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The Synapse I S S U E

INSIDE THIS ISSUE: A Day of

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Growth IAU Way For-

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ward AMSA in Ac-

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tion Cardiac Resyn-

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chronization Medical Stu-

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dent Syndrome Hoop It Up!

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Social Media

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Say Cheese

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Food Break

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Fun Page

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Editorial

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References

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A Day of Growth

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t’s not unusual on any given morning for the halls of IAU to be busy with students coming and going to classes or grabbing a snack from the café during their break. However, this past week was different. There was an extra buzz of excitement in the air as IAU welcomed students from the Vieux Fort Comprehensive Secondary School for Student Mentor Day, a community

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service event started by the SGA to give back to the local community. This event had been much looked forward to by visiting students because of all the stories they heard from their friends and classmates who attended last semester’s inaugural Student Mentor Day event. On this day, visiting students attended several courses in the Basic Sciences program throughout the morning and were given a guided tour of the anatomy lab in the afternoon. Some classes were challenging, but the students were able to appreciate the material taught and were even able to make connections to what they are learning in their science classes. Talking to students after their classes, one would be taken aback by just how much some actually learnt. Following a morning full of lectures, students were able to

spend time together with their mentors over lunch, sharing experiences from the morning and asking any questions they had about medical school. Maher Elajami, the president of the SGA shared words of encouragement and motivation saying that, “medicine requires a lot of dedicated time” and “to pursue medicine requires a love for medicine.” It is the hope of both IAU and the SGA to continue having events such as Student Mentor Day in order to foster a love of science and medicine in the lives of young students that they may be encouraged to pursue their dreams and become future leaders in their communities. - David Dragas

ICMF Gives Back - A Fun Day with the Elders

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he IAU Christian Medical Fellowship (ICMF) visited the “Home Assisted Living for the Elderly” facility in Black Bay, Saint Lucia. This visit was one of the many charitable events organized by ICMF. The visit was an extremely

enjoyable and a successful event. About 25 students, faculty and staff members from IAU were in attendance. Donations included prune juice, water, toilet paper, detergent, adult diapers, milk, cereals, nutritional food, soap and other non-perishable

items were collected from IAU students, staff and faculty and given to the residents. The president of ICMF, Mr. Benjamin Owalefo presented the items to the residents. When addressing the residents, he said “the items were meant to demonstrate respect and support for the elderly”. [Continued on Page 10…]


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It’s Raining Partnerships.. “IAU believes that education must uncover talents, impart skills, nurture the genius, unleash the leader within, enhance capabilities, enlighten, and embolden you to set things right and thus empower yourself to achieve righteously what one is capable of”

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t has been eight years since IAU began its journey in the field of Medicine. Now we are a wellknown Medical School in St. Lucia and in the Caribbean. Amidst challenges, the school was established in 2003 and are currently in a stage of rapid growth. I would like to update you on the recent developments beneficial to our student community. ICM in St. Lucia IAU is partnered with Tapion Hospital, (www.tapionhospital.com) Castries, for Introduction to Clinical Medicine (ICM) in St. Lucia. The first batch of four students completed their ICM during the period of February-March 2012. This is great news for students who would like to do their ICM in St. Lucia. There will be an ICM batch every semester from now on and our students can pursue ICM once they complete their four semesters at the campus. Tapion Hospital is the only private hospital in the Eastern Caribbean Region and the only hospital in theO.E.C.S (Organization of Eastern Caribbean States) accredited by Accreditation Canada International. Pre-Med Program in London, UK More great news! IAU in

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affiliation with University of Bedfordshire (UoB) now offers a 3 year Pre-Medical Program in the United Kingdom, leading to a Bachelor's Degree (BSc) in Biological or Biomedical Sciences from UoB. This program also offers guaranteed acceptance to the 4 year Doctor of Medicine (MD) program at IAU. The pre-med program covers a wide range of biological and molecular sciences and is offered at the UoB campus in collaboration with local hospitals in the UK. The course provides a sound theoretical and practical foundation in a range of sciences that are used to aid the diagnosis of human disease. The aim of the course is to produce highly trained scientists for physician training. “Students now have an option of doing rotations in the UK, both core and electives.”

