Medicine Department

Thursday, February 11, 2021

Ongoing and completed projects

1) 2018-19 (ongoing)

Scope

Resolving diagnostic and therapeutic uncertainty in diabetics with heart failure symptoms in a rural teaching hospital

Sponsoring Agency: Current institution

Project leader: AS (PG) and RB (guide)

Year in which started: 2018

Duration in months: 24

Capital estimated in Lakhs: 5

Echo machine as a tool (pre existing institutional capital)

Recurring estimated in Lakhs: 0.5 (annual maintenance of tool) and ancillary 0.5

Total estimated in Lakhs: 7

Foreign exchange in lakhs NA

Remarks: Ongoing with findings soon to be shared in peer reviewed as well as non peer reviewed platforms from time to time.

2018-2019 (ongoing)

2) Scope

Resolving diagnostic and therapeutic uncertainty in patients with critical illness and hyponatremia in a rural teaching hospital

Sponsoring Agency: Current institution

Project leader: MR (PG) and RB (guide)

Year in which started: 2018

Duration in months: 24

Capital estimated in Lakhs: 10

Laboratory testing infrastructure (pre existing institutional capital)

Recurring estimated in Lakhs: 0.5 (annual maintenance of tool) and ancillary 0.5

Total estimated in Lakhs: 12

Foreign exchange in lakhs NA

Remarks: Ongoing with findings soon to be shared in peer reviewed as well as non peer reviewed platforms from time to time.

2019-20 (Ongoing)

Scope:

Resolving diagnostic and therapeutic uncertainty in patients with heart failure and preserved ejection fraction

Sponsoring Agency: Current institution

Project leader: AV (PG) and RB (guide)

Year in which started: 2019

Duration in months: 24

Capital estimated in Lakhs: 5

Echo machine as a tool (pre existing institutional capital)

Recurring estimated in Lakhs: 0.5 (annual maintenance of tool) and ancillary 0.5

Total estimated in Lakhs: 7

Foreign exchange in lakhs NA

Remarks: Ongoing with findings soon to be shared in peer reviewed as well as non peer reviewed platforms from time to time.

2020-21

4) Scope

Resolving diagnostic and therapeutic uncertainty in unexplained pulmonary hypertension

Sponsoring Agency: Current institution

Project leader: VK (PG) and RB (guide)

Year in which started: 2020

Duration in months: 24

Capital estimated in Lakhs: 5

Echo machine as a tool (pre existing institutional capital)

Recurring estimated in Lakhs: 0.5 (annual maintenance of tool) and ancillary 0.5

Total estimated in Lakhs: 7

Foreign exchange in lakhs NA

Remarks: Ongoing with findings soon to be shared in peer reviewed as well as non peer reviewed platforms from time to time.

Scope:

Resolving diagnostic and therapeutic uncertainty in critically ill renal failure patients in a rural teaching hospital

Sponsoring Agency: Current institution

Project leader: KM (PG) and RB (guide)

Year in which started: 2020

Duration in months: 24

Capital estimated in Lakhs: 10

Laboratory testing infrastructure (pre existing institutional capital)

Recurring estimated in Lakhs: 0.5 (annual maintenance of tool) and ancillary 0.5

Total estimated in Lakhs: 12

Foreign exchange in lakhs NA

Remarks: Ongoing with findings soon to be shared in peer reviewed as well as non peer reviewed platforms from time to time.

3) 2017-18 (completed)

Scope:

Collective Conversational Peer Review of Journal Submission: A Tool to Integrate Medical Education and Practice.

Sponsoring Agency: current institution

Project leader: RB with BMJ Elective fellows (AG, VP, MS)

Year in which started: 2017

Duration in months: 24

Capital estimated in Lakhs: 1

Recurring estimated in Lakhs: 0.5

Total estimated in lakhs: 1

Foreign exchange in lakhs NA

Remarks: Ongoing with findings shared in peer reviewed as well as non peer reviewed platforms from time to time (attached).

Publications:

1) Title: Collective Conversational Peer Review of Journal Submission: A Tool to Integrate Medical Education and Practice.

Authors: Poddar et al with corresponding author RB

Journal name and volume:

Annals of Neurosciences. 2018 Jul;

Vol 25(2): pages 112–119.

Impact factor: 2.04

Full text link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103343/#!po=0.757576

2) Patient of pulmonary embolism and online conversational learning among global medical students through a journal review platform.

Authors: Poddar et al with corresponding author RB

Medical Journal of Dr. DY Patil Vidyapeeth. 2019 May 1;12(3):281.

