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12/20/07

The 7 great medical myths


These are the 7 most popular medical myths...I believe you must be one of the believer of these myths.
Original link is HERE


Exposed: the seven

great medical myths


Not to be believed
Drink at least eight glasses of water a day
Reading in dim light ruins your eyesight
We only use 10 per cent of our brains

Hair and fingernails continue to grow after death

Shaving causes hair to grow back faster or coarser

Mobile phones are dangerous in hospitals

Eating turkey makes people drowsy

They are among medicine's most widely held beliefs – drinking eight glasses of water a day is essential for health, shaving hair makes it grow back coarser, reading in a dim light ruins eyesight. Yet despite their popularity, they are myths.


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12/16/07

Dynamic world clock


Here goes a unique site where u can find the "live data" related to the
World population
Birth
Death
Population growth
Communicable diseases
Non communicable diseases
Abortions
...these data goes on are dynamic data..and goes on increasing in "live time".
This site is a real world clock...
Link--HERE

Best medical sites 2007


Best medical sites taken from http://open.medicdrive.org/
Link to site-HERE


clipped from open.medicdrive.org

20 Most Popular Health Websites in 2007

1 | WebMD.com
2 | NIH.gov
3 | MayoClinic.com
4 | MedicineNet.com
5 | everydayHealth.com
6 | Healthline.com
7 | RevolutionHealth.com
8 | Drugs.com
9 | MedHelp.org
10 | RxList.com
11 | eMedicine.com
12 | RealAge.com
13 | QualityHealth.com
14 | eDiets.com
15 | familydoctor.org
16 | diet.com
17 | Prevention.com
18 | Healthology.com
19 | MensHealth.com
20 | WHO.int

Constructive Medicine 2.0


Constructive Medicine 2.0
Bench side to Bed side 2.0
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Visible body


This is one of the best site for medical students and docs.Here u will can learn anatomy in an interactive way.I strongly recommend this site.U need to register to this site...but don't worry, i am gonna give u user name and password too.
user name - email11240036@kinglibrary.net
password-visiblebody123456

website-www.visiblebody.com
clipped from www.visiblebody.com

The Visible Body

Features:

  • Complete, fully interactive, 3D human body model

  • Detailed models of all body systems

  • Dynamic search capability

  • Easy-to-use, 3D controls

  • Seamless compatibility with Internet Explorer


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11/25/07

Story of a MD doc working as medical rep


This is a great article by a MD doctor who worked as a medical rep for a company and gave talks on Effexor and its use.
He also mentions in detail about the process by which company uses high tech techniques to find out doctors prescribing habits and then targets them for the particular medicines.
Finally he describes about the moral dilemma he faces when he works as a medical rep.

link from Nytimes.com at -HERE
clipped from www.nytimes.com

Dr. Drug Rep
a friendly representative from Wyeth Pharmaceuticals came into my office in Newburyport, Mass., and made me an offer I found hard to refuse. He asked me if I’d like to give talks to other doctors about using Effexor XR for treating depression
I would be paid $500 for one-hour “Lunch and Learn” talks at local doctors’ offices, or $750 if I had to drive an hour.
clipped from www.nytimes.com
One note informed me that the physician we’d be visiting that day was a “decile 6 doctor and is not prescribing any Effexor XR, so please tailor accordingly.
clipped from www.nytimes.com
I found myself astonished at the level of detail that drug companies were able to acquire about doctors’ prescribing habits. I asked my reps about it; they told me that they received printouts tracking local doctors’ prescriptions every week.
clipped from www.nytimes.com
I feared I had become — a drug rep with an M.D. I began to think that the money was affecting my critical judgement. I
clipped from www.nytimes.com
I’ve asked myself if my work as a company speaker led me to do bad things

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11/13/07

Best sites for thanksgiving best deals

Looking for best sites for shopping and the best
deals?
Here are the best sites that collects the BLACK
FRIDAY 2007 DEALS. I am sure these sites will help you to find some cheap deals.

