[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Dear Dr. Williams

Re: Ms. Gwen Brown, DOB: 22. Apr. 1975

✅ I am writing to refer Ms. Brown, a 44-year-old married woman, who requires your assessment regarding a periodontal lesion on tooth 22.

✅On 5. April. 2018, Ms. Brown first presented at my clinic with a generalized periodontal attachment* loss(,) for which a cleaning and scaling was performed,* and she was (then) referred to a periodontist for a flap surgery on tooth 22 (,) which had a 5-mm attachment loss and bleeding on probing associated with a developmental groove.

• کل این پاراگراف یک جمله شده که خیلی طولانی هست. به وصل کردن جملات و عبارات اصرار نکنید و سعی کنید 2 و نهایت 3 عبارت رو متصل کنید. جاهای که ستاره گذاشته شده بهتره نقطه بیاد.

• On 5 April 2018, Ms Brown first presented to my clinic with generalised periodontal attachment loss. Scaling and cleaning were performed. She was then referred to a periodontist for flap surgery on tooth 22, which exhibited a 5-mm attachment loss and bleeding on probing associated with a developmental groove. 

•  “On 5 April 2018” 

• “Surgery” is usually uncountable.

✅ There was (were) no significant findings on reviews in 6-month intervals.

“There were no significant findings” : Use the plural findings

✅On examination today, there was a 4-mm probing depth on tooth 22(,) accompanied by bleeding on probing. There was no conclusive response to cold stimuli due to connected crowns on tooth 22 and 23. I suspected a pulpo-periodontal lesion on tooth 22.

• Passive: A pulpo-periodontal lesion affecting tooth 22 was suspected. 

Please note that she was diagnosed with alopecia areata on her left temporal region in October 2019, and had experienced  an exudative tonsillitis in 2014.

• affecting her left temporal region 

• No article (an) is needed before the disease name 

It could (would) be greatly appreciated if you could assess and manage tooth 22 as you feel appropriate, and assess (x2, determine) if there was (is) any inflammatory relation(ship) between her dental condition and the onset of the (her)  alopecia areata.

Yours sincerely,

Dr. Setareh Salehi

 

• Purpose: 3/3

• Content: 5/7

• Clarity & consciousness: 4/7

• Genre & Style: 4/7

• Organization and layout 5/7

• Language 4/7

  B Overall score: (370)

@Setisal

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Dear Mrs. Martinson,

Re: Mr. Kenneth Phillips DOB: 05/05/1973

✅ I am writing to request ongoing care for Mr. Phillips, a 45-year-old divorced builder, who was admitted to Spirit Hospital on 10/01/2019 and underwent a bilateral lung transplant and** (full stop) (He) is scheduled to be discharged from the rehabilitation ward today.

• ❌ Avoid joining several major events in one long sentence.

✅Post-operatively, he remained in the ICU ward (for) 10 days (,) and 3 weeks in the Thoracic Ward and subsequently he was transferred to the rehabilitation ward for (another/further) 2 weeks. The patient’s healing process was satisfactory,(.) His dependence on oxygen therapy has gradually decreased (,)and he is currently managing without supplemental oxygen, maintaining an oxygen saturation level of 94% on room air. At present (,)he is self-sufficient in personal care and activities of daily living; however, he requires supervision. He is on a low listeria diet and thin fluids,(and) his appetite has also improved.

• سعی کنید بیش از دو عبارت یا جمله رو لینک نکنید تا جمله خیلی طولانی نشه و روانتر خوانده بشه.

• ❌ The patient’s healing process ✅ The patient’s recovery 

• Healing process معمولاً به بهبود زخم یا محل جراحی اشاره دارد، نه وضعیت کلی بیمار. بنابراین در این جمله طبیعی نیست. 

• self-sufficient  معمولا در گفتار کاربرد دارد نه در نامه های پزشکی. بهتره بگیم independent.

✅Regarding his medical history, he has been suffering from interstitial lung disease since 2012 and has been taking a variety of medications, (.) please refer to the attached medication chart for further details.

✅Mr. Phillips lives alone and receives good support from his sister. He is able to self-medicate but requires supervision. There is a wound in the coccyx area that needs to be monitored and the dressing should be changed every three days.

Please do not hesitate to contact me if you require further information.

Yours sincerely,

Registered Nurse – Rehabilitation Ward

عالی – خیلی خوب همه چی، فقط استفاده از نقطه به جای کاما وقتی که جمله ی شما مفهوم کاملی میرسونه و همچنین استفاده درست از کاما بین عبارات طولانی. جز این پیشنهادی نیست. Well Done!

