What's New

Sepsis & ICU Scoring Correction

An observation entered with a decimal no longer scores zero. A saturation of 91.5, a respiratory rate of 8.5, a systolic of 90.5 or a heart rate of 40.5 fell between two bands and added nothing to NEWS, MEWS or qSOFA; these four are now read to the nearest whole number, and the NEWS card says when one was rounded. APACHE II likewise now scores a pH of 7.325, sodium 129.5, potassium 3.45, haematocrit 29.95 or white count 2.95 as abnormal. Whole-number entries score exactly as before.

Kinetic GFR CalculatorAntimicrobial Dosing Guide Correction

Where a baseline creatinine is entered and the creatinine falls faster than the pre-illness kidney could clear it, the working clearance is now held at the baseline clearance, with the calculated kinetic figure printed beside it.

Kinetic GFR Calculator Reviewed

Reviewed by Dr Shashikiran Umakanth, including the new hold at the baseline clearance.

Acute HyponatraemiaAcute HypernatraemiaKinetic GFR CalculatorVKA / Warfarin TitrationLevothyroxine DosingAlcohol Withdrawal PathwayRefeeding Syndrome PathwayATT Hepatitis (DILI) PathwayDKA & HHS Protocol Guidance update

Computation unchanged. Each tool now draws its plan or its value as a figure: the sodium tools draw the 24-hour ceiling from the entered sodium as a course over time, kinetic GFR draws the entered creatinines against the anuric rise, refeeding draws the day-one start against the full requirement, and the rest draw the result on the tool's own bands with its targets and thresholds marked. Where a tool computes no course, none is drawn.

ABG & Acid-Base PathwayAKI & CKD Staging PathwayUPCR & UACR CalculatorAnaemia Indices CalculatorThyrotoxicosis PathwayAF Anticoagulation PathwayCOPD ManagementBronchial Asthma PathwaySpO2/FiO2 Ratio & ARDS Severity Guidance update

Computation unchanged. Each tool now draws its result as a map: the blood gas on a Davenport plane with the compensation rules it applies, kidney staging on the KDIGO heat map with this patient's cell marked, MCV against RDW, the thyroid pattern grid, the GOLD group grid, the GINA step ladder, and the oxygenation ratio on its bands. The verdict is still read from the rules, and the caption on every figure says so.

MAP, Shock Index & Pulse PressureAcute HyperkalaemiaAcute HypokalaemiaAcute HypercalcaemiaAcute HypocalcaemiaAcute HypomagnesaemiaCombined Electrolyte PanelCorrected QT (QTc) CalculatorBMI, BSA & Dosing WeightFIB-4 and ElastographyCorrected Phenytoin (Sheiner-Tozer)Hyperuricaemia & Gout PathwayHypertension OPD PathwayCURB-65 / CRB-65 Pneumonia SeverityCentor / McIsaac Score4Ts Score for HITPre-Surgical Risk PathwayPregnancy VTE Exclusion Guidance update

Computation unchanged. Each tool now draws the printed value on a banded ruler built from the same bands the verdict is read against, with the target or threshold the tool names marked on it, so a value at an edge is seen as one. Scores draw one rung per point with the risk figure the tool already prints.

Diabetes Diagnosis New tool

New tool. Reads fasting, 2-hour, random and HbA1c results against the ADA 2026, WHO and Indian criteria, applies the confirmation rule and the HbA1c exclusions, covers pregnancy on DIPSI and IADPSG, and draws each value on a band graphic beside the treatment target that a person with diabetes would be asked to reach, so that a result at target is never read as a normal one. One field decides what every number means: a fasting glucose of 120 mg/dL is impaired fasting glucose in a person without diabetes and inside the 80 to 130 target in a person with it. The fasting intermediate band is reported on both the ADA range of 100 to 125 and the WHO and RSSDI range of 110 to 125, asserting neither, because ICMR 2018 prints both without choosing. Thresholds are compared as the published pairs in the unit entered, because 11.1 mmol/L times 18 is 199.8 and would read a diabetic 2-hour value as impaired glucose tolerance. The IDF 2024 1-hour value is printed as an advisory that never enters the verdict, since no Indian guideline, the ADA or WHO has adopted it. Remission is the Riddle 2021 definition; a non-diabetic HbA1c on treatment is a result at target, not remission.

