Medical Education Commons^™

A Study Of Electrocardiogram And Echocardiography Parameters Of Post Covid – 19 Patients, Venkateswararao K, Durga Prasad Sadhupati

Digital Journal of Clinical Medicine

Background: Coronavirus Disease – 2019 [COVID-19] infection is multisystem disease not restricted to the lungs it has negative impact on Cardiovascular system by activation of ACE-2 receptors causing plaque stability, vascular inflammation and MI. ECG and 2D ECHO is a simple bed side diagnostic test can be used to assess cardiovascular disease involvement in such patients. We aimed to find out ECG and 2D ECHO abnormalities of Covid – 19 patients. To Study relation of SARS-COV-2 infection and Prevalence of Cardiovascular disease.

Methods: We perform Cross Sectional study among 500 Post Covid – 19 patients [>20 and

Results: Out …

Subclinical Myocardial Disease: The Next Frontier In Cardiovascular Prevention., Param Darpan Sheth, Chandana S., Nimrah Rehman

Digital Journal of Clinical Medicine

Subclinical myocardial disease refers to pathological cardiac changes that precede overt symptoms. It represents an emerging frontier in cardiovascular disease prevention; wherein early detection of myocardial dysfunction could allow timely intervention to avert heart failure (HF) and other outcomes. This narrative review summarizes the current and emerging tools for detecting subclinical myocardial disease, including advanced cardiac imaging and circulating biomarkers, and discusses their potential to improve risk stratification and preventive care in asymptomatic high-risk individuals. Novel echocardiographic measures such as global longitudinal strain (GLS) can unmask subtle systolic dysfunction despite preserved ejection fraction, while cardiac magnetic resonance (CMR) tissue mapping …

Comparison Of Transversus Abdominis Plane Block Versus Intrathecal Clonidine In Lower Segment Caesarean Section - A Prospective Observational Study, Christy Maria Paul, Dr Somsundar R G Associate Professor, Dr Archana B N Assistant Professor, Dr. Shivakumar G Pofessor And Hod

Digital Journal of Clinical Medicine

Comparison of Transversus Abdominis Plane Block versus Intrathecal Clonidine in Lower Segment Caesarean Section - A Prospective Observational Study

Background and Objective: In the majority of abdominal procedures, transverse abdominis plane block, one of the fascial plane blocks, has been used extensively to treat post-operative pain. Ultrasound has gained popularity in the management of cesarean patients due to its ease of use and reduced adverse effects.To assess the effectiveness of ultrasound guided transverse abdominus plane block with intrathecal clonidine for post surgical pain control in lower segment cesarean patients.

Material and Methods: This prospective observational study was done in …

Self-Inflicted, Non-Sexual, Non-Masturbatory Penile Fracture Case Report - An Atypical Presentation, Sajan Sehgal, Vijayakumar R, Sachin Dharwadkar, Amruthraj G. Gowda

Digital Journal of Clinical Medicine

Background: Traumatic injuries to the genitalia are uncommon due to the mobility of the penis and scrotum. Penile fracture is a relatively rare condition arising from disruption of tunica albuginea with rupture of the corpus cavernosum. In order to ensure that such an injury is not missed, it is necessary to have a high index of suspicion to diagnose this condition.

Result: Patient underwent an emergency repair of penile fracture.

Conclusion: We hereby, report a rare case of accidental, non-masturbatory, self-inflicted penile fracture which was diagnosed promptly based on clinical assessment, confirmed radiologically and managed surgically, resulting …

Case Series On Consultation-Liaison Psychiatry In Pain Abdomen With School Refusal Among Children, Jatin Kumar, Aditya Takiar, Kishor M, Sudhamshu K.C, Anil Kumar M.G., Prashanth S.N

Digital Journal of Clinical Medicine

Chronic abdominal pain is one of the most common causes of school refusal in children often leading to multiple hospital visits and expenses. This study was done to assess the psychiatric morbidity underlying functional gastrointestinal complaints in children presenting to paediatric surgery unit. We conducted a prospective case series (N=11; ages 8–13) of children referred from Paediatric Surgery between June and December 2025. All these children presented with idiopathic abdominal pain and a significant period of absence from school. These children were evaluated for any organic causes through the use of various investigations including imaging studies and were referred to …