• Purpose: 3/3

• Content: 6/7

• Clarity & consciousness: 6/7

• Genre & Style: 5/7

• Organization and layout 5/7

• Language 6/7

  B Overall score: (430)

@user-685405

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Dear D. Rosenberg,

Re: Ms. Taylor Hawking, DOB: 24, Mar,1999

✅ I am writing to refer Ms. Hawking, a 20-year-old university student, (Unnecessary comma) who requires your assessment regarding her dental crowding.

✅ Ms. Hawking has been a patient at my clinic since 2016 and has received restorations and routine scaling and cleaning on a regular basis. In July.2017, the patient presented with an acute pericoronitis on tooth 38 (,) which was managed by an in-office hydrogen peroxide irrigation. She was also advised to take Erythromycin 250 mg 4 times daily and Metronidazole 200 mg 3 times daily, and (to) rinse with a Chlorhexidine mouthwash. On the 2-week and 1-year recall appointments, no signs and symptoms of inflammation were observed at the site of the wisdom tooth.

• ❌ July.2017 ✅ July 2017 

✅Today, she presented with a complaint of “an ugly smile”. On examination, there was a severe 9-mm crowding on the maxillary arch and a moderate 6-mm space deficiency on the lower dentition, associated with a rotation of teeth 13 and 23 and a 5-mm lower midlineshift to the left. The patient was referred to take an OPG.

• ✅ She presented with concerns regarding the appearance of her smile.

✅In terms of her medical history, she has asthma and allergy to penicillin and peanuts(,) for which she uses a Ventolin inhaler and carries an EpiPen. Your assessment and management regarding her condition would be greatly appreciated

Yours sincerely,

Dr. Setareh Salehi

• Purpose: 3/3

• Content: 6/7

• Clarity & consciousness: 6/7

• Genre & Style: 6/7

• Organization and layout 6/7

• Language 6/7

⭐Well Done!⭐

  A Overall score: (450)

@Setisal

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Dear Doctor, 

Re: Mr. Dave Cochrane DOB:20 November 1962 

✅ I am writing to refer Mr. Cochrane , a 57- year-old retired (man: need a noun) who is (has been) diagnosed with acute left ventricular failure and needs (requires) emergency admission to cardiology until for stabilization. 

✅Initially,Mr Cochrane presented at my practice 7 weeks ago, (no comma) with complaints of positional shortness of breath,chest tightness and nocturnal cough. He ,also was (He was also) dyspnoeic and had a bilateral ankle edema,as well as a high jugular venous pressure. On examination,crepitations were heard in (both) lung bases (,)with no other significant abnormalities.his ECG showed cardiomegaly and an (chest) X-ray revealed features of infection. Given the diagnosis of left ventricular failure,a broad spectrum antibiotic for 7 days,furosemide and digoxin were prescribed.he also,was advised to quit smoking and drinking. 

✅On a review 2 weeks later, his symptoms had decreased (worsened) and he had reduced (his) alcohol consumption and smoking. Today, he presented with (a) flare up symptoms(,) including breath shortness (shortness of breath), chest pain and a 2-hour sweating spell. he was anxious and dyspnoeic. On examination, he had high jugular vein (venous) pressure, crepitation in (his) both his lung bases and a left shifted apex beat. However, there was no murmur and his (other) vital signs were normal. 

• Decreased: برای مقدار به کار میره

• “spell” is more common in general English 

✅I would appreciate (it) if you could assess and treat him as you feel appropriate.if you require any further information, please don’t (do not) hesitate to contact me. 

Yours sincerely, 

Doctor 

• Purpose: 3/3

• Content: 5/7

• Clarity & consciousness: 3/7

• Genre & Style: 3/7

• Organization and layout 5/7

• Language 3/7

  C+ Overall score: (340)

 

@Shivam

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Dear Dr. Harrison,

Re: Ms. Christina Hollins, DOB: 20 Mar 1955

✅ I am writing to refer Ms. Hollins, a 64-year-old teacher, who requires further investigation regarding her oral mucosal lesions.

✅Ms. Collins is (has been) a regular attender at my practice for 10 years. She has been always (always been) reluctant to undergo periodontal scaling due to gingival bleeding and sensitivity associated with episodes of dry mouth. 

• چون for the last 10 years آوردید باید has been بیاد، اما is هم درست میشد در صورتی که نشانگر زمانی نداشتید.

✅Two weeks ago, she reported pain in her gums, for which she was advised to rinse with Oral-B mouth wash. The pain initially subsided. However, it recurred later.

(وصل بشه به پاراگراف قبل)I suggested (that) she use Biotene Dry Mouth toothpaste and mouth wash (mouthwash) and avoid spicy foods for two weeks.

