Tuesday, August 29, 2023

Metapsych Task shifting: From anthrocentric humanism to post humanism

Metapsych conversational learning around the titled topic, beginning with sharing a global call for papers! 



[8/23, 6:23 AM] 


*Theme and Scope:*

The Journal of Posthumanism (Transnational Press) invites submissions for a special issue exploring the intersection of posthumanism and media studies.

Posthumanism fosters a more inclusive and less hierarchical approach to our entanglements with both human and non-human elements. 

Posthuman theory, particularly as articulated by N. Katherine Hayles and Rosi Braidotti, has long been influential in media studies. However, it has often been applied without a systematic or thoroughly developed methodology. Ferrando (2020) argues:

“posthuman ethics invites us to follow on three related layers. First of
all, as a post-humanism, it marks a shift: from universalism to perspectivism, from multiculturalism to pluralism and diversity. 

As a postanthropocentrism, it induces a change of strategy: from human agency
to agential networks, from technology to eco-technology. 

As a postdualism, it requires an evolution of our awareness: from individuality to
relationality, from theory to praxis.”

This Special Issue of the Journal of Posthumanism therefore asks, how does such posthuman perspectivism, pluralism, agentiality, eco-technology, relationality, and praxis, apply to the future and how might we understand the very concept of “future”?

In 2021, Posthumanism in Art and Science: A Reader was published, making the argument that “aesthetic production is a vital part of posthumanist thinking processes, which thereby grow ever more urgently relevant to social and ecological problem-solving.” (Aloi & McHugh, 2021, 2)  Recent studies have developed posthuman approaches to rhetorical practice (Boyle, 2018) and explored how we might understand the combination of humans and technical media as synthetic subjects (Wiley & Elam, 2018). Elsewhere, Iliadis (2013) proposed that a shift away from a cybernetic understanding of communication as a process of pre-existing agents that transmit messages to one another could offer the possibility for the development of a new underlying informational ontology for communication and media studies, which would lend itself to new methods. Such ontologies and methods have been explored in relation to media studies through, for example, posthuman approaches to autoethnographies and subjectivities (Wilde, 2020; 2022). Monea and Packer (2016) have proposed a media genealogy approach that extends the type of work being done in media archaeology.

Building on this genealogical approach, Sylvia (2019; 2021) has argued that posthuman ethics, ontology, and epistemology could be adopted in media studies through a more explicit embrace of affirmative approaches such as counter-actualization, modulation, and counter-memory. Elsewhere, exploring the tensions and potential contradictions between the history of cultural studies and posthumanism, Cord (2022) asks, “can or should Cultural Studies and the nonhuman turn really be brought into the contact zone?” There are therefore a variety of possible responses and resonances between posthumanism and media studies.

We propose this special issue as an avenue to explore, extend, and develop a posthuman praxis for media studies. We invite researchers to explore themes related to these posthuman approaches. This might include, but is not limited to:

* Pieces that build on or extend existing theory and methods in posthuman media and/or communication practices.

* The role of AI in shaping posthuman futures and subjectivities.

* Posthuman approaches for the study of games, television, social media, journalism, and rhetoric.

* The exploration of posthuman ethics in media studies.

* Application of posthuman paradigms such as counter-actualization, modulation, and countermemory in media case studies.

* Posthuman conceptualizations of media’s role in processes of subjectivation.

* How media intra-actions emphasise different modes of materialism and materialities.

* Experimental approaches to media studies.

* Post-anthropocentric or non-human media studies.

* Ontologies of posthuman media.

* Posthumanist entanglements of media and culture.

* Onto-epistemological postdualisms that could/should be applied to media studies.

*Guest Editors:*

Dr. J.J. Sylvia IV, Associate Professor of Communications Media, Fitchburg State University

Dr. Poppy Wilde, Senior Lecturer in Media and Communication, Birmingham City University

Please feel free to circulate this call for proposals among your colleagues and networks. If you have any questions about this call or the proposed special issue, please feel welcome to contact us. All inquiries and submissions can be sent to: jsylvia3@fitchburgstate.edu and poppy.wilde@bcu.ac.uk.

*References*

Aloi, G., & McHugh, S. (eds) (2021). Posthumanism in art and science: A reader. Columbia University Press.