Evaluating The Efficacy Of Vertical Integration In Training Undergraduate Medical Students Under Competency Based Medical Education Curriculum, Pratham Mehta, Yashika Sharma, Kishor M, Arun M

Digital Journal of Clinical Medicine

Background: The National Medical Council in the Indian Medical Graduate guidelines to enhance learning, recommends Vertical and Horizontal Integration. Vertical integration may be defined as a curricular strategy that aligns para-clinical and clinical teaching across time with a view to enhancing relevance and application of knowledge. The present study is an attempt to test whether vertical integration of Forensic Medicine and Psychiatry is associated with greater short-term learning gains and improved student perceptions compared with conventional didactic lectures.

Methods: With Institutional and Ethics Committee clearance, a two-phase quasi-experimental study was performed across two consecutive academic cohorts (Phase 1, …

Cultivating Compassion: A Cross-Sectional Evaluation Of Empathy Among Medical Undergraduate Students, Anchu R Nath, Ishika Jindal, Nayanabai Shabadi, Sunil Kumar D

Digital Journal of Clinical Medicine

ABSTRACT:

BACKGROUND: Empathy plays a crucial role in medical practice, profoundly affecting patient outcomes and treatment. Understanding the factors that influence empathy among medical students can help in developing strategies to enhance empathetic skills during medical training. This study aims to evaluate the correlates of empathy among medical undergraduate students using an epidemiological cross-sectional design.

MATERIALS AND METHODS:

A cross-sectional study was conducted among 270 medical undergraduate students from various academic years at JSS Medical College for four months (September 2023-December 2023). Convenient sampling was used to select study participants. Participants completed a standardized empathy questionnaire, the Jefferson Scale …

The Life And Discoveries Of Yellapragada Subbarow, Nikhil R, Varuni Pragya, Subramanian Ramaswamy, Shiva Prasad B N, Mahabaleshwar Mamadapur

Digital Journal of Clinical Medicine

Dr. Yellapragada Subbarow was a researcher, teacher, and a wizard of wonder drugs who constantly made efforts in the discoveries/ inventions such as vitamins, anti-vitamins, antibiotics, and many more by disentangling the mysteries of nature for the betterment of the people. He inspired the youngsters to take up the challenges and to stand up above mediocrity. The reward for his achievement was delayed. The article describes a true humanist's journey, discoveries, and his achievements that are largely unknown to date.

Case Title: Uncovering The Truth: The Unexpected Incidental Discovery Of Metastatic Carcinoid Tumor In An Elderly Patient., Kavitha Chittaragi Dr, Shwetha R. Poojary Dr

Radiology Teaching Files

Carcinoid tumors are rare neuroendocrine neoplasms with varied clinical presentations. We report a case of a 70-year-old female patient who presented with history of loose stools, vomiting, and abdominal pain. Imaging revealed a small hyper-enhancing nodule in the small bowel, multiple liver lesions, and a mesenteric mass, all suggestive of metastatic carcinoid disease. Biopsy confirmed a neuroendocrine tumor. As these tumors can remain indolent for years, early detection and treatment are critical for effective management and better prognosis.

Hampton's Hump- A Rare Radiographic Finding In Pulmonary Embolism, Tanshi Anand

Digital Journal of Clinical Medicine

Background- Pulmonary embolism is a condition that is characterized by occlusion of the pulmonary circulation, usually originating from deep vein thrombosis in the lower extremities. This condition is difficult to diagnose as it can present with a wide spectrum of nonspecific symptoms, making it a life-threatening illness.