✅Today, she presented with ulcerated lesions on her left buccal mucosa and (the) side of the (her) tongue (,) associated with shiny(,) red raised patches on both sides of (the) buccal mucosa and (the) dorsal surface of the tongue. She reported that she could only have soft bland diet. (he could only tolerate a soft, bland diet)

(وصل بشه به پاراگراف قبل)I considered (that) the condition could be related to Oral Lichen Planus.

In terms of her medical history, she was diagnosed with heart palpitation in 2017, for which she takes Noten 4mg daily (1/2 tablet am and pm) and Zocor 10 mg daily in order to lower her cholesterol level. Her blood pressure level is in (within) normal limits.

It would be greatly appreciated if you could assess and treat her condition as you feel appropriate.

Yours sincerely,

Dr. Setareh Salehi

 

• Purpose: 3/3

• Content: 6/7

• Clarity & consciousness: 5/7

• Genre & Style: 5/7

• Organization and layout 4/7

• Language 4/7

  B Overall score: (390)

@Setisal

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Re: Mrs Jane Macintyre, DOB: 01 March 1980

Dear Dr Childers,

 

I am writing to refer Mrs Macintyre, a 39-year-old pregnant mother who requires antenatal care and birth due to a history of severe pre-eclampsia, caesarean section, and her age.

 

• سعی کنید تا حدی بازنویسی کنید و عینا از کیس نوت کپی نکنید چون معولا کیس نوت خیلی خلاصه هست، اینطور نمره بهتری میدن مثلا:

• due to her history of severe pre-eclampsia, previous caesarean section, and her maternal age. 

 

Today, Mrs Macintyre presented with a complaint of three-day painful urination (dysuria) .She has (had) a positive home pregnancy test (,)which is (her) fifth pregnancy and her last menstrual period was on 26 June 2019. Upon examination,(her) vital signs were normal and she had some dysuria for the past three days (تکراری).Her urine dipstick showed +3 protein, +2 nitrites, +1 blood.

• with a three-day history of painful urination. 

• رایتینگ یکم طولانی هست از لحاظ تعداد كلمات هم از استاندارد بیشتره بنابراین هر جا تونستید خلاصه نویسی کنید. مثلا جمله آخر و اول پاراگراف بعد میتونه خلاصه بشه و نیازی نیست جزئیات آزمایش رو بیارید:

• Urine dipstick findings were suggestive of a UTI, for which cefalexin …

 

Based on her symptoms and test results,Mrs Macintyre is suspected (of having a) urinary tract infection (,)for which cefalexin 250mg QID for five-day was prescribed. In view of (her) pregnancy and thrombosis risk,folic acid and tinzaparine(3500 units daily) were ordered.Arrange routine antenatal blood test and re antenatal screening for Down’s syndrome (,)in view of her age(,) were also ordered.

• Routine antenatal blood tests and repeat antenatal screening for Down’s syndrome, in view of her age, were also arranged 

 

Please note, Mrs Macintyre has two children(aged 3 and 5) and (a history of) two miscarriages. She had developed severe pre-eclampsia just in (during) her first pregnancy and her (first?) delivery was caesarean section. She had (has) a family history of heterozygous for factor V Leiden (,)for which she was treated with prophylactic low molecular weight heparin in (during) two previous pregnancies.

 

I would appreciate it if you could urgently assess and manage this patient.

 

Should you need more information,please do not hesitate to contact me.

 

Yours sincerely,

 

Dr.Atefeh Mohammadi

 

• Purpose: 3/3

• Content: 4/7

• Clarity & consciousness: 3/7

• Genre & Style: 4/7

• Organization and layout 4/7

• Language 3/7

  C+ Overall score: (340)

@989124149700

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Dear Ms Stuart,

Re: Mr Alex Roden, DOB: 24/09/1951

✅I am writing to request a dietary assessment and appropriate management advice for Mr Alex Roden, a 68-year-old widower, who is recovering from triple bypass heart surgery.

Mr Roden was admitted in (to) Spirit Hospital  following a (an) angina attack on 17/08/2019. He consequently underwent Triple bypass heart surgery on 18/08/2019 and was discharged after an uneventful recovery on 26/08/2019. After discharge, her (his) diet plan includes (a) low-calorie, high-protein, low cholesterol and gluten free diet. He has been advised to increase fluid intake by (a) community nurse(??), as well. However, he does not know (he is unsure) how to follow this plan.

As his past history, although his BMI is 33, he is not doing any exercise. He was previously a regular smoker and heavy drinker but quit smoking in 2016 and has reduced his alcohol consumption.

•  “As his past history,” → Incorrect phrase → ✅ “Regarding his past medical history,”

• “although” is misused (no real contrast)

Mr Roden has continued (to follow) an unhealthy diet since his wife died. Your assistance is required to support him in implementing an appropriate dietary plan and monitoring his adherence. It would be appreciated if you give him a copy of the Heart Foundation’s Health Eating brochures, and write a referral letter to a dietitian to assist him in this way.

