PaJR integrated EHR: 60M with COPD PUO for five years

First encounter and EHR recorded here by our ET at that time in 2022: https://ssahamedicalcases.blogspot.com/2022/11/past-history-pt-is-58-yrs-old-male.html

Since then for two years there was a regular dyadic posting of messages similar to the ones below :

[4/13, 8:01 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/15, 8:24 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/15, 6:09 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/16, 8:06 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/16, 7:18 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/17, 7:59 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/17, 6:19 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

Then after two years there was a different signal in the dyadic PaJR :

[4/17, 6:23 PM] Patient Advocate 60M CAD COPD PUO: 

Aamar Fever hoyechhilo sathe khub kashi,UTI.

Sporidexcv750 oraly o iv fluid er sathe Amikacin sulphate inj diyechhilo ekhan kar dr babu.Ekhan Fever kashi Urine e jala kichhu nei bt khub Weak.

Ki medicine khete parbo weakness er janyo,

Kindly janaben

[4/17, 8:23 PM] Rakesh Biswas: Weakness ta antibiotics aer jonye 

Bondho hoyegele weakness tao kome jabe

[4/17, 8:23 PM] Patient Advocate 60M CAD COPD PUO: Antibiotic 7-8 din aage stop hoyechhe

[4/17, 8:46 PM] Rakesh Biswas: Amikacin koto din niyechilen?

[4/17, 8:54 PM] Patient Advocate 60M CAD COPD PUO: 2 ta kore 

3 din

[4/18, 8:16 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/18, 8:31 AM] Patient Advocate 60M CAD COPD PUO: Weakness er janyo moovment korteo khub asubidha hochhe

[4/18, 8:36 AM] Rakesh Biswas: Aaste aaste oshudh er bishesh kore amikacin aer side effect ta kome gele abar movement feere paben

[4/18, 6:18 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/19, 6:43 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/19, 7:35 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/20, 8:49 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/20, 6:04 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/21, 7:43 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/21, 9:45 AM] Patient Advocate 60M CAD COPD PUO: Weakness theke kichhutei berote parchhina sir,

Amikacin sulphate inj nebar to 15 din er besi hoye gechhe.....

[4/21, 11:31 AM] Rakesh Biswas: Goto kaal shara din ghontai ghontai Ki korechilen ebong Ki Ki kheyechilen janate parben? 

Ekhane dekhun baki ra Ki bhabe janiyechen 👇

https://userdrivenhealthcare.blogspot.com/2024/02/pajr-daily-activities-sharing-guide-in.html?m=1

[4/21, 11:37 AM] Rakesh Biswas: Ekhaneo ekta udaharon👇

http://medicinedepartment.blogspot.com/2023/12/pajr-daily-activities-energy-outputs.html?m=1

[4/21, 12:18 PM] Patient Advocate 60M CAD COPD PUO: Kal sakal 8 tay uthe toilet theke ese sakaler regular medicine "met am50/5,ecosprin av75,aciloc 300 kheye ektu pare tea pan kore bosei chhilam.

10 tar dike 2 ta attar ruti,kala, gur, dudh kheyechhila breakfast e.Tarpar natni ke sara din e dekha suna korte hay,korechhi.

2 tar pare snan kore vat dal sobji kheye ghumiye porchhilam.

5 tar samay uthe tea pan kore bycycle niye ber hoyechhilam,7 tar dike fire jal muri tea kheye bycycle niye ber hoye 80-90 minutes adda mere bari fire rsechhi bt adda marte moteo valo lageni.9:30 pm dudh ruti gur o rater medicine kheye 10:30 pm ghumiye porchhilam.Rate Urimax d,Tryptomer 10,Clonotril 0.5 khai bahu din dhore.Ekhan sakal o rate khabar par Neurobion forte khachhi 5-6 din theke

[4/21, 12:29 PM] Patient Advocate 60M CAD COPD PUO: Aj ghum theke uthe fresh hoye medicine o tea kheye bazar korte giyechhilam.

Besh kasto korei bazar korechhi.

Fire breakfast kore bosei aachhi.

[4/21, 2:09 PM] Rakesh Biswas: Bajar a kibhabe gechilen? Cycle a? korar somoi Ki koshto anubhab korechilen?

[4/21, 2:10 PM] Rakesh Biswas: Cycle niye goto Kal Ko km gechilen?

