Sphygmo 08/09 | Issue 1 | November

MMSA MEDIA IS PROUD TO PRESENT THE NEW

2008-09 issue 1

TRD EDITION

bigger, better, more colourful

Old favourites: - Dear Boozu - Photo Pages New Columns: - wall of shame - Pre-clinical and clinical corners - classifieds - pearls of wisdom And much more

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BEST OF TRD

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L A I R EDITO

HELLO SPHYGMO.PDF

After seven months of Sphygmo lying in complete

humorous by issuing funny class servers emails,

dormancy till Murmur and Fresher’s booklet were

PEARLS OF WISDOM (caps intended) and the very

over and done with… Sphygmo is finally back in all

cheeky Wall of Shame. Also, Sphygmo is very hon‐

its vigour! As already mentioned in this year’s

oured to have a new guest writer to grace us with her

Fresher’s booklet, 2008 marks Sphygmo’s first foray

opinion on anything medical in every issue. Her

onto the internet, circulating it as a PDF format in

name is Aunty ELSA. Mind you, she’s quite an opin‐

every medical student’s inbox whilst also making it

ionated lady so I wouldn’t suggest taking her too seri‐

available on the MMSA website. This will hopefully

ously when reading her articles…

help the whole editorial board keep their commit‐

ment to issuing this newsletter three to four times a

We obviously kept the old time favourites like Dear

year without the headache of finding sponsors to

Boozu’s column (back by popular demand), the Edito‐

fund the (dull, black and white) printing.

rial (at least I would like to believe it’s an old time fa‐

vourite) and, last but not least, YOUR PHOTOS!

What’s more, making Sphygmo available online has

also helped us raise the bar like never before! The

In all honesty, I cannot recall seeing so much material

fact that you’re seeing Sphygmo in full colour is

in one issue of Sphygmo. It’s not so much due to our

nothing. Just wait till you scroll down a bit further

seemingly unlimited space. Rather, it’s more because

and see our new features!

so many students within MMSA were willing to con‐

tribute to Sphygmo – from the 1st years to the 5th years.

This year, Sphygmo has decided to introduce a few

As editor, I just hope that we keep up the good work

study aids for both pre‐clinical and clinical students;

(and, perhaps, do a better job at entertaining the

all done with the hopes of trying to help everyone

medical school population than the Leisure standing

make it through this course together. I also suggest

committee).

checking out Sphygmo’s Classified Ads. You may be

surprised to find useful 2 hand study material be‐

If there is anything you would like to give to

ing sold in good condition by your colleagues.

Sphygmo, please do send us an email on

sphygmo@mmsa.org.mt. We would love to hear from

But, then again, we cannot overdo it with the study‐

you.

nd

ing can we? So, we also kept things very light and

The Sphygmo Team Media Officer: Claire Vella Editor: Marquita Camilleri Article Co-ordinator: Stephanie Azzopardi Layout and Design: Anne Marie Bonnici Mallia Thank you to all those who have contributed to this edition of Sphygmo

Marquita

GO TO: http:/sphygmo. mmsa.org.mt

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MMSA DIARIES With TRD over, we’ve just about got time to catch our breath before the flurry of events happening this November. Here’s an update on what went on, and what’s next for each subcommittee.

Leisure The End of Summer party on the 25th September was MMSA’s first ever foam party, and a rip-roaring start to the semester! Next were the two TRD parties, Hollywood and the now infamous S-Party. We’ve got the dirt on these bashes – be sure to check out our photo section and our Wall of Shame! Next on the calendar are the Christmas Party, the Consultants’ Party, and the football tournament in December, with paintball and wild game sessions also on the cards!

SCOPH Hot on the heels of a wonderful Teddy Bear Hospital at Maria Regina Primary held on the 23rd October, was the World Diabetes Day event on the 8th November at City Gate, Valletta. General consensus was this was one of the best WDD’s ever, with a great medical student turnout! Be sure to check our photos later on this issue. Also coming up is the Blood Donation in conjunction with MKSU held at Students’ House on the 26th and 27th November.

Don’t miss the opportunity to help out on the stand, or better still, give blood!