Boyle, C. A. (2018). Rhetoric as a posthuman practice. The Ohio State University Press.

Cord, F. (2022). Posthumanist cultural studies: Taking the nonhuman seriously. Open Cultural Studies , 6 (1), 25-37. https://doi.org/10.1515/culture-2020-0138

Ferrando, F. (2020). Posthuman feminist ethics: Unveiling ontological radical healing. In M. R. Thomsen and Jacob Wamberg The Bloomsbury handbook of posthumanism , (pp. 141-60). Bloomsbury Academic.

Iliadis, A. (2013). Informational ontology: The meaning of Gilbert Simondon’s concept of individuation. Communication + 1, 2 (1). Article 5. https://doi.org/10.7275/R59884XW

Monea, A., & Packer, J. (2016). Media genealogy and the politics of archaeology. International Journal of Communication, 10 , 3141–59.

Sylvia IV, J.J. (2019). From archaeology to genealogy: Adding processes of subjectivation to artistic intervention. Communication +1, 7(2). Article 3. https://doi.org/10.7275/a3dm-3770

———. (2021). Posthuman media studies. Journal of Posthumanism, 1 (2), 139-51. https://doi.org/10.33182/jp.v1i2.1360

Wilde, P. (2020). I, posthuman: A deliberately provocative title. International Review of Qualitative Research, 13 (3), 365–80. https://doi.org/10.1177/1940844720939853. ( https://www.zotero.org/google-docs/?SSBYIt )

———. (2022). Storytelling the multiple self: Posthuman autoethnography as critical praxis. In C. Blyth & T. K. Aslanian (Eds.), Children and the power of stories (pp. 1-16). Children: Global Posthumanist Perspectives and Materialist Theories. Springer Singapore. https://doi.org/10.1007/978-981-16-9287-1_1.

Wiley, S B. C., & Elam, J. (2018). Synthetic subjectivation: Technical media and the composition of posthuman subjects.” Subjectivity, 11 (3), 203–27. https://doi.org/10.1057/s41286-018-0055-0

Conversational transcripts below pasted from the "Metapsych group" after the call  for papers above was shared. 


[8/24, 7:15 PM] Metapsychist Number 1 Kims 2015: @⁨~Madeeha Abrar⁩ What's this bird?


[8/24, 8:38 PM] +91 7: Parrots,,,πŸ™‚


[8/24, 8:39 PM] Metapsychist Number 1 Kims 2015: Parakeet


[8/24, 8:39 PM] +91 7: Yeah same only


[8/24, 8:39 PM] +91 7: But different species


[8/24, 8:39 PM] +91 7: Budgies


[8/24, 8:39 PM] Metapsychist Number 1 Kims 2015: Yep,budgies,aka Budgerigar
[8/24, 8:40 PM] +91 7: Why are they in cage?


[8/24, 8:42 PM] Metapsychist Number 1 Kims 2015: Let's find out


[8/24, 8:50 PM] Metapsychist Number 1 Kims 2015: They fly away so easily until trained and they cannot survive outside 

πŸ₯²
[8/24, 8:50 PM] Metapsychist Number 1 Kims 2015: Let them fly away,,,


[8/24, 8:50 PM] Metapsychist Number 1 Kims 2015: There are ...but the ones bred this way are generally very fragile ....they are always kept inside even in the shop ....so they don't really know how to survive ...they are easy prey for eagles around


[8/24, 8:50 PM] Metapsychist Number 1 Kims 2015: So there are no wild parakeets?


[8/24, 8:52 PM] Metapsychist Number 1 Kims 2015: Why are they being bred in first place?



[8/24, 8:53 PM] +91 8: I had 4 of them ...i tried soo hard to keep them alive .... even when kept in the cage I kept the cage near the window and an eagle tried to kill one of em


[8/24, 8:54 PM] +91 8: Since it got injured ...it died within two days


[8/24, 8:55 PM] +91 8: Also one more budgie just flew away while we opened the cage to change food and water


[8/24, 8:55 PM] Metapsychist Number 1 Kims 2015: Akin to breeding children in coaching institutions and they succb or suicide when put in real life scenarios?πŸ€”