Please do not hesitate to contact me should you require any further information.

Yours sincerely,

Alice Raymond

Rural Community Health Nurs

• این نامه در واقع نامه ارجاع به متخصص تغذیه هست، و تسک شما این هست. شما اینجا به اشتباه به عنوان درخواست مطرحش کردید

• همچنین بروشور رو شما به بیمار داید و مجدد به اشتباه به عنوان درخواست مطرح شده.

• چند مورد مثل: افزایش وزن بیمار (5 کیلو)، اینکه بیمار خودش مشتاق به رژیم تغذیه هست، و اینکه الان قوت قالبش غذای آماده و یخزده و غیره هست… در رایتینگ ذکر نشده.

• از لحاظ زبانی مشکلی وجود ندارد و بیشتر باید روی محتوا، هدف نوشتن نامه و … تمرکز کنید. نمره این رایتینگ به همین دلیل کم شده

• Purpose: 2/3

• Content: 4/7

• Clarity & consciousness: 5/7

• Genre & Style: 5/7

• Organization and layout 6/7

• Language 5/7

  C+ Overall score: (300)

@Khadi

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Re: Ms Anna Hall (45 years old) 

Dear Dr Roberts,

I am writing to request your further evaluation and definitive diagnosis of Ms Anna Hall whose features are consistent with a possible gastro oesophageal–reflux(GERD) and (a) subsequent stricture. 

Regarding her social and family history, she is an ex-smoker, overweight, long with coffee and alcohol drinker whose (,and her) father has a history of (a) peptic ulcer. On medical history (,) she had a history of dyspepsia in 2012 and takes infrequent aspirin (2-3 times/month). 

• she is an ex-smoker, overweight, long with coffee and alcohol drinker → ✅she is an ex-smoker and overweight, along with being a long-term coffee and alcohol consumer

• On medical history→ ✅in her medical history, in term of her medical history,…

• she had a history of dyspepsia in 2012 → ✅she was diagnosed with dyspepsia in 2012 / she has a history of dyspepsia (2012)

• در کل این پاراگراف دقیق نیست: بیمار 15 سال پیش سیگار رو ترک کرده، مصرف الکل فقط سوشال هست، و اخیرا مصرف قهوه رو زیاد کرده. این اطلاعات خیلی بهتر میتونست به شکل زیر بیاد:

• She quit smoking 15 years ago, consumes alcohol socially, and has recently increased her coffee intake.

On 18 June 2018, Miss (Ms: “keep titles consistent”) Hall presented with solid dysphagia following an upper respiratory tract infection(URTI) two months ago (earlier)(,) for which she took (takes) over the counter (OTC) product. She also reported experiencing 1-2 kg of weight loss and epigastric pain(,) which radiated to her back on (at) the level of T12. According to my preliminary diagnosis of GERD with considering recently increased coffee consumption she was advised to stop taking (the) OTC product and reduce alcohol and coffee consumption(,) and she was (also) commenced on pantoprazole. 

• over-the-counter Chinese herbal product with unknown ingredients

• ✅Reported weight loss and epigastric pain

I would appreciate it if you could assess Ms Hall further including endoscopy if indicated and provide your expert diagnosis. 

Yours sincerely,

Doctor

• پاراگراف سوم نسبت به دوم اولویت دارد، در مقدمه اشاره شده بیمار رو ارجاع دادید به خاطر GERD و در پاراگراف بعد بهتره بپردازید به این مشکل، هیستوری بیمار اهمیت پایین تری دارد.

• Purpose: 3/3

• Content: 4/7 

• Clarity & consciousness: 3/7

• Genre & Style: 4/7

• Organization and layout 5/7

• Language 4/7

  B Overall score: ( “just” 350)

@9360045003

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Dear Dr.Yabe

Re: Sally Webster, DOB: 10/Nov/2003

✅I am writing to refer Ms. Wester(,) a 17-year-old patient with a possible diagnosis of Anorexia nervosa(,) for further assessment. She is a high school student, plays violin for fun and she has a part time job as a ship assistant.

• بخش هایلایت شده قابل حذف است.

✅She first presented to me on (in) Dec (December) 2019 at my clinic with no past history of psychiatric disease (,)due to her constipation and bowel action every 4 to 5 days(,) which (for which) she tried laxatives for that. She has 54kg weight. She was advised to increase vegetable, fibers and fluid intake.

• no past history of psychiatric disease
  Cause–effect confused: این عبارت نباید وسط جمله میومد، بیمار مراجعه کرد + با این مشکل + این دارو. چون خواننده وسط جمله گیج میشه. بهتره اخر پاراگراف میومد یا کلا حذف بشه.