Full text link: https://www.mjdrdypv.org/article.asp?issn=2589-8302;year=2019;volume=12;issue=3;spage=281;epage=283;aulast=Podder

2) 2017-22 (Ongoing)

Scope:

Case based blended learning ecosystem CBBLE toward better medical education, decision making and patient outcomes

Sponsoring Agency: current institution

Project leader: RB with BMJ Elective fellows (AG, VP, MS)

Year in which started: 2017

Duration in months: 120

Capital estimated in Lakhs: 5

Recurring estimated in Lakhs: 1

Total estimated in Lakhs: 10

Foreign exchange in lakhs NA

Remarks: Ongoing with findings shared in peer reviewed as well as non peer reviewed platforms from time to time (attached).

Publications:

1) Developing a Case-Based Blended Learning Ecosystem to Optimize Precision Medicine: Reducing Overdiagnosis and Overtreatment.

Journal name and volume:

Authors: Poddar et al with corresponding author RB

Healthcare 2018, Vol 6, 78.

Impact factor: 1.916

Full text:

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

Non peer reviewed publications:

https://medicinedepartment.blogspot.com/2019/02/utilizing-mobile-user-driven-e-logs-of.html?m=1

https://youtu.be/5CO3FS26CS8

https://youtu.be/1LjB5Lyous8

http://classworkdecjan.blogspot.com/2020/01/vr-art-in-ehrs.html

https://youtu.be/rWog_idt-KU

Sunday, February 7, 2021

Medicine paper for February 2021 bimonthly blended assessment

Answer all questions

Max Marks: 100 (10 marks for each answer)
Submit by:
Date: 16/02/2021 9:00 AM
Below is an online formal question paper to be answered online using all available resources at your online disposal over a period of days and E logged in a manner demonstrated by past examinees in the link here https://medicinedepartment.blogspot.com/2021/02/blended-bimonthly-assessment-dec-2020.html?m=1
And here is a sample answer paper from the last exam here: https://ashiness3.blogspot.com/2020/11/bimonthly-assessment-for-month-of.html?m=1 please note that every logged answer paper should contain the link to this current "assignment/question paper" page and the patient context for each answer as well as avoid plagiarism as illustrated in the sample answer paper.

A sample answer to the last question around sharing your experiences can be seen here: https://onedrive.live.com/view.aspx?resid=4EF578BAE67BA469!4180&ithint=file%2cdocx&authkey=!AOy7BpRTn42DBMo

Questions:

1) Please go through the patient data in the links below and answer the following questions:
50 year man, he presented with the complaints of

Frequently walking into objects along with frequent falls since 1.5 years
Drooping of eyelids since 1.5 years
Involuntary movements of hands since 1.5 years
Talking to self since 1.5 years

More here: https://archanareddy07.blogspot.com/2021/02/50m-with-parkinsonism.html?m=1

Case presentation links:

https://youtu.be/kMrD662wRIQ

a). What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings?

b) What is the etiology of the current problem and how would you as a member of the treating team arrive at a diagnosis? Please chart out the sequence of events timeline between the manifestations of each of his problems and current outcomes.

c) What is the efficacy of each of the drugs listed in his current treatment plan

2) Patient was apparently asymptomatic 2 years back then he developed weakness in the right upper and lower limb, loss of speech.

More here: https://ashfaqtaj098.blogspot.com/2021/02/60-year-old-male-patient-with-hrref.html?m=1

Case presentation links:

https://youtu.be/7rnTdy9ktQw

a). What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings?

b) What is the etiology of the current problem and how would you as a member of the treating team arrive at a diagnosis? Please chart out the sequence of events timeline between the manifestations of each of his problems and current outcomes.

c) What is the efficacy of each of the drugs listed in his current treatment plan

3) 52 year old male , shopkeeper by profession complains of SOB, cough ,decrease sleep and appetite since 10 days and developed severe hyponatremia soon after admission.

More here https://soumya9814.blogspot.com/2021/01/this-is-online-e-log-book-to-discuss.html?m=1

Case presentation video:

https://youtu.be/40OoVEQBgS4

a) What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings?

c) What is the efficacy of each of the drugs listed in his current treatment plan especially for his hyponatremia? What is the efficacy of Vaptans over placebo? Can one give both 3% sodium as well as vaptan to the same patient?

4) Please mention your individual learning experiences from this month.