As per the specific provisions of the affiliation agreement between UoB and IAU, graduates of the BSc Biological/Biomedical Science program from UoB are guaranteed admissions to the 4 year Doctor of Medicine (MD) program at IAU – College of Medicine, thereby offering high school graduates an opportunity to

complete the BSc + MD program within a short period of 7 years. Graduates of the MD program are eligible to practice medicine all over the world and in countries including the US, UK and Canada. Update on Clinicals IAU in affiliation with Whipps Cross University Hospital (UK) now offers Clinical Rotations to our students in the UK. Students now have an option of doing rotations in the UK, both core and electives. Whipps Cross University Hospital NHS Trust has been caring for the people of East London for over 100 years. Whipps Cross provides a full range of general inpatient, outpatient and day care services, as well as maternity services and a 24hour Emergency Department and Urgent Care Center. The Trust has also built a strong reputation as a center of excellence for various specialist services, including Urology, ENT, Audiology, Cardiology, Colorectal Surgery, Cancer Care and Acute Stroke Care. Partnership with Walden University It’s a year of partnerships!!! IAU has partnered with Walden University to offer Combined MD – MBA, MD – MHA and other graduate programs to our students. [Continued on the Next Page…]


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Walden University is an accredited institution celebrating more than 40 years of serving the higher education needs. Walden is distinguished by high academic standards, experienced faculty members, and a rigorous curriculum. IAU Walden partnership helps students

Its smiles all around as IAU enters into a partnership with University of Bedfordshire (UoB)

to achieve personal enrichment and career advancement. Using an array of technology, the university delivers an online education experience when, where, and how students need it. Walden promotes lifelong learning by offering bachelor’s, master’s, and doctoral degree programs online. Areas of study include Health Sciences, Nursing, Education, Counseling, Human Services, Management, Psychology, Public Health, Public Administration, Technology and Engineering. In May 2010, Walden was identified as having the No. 1 largest online graduate public health program by enrollment by US News and World Report. Highlights of the College of Health

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Sciences include:  

Doctoral programs in Health Services and Public Health Master’s programs in Health Administration (M.H.A.), Public Health (M.P.H.), Health Informatics and Clinical Research Administration Certificate available in Clinical Research Administration

IAU believes that education must uncover talents, impart skills, nurture the genius, unleash the leader within, enhance capabilities, enlighten, and embolden you to set things right and thus empower yourself to achieve righteously what one is capable of. As a family we all shall spark ourselves to reach the path towards excellence. - Sulal Mathai

AMSA in Action!

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he past few months saw the American Medical Student Association in the thick of things. From fundraisers to student support, the AMSA was actively involved in everything. Here are the highlights so what they did. A Lending Hand Ms. Purnell had surgery to correct Scoliosis and since then has been suffering from seizures. Since the surgery, Ms. Purnell had been suffering from seizures for a few years. She had been on antiepileptic drugs with no help. AMSA raised money in order to assist Ms. Purnell get an MRI scan done in St. Martin. She was able to successfully get to St.

Martin and receive an MRI so that further treatment can be performed. Journal Club Every non-exam Friday, AMSA gives the opportunity for students to practice their presentation skills by presenting journal articles and research papers, giving them the

chance to have discussions on current topics in Medicine. A Part of Something Bigger A group of about 15 students visited Laborie earlier this semester for a community clinic event. The students were spilt into two groups. One to aid in checking vital signs: pulse, respiration rates, blood pressure, glucose levels and heart/lung auscultations. The second group of students were there to educate the patients and bring awareness about their ailments and to advise them about healthy lifestyles including diet and exercise. After the checkups the patients were advised to follow up with their Health Care Providers.

- Anuradha Ranganath & Tryphaena Manoharan


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Cardiac Resynchronization Therapy Health

Heart Failure (HF) Number of Affected Americans: 5 million Number of Diagnosed New Cases: 0.5 million/ year Average Age of Patients: 75

In Perspective

Heart Failure (HF) is the leading cause of hospitalization for the elderly. Incidence is similar regardless of sex; however a higher risk of HF is associated with African Americans, Native Americans, and Hispanics along with the diabetes and hypertension.

