Monday 29 October 2012

Wednesday 24 October 2012

CME- CASE OF THE WEEK FROM MEDSCAPE EDUCATION

STUDENTS ARE WELCOME TO PARTICIPATE THE CME CASE OF THE WEEK

A 73-Year-Old Woman With Generalized Weakness and Heme-Positive Stool CME

Antonio Mendoza Ladd, MD; Alexander Chun, MD; Nataliya Mar, MD
CME Released: 08/03/2011; Reviewed and Renewed: 10/24/2012; Valid for credit through 10/24/2013

Background

Figure 1.

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Figure 2.

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A 73-year-old woman is referred to the hospital for evaluation of iron-deficiency anemia and heme-positive stool. She has a history of hypertension, hypercholesterolemia, and lobular breast carcinoma for which she underwent a modified right mastectomy 3 years ago. The patient complains of generalized weakness and lack of appetite. She denies any history of shortness of breath, chest pain, nausea, vomiting, obstipation, hematemesis, hematochezia, or melena. Her medications at the time of admission include amlodipine, valsartan, and simvastatin. There is no history of tobacco, alcohol, or illicit drug use. She is not taking any nonsteroidal anti-inflammatory drugs (NSAIDs).
On admission, the patient appears to be a frail, pale, and malnourished elderly woman. Her vital signs are a heart rate of 106 beats/min, temperature of 98.9°F (37.2º C), blood pressure of 156/76 mm Hg, and respiratory rate of 14 breaths/min. Examination of the head and neck is normal. Pulmonary auscultation reveals normal breath sounds bilaterally. The cardiac rhythm is regular and there is a grade II/VI systolic murmur present at the base. Her abdomen is soft and without distention or tenderness. No hepatosplenomegaly is appreciated. The rectal examination is unremarkable except for brown, heme-positive stool. There is no edema present in her extremities.
Laboratory analysis reveals a white blood cell count of 9400/mm3 (normal range, 4500-11,000/mm3), hemoglobin of 6.8 g/dL (normal range, 12.0-16.0 g/dL), mean corpuscular volume of 63 fL (normal range, 80-100 fL), ferritin of 86 ng/mL (normal range, 12-150 ng/mL), and platelets of 644,000/mm3 (normal range, 150,000-400,000/mm3). The results of the basic metabolic panel are within normal limits. The patient receives 2 units of packed red blood cells and undergoes endoscopic evaluation. Esophagogastroduodenoscopy and colonoscopy fail to expose a bleeding source. Capsule endoscopy is then performed and is reported as normal. Subsequent abdominal CT scanning shows asymmetric nodular wall thickening of a short segment of the mid/distal jejunum. This loop of the jejunum is abnormally dilated, measuring up to 4 cm in diameter (Figure 1). In light of these radiologic findings, the small bowel capsule endoscopy images are reviewed again at a lower speed. Guided by the CT results, the review focuses on the jejunal images. After careful examination, a lesion is indeed seen in a location compatible with the one outlined by the CT scan (Figure 2). The patient is then referred for surgery.
What is the most likely etiology of the patient's gastrointestinal bleed?

Hint: Note the patient's medical history.
Peptic ulcer disease
Arteriovenous malformation
Small bowel tumor
Meckel diverticulum
Gastritis
 
 
 

CME Test

To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.
You discover a small bowel tumor in a woman who has a history of breast cancer. Which of the following statements regarding tumors of the small bowel is most accurate?
 
They are easily detected using standard endoscopic techniques
Capsule endoscopy has a high degree of sensitivity for ruling them out
Metastases from the brain are a common cause
Adenocarcinomas are usually found in the ileum
Lobular breast carcinomas are more likely to cause them than ductal breast carcinomas
 
 
Your patient presents with an occult gastrointestinal bleed with severe anemia, a heme-positive stool test, and negative esophagogastroduodenoscopy, colonoscopy, and capsule endoscopy studies. What is the next most appropriate diagnostic step?
 
