DIAGNOSIS:  Bilateral Osteo-Arthritis (OA) Knee.

CHIEF COMPLAINT: known case of bilateral OA knee, more pain in right knee compared with left knee. Patient has generalised nee pain and his overall wellness is fine.

PRESENTING ILLNESS:  A 43 years old male presented with history of pain in bilateral knee joints. His left knee pain has mostly recovered, but his Right knee pain still has its problem in knee joint. He can do regular exercise but feel some pain all the time.

Currently he has pain on lower right part of the right knee. Conservative medicinal treatment is going on. Patient overall health is good. Now patient has come to us for the experimental stem cell therapy for his OA knee and overall immunity booster. We have taken written consent for doing this experimental stem cell therapy.

PAST MEDICAL HISTORY: Patient has h/o Knee joint pains in past too. He has taken stem cell Rx for the same in 2022. Later on he has got recovered from his knee pain in left side but right knee still give some pain.

Also patient has past h/o Covid 19 infection twice since its inception. He has taken covid vaccination (Pfizer) sot for the prevention of covid 19, but still sometime he feels having cough which doesn’t go quickly.

FAMILY HISTORY:  No h/o major illness in family.

ON EXAMINATION:  conscious and well-oriented

B: P:  130/80 mm of Hg

Pulse: 80 b/m

Temp.: 98.6^o F

RR: 22

SpO2: 98% 

INVESTIGATION:

1. All report attached with discharge summery card.
   
   

PLAN OF ACTION:

• UC-MSC cellular therapy
• Bilateral intra-articular injection of MSCs.
• Exosome Inj
• MVI injections
• Inj Vitamin C
• Inj Monocef 1gm & In Pan40mg

OPERATION UNDER TAKEN / PROCEDURE:

1. Umbilical cord derived Mesenchymal stem cells 100 Million + Exosome (50µgm) growth proteins given through intravenous route.
2. Bilateral intra-articular injection of MSCs (60millions) + Exosome protein (50µgm) given in both knee joint spaces by orthopedician with NO any adverse event.
3. MVI injection (5cc) given in 100cc NS for 1 hrs slow infusion.
4. Inj Monocef 1gm stat & Inj Pan40mg stat
5. Vitamin C in 100cc NS given slowly.

IN COURSE OF HOSPITAL AND COMPLICATION IF ANY: Patient was clinically examined and thoroughly investigated, physician opinion taken and informed written consent taken.

1. On day 1^st, patient’s history presenting illness was taken. He has feeling of some bodyache and internal feverishness due to some past viral flu. All necessary blood investigation, chest x-ray and ECG were done. He has been started with inj Paracetamol 1gm stat dose. Post procedure was uneventful (no headache or vomiting). All vitals settled down with GC stable. Patient was afebrile, conscious and well oriented. During post lunch time, patient was given 5cc of Inj MVI via 100cc NS for an hour.
2. On day 2^nd, Patient’s bodyache and feverish feeling was settled down normal and he was feeling better and energetic. Now patient has been given as precautionary dose of inj Monocef 1gm & inj Pan 40mg as stat dose. Then he was given Inj Vit C via 100cc NS slowly.

Patient was taken in OT and under sterile OT environment, 30M UC-MSCs + exosome was administered into intra-articular spaces of each knee joint. The intra-articular inj was administered by orthopedician, by taking aseptic precautions. Post procedure was uneventful (no headache or vomiting). All vitals settled down with GC stable. Patient was afebrile, conscious and well oriented.

During post lunch time, he was also given UC-MSCs (100M) + Exosome protein (50µgm) via 100cc NS. Post procedure was uneventful.

3. On day 3^rd, at time of discharge he is clinically stable. Fever and bodyache also settled down. He has been advised to take proper and regular medications for his low Hb.
   
   

AT THE TIME OF DISCHARGE:

B: P:  130/80 mm of Hg

Pulse: 75 b/m

Temp.: 98.6 F

RR: 22

Spo2: 98% 

DISCHARGE MEDICATION:

1. Boslin….OD…. for 3 months.
2. Omega3 … OD…after Lunch & Dinner… for 3 months.
3. Zincovit…Daily once… for 3 months.
   
   

NOTE:

1. Kindly visit to nearby Hospital emergency ward, if you observe HTN, fever, headache, seizures, severe vomiting, severe abdominal discomfort and decreased appetite.

2. Contact us at scci@gmail.com, what’s app No: +91 78382 23336
   

SIGNATURE AND STAMP OF DOCTOR / AUTHORITY DEPARTMENT