This is a regular academic session log for the post graduate residency training program comprising currently of residents of 2019 and 2020 batch. The training program comprises of a regular hands on learning of clinical decision making during the bedside rounds from 10 AM to 1:00 PM as well as 2-4 sessions officially divided daily into:
TUTORIALS :
TOPIC: DRUG INDUCED LIVER FAILURE
CONTEXT : A PATIENT OF LIVER FAILURE AFTER CONSUMPTION OF TINOSPORA CRISPA MISTAKEN FOR TINOSPORA CORDIFOLIA
TOPIC: POLYGLANDULAR AUTOIMMUNE SYNDROMES PGA
CONTEXT: A PATIENT OF DOWNS SYNDROME WITH PGA TYPE 2
Elogged case report link : http://mahithguduri63.
BY:
DR.A VAISHNAVI PGY3
DR.SWETHA UG 9TH SEM
ATTENDED BY:
DR.PRADEEP PGY2
DR.VAMSHI PGY2
DR.MANASA PGY2
DR.SHASHI KALA PGY2
DR.ZAIN PGY3
DR.AJITH PGY3
DR.AASHITHA PGY3
DR.SUSHMITHA PGY3
DR.USHA SREE PGY3
DR.RASHMITHA PGY3
3RD SEPTEMBER 2021
Friday
GROUP DISCUSSION
TOPIC: CEREBRAL METASTASIS
CONTEXT:
A) 45 YEAR OLD woman WITH ALTERED SENSORIUM AND past cervical cancer and MRI STUDY showing cerebral metastasis.
Elogged case report link : https://madamsneha74.blogspot.
BY:
DR.SHASHI KALA PGY2
DR. NEHA 9TH SEM
DR.MANOGYNA 9TH SEM
ATTENDED BY:
DR.PRADEEP PGY2
DR.VAMSHI PGY2
DR.MANASA PGY2
DR.SHASHI KALA PGY2
DR.ZAIN PGY3
DR.AJITH PGY3
SHI KALA PGY2
DR.ZAIN PGY3
DR
4TH SEPTEMBER 2021
Saturday
LOG BOOK AUDIT :
As mentioned and demonstrated in the links below each student's online portfolio is divided into non verbal procedural and verbal competency logs:
https://
https://
Number of PG students 20 Number of logbooks evaluated 2
Student 1: Dr Raveen PGY1:
https://raveen07.blogspot.com/
Logbook update : last in June 16, 2021 as an answer to the May 2021 online assignment for the monthly summative test.
Learning Competency assessment from the summative test :
Other competencies undocumented by the PG. No assessible link to current workflow showing procedural or case presentation videos as well as verbal report of daily case based workflow.
Impact : Negligible and below expectations in terms of logged workflow.
However, the PG has unlogged competencies demonstrated during work in the form of working longer hours with discipline but tends to avoid academics.
Student 2: Dr Zain PGY2
https://zainalammohammed59.
Logbook update : last in September 8 2020
as an answer to the Sept 2020 online assignment for the monthly summative test.
Learning competency assessment areas:
Other competencies undocumented by the PG. No assessible link to current workflow showing procedural or case presentation videos as well as verbal report of daily case based workflow.
Impact : Negligible and below expectations in terms of logged workflow.
However, the PG has unlogged competencies demonstrated during work in the form of patient empathy, resource generation and utilization to meet patient requirements and this has had palpable impact on our learning ecosystem.
Log Book audit summary:
Logbooks completed : nil Last update months back.
Logged learning points : nil
Logged learning impact: nil
Reasons : Disinterest, apathy, lack of scholarship of integration?
These have been instituted by the department of Medicine as part of a minimum standard paper based requirement carried out in our other accredited medical colleges as per a standard paper based format below
5TH SEPTEMBER 2021
SUNDAY
Online emergency patient discussions
6TH SEPTEMBER 2021
MONDAY
THEORY CLASS
TOPIC: APPROACH TO DYSPNOEA
PULMONARY EMBOLISM DIAGNOSIS AND MANAGEMENT
CONTEXT : ELOG LINKS,
https://gtejaswini61.blogspot.
http://nehareddygaddam.
Presented by :
Dr Karnati Vaishnavi
Dr Rashmita
Dr Raghav
Dr Soumya
Attended by :
PGs and 2017 UGs
7TH SEPTEMBER 2021
TUESDAY SEMINAR
CONTEXT: https://
8TH SEPTEMBER 2021
Wednesday
Journal club
CONTEXT: DIAGNOSTIC UNCERTAINITY IN ADDISON'S DISEASE
ELOGGED case report LINK: Down's with Addison's :http://mahithguduri63.