• She first presented to the clinic in December 2019 with a complaint of constipation and bowel actions occurring every 4 to 5 days, for which she had tried laxatives

• ❌ “She has 54kg weight.” → ✅ “She weighed 54 kg.”

 

✅After 2 months(,) she returned with her mother(,) who was concerned about her lack of appetite and weight loss. They had an argument about her eating habits, however she believed she feels well and there is nothing to worry about. She did not had (have) a good appetite. On examination she had (a) 6kg weight loss(48kg), she looked pale and thin. I performed (ordered) a blood test and urine analysis to investigate any possible underlying illness.

✅Today(,) she re-presented to me (the clinic) and she believes that she needs to loose another 7kg of her weight. She has (had: past) no eye contact (and) her emotions are (were) blunt. She denies vomiting and her claim about using laxatives is not reliable. All of (the) laboratory tests are in normal range. 

• اول پاراگراف ها بعد از timemaker ها باید کاما بیاد.

• are in normal range → ✅ “All laboratory tests are within the normal range.”

• در گزارش ویزیت امروز, همچنان از زمان گذشته استفاده کنید. بیمار ارتباط چشمی نداشت امروز و احساساتش رو بروز نمیداد.

I would appreciate your further assessment of this patient. Should you require more information, (please) do not hesitate to contact me.

Yours sincerely, Dr.Ehsan Sobhanian

Word Count: 210

• Purpose: 3/3

• Content: 5/7 

• Clarity & consciousness: 4/7

• Genre & Style: 5/7

• Organization and layout 5/7

• Language 4/7

  B Overall score: (380)

@user-309455

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Dear parent

✅I am writing to provide you with information regarding an outbreak of head lice at (the) school. Head lice are a common condition among children in school and it’s (are not) not related to poor hygiene.

In terms of treatment, you should apply a large (generous) amount of hair conditioner and leave for 20 minutes. Wet comb hair with fine-toothed comb should be used(X) to divide (the) hair into 3 or(to) 4cm sections. You can wipe (the) comb with (a) paper towel and repeat it for twice (repeat twice). Wet combing method should be used for 10 to 14 days.

• A fine-toothed comb should be used to wet-comb the hair

✅There are some products (treatments) such as Maldison, Permethrin and Pyrethrins to treat head lice. These treatments should be used based on (according to)(the) instructions and repeated after 7 to 10 days. (the) Wet comb (wet-combing) method should be used weekly for several weeks after cure to prevent recurrence.

✅Please wash your hands after lice treatment and wash pillow cases, combs and brushes in hot soapy water. You should also treat (your) family if you observe any live lice. You should avoid using blow-dry hair (using a hair dryer) as it may spread lice.

• Blow-dry hair : V+Noun

✅I hope this information helps you to prevent disease and (to) inform school about this disease. Please do not hesitate to contact me if you have further questions.

Yours faithfully,
Pharmacist

(Persistent head lice/ if treatment fails? / visit a doctor)

• Purpose: 3/3

• Content: 4/7 Clarity & consciousness: 4/7

• Genre & Style: 5/7

• Organization and layout 6/7

• Language 4/7

  B Overall score: (370)

@2480011763

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Dear Dr.Philip Wright

Re: Ms.Marcus, DOB: 15/01/1983

✅I am writing to refer Ms.Marcus, a 36-year-old single mother with a 7-year-old child and positive (a) family history of cancer in her father (colon cancer, aged 72). She has a multi-nodular goiter with the possibility of thyroid malignancy (possible thyroid malignancy), (.) therefore(,) your surgical assessment would be appreciated.

• 7-year-old child → irrelevant

✅Initially she presented on 06/Jul/2019, complaining of a neck swelling(,) which she noticed two months earlier. On examination(,) there was an anterior neck swelling measuring 2.2 cm(,) which was non-tender and moves with deglutition(,) without any palpable lymphadenopathy. An ultrasonography of (the) neck and TFTs were requested to assess her thyroid.

• Correct date format: 06/07/2019,

✅Two weeks later she came in (attended/returned) for her test results follow-up. The TFTs were normal,(; or .) however (,) the ultrasonography reported (revealed/showed) multiple nodules and bilateral thyroid calcification. She was advised to (to have/ to undergo) (a) surgical review for possible thyroid malignancy, but she declined any surgical intervention.

• Came in: a bit informal

✅Today she re-presented with an increased size of swelling. (,) Difficult swallowing (swallowing difficulty) for the last 3 weeks and hoarseness of voice since last week has been developed. On examination(,) (the)thyroid size has been increased (was increased: passive) significantly. Thyroid is firm with limited mobility and there are palpable enlarged lymph nodes on the right side of (the) neck.