http://bfads.net


http://www.blackfridayads.com

http://www.edealinfo.com


http://www.blackfriday.info

http://blackfriday.gottadeal.com


http://www.theblackfriday.com/index.shtml

clipped from bfads.net

New for 2007 is a completely rebuilt, redesigned Black Friday Ads website. With this entire rebuilding process, we've already started to introduce new features, improved the old features and will continue to roll-out new features to help better your Black Friday experience. Because of the amount of changes from 2006 to 2007, we've outlined a lot of the features below.

clipped from www.boddit.com

Find all the latest active Black Friday ads and news from the top Black Friday websites.

Currently featuring 2361 Black Friday sales

Welcome to BlackFridayAds.com, your one stop source for all the best Black
Friday Deals and information. This page is updated each and every day with
the upcoming sales so that you can plan out your all your stops and buys.


We are the official site for all of the 2007 Black Friday ads a
Latest Black Friday News
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11/7/07

Oil prices over $100-a-barrel in near future

this clip is taken from time.com..read more at..
http://www.time.com/time/business/article/0,8599,1681362,00.html
clipped from www.time.com
Oil Prices: It Gets Worse
oil rig prices

Oil prices hit a record high of $97 a barrel on Tuesday
oil prices could move irreversibly over the $100-a-barrel threshold in the not too distant future, as the global economy faces a serious energy shortage.
"Lots of targets have been set but very little has been done. There is a lot of talk and no action."

The reason for the IEA's alarm is its expectation that economic development will raise global energy demands by about 50% in a generation, from today's 85 million barrels a day to about 116 million
barrels a day in 2030. Nearly half that increase in demand will come from just two countries — China and India
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10/31/07

Explore the cities VIRTUALLY

wanna explore the real world in a virtual way...this is one of the exciting way of exploring these cities(besides the google and yahoo map)
clipped from www.everyscape.com


Today, our world includes Aspen, Boston, Miami and New York, with more cities being scaped everyday.
More interior scapes of restaurants, stores, businesses and other attractions are coming soon so check back often.
With EveryScape, experiences will be created and shared.
Just like the real world.
Online.


Explore the breadth of Boston and New York by going down famous streets and avenues. Experience the depth of Aspen and Miami by visiting the inside of thousands of establishments and attractions. Tell us what you like, what you don’t like, what you want. Help us create the real world, online.
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10/22/07

Teenage Bill Gates

this pic is taken from makeuseof.com
lets have a look at Bill gate with is microsoft(computer)
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9/23/07

Learn foreign language

Learn foreign language--best web site

I was always looking for a website that can teach me different language.Recently I have been dealing with persons from different country with different language.And at present its "emergency" for me to learn Spanish and the best rescuer is Trymango.com.It offers 11 languages absolutely free of cost.The best part is its interface and its way of teaching through conversation and practice.I bet, u r gonna like it rather Love it.
www.trymango.com


Retro Medicine
Doctors making house calls for management of medical conditions.
I never liked this concept.As I think doctors don't have all the lab-facilities at hand to diagnose and treat the various conditions.But I am surprised to see that recently this trend is growing.Of course there are reasons to grow this trend.
read more at
http://www.nytimes.com/2007/09/23/business/yourmoney/23doctors.html
www.nytimes.com

Want International phone no with a lot of more features...?
check it out ...pfingo.com
It will provide you an international number and abilities to make and receive call from anywhere in world through phone(wi-fi enabled) or PC.
It needs you to download the software and you also have to provide low subscription fee.
compare it with www.skype.com (another voip) and feel the difference.

9/3/07

How the residency "Match" algorithm works?

Lets me torture your brain..!!
.....

Once residency candidates are done with interviews in different "residency programs", the next and the ultimate thing is "Match".Everybody potential resident is well known with NRMP.
Since 1998, the NRMP has used an applicant proposing algorithm in all its Matches.

