GENERAL MEDICINE : MY EXPERIENCES WITH NEURONAL AND GENERAL CELLULAR PATHOLOGIES WITH CBBLE AND PAJR

 Greetings, I am a medical student from India. By writing this blog I aim to share my journey and experience with CBBLE and PaJR.

CBBLE stands for case-based blended learning ecosystem- which aims in practicing precision medicine ,that focuses on meeting patient requirements accurately, optimizing patient outcomes, and reducing under-/overdiagnosis and therapy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163835/

PaJR- Patient journey records -"The Patient Journey Record system (PaJR) is an application of a complex adaptive chronic care model in which early detection of adverse changes in patient biopsychosocial trajectories prompts tailored care, constitutes the cornerstone of the model".

https://pubmed.ncbi.nlm.nih.gov/22816797/


PaJRs are records of patients that are created from the time of presentation and maintained even after discharge for continued surveillance and monitoring of the patient's health status and to maximize the benefits of the treatment plan over a long period of time. It allows to make changes in the treatment plan with change in health status and provide increased accessibility to a doctor. It also aids in monitoring the compliance of the patient to the treatment given.
PaJR plays a crucial role in preventive medicine and aids in preventing the development of disease and complications.


My journey included learning the basics of communication with patients. To forming trust and rapport, interpreting patient complaints and relating them to the present medical knowledge.

My journey with CBBLE started at the start of my second year of MBBS, when we were introduced to the clinical setup and started communicating with patients in the hospital. 

Due to the pandemic, we were unable to go to the hospital and were sent home, but the interaction with patients continued, as it was organized by the faculty and our seniors. We continued taking patient history over the phone and subsequently made case blogs and recorded the patient journey and patient health, even without physically being present at the hospital.

Since then we have taken several cases over the phone, and in person, connected with people, and provided medical care that was previously out of reach for some people. 

Every case has added to my knowledge and exposed me to the expansive knowledge that medicine provides and the variability in every case and patient. The various diagnostic and therapeutic challenges that are faced with each case, and the required and feasible management for every patient. 

Following are a few of the notable cases that I have seen till now and have provided learning opportunities. Each case depicts different scenarios and outcomes that we have faced and learned from in order to provide necessary and better healthcare.

NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS/HER GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT.

My journey with PaJR started at the start of my third year of MBBS. My first case was of a man with Diabetes Mellitus who presented with chronic chest pain and abdominal pain and had traveled to our hospital from his home state of West Bengal. A thorough history was taken and an examination was done. Subsequently, a PaJR group was set up in which the case was followed and updated timely. The patient had the freedom to communicate with his doctors, whenever in distress.

The PaJR group provided the patient reassurance of the care being given to him and transparency into the treatment program with the explanation for the same, which was decided after extensive discussion. This increased the satisfaction of the patient and aided in the treatment process of the patient.

This is the link to the entire case sheet that was prepared for the patient.

https://113riyagupta.blogspot.com/2022/09/case-of-46-years-old-man-with-type-2-dm.html

Another case was of a 51 years old man who presented with footdrop of the left foot, with progressive loss of all sensations below the level of the ankle. After a long and unfruitful medical journey, the patient presented to us for consultation. 

The PaJR group in this case enabled us to record the events in an organized fashion and provided organized information for a research article. It provided a platform where the case was discussed extensively.

This is the link to the case sheet prepared for the patient.

https://113riyagupta.blogspot.com/2023/05/ajnd-case-presentation.html#more

A case depicting the variation in history taken through the phone and taken physically at the hospital- 

https://113riyagupta.blogspot.com/2022/09/case-of-29-years-old-female-with.html

This was the case of a 33 years old female hailing from West Bengal. This case depicts the short comings and difficulties regarding telephonic history taking and the irregularities between the history taken with the patient physically present in the hospital and over the phone. 

PaJR provides checks for irregularities in the history taken at different times and provide the best possible management for the case .


PaJR group for preventive medicine.

https://113riyagupta.blogspot.com/2022/09/case-of-28-years-old-man-with.html

In this case, the patient had contacted us to set up a PaJR group, in order to record the patient's health over time and help in making better lifestyle changes and better health. The patient was initially unable to maintain a healthy lifestyle on his own and was suffering from dyslipidemia. By creating a PaJR group the individual was able to regularly update his health status on the PaJR group and maintain a healthy living. The patient would update his daily calorie input and output. He was able to receive recommendations about positive lifestyle changes from various doctors. Ultimately the patient was able to control his cholesterol levels.

The PaJR provided a platform for the primary prevention of heart disease, that might have been caused due to his dyslipidemia. The patient who initially presented with disease risk factors, was able to inculcate healthy eating habits and control these risk factors by maintaining a healthy lifestyle.




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