• an increased size of swelling: وقتی an به کار میره پس باید بعدش اسم بیاد یعنی: an increase in the size of swelling

• She has now agreed to undergo surgical intervention

I appreciate your further assessment on (of) this patient. Should you need (require) more information, please do not hesitate to contact me.

Yours sincerely

Dr.Ehsan Sobhanian

 

• Purpose: 3/3

• Content: 5/7

• Clarity & consciousness: 4/7

• Genre & Style: 5/7

• Organization and layout 6/7

• Language 4/7

  B Overall score: (370)

@user-309455

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Dear Endocrine Surgeon

Re: Ms.Marcus, DOB: 15/01/1983

I am writing to refer Ms. Marcus(,) a 43-year-old woman with M(m)ulti-modular goiter for examination of possible thyroid malignancy and surgical consideration.

• → ✅ “and consideration of surgical management.”

She is a single woman with a 7-year-old child with a positive family history of malignancy. (Colon cancer in her mother aged 72). On 5/Jul/2019(,) she presented to me at my general practice with the (a) complain (complaint) of neck swelling since 2 months earlier. On examination(,) there was an anterior neck swelling with the size of 2.2 Cm. It was not tender (non-tender) in (on) palpation (and) was moveable (with) deglutition and no lymph nodes detected at that time. (paragraph break) 2 weeks later I requested a neck ultrasonography and thyroid function test(TFTs) with possible diagnosis of thyroid nodule to assessment of (to assess the) patient(‘s) condition. TFTs were normal and ultrasonography showed multiple nodules and the evidence of (with) bilateral calcification in her thyroid lobes. She was advised for surgical consul(?) for possible thyroid malignancy based on the diagnosis of Multi-nodular goiter, but she denied further follow-up. (she declined surgical intervention, not follow-up)

• جمله اول بهتر بود در مقدمه بیاد چون با ادامه پاراگراف ارتباطی نداره.

• عبارتهای هایلایت شده اضافی هستند.

• ❌ “ the complain” → ✅ “a complaint”

• چون شکایت بیمار شناسه نیست حرف اضافه باید a باشد. همچنین complain فعل است.

• ❌ “since 2 months earlier” → ✅“for the previous two months”

• ❌ “with the size of 2.2 Cm.”→ ✅““measuring 2.2 cm.”

• در جمله two weeks later… شما نوشتید که درخواست آزمایش دادید. در صورتی که آزمایشات در ویزیت اول بیمار انجام شده بود و بعد دو هفته که بیمار مجدد رجوع کرد نتایج آماده بود.

Eventually(,) she presented today with an increased (an increase in the) size of the swelling since last month (over the last month). Furthermore she got (had) difficulties swallowing and voice hoarseness for 3 weeks and 1 week respectively . She has enlarged thyroid in correlation with her first exam, her thyroid mass is firm with limited mobility and there are palpable and enlarged lymph nodes on right side of her neck. (اینها باید در پاراگراف ها همزمان با شرح ویزیت های بیمار میومد)

Rephrased: (linguistic only)
She developed dysphagia for three weeks and hoarseness of voice for one week. Compared to her initial examination, she has an enlarged thyroid. The thyroid mass is firm with limited mobility, and palpable, enlarged lymph nodes are present on the right side of her neck.

I would appreciate for your further assessment on this patient.

Should you need more information about this patient (please) do not hesitate to contact me

Yours sincerely

Dr.Ehsan Sobhanian

• Purpose: 2/3

• Content: 5/7

• Clarity & consciousness: 3/7

• Genre & Style: 4/7

• Organization and layout 3/7

• Language 3/7

  C Overall score: (280)

1️⃣ اول فکر کن، بعد بنویس (Planning قبل از Writing)

❗ بزرگ‌ترین مشکل تو اینه که همه اطلاعات رو پشت‌سرهم می‌ریزی بدون اینکه مشخص باشه:

• کدوم مربوط به ویزیت اول است؟

• کدوم مربوط به follow-up؟

• کدوم symptom جدید است؟

✔️ تمرین پیشنهادی:

قبل از نوشتن، فقط 10 دقیقه فکر کن به تسک و برنامه زیری کن بعد:

• 3 تا bullet بنویس:

• Visit 1 → symptoms + exam

• Visit 2 → investigations + decision

• Current visit → progression + red flags

✳️ بعد نامه را دقیقاً طبق همین ترتیب بنویس و مجدد برام ارسال کن.

