Tuesday, October 17, 2023

A yoga teacher with persistent cheilitis. Int J Clin Pract. 2003

 Biswas R, Dalal M. A yoga teacher with persistent cheilitis. Int J Clin Pract. 2003 May;57(4):340-2. PMID: 12800469.

Diaphragmatic palsy in stroke. Int J Clin Pract. 2004

 Biswas R, Das RN, Rana PV. Diaphragmatic palsy in stroke. Int J Clin Pract. 2004 Apr;58(4):411-2. doi: 10.1111/j.1368-5031.2004.00078.x. PMID: 15161128.





A yoga teacher with persistent reflux symptoms. Int J Clin Pract. 2002 Nov;56(9):723. PMID: 12469992.

 Biswas R, Paul A, Shetty KJ. A yoga teacher with persistent reflux symptoms. Int J Clin Pract. 2002 Nov;56(9):723. PMID: 12469992.




Saturday, October 14, 2023

UDLCO project : Transparency accountability and evaluation of global procedural and declarative clinical encounters and their encounters

Summary : Two artifacts are explored through a user driven learning community UDLC toward ontology (O) creation: 


1) Patient advocate video anecdotal testimonies and problem statement on what ails current healthcare practice resulting in worse patient outcomes and  overdiagnosis and overtreatment 

2) PDF Summary of PIL to stop live recording and sharing in real time of procedural  clinical encounters with pros and cons (related news report : https://www.livelaw.in/top-stories/supreme-court-issues-notice-in-pil-to-regulate-live-broadcasting-of-medical-surgeries-240090)

Transparency accountability and evaluation of global procedural and declarative clinical encounters and their encounters as a solution to the above problem statement in the video and PDF  artifacts are discussed in user driven learning conversations


Conversational transcripts :

Sharing a leaf from another group discussion threadπŸ‘‡

 [10/14, 10:38 PM] Dr Thanga Prabhu: She is talking in Hindi but is calling out the missing trust that today's medical practise has ended up in. TLC - tender loving care and a compassionate attitude goes a long way in the patients treatment. Most i repeat most ailments don't need a Dr. Once that need a Dr don't need a list of investigations. An 89 years old developed a gait with tilting to right. In one of the so called neurology specialist centres they diagnosed dementia stroke and epilepsy and loaded him with drugs. He was drowsy and sleeping all the time. Recently they visited a GP, who questioned the big list of medication and the multiple diagnosis. After a good HPE few tests and MRI a neurologist cut down all the medicines. He is doing very well now. This neurologist is in St Johns Medical College ❤️ so when in doubt please consult a family physician or a charitable hospital or academic medical centre. Let us return to a Trust based Dr - Patient relationship.πŸ«ΆπŸ½πŸ™πŸ½πŸ˜


[10/14, 10:50 PM] Dr Rajeev Joshi: Opinions solicited in this regard (PIL for not sharing procedural clinical encounters) 


[10/14, 11:30 PM] Mr Sundar (in response to Dr Thanga) : 

True. What is disturbing is the growing number of such misdiagnoses and consequent loss of credibility with the profession. This cannot be left unchecked. 
There is a lot of freedom given to the RMP to decide the line of treatment, and rightly so. But can we somehow bring in peer review and accountability to (not just the outcome) the choice of pathways?


[10/15, 10:10 AM] Rakesh Biswas: The first step would be to capture all that clinical encounter data


[10/15, 10:21 AM] Rakesh Biswas: Trying to integrate the two threads (Clinical procedure encounter PIL and perceived problems with current clinical encounters) here: πŸ‘‡

The live recording and sharing in real time of a clinical encounter (be it procedural as in this current IPL) or declarative as in the above patient advocate video are both a first step toward better transparency and accountability! 

The difference between the live procedural clinical encounter is that the data cannot be fudged while whatever the patient advocate is declaring is largely  anecdotal generalization and hence less valid than a real clinical encounter record! 

How do we capture and record and analyze all these big data in the near future preserving patient confidentiality and privacy is currently left to AI and it's ethicists to kaggle about