Makesure:A 20–year–old college student complained of dysuria, frequency and pyuria.

Situation: A 20–year–old college student complained of dysuria, frequency and pyuria.
Reaction: Oh my God! Why did you not advise macrolide?
Lesson: Make sure to remember that macrolide are very effective against E. coli,
S. saprophyticus and C. trachomatis infection.

A 62-year-old diabetic with coronary artery disease, on treatment for the same, comes for follow up.

Situation: A 62-year-old diabetic with coronary artery disease, on treatment for the same, comes for follow up.
Reaction: Oh My God! Why didn’t you put him on antioxidants?
Lesson: Make Sure to add antioxidants to the prescription because of their free radical scavenging and other beneficial effects. 

Emedinews:Maksure:A 26–year–old pregnant woman complaining of lower abdominal pain, burning during urination and increased vaginal discharge is prescribed ofloxacin.

Situation: A 26–year–old pregnant woman complaining of lower abdominal pain, burning during urination and increased vaginal discharge is prescribed ofloxacin.
Reaction: Oh my God! Why did you give fluoroquinolone! They are contraindicated during pregnancy. You should have given a safe and effective antibiotic like azithromycin.
Lesson: Make sure to remember that 1 g single-dose azithromycin is safe and effective in pregnant woman.

Emedinews:Makesure: Sir, he collapsed after sublingual nifedipine was given

Situation: Sir, he collapsed after sublingual nifedipine was given

Reaction: Oh, my God! I forgot to check for LVOT obstruction
Lesson: Make sure that the patient does not have LVOT obstruction (left ventricular outflow tract) before giving sublingual nifedipine.  

Emedinews:Makesure:A patient of suspected MI died after receiving sublingual nitrate.

Situation: A patient of suspected MI died after receiving sublingual nitrate.
Reaction: Oh my God! Why was a history of intake of Viagra drug not taken?
Lesson: Make sure to take a history of Viagra drug intake before giving nitrates, because the two drug if co-administered can cause fatal fall in blood pressure.

Emedinews:Makesure: A patient was brought to the ICU in cardiogenic shock.

Situation: A patient was brought to the ICU in cardiogenic shock.
Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA.
Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2, an ongoing trial suggest that this intervention is much better than thrombolytic therapy in such patients.

Emedinews:Makesure:A patient with 3 hour of developing chest pain went into acute cardiac arrest.

Situation: A patient with 3 hour of developing chest pain went into acute cardiac arrest.
Reaction: Oh my God! Why was water-soluble aspirin not given at the time of chest pain?
Lesson: Make sure that all patients with suspected MI are given water-soluble aspirin to reduce chances of death.

Emedinews:Makesure:A 28–year–old male presented with increased frequency and occasional blood in urine. Urine examination shows sterile pyuria

Situation: A 28–year–old male presented with increased frequency and occasional blood in urine. Urine examination shows sterile pyuria.
Reaction: Oh my God! Why didn’t you check for TB?
Lesson: Make Sure to rule out TB in patients with frequency, dysuria, hematuria. A sterile pyuria is the first clue to diagnosis.

Emedinews:Makesure:A patient of gross ascites presents with complaints of difficulty in breathing on lying down.

Situation: A patient of gross ascites presents with complaints of difficulty in breathing on lying down.
Reaction: Oh my God! Why did you drain so much ascitic fluid?
Lesson: Make sure, to evaluate the patient thoroughly and only moderately tap the ascitic fluid since over-enthusiastic tapping can be life-threatening.

Emedinews:Makesure:A child with sore throat and the large lymph nodes developed fever.

Situation: A child with sore throat and the large lymph nodes developed fever.
Reaction: Oh my God! Why were antibiotics not given in time?
Lesson: Make Sure that all children with sore throat and enlarged lymph nodes are given antibiotics as such sore throats are streptococcal unless proved otherwise.

Emedinews:Makesure:A patient presents with recurrent scaling and itching of the scalp not responding to antikeratolytic agents.

Situation: A patient presents with recurrent scaling and itching of the scalp not responding to antikeratolytic agents.
Reaction: Oh my God! I forgot to prescribe antifungal agents.
Lesson: Make sure that patients with dandruff and seborrheic dermatitis are prescribed antifungal medications. Recent studies implicate pityrosporium yeast infection as the underlying cause.

Emedinews:Makesure:A patient developed high altitude cerebral edema while traveling to Leh

Situation: A patient developed high altitude cerebral edema while traveling to Leh.
Reaction: Oh my God! Why was acetazolamide not started before the journey?
Lesson: Make sure all high risk patients are given acetazolamide before they travel to mountains.

Emedinews:Makesure:A patient with LBBB in ECG developed acute pulmonary edema.

Situation: A patient with LBBB in ECG developed acute pulmonary edema.
Reaction: Oh my God! Why was underlying low cardiac functions not suspected?
Lesson: Make sure all patients with LBB undergo echo to rule out ejection fraction. This may not be true for RBBB.

Emedinews:Makesure:A diabetic hypertensive was denied a beta–blocker because of the traditional teachings.

Situation: A diabetic hypertensive was denied a beta–blocker because of the traditional teachings.
Reaction: Oh my God! You should have used nebivolol.
Lesson: Make Sure that diabetics are not denied beta-blockers when indicated. Nebivolol has no side effect on glucose metabolism unlike atenolol.

Emedinews:Makesure:A rape victim developed HIV infection.

Situation: A rape victim developed HIV infection.
Reaction: Oh my God! Why was she not given post exposure ART prophylaxis?
Lesson: Make sure all rape victims are counseled for HIV post exposure ART prophylaxis.

Emedinews:MakeSure: A patient with acid peptic disease was denied any painkiller for his distressing illness.

Situation: A patient with acid peptic disease was denied any painkiller for his distressing illness.
Reaction: Oh, my God! Why did you not give him nimesulide?
Lasson: Make sure to prescribe nimesulide as it is safe in acid peptic disease.

Emedinews:Makesure: A patient with first-onset LBBB on ECG died six hours later.

Situation: A patient with first-onset LBBB on ECG died six hours later.
Reaction: Oh my God! Why was acute MI not suspected?
Lesson: Make sure to rule out acute MI in all patients with LBBB of first onset.

Emedinews:Makesure: A foreigner with a single loose stool developed sepsis.

Situation: A foreigner with a single loose stool developed sepsis.
Reaction: Oh my God! Why were antibiotics not started in time?
Lesson: Make sure to diagnose all foreigners as suffering from Traveler's diarrhea even if there is one single loose motion.

Emedinews:Makesure: Situation: A 60–year–old male developed acute heart attack after consuming Viagra.

Situation: A 60–year–old male developed acute heart attack after consuming Viagra.
Reaction: Oh my God! Why was cardiac clearance not taken before?
Lesson: Make sure that all older patients get a cardiac clearance before they are given Viagra group of drugs.

Emedinews:Makesure:A foreigner with two loose motions developed sepsis.

Situation: A foreigner with two loose motions developed sepsis.
Reaction: Oh my God! Why was antibiotic not started early.
Lesson: Make sure that all cases of travelers' diarrhea (foreigners) are treated with antibiotics.