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Notice Board
The editorial committee will be active from February to December 2012.
Editorial Team
The Editorial Committee proudly presents to you, Volume 4, Issue 1 of the Medical Student Journal of Australia (MSJA). This year we have chosen the theme “Sui generis”which, in its Latin translation means “of its own kind”. Our journal, inherited from its strong yet humble beginnings as a population health project in 2009 continues from strength to strength. This year the MSJA has embarked on a bold process of expansion that will, in future editions, see this journal include all year levels on the editorial board as well as increasing the number of accepted allied health manuscripts.

The Editorial Committee of the MSJA strongly believe in the philosophy that early exposure to research in medicine fosters a career of life long learning and encourages the pursuit of research. Indeed, a strong research focus early on in one’s career builds a clinician committed to providing evidenced based clinical practice with the greatest benefit to the patient. This is achieved through students actively engaged in the process of expert peer-review and the editorial cycle, giving them a bona-fide experience of submitting, editing, re-reviewing, and publishing a quality manuscript.

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Image Credit:
Ebony Smith

Elective Experiences
Ghana, An unforgettable elective experience
Sarah Simpson
Ghana is a beautiful, diverse, welcoming and unforgettable nation and it is for these reasons, and many others, that I am thrilled to have had the privilege of completing my medical elective there in January 2012. I organised my elective through International Volunteer Headquarters (IVHQ), a New Zealand-based company that offers volunteer experiences in a number of developing countries around the world

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Ten simple rules for your North American elective
Lucas Castellani and Matt Solomon
Australia has become an increasingly attractive place for North Americans to receive their undergraduate medical degree. Many factors, including the quality of education, are responsible for the increase in numbers. An elective experience in North America is essential for students planning to return home to practice medicine. Practical experience familiarises students with the health care system and provides an opportunity to acquire references for postgraduate training (‘residency’) program applications. Developed from our own experience, the following article highlights ten important aspects that medical students should consider when arranging and attending their electives in North America.

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An elective experience in rural and remote Uganda
Julia Victoria Whitby
After a three hour journey from Kampala fellow medical student, Alan, and I reached the turn off point for Ibulanku – a small rural community in the Iganga district of Uganda. Here the road turns from bitumen dusted with potholes to dirt. Only the occasional motorbike passes us, cars are rarely seen and people are mainly walking or otherwise on pushbikes. Kids are out in ragged T-shirts waving and happy to see us, shouting “mzungus!” (“white people”). We passed several games of soccer, women and children carrying water from the bore holes or babies slung across their backs. Small mud brick houses scatter the roadside, surrounded by small patches of subsistence farming.

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Global Rural and Indigenous Health
Prevention of Bordetella Pertussis infection in the Australian community
Megan Hickie
Pertussis, also known as whooping cough, is an acute respiratory condition caused by the Gram negative bacillus Bordetella pertussis. It is highly contagious (1). When untreated, Bordetella pertussis spreads via respiratory droplets to 80% of the susceptible household contacts of the infected individual (2,3).

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A trip to Kokoda
Ruth Townsend, Simone Huntingford and Phillip Hingley
In 2012, two students from The Australian National University (ANU) medical school, Simone Huntingford and Phillip Hingley, one lecturer, Ruth Townsend and Dr Lyle Hingley, self funded a trip to Papua New Guinea (PNG) to walk the Kokoda track. The purpose for walking was to raise money for the Birthing Kit Foundation, an organisation that compiles and distributes birthing kits to women in developing countries

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Careers
Reflections on a career in medicine
Dr Simon O’Connor
In some ways, launching into a medical career was rather simpler when I began at the University of Sydney as a first year medical student in 1973. I came straight from school in Canberra and was only 17 years old. Applying for a place involved writing the name of one’s preferred faculty on a form and posting it. There were no interviews or aptitude tests.

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The green fields of psychiatry
Patrick McGorry
I come from an Irish family with many doctors. My maternal great-grandfather was a doctor, and his daughter, my grandmother, became a doctor in her forties and worked in Dublin, outback WA, and Zambia. My father became a doctor after his brother had died as a young hospital doctor from meningitis in 1924. My dad was a chest and public health physician who looked after young men dying of tuberculosis in the 1930's and 40's, and later coal miners disabled by pneumoconiosis and silicosis. There was consequently much expectation that I should also do medicine, though I was initially not that keen, preferring the humanities

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Letters To The Editor
Man-flu: is it real and why could it be
Damon O’Leary Counahan
Many men are familiar with being mocked for their tendency to revert to childhood as they suffer the symptoms associated with the common cold. On the other hand, women seem to plough on oblivious to the suffering associated with the renowned rhinoviruses. This disparity in symptomatology is now commonly known as the phenomenon of ‘man flu’. Recently, much to the delight of men, some scientific basis for the man flu has been authenticated.

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Research Papers
Laparoscopic versus Open Adrenalectomy: 30 year experience in 88 patients
Joseph Do Woong Choi, Guan Chong
Laparoscopic adrenalectomy (LA) has become the procedure of choice for resection of functional and non-functional adrenal tumours (1,2). Retrospective comparative studies and case series suggest the advantage of LA compared with open adrenalectomy (OA), regarding its decreased requirements for analgesics, minimal morbidity, improved patient satisfaction, shorter hospital stay and recovery time (3-5).

