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MONTHLY ONLINE ASSIGNMENT

>        THIS IS THE FOLLOWING ASSIGNMENT I HAVE BEEN GIVEN TO WORK ON

ASHISH 12 (3rd sem)

             >     This is the link of the questions asked regarding the cases:






1 ) CARDIOLOGY  1

                                                                  CASE-1  

CASE DETAILS -   https://bejugamomnivasguptha.blogspot.com/2021/05/pulmonology.html

CASE REVIEW - https://muskaangoyal.blogspot.com/2021/05/a-73-year-old-male-patient-with-pedal.html 


                                  > illustrated the case very well 
                             > reasons for heart failure , anemia and blebs were given perfectly and explained it with flow charts  



2) PULMONOLOGY 


CASE - 2 


CASE DETAILS - https://budigesaikiran14.blogspot.com/2021/05/xyz.html

CASE REVIEW - NONE 


                            >Evolution of symptomatolgy was explained in flow chart. 
                           >Proper explanation of acute exacerbation is given.




3) NEUROLOGY 



CASE - 3 



CASE DETAILS - https://anuragreddy72.blogspot.com/2021/05/online-blended-bimonthly-assignment.html

CASE REVIEW - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606320/    ( REFFERED FROM )


                         

                                > MECHANISM OF ACTION THIAMINE  WASNT CLEARLY EXPLAINED 
                      > THE CASE WAS WELL PRESENTED THOUGH , IT WAS EASY TO UNDERSTAND
> THE INFORMATION OF THE INJECTIONS LIKE INJ. LOREZEPAM WERE  TAKEN FROM A VERY POPULAR WEBSITE 


4) CARDIOLOGY 2

                                                                 CASE - 4


Case details - https://meghanaraomuddada.blogspot.com/2021/05/medicine-case-based-learning.html 
 
Patient details  -  https://preityarlagadda.blogspot.com/2021/05/biatrial-thrombus-in-52yr-old-male.html

                                     
                                > THE INFORMATION WAS QUITE LENGHTY 
                                >  IT WASNT PRESENTED WITH ANY FLOW CHARTS 



5) GASTROENTEROLOGY 

                                                             
                 
                                                               CASE - 5 

 Link to patient details - https://63konakanchihyndavi.blogspot.com/2021/05/case-discussion-on-pancreatitis-with.html


 CASE DETAILS - https://rithikamukkawar113.blogspot.com/2021/05/medicine-case-based-learning-online_31.html?m=1



                         > CASE WAS PRESENTED NEATLY AND WAS EXPLAINED WELL 
                         > THE USAGE OF DRUGS WERE EXPLAINED BRIEFLY AND WERE RESEARCHED FROM DIFFRENT WEBSITES WITH SOME QUALITY INFORMATION 



6) NEPHROLOGY CASE (UROLOGY)


                                                CASE - 6  






                     > QUANTATIVE ASSESMENT COULD BE RATED 7/ 10

7) CARDIOLOGY 3 

      CASE - 6 

    
case details - https://44jsrinath.blogspot.com/2021/05/44-jsrinath-reddy-general-medicine.html?m=1

                   
                       > case was presented well in points 
                       > it was easy to understand with important points only 




9) GASTROENTEROLOGY 





>answering has been done in a point wise manner, with nice detailing & information.
>reference links to answer information are appreciated





9)  NEPHROLOGY AND UROLOGY 





       >  The management of the disease and the drugs have been well explained. 

         > well organized and the case was explained in detail .                                      

   


Q2) Share the link to your own case report of a patient that you connected with and engaged while capturing his her sequential life events before and after the illness and clinical and investigational images along with your discussion of that case. 

 > Case discussion

A 55 year old male resident of Nunavathanda came to opd with 

 1) Chief complaint of - 

Pain abdomen at right hypochondrium and lumbar region , decreased appetite & SOB (shortness of breath) since 20 days for which he went to a local hospital and diagnosed as Multiple liver abscess(? Pyogenic)-unliquified and treated with IV antibiotics.

<pic>
No H/O Fever,vomitings,loose stools,no other complaints
H/O TB 10 years back used medications for 5-6 months
Not a k/c/o HTN,DM, Asthma,CAD.


2) treatment history

He used medications for TB 10 years back for 5 months.


3) Personal history;

Diet:Mixed
Appetite:Normal
Sleep:Regular
Bowel and bladder:Regular
Occupation: farmer
Patient consumes 180 ml of alcohol daily since 40 years
He smokes sutta 3/day since 40 years

O/E:
Pt c/c/c
PR: 86 bpm
BP:110/80 mmhg
CVS: S1 S2 + , no murmurs
RS: BAE + , NVBS
P/A: soft , Tenderness + in right hypochondrium
CNS: NFND

4) Investigations

serum electrolytes:

serum creatinine:
blood urea
hemogram:

liver function test:


ECG of patient:

Ultrasound report:





 > THESE WERE THE ONLY INVESTIGATIONS DONE ,  I WILL BE UPDLOADING IF THERE IS ANY IMPROVEMNENT OR ANY CHNAGE . 



5) Diagnosis:

Multiple liver absess 

6) Treatment on

1/07/21(day1)-
Inj.MEROPENAM 1gm IV/BD
INJ.METROGYL 100ml NS IV/TID
INJ.TRAMADOL 1amp in 100ml NS IV/OD
BP/PR/Temp/SpO2 mo



Q3)I have chosen the following case to provide my critical appraisal of the captured data in terms of completeness, correctness and ability to provide useful leads to analyze the diagnostic and therapeutic uncertainties 

HFrEF with Atrial fibrillation 2 to ?IHD : 

 Heart failure  is a complex clinical syndrome that results from either functional or structural impairment of ventricles resulting in symptomatic left ventricle  dysfunction. The symptoms come from an inadequate cardiac output, failing to keep up with the metabolic demands of the body.

Etiology


Coronary artery disease (CAD): chronic and acute ischemia causes direct damage to the myocardium and leads to remodeling and scar formation, resulting in inadequate relaxation in diastole and impaired contraction in systole, which decreases contractility and cardiac output (CO).

HBP is an independent risk factor for CAD. The high prevalence of HBP makes it a possible cause of HF in around one-fourth to one-third of cases. HBP increases vascular resistance and activates the renin-angiotensin-aldosterone system (RAAS). The heart must pump up blood against a higher afterload caused by HBP, which increases the myocardial mass as a compensatory mechanism to maintain a normal CO and that causes left ventricular hypertrophy (LVH). 


Treatment / Management


1) 
  • Pharmacologic therapy for HFrEF 
  •  - 1- ACEi or ARBs (class IA) are the first-line therapies
  • 2- Beta Blockers (Class IB)
  • 3- Mineralocorticoid Receptor Antagonists 
  • 5- Digoxin


Q5) Testing scholarship competency in  logging reflective observations on your concrete experiences of this last month : 


we have been under lockdown since 2 years , so i have got no experience being in the hospital , i just had to revise and deal with the cases online and i had to discuss them online with my fellow classmates 

we havent got a chance to interact with the patient , so we have got no clinical experience . 

Presently the impacts of COVID-19 in daily life are extensive and have far reaching consequences. Healthcare category got to face a lot consequences too.

    • • Challenges in the diagnosis, quarantine and treatment of suspected or confirmed cases
    • • High burden of the functioning of the existing medical system
    • • Patients with other disease and health problems are getting neglected
    • • Overload on doctors and other healthcare professionals, who are at a very high risk
    • • Overloading of medical shops
    • • Requirement for high protection
    • • Disruption of medical supply chain. 























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