Repeat esophagogastroduodenoscopy and colonoscopy
Repeat capsule endoscopy
MR enterography
CT enterography
Single- or double-balloon enteroscopy
Intraoperative enteroscopy
Proceed conservatively with continued observation without any intervention
Any of the above except proceed conservatively with continued observation without any intervention

 

Friday 28 September 2012

FAKE JOURNALS ALERT FROM THE HINDU DATED ON 27 SEP 2012.



On the Net, a scam of a most scholarly kind  - R. Prasad

First came the spam emails professing faith in the recipient and requesting the safekeeping of millions of dollars that the sender, located in some distant land, had fortuitously chanced up. Many “lucky” recipients walked into the trap only to lose money.

The scamsters then moved on to hacking the email accounts of individuals and sending distress emails to all their contacts seeking money. In the past few years, as awareness spread of ‘419 scams’ — named after the numbered section of the Nigerian Criminal Code dealing with fraud — the pitches have become ever more focused and sophisticated. The latest — and arguably the most insidious — form: Open Access “journals.”

Unlike subscription-based journals like, say, Nature, Econometrica or the American Journal of International Law, Open Access (OA) journals are freely accessible online. The business model revolves around the author-pay mode — where researchers pay for publishing their work.

This model has become an academic game-changer in the last decade. With the number of genuine OA titles proliferating by the day, and even reputed publishing houses like the Nature Publishing Group jumping on the bandwagon, keeping track of the new additions has become extremely difficult, particularly by scholars in developing countries. The author-pay mode, the number of titles, and the average developing country researcher’s inexperience in scholarly communication have provided the perfect milieu for electronic ‘dons’ to make a killing.
 
Modus operandi
Their modus operandi is to send mails to researchers and scientists soliciting manuscripts but never mentioning the processing fee charged per “article” published. Many of the bogus “journal” websites do not mention the charges. When they do, they are anywhere between $100 and $1,800. But some journals, like ‘Academy Publish’, offer a “discount” up to 75 per cent. “We currently offer a 75 per cent discount to all invitees,” the journal website states. The ‘Asian Journal of Mathematical Sciences’ charges $250 per manuscript. But it offers a bait: “If you do not have funds to pay such fees, you [sic] will have an opportunity to waive each fee up to 50 per cent. We do not want fees to prevent the publication of worthy work.”

If keeping the processing fee low is one way of enticing researchers, all fake journals, as a rule, promise quick processing time. With some publishers offering up to 200 journals, they ensure that a variety of titles covering every imaginable area of specialisation is available. Interestingly, only some of these titles have any “papers” listed and even these cover very different fields from medicine to physics to chemistry in one “issue.” Most of these ‘journals’ would not have progressed beyond the third volume. For instance, the Discovery group of publications has many “titles,” but only Discovery Science has about half a dozen “papers,” all from authors based in India.
Speaking to The Hindu, one of the authors from a reputed institution in Coimbatore, Tamil Nadu, expressed complete ignorance about the status of a ‘journal’ he had contributed an article to. So what prompted him to choose this ‘journal’? “I got an email from them asking me to consider sending my paper. I also saw other papers published by authors based in India”.

While many titles do not have editors listed on the websites, a few others carry the names of respected researchers from reputed institutions. “I get e-mails from the predators’ victims. Some have been named as members of editorial boards without their knowledge or permission,” writes Jeffrey Beall, in Nature. Prof Beall is Scholarly Initiatives Librarian at the University of Colorado, Denver and regularly updates his blog Scholarly Open Access (http://scholarlyoa.com/individual-journals/) with exhaustive posts on several issues pertaining to predatory publishing.


Unaware
Prof. Natarajan Muthusamy, Associate Professor of Internal Medicine and the Ohio State University Medical Center has been named as the Editor-in-Chief of a journal from the OMICS Publishing Group, Journal of Postgenomics: Drug & Biomarker Development. “I am not aware that I am Editor-in-Chief [of this journal]. I do not recall having committed to this job,” he told The Hindu in an email.

