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Dr Patric Dsouza

Senior Endocrinologist

Blue Well Hospital Australia

468 St Kildo Road



14 december 2014

Dear Dr Dsouza,

Re: Ms Maria John, aged 60

Thankyou for seeing, Mrs Maria John who has sign and symptoms suggestive of hyperthyroidism and hyperglycaemia. I am referring her into your care for further assessment and appropriate management

On 11 December 2014, Mrs John was initially admitted with complaints of abdominal pain, joint pain, dry mouth, slurred speech, dizziness, increased thirst and fatigue. Blood pressure was elevated up to 170/110 mm hg. Whereas, other vital signs were remarkable. On further investigation, elevation in t3, t4 as well as blood sugar levels more than 400 were noted. Therefore, commenced on injection insulin and thyroxin 25mg [twice a day] an enlargement of gland on neck were confirmed in x ray hence, thyroidectomy was recommended.

In regard to medical history, Mrs John is a known case of hyperthyroidism and osteoporosis. Since 2014 and 2011, paralysis for which suggested to include fibre and salt restricted diet.

As per discharge plan, ongoing medications including ramprill 5mg daily, paracetamol 500 mg [twice a day ] and pantoprazole 40 mg [once a day] has to be continue enhancement in diet is recommended by involving calcium supplement and lowering dairy products consumption. Continuing monitor of walk after each meal and exercise will be extremely beneficial. Reviewing of TSH report after two weeks in suggested and further esteemed treatment would be required for improving Mrs John’s health condition. If you require any further information, please do not hesitate to contact me.

Yours sincerely,

Shelly Kate

Charge Nurse

Blue Well Hospital


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