breakfast ruti,sobji, dim sedho
[11/15, 16:46] PA: Lunch vat, sag, chochori, sukna lonka vorta, mach er jhol
[11/18, 10:07] PA: Dinner vat, dal, chocha bothi, alusedho , mach
[11/18, 10:07] PA: Breakfast chhatu
[11/18, 10:08] PA: Lunch vat begun vaja, sobji
[11/18, 10:09] PA: Peyara
[11/18, 10:11] PA: Dinner dim biriyani
[11/18, 10:12] PA: Breakfast milk,almond, Banana chhatu
[11/18, 10:17] PA: Lunch vat, dal, chicken fry,
[11/18, 10:20] PA: Dinner vat, chocha bothi, dim er curry
[11/18, 15:54] PA: Breakfast daliya r khichuri sobji diye
[11/18, 15:54] PA: Lunch vat, dal,sag, badhakofi ghonto, alu vaja, paneer
[11/19, 12:02] PPM 1: Ekhane bhaat beshi sobji kom?
[11/19, 12:03] PPM 1: Eta thik mone hocche
[11/19, 12:08] PA: Mama bari ayshechi to tai khaya ta thik moto hoche na
[11/27, 08:07] PPM 1: Hourly activities?
[11/27, 08:07] PPM 1: Fasting and PpBs weekly
Ten BP readings on each Sunday of the week?
[11/27, 11:18] PA: Breakfast roti sobji
[11/27, 11:18] PA: Lunch vat dal dal er bora roaha
[11/27, 11:18] PA: Dinner vat dal badhakofi ghonto
[11/27, 11:19] PA: Phn nasto hoyechilo sir
[11/27, 11:19] PA: Jol a pore gechilo
[11/27, 11:19] PA: Sir 4 din por dichi biye barite aschi
[11/29, 08:57] PA: Sir dat a betha sombar kichu khete parini chaatu kheye chilam
[11/29, 09:00] PA: Kalk lunch a sobji dal diye sedho vat kheyechi pepe sedho, potol sedho, kuyash sedho, phulkofi vaja
[11/29, 09:00] PA: Breakfast a milk kheyechi
[11/29, 09:09] PA: Dinner a daliya kheyechi begun vaja ,dal er bora, phulkofi vaja, papor
[11/29, 16:59] PPM 1: 👍
[11/30, 00:23] PA: Breakfast vat dal sabji dim vaja
[11/30, 00:24] PA: Lunch vat dal bora chochori dim er curry
[11/30, 00:24] PA: Dinner polao mutton papor
[11/30, 21:50] PA: Breakfast vat r sag
[11/30, 21:51] PA: Lunch vat, dal, badhakofi ghonto, chhana rosha, alu vaja
[11/30, 21:52] PA: Dinner daliya khichuri, badhakofi ghonto, chhana rosha
[12/2, 15:19] PA: Breakfast chhatu kola
[12/2, 15:19] PA: Lunch vat fulkofi vaja mach vaja
[12/2, 15:21] PA: Dinner a Maggi gajor capsicum beans diye
[12/2, 15:22] PA: Breakfast vat dal sedho pepe sedho gajol sedho potol sedho
[12/2, 15:22] PA: Breakfast er por fruits kheyechi
[12/2, 15:24] PA: Breakfast er age lal cha r almond kheyechi
[12/2, 15:24] PA: Lunch vat badhakofi ghonto soyabin er rosha
[12/2, 20:29] PPM 1: Dinner a Maggi mane moida!
[12/2, 20:29] PA: Ha sir jani khaya thik na
[12/2, 20:29] PA: Kintu khub khete eche korchilo
[12/3, 15:24] PA: Dinner badhakofi ghonto soyabin er rosha parota chhana salad
[12/3, 15:24] PA: Breakfast a chaa r almond
[12/3, 15:25] PA: Chanar parota lunch a
[12/3, 15:25] PA: Ajk exm chilo tai sokale kichu khaya hoyni r
[12/3, 18:33] PPM 1: Oshudh
Ki Ki newa hocche ekbar share korun
[12/4, 09:30] PA: Eita sokal a khaya hoyni
[12/4, 09:30] PA: Eitao khaya hoyni kal
[12/4, 09:31] PA: Ata niye giyechilam songe parota kheye kheyechi
[12/4, 09:31] PA: Dinner parota pepe ghonto dim er curry
[12/4, 20:40] PPM 1: Eta kokhon khawa hoi?
[12/4, 20:48] PA: Breakfast er age
[12/4, 20:51] PPM 1: 👆Are eta?