Blended bimonthly assessment Dec 2020-Jan 2021 results

Following are the links to the submitted assignments by the students (interns, PGs year 1 and year 2) for the the assignment posted for 16/12/2020 here
https://medicinedepartment.blogspot.com/2020/12/medicine-question-paper-for-december.html?m=0 and the assignment posted for 16/01/2020 here

https://medicinedepartment.blogspot.com/2021/01/?m=0
and in the links below one can find that the summative has been also accompanied by a numerical formative assessment of their online learning portfolios using both verbal and non verbal cues.

Interns from 2015 MBBS batch posted in the department of Medicine from 23.11.2020 to 21.01.2021

https://docs.google.com/document/d/1JTUgVrFL1mJXg33K08G6F_dsDI1VW3QMwXGNLtnd-cI/edit?usp=drivesdk

PGY1s from the 2020 MD General Medicine batch

https://docs.google.com/document/d/1CJRa8ZVjE91xwHl3bZxwn8gm3etFT0G7aOQIbxqYDSQ/edit?usp=drivesdk

PGY2s from the 2019 MD General Medicine batch :

https://docs.google.com/document/d/1sS3uMX2gc6JYrurdya3Wo9qLDtqW88qx3yoOJfAqoSU/edit?usp=drivesdk

The formative assessment has been divided into non-verbal which assesses their competency in procedural domains including empathic communication and body language and verbal which assesses their ability to communicate their work through their day to day E logs.

Most students have done reasonably in the formative assessment in both verbal and non verbal communication domains although a lot remains to be improved on.

Most students haven't done well at all in the summative assessment as they are still trying to get a hang of how to express themselves in an online open access world where their answers are meant to create a societal impact rather than impress just one examiner who may end up giving good numerical scores in appreciation of their ability to answer from rote memorized facts as per tradition. It's possible that in the current phase of evolution we may find that many have not only plagiarised blatantly from articles on the internet (inspite of express instructions on how not to resort to that) but also copy pasted from each other's log books.

Friday, February 5, 2021

Ward PGY3 duty roster

DEPARTMENT OF GENERAL MEDICINE

WARD DUTY

PGY3 INCHARGE

STAFF & PG DUTY ROSTER FOR THE MONTH OF FEBRUARY - 2021

Sl. No	Day	Unit	WARD DUTY PGY3 INCHARGE	FLOOR DUTY	FACULTY
Sl. No	Day	Unit	WARD DUTY PGY3 INCHARGE	FLOOR DUTY	1st Call	2nd Call
1	Monday	I	Dr. Praneeth	Dr. Aditya Dr. Sushmitha Dr. Divya Chaitanya Dr. Vamshi Dr. Sai Charan	Dr. Praveen	Dr. Rakesh Biswas
2	Tuesday	II	Dr. Sathish	Dr. Sufiya Almas Dr. Ushasree Dr. Nikitha Dr. Chandana Dr. Pradeep	Dr. Vijaya Laxmi	Dr. Y.S. Kanni
3	Wednesday	III	Dr. Aravind	Dr. Vamshi Krishna Dr. Aashitha Dr. Raveen	Dr. Hareen	Dr. Y.S. Kanni
4	Thursday	IV	Dr. Laxma Reddy	Dr. Manasa Dr. Ajith Kumar K. Vaishnavi Dr. Durga Krishna	Dr. Vijaya Laxmi	Dr. Rakesh Biswas
5	Friday	V	Dr. Natasha Rao	Dr. Zain Alam Dr. Shashikala Dr. Shailesh	Dr. Praveen	Dr. Y.S. Kanni
6	Saturday	VI- VII	Dr. Sai Radha	Dr. Rashmitha Dr. A. Vaishnavi Dr. Manasa Dr. Vinay	Dr. Hareen	Dr. Rakesh Biswas
7	Sunday	VI	Dr. Sai Radha	Dr. Rashmitha Dr. A. Vaishnavi Dr. Manasa Dr. Vinay	Dr. Hareen	Dr. Rakesh Biswas

Wednesday, February 3, 2021

Ward notes 3rd February 2021 and pending information

ICU

44 M Severe shortness of breath and ascites with features of pulmonary hypertension and history of smoking and alcohol consumption. Died. Autopsy not done.

55 M with locked in syndrome due to pontine infarct noticed after low grade fever, headache and sudden loss of power and speech.

Pending E log link with post admission graphical timeline

55 M CCF with HFrEF due to CAD, Diabetes, HTN, Trunkal obesity, Psoriasis, past splenectomy, PTCA

https://sridevimaddipati.blogspot.com/2021/01/55-year-old-male-with-chronic-heart.html?m=1

No afterload reducing agents given as ACEI had increased his creatinine and patient went LAMA today to Hyderabad to blow his savings as before because his edema and shortness of breath couldn't be relieved on time.

