Can you give me guidelines in online consultation?

Online consultation is just five steps

Step 1
Fill in the basic information

Step 2
Present your complaint in detail. See the guidelines given below

Step 3
Personal information. Present your personal information in detail. See the guidelines given below

Step4
Mental information. Give the details of mind

Step 5
Other information Give your lab report or scanning report/ attached document

 Help for Main Complaints /symptoms & Other Associated Troubles  

When you are presenting a complaint/symptoms  you  have to write in your own words and complaint should be complete. Complete symptoms should include following things

• Sensation=what type of  pain/symptom- aching, burning, bursting or any type of pain presented in your own words, or fever etc
• Location=part where the complaint is right or left or both sides
• Modality =any thing that increases or decrease the complaint eg-head pain is increased by sun exposure, or mental exertion
• Extension=pain or any symptoms are extended to other part eg-head pain is extended to back
• Associated complaint=any other complaint

EXAMPLE 1
For example you are suffering from headache. In these examples above factors should come when your presenting your own complaint. Bracketed words indicate how to include the above five items  (Sensation, Location, Modality, Extension, associated complaint) in the symptom.

I am having headache with aching (sensation) pain in my right side (location)which is extending to spine(extension) when I am having my head ache I have my pain in stomach (associated complaint).

Here associated complaints should also be presented in the above manner of (sensation location modality and extension if present) I  Have aching pain (sensation) in upper right stomach (location) which is acing in nature.

EXAMPLE 2
Some time any of the complete symptoms (Sensation, Location, Modality, Extension, associated complaint) may not be present. SENSATION AND ASSOCIATED COMPLAINTS ARE ABSENT.

I have swelling in my right breast which is not painful. Here sensation is absent as the swelling do not have pain. Here you can describe the size of the swelling.

Eg-A lemon sized swelling. Texture of swelling e.g.-spongy, or hard or slightly hard etc. side is whether right breast or left breast. modality is absent here as it is painless. There is no extension present here. No associated complaints also.

EXAMPLE 3
Fever which is a general symptom DO NOT HAVE LOCATION . HERE THE ASSOCIATED SYMPTOMS ARE PRESENT

FEVER
CHILL (SENSATION)
THIRST (ASSOCIATED SYMPTOM)
COUGH (ASSOCIATED SYMPTOM)
SNEEZING (ASSOCIATED SYMPTOM)
EXPOSURE TO OPEN AIR INCREASES THE SYMPTOM (MODALITY)

EXAMPLE 4
I am having convulsion( sensation) when I get exposed to cold (modality), mental exertion (modality). It do not have location.

Sensation Include pain, heaviness, numbness, feeling the patient call symptom eg epilepsy

Location include sides right, left or both sides

Modality  any thing that increases or decreases the complaint it may include food, weather, drinks, etc

Previous Diseases & Drugs includes any of the drugs taken for a long time and also details of previous illness

Family History (Disease if any in Family) Any of the major disease by any of the nearest family members father, mother, brother, sister, spouse which  may include hypertension, cancer, diabetic etc

Habits may include smoking drinking and extramarital relationship etc

In the vegetables and fruits and other food: Cravings or dislikes or even vegetables that disagree should be mentioned.

Cravings: Extra ordinary craving for certain vegetable or fruits or other food. E.g. -  eats too much of onions and potato. This craving must be differentiated from likes. Person with craving HAVE AN EXTRAORDINARY LIKING FOR THAT FOOD.

Dislikes: Person do not like certain food eg-dislikes apple.

Disagree: Some of the vegetables or fruits  may increases a complaint. For example potato increases the stomach pain, cabbage causes diarrhea etc.

Stool and urine  only if there is some abnormality in stool and urine should be noted

Sleep and dream good or bad sleep or un refreshing sleep should be noted. If the sleep is not good you have to write why you are not getting sleep FOR EXAMPLE SLEEPINESS DUE TO MENTAL STRAIN OR EXCESSIVE WORK OR PHYSICAL STRAIN.

Weather Aggravation or  Amelioration (Any of complaints are modified on weather) For example: its common that cold weather causes increase in cough, fever, coryza, joint pain etc. Conversely fine weather may decrease the existing complaint. Both these should be mentioned in detail- which weather increases or decreases the symptoms. Following types of weather can increase or decrease the existing symptoms.

• Rain
• Cloudy
• Cold dry  or cold wet
• Hot
• Stormy or windy weather
• Summer

Sexual sphere

For men – any difficulty in erection ? or unwanted erection ? or any sexual problems?

For women- menses regular? Or painful? or irregular? Or leucorrhoea or any types of discharge? Or painful sexual intercourse

Mental information

Should cover all aspect of mind. It may include

• What symptoms you suffer from when you are jealous?
• Are you doubtful or suspicious? Of what?
• How long do you remember hurts came to you by others? offended eaily?
• How much revengeful are you?
• What are you proud of? Does your pride easily get hurt (Egotism)?
• Depressed or brooding? You have to mention reason for brooding or depressed?
• Do you ever become suicidal? when? if so in what manner do you prefer  to end your life
• Your sexual life? Any extramarital life?
• Any unwanted thoughts any time? Such thoughts preventing sleep and interfering in normal life?
• Have any imaginary sensations or fear?
• Do you hear voices as that you are called or anything else in this line keeps on occurring in your mind unduly?
• Your memory? Forgetful? Absentminded? eg- forgetting names , place.
• Do you weeps easily for silly matter? How do you feel after weeping? How do you feel if some one offers sympathy or consolation when weeping?
• What makes you angry? what bodily symptoms do you develop when angry? Eg- trembling, sweating etc
• Are you easily irritated?
• Do you like company or prefers to be alone most of the time?
• What are the greatest griefs  that you have gone through your life?
• What are the greatest joys that you have gone through your life?
• In your opinion which aspect of mind and moods  are not agreeable to you. In spite of your awareness and maturity are you unable to change this aspect
• Give a clear cut picture of your situation in life and your relationship with your family member, friends and associates in work?
• How does future look to you?