Evidence Based Date Wise Workflow Logs

 Evidence Based Date Wise Workflow Logs 




Blog 1 


https://manvisharma88.blogspot.com/2023/11/43-yo-woman-with-co-headache-since-2-yrs.html


PaJR 1 

https://chat.whatsapp.com/GvgE5OVaODP0vp6pIn2CP7

[06/11/23, 4:44:18 PM] Rakesh Biswas Sir: Thanks


[06/11/23, 4:45:40 PM] Rakesh Biswas Sir: Please share what we've been able to work up till now. 


Also the ophthalmology notes for her other relative who's admitted in ward?


[06/11/23, 5:59:25 PM] Manvi Sharma: Okay sir


[07/11/23, 8:33:01 AM] Rakesh Biswas Sir: Stop Ultracet bid 


Bring her to the opd today with her relative and his mri films


[10/11/23, 12:43:58 PM] Manvi Sharma: Ophthal referral - 

Impression - no papilledema changes 

Adviced to wear same spectacles


[10/11/23, 12:47:46 PM] Manvi Sharma: Plbs - 162mg/dl 

Hba1c - 6.8%


[10/11/23, 3:32:05 PM] Rakesh Biswas Sir: Share the post meals after every meal 


What's the Fbs?


[11/11/23, 8:06:16 AM] Deb Eshwari Pt: Sri kalke komor betha matha gorano kam chilo akje ratter par theke abar suru hayeche same problem sara rat ghumate pareni Gala mukh sukiye jache komore betha hache matha ghurche chalar mato sharire shokti nei


[11/11/23, 1:34:47 PM] Manvi Sharma: The fast blood sugar as of today is 111mg/dl sir


[11/11/23, 1:51:03 PM] Deb Eshwari Pt: Matha ghurano+kamor bethata ager tulonay berache sir mukhta fulafula lagtece sir


[11/11/23, 3:32:28 PM] Rakesh Biswas Sir: 👆This is the thesis. 


In one report of PpBs among many there's this one value of 200


[11/11/23, 3:49:22 PM] Manvi Sharma: Yes sir


[11/11/23, 4:36:16 PM] Deb Eshwari Pt: Sri tomorrow could not sleep all night due to dizziness what tablet should I take for dizziness.


[11/11/23, 4:38:47 PM] Rakesh Biswas Sir: Tablet Avomine 25 mg (promethazine theoclate) every 8 hours 


@919491418555 @918897908888 Please prescribe asap 


Share the Psy notes here


[13/11/23, 10:29:22 AM] Deb Eshwari Pt: Good morning sir I wake up at 7 Am have breakfast at 8Am my body is very weak  normal selain would be good for me I have not strenght not work sri


[13/11/23, 11:28:57 AM] Deb Eshwari Pt: If you have a headache at home ,if your body is weak the doctor would give your saline


[13/11/23, 1:59:43 PM] Rakesh Biswas Sir: Yes but it may not be a good idea to get such invasive painful placebo therapy


[14/11/23, 8:34:45 AM] Deb Eshwari Pt: morning sir gastro sir akber dakhay din amar gaser samashya tai balchilam


[14/11/23, 8:40:11 AM] Rakesh Biswas Sir: Thik ache 


@919491418555 @916302793602 @917799011162 Please show her to the Gastro today asap


[14/11/23, 8:47:44 AM] Manvi Sharma: Okay sir


[15/11/23, 8:21:38 AM] Rakesh Biswas Sir: Share the Gastro notes asap


[15/11/23, 8:41:08 AM] Manvi Sharma: Yes sir


[15/11/23, 8:43:06 AM] Manvi Sharma: They adviced for cbp, tft, usg abdomen and stool for occult blood


[15/11/23, 8:45:23 AM] Rakesh Biswas Sir: Do the ultrasound yourself and check for grades of fatty liver and share what you learn


[15/11/23, 8:50:26 AM] Manvi Sharma: Okay sir


[16/11/23, 9:53:01 AM] Manvi Sharma: Sir actually she has not reached menopause. According to her - 

Lmp is 28th oct 

Cycles are regular - 30/3 with normal flow


[16/11/23, 9:57:20 AM] Manvi Sharma: Sir could we probably get a neurologist opinion for her today?


[16/11/23, 10:03:43 AM] Rakesh Biswas Sir: For headache?


