CBBLE PAJR PARTICIPATORY LEARNING ACTION RESEARCH

Title: My Journey in the General Medicine Department: A Student's Perspective (2018-2023)

CBBLE PAJR PARTICIPATORY LEARNING ACTION RESEARCH DISCLAIMER

 NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS/HER GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT

In the case-based blended learning ecosystem (CBBLE), I had great experiences studying general cellular and neural cellular pathology. I learned about cellular changes in different diseases and how they affect the body. The case-based approach helped me apply my knowledge to real-life situations, improving my diagnostic skills and critical thinking. Collaborating with classmates and receiving feedback from instructors made the learning process engaging and interactive. The use of technology, like virtual microscopy and online discussions, made learning accessible and flexible. Overall, my time in the CBBLE gave me valuable knowledge and skills that I can use in clinical practice and research.

My Journey in the General Medicine Department: A Student's Perspective (2018-2023)

Introduction:

Embarking on my journey as a medical student in the General Medicine Department in 2018, I was filled with a mix of excitement, curiosity, and a deep sense of purpose. Over the course of five transformative years, I had the privilege of immersing myself in the world of medicine, witnessing the triumphs, challenges, and profound impact of healthcare on patients' lives. In this blog post, I will share a detailed account of my journey in the General Medicine Department from 2018 to 2023, highlighting the milestones, experiences, lessons, and personal growth I experienced along the way.

1. The Early Years: Building the Foundation (2018-2020)

The first years of my medical education were focused on laying a strong foundation of medical knowledge. I attended lectures, participated in practical sessions, and dedicated countless hours to studying anatomy, physiology, pharmacology, and other fundamental subjects. The rigorous curriculum instilled discipline, critical thinking skills, and the ability to assimilate vast amounts of information.

2. Clinical Exposure: Stepping into the Hospital (2021-2022)

 In the clinical years, I transitioned from the classroom to the hospital environment. I vividly remember the excitement and nervousness as I donned my white coat and stepped into the wards. Under the guidance of senior physicians and residents, I began interacting with patients, taking medical histories, and performing physical examinations. These hands-on experiences helped me develop vital skills in patient communication, clinical reasoning, and forming differential diagnoses.

Allow me to share with you the details of my first case, which was taken on March 11, 2022

a patient who has experienced a lack of weight and height gain since childhood. The patient's mother noticed this issue at a young age, leading them to seek treatment at multiple hospitals where they were given multivitamins. However, despite these efforts, the patient failed to clear the 10th class twice and eventually started working as a daily laborer.

In addition to the growth concerns, the patient also has a history of burning micturition and polyuria for the past month. However, there is no history of pica, irritability, weight loss, loss of appetite, diarrhea, steatorrhea, paroxysmal nocturnal dyspnea, orthopnea, recurrent infections, cough, dyspnea, cold intolerance, constipation, hoarseness of voice, or decreased activity.

Moving on to the birth history, the patient was delivered full term via normal vaginal delivery, but their birth weight was only 1kg. They also experienced fever during the neonatal period, potentially related to pneumonia.

In terms of past medical history, the patient is not a known case of diabetes, hypertension, thyroid disorder, epilepsy, or tuberculosis.

Regarding developmental milestones, the patient began walking without support at 2 years of age and feeding themselves independently by the same age. Socially, they smiled and recognized their mother at 3 months of age, while language development included the use of bi-syllable words like "amama nanna" at 2 years of age.

Moving to the patient's menstrual history, their menarche occurred at 12 years of age, and they have irregular periods with a 3 out of 30-day cycle. The last menstrual period was on February 24, 2022.

In terms of family history, the patient's mother's height is 150 cm, while the father's height is 180 cm, resulting in a mid-parental height of 167.5 cm.

During the examination, the patient was conscious, coherent, and cooperative. There were no signs of pallor, icterus, clubbing, cyanosis, lymphadenopathy, or edema.