[4/21, 2:27 PM] Patient Advocate 60M CAD COPD PUO: Updn 2-2.5 km....

[4/21, 2:26 PM] Patient Advocate 60M CAD COPD PUO: 10-15 minutes er janyo bazare giyechhilam,

Mainly 

Swas kasto o Weakness hoyechhe o hochhe

[4/21, 2:26 PM] Patient Advocate 60M CAD COPD PUO: Inhaler nite parina,

Oral thrush hay

[4/21, 2:48 PM] Rakesh Biswas: Bajar koto dur?

[4/21, 2:48 PM] Patient Advocate 60M CAD COPD PUO: 500mt

[4/21, 2:49 PM] Rakesh Biswas: Eta aaste aaste henthe try kora jete pare?

[4/21, 2:49 PM] Rakesh Biswas: Apnar chest X-ray ebong ecg ta dekhte parle bhalo hoto

[4/21, 2:49 PM] Patient Advocate 60M CAD COPD PUO: X'Ray report pathachhi

[4/21, 2:50 PM] Rakesh Biswas: Chobi ta dekha dorkar

[4/21, 2:50 PM] Patient Advocate 60M CAD COPD PUO: Recent Ecg kara hayni

[4/21, 2:50 PM] Patient Advocate 60M CAD COPD PUO: X'Ray film o report pathachhi

[4/21, 2:51 PM] Rakesh Biswas: Purono?

[4/21, 3:14 PM] Rakesh Biswas: Smoking?

[4/21, 3:16 PM] Patient Advocate 60M CAD COPD PUO: Yes,

Smoker

[4/21, 3:16 PM] Rakesh Biswas: Kobe theke?  Roj kota?

[4/21, 3:17 PM] Patient Advocate 60M CAD COPD PUO: Roj 4-5 ta.

Aage besi chhilo.

[4/21, 3:29 PM] Patient Advocate 60M CAD COPD PUO: Rest korun sir,

Pare katha bolchhi....

[4/21, 4:45 PM] Rakesh Biswas: Fasting ebong khawar du ghonta baade blood sugar last kabe test korieyechen?

[4/21, 4:55 PM] Patient Advocate 60M CAD COPD PUO: Anek bar sugar koriyechhi 

Abnormal report kakhano Aseni.

Always Normal Report

[4/21, 6:31 PM] Rakesh Biswas: Ota shothik bhabe korar poddhoti holo 

Jedin korben 

Shedin khali Pete 

Ebong proti ta khawar du ghonta bade

[4/21, 6:32 PM] Patient Advocate 60M CAD COPD PUO: Ok 

Next koriye aapnake janabo.

Ekhan weakness o Swas kasto niye ki korbo ?

[4/21, 6:35 PM] Rakesh Biswas: Roj hourly activities ebong food plate share korben 

Kone ghontai apnar weakness ta anubhab hocche shetao janaben

[4/21, 6:36 PM] Patient Advocate 60M CAD COPD PUO: Thik aachhe

[4/21, 6:37 PM] Rakesh Biswas: 👆Ei ghontai ghontai biboron tai weakness ta kone somoi kotokkhon ter peye chilen?

[4/21, 6:43 PM] Patient Advocate 60M CAD COPD PUO: Sir ekhan anek kichhui mone rakhte parchhina karon Unfit sorir niye kichhui korte ichhe karena

[4/21, 8:39 PM] Rakesh Biswas: Hain kono chinta nei. Eto ta karuri mone thakar kotha noi. Aei jonyei ghontai ghontai roj text Kore janano jate mone rakhar dorkar hoi na. Ekhane whatsapp aer memory te sheta theke jai

[4/21, 9:10 PM] Patient Advocate 60M CAD COPD PUO: Aj bikale aapnar sathe kathar majhe majhei google khule medicine study korchhilam,

Swas kasto ta komle ektu valo thaktam

[4/21, 9:23 PM] Rakesh Biswas: Swas koshtor jonye Ki oshudh nicchen? 

Apnar last Echo Kabe hoyeche? 

Echo video ta Dekhte parle bhalo hoto

[4/21, 9:26 PM] Patient Advocate 60M CAD COPD PUO: Swas kaster janyo medicine nichhi na,

Inhalor nile oral thrush hay.