Diabetes Diagnosis Reviewed

Reviewed before publication, and the pregnancy lane was corrected. The Criteria tab listed an HbA1c of 6.5 per cent among the thresholds for overt diabetes in pregnancy while the engine set every pregnancy HbA1c aside. ADA 2026 gives both instructions and they meet at 15 weeks: recommendation 2.31a applies the standard criteria, HbA1c included, before 15 weeks, and recommendation 2.4 directs plasma glucose in pregnancy after that. The engine now does both, and it prints the ADA 2.31b flag for early abnormal glucose metabolism, an HbA1c of 5.9 to 6.4 per cent or a fasting glucose of 110 to 125 mg/dL before 15 weeks, as a risk marker that never enters the verdict. A random glucose of 200 or more without symptoms in pregnancy now says why it is not a criterion on its own, and a fasting value below the target range in known diabetes on no hypoglycaemia-causing drug is no longer described as within the range.

MAP, Shock Index & Pulse Pressure New tool

New tool. Mean arterial pressure, pulse pressure, proportional pulse pressure and the shock index family from one set of vitals, read against the setting: the obstetric range after delivery, the 2026 Surviving Sepsis Campaign target of 65 mmHg in septic shock with 60 to 65 mmHg from age 65, and the massive transfusion band in trauma.

MAP, Shock Index & Pulse Pressure Reviewed

Reviewed against its sources before publication. In the general adult setting a shock index of 0.7 to 0.9 now asks for a second look and a repeat set of vitals rather than giving the compensated-shock reading, which stays for trauma and sepsis. Every band now reads the number the card prints, so 0.70 is no longer badged above normal. The massive transfusion cut-off is stated as published, 0.81, and one reference nothing on the page drew on was removed.

NIHSS & Acute Stroke Pathway New tool

New tool. All 15 rows of the NIH Stroke Scale by the scale's own rules, then the thrombolysis and thrombectomy decision on the 2026 AHA/ASA criteria, with both tenecteplase doses printed and no thrombolytic dose before a CT has excluded haemorrhage.

NIHSS & Acute Stroke Pathway Reviewed

Reviewed in full by Dr Shashikiran Umakanth against the sources and by running each pathway; the late-window thrombectomy criteria now name the absence of significant mass effect, as the guideline does.

HbA1c Target New tool

New tool. Sets an individualised HbA1c target for an adult with type 1 or type 2 diabetes, before or during pregnancy, or with gestational diabetes, from the ADA 2026 health-status framework and the seven factors of the 2015 ADA and EASD figure, and draws it on a scale beside the normal range so that the two are not confused. It prints the reason for the number, the NICE, ACP, KDIGO, ICMR and RSSDI figures wherever they differ, the glucose targets that go with it, and whether the HbA1c can be trusted at all in this patient.

Inpatient Insulin Protocol Correction

Version 2.1. Pregnancy, labour and the postpartum dose have moved to their own tool, Insulin in Pregnancy, Labour and After Delivery, which is in preparation; the peripartum card, the antenatal steroid option and the pregnancy titration protocol are gone from here and the module points across. In the same sitting, fourteen inconsistencies found by running the seventeen pathways against each other were corrected. The ones that changed a dose: initiation with an eGFR below 60 was reduced twice, once by the 0.3 U/kg cap and again by the renal filter, so an eGFR of 22 started at 0.195 U/kg, below the range being cited, and the cap now stands alone at 0.3, 0.25 and 0.2 by eGFR band. The hypoglycaemia card said "reduce the basal by 20%" and printed 20% of the whole daily dose. The correction scale on a dialysis day was built from that day's basal alone. The premix fractions while fasting were seven different unsourced numbers and are now one rule: a premix that meets a meal is given in full, a morning premix on a fasting day is halved, and a premix with no meal is halved. Basal added to oral agents is refused in Type 1 diabetes at initiation and at discharge, as the conversion pathway already did. A current total daily dose is now read on the bolus-feed arm, and cyclic feeds use one unit per 12 g like every other arm.