Case Description- A 50-year-old man with a medical history of deep vein thrombosis, ischemic heart disease, dilated cardiomyopathy with left ventricular dysfunction, diabetes, hypertension, and COPD presented with fever, cough with expectoration, orthopnea, and exertional dyspnea. A routine X-ray was done and revealed Hampton’s hump, a rare radiographic finding persistent with possible …

Desvenlafaxine Induced Acute Angle-Closure Glaucoma - Case Report, Venkatesh Babu Dr, Priyankha Kothandaraman Dr, Megha Sadashiv Dr., Kishor M

Digital Journal of Clinical Medicine

The World Health Organization (WHO) estimates that Depressive disorder affects more than 264 million people worldwide. The global prevalence of depression among those who are aged 18 years and older was approximately 4.4%. According to a 2017 study by India's National Institute of Mental Health and Neuroscience s (NIMHANS), 7.5% of the population in the nation suffers from depression affecting one in 20 Indians_[1].

SSRIs ( Selective Serotonin Re uptake Inhibitors) and SNRIs ( serotonin-nor epinephrine re uptake inhibitors) are increasingly the first-line choices of anti-depressant because of their tolerable side-effect profile and low rate of lethality if …

Primary Hypertrophic Osteoarthropathy: A Case Series, Varuni Pragya, Mahabaleshwar Mamadapur Dr, Rahul Bisaralli Dr, Deepak Benny Dr, Purna Bansal

Digital Journal of Clinical Medicine

Skeletal dysplasia encompasses a spectrum of over 400 rare inheritable skeletal abnormalities typically manifested early in childhood. Hypertrophic Osteoarthropathy is a clinical syndrome marked by abnormal skin and osseous tissue proliferation at the distal extremities. It is characterized by unique clinical features such as digital clubbing, periostosis of tubular bones, and synovial effusions.

We report three cases of HPOA for further understanding and insight into this infrequent cause of clubbing. Case 1 involved a 25-year-old male presenting with joint pain, primarily in wrists and knees, accompanied by progressive swelling in both lower limbs for the past 3 years. Case 2 …

An Internal Audit On Patient Safety And Quality Of Services In A Rural Health Training Center, Coimbatore., Josphine Priscilla Charles, Kathiravan Rajendran, Jenit Osborn

Digital Journal of Clinical Medicine

Prioritizing patient safety is imperative for enhancing quality healthcare, especially in lower- and middle-income countries. Recognizing this urgency, India's Ministry of Health and Family Welfare introduced the 'SaQushal' toolkit, empowering health facilities to self-assess and improve their safety practices. This study presents an internal audit at a Rural Health Training Centre (RHTC) in Coimbatore, India, utilizing the 'SaQushal' framework. The facility achieved an overall score of 63%, exceeding the 50% minimum threshold for each domain, indicating commendable efforts towards establishing good quality standards. Notably, all domains scored above 50%, highlighting strengths across various safety dimensions. While acknowledging this progress, the …

Neurocystecercosis, Sudha Kiran Das Dr, Vipul Malviya Dr, Sachin P. Shetty Dr, Shrisagar R A

Radiology Teaching Files

• 42 year male patient presented with complains of generalised weakness and 2 episodes of seizures. CT and MRI brain was performed and was diagnosed with neurocystecercosis. Symptomatic treatment with antiseizure medications, along with anthelmintic therapy using albendazole and praziquantel, the two antiparasitics, was planned, accompanied by corticosteroids.

Unveiling A Hidden Peril: Unanticipated Emergence Of Diaphragmatic Hernia After Trauma, Deepak Benny Dr, Deepak K. S Dr, Vishal S. Dharpur Dr, Priyanshi Tapadia

Radiology Teaching Files

This case report presents a rare instance of a delayed diagnosis of obstructed diaphragmatic hernia in a 57-year-old male, a year after sustaining trauma. The patient initially presented with abdominal pain and obstipation, without any overt signs of diaphragmatic injury. Diagnostic challenges were compounded by the patient's non-specific symptomatology and the absence of immediate post-traumatic complications. The report discusses the clinical presentation, diagnostic imaging, and therapeutic management, underscoring the importance of considering diaphragmatic hernia in differential diagnoses of abdominal pain post-trauma. The case highlights the necessity for heightened clinical vigilance and the pivotal role of advanced imaging techniques in diagnosing …

