From the Dean
Professor Nicholas Glasgow, Dean, ANU Medical SchoolIt is my pleasure to welcome you to Volume 3, Issue 2 of the Medical Student Journal of Australia, developed and coordinated by final year medical students at the Australian National University (ANU). Congratulations to the team for producing another edition of the journal, and to all those who have contributed.

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Notice Board
The editorial committee will be active from February to May and From July to October 2011.
Editorial Team
W e are proud to present Volume 3 Issue 2 of the Medical Student Journal of Australia (MSJA). It has been a privilege to work on producing such an exciting and interesting issue of the journal.

Producing this issue of the MSJA has given the editorial team a unique view at the quality of research and opinion produced by the medical student cohort. It is obvious that the Australian National University Medical School's (ANUMS) association with world class research institutions such as the John Curtin School of Medical Research (JCSMR) and the National Centre for Epidemiology and Population Health (NCEPH) have enhanced the research skills of the student population.

This edition has been characterised by a surge in research articles, which reflects the growing reputation of the journal, with increasing numbers of researchers choosing to submit to the journal and allowing the editorial team to select truly high quality research.

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Red earth of the desert near Maralinga in outback South Australia, 2007
Image Credit:
Professor Amanda Barnard
MSJA
Elective Experiences
Glasgow, a Tale of Two Cities
James McCracken
It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the Spring of hope, it was the Winter of despair, we had everything before us, we had nothing before us, we were all going direct to Heaven we were all going direct the other way." A Tale of Two Cities, Charles Dickens.

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Medical electives in developing countries: making a real difference?
Mitchell Blake
I had a very unique and fun experience on my medical elective in Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania, but after I returned home I asked myself why that was. As most medical students undertaking electives in developing countries, I had this optimistic and possibly naive belief that I was going to make a real difference.

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Student Education
Maintenance fluids: how hard can it be?
Paris Ramrakha
Published anecdotes allege that junior doctors are under-prepared or under-informed when it comes to appropriate prescription of intravenous fluids. This paper presents ideas from journal articles on how to optimise maintenance fluid therapy choices, in the form of a summarised literature review.

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Arterial blood gases
Mimi Chiu
The aim of sampling arterial blood gas (ABG) is to assess a patient's acid/base balance, hypoxia and carbon dioxide retention and hence, allow for the initiation of appropriate treatment. This article explains the importance of arterial blood sampling, what the indications, contraindication and risks are as well as some useful tips when performing one.

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Global Rural and Indigenous Health
Infectious, environmental and social determinants of rheumatic heart disease: a comparison of Indigenous and non-Indigenous Australians
Megan Hickie
This paper outlines the ways in which infectious, environmental and social factors interact to give rise to rheumatic heart disease. In some remote Indigenous communities, the rates of rheumatic heart disease have been well documented as being among the highest in the world.

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HIV in Russia
James McCracken
Ischaemic heart disease (IHD) and diabetes are chronic conditions contributing substantially to the total burden of disease and injury in Australia. They are associated with significant morbidity and mortality requiring complex and expensive treatment plans.

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A chlamydia prevention strategy for the Northern Territory: THATS-C
Timothy Lovell
In spite of an increase in the understanding of the pathogenesis, manifestation, and sequelae of the many sexually transmissible infections (STIs), they remain a major health problem. Chlamydia has evaded prevention strategies of the Department of Health and Ageing and increased in incidence in Australia.

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Careers
Life in and out of medicine
David Harley
To tell a story about a medical career is to give it a narrative structure it usually doesn't have. Most of us make up our careers as we go along. There are exceptions: I knew a student whose obsession with platelets continued undimmed into a life as a haematologist working with clotting disorders. I wasn't like that.

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Letters To The Editor
The role of Ethics Committees
Philip Chia
Since the atrocities committed by NAZI researchers in the second World War, human research has undergone increased scrutiny and the role of ethics committees in protecting humans has taken on great importance which has been reinforced by the subsequent formulation of human rights declarations.

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Drug companies pushing the boundaries with direct-to-consumer advertising
Mitchell Blake, Dilip Wickremasinghe
Drug companies are becoming more innovative in the ways they sell products to consumers. Traditionally in Australia, drug companies have targeted doctors by offering them free stationary, medical equipment and paying for conferences in exotic locations. It was up to the doctor to take on this burden, decide whether to accept such gifts and to decide what was best for their patients. These methods are waning with stricter laws recently introduced, but drug companies have also developed methods for getting their product direct to the consumers.

