The Medical Joyworks Monthly


Connect to MJ's thriving community

Issue #23 (August 2021)


Dear Reader,

August is often a quiet month, with most students and practicing physicians enjoying their hard-earned breaks. Nevertheless, we continue working diligently in preparation for great new things. 
With our newest academic partner in North America, we are preparing an initiative to better help medical students and healthcare professionals improve their clinical skills in underserved communities. The action is one we have been planning for months, and pretty soon you will hear more about it!

We are also in talks with several specialist boards and certifying bodies worldwide in order to help our IMB members get additional professional recognition for their volunteer peer review activities. Recall that IMB members are board certified specialists and specialists in training who review every case, scenario, article, and MCQ that we produce. Their contributions are fundamental to ensuring the quality of our work, and we are committed to reciprocating their generosity as best as possible.

So irrespective of the time of year, we continue our mission as a social enterprise. In other words, we are a for-profit operation. But we earn our revenues—and reinvest our earnings—by solving problems for medical students and healthcare professionals for all of society. And by default, we hope to help humanity's well-being as a whole.

That is all for now. Have a great month!

Miguel Angel Molina
Chief Operating Officer
Medical Joyworks


The latest from MJ

  • We want to thank our IMB members who recently helped us with updating their records for public viewing. Keeping this information up to date ensures the highest quality and transparency of our work; benefitting us, our members, and—especially—our customers.
  • The Clinical Odyssey library (600+ cases, scenarios, articles, and MCQs) is now available through the most popular learning management systems, including Blackboard, Moodle, Canvas, and Edmodo. If you would like your LMS enhanced with fun and effective clinical skills learning resources, contact Miguel, our COO, at
  • To help us peer review learning modules, we need specialists in: general surgery, orthopedic surgery, pediatrics, obstetrics and gynecology, neurosurgery, intensive care, critical care, psychiatry, urology, neurology, nephrology, endocrinology, and pulmonology. If you are a specialist (or specialist in training), or know of someone who fits the part, have them contact Julia Botija at


International Medical Board Members

Name: Dr. Jitendra Sisodia MD
Speciality: Chest Medicine, Interventional Pulmonology, Sleep study and Allergy
Designation: Associate Professor 
Work institute: Department of Pulmonary Medicine, Medical College Baroda & M.S University, Vadodara, India
Graduated from: B.J.Medical College, Ahmedabad, Gujarat, India
What attracted you to your specialty?
Lungs are among the most important vital organs of the human body. But nowadays, respiratory problems are more common in both our younger and older generations due to smoking, tobacco chewing, tobacco sniffing, tobacco inhalation in various formats, environmental pollution, and more. These respiratory problems then restrict the routine activities of people, affecting their earning potential, and thus ultimately affecting their personal/family wellbeing. Properly diagnosing, treating, counselling and rehabilitating such patients can help rid them of pulmonary problems and resume a normal life. This accomplishment is the best reward for me.

What have you learned about your specialty solely from experience?
As a respiratory physician, I have learned that proper clinical evaluation and investigations are the mainstay for starting any appropriate treatment of a respiratory problem. If we do not get this right, the patient’s respiratory conditions will deteriorate very rapidly, especially as compared to diseases of other systems. Moreover, proper counselling and rehabilitation is as important—or more so— for ensuring the successful outcome of a given treatment.

What is a common misconception associated with your field of study?
In the past, general physicians would be the doctors treating most respiratory problems. This has now changed. Due to new interventional techniques and medicines, respiratory medicine (chest medicine) has established itself with a strong reputation. Also, people are becoming more trusting of chest medicine as a means to alleviate respiratory problems. Nevertheless, there are still many people out there with misconceptions. For instance, many patients believe that inhaler therapy can be addictive. This is wrong. Inhaler therapy is a highly effective therapy that has less negative consequences than many prescription drugs.

What is your biggest research interest today?
My biggest interest is pulmonary interventional procedures. Pleural and parenchymal diseases are common in young and old populations. Various interventional procedures such as bronchoscopy and thoracoscopy have demonstrated a better yield for diagnosis, and there is great potential for making treatment protocols in accordance with these procedures.

What publication / research are you most proud of?
I am most proud of my work in lung cancer, pleural effusion and tuberculosis related publications; especially since there is an immense need to continue identifying the patterns of these diseases worldwide.

More specifically, my article and research papers worth mentioning include: In your opinion, what is the greatest challenge in your field today?
The COVID 19 pandemic! We are facing a new wave of COVID 19 infections that is worse than the one we experienced at the start of the pandemic. The clinical presentation, severity, number of infected persons, affected age groups, and mortality—all are worse than before. In fact, we are seeing a greater infection rate in the pediatric population. COVID 19 is reaching villages where the severity of the infection is more pronounced, and the management of the disease remains difficult. Drug resistant tuberculosis is the other key challenge we face. Managing these patients is very challenging, leading to an increased prevalence in communities. We must do more research in this field.

What will be a game-changer innovation in your field?
For me, it will be evidence-based guidelines and protocols; as well as more research activities. These activities will definitely provide good quality of care to patients.

How has MJ helped advance your professional objectives (in terms of teaching, research, management, personal development, etc.)?
With Medical Joyworks I have learned that complex materials can be made easily understandable. Learning through short clinical cases and scenarios is an excellent way of strengthening the confidence of students. I see this with my students all the time. Detailed discussions after each case or scenario also helps improve their knowledge, clarifying any doubts they might have with regards to a condition. This form of content presentation has definitely proven to help my students. They enjoy Medical Joyworks’s clinical cases and scenarios; and with these tools, I see my students improve their way of thinking as well.


Q&As from our user community

Clinical Sense: Duncan II: Thumping (Atrial Fibrillation)

Q: Why not prescribe a novel oral anticoagulant (NOAC), instead of warfarin? Wouldn't that be more convenient for the patient?
A:  Novel oral anticoagulants such as dabigatran, edoxapan, and apixaban are indeed suitable choices for anticoagulation in this patient. However, there are pros and cons vis-a-vis using warfarin. For example, warfarin requires careful titration and INR monitoring, but is reversible in emergencies. Most NOACs are not reversible (with the exception of dabigatran); and, depending on the patient's insurance and local health funding, NOACs can be quite expensive. These are all important considerations that need to be individualized to each patient.
If you would like to play this scenario or join the conversation, go to the Clinical Sense app in your mobile device.

Prognosis: Your Diagnosis: Yellow (Biliary Atresia)

Q: Why didn't you consider primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC) in this case?
A: Biliary atresia (BA) is the most common cause of neonatal cholangitis; it is the the key differential diagnosis here. The bile duct abnormalities seen on the ultrasound are consistent with BA; and liver biopsy reveals compatible histology.

Both PSC and PBC do have similar presentations; and can have similar histology. PSC can occur in infants, but is significantly less common than BA, and should be considered if more common pathologies are excluded. PBC is usually seen in middle age, and would be extremely unusual in a 5-week-old infant.
If you would like to play this scenario or join the conversation, go to the Prognosis: Your Diagnosis app in your mobile device.


Recently released stories

Imported - Play it free online
Shaking - Play it in Clinical Odyssey
Unexpected - Play it in Clinical Odyssey
Corroded 2 - Play it free online
Invaded - Play it in Clinical Odyssey
Yellow - Play it in Clinical Odyssey
Pertussis - Read it free online
... and more.
That's all for now!

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