[12/4, 20:52] PA: Atao
[12/4, 20:58] PPM 1: Dutoi sokale ekbar?
Eduto sokale khawar du ghonta bade sugar test ta last kabe kora hoyechilo?
[12/4, 21:34] PA: Haa tai to bolechilen
[12/4, 21:34] PA: Ajk korechi
[12/4, 21:34] PA: Dichi
[12/4, 21:36] PA: Breakfast a chatu kheyechi
[12/4, 21:36] PA: Breakfast er por kora hoyni
[12/4, 21:36] PA: Xm chilo
[12/4, 21:36] PA: Lunch khichuri sobji diye begun vaja
[12/4, 21:38] PA: Lunch er por
[12/4, 21:41] PPM 1: Lunch aer du ghonta bade?
[12/4, 21:41] PPM 1: Ota KalKe Kore janano jabe?
[12/5, 00:10] PA: Haa
[12/5, 00:16] PA: Dinner vat, dal, badhakofi ghonto, begun vaja, fulkopi gajor vaja, dim sedho
[12/6, 17:05] PA: Breakfast chhatu milk almond kola
[12/6, 17:07] PA: Lunch polao chicken curry
[12/6, 17:08] PA: Dinner ruti sobji
[12/6, 17:09] PA: Breakfast milk
[12/6, 17:10] PA: Lunch vat dal sag sukta chachori salad
[12/6, 22:03] PPM 1: 👍
[12/8, 15:18] PA: Dinner dhosa
[12/8, 15:18] PA: Lunch vat dal badhakofi ghonto paneer rosha
[12/9, 07:55] PPM 1: 👍
[12/9, 13:50] PA: Dinner vat dal badhakofi ghonto dim er curry
[9:39 am, 22/09/2025] PPM 1: The patient's advocate has touched base after more than a year for another potential visit to our hospital in December this year.
In the last one year we have no updates of how her blood sugars and overall health has been including the patient's family members who visited us.
@PPM10 you can see how mid last year we had so many more volunteers due to power equations so much so that there are many case report links and two PaJR groups for just this single patient!
@PPM2 @PPM9 in terms of PaJR workflow there are many who value face to face synchronous interactions and as in this particular scenario, end up encountering us just once a year.
This part of the user driven and user dependent nature of PaJR needs a standardization strategy that can provide a baseline continuity and persistent clinical encounter to all PaJR patients regardless of their own drive to communicate their own data
[10:31 am, 22/09/2025] PPM 9: The only way to have continuous data in such a scenario would be wearables with sensors (and data upload to cloud, where it can be accessed by the healthcare provider).
[10:32 am, 22/09/2025] PPM 9: But unless the patient is using a CGM, blood glucose tracking won't be possible
[10:39 am, 22/09/2025] PPM 1: Orwellian wearables that can also unobtrusively track diet plates and daily activities using ambient AI?
[10:45 am, 22/09/2025] PPM 9: Yes. Ambient AI is a feasible solution but I doubt hardly anyone will agree to a 1984 level of intrusiveness😃 (though I agree our smart devices might already be doing that, without our explicit knowledge and consent)
[9:54 am, 08/12/2025] PPM 1: Will be reviewing this patient's annual OPD evaluation now
[10:12 am, 08/12/2025] PPM 1: Last seen in OPD in 2023 May and the PaJR was updated till 2024 may
Reviewing the patient now
[10:13 am, 08/12/2025] PPM 1: @CR can have a mirror case report whenever you are free as the PaJR updates from May 2023 to 2024 are lost as no one archived them
[10.36 am, 08/12/2025] PPM 1: Diabetes since March 2022:
We changed her diabetes medications in 2023 to glimiperide 1.5 mg mornings and 0.5 mg at night and metformin 1g twice daily.
She has stopped the glimiperide since 6 months. Not on regular sugar monitoring and just recalls a fasting value 3 months back which was 110.
[10.43 am, 08/12/2025] PPM 1: 👆on 100 mg of ferrous fumarate since last two years started by us here. I'm assuming we may have diagnosed iron deficiency anemia due to blood loss other than her HbE as she recalls her Hemoglobin was around 3-6 at that time!
Recently 6 months back after her marriage last year she had an episode of menorrhagia for 20 days @PPM11 that was unexplained.
[10.50 am, 08/12/2025] PPM 1: She also complains of this visible cracking of the planter areas along with planter pain which is more of a cramps and unrelated to the cracking. Apparently her mother had this but currently doesn't have it any longer
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