Aside from soliciting scholarly papers, emails requesting scientists to become reviewers, editors and editors-in-chief are not uncommon. “I receive at least two mails a week soliciting papers; also to become a reviewer,” says Dr. Soumya Swaminathan, Director of the Chennai-based National Institute for Research in Tuberculosis. Dr. V.D. Ramanathan, who recently retired as a senior scientist from the same institute, has the same story to tell. “I get three to four mails a week. Some solicit by sending personalised mails where they cite my papers published in reputed journals.”
“They want others to work for free, and they want to make money off the good reputations of honest researchers,” Prof. Beall explains.
How to spot a fake
So how can researchers inexperienced in scientific publishing identify a fake journal? The first stop should be Prof. Beall’s blog where exhaustive lists (http://scholarlyoa.com/publishers/ and http://scholarlyoa.com/individual-journals/) of counterfeits have been listed out. The lists are a product of research done assiduously since 2009, first by following up on email solicitations and then based on tip-offs by scholars. “[They can] consult my list. Discuss with senior colleagues or mentors [to know] which are the best journals,” he told The Hindu.


Caution
Email solicitations are sent out by most, if not all, of the OA publishers. Hence that criterion alone should not be used for determining the status of a journal. Aside from the list of fake journals, all researchers should make it a point to read the exhaustive criteria listed out by Prof. Beall in his August 4 post (http://scholarlyoa.com/2012/08/04/criteria-for-determining-predatory-open-access-publishers/) to separate the wheat from the chaff.
Even if one were to accidentally chance upon these fakes, the websites replete with grammatical mistakes should serve as a giveaway. Many will have at least one blank dropdown box.

Some have titles that are a near replica of genuine ones. For instance, Springer’s Journal of Cloud Computing and the fake one from IBIMA Publishing are one and the same, except that Springer’s has a subtitle, which does not show up in Google’s search results.
At times even a glance at some of the websites should be sufficient to identify a bogus. For instance, the home page of Antarctic Journals group, which has twinkling stars as the background and titles presented in garish colours, should serve as a warning.
But some are too close to the original. Elixir Online Journal published from India is one such instance. “It [Elixir] closely copies the Elsevier logo, and its papers copy the Elsevier layout. The journal's goal is to look as legitimate as possible in order to get authors to submit papers and submit the author fees,” Prof Beall notes. “While it may contain some quality articles by those authors who have been fooled, I recommend that readers remain sceptical of the ‘journal’s content.”

The benchmark
But Scientific Research Publishing (SCRIP) takes the cake for imitation. Apart from correctly assigning and using DOI (Digital Object Identifier), it contains some quality “papers.” “Because the publisher is so successful at making its web presence seem legitimate, it has attracted some quality article submissions. Nevertheless, it is really little more than a vanity press,” he writes.

The ominous part is the wilful use of such “journals” to publish low-quality work or manuscripts that have been rejected by genuine publishers. A young researcher can use this medium to increase his publication list. The publish-or-perish atmosphere exerts tremendous pressure on senior researchers. This forces some to resort to unethical practices like plagiarism, data falsification and fabrication.
Will these fake journals become a most sort-after destination by such scientists? “I think predatory publishers have the potential to do irreparable harm to scholarly communication. Because many of these publishers do not have an honest peer review, articles that represent pseudo-science are being accepted and read,” Prof. Beall warns.
David Knutson, spokesperson for the Public Library of Science (PLoS), a leading OA group, says the problem is not with open access. “There is no evidence that … quality of peer review is worse for OA vs toll access journals,” he writes in an email to The Hindu. “There are many bogus publishers and bogus journals. Some of them are subscription, some of them are ‘free’ funded by commercial interests, and some of them are OA. The dodgy OA ones are pretty easy to spot. The dodgy subscriptions ones are somewhat less so in many cases because they exist within ‘trustworthy’ publishers.”
With no organisation or system in place to check the entry of counterfeits, the onus is on researchers to decide the reliability of what they read, and where to publish their work.