Heart niye vabchhi na,

Last 10th march Cardiologist dekhiyechhi 

Jodio Echo CAG karate bolchhe.....

[4/21, 9:35 PM] Rakesh Biswas: Kono oshudh nicchen na?

[4/21, 9:43 PM] Patient Advocate 60M CAD COPD PUO: Aapni to ekhano balen ni 

Ki medicine nebo.....

[4/21, 9:51 PM] Rakesh Biswas: Aer aage Ki oshudh niten? 

Ami long distance patient der somosya ta puro puri bujhe oshudh er katha janai jeta  unader local daktarer saathe alochona Kore nite hoi 

Apnar somosya ebong aager case report link dekhe bojha jacche je apnar shaansh koshto ta COPD ebong heart failure er jonye howar sombhabona beshi. Aei dhoroner patient ami roj 5-10 jone dekhi ebong amader kache unara bhortio thaken. Unader jehetu amra chokher saamne dekhi ebong nijerai Echo Kore nite pari taate ota khub sohojei bojha jai. Text Kore byapar ta onyorokom

[4/21, 9:57 PM] Patient Advocate 60M CAD COPD PUO: Er aage Budetrol  inhalor o Tiova inhalor nitam bt oral candidisis reccur korto,takhan mandatory Itraconazole nitam 5-7 din.

July 2023 theke last week porjonto 5-7 bar itraconazole 100bd o pare 200 bd niyechhi

[4/21, 9:58 PM] Patient Advocate 60M CAD COPD PUO: Next itraconazole nebo na

[4/21, 9:59 PM] Patient Advocate 60M CAD COPD PUO: Kindly aamake minimum medicine likhe swas kasto theke relief din,

Pare acording to need treatment korbo

[4/21, 10:11 PM] Rakesh Biswas: Apnar local daktarer saathe alochona Kore 

Ipravent inhaler 20mcg dine Teen bar nite paren. 

Ete oral candidiasis habe na 

Candidiasis ta shudhu budetrol er moton steroid inhaler er jonye hoi

[4/21, 10:47 PM] Patient Advocate 60M CAD COPD PUO: Tiova inhaler eo candidiasis hay aamar

[4/22, 7:08 AM] Rakesh Biswas: Newar somoi Spacer use koren?

[4/22, 8:08 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/22, 8:09 AM] Patient Advocate 60M CAD COPD PUO: Spacer mane ? 

Ota ki bujhte parlam na....

[4/22, 8:28 AM] Rakesh Biswas: https://www.amazon.in/Rockoshop-Mouthpiece-Metered-Inhaler-Asthma/dp/B07YR2DCMJ

[4/22, 8:10 AM] Patient Advocate 60M CAD COPD PUO: Ghum theke uthe fresh hoye medicine kheye tea pan korchhi

[4/22, 8:11 AM] Patient Advocate 60M CAD COPD PUO: Sorir ta moteo valo nei sir

[4/22, 8:29 AM] Rakesh Biswas: Details janan ghontai ghontai :

Shorir er kone onghso ta bhalo nei 

Ghum theke othar kotokkhon bade eta ter pacchen?

[4/22, 8:33 AM] Patient Advocate 60M CAD COPD PUO: Rat 3am ghum venge jay,

Toilet theke ese jal pan kore aabar ghumiye pori.

6 tar aagei ghum venge jay,

Thik takhan thekei sorir ta kharap lagte suru kare.Tobuo 7:30 am porjonto suyei chhilam

[4/22, 8:38 AM] Rakesh Biswas: Raate kobar pecchap korar jonye uthte hoi? 

Pecchap korar somoi kono koshto hoi?

[4/22, 8:40 AM] Patient Advocate 60M CAD COPD PUO: Rate Rear urine e jai.

Na na normal urine hay.

Urimax D na khele painfull Incomplete urine pressure diye korte hay...

[4/22, 8:42 AM] Rakesh Biswas: Prostate er jonye Urimax jatio oshudh Kabe theke khacchen?

[4/22, 8:46 AM] Patient Advocate 60M CAD COPD PUO: 2006 theke Urimax .4 diye suru hoye chhilo,

Ekhan Urimax D khete hay.

Anyo medicine valo kaz karena.

Chronic prostites er janyo aage khub pain hoto,

Ekhan seta hayna.

