Medicine CUBE -- Nail growth conversational learning in the CBBLE PaJR group

Medicine CUBE is a positive cross connection toward a broader collaboration. 

Glossary :

CUBE : Collaboratively Understanding Biology Education .More here : https://www.hbcse.tifr.res.in/research-development/collaboratively-understanding-biology-education-cube

Conversational learning : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117104/

CBBLE : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163835/

PaJR : https://userdrivenhealthcare.blogspot.com/2022/09/current-pajr-workflow-and-how-to-make.html?m=1

[9/18, 7:55 AM] MBBS 2019 Batch: Saw about Collasmart capsules adv. does it help for my knees?

[9/18, 7:56 AM] MBBS 2019 Batch: Question from patient

[9/18, 8:12 AM] Rakesh Biswas: Type collagen extract efficacy in osteoarthritis and share what you learn. 

However the more important question earlier asked (and still unanswered) here is : does she have arthritis at all? 

Does she have any feature of swelling, restriction of movement and deformity in any of the joints?

[9/18, 8:12 AM] MBBS 2019 Batch: No sir, she doesn't have any of those

[9/18, 8:12 AM] MBBS 2015 Batch: Doesn't she eat chicken?

[9/18, 8:13 AM] MBBS 2019 Batch: No sir, vegetarian

[9/18, 8:14 AM] Rakesh Biswas: Is the incidence of any disease higher in vegetarians (provided they don't indulge in hogging simple carbohydrates)?

[9/18, 8:15 AM] MBBS 2015 Batch: Not sure sir..

But if she's non vegetarian,there's no requirement to take anymore supplements,I feel

[9/18, 8:17 AM] Rakesh Biswas: Why put non vegetarians on a pedestal. I guess even vegetarians eating healthy also shouldn't need any supplements

[9/18, 8:18 AM] MBBS 2015 Batch: Yep agree

[9/18, 8:31 AM] MBBS 2015 Batch: @⁨MBBS 2019 Batch⁩ However if she feels she needs some collagen,try recommending her some good vegetarian sources of collagen.

Google and also share here what are good vegetarian sources of collagen

[9/18, 8:36 AM] MBBS 2019 Batch: In food, collagen is naturally found only in animal flesh like meat and fish that contain connective tissue. However, a variety of both animal and plant foods contain materials for collagen production in our own bodies.

https://www.hsph.harvard.edu/nutritionsource/collagen/

[9/18, 8:37 AM] MBBS 2019 Batch: This also says that all the collagen sources are animal based. Plant based sources only provide raw material for collagen synthesis and not collagen itself

[9/18, 8:38 AM] MBBS 2015 Batch: How are we sure that she isn't synthesizing enough collagen though?

[9/18, 8:57 AM] Rakesh Biswas: 👍Good research question

[9/18, 8:57 AM] MBBS 2019 Batch: Hair, skin and nails, sir?

[9/18, 8:58 AM] MBBS 2015 Batch: Share your findings after you examine hair,skin and nails.

And also,which type of collagen is present on hair,skin and nails.And which type is present in cartilage and bone.

(NEET PG que)

[9/18, 9:00 AM] MBBS 2019 Batch: Hair, skin, nails -type 1

Cartilage - type 2 (mixed with other types)

[9/18, 9:14 AM] Rakesh Biswas: @⁨MBBS 2019 Batch⁩ These are the learning conversations that need to be published and a correlation between the student's learning outcomes shown with the patient's health outcomes. That's the gist of the CBBLE PaJR project

[9/18, 9:14 AM] MBBS 2019 Batch: Ok sir

[9/18, 9:16 AM] Rakesh Biswas: Awaiting similar learning conversations in your neurodegenerative PaJR groups

[9/18, 9:17 AM] MBBS 2015 Batch: Which one is that group?