To summarize, we have a patient who has experienced a lack of weight and height gain since childhood, along with recent symptoms of burning micturition and polyuria. The patient's developmental milestones were delayed, and their family history shows a significant difference in height between the parents.

Further investigation and evaluation will be necessary to determine the underlying cause of the patient's growth issues. Possible considerations may include endocrine disorders, malnutrition, or genetic factors. Additional tests and consultations with specialists will help us formulate an accurate diagnosis and provide appropriate treatment for the patient.

3.Rotations in Various Specialties.

During my rotations in the General Medicine Department, I had the opportunity to delve into various subspecialties, including cardiology, pulmonology, gastroenterology, nephrology, and endocrinology, among others. Each rotation exposed me to different patient populations, diagnostic challenges, and treatment modalities. I actively participated in patient care, attended ward rounds, and observed and assisted in various procedures. These rotations broadened my understanding of the diverse spectrum of medical conditions and allowed me to appreciate the complexities of managing complex cases.

4. Interprofessional Collaboration: Learning from Peers 

Collaboration with fellow medical students, nurses, pharmacists, and other healthcare professionals was a cornerstone of my journey in the General Medicine Department. Through interdisciplinary discussions and teamwork, I learned the importance of effective communication, mutual respect, and shared decision-making. Working together with professionals from different backgrounds enriched my learning experience, broadened my perspectives, and highlighted the value of a multidisciplinary approach to patient care.

5.Patient Stories: A Lesson in Compassion 

Interacting with patients and hearing their stories was a constant reminder of the human side of medicine. I witnessed moments of vulnerability, strength, hope, and resilience in the faces of those fighting illness. Each patient's journey provided me with valuable insights into the profound impact healthcare professionals can have on individuals and their families. These experiences reinforced the importance of empathy, active listening, and treating patients with compassion and dignity.

Experiences

Blog A: 

As far as I can recall, he was extremely ill and unable to speak. But he managed to talk 

https://sanghamitrarollno191.blogspot.com/2023/04/55-year-male-with-hypovolemic-shock.html

I greeted the patient and asked how they were feeling. The patient replied that they were not feeling well and had been experiencing loose stools for the past two days, with about 15 episodes so far. I expressed sympathy and asked for more details about when the symptoms started and any other symptoms the patient was experiencing.

The patient explained that they believed they had a sunstroke two days ago, followed by consuming alcohol and eating outside food. Since then, they had been having watery and yellowish-white loose stools. They also experienced one episode of vomiting without nausea or headache and had a low-grade fever that came on suddenly and hadn't improved.

I inquired about additional symptoms such as shortness of breath, chest pain, palpitations, or fainting, to which the patient replied that they hadn't experienced any of those. I then asked about swelling in the legs or abdominal distension, and the patient confirmed the absence of such symptoms.

Further, I asked if the patient had any burning sensation during urination, to which the patient responded negatively. I then discussed the patient's medical history, specifically asking about hypertension, diabetes mellitus, asthma, or any previous stroke. The patient reported no known history of those conditions.

I also inquired about the patient's family history, specifically if there were any significant medical conditions among immediate family members. The patient stated that there were no significant medical conditions in their family.

Moving on, I asked for information about the patient's lifestyle, including their diet and any specific eating habits. The patient mentioned having a mixed diet with a normal appetite but noted that their bowel movements had changed over the past two days.

I expressed gratitude for the information provided and proceeded to ask about habits or addictions, such as smoking, tobacco use, or alcohol consumption. The patient disclosed consuming about 90 ml of alcohol 2-3 times a week for the past 20 years.

Finally, I mentioned conducting a general examination and noted that the patient appeared conscious, coherent, and cooperative. I asked the patient to confirm if they had any pallor, icterus, cyanosis, clubbing of fingers, or swollen lymph nodes. The patient confirmed having some pallor but denied the presence of icterus, cyanosis, clubbing, or swollen lymph nodes.

After further questioning about his general well being I examined the patient for any further ailments he could possibly have .

