What is a Journal Club?

A journal club is a group discussion where research papers are critically reviewed. It can be organized for postgraduates (PGs), faculty, or professionals at meetings. It can also be conducted virtually for a wider audience. 

Who Should Present?

Interns are ideal, but since 5th year students are working on their thesis so this activity is necessary for them too.

Choosing the Right Article:

Reputed peer-reviewed indexed articles with high impact factors and rejection rates are generally chosen. Any paper which appropriately presents relevant concepts, stating clearly why the study was done, what problem was being addressed, how the problem is attempted to be solved, with clear conclusions would make a good article. Articles may be selected based on their clinical relevance and educational value. Original articles are suitable for improving critique skills, though metanalysis, case reports, review articles can also be great resources. 

Students must meet any professors well in advance and take suggestions for the selection of the topic. It is better to select recent research papers, which are of importance and interest to the presenter and audience. Systematic reviews or theoretical articles should be avoided. 

Lets Breakdown of Sections to Review:

Introduction:

• Check if the research background, objectives, and outcomes are clearly mentioned.
  
  

Methodology:

• Understand the study design, participant criteria, randomization, blinding, and validity.

• Look for biases (selection, information, confounding).

• Ethical approvals, sample size, and statistical methods should be mentioned.
  
  

Results:

• Should match the objectives.

• All planned outcomes should be reported.

• Tables and figures should clearly present the findings.
  
  

Discussion & Conclusion:

• Should discuss study strengths and weaknesses.

• Limitations, bias, and sample size issues should be addressed.

• Conclusion must answer the research question.
  
  

References:

• Should be recent and relevant.

• Some comparison with other studies is helpful.
  
  

Final Review Before Presentation

• Look for any major flaws or missing information.

• Analyze strengths, weaknesses, clinical usefulness, and how it fits current practice.

• Check if it adds something new or improves practice.

Steps for presentation in the journal club:

• Conclusions should be reviewed by the moderator before the final presentation.

• Editorial comments on the article should be checked. 

• The soft or hard copy of the article should be circulated one week prior. 

• The journal, title and authors are to be identified. 

• The background should be presented. 

• The presenter should interpret the article and explain rather than reading the entire article/PowerPoint presentation 

• Research questions, methods, results and conclusions should be summarised. 

• The critical review should be presented 

• Important points/key comments should be explained well and repeated at the end. 

• Two to three cross‑references should be mentioned. 

• The presentation should be confident. 

Why Journal Clubs Matter

They help students and professionals:

• Improve critical thinking and research skills

• Stay updated with new findings

• Build a culture of evidence-based practice

Common mistakes made while preparing a journal club:

• Ignorance of available online resources. 

• Rapid review of the entire contents of several journals in a short time 

• Using very simplistic and fixed frameworks to analyse varied types of articles like original articles, meta‑analysis, case series, etc., 

• Restricting journal clubs to only original articles excluding case studies 

• Expecting students to have expertise with recent and advanced statistical tests, so better take help from the professors.

• Making arrogant, superficial comments and judgments about the paper or review process. 

Reference: Sanwatsarkar S, Palta S, Parida S, Kamat C, Bala Subramanya H. How to do a journal club, a seminar and a webinar? Indian J Anaesth 2022;66:27-33 

Age: 8 months
Weight: not mentioned but 8 month old weight range from 7.8 – 9.8 kg (avg. 8.6 kg)
Gender: Baby boy

Medical reports indicate that the incorrect medication severely affected the infant’s liver function. Soon after taking the medicine, the child’s health deteriorated.

Hospital authorities confirmed that while the baby’s condition remains critical, there has been slight improvement.

“When the baby was brought here, his condition was at its worst. However, there has been a slight improvement. We are currently trying to stabilize his liver function with medication. However, we cannot be certain that Muhammed will continue to respond to the treatment. If he does not, the only remaining option will be a liver transplant,” said Dr. Nandhakumar of Kannur Aster MIMS.

Following a formal complaint, the Pazhayangadi police have registered a case against Khadeeja Medicals, the pharmacy responsible for dispensing the wrong medication, and have launched an investigation.

The incident took place on Saturday when the parents took the child to a clinic, reporting fever. The doctor prescribed Calpol Syrup 250 mg for the child. However, a pharmacist at Khadeeja Medicals mistakenly gave them Calpol Drops instead of the syrup. The parents realized the mistake three days after administering the wrong medicine to the child.