Recuring UTI tar kichhu din par thekei suru hoyechhe

[4/22, 10:47 AM] Patient Advocate 60M CAD COPD PUO: 2 ta ruti kala gur dudh saho breakfast korlam.stool valo clear holona.Alpo mucus na otha porjonto ektu ektu kore kashi holo.Durbal lagchei

.

[4/22, 10:50 AM] Patient Advocate 60M CAD COPD PUO: Snan karar samay besi durbal lage o khub Swas kasto hay

[4/22, 10:55 AM] Rakesh Biswas: Snan kotai?

[4/22, 11:14 AM] Patient Advocate 60M CAD COPD PUO: 1:30 theke 2:30 modhye snan kori

[4/22, 2:10 PM] Patient Advocate 60M CAD COPD PUO: Ektu baire giyechhilam,

Khub klanto lagchhe.Siri diye upore uthte Swas kasto hay khub.Ekhan snan korbo

[4/22, 2:15 PM] Rakesh Biswas: Eta ingit dicche je shaansh koshto ta kichu ta heart aer jonyeo

[4/22, 2:12 PM] Patient Advocate 60M CAD COPD PUO: Acebrophillin o Asetelsystain group er medicine khaowa jabe naki ?

Jemon.... 

Pulmoclear tablet

[4/22, 2:14 PM] Rakesh Biswas: Aer aage kokhono niyechilen?

[4/22, 2:39 PM] Patient Advocate 60M CAD COPD PUO: Aage kakhano 

Pulmoclear khaini

[4/22, 2:40 PM] Patient Advocate 60M CAD COPD PUO: Hote pare heart er janyo Swas kasto hochhe bt kichhu medicine to khete habe

[4/22, 2:43 PM] Patient Advocate 60M CAD COPD PUO: Chesta korchhi mrs ke niye aapnar hospital e jete but 

samay ber korte parchhina

[4/22, 3:11 PM] Patient Advocate 60M CAD COPD PUO: Sobji shak machh saho vat khelam

[4/22, 3:11 PM] Patient Advocate 60M CAD COPD PUO: Ekhan ektu ghumabo

[4/22, 4:39 PM] Rakesh Biswas: Kashi are cough, sputum koto ta ber hoi roj? 24 ghontar cough ta ekta bisleri joler botole dhore chobi share korle bojha jeto aei oshudh ta apnar koto ta upokar korbe

[4/22, 4:39 PM] Rakesh Biswas: Medicine shothik na hole khoti anek beshi hote pare

[4/22, 4:41 PM] Patient Advocate 60M CAD COPD PUO: Kashi khub alpo just ektu kashi holo mucus discharge holo kashi stop.Sara dine mucus  15-20 ml cough habena,

[4/22, 4:43 PM] Patient Advocate 60M CAD COPD PUO: Aj manoshik duschintar janyo ghumateo parlam na

[4/22, 5:44 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/22, 7:05 PM] Rakesh Biswas: Ki dushchinta?

[4/22, 7:35 PM] Patient Advocate 60M CAD COPD PUO: Sorir ta valo nei....

[4/22, 9:49 PM] Patient Advocate 60M CAD COPD PUO: Ipravent inhaler nile ki Oral Candidiasis hote pare ?

[4/22, 10:04 PM] Rakesh Biswas: Tiotropium a jokhon hote pare, ipravent er o kichu ta sombhabona thakte pare tabe spacer use korle oral candidiasis er chance ta kome jai

[4/22, 10:07 PM] Rakesh Biswas: Aei spacer ta bari te Jekono mineral water er bottle diyeo banano jai👇

https://www.researchgate.net/figure/Spacer-built-using-a-plastic-bottle-for-use-in-emergencies-in-deprived-settings-or_fig1_374143320

[4/22, 10:16 PM] Patient Advocate 60M CAD COPD PUO: Ei plastic bottle e ki Water bhore nite habe naki pichhone futo kore inhaler mouth pics lagiye bottle er mukh diye inhaler nilei habe ?