REVIEW OF LITERATURE around:
Accuracy of the Low-Dose ACTH Stimulation Test for Adrenal Insufficiency Diagnosis:
ONLY 4 OUT OF 36 PATIENTS WERE CLINICALLY TRUE POSITIVE FOR ADDISONS ALTHOUGH 36 TESTED POSITIVE WITH ACTH THAT IS SHOWED IN LOW CORTISOL RESPONSE
LINK : https://www.ncbi.nlm.nih.gov/
ATTENDED BY:
DR.A.VAISHNAVI PGY3
DR.USHA SREE PGY3
DR.RASHMITHA PGY3
DR.MANASA PGY2
DR.SHASHI KALA PGY2
9th September
Thursday
Tutorial
Approach to diagnostic uncertainty around non cardiogenic and cardiogenic pulmonary edema
Context: Patient of cardiogenic pulmonary edema who was possibly treated as a non cardiogenic pulmonary edema as covid pneumonia with remdesivir based only on radiology assessments.
More here in the student logged case report: https://jahnavichatla.
Which EEG patterns in coma are nonconvulsive status epilepticus?
11TH SEPTEMBER 2021
SATURDAY
LOG BOOK Audit
Number of PG students 20 Number of logbooks evaluated 2
Student 1: Dr Shailesh PGY2
Logbook update : last in March 30, 2021
Logged learning Competency assessment : Incomplete case data capture analysis and follow up. No discussion
Learning Impact : Negligible
Student 2: Dr Karnati Vaishnavi
Logbook update : last in September 11, 2021
Logged learning Competency assessment :
Good case data capture, presentation and analysis skills although follow up notes absent.
Learning Impact: Good impact on the local learning ecosystem. Has potential for scholarship of integration.
12TH SEPTEMBER 2021
SUNDAY
13TH SEPTEMBER 2021
2:00-4:00
THEORY CLASS
TOPIC: APPROACH TO COMA
Context:
https://karnativaishnavi.
PRESENTED BY :
DR.AASHITHA PGY3
DR.SHASHIKALA PGY2
Dr Karnati Vaishnavi
ATTENDED BY:
DR.USHA SREE PGY3
DR.MANASA PGY2
DR.SHASHI KALA PGY2
DR.ZAIN PGY3
DR.AASHITHA PGY3
DR.SUSHMITHA PGY3
14TH SEPTEMBER 2021
TUESDAY SEMINAR
TOPIC:
ADVANCED THYROID CANCER
DIAGNOSTIC AND therapeutic UNCERTAINITIES
CONTEXT : https://decodemed.blogspot.
PRESENTED BY: DR A.VAISHNAVI PGY3
ATTENDED BY:
DR.PRADEEP PGY2
DR.MANASA PGY2
DR.SHASHI KALA PGY2
DR.AASHITHA PGY3
DR.K VAISHNAVI PGY3
DR.USHA SREE PGY3
15TH SEPTEMBER 2021
WEDNESDAY JOURNAL CLUB
TOPIC:
CRITICAL ILLNESS POLYNEUROPATHY AND MYOPATHY: A SYSTEMIC REVIEW
https://www.ncbi.nlm.nih.gov/
PRESENTED BY : DR. AASHITHA PGY3
ATTENDED BY :
DR.PRADEEP PGY2
DR.SHASHI KALA PGY2
DR.ZAIN PGY3
DR.AJITH PGY3
DR.AASHITHA PGY3
DR.SUSHMITHA PGY3
DR.USHA SREE PGY3
DR.RASHMITHA PGY3
16TH SEPTEMBER 2021
THURSDAY
TUTORIALS
TOPICs:
Stroke:
Context : POST STROKE ALTERED SENSORIUM
Pancytopenia
Context:
ACUTE DRUG INDUCED PANCYTOPENIA AND HYPONATREMIA (PANTOPRAZOLE)
PRESENTED BY :
DR.RASHMITHA PGY3
DR.SUSMITHA PGY3
ATTENDED BY:
DR.MANASA PGY2
DR.SHASHI KALA PGY2
DR.AJITH PGY3
DR.SUSHMITHA PGY3
DR.USHA SREE PGY3
DR.RASHMITHA PGY3
17TH SEPTEMBER
FRIDAY
GROUP DISCUSSION
TOPIC: CEREBRAL LOBAR FUNCTION TESTING IN STROKE WITH HIGHER MENTAL FUNCTION ABNORMALITIES
TOXIC ADENOMA DIAGNOSIS AND MANAGEMENT
APPROACH TO EVALUATION OF HEART FAILURE
PRESENTED BY:
DR.SHASHI KALA PGY2
DR.USHA SREE PGY3
DR.AASHITHA PGY3
ATTENDED BY:
DR.MANASA PGY2
DR.SHASHI KALA PGY2
DR.ZAIN PGY3
DR.AJITH PGY3
DR.AASHITHA PGY3
DR.SUSHMITHA PGY3
DR.USHA SREE PGY3
DR.RASHMITHA PGY3
18TH SEPTEMBER 2021
SATURDAY
LOG BOOK
19TH SEPTEMBER 2021
SUNDAY
20TH SEPTEMBER 2021
MONDAY
THEORY CLASSES
Approach to quadriparesis and myelopathy
21ST SEPTEMBER 2021
TUESDAY
CLINICAL SEMINAR
TOPIC: NECROSITING PANCREATITIS : DIAGNOSTIC AND THERAPEUTIC OUTCOMES
BY:
DR.DURGA KRISHNA PGY2
DR.AJITH PGY3
ATTENDED BY:
DR.SHASHI KALA PGY2
DR.ZAIN PGY3
DR.SUSHMITHA PGY3
DR.A VAISHNAVI PGY3
DR.USHA SREE PGY3
22ND SEPTEMBER 2021
WEDNESDAY :
JOURNAL CLUB
TOPIC :
OCTREOTIDE EFFICACY IN PANCREATITIS
https://www.ncbi.nlm.nih.gov/
PICO format :
(P) Total patients (n=302)