About one-third of patients with systolic heart failures have a delay in ventricular conduction, also known as Left Ventricular Dysynchrony, where QRS duration is greater than 120msec in EKG. These patients also exhibit irregular left ventricle contraction, 'CRT improves symptoms and which further quality of life, and reduces impairs the mortality in patients with pumping ability of the almoderate to severe ready symptomatic heart failure…” failing heart, ventricular filling and aggravate mitral regurgitation. The Cardiac Resynchronization Therapy (CRT), or biventricular pacing, is a T HE

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device used to correct ventricular dysynchrony. CRT uses specialized pacemaker to recoordinate the action of the right and left ventricles in patients with heart failure. Therefore, this technique restores and improves ventricular filling and contraction, resulting in better patient outcomes. Indications According to Davidson’s Principles & Practice of Medicine, CRT is effective for patients who have severe heart failure with sinus rhythm and left bundle branch block, which leads poor ejection fraction and worsening the perfusion of the heart, furthering the heart failure. The American College of Cardiology and the American Heart Association indicated that, “Patients with QRS of at least 120msec, should receive CRT, unless contraindicated.” Treatment Cardiac Resynchronization Therapy involves the placement of at least two pacing leads. The first lead goes into the right ventricle, while the second lead goes into a branch of the coronary sinus, so that it is epi-

cardially over the left ventricle. A third lead may be placed in the right atrium to optimize the timing between the atrial contractions and ventricular contractions, but this is contraindicated in patients with permanent atrial fibrillation. The main objective of CRT is to resynchronize the septal and left ventricular contractions. Outcomes The success rate ranges from 88% to 92% in various clinical trials. While the percentage of failure is relatively low, this also means that there are many patients with failed implants who must choose between undergoing the surgery again for a new implant and resigning from CRT. Additional surgery would mean prolonged recovery and higher cost along with very high risk of morbidity and mortality. Even with successful implantation of a working CRT system, some patients do not respond to CRT. [Continued on Page 10…]


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Medical Student Syndrome - Watch Out Or it Might Get You!

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32-year-old radiologist is evaluated for physical symptoms he describes as occasional twinges of mild abdominal pain, sensations of bowel rumblings, and a firm abdominal mass, which he can sometimes palpate in his left lower quadrant. He admits to being fearful of colon cancer and routinely checks his stools for blood. Having recently had extensive physical and laboratory examinations, X-ray examinations of the entire gastrointestinal tract, esophagoscopy, gastroscopy, and colonoscopy with negative results, he appears resentful and disappointed rather than being relieved. He admits to secretly performing X-rays on himself after hours at his workplace (Spitzer et. Al.,1994). What is the diagnosis? The radiologist was diagnosed with hypochondriasis, which is defined as a belief that physical symptoms are signs of illness, even when no medical evidence exists to support the presence of illness (Pubmed, 2011). Hypochondriasis-like symptoms have been identified in medical students who experienced signs associated with diseases learned in school and the symptoms may evolve to mimic diseases directly associated with course content (Hunter et. Al., 1964 &

Howes, 1999, dester, 2008).

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Although true hypochondriasis is a serious somatic illness requiring accurate diagnoses and treatment; student hypochondriasis commonly referred to as “Medical Student Syndrome” is important to note as it may cause undue anxiety in students (Puddester, 2008). Hypochondriac-like symptoms are primarily associated with first and third year medical students, and least associated with medical graduates (Puddester, 2008). The latter graduates being more comfortable in a medical environment focusing on illnesses.

“For students who can relate to associating abnormal body symptoms and self-diagnosing themselves with serious illnesses, rest assured that medical school syndrome is thought to resolve as you progress through your medical education.”

Have you ever associated disease symptoms with personal aches or pains? Is fear of having a serious illness worrying your subconscious self? You are not alone; in fact, many professional students suffer from hypochondriac-like symptoms including fear of health deterioration. Medical students perhaps have a greater awareness of illness symptoms due to the nature of their profession (Howes, 1999; Hunter et. Al.,1964) making them more prone for hypochondriasis. For students who can relate to associating abnormal body symptoms and self-diagnosing themselves with serious illnesses, rest assured that medical school syndrome is thought to resolve as you progress through your medical education. What is important is to encourage students to attend regular medical checkups to rule our health deviations, and to encourage students to express and rationalize illness related fears alleviate anxiety and normalize such experiences throughout their medical career. - Rachelle Mutch

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“Hoop It Up will go a long way in

Hoop It Up!