Hyperuricaemia & Gout Pathway New tool

New tool, five ways in. A raised urate with no symptoms, an acute flare, starting or titrating urate-lowering therapy, tumour lysis, and a uric acid stone. On the raised urate with no symptoms it gives no answer of its own: it places the patient against ACR 2020, EULAR 2016, ACP 2017, APLAR 2021, the Japanese third edition and the Chinese 2017 consensus, and prints what each would do with this urate and these comorbidities, because the six do not agree and Japan is narrower than its own threshold table. Colchicine is dosed in the 0.5 mg tablet India stocks, using the EULAR regimen of 1 mg then 0.5 mg an hour later, because the American 1.2 mg schedule cannot be delivered from that tablet; where the American label and EULAR disagree on colchicine with a strong CYP3A4 or P-glycoprotein inhibitor, the European rule is followed and the tool says so. Allopurinol starts at 100 mg, or 50 mg in chronic kidney disease stage 3 or worse, and is then titrated to target with no ceiling by creatinine clearance, which is the American position and the one the randomised evidence supports. HLA-B*58:01 frequencies are reported for eight Indian linguistic populations, with the carrier frequency computed beside the allele frequency, and no recommendation attached, because no Indian case-control study of the allele and allopurinol reaction exists. Tumour lysis is scored on Cairo-Bishop, with the Howard modification named where it disagrees, and the published Indian single fixed 1.5 mg rasburicase regimen is printed beside the licensed weight-based dose. Every flare aspirate is sent for Gram stain and culture: 4 per cent of crystal arthritis presentations in one recent series were also septic.

Hyperuricaemia & Gout Pathway Reviewed

Reviewed against its sources before publication, and eight statements were corrected. The Mendelian randomisation figure for ischaemic stroke of 1.00 was paired with the wrong instrument set: 1.00 is the 28-variant estimate and 0.96 the estimate restricted to variants specific to urate. ALL-HEART is now stated as a trial in patients with ischaemic heart disease and no gout, which is the population its recommendation applies to. The diet figures come from four separate analyses of one cohort with four different sample sizes, not from one. The 24-month allopurinol figures by creatinine clearance are from a post hoc analysis and were attributed to the trial report. The two cardiovascular death counts quoted from CARES could not be found in the paper and have come out; its hazard ratios, which are in the abstract, stay. Twelve sources were added, because the tool printed figures from them and named none of them.

ABG & Acid-Base PathwayToxidrome Identification Correction

The temperature field on both tools now opens in Fahrenheit, which is the unit Indian ward charts are written in, and it reads the unit off the number: an entry below 50 is taken as Celsius and the selector beside the field changes to match, with a line saying which unit was read. Both tools previously opened in Celsius.

Diabetes Classification Pathway Correction

The C-peptide field now accepts ng/mL, nmol/L and pmol/L and opens in ng/mL. It offered pmol/L and ng/mL only, with pmol/L preselected, so the unit most Indian laboratories report in had to be chosen by hand and nmol/L could not be entered at all. An entry that cannot be a C-peptide in the unit selected is now flagged, with the same figure read in each of the three units.

Undifferentiated Fever Pathway New tool

New tool, for fever with no localising source in the first two weeks. It sequences investigation by the day of illness on ICMR acute fever guidance, says whether the DHR-ICMR case definition for empirical doxycycline is met and prints the regimen by weight, and decides the level of care. Where the picture fits dengue it grades Group A, B or C on the National Guidelines for Clinical Management of Dengue Fever 2023, which retired the dengue fever, dengue haemorrhagic fever and dengue shock syndrome grades, and it grades conditionally where serology is not back, because a negative NS1 does not exclude dengue. The influenza screen follows the MoHFW Category A, B(i), B(ii) and C scheme, and every letter the tool prints names which of the two schemes it belongs to. The tool escalates on its own respiratory danger sign at an SpO2 below 94 per cent while MoHFW writes Category C at 90 per cent, and the result prints both figures rather than choosing one. Malaria is named and not dosed, and the rickettsial regimen printed here is not cover for bacterial sepsis, severe leptospirosis or enteric fever.

SpO2/FiO2 Ratio & ARDS Severity New tool

Works the SpO2/FiO2 ratio where no blood gas is available, and classifies the patient against the Global 2023, Berlin 2012 and Kigali definitions side by side, including where they disagree. Reports the Indian thresholds of 321 and 252 alongside the 315 and 235 of Rice.