Treatment groups:
(I)ntervention: Octreotide
O1 (n=98); O2 (n=101) ;
Comparator:
Placebo (n=103) ;
(O)utcomes:
Death (Total) 43 (14%) ;
Death outcomes compared in the three groups :
(P)16 (16%); (O1)15 (15%) ;(O2) 12 (12%)
BY:
DR.AJITH PGY3
DR.DURGA KRISHNA PGY2
ATTENDED BY:
DR.SHASHI KALA PGY2
DR.AJITH PGY3
DR.SUSHMITHA PGY3
DR.USHA SREE PGY3
DR.RASHMITHA PGY3
23rd Thursday
Tutorial :
Approach to lowbackache and polyarthritis
Context : link?
Learning outcomes were translated to patient outcomes as a clinical decision to obtain brucella serology was made based on the tutorial discussion
Approach to refractory hypertension
Context:
Current:
http://keerthykasa80.blogspot.
Past: http://globaludhc07.blogspot.
Review:
Diagnosis and treatment outcome in primary aldosteronism based on a retrospective analysis of 187 cases
Presenter :
A Vaishnavi PGY2
Learning outcomes were translated to patient outcomes as a clinical decision to add spironolactone was made based on the tutorial discussion
24th Friday
Group discussion
Topic : Myxedema coma with hypotension, pericardial tamponade, thyroxine and adrenergic pathways.
Context : http://mahithguduri63.
Presenter : Ajit PGY2
Outcome:
Learning outcomes were translated to patient outcomes as a clinical decision to do emergency pericardiocentesis was made based on the group discussion
25th Saturday
Log Book audit
26th Sunday
27th Monday
Theory class
Topic: Pancreatitis
E Log link to patient context :
http://prakashgowtham65.blogspot.com/2021/09/50-year-old-male-with-chronic.html
28th Tuesday
BDS UG university exams and Flood holiday
29th Wednesday
Journal club
Catheter-directed thrombolysis of deep vein thrombosis: literature review and practice considerations
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778526/
Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial:
Conventional anticoagulant treatment for acute deep vein thrombosis (DVT) effectively prevents thrombus extension and recurrence, but does not dissolve the clot, and many patients develop post-thrombotic syndrome (PTS). We aimed to examine whether additional treatment with catheter-directed thrombolysis (CDT) using alteplase reduced development of PTS.
P - 209 patients were randomly assigned to treatment groups (108 control, 101 CDT). Patients aged 18–75 years with a first-time iliofemoral DVT were included within 21 days from symptom onset.
I - CDT vs Conventional anticoagulantion.
O- At 24 months, 37 (41·1%, 95% CI 31·5–51·4) patients allocated additional CDT presented with PTS compared with 55 (55·6%, 95% CI 45·7–65·0) in the control group (p=0·047). The difference in PTS corresponds to an absolute risk reduction of 14·4% (95% CI 0·2–27·9), and the number needed to treat was 7 (95% CI 4–502). Iliofemoral patency after 6 months was reported in 58 patients (65·9%, 95% CI 55·5–75·0) on CDT versus 45 (47·4%, 37·6–57·3) on control (p=0·012). 20 bleeding complications related to CDT included three major and five clinically relevant bleeds.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61753-4/fulltext.
Context: 13 Year old girl with extensive iliofemoral thrombosis and suspected pulmonary infarction referred to KHL for catheter directed thrombolysis
30th Thursday :
Tutorial
Transfusion associated graft versus host disease
Context:
A young man with dengue thrombocytopenia refused platelet transfusion by the blood bank as his sister (first degree relative) was the only available donor.
Readings:
Malladi SV, Paul R, Chandra N, Rao NM, Raju SY. TA-GVHD, a Fatal Complication Following Blood Transfusion from a First-Degree Relative. J Obstet Gynaecol India. 2013 Oct;63(5):344-6. doi: 10.1007/s13224-012-0189-x. Epub 2012 Oct 3. PMID: 24431673; PMCID: PMC3798441.