Blog B :

https://sanghamitrarollno191.blogspot.com/2023/04/70-years-with-sob.html

I would like to share with you a fascinating case involving a patient who has been experiencing breathlessness and leg swelling. This individual came to us with concerns about their health, and it is our responsibility to thoroughly investigate their symptoms and medical history. 

The patient's primary complaints include breathlessness over the past 10 days and swelling in the legs during the same period. As we delve deeper into the details, we discovered that this all began with a high-grade fever accompanied by chills and rigors. Luckily, the fever subsided after one day with the help of medication. However, the breathlessness has been progressively worsening and has now reached grade-IV intensity. It is important to note that the patient denies experiencing orthopnea or paroxysmal nocturnal dyspnea.

In addition to breathlessness, the patient mentioned experiencing pitting pedal edema and a bothersome, itchy, scaly lesion on the dorsum of their foot for the past year. They also reported burning micturition for the past three days, although their urine output appears to be normal. On a positive note, the patient denies experiencing any other symptoms such as cough, chest pain, or abdominal issues.

Regarding the patient's medical history, they have been diagnosed with hypertension for the past four years. However, they do not have diabetes, tuberculosis, epilepsy, stroke, or coronary artery disease. In terms of personal history, the patient has a normal appetite, follows a varied diet, and believes their sleep is adequate. It is worth mentioning that they recently ceased consuming 90ml of whisky per day, which was a regular habit.

Exploring the patient's family medical history, we found no significant medical conditions among their immediate family members. 

Upon conducting a physical examination, we observed that the patient appeared conscious, coherent, and cooperative. Although they exhibited mild pallor, we did not detect any signs of icterus, cyanosis, clubbing, or lymphadenopathy. Notably, we identified the presence of edema in their feet.

Vital signs revealed a temperature of 98.8°F. Initially, their blood pressure was measured at 180/100mmHg, but it decreased to 150/100mmHg and then to 130/100mmHg. The patient's heart rate was 100 beats per minute, respiratory rate was 32 breaths per minute, and oxygen saturation was 85% on room air. Additionally, their random blood sugar level was 111 mg/dl.

During the cardiac examination, we carefully observed the patient's chest and found no scars, sinuses, engorged veins, or visible apex beat. Palpation and auscultation revealed no abnormalities or murmurs. 

Moving on to the respiratory examination, we noted that the patient's chest shape appeared bilaterally symmetrical and elliptical. No scars, sinuses, or engorged veins were observed. The position of their trachea appeared central, and upon palpation and auscultation, we did not detect any abnormal findings.

The abdominal examination revealed a soft and non-tender abdomen, along with normal bowel sounds. Lastly, the neurological examination did not indicate any focal neurological deficits.

To summarize, we have a patient presenting with breathlessness, edema, fever, and an itchy skin lesion. Their medical history includes hypertension and recent alcohol cessation. Our examination findings revealed mild pallor, edema, and normal findings in the cardiac, respiratory, abdominal, and neurological systems.

Moving forward, we will consider various possible diagnoses such as heart failure, respiratory infection, dermatological conditions, or urinary tract infection. To gain further insight, we will order additional tests including complete blood count, renal and liver function tests,

Blog C :

https://sanghamitrarollno191.blogspot.com/2023/04/35-years-male-with-uncontrolled-sugars.html

7. Research and Scholarly Activities 

Engaging in research and scholarly activities played a significant role in my journey. I had the opportunity to participate in research projects, present posters at conferences, and contribute to scientific publications. These experiences fostered critical thinking, enhanced my understanding of evidence-based medicine, and cultivated a lifelong appreciation for the importance of research in advancing medical knowledge and patient care.

8. Personal Growth and Resilience: Overcoming Challenges 

The general medicine department ignited my passion for lifelong learning and research. I immersed myself in exploring the latest medical advancements, reading research papers, and engaging in scholarly discussions. Participating in research projects allowed me to contribute to the expanding body of medical knowledge and fostered critical thinking skills that I can apply to future patient care.

Conclusion:

My journey as a medical student in the general medicine department has been a transformative, challenging, and immensely rewarding experience.