SCORA World AIDS Week is about to hit! From the 26th November – 3rd December, SCORA will be busy with outreaches, the Candle Vigil, and their annual Piazza Café on campus, as well as a completely revamped World AIDS Day concert featuring topical drama and music at the KSU common room.

The SCORA team is also busy with the National Peer Education Training project. The first NPET weekend held in Verdala on the 3rd – 5th October attracted IHC, psychology, and medical students interested in giving sexual health education sessions at secondary schools. The Peer Ed project is thus getting started, with talks at St. Edwards and San Anton scheduled in the near future.

SCORA will also be holding a National Antibiotics Awareness outreach in Valletta on the 22nd November, in conjunction with SCOPH.

SCORP SCORP has been busy with preparations for Human Rights Week (December 8th-12th). SCORP’s TB DOT project is also in the pipeline and is expected to start soon. The TB Direct Observation Treatment project, or TB DOT, involves monitoring patients with tuberculosis, and is a great learning opportunity for any interested students. Also – make sure you get your hands on the new SCORP T-shirt!

SCOME The SCOME team was very busy during Freshers’ Week, and their Freshers’ Talk and Buddy Sessions were deemed a success. SCOME also held their first ever Cinemed live, organizing a trip to watch Ippermettili Nitlaq at St. James Cavalier on the 10th October. This was followed by a discussion of the play’s ethical issues on the 15th. The preclinical visits are resuming again this year, and preparation for Careers’ Convention is in full swing. Keep your diary clear this February – it promises to be a good one!

Media We’ve saved the best for last! With Freshers’ Booklet already under our belt, and this Sphygmo hopefully a success, we’re casting our eyes on the next task at hand – Murmur! Media needs people for this year’s editorial board. Are you up for the challenge?

Exchanges With Summer over and everyone settling back in at home, it’s time to start thinking about next year’s trips, of course! Applications for professional and research exchange will be out from the 1st-10th December. Don’t miss out!

WATCH THIS SPACE: MMSA is planning a big event on the 8th December at City Gate, Valletta! Every subcommittee will be on site to promote health and to give the public more information about MMSA and its projects. Details are as yet sketchy but keep an eye out for information on the servers and MMSA News – this should be shaping up to be a good one!

Pearls of Wisdom Dr. S. Ali in response to two students talking during his lecture...

“YOU CAN ONLY BREATHE HERE.”

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“NO MATTER WHAT KIND OF DOCTOR YOU BECOME, BE A KIND DOCTOR!” Written by Claudine Micallef based on Mr. K. Cassar’s talk Plumbing the Human Body This article title was, in Mr. K. Cassar’s words, the most important take‐home message at our first TRD for this year during his talk ‘Plumbing the Human Body’. Are we in this for the “Power, Money and Chicks (or analogous male for us girls)”, as the fa‐ mous physician Dr. Cox says? And what is it that really makes us good doctors?

Mr. Cassar started off by giving us a brief introduction to what his work as a consultant vascular surgeon in‐ volves, while illustrating a number of conditions he encounters throughout his job. However, the empha‐ sis of his talk was not on clinical practice or academic achievements, but on the humanistic side of what be‐ ing a good doctor entails. The General Medical Coun‐ cil (UK) defines good doctors as follows:

“Good doctors make the care of their patients their first concern: they are competent, keep their knowl‐ edge and skills up to date, establish and maintain good relationships with patients and colleagues, are honest and trustworthy and act with integrity”.

But this, Mr. Cassar insists, is not enough. There are other factors that are also fundamental.

Primarily, he mentions attitude. A bad attitude in our profession will not do. And those who already have one are very misfortunate since it is difficult to change. Although difficult to define, some examples were mentioned as to what a bad or ‘rotten’ attitude would be: Being arrogant… Rude… Thinking that we know everything… Always rushing and having no time for others… And these are just a few!

Humility is also key to being a good doctor, with the worst thing that can happen to us being arrogance. It is important to recognise that there are innumerable things that we cannot understand completely in medi‐ cine; conditions that we will be unable to diagnose, and patients who will die despite our treatment. We can also make errors of judgement or procedure. After all, we’re only human! Mr. Cassar tells us that the more experienced we get, the more humble we should become.

Working with integrity is also essential, and this means always being honest with the patients and rela‐ tives… Represent things how they really are and not how we want them to be. We should also explain our mistakes truthfully.

