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Evidence based medicine

  Octreotide Compared With Placebo in a Treatment Strategy for Early Rebleeding in Cirrhosis. A Double Blind,Randomised Pragmatic Trial  https://aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.1002/hep.510280507 Objective:  Comparison of Octreotide with placebo in a treatment strategy for Early Rebleeding in Cirrhosis.  P- 262 cirrhotic patients after control of acute upper digestive bleeding. I-131 patients were given a randomized, double blind trial of a 15-day course of subcutaneous octreotide vs placebo after control of upper digestive bleeding from any portal hypertensive source in cirrotic patients. C- Early rebleeding, from any source, within 15 days after randomization, was the primary measure of treatment. Secondary measure was the assessment of a 42-day rebleeding rate. O- Octreotide may safely reduce the risk of early rebleeding after upper digestive portal hypertensive hemorrhage in cirrhotic patients treated by Beta- blockers and/or sclerotherapy for long-term prevention of
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Short case 2

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 A 33 year salesman, who was apparently asymptomatic 4 months ago, came to the OPD with C/O weight loss.  Pt was apparently asymptomatic 4 months ago, then noticed a weight loss of 16 kgs i.e from 86kgs to 72 kgs in the 4 month duration. He then went to a local doctor and was later diagnosed with Diabetes Mellitus. He was treated with Glimepride 2mg + Pioglitazone 15mg and metformin 1000mg. His blood glucose levels were under control since the start of the treatment.  The patient eventually developed loose stools-1-2 episodes/day with loose consistency,normal volume and colour,not associated with mucus or blood in stools. No change in volume of stool. Consumption of milk and milk products like paneer aggravated his diarrhea to 3-4 times/ day. C/O tenesmus, incomplete evacuation, mucus in the stool.  C/O frothy stool once in a month. C/O abdominal pain since 3 months with pain radiating to the back. Ranitidine 150 mg on and off when the patient has gaseous distension. C/O chest pain on
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Short case 1

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 Short case 1: A 70 year old Paddy farmer, came to OPD with c/o B/L pedal edema and shortness of breath since 6 months Pt was apparently asymptomatic 6 months back, then developed B/L pitting type of pedal edema upto thighs, facial puffiness, anasarca. Then he went to a private hospital in Hyderabad, during routine investigations was told to have elevated creatine levels and was told to undergo dialysis Pt then came to KIMS, NKP for further management.  Pt has lost his livelihood since the last 6 months because he's been unable to work. He's survived by his wife and his son who lives elsewhere. He also has two daughters but they don't live with him. C/o B/L hip pain since 6 months  No c/o decreased output of urine No h/o Fever, cough, cold In KIMS, KNO, pt underwent 10 sessions of dialysis 1st-8/12 2nd-11/12 3rd-15/12 4th-22/12 5th-27/12 6th-31/12 7th-8/1 8th-17/1 9th-22/1 10th-26/1 Patient is a k/c/o Hypertension and DM since 20 years, on regular medication. Started on ins
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Long case

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 Case presentation: Chief complaints : Yellowish discolouration of eyes since 4 days Indigestion and tightness of abdomen since 4 days History of present illness: Pt was apparently asymptomatic 2 yrs back,then he developed pain abdomen,acute in onset,not associated with vomiting,diarrhoea,jaundice or fever,  he went to nearby hospital and was diagnosed with fatty liver, pt said that Doctors prescribed some medication and pain got relieved after using those medicines. Then after 1year patient developed pedal edema which gradually progressed and developed generalised anasarca,jaundice and abdominal distension and abdominal tightness.he was admitted in hospital and evaluated. He got diagnosed  with liver disease during hospital stay and underwent paracentesis for ascites. Since then patient had 2 to 3 hospital admissions  with similar complaints like pedal edema,abdominal distension,jaundice. 6months later patient had complaints of blood in vomitus suddenly.he had 4 to 5episodes of vomiti
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Competencies and academic presentations

 1.covid case presentation https://docs.google.com/presentation/d/1RtW8_TkL0NGvszp1RfNia6n9hZN1Ii7D/edit?usp=drivesdk&ouid=104540678885035381038&rtpof=true&sd=true  1.CME presentation https://docs.google.com/presentation/d/1Rl1LvM27PlCdi6hzWwgA1u718gDkJeKd/edit?usp=drivesdk&ouid=104540678885035381038&rtpof=true&sd=true  Video youtube link: https://youtu.be/PUdXb21FeTQ 2.Poster presentation https://drive.google.com/file/d/1RspoR-hu0TaTK8vy8wg990-HBqaUh0cx/view?usp=drivesdk  3.Paper presentation video: https://drive.google.com/file/d/1S-gbozbmloRz6KGAtmyT1EQNnJxdIrvx/view?usp=drivesdk 4.pancreatitis case presentation: https://drive.google.com/file/d/1S0TleAu3dvaiDuABTjJHvbGnD8QkuE-4/view?usp=drivesdk 5.thesis presentation: https://drive.google.com/file/d/1S0TleAu3dvaiDuABTjJHvbGnD8QkuE-4/view?usp=drivesdk  6.Pleural tapping procedure: https://drive.google.com/file/d/1TSEW6gBKYmzAOoIYbpk7F1ZFj6tDzJDK/view?usp=drivesdk  7.Ascitic tapping:  https://drive.google.com/f
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Thesis

 https://drive.google.com/file/d/1RjNF_-gSFPgeU5oaON2c_EsD3QCONHVL/view?usp=drivesdk
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Case presentation

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  50 yr Male Farmer By Occupation  Came to Casualty With Cheif Complaints of Pain both knees since 6 days HOPI :- Patient Was Apparently Asymptomatic 4 years Back , Then He Developed  Knee joint Pains,bilateral ,which is Insidious In Onset, Gradually Progressive over years,and similar complaints On & off ,went to Rural Community Practitioner And Given Medicine and got relived.  The Patient Had Been Taking pain management Medication whenever he has Joint Pains,Swelling was also present at the knee and Ankle joints during during Pain whenever he gets pain. The patient was able to do his Routine farming Activities for 2 years . Since 2 years the patient stopped  doing  farming works and used to stay at home and was able to take care of his daily activities.  Aggravated during walking and relived with rest and also with medication.  Pain was not completely relieved On taking medication but patient used to feel better. Usually pain is migratory type,unilateral and no involvement of smal
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