Wednesday 27 December 2017

diabetes and a refractory skin ulcerations

This is a HIPAA de-identified open-online-patient-record with initial information in patient's voice, posted here december 2016 after collecting informed patient consent (form downloadable here) by BMJ Elective Student.

Tuesday 26 December 2017

Diabetic's Data Visualization & Queries -1


This is a HIPAA de-identified open-online-patient-record with initial information in patient's voice, posted here december 2016 after collecting informed patient consent (form downloadable here) by BMJ Elective Student.

History :- https://bmjcaselogvivek.blogspot.in/2017/11/23-years-old-women-with-diabetes-and.html?m=1




Questions:-

+91 91406 54820:-  3 straight lines = 90 , 100 & 130 for reference to Normal FBS and normal PPBS
+91 91406 54820: moving trend lines to show average update of blood glucose level.
+91 91406 54820: lowest - 51 near fatal?
 +91 91406 54820: taking proper insulin + medicine and diet control but blood sugar level (graphs) rarely in normal range
+91 91406 54820: aren't medicine/insulin+drugs intervention expected to keep blood glucose levels withing normal range?
 +91 91406 54820: are they failing here?
 +91 91406 54820: 5, 7, 15, 23, 30 a patter shown that around gap of 1 week her ppbs2 going very high. is she taking sweets / high sugar after avoiding/controling few days. ( sweets are addictive )
+91 91406 54820: FBS , PPBS, PPBS2 are so much out of normal range but PPBS1 is so close always. any insights about this?



Questions:-
+91 91406 54820: same data from JAN 2016.
+91 91406 54820: is it a better visualization (clinical significance) of varying blood glucose levels?
+91 91406 54820: showing better way, how far patient is from normal and for how much duration in a month.
+91 91406 54820: need to find an algorithm or design a custom one to do some mathematics on this. will update about that in someday late.

Tuesday 5 December 2017

Need Advice on Blood Reports


42/F, married, 12.5 yr T2D (gestational), hypothyroidism (Hashimoto), Lichen Planus in the mouth and steadily extending below the neck region, history of Bell's palsy that reversed, multiple off n on events of hypotension and hypoglycemias ..  
HbA1c remains 8.5 on average ....
Hb remains 10 on average ...microcytic hypochromic anaemia on PBS
Also has multiple degenerative lumbar discs and cervical spondylosis 


Completed Tests/Profiles :
1. ALKALINE PHOSPHATASE, SERUM
2. CALCIUM ; SERUM
3. CREATININE; SERUM
4. GLUCOSE FASTING :PLASMA
5. GLUCOSE PP : PLASMA
6. Lipid Profile;BASIC; SERUM
7. Liver Function Test (LFT)Serum
8. PHOSPHOROUS;SERUM
9. UREA BLOOD
10. URIC ACID ; SERUM
11. CBC ( COMPLETE BLOOD COUNTS), BLOOD
12. ERYTHROCYTE SED. RATE (WG) BLOOD
13. GLYCOSYLATED HAEMOGLOBIN-HBA1C
14. PERIPHERAL SMEAR (PBF)
15. Thyroid Profile ,Total;T3,T4,TSH Ultrasensitive ;THYROID PANEL IV