Natl Med J India
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Background Fundus examination is an integral part of the clinical evaluation of patients with medical emergencies. It is done at the bedside using a portable direct ophthalmoscope. Smartphone fundus photography (SFP) is a novel technique of retinal imaging. ⋯ Papilloedema (21.4%), haemorrhages (20%) and Roth spots (12.5%) were most common. DO missed early papilloedema and findings in the peripheral retina. Conclusions SFP is as effective as DO, in detecting retinal findings in patients with medical emergencies and can be performed at the bedside by the physician.
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We report a 26-year-old girl who was diagnosed with diabetes mellitus in her childhood and was treated with insulin. With a history of visual disturbances during her childhood and anaemia, which was partially evaluated; the possibility of syndromic diabetes was considered. ⋯ She was supplemented with thiamine, which dramatically improved her haemoglobin levels and glucose control. However, her vision could not be salvaged as the rod-cone dystrophy is a permanent damage.
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Background In general surgery, a clinician is commonly required to break bad news. However, training in communication is not a part of the formal curriculum either in medical school or in surgical residency and there is a paucity of data on awareness of the SPIKES (Setting up the interview, Perception, Invitation, Knowledge sharing, Emotion, Strategy and Summary) protocol among practising surgeons and residents in India. Methods We did a cross-sectional study in the Department of General Surgery at our institution. ⋯ Although the complete SPIKES protocol was followed only by 25 (31.3%) residents, 46 (56.1%) felt that it was practically possible to follow the SPIKES protocol. Conclusion Resident doctors in general surgery face situations of breaking bad news and adherence to the SPIKES protocol is poor. Formal training at every level may enhance their communication skills and enable better healthcare delivery.
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Background Reflective practice is an integral component of continuing professional development. However, assessing the written narration is complex and difficult. Rubric is a potential tool that can overcome this difficulty. ⋯ Kendall's coefficient of concordance, which is a measure of concordance of scorers among more than two scorers, was higher after using rubrics. Conclusion Our attempt to develop an analytical rubric for assessing reflective narration was successful in terms of the high content validity index and better inter-rater concordance. The same process can be replicated to develop any such analytical rubric in the future.