Cases in medicine

Pak Emirates Military Hospital, Rawalpindi Well furnished floors, well mowed lawns, guards stationed at intervals guiding you along the way. While the highways and the developments around the area make the trip easy. You’re inside a military hospital in Pakistan. What most surprised me when I started working in a military hospital in Pakistan is that there’s no shortage of equipment here. A surplus of supplies means you don’t need to keep disinfectants in your pocket to use only when need arises, which is the case in the public sector. In fact you see disinfectants spread around like confetti. In my analysis, that is because they channel their resources in the correct way and don’t waste the allocated finances. Actually showing other departments what they should be doing. The question arises: What does the civilian health sector do with their resources, dump it in the ocean? Actually yes, they put some of it in the holds of a small army of caretakers. Then another army of disposal peo...

Structure your talk A PowerPoint presentation is a usual method of delivering a CPC. Most presentations range from 5 minutes to 45 minutes. Although the headings can vary, here's an example presentation structure that I use. -Title page :  List the title, authors, and include a logo of the institution you're affiliated with -Literature findings: Throw light on the questions that are already addressed, and identify the gaps that remain - Include the chief complaint, the history of present illness, past medical and surgical histories, social history, and medications. Provide the vital signs and physical examination at an appropriate level of detail. If diagnostic studies were obtained, present the results. Do not interpret data.   Summarize the findings, and the management of your case in tables or drawings, as they are easier to interpret than written results -"Thank You" Slide - Conclude the case presentation and offer the floor to the audience Overall, limiting the ...

You're a first year intern and asked to present a clinical pathologic case (CPC). You've got two days. Don't fume just yet. F ollow the template below and you'll be fine. B esides, I've added i n italics the clinical aspects of the presented case that typifies the rational approach to a patient with community-acquired pneumonia (CAP). CAP is one of the most common presentations clinicians face but it's mostly not dealt with fairly, since most physicians tend to run overboard while prescribing tests or antibiotics . CLINICAL PATHOLOGIC CASE #1 A 66-year-old woman presents with chief complaints of fever and a productive cough for the past one week. She is generally healthy and leads a healthy lifestyle. But lately she has been feeling lethargic and has generalized body aches. Temperature is 100 F, blood pressure is 140/80 mm Hg, and pulse is 92/min. Lung auscultation reveals abnormal breath sounds and increased vocal fremitus over the right side of the chest. CH...

Introduction: Continuous cardiac monitoring, or telemetry, is a noninvasive method of closely monitoring a patient’s heart rate and rhythm in the healthcare setting. Figuring out the right patient to monitor remains imperative, especially as its costs increase while there is pressure to reign in costs for healthcare (1). Growth in the United States healthcare expenditures is astronomical to say the least. Paradoxically, higher cost regions in the country are not associated with improved quality or outcomes. In many cases, the reverse is true (1). Variations in healthcare likely explain this discrepancy (2). An example of necessary variation is a patient who has an allergy to aspirin or chooses not to proceed with an intervention. Contrarily, unnecessary variation does not result in benefit to the patient and is associated with increased cost. For instance, a patient presents with stable atrial fibrillation and gets admitted for cardiac telemetry, the c...

I've had a few requests for prep guidance for step 1 so I am going to lay down a detailed account in the hope that it may help someone else one day as well. I am a graduate of Rawalpindi Medical College, your achievements throughout med school are useless when you compete with the rest of the world, the earlier in med school you realise this the better it is for you and your future. If you remain as ignorant as I have been during that time, it will dawn upon you by the time of your graduation that they are giving you a rolled up empty piece of paper and calling out your name in front of a bunch of people most of whom are even more ignorant than you as far as the dynamics of medical education are concerned around the world in this day and age. If you have already graduated and reading this and starting prep for step 1 now, with no electives and research in med school, congratulations, like me you also have wasted the last 5 years of your time. I had never planned to take the USMLE...

One minute case: It's 3 am and you are called because a patient, known case of MI, just admitted with dengue fever, says he experienced left-sided chest pain unrelated to exertion this evening, but there's no chest pain at the moment. They send you a picture of the ECG strip and these lab values, while you're walking to evaluate the patient: Platelets 226, Trop-I 0.01, Repeat Trop-I 0.03. You can tell them to live in the moment! Here's why: Despite T wave inversions in this ECG, this dengue-inflicted patient's asymptomatic at the moment, and so we've decided against ACS protocol.  But if patient complains of chest pain, YOU'VE TO administer oral aspirin and IV heparin, and observe.