JULY BIMONTHLY ASSIGNMENT

General medicine July assignment

I have reviewed the june assignment of roll number 9

 

https://angasanvith09.blogspot.com/2021/07/general-medicine-assignment.html

 

-the reviews were very well thought-out  and it was clear that the student has done a through review of the cases presented to them .

-the case reviews for hepatology and pulmonology were a bit lacking

-the gastroenterology and neurology cases were extremely well done and the detailed findings made it easy to understand

-the font was easy to read but the background color of the text made it difficult to read, a more lighter color would captivate the readers attention

This is my case study for july

https://anahitabehara.blogspot.com/2021/07/anahita-behara-roll-no-08-this-is.html

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CASE REVIEW

Case -1

https://laharikantoju.blogspot.com/2021/07/58-year-old-male-patient-elog-lahari.html?m=1

-The sequential order of events was well recorded and very clear and comprehensible

-the use of highlights would make an even interesting read

-the description of the diagnostic report and inclusion of  the pictures of the report was a good choice it made the reader go over the values once more and make us (the reader) ponder about the reports

-grade: 9/10

 Case-2

https://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html

-The day-wise treatment plan was well organised  

-the diagnostic images were clear and placed well , however the findings of the blood tests , MRIs and color dopplers 

-the highlights were pleasant to the eyes and made it easy to read

Case-3

https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1

-could’ve added normal values as a comparision in the hemogram , vitamin and iron reports at first glance instead of adding it later ,thus making it a bit cumbersome to compare values.

-could’ve added the X-ray report and its interpretation immediately after the X-rays were shown

  -the day wise progression of the patient when they arrived in the hospital along with the treatment plan was extremely well written and an interesting read

Grade:8/10

Case -4

https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html

-the abbreviations could have been replaced with the full form . Eg ; ROSC : Return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation from cardiac arrest (CA) , it would have been easier to understand this way.

-usuage of terms like yesterday and today to signify the progression of coma instead of dates , made it a tad bit confusing

-the well documented progression of the patients coma , their day wise diagnostic reports and images of the bed sores helped us understand the treatment plan better

-the through history and the brief summary of the case given at the end was a great choice.

Grade :9/10

Case-5

https://kavyasamudrala.blogspot.com/2021/05/medicine-case-discussion-this-is-online.html

-the usage of highlights in the history of illness , made the important points stand out and brought more attention to them.

-the history of the patient was easily comprehendible and it grips the readers attention.

-the discharge summary or status of the patient remained unclear

-adding a reference image to show normal KUB (kidney,ureters and bladder) was a nice touch

Grade : 9/10

Case-6

https://rishikakolotimedlog.blogspot.com/2021/07/45-year-old-male-with-chief-complains.html

-the use of dates in presenting illness would’ve been better as the time of reading may differ for other readers and would give a false impression of the history of past illness.

-the usage of highlighted text a the right places helped a lot to put emphasis on the patients presenting illness as well as progression of their past illness .

-the interpretation of the diagnostic reports were written separately and mention above the images this helps the reader understand and comprehend the results of the reports.

-the links for the research of beta-blockers and renin-angiotensin inhibitors is very thought provoking and was a good way to complete the case report

Grade:9/10

Case-7

https://keerthireddy42.blogspot.com/2021/07/43-yr-old-male-of-nalgonda-came-to.html?m=1

 - a very simple presentation of the case

-the organized and orderly manner in which the day wise progression symptoms, vitals and the treatment plan was well done.

-the absence of a discharge summary or whether the case is ongoing makes the report feel a bit unfinished

Grade:8.5/10

  

ANSWER-4

                                                              CASE-3

CASE-4

https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html

"Chief complaints"

Fever and Diarrhea since 5 days( 4 to 5 times a day with blood discharge).

Back pain( 5 days ago) with abdominal pain and chest pain.

Provisional diagnosis:  DKA with AKI ( ? Pre renal)

PIPATZ

Piperacillin-tazobactam is a beta-lactam/beta-lactamase inhibitor combination with a broad spectrum of antibacterial activity that includes Gram-positive and -negative aerobic and anaerobic bacteria

It contains the active ingredients piperacillin and tazobactam. They belong to a group of antibiotics called penicillins that work by killing bacteria. Piperacillin is an antibiotic that kills many types of bacteria.It contains the active ingredients piperacillin and tazobactam. They belong to a group of antibiotics called penicillins that work by killing bacteria. Piperacillin is an antibiotic that kills many types of bacteria.

NORAD/Nor-adrenaline

 noradrenaline, is a medication used to treat people with very low blood pressure. It is the typical medication used in sepsis if low blood pressure does not improve following intravenous fluids. It is the same molecule as the hormone and neurotransmitter norepinephrine.

Noradrenaline is a vasoconstrictor that predominantly stimulates α1 receptors to cause peripheral vasoconstriction and increase blood pressure. It also has some β1 receptor agonist activity that results in a positive inotropic effect on the heart at higher doses.

Dopamine 

Dopamine produces positive chronotropic and inotropic effects on the myocardium, resulting in increased heart rate and cardiac contractility.

Dopamine is an important regulator of salt and water excretion by the kidney. The kidney has a robust intrarenal dopaminergic system

Circulating and locally formed dopamine can affect both sodium excretion and renal hemodynamics via activation of the D1-like and D2-like receptors [1,4,5]. Natriuresis — Dopamine is a natriuretic hormone, increasing sodium excretion by diminishing reabsorption, primarily in the proximal tubule

Clexane

Clexane belongs to a group of drugs called anticoagulants. Clexane stops unwanted blood clots from forming and can stop any blood clots that have already formed from growing bigger. Clexane does NOT break down blood clots that have already formed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358682/

Meropenem

Meropenem is a broad-spectrum carbapenem antibiotic. It is active against Gram-positive and Gram-negative bacteria. Meropenem exerts its action by penetrating bacterial cells readily and interfering with the synthesis of vital cell wall components, which leads to cell death.

Meropenem is a broad-spectrum carbapenem antibiotic with excellent activity against many pathogens associated with complicated skin and soft tissue infections (in this case : the patients , bed sores)

Fosfomycin

fosfomycin was also the most effective antibiotic against all MDR and ESBL producing isolates followed by amikacin, amoxicillin-clavulanic acid and nitrofurantoin.

Levoflox 

Levofloxacin is used to treat a variety of bacterial infections. This medication belongs to a class of drugs known as quinolone antibiotics. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections.

Vancomycin

Vancomycin is in a class of medications called glycopeptide antibiotics.

Vancomycin is used to treat an infection of the intestines caused by Clostridium difficile, which can cause watery or bloody diarrhea. This medicine is also used to treat staph infections that can cause inflammation of the colon and small intestines.

CASE-5

https://pubmed.ncbi.nlm.nih.gov/

https://www.ahajournals.org/doi/abs/10.1161/CIRCHEARTFAILURE.113.000132

ANSWER-5

These online postings were helpful but the connection was not strong so we were

Not able to see the patients . The case sheet review was really helpful as we learnt a lot about AKI and kidney diseases . The effort and dedication that the doctors show to teach us and make sure we understand is commendable . Amidst these tough times we looking forward for general medicine postings