33F Rheumatoid Arthritis 3 years Telangana PaJR

 

17-06-2025

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.

[17-06-2025 19:02] PPM 1: @PPM3 do you remember her history?

[17-06-2025 19:03] PPM 3: Yes sir, I’ll share in a bit

None of the juniors have reached out to me yet, once they do, I’ll add them to this group too sir.

22F Lupus Nephritis, Past Azt Pancreatitis, Pyopneumothorax, Meningitis Telangana PaJR

 

Thursday, August 15, 2024

20F Lupus clinical complexity EHR deidentified horcrux links to all three admissions and follow up

 Summary: 

This patient was first presented to Prof Michele Meltzer  in Jan 25, 2022 (link: https://youtu.be/X5NBa_0VVUw?feature=shared) in this CPD linked here: https://medicinedepartment.blogspot.com/2022/12/?m=1 and she first presented to the presenters in September 2022 which is recorded in the link below but to summarise it drastically, she had nephrotic glomerular proteinuria, cutaneous vasculitic lesions, CNS vasculitic lessons (investigated for altered cognition) and endocardial and pericardial inflammation (acute heart failure with pericardial effusion)that was attributed to lupus in view of a strong ANA positivity particularly of the ds-dna fraction in ELISA. https://medicinedepartment.blogspot.com/2024/08/first-admission-september-2022-20f-with.html?m=1

Second admission: She again got admitted in December 2022 with headache, altered sensorium and meningeal signs, which was associated with a minor CNS bleed on MRI was later attributed to warfarin (link:

https://drsaicharankulkarni.blogspot.com/2022/12/20f-sle.html?m=1

Her discharge after September 2022 was relatively uneventful on immunosuppressives and while her cardiac and CNS issues were the first to resolve even during admission, her proteinuria also subsided and she gradually withdrew all immunosuppressives in a year with a brief period of iatrogenic Cushing in between. Recently in June 2024, she presented with an ankle flare along with anasarca that also revealed a nephrotic relapse on evaluation of 24 hour urine protein as archived in her PaJR conversations here:https://drsaicharankulkarni.blogspot.com/2022/12/20f-sle.html?m=1

Her 3rd admission recently in July 2024 was for a right hypochondrial pleuritic pain that ultimately revealed a large hydropneumothorax along with multiple lung abscesses. Again this was possibly an iatrogenic result of the high dose immunosuppressives for just a month! There's still a persistent diagnostic uncertainty around the etiology of her lung abscesses and hydropneumothorax as her dry cough persists and her last antibiotics choice was quinolone!https://drsaicharankulkarni.blogspot.com/2022/12/20f-sle.html?m=1

27F SLE Vomitings since 1 month pain abdomen since 10 days Telangana PaJR

 

09-06-2025

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.

DESCRIPTION:

27 year old female k/c/o SLE since 3 yrs came to the casualty with c/o vomitings since 1 month

C/O Pain Abdomen since 10 days.

Vomitings for 1 month, immediately after intake of food (for both solids and liquids) associated with nausea, pain abdomen, diffuse, sudden onset, spasmodic type, non radiating, aggravated on food intake.

H/O Fever on and off 1 month back with discoid type of skin lesions.

H/O skin lesions over ear and face 2 yrs ago with alopecia, and diagnosed as SLE based on positive anti ds DNA antibodies and ANA and patient was treated with steroids and methotrexate, HCQ since then.

8F Suspected Inflammatory Bowel Disease WB PaJR

 

08-06-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUS 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 COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.

[08-06-2025 06:48] PPM 1: গত পরশুদিন আমার আট বছরের মেয়ের পায়খানা এরকম হয়,, এখন ওর কোনো শারীরিক সমস্যা নেই,, কিন্তু কেনো এরকম হলো সেটা নিয়ে চিন্তায় আছি । ওর বয়স যখন 3/4 বছর ছিল তখন রক্ত আমাশয় প্রায় বছর খানেক ভুগেছিল,তারপর প্রায় 7 বছর পর্যন্ত কোনো সমস্যা ছিল না । এক বছর আগে আবার আগের মত রক্ত আমাশয় হয়েছিল শুধু একদিন,, তারপর একবছর পর গত পরশুদিন এরকম পায়খানা করে । এরকম অবস্থায় কি করবো বুঝতে পারছি না ।

[08-06-2025 06:48] PPM 1: স্যার একটু দেখবেন

[08-06-2025 06:48] PPM 1: Ore jonye ekta PaJR group create kore okhane janacchi.

PaJR group create korar jonye ekhane bangla consent form ta pore apnar signature, full address, patient er age gender, aajker date, ebong diagnosis 'suspected inflammatory bowel disease' eta form tai likhe, abar chobi tule share korte parle bhalo hoto

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:

26F With Acute Poly-enthesitis due to Chikungunya Telangana PaJR

 

23-05-2025 

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 PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.

[24-05-2025 16:13] PPM 1: @CR can we find out from her how is she now?

[24-05-2025 16:20] CR: Patient still having pains and is not well.

[24-05-2025 16:26] PPM 1: Did she take the Ultracet 1/2 tablet every 6 hours and P650 every 6 hours yesterday?

Can she share the picture of what medicines she is taking?

[24-05-2025 16:30] CR: According to PA, she is taking both the tabs. He will share the med pics asap.

[24-05-2025 16:37] PPM 1: 6 hourly?

[24-05-2025 16:37] CR: Yes, according to him.

[24-05-2025 16:46] PPM 1: If they take it regularly it should start reducing by third day and if not then we can add more drugs.