74F Altered Sensorium Uremic Encephalopathy Telangana PaJR

 

16-06-2025 

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.

[16-06-2025 17.36] PPM 1: @PPM3 can you share her brief history and a lateral view of her arms and abdomen?

NOTES 👆

[17-06-2025 15.40] PPM 1: @PPM3 why is she hypoxic? Please share her chest X-ray.

[17-06-2025 19.01] PPM 1: Sarcopenia and abdominal obesity

40M Son has the same and developed DM 2 since he was 25!

Talk about epigenetic transformations promoting onset of metabolic syn and DM2 earlier in each generation! @PPM4 @PPM2

[17-06-2025 22.06] PPM 2: "Diets of the same feather, flock together!"

PPM 1: 👍

[17-06-2025 23.41] PPM 4: ## Epigenetic Acceleration of Metabolic Dysfunction: The Generational Decline toward Early-Onset Sarcopenic Obesity and Type 2 Diabetes

The *alarming trend* of earlier-onset metabolic syndrome (MetS), type 2 diabetes (T2DM), and sarcopenic obesity (SO) across generations—exemplified by your 40M son developing T2DM at 25—reflects a complex interplay of *environmental triggers* and *epigenetic reprogramming*. Here's how epigenetic mechanisms drive this generational decline and potential therapeutic strategies to break the cycle.

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80F PUO Stroke Altered Sensorium Telangana PaJR

 

13-06-2025 

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.

[13-06-2025 20.02] PPM 1: Yesterday's clinical meeting discussion inspired us to share one of our similar patients to be archived by CR.

[13-06-2025 20.07] PPM 1: While discussing in the meeting we realised we have a similar patient who's clinical complexity of stroke, coma and fever had compelled us to start her on all available interventions such as antibacterials as well as antimalarials for suspected cerebral malaria as delineated in this time line since admission.

70F Altered Sensorium Uremic Encephalopathy Telangana PaJR

 

05-06-2025

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.

[05-06-2025 16:15] PPM 1: @PPM @PPM4 @PPM5 please update her current status

[05-06-2025 16:20] PPM 1: Is she currently in ICU bed 6?

[05-06-2025 16:26] PPM 1: It's not 75F but a 70F who was in ICU bed 6 yesterday 👇

Age/Gender: 70 Years/Female

Admission Date: 28/05/2025 04:57 PM 

Name of Treating Faculty: (PGY3) (PGY1)

Diagnosis

?POST BAL HYPERSENSITIVITY REACTION

ENDOBRONCHIAL INFECTION ?VIRAL TB

ACUTE ON CHRONIC KIDNEY DISEASE

MCHC ANEMIA SECONDARY TO CHRONIC DISEASE, IDA

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:

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.

32M With Wernicke's Encephalitis Telangana PaJR

 26-05-2025

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.

[26-05-2025 16:40] PPM 1: @PPM4 please add the patient's history here

[26-05-2025 16:42] PPM 4: 1. COMPLAINTS AND DURATION

32 year male resident of Pochampally. Bike mechanic by occupation. 

Chief complaints: 6 days ago continuous general weakness.

Insidious onset, progressive weakness,

 Hematuria 2 episodes - yest night gradually progressive loss of appetite.

 No C/o Fever, cough, cold, loose stools, Nausea, vomiting, Burning micturition

 No C/o Chest pain, SOB, orthopnea, palpitations

 No C/o Visual or Auditory hallucinations

 No C/o Trauma

20M UNCONTROLLED DM1 Telangana PaJR

 

13-05-2025

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.

18M WITH POST COVID FULMINANAT HEPATIC FAILURE.

62F Chronic Anasarca, Heart Failure, Post Cholecystectomy since 1 year Telangana PaJR

 

01-05-2025

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.

EMR SUMMARY

MARCH 2025

Age/Gender: 65 Years/Female

Address:

Discharge Type: Relieved

Admission Date: 03/03/2025 12:11 PM

Diagnosis

DECOMPENSATED CHRONIC LIVER DISEASE SECONDARY TO ? NAFLD WITH OESOPHAGEAL VARICES WITH PHGD

GRADE I - II HEPATIC ENCEPHALOPATHY

S/P LAP CHOLECYSTECTOMY 1.5 YEARS AGO K/C/O TYPE II DIABETES MELLITUS SINCE 10YEARS K/C/O HYPOTHYROIDISM SINCE 30YEARS

33M Alcoholic Chronic Cryptococcus Meningitis

 

29-04-2025

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.

Afternoon session: 33M with fever and headache for three months

Yesterday admitted in delirium

On examination: Meningeal signs not very definitive 

Past alcoholic but stopped due to illness for the last few months

CSF showed these attached organisms along with protein of 105 mg/dl and sugar 45 mg/dl and 20 cells

[29-04-2025 15.38] PPM 1: @PPM2 @PPM3 Last time remember we couldn't procure Amphotericin B and had to refer the patient and we don't have any clue as to what is happening to all these patients for who are unable to procure amphotericin B! @PPM4 @PPM5 @PPM6 do you see such patients in your Telangana practice? How do you procure amphotericin for them?

13F ADEM Cerebellar Ataxia

 

23-04-2025

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.

50F Chronic Alcoholism Wernicke's Acute CVA Telangana PaJR

 

14-04-2025

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.

50F with coma and left sided conjugate eye deviation and as described by @~PPM 3 hypoactive delirium but what is hypoactive delirium? She had recently increased her alcohol consumption from a quarter bottle to one bottle of OC per day!