This is a HIPAA de-identified open-online-patient-record, posted on autumn 2015 after collecting informed patient consent (form downloadable here ) by LNMCH research assistant and patient-information-communication-executive Dr Jyoti
Patient history:
a 45 yr old woman complaining of difficulty in walking n stair climbing due to B\L knee pain.
pt also complaining pain in left side of whole body n heaviness of lt side of head.
On examination :- during palpation muscular pain at left scapular muscle difficulty in long standing n radiating pain numbness n tingling sensation from back
Investigations:
Hospital duty doctor notes:
45 yrs/FM
K/C/O-DM2 with Lumber Radiculopathy
Present History- pain in Rt.upper and lower limb FBS-141Mg/dl PPBS- 393mg/dl
Adv-
Physiotherapy; Moist heat+exercise Pt is stable
Rx
Tab Daonil5mg1..0..1/2
Tab metfarmin 500mg BD
Tab tryptomer 25 mg HS
Tab PCM 500 mg QID
Tab Ultracet QID
.
Patient history:
a 45 yr old woman complaining of difficulty in walking n stair climbing due to B\L knee pain.
pt also complaining pain in left side of whole body n heaviness of lt side of head.
On examination :- during palpation muscular pain at left scapular muscle difficulty in long standing n radiating pain numbness n tingling sensation from back
Investigations:
Hospital duty doctor notes:
45 yrs/FM
K/C/O-DM2 with Lumber Radiculopathy
Present History- pain in Rt.upper and lower limb FBS-141Mg/dl PPBS- 393mg/dl
Adv-
Physiotherapy; Moist heat+exercise Pt is stable
Rx
Tab Daonil5mg1..0..1/2
Tab metfarmin 500mg BD
Tab tryptomer 25 mg HS
Tab PCM 500 mg QID
Tab Ultracet QID
.
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