[8/24, 8:55 PM] +917 : Flew away safely is good


[8/24, 8:56 PM] +91 5: This was sad,,,!πŸ˜₯

[8/24, 8:56 PM] +91 : But idts ....if a budgie got hurt like that inside the cage ...I'm sure the other one couldn't have survived either


[8/24, 8:56 PM] Metapsychist Number 1 Kims 2015: Agree



[8/24, 8:57 PM] +91 : Once they start falling Ill for whatever reason ....it's only a matter of 3-4 days


[8/24, 8:58 PM] Metapsychist Number 1 Kims 2015: In an experiment, a scientist placed a number of fleas in a glass jar. They quickly jumped out. He then put the fleas back into the jar and placed a glass lid over the top. The fleas began jumping and hitting the glass lid, falling back down into the jar. After a while, the fleas, conditioned to the presence of the glass lid, began jumping slightly below the glass lid so as not to hit it. The scientist then removed the glass lid as it was no longer needed to keep the fleas in the jar. The fleas have learned to limit themselves from jumping beyond the height of the lid even if the lid was removed as they have been conditioned to the fact that they cannot escape from the jar.




[8/24, 8:58 PM] +91 8: Did y'all see those colourful chickens in local markets ?? It's the same case with them too ...i used to be very excited when I was small but now I realise they treat them soo badly , colour em and sell. The other day a lady was carrying one in a plastic bag, that's just very sad to watch

.
[8/24, 8:59 PM] Metapsychist Number 1 Kims 2015: Yess...
That's rly sad.
They hardly live for 1 to 2 months.
Even few exotic dog breeds are like this..


[8/24, 8:59 PM] +91 8: True



[8/25, 7:24 AM] Avinash Gupta Nepal: Even trained ones will die in concrete jungle..they need natural habitat too.



[8/25, 8:03 AM] Rakesh Biswas: What's their average life span in jungles v captivity? πŸ™‚πŸ™


[8/25, 8:11 AM] Avinash Gupta Nepal: My opinion for animals in captivity is, either provide them good food, security, play (mashlow's pyramid base) or if that anyway difficult then not bring them in captivity.

Raising once In captivity and then sending back to jungle may be worst.

So like raising children is a 20 Years project, raising animals in captivity is also similar untill they live their natural life.


Ps- I like animals, and also eat them in dinner.


[8/25, 8:18 AM] Avinash Gupta Nepal: Raising animals on industrial scale for business (food, captivity) is different.

Common cruelty there is inbreeding and toxifying their liver and kidneys.
[8/25, 8:20 AM] Rakesh Biswas: The BBC post that you shared contradicts your statement here about what I thought was mortality differences between captivity and natural habitat but I now realize you may have wanted to make a different poimt here


[8/25, 8:22 AM] Avinash Gupta Nepal: Yes sir.

My point was, to either let them be in natural habitat or give good accommodation, food and security. 

Bad captivity should be prevented like torture, punishment, inbreeding, etc.


[8/25, 8:25 AM] Rakesh Biswas: What about bad parents! I guess the law needs more transparent and accountable parental monitoring systems data to decide who to catch (catch up with @⁨Metapsychist Number 1 Kims 2015⁩)?


[8/25, 8:28 AM] Avinash Gupta Nepal: One of bad practice becomes best practice when we do industrial scale captivity for human food, or pearls, meds etc.

That is toxifying animals including chicken for dinner or horse's for snake antivenom. 

It's interesting how bad becomes best when context changes.


[8/25, 8:31 AM] Avinash Gupta Nepal: Here bad with respect to context becomes important then.


In usa throwing out an 18 year old away from home to earn himself can be best practice an in India can be considered worst. 


When bad identified, there are choices-
1) educational intervention. 
2) corrective/ self-corrective intervention.


[8/25, 8:33 AM] Rakesh Biswas: Bad and best are judgmental labels and as you rightly pointed depend on context 

But then what is toxifying animals for dinner! 😳😨


[8/25, 8:35 AM] Avinash Gupta Nepal: Overuse of antibiotics and steroids in poultry and other livestock industries. hormones like in cows.


[8/25, 8:36 AM] Avinash Gupta Nepal: Toxifying to increase efficiency/produce

.
[8/25, 8:37 AM] Avinash Gupta Nepal: With respect to horse's for snake antivenom - it may be  a peaceful v/s painful death in neglect.


