Self reflective writing on their medical student career

 Hi, I am Mahitha Akireddy , Foreign Medical Graduate, doing my internship in Kamineni Institute of Medical sciences. I'll be sharing my experiences during my postings in general medicine. 

All my experiences were only possible because of the guidance I received from our HOD sir and my mentors. 

They have encouraged me in their unique way, sharing examples and taught me to pursue my dreams so I would like to express my gratitude to them.

My first ever encounter with a patient was when I was posted in the general medicine department and all of us were supposed to take up a patient's history and diagnose by ourselves. 

I was in OP Room since it was my unit's OP Day and I saw this patient walk in with her attender. It was a 72 year old female with deviation of mouth to left side and slurring of speech.

Patient was apparently asymptomatic 1 week ago and she developed swelling, redness and tenderness over left lower limb after scratching her leg for which has been undergoing regular dressing. 

Few hours before admission, Patient was doing her daily activities in the morning and she suddenly developed giddiness and had a fall at home. She was noticed by the attenders few hours later and she was gaining consciousness slowly. They observed that her mouth was deviated to the left side and had slurring of speech. Her symptoms were also associated with weakness of left upper limb which was sudden in onset and non- progressive in nature.Her condition was not associated with any involuntary movements.

The patient was admitted in general medicine ward and all the necessary investigations were done. Her Blood pressure and GRBS was normal at the time of admission.

Patient had difficulty feeding due to the deviation of mouth to left side. She was placed on liquid diet. 

The patient had left lower limb cellulitis which was treated with Magnesium sulphate crystals and glycerine combined with regular dressing. Then she was taken for chest X-ray to rule out any respiratory diseases. 

The laboratory reports have shown that the patient has pre-renal Acute kidney injury and its necessary treatment was initiated immediately. 

Her Hemogram report has shown that she has mild Anemia which was treated conservatively. MRI of brain (plain) was done to find out the abnormal pathology that caused the above neurological deficits. 

She was eventually diagnosed to have CVA ischemic stroke and given symptomatic treatment for the 3 days of admission. Patient is shifted to soft diet eventually. Her bowel and bladder activity is normal. 

Regular dressing to the left lower limb was done with MGSO4 + Glycerin, by the general surgery department and the cellulitis has eventually resolved.  

The treatment for pre-renal Acute kidney injury was also given and it started resolving too. Her hemoglobin level has slowly improved too. 

Patient is hemodynamically stable and advised for discharge. Although the neurological deficits due to stroke would be permanent. 

It is important to always find the root causes of the problems that led to the patient's presenting illness. So, I figured that the patient was a know diabetic and hypertensive for 16 years. She is at risk of CVA ischemic stroke because of her underlying comorbidities. 

Here is the blog link of this case: 

https://mahithaakireddyfmg07.blogspot.com/2023/08/72-f-co-deviation-of-mouth-to-left-side.html

The true method of knowledge is experiment. The more I learn, The self confidence I will have. 

In closing, I want to remind you to never stop learning, and never forget that medicine is an art practiced by doctors. We bring to people not only technology and training, but also our humanity and caring. 

Thank you!