We must also keep focused. We are in this for our pa‐ tients and not to look good. After all, we are dealing with human life and people will entrust it in our hands. Our responsibilities will be huge and our er‐ rors will also have huge consequences on people’s lives. Thus, we have to not only be good, but great doctors. As great doctors, we will need to have con‐ cern for other people, an enquiring and open mind, a rational approach, imagination, the ability to handle pressure, the ability to sympathise and be non‐ judgemental, work hard, be patient, be determined, decisive and aware of our own limitations.

Mr. Cassar particularly warns us against the ‘evil of private practice’ – particularly prolific on our small island – since this can cause a conflict of interest with the public service and our decisions might be influ‐ enced by financial gain.

During the talk, Mr. Cassar also compared the student selection for the course of Medicine in Malta with that in the UK. In the UK, students have to undergo a UK Clinical Aptitude Test (UKCAT), where they are as‐ sessed regarding verbal, quantitative and abstract rea‐ soning, decision analysis and non‐cognitive analysis.

The latter includes attributes related to robustness, empathy and integrity. On the Maltese islands, stu‐ dents have only to obtain good grades at their Ad‐ vanced Levels examinations. This clearly illustrates the emphasis on academic achievement in Malta, per‐ haps at the expense of other cognitive and people skills considered important outside our shores.

On a positive note, although the list to what consti‐ tutes being a good doctor seems inexhaustible, we are ensured that it is great to be a doctor! We will never get bored and we will get to do some amazing things.

We’ll test the limits of our minds, we will earn respect (deserved or not) and we will do some good, even if we do not mean it. We will also get to work with some great people and some patients will change our lives forever.

Finally, even if we fail to help our patients, if we keep the above in mind, at least we know that we would have done everything possible to help that individual.

And just to make sure that the point does come across, “No matter what kind of doctor you become, be a kind doctor!”

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Aunty ELSA (LL.B) on TRD Lately, there was much fuss centring round the date 17th of October 2008, both on PBS and on YouTube. For the first time ever, Dr. Gonzi and Dr. Muscat crossed swords live on Xarabank. Admittedly, it actually was quite a Red Letter Day for

And what cracks me up even further is the sight

Xarabank… Fuss justified! It was not really the en-

of my nephew giving talks to school children on

counter that made the day so historic. It’s simply

eating healthy, not smoking and wearing con-

because Xarabank rarely ever gets this good!

doms before sex.

Funnily enough, I’ve never

It was a programme that could have poten-

heard of SCOPH working towards the cessation

tially stirred an intellectual and highly stimulating

of alcohol abuse. And they shouldn’t! Because

adult conversation with my nephew, a budding

they would be complete hypocrites if they do!

doctor, the following Sunday morning. He usually

Perhaps they should leave that sort of work to

comes to see me on Sundays. But that week, it

the law students. They don’t share this same pro-

just did not happen. He had to make a miss this

pensity to drink so heavily. And it’s not because

weekend since, apparently, he was still recover-

they lack performance stress! Law students sim-

ing from the two TRD parties where he had ‘a few

ply have other leisure activities like… erm… ‘D’

drinks too many’. Yes… he went to that distaste-

Treasure Hunt… ‘D’ Sant’ Ivo dinner… “among

ful weekend called ‘TRD!’ How can I forget that

others”… Excuse me. Can’t think of further activi-

he’s studying to become a one track minded

ties… That’s all the ELSA website mentions.

doctor of medicine rather than a well cultivated,

Very well!

Granted!

Perhaps in the eyes of

highly educated and tastefully cultured doctor of

MMSA we law people might not have so much

law?!

going on.

You know, MMSA has become nothing but one

For those of you who don’t know,

MMSA boasts about being the most active or-

big piss-up these days! The only thing medical

ganisation on campus.

And if you bump into

students are really known for is for their parties

one of their EB members, or a very active alum-

and their excessive reliance on alcohol con-

nus who was an ex-EB member back in his day

sumption to have a great time with friends. Per-

(Dr. Pierre Schembri Wismayer anybody?), the

haps I might be sounding a bit unfair.

gloating just gets too nauseating – way beyond

Well, forgive the scrutiny! But it is rather funny

treatment with a Maxolon gulp-down! The quea-

how students who are expected to be society’s

siness is even worse than the one you get whilst

health role models, all because they act so well

watching Dejjem Tiegħek Becky on television. Or

at knowing better, are renowned for “always

now should I say KC? Komplete Crap none the

smoking and drinking, and lounging” (Pickwick

less if I may say!