Wednesday 26 September 2012

NEET FOR POSTGRADUATE ADMISSION EXAMINATION INDIA

NEET-PG: National Eligibility cum Entrance Test - Post Graduate
(For admission to MD/MS/Post Graduate Diploma Courses 2013 Admission Session)
NEET-PG is the eligibility-cum-ranking examination prescribed as the single entrance examination to various MD/MS and PG Diploma Courses under ambit of Post Graduate Medical Regulations 2000 (as amended) notified by Medical Council of India with prior approval of the Ministry of Health and Family Welfare, Government of India.
As per the Post Graduate Medical Education Regulations (duly amended) vide notification dated December 21st , 2010, the procedure for selection of candidate for Postgraduate courses is prescribed as “There shall be a single eligibility cum entrance examination namely ‘National Eligibility-cum-Entrance Test for admission to Postgraduate Medical Courses’ in each academic year”.
NEET-PG is a mandatory test for gaining entry to MD/MS/PG Diploma Courses at all medical colleges under ambit of PGME Regulation of MCI. No candidate who has failed to obtain the minimum eligibility marks as prescribed, shall be admitted to any Post Graduate course.
Ministry of Health and Family Welfare, Government of India has notified National Board of Examinations (NBE) for conducting the National Eligibility-cum-Entrance Test for Post Graduate courses.
NBE shall be conducting NEET-PG as a Computer Based Test (CBT).from November 23rd, 2012 to December 6th, 2012 at test centres located at 33 cities across the country.
Eligibility Criteria for NEET-PG 2012:
Candidates who are in possession of MBBS degree/Provisional MBBS Pass Certificate from an Institute recognized as per the provisions of the Indian Medical Council Act and possess permanent or provisional registration certificate of MBBS qualification issued by the Medical Council of India / State Medical Council and have completed one year of internship or likely to complete on or before 31st March 2013 may apply for NEET-PG through online application system at www.nbe.gov.in/neetpg
For further details as instructions, scheme of examination, syllabus, list of seats available, Counseling etc. please refers to information bulletin for NEET-PG at website: www.nbe.gov.in/neetpg;
Fees: Composite examination fee and information bulletin voucher (required for online application system) can be obtained from selected branches of Axis Bank on payment of Rs.3750 for General/OBC and Rs.2750 for SC/ST/PWD Category.
Important Dates for NEETPG:
Availability of Information Bulletin-cum-Examination Fee Voucher at designated branches of Axis Bank
:
4th October – 10th November 2012
Online Registration and Scheduling for NEET-PG
:
4th October – 12th November 2012
Examination Dates for NEET-PG
:
23rd November – 6th December 2012
Candidates will be able to schedule their exams at the online registration system based on the availability of test centre on the date, time and venue of their choice on first come first served basis.
For list of branches please refer to NEETPG website or Candidate Care helpline number: 0124-4517187 (From Monday to Friday from 0930 Hrs to 1700 Hrs).
For queries if any, kindly contact the above referred Candidate Care helpline or email: neetpg@nbe.gov.in

Tuesday 18 September 2012

GREETINGS STUDENTS. HERE ATTACHED INVITATION OF SECOND GRADUATION DAY FUNCTION .
ALL ARE WELL COME

VINAYAKA MISSIONS MEDICAL COLLEGE & HOSPITAL KARAIKAL

SECOND GRADUATION DAY ON 22-09-2012 SATUDAY

TIME: 11:00 A.M.

ALL ARE WELL COME




REGARDS
M.MADAN MOHAN
LIBRARIAN
VMMC -KKL

Sunday 5 August 2012


Essential Evidence Plus is the only evidence-based, point-of-care clinical decision support system that gives you access to over 13,000 topics, guidelines, abstracts, and summaries

            Healthcare in the 21st Century relies not only on individual medical skills, but also on the best information on the effectiveness of each intervention being accessible to practitioners, patients, and policy makers. This approach is known as "evidence-based healthcare".
            As interest in, and commitment to, an evidence-based approach to healthcare grows, Wiley aims to equip clinicians and healthcare professionals with up-to-date, global, unbiased, and independently reviewed medical information to facilitate diagnosis and improve patient care. Clinical workflow information is a carefully-constructed formula of information types including evidence-based data, expert opinion, guidelines, and protocols. None of these information types alone will fully answer any complex clinical question.