VOCAL-Penn Surgical Risk Score New tool

New tool. Four published models for an adult with cirrhosis facing non-hepatic surgery: mortality at 30, 90 and 180 days, drawn as one cumulative curve, and new hepatic decompensation at 90 days as a separate question that a low mortality does not answer. The only published threshold is marked on the curve, the 15 per cent 90-day mortality at which the 2025 American College of Gastroenterology guideline suggests considering pre-operative transplant evaluation. Every other band on the page is this tool's own display convention and says so on every run. Six surgery categories, with abdominal read as open or laparoscopic, because the operation carries an odds ratio of about 4.8 for 30-day mortality between those two before anything about the patient is considered. The obesity term is the World Health Organization cut-off of 30 and not the Asian cut-off of 25 used elsewhere on this site, and the tool flags that collision rather than resolving it silently. Albumin and bilirubin are accepted in either unit, and a value outside the range the models were fitted on raises an advisory. There is no published Indian validation.

FIB-4 and Elastography New tool

New tool. A staged non-invasive assessment of liver fibrosis in the compensated patient. Stage one computes FIB-4, APRI and the AST to ALT ratio from a blood count and a liver panel, and bands FIB-4 against the threshold that applies to the patient rather than a single number: 1.3 below 65, 2.0 at 65 and over, and none at all below 35, where no cut-off has been published and the score performs at an area under the curve of 0.60. APRI is computed beside it in every result, because in the only Indian study to compare the two against liver biopsy the area under the curve was 0.95 for APRI and 0.78 for FIB-4. The platelet count is entered in either unit an Indian report prints, and four non-hepatic causes of a low count are asked about, because both scores carry the platelet count in the denominator and a convalescent count raises both. Stage two reads the elastography report. The stiffness is banded against the cause of the disease, which is where the cut-offs differ most: 8 and 12 kPa in metabolic and alcohol-related disease, a set that depends on the ALT in hepatitis B with a refusal to interpret above ten times the upper limit of normal, 10 and 13 kPa in untreated hepatitis C, and after hepatitis C has been cured no stage at all, because EASL instructs that the pre-treatment cut-offs must not be used. Three Indian documents give three different stiffness thresholds for these diseases and all three are printed. The same number is then read against Baveno VII, including the 15 kPa and 150 platelet combination that rules portal hypertension out, the 25 kPa that rules it in, the two aetiologies and the body mass index of 30 outside which that rule and the ANTICIPATE model do not apply, the endoscopy trigger, and the spleen stiffness marks that hold only in viral hepatitis. The attenuation parameter is graded against the international, the Indian national and the Indian body-mass-index-stratified bands together. Where the blood score and the scan disagree the tool prints the reasons each could be wrong and resolves neither, because no current guideline does. What is not known is stated on screen, including the absence of any Indian elastography study with biopsy-derived kilopascal cut-offs of its own.

Levothyroxine Dosing New tool

A levothyroxine tool that computes the replacement dose three ways, because 1.6 mcg/kg of actual body weight, 2.3 mcg/kg of lean body mass and ideal body weight do not agree and the gap widens with obesity, and that then changes the dose, the target and the interval for pregnancy, intensive care, an acute coronary syndrome, myxoedema coma and thyroid cancer suppression. It rounds to the Indian tablet strengths, and follows the ATA pregnancy guideline of 31 May 2026, which replaced the first-trimester TSH ceiling of 2.5 with a reference interval of 0.1 to 4.0 mIU/L.

Forrest Classification New tool

New tool. Takes what a peptic ulcer base looks like at endoscopy and returns the Forrest class with the plan that goes with it, through to the end of the first 72 hours. It will not assign a class until the base has been irrigated, because the adherent clot is defined as one that resisted irrigation and most clots come away. It prints the prevalence of each class and the 30-day rebleeding rate from a registry of 397 patients, no mortality figure by class because that registry found the classification does not predict mortality, and no untreated natural-history rate because the source of those familiar percentages was not read. It says which modalities each guideline allows, and prints the three questions on which the 2026 European update and the 2021 American guideline disagree rather than resolving them: the adherent clot, the over-the-scope clip as a first-line device, and haemostatic powder used alone. It questions adrenaline used by itself, gives the three ampoules of 1:1000 that make up the injection volume the randomised evidence supports, sets out the 72-hour acid suppression with the number of pantoprazole vials a ward will need and the intermittent alternative where there is no infusion pump, and names the four features that put prophylactic embolisation on the table. It then covers what is usually left out: feeding within 24 hours, iron before discharge, why a negative rapid urease test taken during a bleed misses one infected patient in three, when the aspirin and the anticoagulant go back, and why no second-look endoscopy is booked for the morning. Nine things it does not print are listed on screen with the reason, among them the absence of any published Indian cohort reporting outcomes by Forrest class.