Papers).

Crap…

Pure and simple Komplete

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Wall o

f sham

e

Thanks to Stefan Buttigieg for providing photos

Pearls of Wisdom Mr. A. Casha’s answer to the typical question “But how would you identify this?”...

“WELL, YOU KNOW, IF IT LOOKS LIKE A DOG, AND IT BARKS LIKE A DOG, THEN IT’S PROBABLY A DOG, YOU KNOW?”

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Dear Boozu,

I am at my wit’s end! No matter what I do, I can’t seem to get hold of the lecturer I need in order to get my physiology long essay title approved! I’ve tried everything, from setting up a spy network system with fellow desperados, to snooping out all the dusty faculty corners I could think about…again…and again…but the guy never shows up...

Please, I need your wisdom….fast!

Desperate McPanicky

—————————————————————————————————————————————————————To Desperate McPanicky, Oh young one… Fear not! Advice is forthcoming.

The lecturer is a crafty, cunning and surprisingly agile creature, so you need a game plan to settle

this issue.

First and foremost, it seems that you’ve been studying the said creature, so I’m pretty sure you’ve got all the standard stuff sorted such as car, office location, phone number, mobile number, email and home address.

Next thing is to get him/her to notice you! (This is where the editor starts getting annoyed at me!)

Now I don’t want you to do anything stupid like streak in the middle of one of his lectures!!! That won’t do you much good. Do something normal, like sit in front of his car till he shows up. Make sure you get the right car and/or a blanket and some food just in case he tries to avoid you, in which case you’re in for the long haul.

If the said lecturer is hiding out in the office you can always smoke him out of his hideaway. Now, here is where I can really help you! Various methods can be used ranging from small fires to fire extinguishers. If the lecturer is a she, then little mice running around her office would definitely make sure she leaves! Be on guard to have a full explanation of what you want out of the lecturer so that as he/ she escapes from the office in a frenzy they will hear you out and agree with you on the spot.

You could also try leaving subtle hints like the odd garbage can emptied on their car or outside their house, along with a few notes explaining your distress.

As a 5th year studying psychiatry, I do urge you to use some restraint. The line between diligent medical student and psychotic inpatient at MCH is becoming ever so fine.

If this doesn’t work you can always try the direct approach like getting his mobile number from a secretary or a student who had some form of contact (however weird) with this lecturer.

I hope this has been helpful.

Boozu

PS: don’t panic too much, life is full of these little challenges, and remember… If you don’t get anything out of this, you’ll always a better stalker for it!!!

PS 2: (No, not the games console) If ever you get into any trouble with the police… we never met ok?

Pearls of Wisdom Dr. E. Farrugia on collecting a MSU (mid-stream urine)…

“WHEN THEY URINATE, THEY DO IT IN THE TOILET.”

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NOVEMBER From: alex curmi Date: Fri, Oct 24, 2008 at 5:57 PM Subject: [mmsa-2008] Re: Election Results!

To: mmsa-2008@googlegroups.com

Attard / Mamo '08 Progress Prosperity Procrastination Here’s are a bunch of Nick Mamo slogans I toyed around with before settling with Nick Mamo: Why Not? : Practice Makes Mamo Mamo: Because the other candidates eat babies Not without my Mamo He-llo Ma-mo Nick Mamo: The World's Local Class Rep That is all.

Kudos to Stefan Buttigieg for the forward.

Funny Class Server E-Mail of the Month

Pearls of Wisdom Mr. L. Zrinzo on Relationships...