1.Cochrane Systematic Reviews

Abstracts of the Cochrane Database of Systematic Reviews that summarize the world’s best evidence on the effectiveness of more than 3300 therapeutic interventions.
You  are found (4964) articles. Click on a Subject Area to browse the available articles..

2. Essential Evidence Topics

The cornerstone medical reference providing highly relevant, trusted content in a concise, structured evidenced-based format. You are found (743) articles.

3. Diagnostic Test Calculators (508) articles

4. EBMG Guidelines: Evidence-based summaries of symptoms and diseases. (936) articles. and more.

How to cite these much of information Visit Vinayka Missions Library at Karaikal.

Thursday 26 July 2012

Vinayaka Missions Library is a place for good resources of  Information to more information is available in the E - journals, books and research materials. They publishing original research papers at free in the Journal of IML- Medical Research Review. It is a Peer  Reviewed Journal and good information in current research activities of Medical Colleges in all over India particularly Tamilnadu and Pudhucherry. 

 please send your  papers to: The Librarian, Vinayaka Missions Medical College & Hospital, Kottucherry (po),Karaikal.

Tuesday 8 May 2012

INTER-BATCH VOLLEYBALL TOURNAMENT

In our college Inter -Batch Volley Ball Tournament held at our College Campus. The winner is Scorpions 08-09 Batch.

Saturday 4 February 2012

BASIC FOODS


BASIC FOODS



PROTEIN – HELPS BODY GROW AND REPAIR.

Protein is a nutrient that helps body grow and repair itself. It has other jobs too. Every part of your body that you see your skin, hair, eyes is made up of protein.

Protein helps your body grow, repairs work. Your body is made of cells. Every day billions of worn-out cells are replaced, and protein is needed to help make these new cells.

Protein also gives you energy. But that’s not its main job. Helping to build and repair your body cells is its major function.

Protein mostly food from animals and a few plant foods are good sources of protein. Nuts, peanut butter, dry beans, and seeds are all foods from plants and good sources of protein.


CARBOHYDRATES    - PRIME SOURCE OF ENERGY

Carbohydrate is an excellent source of energy. The amount of energy food provides your body is measured in calories. Two kinds of carbohydrates provide energy - starch and sugar.

CARBOHYDRATES come from grain foods, fruits and vegetables and foods made from sugar.

FIBER is another kind of carbohydrate that you need to stay healthy.  Fiber helps food move through your body during digestion. It comes from fruits, vegetables, nuts, dry beans and whole-grain breads and cereals. 

 
FAT  IS  NUTRIENT - GIVES ENERGY

It provides calories, too. Fat gives more calories than an equal amount of carbohydrate would. As a nutrient, fat has other functions:

It adds flavor to food. It helps satisfy your hunger because fat stays I your stomach longer than other nutrients do. It promotes growth and health skin.

Fat come from foods such as butter, salad dressing, vegetable oil, and margarine. Other foods such as nuts, peanut butter, meat and cheese have some fat in them along with many other nutrients.

Fat is important, too much isn’t good. It can lead to weight problems and heart disease.

VITAMINES

Vitamins are nutrients that help your body do its work. Even though your body only needs tiny amounts of each vitamin, they are essential to life. The name “vitamin” comes from the Greek word for life, “Vita”!

Vitamins are named after the letters of the alphabet. Some important vitamins are Vitamin A, the B Vitamins, and Vitamin C.

Vitamin A helps you eyes adjust to the dark. It comes from dark-green, leafy vegetables and yellow fruits and vegetables.

B Vitamins are grouped together because their job are similar. They all help your body use energy from Carbohydrate, fat, and protein. These nutrients keep your body healthy in other ways, too. For example, they help keep your eyes, skin and hair healthy.