Pregnancy & Antenatal Scheduler Guidance update

The estimated date of delivery can now be entered directly, for a pregnancy an obstetrician has already dated. Gestational age and every scheduled date are counted back 280 days from it, and the date is adopted as given rather than revised.

Hypertension OPD Pathway Guidance update

The result now prints what each of the three current Indian guidelines calls this blood pressure and the target each sets: IGH-V of May 2026, the ICMR Standard Treatment Workflow of May 2026 and the InSH consensus of 2025, which define hypertension at 140/90, 140/90 and 130/80. The tool's own target is unchanged.

Pregnancy & Antenatal Scheduler Guidance update

A gestational age stated for today, from a referral letter or an antenatal card, can now be entered on its own. Cycle length is not applied to it, since a stated gestation already carries whatever correction was used to derive it.

Pregnancy & Antenatal Scheduler Reviewed

Independently reviewed by Dr Shashikala K Bhat, a second clinician reading the module against its sources.

AF Anticoagulation Pathway Guidance update

The score and its computation are unchanged. A citation to a Cardiological Society of India consensus statement on atrial fibrillation, which does not exist, is replaced by the ICMR Standard Treatment Workflow of January 2026.

Pregnancy VTE Exclusion Correction

A reference to a FOGSI recommendation on venous thromboembolism in pregnancy is removed, no such document existing, and the author list on the 2026 pulmonary embolism guideline is corrected. The pathway itself is unchanged.

Antimicrobial Dosing Guide Correction

The Stat or loading phase invented a loading dose for the 45 agents that have none. It now offers only the phases actually published for the agent chosen.

Antimicrobial Dosing Guide Guidance update

109 dose regimens for named syndromes added, covering 37 agents, each carrying the guideline it came from. None of them is renally adjusted.

OI Prophylaxis PathwayHIV Clinical Pathway Hub Correction

Cotrimoxazole prophylaxis now starts at a CD4 below 350, per NACO and WHO, and not below 200. The hub CD4 bands are split at 350 to match.

Empirical Antimicrobial Pathway Correction

Several agents printed their full normal-clearance dose on dialysis. Every dose is now generated from the same audited renal table the dosing tool uses.

ICU Infusion & Inotropes Correction

The vecuronium loading dose was labelled in micrograms where milligrams are meant. The unit is corrected.

HPV Vaccination Pathway Correction

A girl aged 9 to 14 now gets the single dose IAP, WHO and the national programme recommend, and not two. The 15 to 26 year schedule follows the Indian intervals.

Tuberculosis Treatment Pathway Correction

The adult NTEP weight bands were a generation out of date and now run to above 75 kg at 6 tablets. Nikshay Poshan Yojana corrected to Rs 1,000 a month.

DKA & HHS Protocol Correction

The intravenous insulin bolus is withdrawn, and HHS now runs at 0.05 U/kg/hr rather than at the DKA rate.

Acute Hyperkalaemia Correction

Insulin is now 10 units at every glucose band, and not 5 units at a glucose of 70 to 149 mg/dL.

Acute HyperkalaemiaAcute Hypomagnesaemia Correction

An out-of-range value was refused silently, the message erased on the line after it was written. Both pages now say why.

Acute Hypomagnesaemia Correction

The calcium antidote for magnesium toxicity is widened to 10 to 20 mL over 5 to 10 minutes, matching the electrolyte panel.

Acute Hyperkalaemia Correction

Calcium gluconate for membrane stabilisation rises from 10 mL to 30 mL, on the UK Kidney Association guideline and the June 2023 safety alert.

Combined Electrolyte Panel Rebuilt

Rebuilt. The calcium and magnesium regimens were wrong, four thresholds and rules changed, three abandoned calculations came out, and the units, the sample-plausibility check and the sodium rate budget are new.

Alcohol Withdrawal PathwayKinetic GFR CalculatorAlcohol Unit & AUD PathwayAcute HypomagnesaemiaAF Anticoagulation PathwayCorrected Phenytoin (Sheiner-Tozer) Reviewed

Reviewed in full by Dr Shashikiran Umakanth, against the sources and by running each tool.

