And a typical journal club RCT article with ridiculous efficacy such as this one
50 patients presenting to the hospital with peritonitis.
39 of them had typical infectious peritonitis, and their mean peritoneal fluid amylase level was 11.1 (range, 0 to 90).
6 patients had pancreatitis and a mean peritoneal fluid amylase level of 550 U/L (range, 100 to 1,140 U/L).
5 patients were found to have other intra-abdominal pathology, and their mean peritoneal fluid amylase level was 816 U/L (range, 142 to 1,746 U/L).
Context :
November 18, 2021
Thursday :
Tutorial : CNS localization
Presenter : Dr A Vaishnavi, Dr Zain, Dr Raveen and
Dr Bhavani
November 19, 2021
Friday
Group discussion:
Context : PUO in a male diabetic with loin pain and lower urinary tract symptoms of urgency and burning
Presenters : Dr Vaishnavi, Dr Nikita, Dr Pooja (intern) and Dr (Soujanya 2017)
Impact :
On learning ecosystem :
Cognitive competency levels touched :
Approach to clinical localization of disease pathology was done reasonably well and differential diagnostic hypothesis formulated in the face of high diagnostic and therapeutic uncertainty
On patient care outcomes :
Empathic trust built with patient and relatives
Standard of care provided with provision for care continuity
Challenges met/not met :
Fever monitoring and post admission illness timeline was well supervised.
Imaging and labs for further clinical localization of the PUO was driven by the discussion
Multiple therapeutic interventions were made for the differentials in the face of diagnostic uncertainty further driven by ongoing patient suffering and an attempt to gather the "medical cognition" learning points made here :
November 20, 2021
Saturday
Log Book assessment: Dr AV, Dr Nikita
Context : An elderly patient with severe anemia, hypotension, severe metabolic acidosis, encephalopathy and recent fracture femur
Case report link :
Impact :
On learning ecosystem :
Cognitive competency levels touched :
Approach to clinical localization of disease pathology was done reasonably well and differential diagnostic hypothesis formulated
On patient care outcomes :
Empathic trust built with patient and relatives
Standard of care provided with provision for care continuity
Challenges met/not met : managing diagnostic arranging of repeating hemoglobin levels, repeat imaging to assess hematoma, continuing dialysis, reviewing the literature around giving bicarbonate in high anion gap metabolic acidosis and an attempt to gather the "medical cognition" learning points made here :