Unveiling The Silent Specter: A Comprehensive Exploration Of Silent Sinus Syndrome, Deepak Benny Dr, Sudha Kiran Das Dr, Shwetha R. Poojary Dr, Priyanshi Tapadia

Radiology Teaching Files

A 42-year-old individual presented to the outpatient clinic with subtle facial asymmetry noted over the past year, primarily characterized by a progressive, painless sinking of the right eye (enophthalmos). The patient reported a history of mild, intermittent nasal obstruction but no acute sinus infections, significant nasal discharge, or facial pain. Despite these mild symptoms, the patient expressed concern over the noticeable change in facial appearance and occasional double vision, which prompted a visit to the clinic.The patient described a gradual onset of the right eye appearing "sunken" without any preceding trauma, infection, or significant weight loss. Initially dismissed as a …

Pericallosal Lipoma Unveiled: A Rare Case Of Incidental Discovery And Its Clinical Implications, Deepak Benny Dr, Sachin P. Shetty Dr, Kavitha B. C Dr, Sinchana N Dr

Radiology Teaching Files

This case report delves into the incidental finding of a pericallosal lipoma during routine neuroimaging conducted for non-specific neurological symptoms. It provides a detailed examination of the lipoma's radiological features, outlines the clinical significance of such findings, and discusses the management approach adopted, including considerations for surgical intervention versus conservative monitoring. The report further explores the implications of incidental pericallosal lipomas on patient outcomes, emphasizing the need for awareness among clinicians about this rare condition and the importance of individualized patient care strategies in the context of such incidental neuroimaging discoveries.

Emerging Mania In Young Adulthood: A Case Report Of Idiopathic Fahr's Syndrome Unveiling Neuropsychiatric Dimensions, Deepak Benny Dr, Shwetha R. Poojary Dr, Kavya B. T Dr, Sudha Kiran Das Dr.

Radiology Teaching Files

This case report outlines the diagnosis and management of an 18-year-old male presenting with first episode mania, attributed to idiopathic Fahr's Syndrome. Despite having no significant past medical or psychiatric history, the patient exhibited classic manic symptoms alongside grandiose delusions. Notably, CT imaging revealed brain calcifications characteristic of Fahr's Syndrome, absent metabolic disturbances commonly associated with the disorder. This case underscores the clinical complexity of Fahr's Syndrome, illustrating its potential to manifest primarily with psychiatric symptoms and the importance of integrating neuroimaging in the psychiatric evaluation to uncover underlying neurological disorders.

Pulmonary Infarction, Manu Chaudhary Dr, Sachin P. Shetty Dr, Sinchana N Dr

Radiology Teaching Files

68 years old female presented with breathlessness and chest pain to EMD, on clinical examination her saturation was low and D-Dimer levels were significantly elevated raising the possibility of pulmonary thromboembolism. Further the patient was referred for chest radiograph and CT thorax with contrast for better evaluation and was diagnosed with pulmonary thromboembolism with pulmonary infarct. The patient was treated for the same.

Intraductal Papillary Mucinous Neoplasm(Ipmn), Vikram Patil, Varun Venkatesh Dr, Sudha Kiran Das Dr

Radiology Teaching Files

A 50-year-old male presented with complaints of abdominal pain which was on and off along with weight loss of 6kg in the last 1 month and was diagnosed of intraductal papillary mucinous neoplasm.

EUS+FNA was performed which showed hypoechoic cystic mass with solid component in head of pancreas communicating with MPD. FNAC was performed in the same setting which showed benign ductal epithelial cells. Cystic fluid was aspirated and CEA and amylase were elevated. The treatment and prognosis of IPMNs (intraductal papillary mucinous neoplasms) depend on factors like lesion type and patient condition. However these lesions possess malignant potential which …

An Uncommon Culprit In Sma Syndrome: Navigating Through Duodenal Adenocarcinoma-Induced Obstruction, Deepak Benny Dr, Vikram Patil, Shrisagar R A

Radiology Teaching Files

Superior Mesenteric Artery (SMA) Syndrome is an infrequent vascular compression disorder, characterized predominantly by the extrinsic obstruction of the third part of the duodenum by the SMA, leading to a spectrum of gastrointestinal symptoms. While most commonly associated with rapid weight loss and anatomical variations, its occurrence in the context of adjacent malignancies remains exceedingly rare and clinically significant.