Inpatient Insulin ProtocolNeedlestick & PEP PathwayUPCR & UACR Calculator Reviewed

Reviewed in full by Dr Shashikiran Umakanth, against the sources and by running each tool.

Empirical Antimicrobial PathwayLight's Criteria (Pleural Fluid)HPV Vaccination Pathway Reviewed

Reviewed in full by Dr Shashikiran Umakanth, against the sources and by running each tool.

Anaemia Indices CalculatorCorrected QT (QTc) CalculatorOutpatient Diabetes PathwayAcute HypocalcaemiaATT Hepatitis (DILI) PathwaySeizure & ASM Dosing Pathway Reviewed

Reviewed in full by Dr Shashikiran Umakanth, against the sources and by running each tool.

Antimicrobial Dosing GuideAdult Immunisation GuideVTE Exclusion PathwayOI Prophylaxis Pathway Reviewed

Reviewed in full by Dr Shashikiran Umakanth, against the sources and by running each tool.

Hypertension OPD PathwayTuberculosis Treatment PathwayPaediatric Immunisation SchedulerOrganophosphorus PoisoningDKA & HHS ProtocolToxidrome Identification Reviewed

Reviewed in full by Dr Shashikiran Umakanth, against the sources and by running each tool.

BMI, BSA & Dosing WeightAKI & CKD Staging PathwayAcute HypercalcaemiaSecond-Line ART PathwayOpioid Conversion CalculatorPathogen-Directed Therapy Guide Reviewed

Reviewed in full by Dr Shashikiran Umakanth, against the sources and by running each tool.

Acute HypernatraemiaCURB-65 / CRB-65 Pneumonia SeverityVKA / Warfarin TitrationAcute HyperkalaemiaSepsis & ICU ScoringPre-Surgical Risk Pathway Reviewed

Reviewed in full by Dr Shashikiran Umakanth, against the sources and by running each tool.

IV Fluid & Calorie CalculatorFirst-Line ART SelectionRabies PEP PathwayAtherogenic Risk PathwayCombined Electrolyte Panel Reviewed

Reviewed in full by Dr Shashikiran Umakanth, against the sources and by running each tool.

CVD Risk & CKM StagingAcute HypokalaemiaICU Infusion & InotropesABG & Acid-Base PathwayThyrotoxicosis PathwayPregnancy VTE Exclusion Reviewed

Reviewed in full by Dr Shashikiran Umakanth, against the sources and by running each tool.

Snakebite & ASV ProtocolHepatic Staging PathwayGlasgow Coma Scale & GCS-PPyrexia of Unknown OriginCervical Screening & PapHIV Clinical Pathway Hub Reviewed

Reviewed in full by Dr Shashikiran Umakanth, against the sources and by running each tool.

Pregnancy & Antenatal SchedulerTetanus Prophylaxis PathwayART Monitoring & ADR GuidePMTCT PathwayGlucocorticoid ConverterAcute Hyponatraemia Reviewed

Reviewed in full by Dr Shashikiran Umakanth, against the sources and by running each tool.

Pathogen-Directed Therapy Guide Rebuilt

Rebuilt. 30 organisms became 66, and the regimen now follows body site and resistance phenotype as well. Piperacillin-tazobactam is withdrawn for ESBL bacteraemia, and intrinsic resistance is printed on every result.

Empirical Antimicrobial Pathway Rebuilt

Rebuilt. 10 syndromes became 54, every dose is now adjusted for the creatinine clearance entered, and the resistance figures follow ICMR AMRSN 2024.

Inpatient Insulin Protocol Rebuilt

Rebuilt, with four new pathways: an infusion outside ketoacidosis, hypoglycaemia, conversion between regimens and preparations, and dialysis.

PHQ-9 + GAD-7 Screening New tool

New tool. Scores the PHQ-9 and the GAD-7, and flags an endorsed item 9 on screen with the Tele-MANAS number whatever the total. English only.

CURB-65 / CRB-65 Pneumonia Severity New tool

New tool. Scores CURB-65, falls back to CRB-65 where there is no same-day urea, and turns the score into a site-of-care recommendation.

Corrected Phenytoin (Sheiner-Tozer) New tool

New tool. Corrects a total phenytoin level for the albumin actually present, with a separate coefficient for severe renal impairment and dialysis.