[4/22, 10:18 PM] Rakesh Biswas: Water bhore noi 

Pichhone futo kore inhaler mouth pics lagiye bottle er mukh diye inhaler nilei habe

[4/22, 10:21 PM] Patient Advocate 60M CAD COPD PUO: Ok sir,

Kal theke try nebo

[4/22, 10:22 PM] Patient Advocate 60M CAD COPD PUO: Bt inhaler e je medicine aachhe seta to mukhei jabe

[4/23, 7:05 AM] Rakesh Biswas: Spacer chara medicine ta direct mukhe hit korle beshi candidiasis howar sombhabona. Spacer thakle aaste aaste medicine golai na theke lungs a chole jai jate medicine er karjokorita bare ebong hani ghote

[4/23, 9:04 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/23, 9:11 AM] Patient Advocate 60M CAD COPD PUO: Ghum theke uthlam.

Valo ghum hayni.

Sorir mon kono tai valo nei

[4/23, 9:18 AM] Rakesh Biswas: Mon sombondheo janate paren

[4/23, 9:50 AM] Patient Advocate 60M CAD COPD PUO: Asole last 7 years aage jakhan Cancer detected o surgery gulo hay takhan thekei medicine practice ta chhere diyechhi

[4/23, 9:52 AM] Patient Advocate 60M CAD COPD PUO: Ekhan just ektu free practice korchhi.

[4/23, 12:30 PM] Patient Advocate 60M CAD COPD PUO: Aj ar berotei parlam na,

Weak lagche,

Suye aachhi

[4/23, 6:22 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/24, 7:24 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/24, 6:09 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/25, 9:08 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/25, 2:10 PM] Patient Advocate 60M CAD COPD PUO: Aj ektu ber hoyechhilam,

Swas kasto hochhe.

Oximeter e Oxygen S...93-95 

O 

Pulse 115-120 pm hochhilo.

So,

Cardiac problem vitore vitore khub betechhe.....

[4/25, 2:12 PM] Patient Advocate 60M CAD COPD PUO: 3 din aapni kono text korchhen na.....

Hayto birakto hoye thakte paren.....

[4/25, 2:13 PM] Rakesh Biswas: Respiratory rate ta jante parle bojha jeto

[4/25, 2:14 PM] Rakesh Biswas: Na ami kokhono birokto hoina. 

Ami nije theke kokhono text korina. Shudhu text aer uttor di

[4/25, 2:20 PM] Patient Advocate 60M CAD COPD PUO: Dekhi meye ke diye Respiratory rate dekhiye aapnake janate pari kina

[4/25, 4:08 PM] Rakesh Biswas: Ghontai ghontai jana dorkar

[4/25, 6:12 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/25, 6:13 PM] Patient Advocate 60M CAD COPD PUO: Meye last 3 days night duty korchhe,rate meyer sathe katha bolbo

[4/26, 10:29 AM] Patient Advocate 60M CAD COPD PUO: Kal rat theke Abflon khachhi

[4/26, 12:52 PM] Patient Advocate 60M CAD COPD PUO: Kheye swas kasto ektu kom bt kichhu problem hochhe

[4/26, 1:02 PM] Rakesh Biswas: Ki problem hocche?

[4/26, 1:03 PM] Patient Advocate 60M CAD COPD PUO: Ghum ghum pachhe ar matha ghurchhe ektu....

[4/26, 2:02 PM] Patient Advocate 60M CAD COPD PUO: Kal rate 1 bar Tiova inhaler niyechhi,

Aj oral candidisis growth start korechhe

[4/26, 6:20 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/26, 7:55 PM] Patient Advocate 60M CAD COPD PUO: Left hand o left leg pain hochhe aj sakal thekei

[4/26, 10:19 PM] Rakesh Biswas: Proti ghontai Ki hocche jante parle better bojha jeto.

Jemone dhorun byatha ta kotar theke shuru hoye kota obdhi chilo?

[4/26, 10:19 PM] Rakesh Biswas: Ki bhabe jana gelo oral candidiasis?

[4/26, 10:25 PM] Patient Advocate 60M CAD COPD PUO: Galay growth suru hoyechhe

[4/26, 11:17 PM] Patient Advocate 60M CAD COPD PUO: Oximeter e O2 94 to 99 er modhye thakchhe.

Pulse Rate 80 to 90 er modhye,

Kakhno aro kom thakchhe

[4/27, 8:02 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/27, 9:28 AM] Rakesh Biswas: Chobi tule share korun. 

Naki growth ta byathar jonye anumaanito?