[16/11/23, 10:04:01 AM] Rakesh Biswas Sir: If she wants it


[16/11/23, 10:04:10 AM] Rakesh Biswas Sir: Perimenopausal

[16/11/23, 10:04:40 AM] Rakesh Biswas Sir: How is it defined?

[16/11/23, 10:35:46 AM] Manvi Sharma: Yes sir

[16/11/23, 10:36:01 AM] Manvi Sharma: Yeah sir she wants to

[16/11/23, 10:39:46 AM] Manvi Sharma: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834516/

The perimenopause is an ill-defined time period that surrounds the final years of a woman's reproductive life. It begins with the first onset of menstrual irregularity and ends after 1 year of amenorrhea has occurred, thereby defining the final menstrual period (FMP). There are two stages to the perimenopause or menopausal transition: the early transition, where cycles are mostly regular, with relatively few interruptions, and the late transition, where amenorrhea becomes more prolonged and lasts for at least 60 days, up to the FMP.

[16/11/23, 12:05:44 PM] Manvi Sharma: ? Vestibular migraine

[16/11/23, 12:47:51 PM] Rakesh Biswas Sir: Good. It's ill defined

[16/11/23, 12:48:23 PM] Rakesh Biswas Sir: Review the literature and share the criteria and check how many she fits into

[16/11/23, 1:41:12 PM] Manvi Sharma: Ok sir

[19/11/23, 5:19:32 PM] Deb Eshwari Pt: Sir  kalkar tikit hayeche sir sakal sakal chutita kariye diyen sir

[20/11/23, 11:11:03 AM] Deb Eshwari Pt: Good morning sir today I have at train at 3pm from nalgonda to dircharg it is better if it is little early.


Blog 2 


PaJR 2 


[24/11/23, 9:52:21 AM] Rakesh Biswas Sir: Is this her first admission? 

When admitted? 

Yesterday?

[24/11/23, 9:58:50 AM] Nithin Sir Gm: No sir its her second visit 
She got admitted for the same reason one yr before 

Now she was admitted on 20/11

[24/11/23, 10:00:26 AM] Rakesh Biswas Sir: @919491489659 @919573286207 @916302793602 @917799011162 Find out who was the intern who had documented her data online one year back and share those links asap here

[24/11/23, 10:00:41 AM] Manvi Sharma: Okay sir will find out

[24/11/23, 1:42:19 PM] Kranthi Sir: Okay sir

[25/11/23, 1:15:22 PM] Rakesh Biswas Sir: Update?

[25/11/23, 2:03:15 PM] Manvi Sharma: Yes sir she was previously admitted in March and again in June this year

[25/11/23, 2:03:51 PM] Manvi Sharma: I couldn’t trace her case report link sir

[25/11/23, 2:11:52 PM] Manvi Sharma: She was under Shashikala ma’am’s care sir , I’ll find out and soon update regarding the links sir

[25/11/23, 2:12:13 PM] Manvi Sharma: As of now she has been discharged sir with insulin medication


Blog 3 


PaJR 3 


[25/11/23, 1:14:06 PM] Rakesh Biswas Sir: Update?

[25/11/23, 7:00:29 PM] Manvi Sharma: 25/11/23 
Patient shifted to ward 
S - not passing stools 

O - Pt is c/c/c 
Vitals 
BP - 110/70 mm hg 
PR - 79bpm 
Temp - 97.5 F 
GRBS - 96mg/dl 
I/o - 1600/850 ml
Systemic Examination - 
CVS - S1,S2 + , no murmurs 
RESP SYS - BAE+, NVBS heard 
CNS - NFND 
P/A - soft, non tender

A- severe iron deficiency anemia 
Heart failure (57%) 
CAD - s/p PTCA 2yrs ago 
Acute gastroenteritis (resolved) 
3 PRBC transfusions done 
Sliding hiatus hernia , GERD 

P - 
INJ CEFTRIAXONE 1g IV BD 
INJ PAN 40 mg IV TID 
INJ EMSET 8mg IV TID 
IV fluid NS & RL @ 100ml/hr 
Tab ROSUVASTATIN 20mg HS (9pm)
Tab ECOSPRIN 75 mg OD (8am)
Tab CLOPIDOGREL 75 mg OD (2pm) 
Tab PROLOMET 25mg PO OD (8am)
Tab BISACODYL 5mg PO HS  
INJ Iron sucrose 200mg in 100ml NS IV OD 
Syp GUT CLEAR 30 ml OD HS 
Procto clyisis enema stat 
Strict I/o charting

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