PSP-Patient Details Phoolchand Ram Pal

[1Brijesh]

Please find below details for treatment of patient

e-mail ID : [e-mail]

Age : 63 Years

Sex : Male

Height : 5”8 inch

Weight : 85 KG

Structure

(Obese/Medium/Lean) : Medium

JOB DETAILS

Nature of work and whether it involves traveling

No Job (standing and sitting)

COMPLAINTS

List of present complaints with duration of each

SNo

DESCRIPTION

DURATION

1

PSP – Progressive supranuclear palsy

3 Year

2

Falling back side, imbalance, anxiety, body tends to move back while walking, dementia

2.5 Year

Choking, gagging or gasping for air. causing cough

1 Year

3

Legs spreads if walk too much (500 meter)

4

slurred speech, less visibility

5

UTI

4 months

6

Diabetes

15 years

7

High Blood pressure

6 Year

Full present complaints:

PSP and Dementia

Gradually worsening in speech and gait, memory, walking, standing.

Visual Agnosia++, excessive watering from eyes

Postural Imbalance ++,

Frequent Fall++

Sleep-disturbed

Swallowing difficulty while drinking water and eating.

Tendency to retropulsion.

Reduced hearing.

Dysarthria.

Short and fast breath.

Urinary frequency++

Cough +

Details of investigations done so far:

MRI Brain.

Electrolytes

Details of treatments done:

Allopathy,

Syncapone 100 mg 3 times in a day

Rivamer 3 mg- 2 times in a day

Nicerbium 2 times in a day

Amantral- 2 times in a day

Current Medication:

Syncapone 100 mg 3 times in a day

Rivamer 3 mg- 2 times in a day

Nicerbium 2 times in a day

Amantral- 2 times in a day

Nuero Kind Injection.

Allergies:

History of previous illnesses: (Option)

Past Medical History

DISEASES

YES

NO

HYPERTENSION

5 Years

DIABETES

15 Year

Blood pressure

6 Year

OTHERS

STATE OF DIGESTION

APPETITE

Normal / Less / More

Normal

BOWEL HABITS

Regular / Irregular

Regular

URINE QUANTITY

Adequate / Less / More

Adequate

SLEEP

Adequate / Less / More / Disturbed

Disturbed

MARITAL STATUS

Married / Unmarried

Married

DIETARY HABITS

Vegetarian / Non Vegetarian

Vegetarian

SCHEDULE

MENU

TIMINGS

EARLY MORNING

Mild hot water

8AM

BREAK FAST

UPPAM (uttapma)with vegitables

8AM

MID MORNING

Apple, Pineapple, cow milk with roti(chappti)

10:30 AM 12:30 PM

LUNCH

Daliya (Thuli -broken wheat with daal, vegetables)

2PM

EVENING

Apple/ roasted gram/cow milk

6pm

NIGHT

Daliya (Thuli -broken wheat with daal, vegetables)

8:30 PM

ADDICIONS

IF ANY

Smoking / Alcohol / Tobacco chewing

NO

Thanks & Warm Regards

Brijesh Pal

[daddyt]

Not quite sure why we need all this information.

Tim

[1Brijesh in reply to daddyt]

Full diagnosis and daily activities along with diet plan