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Research Papers
Radiation Exposure from Diagnostic Imaging in Trauma Patients Presenting to Emergency Department
Hilman H. Tjiang, Drew Richardson
Trauma patients presenting to emergency department require extensive radiologic investigations which are associated with high-radiation doses. The objective of this study is to determine the amount of cumulative effective dose received by adult trauma patients presenting to emergency department during the first 24 hours of their care.

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Osteoporosis: the forgotten diagnosis?
Michael Jenkins, Paul N. Smith, Jennifer M. Scarvell

The objectives of this study were to determine:

  1. The incidence of minimal trauma fractures in patients over 40 years of age presenting to The Canberra Hospital (TCH) Fracture Clinic,
  2. The incidence of osteoporosis screening and intervention in patients presenting to TCH with a minimal trauma fracture, and
  3. The incidence of repeat fractures in patients suffering a minimal trauma fracture

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Evaluation of transition of type 1 diabetes paediatric patients to the adult service at the canberra hospital
Danica Vress, Robert Schmidli
To determine the age of transition of type 1 diabetes patients from the paediatric to adult service at The Canberra Hospital and to compare the clinical attendance rates between adult and paediatric services.

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The role of clinician gender in the performance of pap smears: a rural focus
Daniel Heard, Martin Dempsey, Jessica Tidemann, David Baker, Yin Lee, Anna Piggin, John Sullivan
This is a retrospective cross sectional study as part of a Clinical Audit Project (CAP) undertaken by the Australian National University (ANU) Medical School. Data is collected on patient presentations while students are on clinical placements which may be in general practice, community health or hospital settings, in both rural and urban locations. Patients give written consent to the collection and use of the data.

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A search for the high risk patient: a retrospective study of carotid endarterectomy
Priyanka Dhillon, David Hardman
This study attempted to identify a subpopulation of patients who underwent CEA and responded poorly on the basis of risk factors. If a group of patients who were known to have risk-factors for CEA and performed poorly then perhaps the concept of the 'high-risk' patient for CEA is warranted and should not be discredited as an agenda driven attempt by industry to create its own niche market and supply the needs of that market.

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News and Topics of Interest
What's in a name? Gender and the eponym
Ross Penglase
The human desire to be remembered has ironically conjured that which many medical students tend to forget – the medical eponym. In fact, our medical forefathers (and mothers) have been so busy naming things that we have ended up with over 8000 medical eponyms – enough to make you develop Magnan's sign . Thankfully, these eponyms can be attributed to only 3383 people, so if you remember Charcot and his triad, you can be merciful that he also coined a syndrome, joint, zones, a type of vertigo and aneurysms to name but a few.

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Man made miracle
Nishant Valecha, Bhavya Bharadwaj
Organ transplantation has revolutionised modern medicine. It is one the most effective treatment options for many otherwise fatal conditions. Australia, with one of the most sophisticated healthcare systems in the world is currently ranked 17th globally for the number of transplants performed per annum .

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Case Reports
Gender and suicide
Josephine Goodyer
During a GP placement, I sat in on a consult with a year 12 high school student and her boyfriend. Her usual GP was away and as such she had never met this GP nor me before. The consult centred on the patient's increasing anxiety. She described having a low mood and that her anxiety had worsened since being prescribed an anxiolytic.


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Student Life
This is NOT a scapula – a final-year medical student's experience at teaching anatomy
Kaihan Yao
Altruism [al-troo-iz-uhm] /–noun The principle or practice of unselfish concern for or devotion to the welfare of others.

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Medical school and the enculturation of self-neglect
Jared M. Stephenson, Michael Li
I came to Australia in 2005 to be with my partner in Perth. After my attempts to secure a spot at Medical School in Canada had been dashed for another year, my partner's mother suggested that I should try applying in Australia. Having looked into it, I decided to write the GAMSAT and started preparing my applications.

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Scrubs and ties
Timothy Lovell
Scrubs; introduced to the ANU medical students in 2011. Scrubs; taken up with rapture by many from the cohort. OK... maybe 'many' is overstating it. Adopted by 'some' or 'several' may be more accurate. And 'rapture', that's just not the right word.

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Choices
Morgan Edwards
My eyes flick open – they mirror my wife's. We lay there silent, hoping she goes quite, wishing her breathing to settle. If we don't move, no decisions need to be made. But it worsens, constant, she tries to cry but it is stifled as if she needs to breathe more.

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