[8/25, 8:39 AM] Rakesh Biswas: Is that good practice?


[8/25, 8:40 AM] Avinash Gupta Nepal: No sir, best practice is use cautiously.. real implementation of that best practive or gbm is rampant use..


[8/25, 8:40 AM] Rakesh Biswas: Please review the literature on the exact methodology of horse serum extraction for antivenom as there appear to be a few assumptions here


[8/25, 8:41 AM] Avinash Gupta Nepal: Sure sir


[8/25, 8:42 AM] Rakesh Biswas: So the chicken example is Bad rampant use while the horse antivenom example is best use (pending detailed review)?
[8/25, 8:43 AM] Avinash Gupta Nepal: Making antivenom - good.

_Neglecting_ horse's in captivity - sick, suffering, dying early. Is bad.


[8/25, 8:45 AM] Rakesh Biswas: So all practices in an aggregate in your examples contain good bad and ugly?


[8/25, 8:45 AM] Avinash Gupta Nepal: Yes sir


[8/25, 8:47 AM] Avinash Gupta Nepal: Making antivenom - good. Retire after 50 years age - good. Cared well - good
[8/25, 8:48 AM] Avinash Gupta Nepal: Sick and cared - good. Sick and neglected - bad. Sick and die became of neglect - ugly
[8/25, 8:49 AM] Avinash Gupta Nepal: Above statements in context of industrial scale production.




[8/25, 9:25 AM] Rakesh Biswas: Just metapsyasKing as a horse :

How's it good for me to lose my freedom to some monkeys with AI (the overall bigger asynchronous intelligence of which the current populist AI is just a small subset) and get pricked with a needle first to get injected with snake venom and then to collect my antibodies to benefit the monkeys?!πŸ˜…


[8/25, 9:27 AM] Avinash Gupta Nepal: That's also valid point sir, just context is changed from human wanting industry to horse wanting to be horse. Same as individual wants to be individual but public health wants them to be 1 in large number.

[8/25, 9:28 AM] Rakesh Biswas: Yes task shifting from Anthrocentric humanism to post humanism will take time! 



Licenced from : Wikimedia commons 

Monday, August 28, 2023

Transitioning from fast system 1 synchronous to system 2 fast (traditionally largely slow) asynchronous intelligence (AI primordial) in the duality of our current medical cognition landscape! A man with mild lower limb paresis who couldn't stand even with his eyes open

Conversational decision support from our CBBLE PaJR below:



[8/27, 2:59 PM] Rakesh Biswas: https://chat.whatsapp.com/JNwDDlalC8TLXjwIsR3u53

Other than falling with eyes open and mild disturbances in the heel shin test video what other signs suggest involvement of the cerebellum in this man who has this gradually progressive ataxia since 5 years? 

What is his joint position and vibration sense? 

Areflexia and reduced nerve conduction velocity suggests associated axonal demyelinating neuropathy but what does the conduction blocks in addition suggest?

@⁨Chandana Kims Med PG⁩ @⁨Aditya Samitinjay Medicine SR⁩ @⁨Raveen 2020 Pg Med KIMs⁩ @⁨Metapsychist Medical Student 2⁩ @⁨Akhil Kims SR Medicine⁩



[8/27, 3:13 PM] Aditya Samitinjay Medicine SR: Blog link please?

[8/27, 6:51 PM] Rakesh Biswas: πŸ‘†@⁨~Sampath Kasarabadha⁩


[8/27, 8:18 PM] Aditya Samitinjay Medicine SR: Looking forward to this. Thank you.


[8/27, 8:20 PM] Rakesh Biswas: While it materializes can we see how to answer the question of confirming if the man's inability to stand with eyes open is specific to cerebellar or could it even be just due to his neuropathy?
[8/27, 8:32 PM] Aditya Samitinjay Medicine SR: From whatever information I have

Problem Representation - 72/M with? Chronic Progressive Gait instability, areflexia and axonal neuropathy on NCS

Guided exam - would do a full cerebellar exam (Dysdiadochokinesis, intention tremor, past pointing, nystagmus with HINTS exam, heel shin, finger nose and finger finger)

We have data that he is falling with eyes open and also has impaired heel shin on both sides, suggesting a midline cerebellar involvement? Checking for nystagmus and delayed corrective saccades can weigh it in favor of a cerebellar lesion.