“YOU WOULDN’T BE HERE IF IT WASN’T FOR ACCESSORIES”

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Pre-clinical Corner Useful Websites ♦

The Interactive Atlas of Thoracic Viscera

http://da.biostr.washington.edu:80/cgi‐bin/ DA/PageMaster?atlas:Thorax+ffpathIndex/ Thoracic^Viscera+2

This site has 3D views of thoracic organs. It also contains normal x‐rays and CT scans of the thorax and anatomical cross‐sections of cadaver specimens at different levels. The atlas is divided into various subcategories, such as mediastinum, pericardium and heart and lungs and bronchial tree. Users may navigate through the atlas by clicking image button of that image. Each image contains options, such as a “Label all” button to provide labels to the image. It also has a “Quiz” option with each image that allows you to test yourself. The quiz operates by naming a structure which you have to then click on, on the particular image.

♦

Human Embryology Lectures

http://dentistry.ouhsc.edu/cell8110

A series of Embryology lectures filmed in 2007.

The lectures start from week 2 after fertiliza‐ tion, gastrulation (week 3) and week 4. After that the embryological development of the dif‐ ferent systems (cardiovascular, respiratory, gastrointestinal, etc) is discussed. The lectures are very useful if you miss (on purposely or not) an embryology lecture.

♦

The Body Guide

http://www.mercksource.com/ppdocs/us/ cns/content/adam/visualbody/ frameParent.html

An interactive website showing the different systems of the body. By pressing onto the de‐ sired system the figure on the left changes to portray the major structures of that particular system. When you runn your mouse over the desired structure it’s name appears on the bottom right side of the screen.

MNEMONICS THORAX Superior Mediastinal Contents: "BATS & TENT": Brachiocephalic veins Arch of aorta Thymus Superior vena cava Trachea Esophagus Nerves (vagus & phrenic) Thoracic duct Posterior Mediastinal Contents: There are 4 birds: The esophaGOOSE (esophagus) The vaGOOSE nerve The azyGOOSE vein The thoracic DUCK (duct) Bronchi: which one is more vertical?

“Inhale a bite, goes down the right”: Inhaled objects more likely to lodge in right bronchus, since it is the one that is more vertical Heart valve sequence: “Try Pulling My Aorta”: Tricuspid Pulmonary Mitral Aorta Diaphragm innervations: “C 3, 4, 5 … keeps the diaphragm alive!”

Diaphragm innervation is cervical roots 3, 4, and 5 (ie phrenic nerve).

NEUROANATOMY For the function of the temporal lobes, think of a helmet which covers the side of the head: HELM: H : hearing E : emotion L : learning M : memory Composition of cranial nerves (Motor, Sensory, or Both) “Some Say Marry Money, But My Brother Says Big Breasts Matter More” I.E. starting from cranial nerve I (olfactory) : sensory, sensory motor, motor, both, motor, both, sensory, both, both, motor, motor!

Trigeminal nerve: where branches exit skull “Standing Room Only” V1 = > Superior orbital fissure V2 => Foramen Rotundum V3 => Foramen ovale Pterygoid muscles: function of lateral vs. medial “Look at how your jaw ends up when saying first syllable of ‘Lateral’ or ‘Medial’”: “La”: your jaw is now open, so Lateral opens mouth.

“Me”: your jaw is still closed, so medial closes the mandible.

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CLINICAL CORNER Clinical Case AZ is a 74 year old retired gentleman and known case of IgA nephropathy, asthma, hypertension, CHF and gout who presented at A&E greatly distressed, tachypnoeic and unresponsive. According to the patient’s wife, he had been suffering from increasing SOB over the past two days, which worsened overnight. He also had a history of PND, orthopnoea (using 4 pillows) and dyspnoea on exertion. There was allegedly no chest pain, no cough or sputum and no fever. On looking through his records, it was noted that the patient had been admitted twice over the previous two months with similar episodes.

On admission, the patient was on treatment with several drugs, including burinex 1mg daily, enalapril 20mg bd, aspirin 75mg bd, zantac 150mg bd, allopurinol 700mg daily, flixotide 2 puffs bd, atrovent 2 puffs bd and ventolin 2 puffs PRN. He had no known drug allergies.

