My experiences with general cellular and neural cellular pathology in a case based blended learning ecosystem's CBBLE

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

Welcome

I am Aashish, medical student would like share some of my experience with medical cases that have seen through my career Upto now with collaboration with department of internal medicine and surgery.

My first encounter with special cases is through my childhood where I have my two grandfathers suffering from Parkinsonism where I was a part of their lives but not as a doctor or medical student. And my own sister is suffering from intellectual Disability and cerebral palsy ( spastic diplegia involving spasticity of both the lower limbs).This actual made me to pursue medicine. I am interested in learning neurology, neurosurgery. My special interest is in dealing with neurodegenerative disorders like Alzheimer’s disease, Parkinsonism, stroke, and in regenerative medicine where actually there is a scope of treating them through stem cell therapy which is still in research state. I am also interested in dealing with cardiovascular diseases.

Here I would like to briefly my clinical experiences in my med school:

One of my fascinating cases is dealing with nystagmus which is peripheral type involving the vestibular apparatus. Then I thought that why disease in vestibular apparatus causes nystagmus(involuntary movement of eyeballs). Then I got know about the vestibulo-ocular reflex pathway in medial regions of the brain stem.

Then remembered a proverb that “ He who studies medicine without books sails in an uncharted sea, but he who studies medicine without patients does not go to sea at all.”

In my career Upto I have seen many cases of heart failure and renal failure, cirrhosis that I would like share the links below:

https://aashishyadlapally.blogspot.com/2022/12/a-case-of-heart-failure-with-reduced.html

https://aashishyadlapally.blogspot.com/2023/01/75-year-old-male-with-sob.html

https://aashishyadlapally.blogspot.com/2022/02/a-45yr-old-female-with-pedal-edema-and.html

https://aashishyadlapally.blogspot.com/2023/01/severe-anemia-associated-with.html

https://aashishyadlapally.blogspot.com/2023/01/a-55-yr-old-man-presented-with.html

One of the interesting thing I like to do auscultation of heart and the breath sounds; which requires experience and good listening skills though in modern days have phonocardiograms and digital recording stethoscope and 2d and 3d echo which makes learning and diagnosis much easier.

Here is a fascinating case of patient with a oro antral fistula with odontogenic cyst which got infected which travelling through maxillary sinus causing maxillary sinusitis caused by anaerobic bacteria like fusobacterium. The patient is chronic alcoholic and chronic smoker; so that also may precipitate this infection and he is last two molars in left lower jaw had inadequately erupted. Endoscopic surgery done and he is fine now.

https://aashishyadlapally.blogspot.com/2022/01/a-33-year-old-male-with-pus-discharge.html

Here is a case of liver abscess:

Liver abscess is an inflammatory space‐occupying lesion of the liver caused by infectious agents. Amoebic liver abscess (ALA) and pyogenic liver abscess (PLA) are its two predominant causes. Rarely, liver abscess can be caused by fungi, mycobacteria, and other atypical organisms. ALA is the predominant cause of liver abscess in India, seen in more than 60% of cases.  It is caused by Entamoeba histolytica with feco‐oral route, the predominant mode of transmission. In this review, we describe the overview of ALA and PLA, along with its complications and management. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518335/

https://aashishyadlapally.blogspot.com/2023/04/38-year-old-male-with-liver-abscess.html

Diagnostic criteria:

Here is case of ischaemic stroke with ischaemia of internal capsule involving pure motor stroke with unilateral hemiplegia and UMN type of facial palsy involving paralysis of lower half of the contralateral face ( also called pseudobulbar palsy of facial nerve)

https://aashishyadlapally.blogspot.com/2023/03/1801006199-long-case.html

The stroke which involving the internal capsule may involve pure motor strokes and pure sensory strokes.In diagnosing strokes we concentrate mainly on clinical neuro exam and anatomy of the tracts, structures and nuclei and their functions in the central nervous system. We should also keep in mind about structure involved in central and peripheral nervous system and if they get damaged what are the manifestations occurring. This integrates all our knowledge of basic medical sciences i.e anatomy, physiology, pathology, internal medicine, surgery, Paediatrics and Radiology and so medical branches and their should be integration of them and applying the knowledge gained in order to solve the clinical real life scenarios and better patient compatibility. This would remained me again the proverb that I had mentioned above.

And I also thank every department in my med school whether it is Internal medicine or surgery or Radiology or Pathology or Psychiatry or Dermatology or Obs gynae and all departments like from anatomy, physiology, pharmac, micro, otolaryngology, opthalmology, community medicine etc.