Lets Analyze error:

Paracetamol (Acetaminophen) Dosage Analysis for an 8.6 kg Infant

1. Standard Pediatric Dosage Recommendations

Harriet Lane Handbook (Standard Pediatric Dose)

• Dosage Range: 10–15 mg/kg every 4–6 hours, max 4 doses/day

• Baby's Weight: 8.6 kg

• Lowest Dose Calculation:

  • Per dose: 10 × 8.6 = 86 mg

  • Per day (assuming 4 doses): 86 × 4 = 344 mg

• Highest Dose Calculation:

  • Per dose: 15 × 8.6 = 129 mg

  • Per day (assuming 4 doses): 129 × 4 = 516 mg

Maximum Safe Dose Limit (General Guidelines)

• Max paracetamol dose: 60–90 mg/kg/day, up to 3250–4000 mg/day

• For 8.6 kg infant:

  • Lowest max daily limit: 60 × 8.6 = 516 mg/day

  • Highest max daily limit: 90 × 8.6 = 774 mg/day

2. NHS & Manufacturer Dosage Recommendations

NHS Guidelines (For 6–23 Months Old Infants)

• Recommended Dose: 5 mL of 120 mg/5 mL infant syrup

• Per dose: 120 mg

• Max daily dose (4 doses): 120 × 4 = 480 mg

Manufacturer Recommendation for Calpol Drops

• For babies weighing 8–8.9 kg:

  • Per dose: 1.2 mL of Calpol Drops (100 mg/mL)

  • Total per dose: 1.2 × 100 = 120 mg

  • Max daily dose (4 doses): 120 × 4 = 480 mg

3. Pharmacist’s Error and Possible Overdose

• Parents followed syrup dosing (5 mL) but used Calpol Drops (100 mg/mL) instead

• Calpol Drops Concentration: 100 mg/mL

• Administered per dose (based on syrup instructions): 5 × 100 = 500 mg

• Total dose given is unknown, but if given four times daily as per typical dosing schedules:

  • 500 × 4 = 2000 mg (hypothetical maximum overdose)

4. Expected vs. Administered Dose Comparison (If Given Four Times Daily)

Harriet Lane (Max 15 mg/kg)

516 mg Max Recommended Daily Dose (mg)

NHS Guidelines (6–23 months)

480 mg Max Recommended Daily Dose (mg)

Manufacturer (for 8–8.9 kg)

480 mg Max Recommended Daily Dose (mg)

Max Safe Dose (60–90 mg/kg/day)

516–774 mg Max Recommended Daily Dose (mg)

Hypothetical Administered Dose (If Given 4 Times)

2000 mg Max Recommended Daily Dose (mg)

5. Additional Risk Factors for Liver Damage

Children may be at an increased risk of liver toxicity from paracetamol overdose if they:

• Are malnourished or have poor oral intake (nutrition/hydration)

• Are obese

• Have a febrile illness (like a viral or bacterial infection)

• Are on a prolonged course of paracetamol

• Are taking liver enzyme-inducing drugs

Key Considerations

• The exact frequency of administration is unknown, but if given four times daily, the child received approximately 4–5 times the recommended dose.

• Even a single overdose of 2000 mg (compared to the 480–516 mg max) could cause severe liver toxicity.

• The child’s existing illness (fever) could have increased susceptibility to liver damage.

Conclusion

• The pharmacist’s error resulted in a severe overdose of paracetamol, likely leading to acute liver failure, as seen in the hospital reports.

• The case highlights the critical importance of verifying medication formulations before administration.

reference: 

https://www.newindianexpress.com/amp/story/states/kerala/2025/Mar/14/eight-month-old-critical-after-pharmacys-medication-error

https://timesofindia.indiatimes.com/city/kozhikode/pharmacist-booked-for-dispensing-wrong-medicine-in-kannur/articleshow/118987285.cms

In the field of healthcare, patient engagement is a fundamental skill that every student must develop. However, any misstep in interacting with patients or their families can lead to complaints and dissatisfaction. A recent incident involving one of our students highlights the need for a thorough understanding of patient rights and how to ensure ethical, professional, and respectful interactions in a clinical setting.

Why Are Patient Rights Important?

Patients have legal and ethical rights that ensure they receive proper medical care while maintaining their dignity, privacy, and autonomy. These rights help establish trust between patients and healthcare providers, ultimately improving treatment outcomes.

Key Patient Rights Every Student Should Know

1. Right to Respect and Dignity
   Patients have the right to receive care without discrimination based on illness, gender, religion, socio-economic status, or any other factor. Every interaction should be conducted with empathy and professionalism.

2. Right to Privacy and Confidentiality
   Medical discussions should remain confidential, and patients should be examined in a private setting whenever possible. Avoid discussing patient details in public areas.

3. Right to Be Heard and Informed
   Patients have the right to explain their symptoms and concerns without interruption. They must also be informed about their diagnosis, treatment plan, and medication in a language they understand.

4. Right to Informed Consent
   Before any procedure, patients should be fully aware of the risks, benefits, and alternatives. Informed consent must be obtained before any major intervention.

5. Right to Redressal
   Patients can file complaints if they feel mistreated or disrespected. As healthcare professionals, we must ensure that concerns are addressed promptly and professionally.

Important Guidelines for Students

• Always introduce yourself before engaging with a patient.

• Speak respectfully and listen attentively to their concerns.

• Maintain professionalism, especially in private ward settings where families may be highly involved.

• If discussing an Adverse Drug Reaction (ADR), always take a nurse with you. This ensures transparency, credibility, and better communication with the patient and their family.

• If a patient or their family appears dissatisfied, inform your supervising doctor or nurse immediately.

As future pharmacists and healthcare professionals, our responsibility is not only to provide medical care but also to uphold patient rights with the highest ethical standards. By understanding and respecting these rights, we can create a healthcare environment that is compassionate, professional, and patient-centered.