72 M with recent left supeaorbital swelling, diabetic foot and massive right pleural effusion with mediastinal shift and renal failure dialyzed.

Pending E log link with post admission graphical timeline

30M with abdominal pain after alcohol and severe shortness of breath with clinical findings of severe pulmonary hypertension and a history of surgery (sternotomy scar) for congenital heart disease

Pending E log link with post admission graphical timeline

63M with shortness of breath CCF and CAD

Ward updates at 8 pm

PGY3- ARAVIND REDDY

INTERN - JEEHARIKA

Male ward - 14 patients

1)68/M with ischaemic CVA with infarct in left mca territory(lentiform parietal)

Pending E log link with post admission graphical timeline

2) 60/M with heart failure with HFPEF (56%)secondary to CAD

https://navyamallempalli.blogspot.com/2021/02/a-60yrs-old-male-with-sob.html

3)49/M with alcohol liver disease with AKI ; sepsis HBSAG positive

Pending E log link with post admission graphical timeline

4 )50/M GCTS secondary to epileptic foci with old infarct with DIABETIC KETOACIDOSIS(resolved)

Pending E log link with post admission graphical timeline

5) 63/M with Parkinson's disease

Pending E log link with post admission graphical timeline

6 )46/M with alcohol dependence with tobacco dependence with dysthymia

https://manivarma7.blogspot.com/2021/02/46-year-old-male-who-is-daily-wage.html?m=1

7) 27/M with anasarca, ascites and hypoalbuminemia due to malabsorption

https://navyamallempalli.blogspot.com/2021/01/26-year-old-man-from-north-east-india.html?m=1

8)58/M with CKD ?diabetic nephropathy,anaemia secondary to CKD

Pending E log link with post admission graphical timeline

9)60/M HFREF secondary to CAD

10) 73/M with right facio brachial monoparesis ( acute infarct in left frontal lobe)

11) 36/M with alcohol dependence syndrome ? Alcohol withdrawal syndrome

12 ) 27/M with low back ache and B/L axonal neuropathy of upper limbs

https://mohithak.blogspot.com/2021/01/27year-old-male-with-ankylosing.html?m=1

13)71/M CKD left hydroureteronephrosis with prostatomegaly( obstructive uropathy)

14) 42/M with c/o pain abdomen k/c/o pancreatitis (today's admission)

Pending E log link with post admission graphical timeline

Female ward - 3 Patients.

1) 73/F with HFPEF with AF secondary to CAD

Pending E log link with post admission graphical timeline

2) 47/F with HFPEF secondary to anaemia

http://abdulraheem7168.blogspot.com/2021/02/47-year-old-female-presented-with-acute.html

3) 22/F with hypertensive urgency (resolved ) with iron deficiency anaemia

https://yaminimandava4114.blogspot.com/2021/01/22-year-old-female-with-complaints-of.html

4) 26 F with nephrotic syndrome

https://asrithareddy10.blogspot.com/2021/01/this-is-online-e-log-book-to-discuss.html

Discharged

Tuesday, February 2, 2021

Current ward cases

ICU 4 patients

50 M with Shortness of breath

55 M with Anasarca and dyspnoea along with DM 2 HTN psoriasis since years

case 3: 55 yr old man with severe PAH with moderate AS And AR with AKI on CKD

Case 4: Acute GE with left lower lobe pneumonia with k/c/of congenital heart disease

AMC 0

Ward patients

1. 60/M with heart failure discussed in the afternoon

2. 49/M Hbsag +ve case with AKI and alcoholic liver disease

3. 71/M with CKD with prostatomegaly

4. 60/M with HFREF with CAD

5. 35/M with headache giddiness ?hypochondrasis

6. 63/M with Parkinson’s disease

7. 27/M with celiac disease

8. 68/M with ischaemic cva with left mca territory infarct with HTN and DM -2

9. 78/M with HFREF with PAH

10. 27/M with ankylosing spondylitis

11. 50/M with seizures secondary to old infarcts

12. 58/M with CKD with HFPEF

13. 16/M with HBSAG +ve with acute cholangitis and acute cholecystitis

14. 36/M with alcohol withdrawal seizures with alcohol dependence syndrome

15. 75/M with seizures with rt lmn facial palsy with rt monoparesis

16. 47/F with HFPEF secondary to ?viral/anaemia

17. 73/F with HFPEF with AF secondary to CAD

18. 22/F with DKA with Hypertensive urgency with Iron deficiency anaemia