Rank list for applicants is a list of residency programs given to the NRMP by applicants including all programs that the applicant is willing to participate. Rank list for residency programs contains all applicants whom the program is willing to accept. Using these two rank lists, the Match algorithm is processed in order of preference until it gets best "match".
sounds complicated?...The fact is ...It is complicated!

so lets try to understand with the help a more professional site..www.aafp.org(American Academy of Family Physician)

some excerpt
Guidelines for preparation of applicant "Rank list"
Applicants are advised to include on their Rank Order List those programs that represent their true preferences. Programs should be ranked in sequence according to the applicant's true preferences. Applicants are advised to rank all programs acceptable to the applicant
How the matching algorithm works? --An applicant can be tentatively matched to a program in this process if the program also ranks the applicant on its Rank Order List, and either:

  • the program has an unfilled position. In this case there is room in the program to make a tentative match between the applicant and the program.
  • the program does not have an unfilled position, but the applicant is more preferred by the program to another applicant who is currently tentatively matched to the program. In this case the applicant who is the least preferred current match in the program is removed from the program to make room for a tentative match with the more preferred applicant.
This process is carried out for all applicants, until each applicant has either been tentatively matched to the most preferred choice possible...read more..
How the residency "Match" algorithm works? (www.aafp.org)

Hate reading interview preparation?


Do you hate reading interview preparation?...
Do you hate going through all those black and white lines.....
If yes...
Then this video is for you.This will show you an example of "unprepared interview" and will guide you through interview preparation along with tips for interview preparation.

Note-just click on the picture and it will take you to an external link(video for interview preparation)

Interview preparation(residency &...)-2

This post is continuation of my previous post on "Interview preparation". Basically I am giving you the "website link" where you can browse all about the interview preparation.It will guide you through the "simplest" to "most trickiest" and deceptive questions.


A.Articles from American Academy of Family Physicians
1.Goals of your interview-can be summarized with three goals: A.Assess your compatibility and criteria with the program. B.Convey your sense of compatibility with the program to those faculty members, residents and staff who interview you.Its like an exercise in "role playing" which is not same as "acting", but don't give false impression. C.Assess the program’s relative strengths and weaknesses so that you will be able to structure a justifiable rank order list.

Your interviewers want to find out who you really are.....read more
Goals of interview (http://www.aafp.org)

A glimpse from this site-
Some of the questions that you can expect to be asked include:

  • Why did you choose this specialty?
  • Why did you choose to apply to this residency?
  • What are your strong points?
  • What do you consider are your weaknesses?
  • What are your overall career goals?
  • How would you describe yourself?
  • What do you do in your free time?
  • Describe a particularly satisfying or meaningful experience during your medical training. Why was it meaningful?
2.Interview preparation
3.Interview elements
4.Questions to ask
5.Follow up


B.Articles from kaplan(kaptest.com)
1.The Residency Interview: What Are They Looking For?
There have been a number of studies to uncover the key factors programs use to decide which applicants it will rank highly. Here is a synopsis of the results of these studies.

The compatibility of the applicant (how much they liked you).
The applicant’s ability to grow in knowledge (your learning skills).
The applicant’s maturity (how calm, realistic and confident you appeared).
The applicant’s commitment to hard work (did you seem eager and energetic).
The applicant’s fund of knowledge (your board scores, school rank, articulateness).
read more...articles for IMG (www.kaptest.com)

2."Interview Don'ts"
Don't act like a student. As this is really a job interview, relate on a professional level. Be polite to everyone you meet, as you never know who really wields power in the program.
Don't try to impress an interviewer by exaggerating your credentials or past experiences.
And finally, don't forget to send thank you letters with special thanks to those who went out of their way to be informative or kind. Mention specifics that make their program particularly attractive to you.
read more residency interview (www.kaptest.com)