As alluded to, vibration and proprioception can weigh it in favor of a sensory neuropathy.

Really big data gaps which need some filling here. Looking forward to more info.


[8/27, 8:53 PM] Rakesh Biswas: @⁨Metapsychist Medical Student 2⁩ Can you fill these information gaps by asking the duty interns to check these findings that haven't been shared yet? 

@⁨Aditya Samitinjay Medicine SR⁩ I'm expecting his joint position sense and vibration sense to be impaired and his other cerebellar signs to be negative and there's no doubt that he could be labeled sensory ataxia alone if not for that Rhomberg's fall with eyes open (can we even call it rhomberg's negative) but I guess I'm hinting at either a limitation of the specificity of rhomberg's test here and need to know if it has been publicized before in this manner by others (from a review of literature) 

I also need to know more about the significance of his conduction block along with the neuropathy 

@⁨Metapsychist Number 1 Kims 2015⁩ @⁨Rahul healthcare 2.0⁩ Can an ΔΉΔΉM help here?


[8/27, 8:55 PM] Metapsychist Number 1 Kims 2015: No,LLM can't help here.
There are few things which LLM can't replace yet..
Like,affective/hands on domain,clinical sense and emotional intelligence


[8/27, 8:56 PM] Metapsychist Number 1 Kims 2015: We need a skillful intern at point of care.
No replacements for this


[8/27, 8:59 PM] Rakesh Biswas: Why don't we have them when we need them? Answer this from your own experiences as an intern here in 2021-22! 

Feel free to destroy our own high and mighty assumptions! πŸ™‚


[8/27, 9:01 PM] Metapsychist Number 1 Kims 2015: In technical terms,we define them as hidden nodes.

Hidden nodes maybe
1.Lack of understanding of purpose of medical education.
2.High of trying to get a PG seat by few months of roting 

Many more..
[8/27, 9:30 PM] Rakesh Biswas: Those hidden nodes appear to be part of a hidden curriculum? Would be nice to identify these nodes further and list them for better effective optimizing strategies


[8/28, 10:45 AM] Rakesh Biswas: Here's the case report prepared by @⁨~Sampath Kasarabadha⁩ πŸ‘‡


Please guide him how to develop it further @⁨Chandana Kims Med PG⁩ @⁨Aditya Samitinjay Medicine SR⁩


[8/28, 12:00 PM] Chandana Kims Med PG: 


Firstly , we’ll done @⁨~Sampath Kasarabadha⁩ 
Can improve the blog by adding individual muscle testing of lower limbs.
Heel knee test can be misleading ,may be he is unable to do it because of the neuropathy.
His gait appears to be a little high stepping kind of gait ,but it is not as clear as in a patient of peroneal palsy because is this patient the muscles supplied by tibial nerve are also affected,so I suggest you to check dorsi flexion and plantar flexors power separately if not already done .
…………..
Coming to the NCS report:
In Upper limbs :
NCS shows reduced _*motor conduction velocity *_in Right median nerve with *conduction Block * and 
*reduced motor conduction velocity * in left mediam Newe. There is *conduction block * across right ulnar nerve.

This is suggesting demyelination (along with absent reflexes)
…………..
In Lower limbs:
*Absent MUAPS  * in Bilateral peroneal nerve and *reduced CMAP*  in B/L TibialNerves . 

Reduced CMAP ,MUAPS is not always axonal,This can also be due to demyelination when there is a conduction block.For this we need to know the conduction velocity and presence of any conduction block in tibial and peroneal nerves which is not given in this report.
If there is conduction block and conduction velocity is slow with reduced CMAP it is demyelination and not necessarily axonal.
…………
sensory conductions show *absent SNAP*  in Right median nerve with absent SNAP in Bilateral sural nerves.
The same applies for sensory nerves ,reduced /absent SNAP can be there in demyelination,we need to know the conduction velocity in these nerves.
If conduction velocity is also decreased it is sensory motor demyelination (CIDP)


[8/28, 12:04 PM] Chandana Kims Med PG: Any drop in CMAP amplitude or area of more than 20% implies conduction block and any increase in the CMAP duration of more than 15% signifies temporal dispersion; both are hallmarks of demyelination



[8/28, 12:07 PM] Chandana Kims Med PG: And what about upper limb muscles? All muscles 5/5? @⁨~Sampath Kasarabadha⁩


[8/28, 12:10 PM] Vivek Kurma 2022 KIMs Pg Med: Ma'am will do all the individual muscle testing and upload it by today evening


[8/28, 12:23 PM] Rakesh Biswas: Very well done inputs πŸ‘πŸ‘

Can we explain away his inability to stand with his eyes closed as not cerebellar but simply part of his chronic upper and lower limb demyelination?