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he Jets reigned supreme and swept the winning trophy and a top cash prize of EC $1,500 at the 5th annual Hoop It Up Basketball tournament on October 16, 2011 in Vieux Fort. The Jets finished strongly with a score of 15-10 against a fierce team, BBC. There was never a dull moment during the duel as both teams fought hard for supremacy, displaying some dazzling performances. BBC took the second place with a prize of EC $750 , while the third place was closely followed up by Maze Sniperz, winning EC $500.

between IAU and the community of St. Lucia.”

full opportunity to check their blood pressure and blood sugar level, which was a big part of the event organized by the IAU Student Government Association (SGA). Moreover, the president of the St. Lucia Basketball Federation, Leslie Collymore, applauded the effort of IAU in hosting such a tournament and pledged that his association will continue to support the initiative in whatever way it can. After the event, all of the participants were overwhelmed with community spirit, and many players expressed satisfaction with their willingness to partici-

Ten teams, consists of people from all over the island participated in the IAUCOM’s community outreach program. During the event, spectators also had a

pate in the next tournament. IAU-COM and SGA are grateful to reach out to the community in whatever way they can. They promise to return with a bigger and a better tournament next year. Such initiative enables the citizens of St. Lucia to be aware of the school and appreciate its role in the community. Hoop It Up is an event that will go a long way in building a stronger relationship between the university and the community of St. Lucia. The school would like to thank the sponsors of the event for making it successful. “We appreciate the contribution of the sponsors very much. They play a big role in turning the event to reality.” - Nisarg Patel

Doctors, Patients and Social Networking

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ocial media while you’re in school can mean posting a complaint about an upcoming test, creating a finals week celebration or liking a comment about a photo you were tagged in with classmates. T HE

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No one can criticize that tweeting during a study session is a distraction; it’s under 140 characters and takes only a minute to let your followers know you’ve cracked the lab question at last.

But will you have to give it all up when you graduate? Do respected practicing physicians tweet their hangover details and tag themselves covered in body paint at the football game? The answer is yes and no. Doc-


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tors are respected for their knowledge and respect for the human body, so it would probably be discouraging to visit your local doctor after seeing a picture of him downing a martini at a cigar bar. As a professional with a social life, doctors can always keep separate profiles and accounts limited to family and friends by utilizing the functions of social media to restrict who has access to posts and photos. As a professional with a job to do, social media can also be a great tool to provide current patients with medical updates, build a practice by reaching new clientele and promote the medical advances and miracles that take place all while maintaining patient privacy. As a patient, we know that a doctor’s time is valuable and visits can be limited to a matter of minutes. In order to be more accessible to patients, doctors can make themselves available via social media. A gynecologist from Beaumont, TX uses Facebook and Twitter as an educational tool to dispel myths about women’s health and reduce patient anxiety. “The role is not to treat or serve as medical consultation,” said Dr. Suzanne Hall. “My goal is to act somewhat as the mediator between the information and the patient.” According to the National “Do respected practicing physicians tweet their hangover details and tag themselves covered in body paint at the football game?”

Research Corporation, almost 20% of patients use social media for healthcare information. Dr. Thomas Lee is an orthopedic surgeon in Ohio who regularly tweets, checks in on FourSquare, updates his GooglePlus profile and even has a link to his Facebook account on his business cards. Lee used Facebook to promote a fitness challenge that more than 100 people participated in by posting pictures of themselves engaged in the weekly challenges and posting updates about their progress. While social media is a great way to build dialogue between the doctor and patient, it can also work as a marketing tool to build a practice and attract patients. According to Dr. Vandna Jerath, an hour and half more at her computer each week has resulted in new patients at her Optima Women’s Healthcare Practice. “It has allowed me to show patients transparency and build credibility and build a bond with them before they even step in the door,” Jerath said. She even expects more colleagues to begin using social media. Currently, there are more than 1,300 doctors participating in TwitterDoctors.net. A post here and a tweet there in an already crammed schedule is part of practicing in a media saturated society. According to the US Hospital Social Network list, 1,229 hospitals nationwide use social media and more than 4,000 social networking sites exist such as YouTube, Facebook, and Twitter and LinkedIn accounts. A recent November surgery was the first to in-

