Sunday, June 14, 2020

Pediatric Residency Series: Research

In addition to its valuable role in helping humanity, research is one of the most important aspects of the fellowship application.


In this post, I will mention some points that will help in getting more research and in having a more systematic approach towards this field.


1-Start early

Time in residency flies very fast. If you know which specialty you are targeting, start doing research as early as you can. This will expose you to more ideas, allow you to have more possible publications and may also strengthen your clinical grasp on that specialty. 


2-Mentors

A mentor can be a current senior or an attending in your program or in any other program. Mentors have more experience and will shine a light on things that you may not consider. They will also give you research ideas and inform you about the conferences specific to your field of interest. The fellowship world is smaller than the residency one and mentors can write you letters of recommendation, put a good word for you and direct you to fellowship programs that best suit you.


Do not forget to check the: AAP Mentorship Program. As an AAP member, you have free access to this mentorship program which links you to mentors through its algorithm based on your preferences. This AAP feature is a hidden jewel that everyone should use.


3-Finding Research:

“How can I find research opportunities?” This is the-million-dollar-question and one of the most frequent ones I get.

I like to divide the answer into two main parts:


*Research at your program

This varies a lot based on your residency program but options include and are not limited to:

A- Case reports and case series

Do you have an interesting case on the Pediatric ward, PICU or NICU? Ask your attending if it is reportable, decide which journal or conference to target and start writing!

AAP has an amazing summary about this here.


B- Retrospective studies

Is your NICU big and with a high patient turnover? Come up with a research hypothesis or let your seniors and attendings aid you in this. These days and especially with the ICD code system, you can think about any research idea and find the research objects within seconds!


C- QI projects

Have you noticed anything in your program that can be improved? Is it an order set that can be added to your EMR? Do you feel a teaching module for residents or students would help? Create your own QI project, compare pre and post intervention results and present the findings at a regional conference or wherever you deem appropriate.


D- Surveys

Surveys are usually easy to do. Come up with the survey questions (search and ask while doing so) and run it by your mentor. You may do a pilot survey on a smaller amount of people before sending your official survey to your target group. The downside is possible low response rates which can make the survey hard to be published.


Do not forget to obtain the needed IRB approval in your program before doing anything :D 


*Research outside your program


A- Meta-analysis / Systematic reviews / Review articles

The above mentioned types of research can be done anywhere and anytime. They are usually carried out in teams including a statistician (or anyone who knows statistics) needed for meta-analysis. They may be time consuming so keep that in mind.


B- Global projects

Collaborative research is a type of research that is recently getting more publicity. There are infinite projects out there that you can join. You just have to know about them. An example is the Covidsurg collaborative project


C- Databases

Databases are incredible - and sometimes costly- sources for retrospective research. The hardest part is formulating the research question. After you have your idea, search online to see if it has been done before. An example is the famous Healthcare Cost and Utilization Project (HCUP) database. This database has many sub-databases with gigantic amounts of info that can be used for research purposes. Every disease you can think of is there with its corresponding ICD code. KID (Kids Inpatient Database) and NIS (National Inpatient Sample) are two subsets that include Pediatric patients. 


D- Twitter

Yes, as you have read! Some research projects can be posted on Twitter and you can directly contact whoever posted them and start.


4-Conferences

Conferences are very vital when it comes to research. Not only that attending conferences gives you the chance to meet people who share your interest, socialize and make new connections, find mentors, look for possible away electives and present your work. It also excites you, gives you new ideas and allows you to discover new places which will help in breaking the “stressful” residency routine.


Always know when the conferences are held, the early vs late registration fee, abstract submission opening date and deadlines so you can plan your traveling, accommodation and schedule changes.


Stay tuned for a list for conferences that you can attend/present at whether for general Pediatrics or Pediatric sub-specialties.


This post mainly applies to those in Pediatrics but same principles apply to most other specialties.



-Murad :)


Saturday, June 13, 2020

Clinical correlates: Epinephrine vs Norepinephrine reversal

Hey Awesome peeps :)

This post is about variation in the effects of epi- and norepinephrine depending on its dose.

Monday, June 8, 2020

Topical Drug Absorption.

Hello everyone!

This is the brief mention about the extent of topical absorption of drugs. 

In decreasing order-

Posterior auricular
Scrotal
Scalp
Dorsum of hand
Plantar area.

Absorption mainly depends on the thickness of the skin and is inversely proportional to it.



Hope this was helpful! 

Let's learn Together! 

Dr. Medha Vyas 


Tympanogram.

Hello Everybody!

Let us quickly review the different curves of a tympanogram. 


The following are the yypes of curves in you'll see on a tympanogram:

Type A – Normal pressure and normal compliance in normal ear.

Type As – Reduced compliance (‘s’ means stiffness leading to reduced compliance) and normal pressure.

  • Seen in
    • Otosclerosis or other ossicular fixation
    • Tympanosclerosis
Type Ad – Increased compliance (‘d’ means discontinuity leading to increased mobility) and normal pressure.
  • Seen in
    • Ossicular discontinuity
    • Thin and lax TM

 

Type B – Flat or dome shaped graph i.e. reduced compliance.

Seen in case of:Serous otitis media.

Thick tympanic membrane.


Type C – Normal compliance but negative pressure due to eustachian tube obstruction.

  • Seen in case of:
    • Retracted tympanic membrane,
    • Early stages before collection of fluid in middle ear.


Hope this was helpful. 

Let's Learn Together! 
Dr. Medha Vyas 

Sunday, May 24, 2020

Two components of Sulfasalazine : Indications

Hello

Sulfasalazine has two components:
- 5-ASA
- Sulfapyridine (SP)

Tuesday, May 19, 2020

High-yield : Risk of stroke with cardioversion

Hello

Electrical/chemical cardioversion performed in a case of atrial fibrillation may carry a high-risk of stroke, especially if >48 hours of time has passed (thrombus formation takes about 48 hours).

Monday, May 18, 2020

Causes of holosystolic murmur mnemonic

Hello

Causes of holosystolic murmur: MTV reality shows
- Mitral regurgitation
- Tricuspid regurgitation
- Ventricular septal defect

- Jaskunwar Singh

Sunday, May 17, 2020

High-yield : Absence of tachycardia in cardiac tamponade (mnemonic)

Hello

Tachycardia is a characteristic feature of decreased systolic blood pressure in the patients of cardiac tamponade. However, there are exceptions to be taken care of during diagnosis and workup on the patients with following conditions (absence of tachycardia):

A Factor A Day Keeps Colon Cancer Away

Protective Factors For Colon Carcinoma

A - Aspirin,vitamin A 

B - Bisphosphonates
C - Calcium, Coffee, vitamin C
D - Dietary Fiber
E - vitamin E
F - Fruits
G - Green Vegetables

Chest pain in acute pericarditis vs myocardial infarction

Hello

Acute myocardial infarction is one of the miscellaneous causes of acute pericarditis. Differentiating features of chest pain in these two cases are many, but the high-yield points to be noted are:-