[8/28, 12:28 PM] +91 95024 79628: Thank you mam
I will do individual muscle testing  with help of Vivek sir mam



[8/28, 11:04 PM] Rahul healthcare 2.0: As @⁨Metapsychist Number 1 Kims 2015⁩ said, LLMs can't compensate for domain knowledge and reasoning skills, at least not yet. I tried to ask it relevant questions and here is what Google Bard gave me. 
----
Q1. What are conclusive tests to determine - 
1. Cerebellar Ataxia
2. Sensory Neutopathy
3. Guillain Barre Syndrome

A1. There is no single conclusive test for any of these conditions, but a combination of tests can be used to make a diagnosis.

Cerebellar ataxia: The following tests may be used to diagnose cerebellar ataxia:
Cerebellar exam: This exam is performed by a doctor to assess the patient's coordination, balance, and reflexes.
Magnetic resonance imaging (MRI): This imaging test can be used to visualize the cerebellum and look for any structural abnormalities.
Electroencephalogram (EEG): This test records the electrical activity of the brain and can be used to look for abnormalities that may be associated with cerebellar ataxia.
Sensory neuropathy: The following tests may be used to diagnose sensory neuropathy:
Nerve conduction studies (NCS): This test measures the electrical activity of the nerves and can be used to assess the severity of nerve damage.
Electromyography (EMG): This test measures the electrical activity of the muscles and can be used to assess the health of the nerves that innervate the muscles.
Skin biopsy: This test may be performed to look for changes in the skin that may be associated with sensory neuropathy.
Guillain-BarrΓ© syndrome: The following tests may be used to diagnose Guillain-BarrΓ© syndrome:
Cerebrospinal fluid (CSF) analysis: This test can be used to look for proteins and cells that are characteristic of Guillain-BarrΓ© syndrome.
Nerve conduction studies (NCS): This test can be used to assess the severity of nerve damage.
Electromyography (EMG): This test can be used to assess the health of the nerves that innervate the muscles.
In addition to these tests, the doctor may also ask the patient about their medical history, symptoms, and family history. This information can also be helpful in making a diagnosis.

If you are concerned that you or someone you know may have one of these conditions, it is important to see a doctor for evaluation. Early diagnosis and treatment can help to improve the outcome of these conditions.

=================

Q2. What is Rhomberg's test? Are there places where it gives false negatives?

A2. Romberg's test is a simple neurological test that is used to assess balance and proprioception. It is performed by asking the patient to stand with their feet together and their eyes closed. If the patient sways or falls, the test is considered positive.

Romberg's test is a sensitive test for detecting proprioceptive deficits, which are problems with the body's ability to sense its own position in space. However, it can also give false negatives, meaning that the test is negative even though the patient has a proprioceptive deficit.

There are a few reasons why Romberg's test can give false negatives. One reason is that the test relies on the patient's ability to see. If the patient has their eyes open, they can use visual cues to help them maintain their balance. This can mask any proprioceptive deficits that they may have.

Another reason why Romberg's test can give false negatives is that the patient may be compensating for their proprioceptive deficit. For example, they may press their feet down harder on the ground or take a wider stance to help them stay upright. This can also mask any proprioceptive deficits that they may have.

Finally, Romberg's test is not always performed correctly. If the patient is not standing still or if they are not asked to close their eyes for long enough, the test may be inaccurate.

If Romberg's test is negative, it does not mean that the patient does not have a proprioceptive deficit. Other tests, such as the Unterberger's test or the tandem gait test, may be more sensitive in detecting proprioceptive deficits.