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volve two smartphones during a hysterectomy. While the phones didn’t take part in the actual surgery, they were used to tweet the surgery in real time. “We saw it as a way to use a leading edge social media tool to showcase the leading edge medical procedures we have here,” said Jason PA pagan, marketing Manager for Rex Healthcare. Another hospital, Ohio State Medical Center tweeted a knee procedure to advertise the availability of a particular procedure as well as create an education aid for medical students who are interested in orthopedics. Twitter was also used to mark the 2000th surgery performed with the Da Vinci robotic surgery system. There are privacy concerns associated with social media. By tweeting and posting the diagnosis or treatment, the doctor or patient may unwittingly reveal themselves. Pricewaterhouse Cooper’s Health Research Institute revealed that 2012 will be an important year for re-assessing security and privacy models in health informatics and social media in the health sector. By sharing information from different health agencies, data can be converted to identify health trends and manage high risk populations among other uses. Social media outlets are increasingly adding to the data mix thus producing a need for tighter controls on access to personal information while still capturing useful statistics. While medical school students use social media such as Facebook or Twitter for personal reasons, it will become a serious point of

interest in the future. What you post today in the form of words, pictures and videos may be there when you start visiting patients in the future. Social media can act to help a physician sworn to helping others by providing information and accessibility after office hours. “These are powerful, tremendously influential tools. Doctors should be taking advantage of the opportunity,” says Kevin Pho, internist and medical blogger. Lee concludes “It’s the evolution of how we communicate with each other. And I have to remind doctors that if they think they don’t have time for this…they may be behind the learning curve and behind the times.” - Abby Ucur


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Say Cheese!

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[CRT, Continued from Page 4…] The nonresponder rate of CRT is about 25%. This can be due to poor lead placements, scar tissue interference, or even lead dislodgement.

Radiograph of CRT Device

Despite these limitations, the CRT has been proven to significantly increase the quality of life, decrease mortality and re-hospitalization rate of patients. In the MIRACLE trial, the first randomized, doubleblinded clinical trial conducted in October 1998 with 453 patients with moderate to severe heart failure, associated with an Left Ventricular Ejection Fraction (LVEJ) less than or equal to 35% and a QRS duration of 130msec, there was a significant improve-

ment in quality of life score (18 vs. 9 points; measured via the Minnesota Living with Heart Failure Questionnaire). When compared to the control group, only 8% of the patients required re-hospitalization, vs. 15%. There was also a 77% decrease in total days of hospitalization over six months, from the control group. In the COMPANION trial, which took place in early 2000, the combined endpoint of mortality and hospitalization related to heart failure was decreased by 35% for patients receiving CRT and it was further decreased to 40% for patients receiving CRT plus a defibrillator. For mortality alone, CRT patients had a 24% risk reduction compared to the controlled group; 36% for patients receiving CRT and a defibrillator.

there was a 36% reduction in mortality in patients receiving CRT. There was also a 52% difference in heart-failure related hospitalization. Conclusion Cardiac resynchronization therapy is a proven technique for patients suffering from ventricular dysynchrony and severe heart failure. Trials have demonstrated it to be a safe and effective option in the treatment of HF with significant gains in quality of life, motor function, and EKG readings. Ongoing and future clinical trials will further shape the usage of cardiac resynchronization therapy, help reduce the nonresponder rate, and perhaps expand its use to patients with asymptomatic or minimally symptomatic heart failure. - Timothy Lam

In the CARE-HF Trial,

[Fun day.., Continued from Page 1..] A majority of the residents spoke and interacted with the students in English even though English was not their first language. Talking with one of the residents, Mr. Leonard, 83 years old, he said “I’m very happy with the love shown to me today and appreciate everything the students are doing.” The managing nurse was overwhelmed with joy to see the passion from the medical students for the elderly. It was a great experience and should be

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done more often. The elderly residents living in the senior homes are often bedridden and suffer from low self-esteem. It is difficult for them to open their hearts

to total strangers. That’s why long-term commitment and regular visits should be encouraged. - Paul Ngobili


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A Trip to Remember

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he word was out, a visit to the local orphanage in Soufriere was an event to look forward to this semester. All that were interested were encouraged to attend. IAU’s Christian Fellowship raised funds, collected food and school supplies to aid the event. A couple of hours were spent at the orphanage followed by lunch at a local restaurant followed by a scenic view of Soufriere. Upon arrival at the orphanage, IAU students and a few faculty members were greeted by the orphanage. Together they all gathered in prayer led by one of our IAU student’s Ben who was an ordained pastor. Some in attend-

Neuroplasticity

ance took a quick tour of the facility while others played kick ball with the children. After two hours of an enlightening visit at the orphanage, IAU students, faculty, the children of the orphanage and their caretakers all went to have lunch at a restaurant with a breathtaking view.