2️⃣ هر پاراگراف = یک بازه زمانی (Timeline discipline)

تو مدام این اشتباه را تکرار می‌کنی:

• علائم جدید را می‌بری داخل پاراگراف ویزیت قدیمی

• یافته‌های معاینه را جدا از زمانش می‌نویسی

✔️ قانون طلایی:

هر پاراگراف فقط یک ویزیت

اگر ویزیت جدید است:

Eventually / On her most recent visit / She re-presented today

علائم + معاینه همان روز

3️⃣ از عبارت‌های ترجمه‌ای فارسی استفاده نکن

این‌ها نمونه‌هایی از تفکر فارسی در متن تو هستند:

• ❌ got difficulties

• ❌ in correlation with

• ❌ with the size of

• ❌ denied follow-up

✔️ جایگزین‌های استاندارد OET:

• developed dysphagia

• compared to her previous examination

• measuring …

• declined surgical intervention

📌 این‌ها را باید حفظ کنی، نه اختراع!

📌 جملات اصطلاحا wordy هستند یعنی کلمات اضافه داخل جملات هست که چیزی اضافه نمیکنن مثل:

She was advised for surgical consultation for possible thyroid malignancy based on the diagnosis of Multi-nodular goiter

4️⃣ روی Collocationهای پزشکی تمرکز کن (نه گرامر عمومی)

مشکل تو بیشتر از grammar، medical collocation است.

• complaint ❌ complain

• non-tender ❌ not tender

• measuring 2.2 cm ❌ with the size of

• hoarseness of voice ❌ voice hoarseness

✔️ تمرین پیشنهادی:

• یک دفترچه داشته باش

• Heading: Medical Collocations

• هر رایتینگ → 10 collocation جدید اضافه کن

• هفته‌ای 2 بار فقط آن‌ها را مرور کن

5️⃣ جملات بلند = نمره کمتر

تو جملات را بیش از حد کش می‌دهی:

چند ایده + چند زمان + چند یافته = یک جمله

این مستقیماً نمره Clarity & Organization را پایین می‌آورد.

✔️ قانون ساده:

• اگر جمله‌ات بیشتر از 25 کلمه شد → بشکنش

• اگر 2 ویرگول داشت → بشکنش

6️⃣ Phraseهای آماده OET را حفظ کن

به‌جای ساختن جمله، از قالب‌های امن استفاده کن:

🔹 Introduction

• I am writing to refer …

• I am seeking your assessment regarding …

🔹 History

• She initially presented with …

• Two weeks later, she re-presented …

🔹 Closing

• I would appreciate your assessment and advice regarding …

• Should you require further information …

📌 این‌ها band-safe هستند.

7️⃣ بازنویسی فعال (Active Rewriting) انجام بده

فقط دیدن اصلاحات کافی نیست.

✔️ تمرین طلایی:

• نسخه اصلاح‌شده را بخوان  و همچنین رایتینگ های دیگر زبان آموزان مربوط به این رایتیگ در لینک زیر گذاشتم. بخون و ایرادات رو ببین و مقایسه کن 👍

https://oetbook.ir/?s=Marcus&bp_search=1&view=content

لطفا این رایتینگ رو دوباره بنویسید و ارسال کنید😊

@user-309455

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

RE:Sally Webster (DOB:10.11.2003) 
Dear Dr Yabe, 

I am writing to request your further evaluation and assessment of Sally Webster, whose features are consistent with probable anorexia nervosa. 

• “evaluation” و “assessment” تقریباً هم‌معنی‌اند

Initially, on 17.12.2019, she presented with a complaint of constipation with firm about bowel actions 4-5 days, which had been present for 3 months (for the last three months). She consumed (consumes) 2 tablespoons of bran every morning and had tried taking laxatives. On examination, her findings were unremarkable. I advised her to increase vegetables’ fiber and fluid intake (in her diet).

• Correct date format: 17/12/2019

• →  “constipation with firm bowel motions”

• 4-5 days >> گنگ >>every 4–5 days

• examination findings were unremarkable

Six weeks later, she attended (again) with her mother(,) who was concerned about her weight loss and lack of appetite. She has been having fights with her mother due to her involvement with her diet(این جمله ضروری نبود). Her examination, apart from 6 kg of weight loss and pale skin, was remarkable. 

On review today, she was distant and avoided eye contact. She believes her ideal weight is 40 kg. She denies vomiting and is vague about laxative use. Examinations was (were) unremarkable and investigations revealed no abnormalities. My provisional diagnosis is anorexia nervosa(.) Because of that (In view of this:formal), I consider (that) psychiatric evaluation is necessary.

Regarding her social history, her father has died (died/passed away) 3 years ago and(.) (she) lives with her mother and sister,(and) has a part-time job and is a student. این جمله خیلی طولانی شده 

I would appreciate it if you could assess Sally. Should you require more information, don’t hesitate to contact me.