C.Articles from AIPPG.info
1.Tips for interview--Appear EXCITED and INTERESTED. When relating the history of your interesting case use vivid descriptions of what else was going on at the time. "We were on call that night. It was bitter cold out. The hospital was dead quiet when suddenly everyone was called to...
2.Be ready to ASK QUESTIONS.The worst thing you can say is, "No, I have no questions." This translates to "No, I have no interest."
3. Research the program as much as possible.Will there be a conference for you to attend on the day of your interview?If possible make sure you've read the article in advance plus any accompanying editorial.
Tips for the residency interview
INTERVIEW PROCESS(in detail)
sample thank you letter
(www.aipg.info)

D.One of the best site that I will like to recommend is
http://mdinterviews.blogspot.com/
this blog belongs to usmletomd.com and the author is digitialdoc

E.10 Interview bloopers
  • Poor handshake
  • Talking too much
  • Talking negatively about current or past employers/managers
  • Showing up late or too early
  • Treating the receptionist rudely
  • Asking about benefits, vacation time or salary
  • Not preparing for the interview
  • Verbal ticks
  • Not enough/too much eye contact
  • Failure to match communication styles
  • (avoid these 10 interview bloopers)(http://www.quintcareers.com)

E.Other sites
About.com(
Job interview questions)
Yahoo.com(Interviewing)
Rajankanth.blogspot.com(Interview preparation)

8/16/07

ccs step by step-3

USMLE-STEP-3(CCS case management guideline)-This post has been copied from "usmleforum".Thanks to "original writer".

Select ‘Start Case’ button to begin.

You will see the case introduction. Wait! Note on the erasable board:

Setting
Age of the patient
Race of the Patient
Sex of the patient


Then click ‘OK’ and you will see the initial vital signs. Wait! Note on the erasable board:

Stable or unstable?


Then click ‘OK’ and you will see the initial history. Wait! Think and write on the erasable board:

Differential Diagnosis :
Allergies
Habits – smoking , alcohol , drugs , etc. Anything worrisome?


Then ask:

Is the patient stable or is it an emergency? A clue to this would be in the history - for emergency cases, you will see only the basic history of present illness and not the detailed history (social, past, etc). All other history will be ‘unobtainable’.

If unstable, do a EMERGENT physical exam. No emergency case should get a full physical exam - it’s an emergency!!

For the EMERGENT physical, choose the 'general appearance' and the relevant system. If needed, add one or two relevant systems.

After you note the results of the EMERGENT physical, stabilize patient immediately:

Airway – Intubation?
Breathing – Oxygen mask? Chest tube?
Circulation – IV fluids? Dopamine?
Drugs – Naloxone? Dextrose? Thiamine?
IV Access?

Then ask:

Does the patient’s condition correlate to the setting?

Emergency or unstable patient in office needs to go to the ER immediately!! Change location if necessary.

After the patient is stable and in the right setting, proceed to ‘Interval/follow-up history’ and a more detailed RELEVANT physical exam.

If the patient is already a stable case in the right setting, proceed straight to the RELEVANT physical exam.

Then ask:

Is the case limited to one particular system? Like Asthma or MI?

Choose the particular system and a few related systems, based on the most likely diagnosis.

Is the case not limited to one particular system?

Choose a COMPLETE physical exam. This option is available on the top of the physical exam choices. Examples of such cases include Case for Annual Physical Exam, Child Abuse, Depression, Asymptomatic Hypertensive for Office Management, etc.

Note the significant findings on the physical exam and go back to your erasable paper and revise your Differential Diagnosis. Strike out those which are less likely and add those are more likely.

Then keeping the Differential Diagnosis in mind, consider the labs to be done.

When considering labs use this mnemonic:

I B U O P

I – Imaging –> X-Rays, CT, USG, MRI, Echo, Scopy, VQ Scan, etc.