Centor / McIsaac Score New tool

New tool. Scores the Centor criteria with the McIsaac age adjustment for the probability of streptococcal pharyngitis.

4Ts Score for HIT New tool

New tool. Scores the 4Ts for heparin-induced thrombocytopenia and sets out what to do at each score.

Sepsis & ICU Scoring Correction

A blank diastolic produced a MAP computed from the systolic alone. Diastolic pressure is now required before any score is given.

Hepatic Staging Pathway Correction

A missing PaO2 was graded Very Severe. The grade is now withheld until a PaO2 is entered.

Alcohol Unit & AUD PathwayAlcohol Withdrawal Pathway Correction

The two tools gave opposite instructions on thiamine and glucose for the hypoglycaemic patient. They now agree: glucose first, thiamine immediately after.

BMI, BSA & Dosing Weight Correction

The screen called aminoglycosides lipophilic and the copied note called them hydrophilic. They are hydrophilic, and both now say so.

Opioid Conversion Calculator New tool

New tool. Converts every opioid the patient is on through the oral morphine equivalent to the drug, route and Indian preparation you want.

Diabetes Classification Pathway New tool

New tool. Ranks every kind of diabetes against the phenotype alone, before antibodies or a C-peptide, and says which of the numbered names in circulation are real.

Hyperuricaemia & Gout Pathway New tool

New tool. Hyperuricaemia and gout around the drugs stocked here and the Indian HLA-B*58:01 frequencies. Colchicine is dosed at 0.5 mg.

Corrected QT (QTc) Calculator New tool

New tool. Corrected QT and torsades risk, with both correction conventions printed rather than one.

Anaemia Indices Calculator New tool

New tool. The derived red cell indices, including the functions that separate iron deficiency from thalassaemia trait.

ANA & Autoimmune Serology Correction

Reviewed in full, all thirteen references checked against source, and the reading of several antibody patterns changed as a result.

Kinetic GFR Calculator New tool

New tool. Kinetic GFR, for the patient whose creatinine has not settled.

Pregnancy & Antenatal Scheduler Rebuilt

Iron and folic acid corrected to 60 mg of elemental iron, per the national programme, and gestational diabetes screening now follows DIPSI.

Antimicrobial Dosing Guide Correction

Cefepime with tazobactam added. It is in common use in Indian hospitals and the tool had nothing to say about it.

Antimicrobial Dosing Guide Correction

Seven dosing errors corrected against current labels, including a 50 per cent amikacin overdose and a doubled vancomycin dose on haemodialysis.

Pre-Surgical Risk Pathway Rebuilt

Rewritten against current sources and audited a second time for safety. Neuraxial anaesthesia now carries its own, longer, interruption intervals for the direct oral anticoagulants.

🇮🇳 Soft launch, on Independence Day Milestone

MEDiscuss CDSS was opened to its first users on India's Independence Day. Quietly, and on purpose: a soft launch puts the tools in front of clinicians before any announcement is made.

AF Anticoagulation Pathway Guidance update

The score and its computation are unchanged. A note now explains the 2024 ESC move to CHA2DS2-VA and how to read the sex point off the score.

First-Line ART SelectionSecond-Line ART PathwayART Monitoring & ADR GuideOI Prophylaxis PathwayPMTCT PathwayNeedlestick & PEP Pathway Guidance update

NACO guidance still governs and the logic is unchanged. Where WHO 2026 would choose a different drug, the advisory now appears in the output itself.

CVD Risk & CKM Staging Guidance update

The 2025 AHA/ACC blood pressure guideline and LAI Consensus Statement IV added to the references, with a note on why PREVENT is preferred.

ANA & Autoimmune Serology Rebuilt

The antibody interpretation and the teaching text behind it were rebuilt, so a result read off the old version will not always match this one.

Cervical Screening & Pap New tool

New tool. Cervical screening and the management of an abnormal Pap, on the screening intervals in use here.

Pyrexia of Unknown Origin New tool

New tool. A staged workup for pyrexia of unknown origin. It sequences the investigations rather than ordering everything at once.

Antimicrobial Dosing Guide Rebuilt

Rebuilt: the renal adjustment model, the dialysis modalities and the list of drugs covered.

Undifferentiated Fever Pathway New tool

New tool. Acute undifferentiated febrile illness, the commonest reason a patient arrives on our wards and the hardest to work up in the first hour.