Yours sincerely
Aynaz Behnoud MD

• Purpose: 3/3

• Content: 5/7

• Clarity & consciousness: 3/7

• Genre & Style: 4/7

• Organization and layout 6/7

• Language 3/7

  B Overall score: (350) با ارفاق

@aynaz-behnoud

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Dear Dr Wright, 
Re:Ms Sandra Marcus

DOB:15 Jan 1983

✅I am writing to refer Ms Marcus, a 33-year-old woman, for assessment regarding a possible thyroid malignancy.

✅Ms Marcus presented on 05 Jul 2019, with a painless neck (,) that she had noticed for the past two months, (measuring) approximately the size of an olive🚩. On examination, a non- tender thyroid nodule was palpated, which moved with deglutition. 

• ❌ “with a painless neck” → Meaning unclear (swelling/lump?) گردن بی‌درد؟

• 🚩Not technically incorrect but…“approximately the size of an olive” is a noun phrase. 

• (در نوشتار رسمی) میکس noun phrase و relative clause در صورتی صحیح است که ابتدا noun phrase آورده بشه:

• …a painless neck swelling, approximately the size of an olive, which she had noticed for the past two months.

• یا …a painless neck swelling, which she had noticed for the past two months, measuring approximately the size of an olive.

✅At Ms Marcus’ (Marcus’s) follow-up appointment two weeks later, her ultrasound results revealed multiple nodules and calcifications on both lobes of the thyroid gland. At the time, she was reluctant to undergo surgical intervention. 

• Provisional diagnosis? Multi-nodular goitre

• TFTs normal

✅Ms Marcus presented again today with (a) progressive increase in size of the neck swelling since over the past month, associated with dysphagia for 3 weeks and hoarseness of voice for one week. On examination the nodule has (had) increased in size, demonstrated limited mobility(,) and right-sided cervical lymphadenopathy were (was) detected. She has now agreed to proceed with surgical intervention. 

• “progressive increase” is treated as a countable noun here.

• ❌”since over the past month” → “over the past month”

• “hoarseness of voice” → simpler: “hoarseness”

✅I would be grateful if you could assess Ms Marcus for possible thyroid malignancy and advise on further management. 

If you require further information, please do not hesitate to contact me. 

Yours sincerely, 

Doctor

• Purpose: 3/3

• Content: 4/7 (provisional diagnosis / neck swelling was not mention/ TFTs normal)

• Clarity & consciousness: 6/7

• Genre & Style: 5/7

• Organization and layout 6/7

• Language 4/7

  B Overall score: (400)

@user-961619

[Siavash Zare]

▇ Errors     ▇ Suggestions   ▇ Rephrased

Dear Emergency Registrar,
Re: Mr. Dave Cochrane, DOB: 20/11/1962 

Thank you for seeing Mr. Cochrane, a retired gentleman for urgent admission to the cardiology unit, for stabilization of current cardiac failure. (his acute left ventricular failure)

• عبارت current cardiac failure قابل درک است اما دقیق نیست. در نامه‌های اورژانسی به خصوص، وضعیت بیمار واضح و دقیق ذکر شود و سعی نکنید اطلاعات پزشکی را rephrase کنید.

Mr. Cochrane presents (presented) today with severe shortness of breath, chest pain and sweating since two hours prior (prior to presentation). On examination, his jugular venous pressure is (was) high and he has (had) bilateral ankle edema. His apex beat is (was located) in the sixth intercostal lateral mid clavicular line. His vital signs are stable, although crepitations are heard in both lung bases.

• شما در این پاراگراف از حال ساده استفاده کردید که اشتباه است. دقت کنید حتی اگر امروز بیمار رو ویزیت کردید باز هم گذشته و تمام شده و از زمان گذشته فعل باید بهره بگیرید.

❌ “His apex beat is in the sixth intercostal lateral mid clavicular line.”  → ✅ “His apex beat is located at the sixth intercostal space, lateral to the mid-clavicular line.”

Mr Cochrane first presented on 12/09/2019 with similar symptoms of shortness of breath and also coughing (cough) and was diagnosed with left ventricular failure. He was started on broad-spectrum antibiotics for a week, in addition to Frusemide 40mg/day and Digoxin 0.25 mg/day. 

On (the) follow-up visit two weeks later, his general health had improved, although his examination revealed mild residual ankle edema and a few lung crepitations. 

I would be grateful for your expertise in caring for Mr. Cochrane and (for) admitting him to the cardiology unit for stabilization of (his) left ventricular failure. 

If you have any further queries, please don’t hesitate to contact me. 

Sincerely yours
Doctor

 

• Purpose: 3/3

• Content: 4/7

• Clarity & consciousness: 4/7

• Genre & Style: 5/7

• Organization and layout 6/7

• Language 4/7

  B Overall score: (380)

@user-961619