B – Blood –> CBC, Basic Metabolic Panel, Lipid Profile, LFT, Smears, Cultures, etc.

U – Urine –> Urinalysis, Toxicology Screen, Ketones, etc.

O – Others –> Other tests which do not fall under IBU, like EKG, PEFR for Asthma, Pulse Oximetry, Biopsies, etc.

P – Pregnancy test –> For any female of reproductive age presenting with abdominal or pelvic symptoms, or trauma.


When ordering labs, consider:

Is this test time-effective/time-consuming? Choose time-effective.

Is this test initial screening/confirmatory? Choose initial screening.

Is this test cheap/expensive? Choose cheap.

Is this test non-invasive/invasive? Choose non-invasive.


Then ask:

Will this test tell me anything useful? Tests like CBC, ESR, Chem 7, etc might satisfy the above criteria but will not tell you anything useful.

Are there any specific tests for this condition? Examples are Cardiac Enzymes for MI, Sweat Chloride test for Cystic Fibrosis, etc.

Are the tests in the right order? Example – Pulse Oximetry before ABG, CT before Spinal Tap, etc.


Order the labs using the Order button.

Then advance clock to the ‘Next Available Result’.

Understand the results. Ask:

Is the diagnosis clear or do I need any confirmatory tests?

If diagnosis is clear, start treatment.

If confirmation is needed, order confirmatory tests and then start treatment.


Treatment :

Determine if the patient is in the right setting. If patient is in office and needs to be admitted, change location to ward. If patient is in ward and is in a serious condition, change location to ICU.

If case is admitted, order:

IV access (unless IV drugs are not indicated) – Type ‘IV Access’.

Vital Signs – Type Vitals and click on ‘Every 1,2, 4 or 6 hours’ depending on the condition of patient.

Activity – Type ‘Bed Rest’ and choose ‘Complete bed rest’ or ‘Bed rest with bathroom privileges’ or type restrain and choose ‘Restrain patient in bed’.

Diet – Normal, liquid, NPO, 2 gram Sodium, ADA, etc. Order ‘Diet’ and you will see the list of options, choose which is the best for this case.

Tubes – NG Tube? Foley’s catheter?

Fluids – Saline, Ringer, etc. Type ‘Fluids’ and choose which is the best for this case.

Urine output – Type ‘Urine Output’ and choose frequency. There is no option for Input/output chart.

Medications :

Stop! Check for allergies on erasable board!

Order standard drugs for this case.

Decide IV or Oral. Decide bolus or continuous. Decide frequency.

Labs :

Additional labs to confirm diagnosis?

Labs to monitor? Cardiac Monitor? Pulse Oximetry?

Consults :

Order consults if necessary. GI, Ophthalmology, Psychiatry, Genetics, Social worker, etc.


Then move clock!

Depending on severity of case, move by 30 minutes/1 hour/2 hours/3 hours/6 hours/12 hours/1 day/2 days/1 week.

Do Interval/follow-up history.

Understand the results of the labs.

Then ask:

Has the patient’s condition changed significantly?

If yes, change locations.

If the condition has improved, move the patient to the next location in the order ER --> ICU --> Ward --> Office/Home.

If the condition has worsened, move the patient to the next location in the order Home/Office --> Ward/ER or Ward/ER --> ICU.


If you are changing location from inpatient (ER/ICU/Ward) to outpatient (Office/Home):

Stop unnecessary medications and change IV medications to oral.
Discontinue IV fluids.
Remove tubes.
Remove IV access.
Schedule followup visit in 1 or 2 weeks as relevant.
Patient education or counseling or diet specific and vital to this case. Type ‘patient education’ and ‘counsel’ and see if anything is relevant to this specific case. Type ‘Diet’ and see if anything is relevant to this specific case.


By this time, the 5 minute screen will appear!

Then type ‘counsel’ and choose the relevant things. You can choose multiple things at a time. See your erasable board for any worrisome habits like alcohol or smoking!