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Barriers and solutions to the implementation of diabetes management plans in a rural Aboriginal health service
Caitlin Keighley and Bronwyn Scarr
An Aboriginal Medical Service (AMS) asked for an assessment of their diabetes management procedures in order to improve practice. A recent turnover of staff had helped identify various deficits between practised and ideal management, and in measured outcomes. This was particularly evident with regards to diabetes, one of the national health priorities.
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Computed tomography utilisation in tertiary hospitals and community settings in the Australian Capital Territory and South Eastern New South Wales
Aditya Bhat, Sheila Rahman, Chuong Vinh Huynh, Ray Mun Koo, Mya Thida, Yinan Zhang, Eva Y Lam, Matthew Thompson
Since its introduction in the 1970s, the demand and availability of computed tomography (CT) has increased, largely due to the relative ease, rapidity and accuracy of this imaging modality (1). However, there are increasing concerns with regards to the economic and health burdens associated with this diagnostic tool.

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The appropriate pathology test study: optimising pathology blood test ordering in the hospital setting
James McKinney, Luan Pham, Ko-Chin Chen, Ashwin Swaminathan
Inappropriate pathology testing creates unnecessary patient discomfort, consumes limited hospital resources and negatively impacts on medical staff efficiency. High rates of unnecessary pathology test ordering have been documented in international studies (1-5).

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News and Topics of Interest
Towards greener health: a brief look at the Global Green and Healthy Hospital Agenda
Tom Owen Morley
On October 13, 2011 Health Care Without Harm (HCWH), an international alliance that endeavours to reduce the healthcare sector’s harm to both human and environment health, released the Global Green and Healthy Hospital Agenda (GGHHA) (1).

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Autism as a 'desirable diagnosis' - 'correcting' a sex bias?
Phoebe Moore
There has been much talk about the increasing prevalence of autistic disorder and autism spectrum disorders in recent years. This has centred on discussion of whether the condition is actually increasing in our society, and what might be causing this, versus the perception that it is being over-diagnosed. Although the cause of this increase remains unclear, one thing not disputed is a strong preponderance for the male gender.

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Case Reports
A case of pulmonary-renal syndrome: Wegener's granulomatosis with evidence of co-existing anti-GBM disease
Stephen Muhi
This case of pulmonary-renal syndrome presented a unique diagnostic dilemma, and serves as a useful platform to discuss the systemic vasculitides. Although a diagnosis of Wegener's granulomatosis (WG) was highly probable, evidence of a coexisting anti-glomerular basement membrane (GBM) disease made for an interesting differential diagnosis.


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Caffeine-induced rhabdomyolysis at a near-toxic dose
David Phillips, Mark Russell, Budhima Nanayakkara
Rhabdomyolysis has many causes including drugs and toxins, trauma, muscle ischaemia, intense exercise, prolonged immobilisation, infection, electrolyte and endocrine abnormalities, genetic defects, connective tissue disorders and temperature extremes (1, 2).


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Student Education
The need for an emphasis on communication in medical training: If you can't communicate you can't be a good doctor
Damon O’Leary Counahan
All efforts to treat a patient are futile if the patient's concerns are not addressed. Such concerns can only be elicited through communication, which is therefore central to the role of a doctor. Developing communication skills in junior doctors and medical students is not only fundamental to their education, but is proven to protect against adverse medical and legal outcomes. There is no doubt that in more recent years Australian medical schools have made an effort to better prepare students with communication skills. Nevertheless, contemporary research suggests that certain aspects of communication need to be emphasised more in medical school curricula (1,2).

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Breaking men: gender perspectives in medicine
Kate Brown
Osteoporosis has historically been considered a woman’s disease and has not received the same degree of awareness in men. About 50% of women and 25% of men will have an osteoporosis-related fracture in their lifetime, resulting in significant morbidity and mortality (1, 2). Even though roughly 1 in 3 osteoporosis-related fractures occur in men, this disease remains under-diagnosed and under-treated.

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Why do we shy away from the sexual history, and how can we approach it more confidently?
Michael Samuel Krasovitsky
The sexual history is a vital part of a number of medical disciplines, ranging from infectious diseases to urology, obstetrics and gynaecology, general practice and psychiatry. Yet despite its importance in both the diagnostic and management components of medicine and surgery, the sexual history is often forgotten or glossed over. What is it about the sexual history that deters us from delving into this important area of our patient’s presentation?

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Lit Review
The impact of maternal employment on infant attachment and cognitive development: a literature review
Erin O’Reilly
Over the past thirty years it has become increasingly common for mothers to return to paid employment within a year of their infant’s birth (1). The implications of this change for infant social, emotional and cognitive development has generated widespread interest within the field of psychology, as well as much debate and controversy (2)

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The molecular pathogenesis of primary erythromelalgia, a painful inherited syndrome : An update
Budhima Nanayakkara, David Phillips and Mark Russell
Chronic pain is a complex, disabling medical problem that presents constant challenges to pain specialists worldwide. Much research has been done in order to understand the molecular and functional characteristics of acquired inflammatory and neuropathic pain but little is known about the inherited pain syndromes

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The birthplace of chronic disease
Mark Russell, Budhima Nanayakkara and David Phillips
The obesity epidemic is a rapidly progressing global concern (1). Obesity has a multifactorial aetiology and is the result of a complex interplay between genetic and environmental factors overlaid on variable socio-economic conditions

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