On examination at A&E, the patient was found to be distressed and tachypnoeic, with a respiratory rate of 40/min. Rectal temperature was 95oF. He had a patent airway; a guidal airway had been inserted in the ambulance. He was found to have an SaO2 of 80% off O2, prolonged expiration, crackles over the lower 2/3 of the lungs and scattered rhonchi. His pulse rate was 120bpm, he had a BP of 220/110 and no added heart sounds. His abdomen was soft and non-tender, while he was found to have pitting oedema in both lower limbs. CXR indicated cardiomegaly and congestion of the pulmonary veins. The ECG demonstrated sinus tachycardia, with frequent ventricular ectopics.

and asthma. Enalapril was stopped, and atacand was increased to 5mg bd. Amiodarone was considered for possible future VT. Serial ECGs were ordered, and the patient was kept warm.

After six days in intensive care, the patient was in a stable general condition and afebrile, and had been weaned slowly of ventolin. BP had been lowered to 169/90 whilst SaO2 on oxygen was 94%. AZ was moved to the Cardiac Medical Ward. GC remained stable, and BP was reduced to 130/80. The patient was in normal sinus rhythm with occasional ventricular ectopics. K+ was found to be low. Hence, KCl syrup was started with an aim to a K+ of 4.0mmol-1. Urine and electrolytes, creatinine, Ca2+, Mg2+ and phosphate were ordered to monitor his condition.

AZ is still awaiting a full recovery.

AZ was given becotide 2mg + 2mg i.v., isoket 3mg/ hr, ventolin/atrovent nebulizer and hydrocortisone 200mg i.v. In view of ABGs and a poor clinical response, the patient was intubated and given 100% O2. He was then given tazocin 4.5mg, and a urinary catheter was inserted. AOS was done.

QUESTIONS 1. What is the possible cause of hypertension in this patient?

2. How does hypertension bring about LVF? 3. What is the rationale behind prescribing tazocin®?

4. Is there a link between the patient’s treatment and the ventricular ectopics?

AZ was admitted to ITU with an exacerbation CHF

ANSWERS BELOW!

ANSWERS 1. What is the possible cause of hypertension in this patient?

Hypertension is due to renal failure as a result of chronic renal failure, which is a complication of IgA nephropathy, a condition in which there is deposition of IgA antibodies onto the glomerular basement membrane of the glomerulus.

2. How does hypertension bring about LVF? Systemic hypertension causes an increase in the afterload, and hence an increase in cardiac work, since the heart must pump with an aim to exceed diastolic pressure in the aorta. There is an increased end diastolic volume in the left ventricle, leading to dilation of the ventricle and further exacerbating the problem of afterload.

3. What is the rationale behind prescribing tazocin®?

Tazocin® (piperacillin/tazobactam) is a combination of the extended spectrum β-lactam antibiotic piperacillin and the β-lactamase inhibitor tazobactam. The combination is active against a broad spectrum of gram positives and gram negatives as well as anaerobes, including Pseudomonas aeruginosa. Tazocin® was given as prophylaxis due to the insertion of a urinary catheter as well as a central line.

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4. Is there a link between the patient’s treatment and the ventricular ectopics?

The patient is receiving the loop diuretic burinex® (bumetanide), which causes Na+ and water retention at the expense of K+. Change in concentration of K+ is a possible cause of the ventricular ectopics – hence, KCl syrup was started with aim to an extracellular [K+] of 4.0mmol-1.

This is All Greek to Me!

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2

Christian Camilleri

Well, it’s not all Greek! The language of Medicine and Surgery also comprises a hefty dose of Latin, and English acronyms too, apart from the local input from the native language. We Medical Students can never learn enough Medical Jargon, so here's some more of that mind-boggling gobbledygook*. (*Note from the editor: Someone seems to be going to Zrinzo’s lectures… and paying attention!)

Acronymophilia Obsessive compulsive usage of acronyms.

Endemic to medical staff.

Acute Hyponicotinaemia Desperately need a smoke.

Acute Incarceritis Dubious disease affecting those just arrested or in court.

GOMERE: Female version of the GOMER. Often more annoying, unless exhibiting callipygianism.

Lantern Test Shining a torch in patient's mouth results in eyes lighting up. Diagnostic test for Pneumocephaly.

Narcolepsy Disease where main symptom is sleepiness.

AQP "Assuming the Q Position". Dead/ Dying with Endemic to Radiologists and Medical Students. tongue hanging out Callipygian [From Greek kallos (beautiful) + pugē, buttocks.]

Nice ass.