Type ‘patient education’ and choose the relevant things. You can choose multiple things at a time.


Patient education / Counseling options :


Every adult person - Drive with seat belt, Exercise program, No illegal drug use.

Every person taking long-term medications - Medication compliance, Side effects of medication.

Every person who takes alcohol - Limit or stop alcohol intake.

Every person who smokes - Smoking cessation.

Every person of reproductive capacity - Safe sex techniques.

Every person with long-term conditions, life-threatening allergies, chronic illnesses - Medic Alert Bracelet.


Female requesting contraception or practicing unsafe sex - Birth control, Contraception, Safe sex techniques.

Cancer case - Cancer diagnosis.

Asthmatic - Asthma care, medication compliance.

Terminal case - Advance Directive (Family), Advance Directive (Patient) and Living will.

Every post-operative case - Deep breathing and coughing

Diabetic - Diabetic foot care, Home glucose monitoring, Diet.

Learning disorder kid - Educational remediation.

Osteoporosis - Estrogen replacement therapy.

HIV case - HIV support group, safe sex techniques.

Hypothyroidism or endocrine case - Hormone replacement therapy.

Lactose intolerance - Limit cow's milk intake, Diet.

GI bleeding, peptic ulcer case - No aspirin, Sit upright after meals.

Old age, epileptic, vision defects, narcolepsy - No driving.

Anxiety case - Relaxation techniques, Rebreathing into a paper bag.

Violent psychotic case - Restraining order.

Spousal Abuse - Safety plan.

IV drug use - No illegal drug use, SBE prophylaxis, Safe sex techniques, Stop alcohol, Smoking cessation.

Pelvic surgery - No intercourse.

STD - Safe sex techniques, Sexual partner needs treatment.

Depression - Suicide contract.


Routine screening : Schedule appropriate screening tests as per age. Type the relevant test and schedule.

Immunizations : For Pediatrics and Geriatrics as relevant. Type ‘Vaccine’, choose and schedule.


At the end of the 5 minutes:

Type the Final Diagnosis.

You are done!!!

For Kids: Add age appropriate vaxine.
Helmets when Bicycle riding.
water temp<120>
Dental health.
GUn safety.
smoke detector.
Teenage : DOnt drink while drive counsel.
For every one add age appropriate SCREEN.UV protection .Postexposure prophylaxis.
CANCER screen everyone gets it.

Females: think if she neeeds to be PAPed.
Chlamydia screen for a sexualy active with many.
Elderly geriatic *Mamograph if older.
*osteoporosis screen.
*pneumovax and flu vax for elderly.
*elderly fall prevention.
*Hormone replacement.


Screening :

Consider:

Self-breast exam every month after age 20.
Clinical breast exam every year after 40.
Mammography every year after 50 in normal-risk females.
Mammography every year after 40 in high-risk females.

Pap smear - every year (for 3 years) after 18 years or earlier if sexually active. Then, every 3 years until 65.

FOBT every year after 50 + Sigmoidoscopy every 3 years after 50 years.
OR
Colonoscopy every 10 years after 50 years.

Digital Rectal Exam every year after 40.
PSA every year after 50.


Vaccines :

Geriatrics :

Pneumococcal vaccine once for every person above 65. High-risk patients get earlier.
Influenza vaccine every year for every person above 65. High-risk patients get earlier.


Pediatrics :

DTaP - 2 months, 4 months, 6 months, between 15 and 18 months, between 4 and 6 years.
IPV - 2 months, 4 months, between 6 and 18 months, between 4 and 6 years.
Hepatitis B - Birth, 2 months, 4 months.
H. influenza B - 2 months, 4 months, 6 months, 12 to 15 months.
Pneumococcus - 2 months, 4 months, 6 months, 12 to 15 months.
Varicella - Between 12 and 15 months.
MMR - Between 12 and 18 months.

once again thanks to original writer.

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