How to write a casereportDr Taqi Hashmi MB BChir MA (Cantab) MRCGP
Family Medicine ConsultantDepartment of Family MedicineKing Faisal Hospital & Research Centre - Jeddah
The research challenge
The first step : the case report
The basic case report componentsCase presentation: C/O, O/E, (PMH, FH, Investigations, Differentials, Rx) if indicated, OutcomeAbstract (summary)Refs Background (Why this case?)Discussion (Validity, uniqueness, new knowledge, review of cases)Learning points (3)
We want this
But we start with this
Think process not outcomeCase presentation: C/O, O/E, (PMH, FH, Investigations, Differentials, Rx) if indicated, OutcomeAbstract (summary)Refs Background (Why this case?)Discussion (Validity, uniqueness, new knowledge, review of cases)Learning points (3)
What do they want?"In the era of evidence-based practice, we need practice-based evidence.Professor Michael Kidd AM
New!PathogenesisAdverse effectDiseaseDiagnostic procedureTreatment (drug/intervention)
UnusualUnusual or rareUnusual presentation of a common diseaseUnusual association of diseases/symptomsRare diseaseUnexpected outcome (positive or negative) including adverse drug reactionsImportantClinical lesson reminderImages
We are all exhausted but
Dont let the opportunity pass
Make a note!
Get the consent before they go!
Will it fly?
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The 3 SsSearchSummariseSort
Get the format & syntax right
Write clearly & logically
Proof read multiply
Identify your weak linksTime managementLiterature searchWeak syntaxWeak logic
Organise your tasks & info
But be prepared to go alone
It is going to happenRejection is good news.Revision is great news!Major revisionMinor revisionAddress the points ONLY
Rejection? Resubmit at least eight times
A different angle
How is Saudi Arabia doing?
YearNo 1No 2No 3Saudi Arabia1996USA (321,877)JapanUK42 (793)1997USAJapanUK431998USAJapanUK431999USAJapanUK442000USAJapanUK472001USAJapanUK482002USAJapanUK482003USAJapanUK482004USAChinaUK492005USAChinaUK502006USAChinaUK512007USAChinaUK522008USAChinaUK542009USAChinaUK512010USA (502,804)ChinaUK46 (5739)
Similar population size2010 FiguresMSA28m, GDP $442b, 15KKSA27m, GDP $676b, 25K
Increasing contribution of other fields
Why arent we achieving our potential?
Even ice melts
A supportive environment
Leadership by example at the local level
Streamline the approvals process
Be part of a local research network
* Professor Michael Kidd AM is the Executive Dean of the Faculty of Health Sciences at Flinders University in Australia, past president of the Royal Australian College of General Practitioners and president-elect of the World Organization of Family Doctors (WONCA). He is the founder and Editor-in-Chief of the Journal of Medical Case Reports, the world's first journal devoted to case reports from all medical disciplines.*http://casereports.bmj.com/content/2011/bcr.04.2011.4157.fullUnilateral onycholysis with chemoRx erlotinib. Occurs bilaterally but rare 1:1000Onycholysis refers to the detachment of the nail from the nail bed, starting at its distal and/or lateral attachment.
Not onychomycosis (fungal infection)*We are all exhausted. But the opportunity *Spot the right case*Preferably online so you dont loose your notes. Patient ID + your observations.*Keep printed copies with you!Sign up patients first dont chase them they may not come back.*Ask someone with experience if you are not sure. If not just drop it.*Not an expert? Read all the relevant articles
*Reference format Get the language rightFollow the template
*Organise your discussionIt is not a story write to the pointDont repeat points
*Divide your tasks.Set time limits.Meet regularly to assess progress.*Within Meast: Iran, Israel, Egypt, Pakistan then Saudi.Asia exclude the Pacific region and the Middle East.N America exlcudes**Saudi falling percentage of medical field (outsourcing of Postgraduate training / not enough interinstitutional cooperation)USA / UK / Canada has maintained a 23% constant fieldChina 8% and risingIndia 16% and rising*No definitive answers but here are some thoughts *Left without support most people will be unable to achieve the discipline to achieve things.The odd person here and there will manage but will be a like a melting ice cube who will eventually melt.*A supportive and transparent working environment where research is supported & clearly rewarded is needed.*We need leadership by example.*Residents seem to take a very long time to get approval of their projects and research proposals.This needs to be speeded up other wise they are going around in circles and not really getting anywhere.*This will inspire and generate ideas.If one does not exists set it up!*If research does not interest you dont do it. Dont do it and pretend you like it. Genuine enthusiasm takes you a long way.*