Here I detail a compelling case of a 49-year-old male, initially presenting with nonspecific symptoms of intermittent abdominal pain and vomiting. The diagnostic journey, propelled by computed tomography (CT) and subsequent investigations, unveiled an underlying duodenal adenocarcinoma exerting extrinsic pressure, precipitating …

Parental Perception Of Improvement In Prelinguistic Skills In Kids With Autism In Two Months Of Goal Directed Cognitive Approach, Ratnapriya Chowdhry, Santosh Kondekar, Surbhi Rathi, Abhinaya V, Tasneem Motiwala

Digital Journal of Clinical Medicine

The study aimed to assess the parental perception of improvement in prelinguistic skills in children with Autism Spectrum disorder [ASD] after 1 and 2 months of Goal Directed Cognitive Approach. This was assessed by a questionnaire filled by parents of 26 consecutive ASD kids at a neurodevelopmental center. Parents were asked to rate these skills on a Likert scale of 1-5 before and after 1 month and 2 months of GDCA to check for any improvement. 69% of ASD kids were boys. Mean age at presentation was 2.6 years. The children were subjected to GDCA for an average duration of …

Evaluation Of The Role Of Prolactin To Prevent Diabetic Retinopathy, Suliman A. Suliman

Digital Journal of Clinical Medicine

Abstract:

Introduction: Diabetic retinopathy (DR) is a one of the long-term complications of DM and constitutes the leading cause of blindness in working-age individuals and affects a majority of diabetic patients by 20 years after disease onset.

Objective: The aim of this study it investigation of the potential role of prolactin in the prevention of Diabetic retinopathy.

Methods: The study was conducted on 90 diabetic patients who were divided into a group that included 37 patients without retinopathy and a group that included 27 patients with non-proliferative retinopathy and 26 patients with proliferative retinopathy who attended the Endocrinology clinic and …

The Crucial Role Of Community Medicine In Improving Public Health, Malik Maaz Ahmad, Imran Ahmed Khan, Neha Priyanka

Digital Journal of Clinical Medicine

Community medicine, also known as Social and Preventive Medicine, is a specialized field of medicine that focuses on promoting and protecting the health and well-being of communities and populations. Unlike other medical specialties that primarily focus on individual patients, community medicine takes a broader approach, addressing the health needs of entire populations. The specialty of community medicine plays a vital role in clinical practice and public health. Its focus on prevention, population health, and evidence-based medicine makes it an essential discipline in improving the health and well-being of communities. Community-based medical education is of vital relevance in the modern change …

Magel2 And Oca2 Dual Mutation In A Case Of Prader-Willi Syndrome, Anisha Jain, Gulrej Shaikh, Santosh Kondekar, Surbhi Rathi

Digital Journal of Clinical Medicine

Prader-Willi Syndrome (PWS) is an epigenetic disorder caused by the absence of paternal gene expression on chromosome 15q11-q13. It typically presents with hypotonia, hyperphagia, obesity, and short stature. Oculocutaneous Albinism (OCA) is an autosomal recessive disorder characterized by hypopigmentation of the skin and hair, resulting from mutations in the OCA genes. Mutations in MAGEL2, a member of the melanoma-associated antigen gene (MAGE) protein family, often present with features of autism spectrum disorder and arthrogryposis. This case is notable for its presentation of dual OCA2 and MAGEL2 mutations, with an atypical phenotype of Prader-Willi Syndrome. We present a 9-year-old boy of …

Umbrella Review As A Data Collection Tool: Towards Observation, Analysis, And Empirical Transformation Of Qualitative Drivers Describing Healthcare Workforce Shortage Factors Into Quantitative Data To Support Medical Education Interventions In A Global Challenge., Fabio Galli, Marco Grech

Digital Journal of Clinical Medicine

A healthcare workforce shortage of 18 million is expected by 2030, against a global demand of 80 million, and it is difficult to analyse and monitor the real drivers driving this personnel shortage on a global level. The transformation of qualitative data into quantitative data can be a strategy in this global challenge, that can implement the medical education intervention strategies.

