55F Dengue thrombocytopenia metabolicsyn heart failure pulmonary edema Telangana PaJR

09-10-2025 

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.

[09-10-2025 21.35] PPM 1: https://youtube.com/shorts/UdBs7tlct74?si=MbA2S_Pf5tCvHvn9

[10-10-2025 10.54] PPM 3: Was mulling over this PaJR and wondering if Acoustic Cardiography's role in the differential to consolidate the issues related to timely response and its long term management. The debate would be an interesting format for easy listening?

A discussion on the utility of AC in this PaJr case.m4a

21M Fever, Thrombocytopenia Telangana PaJR.

 

18-08-2025

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.

[18-08-2025 11:53] PPM 3: 21/M

1. COMPLAINTS AND DURATION

C/o fever since 7 days

Vomiting since 3 days

Cough since 2 days

2. HISTORY OF PRESENT ILLNESS

Patient was apparently normal 7 days back then he developed fever; insidious in onset, high grade, associated with chills & rigors.

H/o diurnal variation (↑ at night). Vomiting – 8–9 episodes/day, non-bilious, non-blood stained, containing food particles.

Cough – non-productive, h/o diurnal variation (↑ at night).

No h/o hemoptysis. No h/o hemetemesis 

3. HISTORY OF PAST ILLNESS

No h/o DM, HTN, CVA, CAD, TB, Epilepsy, Thyroid illness

[18-08-2025 11:57] PPM 3: After test dose of injection monocef was given, he developed a swelling right forearm, and a swelling at left arm (after pricking for sample)

On 14/8/25 he developed petechiae over the chest

On 15/8/25 

SDP transfusion was done.

72F Recent Fever Thrombocytopenia alt sens hypoxia ventilator Telangana PaJR

 

24-07-2025

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 ISCUSS 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.

[24-07-2025 16:18] PPM 1: @PPM3 share her serial ABGs

[24-07-2025 16:33] PPM 1: [23/07, 17:22]cm: Looks like she could be having a pulmonary embolism!

A CT angiography now may help

[23/07, 17:28] Anonymous Pm: Why Pulmonary embolism?

[23/07, 17:29] Anonymous Pm: Why did her gcs deteriorate?

[23/07, 17:30] Anonymous Pm: I mean what in the 2d echo indicated that

[23/07, 17:30] Anonymous Pm: Dilated Pulmonary artery?

[23/07, 20:51]cm: RV appears more dilated than the first echocardiography

[23/07, 20:52]cm: Yes please update minute by minute on how it deteriorated

[23/07, 22:47] Anonymous Pm: Ok sir

[24/07, 08:40]cm: Was looking forward to it

[24/07, 08:43] Anonymous Pm: I'm sorry for the delay

[24/07, 08:44] Anonymous Pm: Basically when she came to op her higher mental functions were intact and gcs was 15/15

[24/07, 08:45] Anonymous Pm: Then yesterday morning around 4 am she developed headache

[24/07, 08:45] Anonymous Pm: At 6:30 am when we checked

[24/07, 08:45] Anonymous Pm: She was unable to name her attenders

[24/07, 08:45] Anonymous Pm: And was repeating things

[24/07, 08:45] Anonymous Pm: Then at 2 pm her gcs was around 12

[24/07, 08:45] Anonymous Pm: She also developed severe sob

[24/07, 08:49]cm: From the entire event looks like she had an ischemic stroke, also affecting her cortico diaphragmatic pathways, as noted by us in bedside ultrasound but unfortunately not captured on video.

Subsequently was the shortness of breath due to diaphragmatic palsy alone, it's difficult to say and is unlikely but it's more likely she developed a pulmonary embolism!

So essentially this disease made her develop thrombi at multiple arterial and venous locations.

A detailed history of when was she absolutely alright, and what were the events that led to her admission needs clarification.

[24-07-2025 16.28] PPM 1: https://youtu.be/qTgl1uOEaWY?si=bT2L8gDdO6cavTgf

https://youtube.com/shorts/R5CUPNA8PlI?si=KQ_knLYXwId5Eupo

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.