Here are some of the places where Romberg's test can give false negatives:

* **In patients with visual impairment:** Patients with visual impairment may rely on proprioception more than patients with normal vision. This means that they may be more likely to sway or fall even if they have no proprioceptive deficits.
* **In patients with fatigue:** Fatigue can also affect balance. Patients who are fatigued may be more likely to sway or fall, even if they have no proprioceptive deficits.
* **In patients with anxiety or stress:** Anxiety and stress can also affect balance. Patients who are anxious or stressed may be more likely to sway or fall, even if they have no proprioceptive deficits.
* **In patients with musculoskeletal disorders:** Musculoskeletal disorders, such as arthritis or muscle weakness, can also affect balance. Patients with musculoskeletal disorders may be more likely to sway or fall, even if they have no proprioceptive deficits.

If you are concerned that you or someone you know may have a proprioceptive deficit, it is important to see a doctor for evaluation. Early diagnosis and treatment can help to improve balance and prevent falls.


[8/29, 8:53 AM] Rakesh Biswas: Well done google bard πŸ‘πŸ‘

So the bard feels that the only other test we can do to look for structural cerebellar involvement is an mri that may show cerebellar involvement and there may be nothing else other than a clinical examination (showing more points than falling with eyes open, which could even be due to just his peripheral neuropathy)! 

The other things picked up by the bard can be discounted by epidemiologic reasoning hinting at likelihood or probability estimates. 

Was asking our intern yesterday to do this kind of a literature search and I guess the bard beat him to it πŸ‘πŸ‘

AI driven LLMs are already into our workflow now with a little bit of enthusiastic promoting by AI engineers. πŸ™‚πŸ™


[8/29, 9:21 AM] Rakesh Biswas: We "healthcare only people" would need to fasten our seat belts for the roller coaster ride ahead πŸ™‚πŸ™@⁨Rahul healthcare 2.0⁩



Thursday, August 24, 2023

Reflecting Renegades

By 15th June, all students currently doing their medicine postings will need to share a summary of their logged learning experiences in medicine department introduced through their unique personal practical patient  experience narrative with detailed patient follow up data in links to their logged case report entries beginning with their very first practical patient experience when they had their first posting in medicine department and when they initiated their logbook entries into their online learning portfolios for the first time. 


This is for their internal assessment toward final exam assessments as well as internship completion. 

Sharing below a few samples already submitted that others may improvise on. Their unique individual work should be reflected and marks will be deducted if any kind of plagiarism is detected. 

2019-20 submitted sample links in no particular order :










"P.O.I.N.T

While the issue of data versus narrative may make a whole lot of intellectual sense, working with it in real-time is challenging since the mind easily confuses narrative to data to suit its... well, narrative!

POINT is an acronym for Pause, Observe, Inquire, Notice and Tell The Truth.  Click here to download the POINT document.

While pausing, observing, inquiring and noticing are relatively easy, telling the truth is where we get stuck, not only because of confusion between data and narrative but also because we tend to remain unaware of why the narrative is as it is"

Above quoted from :


Link to all our online learning portfolios in our departmental dashboard here πŸ‘‡




Tuesday, August 22, 2023

"Jar of mango pickles" sign: system 2 medical cognition PaJR from 2013 revisited

In this link : http://www.udhc.co.in/INPUT/displayIssueGraphically.jsp?topic_id=218 used to be the patient input record


Please find the output after discussion including the current status here: http://www.udhc.co.in/SOLUTION/viewSolution.jsp?solution_id=40&topic_id=218

Also please find the discussion we had in our forum (including comments from Prof Dilawari):

Rakesh Biswas
Currently we are managing this 23 year old lady suffering from symptoms of malabsorption syndrome since the last 14 years when she was given a diagnosis of gluten sensitive enteropathy at the age of 9.

Presently possibly since the last 2 years she has severe kyphoscoliosis along with severe bowing of her upper limbs as well as a left clavicular fracture with callus (Ela can you upload her clinical pictures?). Her neurological examination suggests paraplegia with increased DTRs and bilateral flexor planters.

We have done a macroscopic examination of the 24 hour stools which looks like a 'jar of pickles' (Ela picture?) with undigested fecal food particles. What are your thoughts on further management of this lady in pain?
Like · · Unfollow Post · February 24 at 4:40pm


As all the content including the actual stool image has been lost on changing the PaJR platform, shared a few google images of actual mango pickles jar from the internet from witch's kitchen and Tarla Dalal