MY EXPERIENCES WITH GENERAL CELLULAR AND NEURAL CELLULAR PATHOLOGY IN A CASE BASED BLENDED LEARNING ECOSYSTEM'S CBBLE

 Greetings, 

I am Anahita Behara a final year medical student from India .I welcome you to join me on my journey in navigating the topsy turvy road of learning in medical school. 

 

 

CBBLE PAJR PARTICIPATORY LEARNING ACTION RESEARCH DISCLAIMER

 NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS/HER GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT.

 

I remember the first-time general medicine sparked interest in me . Due to covid restrictions our second year of medicine was conducted online .We had telephonic conversations with the patients to take their history and subsequently document elogs or online case logs.

I vividly recall the case of a 70 year old woman with hypothyroidism who was administered amiodarone.
amiodarone is a class 3 anti-arrhythmic drug , having 37 percent iodine , with structural similarity to thyroxine , resulting in hyperthyroidism and thyrotoxicosis . Hence it is contraindicated in patients suffering from thyroid disorders .

source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6661016/

case link : https://60shirisha.blogspot.com/2021/06/medicine-case-discussion_14.html?m=

I approached my mentor with this perplexing doubt , I was encouraged to educate myself on the multifaceted modalities of prescribing a drug , and how prescriptions are personalised to meet the needs of each individual and how there is no standardised treatment regimen for a specific illness.
It changed my perspective that medicine should be more patient-centric and not limited to the disease.

This paved the path for my passion to study and interact with patients , and  I was given the chance to accompany  patients in their quest to control their condition via lifestyle changes .

limiting this voyage to a single disorder , let us delve into one of the most common ones , "ANEMIA"

Anaemia results from a lack of red blood cells or dysfunctional red blood cells in the body. This leads to reduced oxygen flow to the body's organs.
Let’s us contemplate the varied complaints and presentations of the same sign 'PALLOR'
often overlooked pallor is an extremely important finding as it gives an insight into the patient's problem , the infinite causes and resulting symptoms of the same problem
Anemia can cause :



source of image : https://images.app.goo.gl/MCj3j6h5fydZS7naA

33/F chronic anemia 2° to haemorrhoids 

 

A 33 year old woman hailing from Karnataka presented with
shortness of breath graded 3 according to NYDA classification to the gen med opd , she had previously received blood and iron transfusions over the course of 15 years , on taking her history , it was found that she was a vegetarian and did not harbour the desire to eat ever since she was a child ,
the primary cause of her anemia might have been dietary , however after her first pregnancy she developed grade one haemorrhoids , which led to chronic blood loss via stool ,which might have been another cause of her anemia

-case link : https://anahitabehara.blogspot.com/2023/05/33f-chronically-anemic-since-15-years.html

after making her PaJR group and evaluating her diet , it didn't seem as her symptoms were stemming from a dietary insufficiency as she had a balanced diet . Thus, we could eliminate one of the varied causes of anemia. This way we could come to a reasonable diagnosis and continue with the treatment.

 

24/F chronic anemia since 7 years 

The case of a 24 year old woman , a local of west Bengal , with chief complaints of hypomenorrhea and dizziness was assigned to me , on probing further she also was suffering from diabetes mellitus and recently had a cholecystectomy operation for cholelithiasis .
It made me wonder if the plethora of all her  problems was related to unhealthy diet and lifestyle.

We made the PaJR group and have actively advised her to include green leafy vegetables and lower the amount of rice consumed on a daily basis ,  the patient was able to voice her concerns and was satisfied with the quality of care.

case link : https://anahitabehara.blogspot.com/2023/05/24f-chronic-anemia-2-dietary-iron.html


SWOT analysis
S- strengths
-we can directly communicate the necessary changes to be made on a daily basis
-patient compliance is higher as they feel reassured

W : weaknesses
-we have to rely on images for examination of patients hailing from different states
-clinical investigations and examination play an important role , however we are limited to inspection and cannot palpate , percuss and auscultate as a part of the routine examination

O : opportunities
-the patient is educated about the necessary changes to be implemented
-there is no travel cost as it is online

T: threats 
-due lack of physical examination we may not be able to provide correct diagnosis