B Vitamins come from different foods.

NIACIN                                 B                     Meat, dry beans, breads, cereals.

THIAMINE                            B1                   Meat, dry beans, breads, cereals

RIBOFLAVIN                       B2                   Milk and many foods from milk


Vitamin C helps the wound heal. Vitamin C keeps your gums healthy too. Vitamins C come from fruits, such as oranges, berries and melon. Some dark-green vegetables such as spinach have Vitamin C.




MINERALS – REGULATORS

Like Vitamins, minerals often act as regulators, used by the body in its many processes.  There are 20 known minerals. By eating a variety of foods daily, you should get the minerals you need.

Calcium

It has two basic jobs. Ninety-nine percent of your body’s calcium is in your bones and teeth. The best source of calcium is dairy food. Some green leafy vegetables and fish eaten with their bones, such as sardines or canned salmon, have calcium too.

Iron

The nutrient iron becomes part of your blood. Iron helps carry the oxygen breathe muscles, brain, and infact, to every part of body. The best source of iron is liver. But iron also comes from meat, eggs, dry beans and some breads and cereals.

WATER  - BODY

Water is a nutrient. You can’t live without it. In fact, water makes up about two thirds of body.  For example, blood is mainly water. It carries nutrients to every part of body. It also helps keep body at just the right temperature.

Need of water every day to replace water lose. Lose water in sweat, breath and in urine. Milk, juice, and soup are mostly water. Know that lettuce, apples, bananas, and cooked beef are more than half water.


















Wednesday 1 February 2012

STORIES OF FOOD


STORIES OF FOOD:

The Hamburger, a typical American food, came from Hamburg, Germany, in the 1870’s. It was ground beefsteak. In 1904 at the St.Louis  World’s Fair, hamburgers were first sold on buns.
 
Ice cream cones were invented at the 1904 St.Louis World’s Fair, too. An ice cream stand ran out of glass dishes. A Salesman has a smart idea.. He rolled thin wafers from a pastry stand into a cone. The cone become an Ice cream “dish”!.

Popcorn is an American India food. Hostory suggests that they brought it to the Pilgrims’ Thanksgiving feast in 1621.

Peanut butter was invented by an American doctor in 1890 for his patients. They needed a high-Protein food.

Raisins were first made as an accident! In 1873 the sun was very hot in
California. Juicy grapes dried up on the vines. One clever grower didn’t destroy the grapes. Instead he sold them as something special, “Peruvian delicacies”. And a new food was invented.



Coutesy :  Fist Foods by Roberta Larson Duyff



FOODS WE EAT FROM OTHER COUNTRIES

FOOD
PLACE
DESCRIPTION
Chicken Curry
India
Chicken dish made with special spices
Egg Roll
China
Egg and vegetables wrapped in a tin pancake and fried.
Fish and Chips
England
Fried fish and Fried Potatoes
Kiwi (KEE Wee) fruits
New Zealand
A fruit that’s green on the inside with a fuzzy brown peel
Lasanga (lahZAH nya)
Italy
Dish made with wide, flat noodles, meat, cheese, and tomato sauce
Okra (OH Krah)
Africa
A Green Vegetables
Paella (Peye AY yah)
Spapin
Dish made of fish, Chicken, meat, Vegetables and rice
Pita (PEE tah) Bread
Middle East
Flat, round bread with a pocket inside which is often stuffed with salad or meat.
Quiche (keesh)
France
Cheese and egg pie often made with vegetables, meat, or fish.
Sauerkraut (SOW er krowt)
Germany
Salted Cabbage prepared in a special way
Shish Kebabas (Shish KEH babz)
Middle East
Meat cut in cubes and cookd on a stick
Sushi (SOO Shee)
Japan
Raw fish and Rice
Tortilla (tor teeyah)
Mexico
Round, flat bread made from corn mean or wheat flout; used to make tacos, enchiladas, and burritos.