[9/18, 9:18 AM] Rakesh Biswas: Find out. You are there in those too

[9/18, 9:47 AM] MBBS 2019 Batch: Skin change again since 4 to 6 weeks

[9/18, 9:47 AM] MBBS 2019 Batch: Hair fall is normal and never checked nail brittleness

[9/18, 9:47 AM] MBBS 2019 Batch: But growth of nails has become slow

[9/18, 9:48 AM] Rakesh Biswas: How? What was the usual time she had earlier noted for her nail growth and what is the current time?

[9/18, 9:49 AM] MBBS 2019 Batch: Not sure of the correct time sir, but while regularly cutting nails, she noticed that they were not growing kuch

[9/18, 9:49 AM] MBBS 2019 Batch: *much

[9/18, 9:50 AM] MBBS 2015 Batch: Recall bias

[9/18, 9:51 AM] MBBS 2019 Batch: I didn't ask about nail growth sir, i asked about nail brittleness and she mentioned they growth

[9/18, 9:51 AM] Rakesh Biswas: So let's say earlier she needed to cut them in a week or 7 days and after how many days does she need to cut it now?

[9/18, 9:52 AM] Rakesh Biswas: She was more correct

[9/18, 9:52 AM] MBBS 2019 Batch: I'll ask sir

[9/18, 9:54 AM] MBBS 2019 Batch: 2 weeks or a little long

[9/18, 9:54 AM] Rakesh Biswas: And previously? 1 week?

[9/18, 9:55 AM] MBBS 2019 Batch: Yes sir

[9/18, 9:55 AM] Rakesh Biswas: Since when has she noticed this?

[9/18, 9:57 AM] MBBS 2019 Batch: Around 2 months

[9/18, 10:00 AM] MBBS 2015 Batch: 

@⁨Rakesh Biswas⁩ Is slow growing nails a serious sign?

We can do one thing to confirm if they are growing really slow.

@⁨MBBS 2019 Batch⁩ Can u ask your patient to trim nails today and share pics on day 7 and day 14 from now?

Let's compare it with our nails and also @⁨ might help us sharing picture of her patient's(another 47F) nails,today,at day 7 and at day 14

[9/18, 10:05 AM] Rakesh Biswas: Also review the literature to see if someone else has already done this experiment

[9/18, 10:05 AM] MBBS 2015 Batch: Sure sir

[9/18, 10:30 AM] MBBS 2019 Batch: Will do sir, but is it a serious concern? I think we're deviating from the question on whether she needs collagen supplements?

[9/18, 10:34 AM] MBBS 2015 Batch: She's doesn't need any collagen supplements because she doesn't have arthritis.

It is not a serious concern.However,we don't even know if her nails are really growing slow.If we confirm that her nails are growing too slow(as compared to others),we evaluate it further.

[9/18, 10:35 AM] MBBS 2015 Batch: Nail brittleness and slow growth of nails is commonly seen in water soluble vitamins,zinc deficiency.She is already on mvt supplements as you mentioned earlier.

[9/18, 10:37 AM] Rakesh Biswas: This factual statement needs to be supported by some literature

[9/18, 10:38 AM] Rakesh Biswas: We don't yet know if she has or doesn't have arthritis till we have the clinical examination findings and images

[9/18, 10:39 AM] Rakesh Biswas: Seriousness of concern is very subjective and is a variable of how the individual patient perceives seriousness and that is again perhaps dependent on his her worldview? @⁨Psychologist⁩

[9/18, 10:40 AM] Rakesh Biswas: We still need to evaluate her ourselves if there is no clinical video evidence

[9/18, 10:43 AM] Psychologist: Yes Sir, from her perspective it can be understood that she has been going through pretty tough period since march. She agrees to the fact that her physical symptoms have a direct correlation with her life situation

[9/18, 10:44 AM] Psychologist: It might be a definite possibility that as her life situation improves, her physical symptoms too would subside

[9/18, 3:17 PM] Rakesh Biswas: Check out the CUBE STEM discussion on nail growth here : https://metastudio.org/t/s4e78-cube-chatshaala-analysis-of-nail-data/11940 

Will also archive ours as "Medicine CUBE conversational learning session on "nail growth."