Necrophiliac [From Greek necro(death) + filia (love)] Pathologist

Cold T-sign Pneumocephalic Number of untouched cups of cold tea at a deceased patient's bedside. A useful indicator of [From Greek pneumo(Air) + Romano-Greek cepha (head)] approximate time of death.

Air-head.

COPD Chronic Old Persons Disease TMB Too Many Birthdays. See COPD Eiffel Syndrome [From English "I Fell On It!"] Universal explanation given by a patient with a TTFO large foreign object in the rectum.

Told To F**k Off , eg. "GOMER returned for the 3rd time, with no convincing signs and GOMER: symptoms and TTFO" [Acronym: Get Out of My Emergeny Room] Refers to that exasperating git that wastes your When questioned by the administration why you time at 1am in Casualty. Often presents with symp- were daft enough to write this on the report, say it toms as serious as tummy ache, apathy and pinky- meant "Told to Take Fluids Orally” hangnail (xliefa). Alternatively a demented social case occupying a hospital bed instead of a nursing home. Both variations of the GOMER may be sub- TTJ Transferred to Jesus ject to Assisted Aggressive Euthanasia

More of this mind-boggling gobbledygook coming up in the next issue of Sphygmo

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Medical Equipment

S D E I F I S S CLA

Welch Allyn Diagnostic Set, hardly used, is being sold at €120. Please call on: 21438524/79288393.

—————————–————————————————‐ Two Reister tuning forks (128 Hz and 256 Hz) and 1 Send any classified adverts you have Reister pinard, all in impeccable condition, for sale at the following prices: €15 per tuning fork (retail price €28.86) for free to sphygmo@mmsa.org.mt and €6 for the pinard (retail price €11.26). Any interested takers should send an email to joelleazzo@yahoo.com.

Books

Biochemistry 5th Edition by L. Stryer, J.L. Tymoczko and J.M. Berg, excellent condition, being sold at €30 – SMART CARD REFUNDABLE. Anyone interested please email me at: mcam0012@yahoo.co.uk.

——————————————–———————————‐ MD Ist – Vth year books for sale, some still brand new, with the comprehensive list and prices pinned on the no‐ tice board next to the Health Sciences (i.e. Medical School) Library at Mater Dei Hospital. Books with MCQs and Clinical cases are also available. For more information call on: 21438524/79288393.

—————————————————————————‐‐ Kumar & Clark’s Clinical Medicine 6th Edition, brand new, is being sold at €27.82. Anyone interested can reach David Grima on 79418130.

—————————————————————————‐‐ MD IIIrd‐Vth year books for sale in excellent condition.

Please contact David Grech on 79315897 (message) or davegrech@gmail.com.

MMSA NEWSBOARD

COMING SOON!!!!

MMSA EVENT Human Rights Week World AIDS Week

Wanted!!

Media needs new recruits to form the new Murmur Edito‐ rial Board. Anyone interested, email Claire Vella (Media Officer) on media@mmsa.org.mt

For the next issue Sphygmo is still in need of:

•

Your Photos including one for The Wall of Shame corner.

•

Your Funny Class Server Emails (please, not 6 pages long. Ideally just one email or one very short thread).

•

Your Announcements for Sphygmo to put up on the Notice Board and the Sphygmo Classified Ads col‐ umn. Please note, advertising here is free of charge.

•

Your Difficulties sent to Dear Boozu on dru@itt.net.mt. Anonymity guaranteed!

• Your Lecturer’s Bloopers for the column PEARLS OF WISDOM. And anything else YOU find pertinent.

If you can help us, just send an email to sphygmo@mmsa.org.mt.

CHILDREN'S BOOKS WANTED FOR LIBRARY IN RAINBOW WARD The children's ward Rainbow at Mater Dei Hospital is unfortunaltely known to have children suffering from cancer. As an initiative to alleviate their suffering, there's going to be a book library set up in Rainbow ward for these children.

If you have any children's books which are still in good condition and are just gathering dust on your shelves, do consider donating them to this library and contact Andrea Scopazzi on 23403096 (during office hours) or 79811878.

Or else, send an email to andrea.scopazzi@um.edu.mt.

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Exchange Photos Competition

WINNER: Francesca Lentini

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photo album - world diabetes day 2008

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