[4/27, 2:19 PM] Patient Advocate 60M CAD COPD PUO: Aj 10 tar pare kichhu samay er janyo chest tight lagchhilo,sathe mild pain(kayek minutes)er janyo  hoyechhoilo

[4/27, 2:21 PM] Patient Advocate 60M CAD COPD PUO: Tabe 

4 ta abflon kheye swas kasto ektu komchhe

[4/27, 2:22 PM] Patient Advocate 60M CAD COPD PUO: Oximeter e ekhan oxygen 96 o pulse 83

[4/27, 6:21 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/27, 9:54 PM] Patient Advocate 60M CAD COPD PUO: Kichhu samay mane ghanta khanek aage theke chest e kemon jeno tightness mild pain onuvab korchhi

[4/28, 8:11 AM] Rakesh Biswas: Local daktarer saathe joga jog Kore oi somoi ekta ECG korte parle bhalo hoi

[4/28, 8:36 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/28, 8:37 AM] Patient Advocate 60M CAD COPD PUO: Kono karon chharai left arm pain hoye aachhe

[4/28, 11:16 AM] Patient Advocate 60M CAD COPD PUO: Ekhani karalam ECG ta,

Dekhe janaben ki abostha ?

[4/28, 11:58 AM] Patient Advocate 60M CAD COPD PUO: ECG dekhe bolun,ECho ki urgently karabo ?

[4/28, 12:22 PM] Rakesh Biswas: 👆ECG ta Ki chest tightness howar somoi kora? Chest tightness ta kotokkhon chilo? 

Local daktarer saathe alochona Kore neben. 

Aemni te ecg te temon kichu somosya nei tabe ecg ta holo clinical symptoms er saathe correlate korar ekta upolokkho matro. Ecg normal thakleo manusher heart attack thakte pare jeta ekmatro local daktar patient Ke clinically dekhe bibechona korte paren ebong observation a rekhe serial ecg Kore dekhte paren

[4/28, 12:30 PM] Patient Advocate 60M CAD COPD PUO: Hu 

ECG ta chest tightness er samay e karano

[4/28, 12:32 PM] Rakesh Biswas: Tahole temon correlation nei 

Alpo rbbb changes jeta ache sheta aage thekei ache kina, patient er aager ecg thakle sheta dekhe jana jeto

[4/28, 12:30 PM] Patient Advocate 60M CAD COPD PUO: ECHO ta ki kal porsu karabo ?

[4/28, 12:33 PM] Rakesh Biswas: Hain apnar local daktarer saathe alochona Kore

[4/28, 12:33 PM] Patient Advocate 60M CAD COPD PUO: 6-9 mass er modhye kono ECG nei

[4/28, 12:38 PM] Rakesh Biswas: Taar aager ta thakle share korun

[4/28, 12:42 PM] Patient Advocate 60M CAD COPD PUO: Khuje paowa muskil tabe khujbo

[4/28, 12:42 PM] Patient Advocate 60M CAD COPD PUO: Pele Share korbo

[4/28, 6:07 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/28, 6:09 PM] Patient Advocate 60M CAD COPD PUO: Ekhane Dr babu ke ECG pathiyechhi,

Dekhe bolchhe,

ECHO tato Urgent nay

[4/28, 6:10 PM] Patient Advocate 60M CAD COPD PUO: Tai kolkata theke fire ECHO karabo thik korechhi

[4/29, 8:03 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/29, 8:05 AM] Patient Advocate 60M CAD COPD PUO: Most probably kalker ECG dekhe o dr babu der katha sune mentaly strong bodh korchhi...

[4/29, 6:25 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[4/30, 7:29 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[4/30, 6:20 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[5/1, 7:21 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[5/1, 6:21 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[5/2, 8:18 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[5/2, 6:14 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[5/3, 8:00 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[5/3, 6:01 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[5/4, 7:11 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[5/4, 6:00 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[5/5, 10:05 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[5/5, 6:10 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[5/6, 8:30 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[5/6, 6:08 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[5/7, 8:28 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[5/7, 6:08 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[5/8, 6:27 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[5/8, 6:52 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[5/9, 8:36 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

[5/9, 6:44 PM] Patient Advocate 60M CAD COPD PUO: Good Evening sir

[5/10, 6:12 AM] Patient Advocate 60M CAD COPD PUO: Good morning sir

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