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.

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.

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

De-Identifying patient data

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528047/figure/fig1/

UDHC Citizen Science

This is a citizen science approach in medical science to engage school (and college) students to learn clinical problem solving.

A Doctor (clinician) takes history from patient and then try to find out clues as symptops and events in life of a person and take help of medical reports to come to a diagnosis and help to cure it. Same way our citizen scientist will work with these steps.

1) A Signed Informed Consent Form - this is a form to ask permission from patient/patient family to collect their health information/data and share it in UDHC Netrowk.

2) Taking History - A history of a patient don't need to be always a list of medical jargon, any student can talk to a patient and collect information about their story, like what happened, when happened, what treatment started etc... simply need is to create story of patient's journey with any disease in a text format and one more important thing is add if patient have any specific question/need. ( do not hesitate about adding anything that patient tells you, best way is to add all information they say.)

3) Taking Medical Records - Simply take pics of all important medical records ( or all if you don't understand what important and what not ) and De-Identify them. De-Identify means hide all information that gives, patient's identity as given here. How to De-Identify is given here).

4) Update all information in a Blog and share in UDHC network so that all can engage and try to solve patient problems/questions.


Consent forms:-
Signed informed consent from the patients have been taken using the consent forms. 

for training/implementation of this contact me at - avi33tbtt@gmail.com or +917318510434 (whatsapp)

7 Life stages

Medical Cases at Various Life Stages

1 - Fetal stage - Hydrocephalus in a 7-month-old fetus and currently a healthy new born baby  http://bmjcaselogvivek.blogspot.com/2017/10/hydrocephalus-in-7-month-old-fetus-and.html

2 - Neonate - A 49 days old infant baby with persistent Jaundice since 3 weeks http://bmjcaselogvivek.blogspot.com/2017/10/a-49-day-old-neonate-baby-girl-with.html

3 - Child - An 18 Year Old Girl with Recurrent Fever http://bmjcaselogvivek.blogspot.com/2017/10/an-18-year-old-girl-with-recurrent-fever.html
Continued back pain of my daughter aged six and half years Past three months http://care.udhc.co.in/INPUT/displayIssueGraphically.jsp?topic_id=331

4 - Adult - Pregnancy that changed her life http://sivapuramsai.blogspot.in/2017/05/pregnancy-that-changed-her-life.html?m=1

5 - Middle age - Suspected diaphragm palsy http://www.udhc.co.in/INPUT/displayIssueGraphically.jsp?topic_id=1313

6 - Old age - Dolls eye movement http://sivapuramsai.blogspot.com/2017/05/copd-with-infarct-dvt-pneumo-thorax.html

7 - Death - 60F with Coma, E Coli sepsis and upper motor neuron signs with albumino cytological dissociation in CSF. http://classworkdecjan.blogspot.in/2016/12/60f-with-coma-e-coli-sepsis-and-upper.html?m=1


1) Empathy (Text Prose Poetry)
2) Sketches. Paintings
3) Sculptures, sand/clay/stone art
4) Music
5) Video
6) Drama
7) Innovation

Consent Forms for BMJ Elective Students

- consent form Online Forum English - here
- consent form BMJ  English - here

- consent form BMJ Telegu - here
- consent form Online Forum Telegu - here

- consent form Online Forum Hindi - here
- consent form BMJ Hindi - here

- consent form Online Forum Bengali - here
- consent form BMJ Bengali - here