No 2 April 2009 GENERAL

UPCOMINGCONGRESSES______________

QUOTE OF THE MONTH

____________

MELISA NEWS

Imagination is more important than knowledge.

Knowledge is limited. Imagination encircles the

world.

~ Albert Einstein ~

Upcoming congresses:

2009 FCA Anaesthesiology Clinical Course - (2009-04-20 - 2009-04-24)

· 2 DAY WORKSHOP: THE ESSENTIALS FOR CRITICAL READING AND INTERPRETA-TION OF MEDICAL LITERA-TURE -

(2009-05-08 - 2009-05-09)

It has been a busy month for us.

We visited the Neurology Congress in Muldersdrift as guests of GSK earlier this month to show case MELiSA. (GSK has sponsored NASA members with access to MELiSA… go GSK!!) It was really fun and ex-tremely exhausting. I have a new found respect for reps… their stamina is admirable! I can happily say all who saw MEliSA in action (even at ½ a G!… there is really bad signal in Mulders) loved it. It was interesting to note as well that Texbook of Clinical Neurology, the top Neuro textbook, is available in MELiSA books or you could go and buy it for R4500!!

The next big April event for us was PubMed. We have loaded almost all our titles to PubMed. Now when you do a search in PubMed and find an article in a journal that is in MEliSA you will be able to get a direct link to the full text article. How you do it is to select the article/s you want to read from the PubMed results, then select ‘view abstract’. This will open most articles in the abstract but more importantly this is where you will find the MELiSA icon which will take you to the full text article. If you get an option of Publisher e.g. Science Direct or Journal e.g. Pain, choose the publisher.

If you have no idea what I’m talking about have no fear because MELiSA is near with a new exciting workshop on how to use PubMed properly and all these details will be elaborated on as well as Mesh searching etc. etc. The workshops will be a hands on experience lasting about 2 hours. The first workshop is being held at the Wits Medical School Library on Tuesday the 5th of May starting at 14h00. CPD points will be awarded including one on ethics and the cost is R350. Limited seats are available so please contact us to book your place at info@melisa.co.za.

We have a winner of the Mauritius Holiday… will Dr S Chobokoane please step forward. The winners of the 3 Intellipens are Drs Padia, Chundra and Gunguwo. Congratulations to you all and we hope you enjoy your prizes half as much as you enjoy MELiSA!

To the CMSA members in the throws of exams, good luck! All the best and regards till next time.Ed.

MELiSAMedical Library of South Africa

TIP OF THE MONTH

JUNIOR DOCTORS’ CORNER

Use ‘My Favourites’ to make your MELiSA experience more efficient.

You are able to personalize your ‘My Profile’ page by adding onto this page links to your favourite journals. You do this by clicking on the ‘blue folder’ icon displayed next to the journal title/s of your choice in the Library (see below). It is just as easy to remove them from the ‘My Profile’ page so try it out… you won’t break the system.

It’s hard to believe that in roughly two weeks’ time, it’ll be four months of 2009 under the belt. That means a sixth of internship and a third of community service already down.

MELiSA has received a great deal of positive feedback from the many interns and com-munity service doctors who have signed up for their free access to MELiSA for 2009. It appears that the most commonly accessed components on MELiSA, by junior doctors, are MD Consult and First Consult (affording doctors a quick and simple means of ac-cessing up-to-date information on the differential diagnoses for a plethora of presenting problems and the management thereof).

Just to recap: As a doctor registered with the HPCSA to do your internship or com-munity service in 2009, MELiSA offers you 1000+ medical full-text journals, 100+ e-textbooks, MD Consult and First Consult as well as vibrant medical information websites both at www.melisa.co.za and on our facebook page 100% free. We are committed to making medical knowledge more accessible and affordable for doctors and we believe that as a junior doctor-in-training or a ‘’medical servant’’ of the wider community you are entitled to develop your medical brainpower at no cost to you. So we’re giving you a world of medical knowledge at your computer or cellphone fingertips, fully sponsored. You’d be crazy not to utilise this gift while it is still available to you.

Send us an email to dan@melisa.co.za and tell us about your experience. We’re look-ing out to ensure that MELiSA is fulfilling your needs. While you’re at it, visit our “Melisa for Interns and Com Serv Docs” page on Facebook and keep abreast with the latest happenings and developments in the junior doctor world! Assist us by informing your colleagues at other hospitals about this great opportunity.

See you online soon!