Atypical Immune Response: Acquired Hemolytic Anemia In A Non-Hodgkin Lymphoma Patient With Unusual Findings, Mannan Mangal

Digital Journal of Clinical Medicine

Acquired hemolytic anemia, caused by external factors like autoimmune disorders or infections, includes rare cases of Cold Agglutinin Syndrome (CAS), a cold-antibody-mediated condition affecting 1 in 1 million annually. This report highlights a unique case of CAS in a patient with Non-Hodgkin lymphoma and polyclonal gammopathy, contrasting with the typical presentation of warm-reactive autoantibodies and monoclonal antibodies. The patient presented with weakness, breathlessness, and splenomegaly, with laboratory findings showing a hemoglobin level of 5.8 g/dL and elevated ferritin. Imaging revealed mesenteric lymphadenopathy and thickening of the cecum, suggesting possible lymphomatous involvement. Non-Hodgkin lymphoma was confirmed via lymph node biopsy. This …

Group Approach: Inter-Institute Interactive Sessions For Psychiatry Postgraduate Residents On Mastering The Art Of Prioritization In Everyday Learning., Abhay Koul, Murali M R, Kishor M, Narendra Kumar M S

Digital Journal of Clinical Medicine

Collaboration and knowedge-sharing are essential in Psychiatry as complex mental health challenges require innovative solutions. Inter-institute interactive sessions are important platforms, providing psychiatry postgraduate residents with opportunities to connect, exchange ideas, and advance their understanding of the field collectively. Inter-institution sessions help break the geographic barriers between institutions and build bridges that foster collaboration, networking, and professional growth. There is hardly any literature available on these aspects. The Department of Psychiatry, JSS Medical College, Myusru organized an interactive session between psychiatry post-graduates of JSS Medical College and Mysore Medical College. Students were informed about the rules of the group approach …

Grading Of Malnutrition Among Under 5 Children Residing In Urban Slum In Mysuru Using Who Classification And Indian Academy Of Pediatrics (Iap) Classification: A Comparative Study, Ravali Annaram Dr, Amogha Shree Dr, Saurish Hegde Dr, Krishnaveni Y S Dr

Digital Journal of Clinical Medicine

Background

Malnutrition in Indian children under five is widespread, driven by insufficient food intake and diseases like diarrhoea and respiratory infections. Factors such as food security, maternal literacy, and healthcare access influence malnutrition rates. Growth monitoring utilizes WHO standards globally and IAP guidelines in India. Implementing these charts improves early identification and management of malnutrition, crucial for addressing childhood health challenges in India. This study compare the prevalence of malnutrition in WHO classification with Indian Academy of Paediatrics (IAP) classification among under 5 children residing in urban slum.

Methodology

A community based cross-sectional study was conducted among children aged 6 …

Alopecia As An Early Clinical Marker For Azathioprine Induced Myelosuppression: A Case Report, Nilanjana Dutta , Final Year Mbbs, Dr. M Suresh Babu , Professor, Dr. Subramanian Ramaswamy , Professor, Dr. Mahabaleshwar Mamadapur , Assistant Professor

Digital Journal of Clinical Medicine

Azathioprine is a pro-drug and is metabolized by the TPMT enzyme in the body. In South Asians, Azathioprine is known to cause alopecia and bone marrow suppression in patients with TPMT enzyme deficiency. In India, the prevalence of TPMT mutation varies from 1.2- 10%. A new mutation was detected in 2014, NUDT15 whose incidence varies from 8.5-16%. Patients with mutation in both TPMT and NUDT15 develop myelosuppression faster. In our case, alopecia manifested as the first clinical feature of Azathioprine myelosuppression. Physicians need to recognize early clinical clues (alopecia) to avoid the impending development of myelosuppression and to look for …