Dr. Daniel Israel

Intern and Community Service member liaison

Article title: Moxifloxacin versus ethambutol in the initial treatment of tuberculosis: a double-blind, randomise

In an exciting trial comparing INH, Rifampicin and Pyrazinamide with either moxifloxa-cin or ethambutol, an 80% conversion to sputum negative for AFBs was seen in the moxifloxacin group compared with 60% in the ethambutol group at 8 weeks. The edi-tors comment that this is strangely large and may be due to improved bactericidal ac-tivity but may not have an effect on removing persistent organisms and hence relapse. However, it is promising in terms of a) potentially shortening treatment duration and hence compliance and b) efficacy in multidrug resistant TB.For more info click here

European Journal of Paediatrics April 2009

Article title: European online postgraduate educational programme in neonatology—the way forward?

I include this article for comment as it is (obviously) right up our alley. Due to limited resources in both time and qualified tutors Dr Hall and colleagues set up and studied an online series of tutorials in neonatology cover 12 countries in Europe and enroll-ing 90 trainees. There was quite a high drop out rate but of the ones that stuck it out 90% reported value to their learning and practice. I think it’s a great idea and is cer-tainly a means to achieving standardised training certainly in areas where training is limited.For more info click here

MELISA JOURNAL WATCH - GENERAL

Journal: Lancet April 4th – 10th

Article Title: Crunch time for TB control

This somber editorial on the WHO’s 13th annual report on Global Tuberculosis Control 2009, highlights the deficiencies in the global fight against TB. Some of the stats are astounding and frightening e.g. 9.3 million incident reports in 2007, a third of which are in Africa!! TB was also found to be the commonest cause of death in patients with HIV/AIDSFor more info click here

Article title: Bringing JUPITER down to earth

Article summary: Dr Després writes a nice editorial on the subanalysis of the Jupiter trial. The subanalysis (also in this edition of Lancet – quick link provided from the edito-rial) looked at the relative risk reduction of ischaemic cardiac events in asymptomatic people with high CRPs and low LDL cholesterol who were randomized to take rosu-vastatin over a 2 year period. The statin group showed benefit! Does this mean that statins should be incorporated into our drinking water?? Dr Després puts it nicely that the study positively shows that ischaemic heart disease is an inflammatory condition but more research is needed to see whether a positive lifestyle doesn’t have the same effect.For more info click here

Article title: Congenital diaphragmatic hernia: current status and review of the literature

This is a very nice review of the management of Congenital Diaphragmatic Hernia from prenatal surgery, Tracheal Obstruction (a relatively new treatment modality) to post operative ICU including ventilation strategies, inhaled nitrous oxide and the use of ECMO.For more info click here

Article title: Clinical treatment practice of HIV in childrenThis really nice review by Drs Brichard and Van der Linden covers many treatment as-pects of HIV in children including a review of the different drug classes, viral replica-tion and treatment recommendations. These are divided into early therapy in children less than 12 and > 12 years of age, drug resistance testing and changing retroviral therapy. If you want (or need) a brush up on antiretrovirals this is for you.For more info click here

Journal: New England Journal of Medicine - April 4th 2009

Article title: Effect of Early versus Deferred Antiretroviral Therapy for HIV on Survival

The optimal time for initiating antiretrovirals in North America is 350cell/cm3. This study looked at 17000 odd patients and analysed the effect of starting antiretrovi-rals between 350 – 500cells/cm3 as well as > 500 cells/cm3. Their findings show an astounding increase in rsik of death of 64% if antiretrovirals were deferred in the 350 – 500cells/cm3 group and a 94% increase if deferred in the 500cells/cm3 group. The downside to the study was that it was observational, retrospective and non-ran-domised and was conducted over a 10 year period starting in 1996. However, impor-tant lessons are the question of whether immune function (or rather immune dysfunc-tion) related to HIV is reversible. Also important to note is that the CD4 count may improve with antiretrovirals but not necessarily return o normal levels. Perhaps early initiation of therapy may offset the deterioration in immune function and preserve the CD4 level. For more info click here

Journal: Medical Clinics of North America - March 2009

Very briefly this edition is rich with reviews on a range of various neurological con-ditions including Migraine, Dizziness, Neck Pain, Entrapment neuropathies, Periph-eral neuropathies, Seizure disorders, cerebro-vascular disease, Movement disorders, Dmentia and memory complaints, Sleep reviews, Syncope and orthostatic intolerance, Multiple sclerosis and lastly lower back pain. This edition may be of interest to the ‘team’ involved in treating these conditions.For more info click here

MELiSAMedical Library of South Africa