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he brain is an extremely complex organ of the body with multiple regions that are highly nucleated. In particular, there are incalculable neurons connected with the help of glial cells to axons and dendrites. The question of plasticity pertaining to the brain is a complex issue. For example, if a person was to injure the medulla oblongata it is unlikely that there is any residual plasticity in the brain to repair this vital region, and in fact, the person would likely die. Yet, for other portions of the brain there is hope. The brain is capable of budding new axons as it sees fit. The hippocampus is an area of the brain that seems to exhibit neuroplasticity, yet this is not seen in patients with Alzheimer’s, primarily due to the accumulation of neurofibrillary tangles and plaques.

Everyone enjoyed a three course meal that included some of St. Lucia’s most popular dishes. This was later followed by ending the day with a visit to the Sulfur Springs. The children spent the day laughing, playing and expressing their gratitude. Many of the students expressed how this experience has made them realize how fortunate they really are and how easily things are

children have the most regenerative power when it comes to the brain. In fact, most would say that adults do not have recuperative powers when it comes to brain damage. Yet, neuroplasticity does not end with repair. The brain also has the ability to adjust to the demands of its environment. For example, the brain can be trained to improve memory and comprehension; both of which are the result of plasticity. The brain can increase the density of axons in different processing centers, such as the hippocampus via neurogenesis. There is also evidence of reorganization of the somatosensory cortex as mentioned. (Pinel, 2011). It has been understood for decades that adults can acquire the ability to perform higher math as well as learn to play instruments, both of which appeared too difficult when they were children.

It has been the consensus of the medical community that With respect to regeneration,

taken for granted. We often find ourselves complaining about the insignificant things and seeing the children from the orphanage live a simple life but being happy engrained a feeling of contentment in us. The most gratifying part of the event was being able to demonstrate the Christian Fellowship’s goal of displaying Christian love. Put a value on the trip – priceless!

- Jenny Thomas

the brain lacks Schwann cells and has to rely on oligodentrites for myelination. This is one of the reasons that the peripheral nervous system has regenerative capability, whereas the central nervous system is not as nearly as adaptive to regeneration. Mammals do not possess a high ability to regenerate damaged neurons. (Pinel, 2011) yet the neurons in the human olfactory system have the ability to regenerate. In conclusion, the adult brain is not very plastic when it comes to injury or disease; however, it does have the ability to adjust to its environment by adding additional processors in specific regions that are being accessed at a higher rate than normal. We adults can learn and adapt to new environments due to the neuroplasticity of our brains. - Cary Bybee


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The Multiple “Pearsonalities” of Pyrus

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ears belong to a family of flowering plants known as Rosaceae. This family of plants includes pears, apples, cherries and several other fruits. The pear skin typically appears yellow and at times a blushed pale red. It is sweet, succulent and aromatic; ideal for salads, eating fresh and is excellent for cooking. Pears contain no cholesterol, sodium or saturated fat. They contain two important monosaccharides: Glucose and Fructose. Moreover, pears also have Levulose which is considered the sweetest natural sugar. Fresh pears offer about 210mg of potassium per serving which makes them a good source of Potassium required for maintaining proper heartbeat and muscle contraction. Fresh pears also provide about 10% of the recom-

Blood Pressure: Pears have anti-oxidant and anti-carcinogen glutathione, which help prevent high blood pressure and stroke. Cancer Prevention: The high vitamin C and copper content act as good antioxidants that protect cells from damages by free radicals. Cholesterol: The high content of pectin in pears make it very useful in helping to lower cholesterol levels. Colon Health: When not juicing, eat the pear whole for its precious fiber that are highly beneficial for your colon health. Constipation: The pectin in pears is diuretic and have a mild laxative effect. Drinking pear juice regularly helps regulate bowel movements. T HE

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mended dietary allowance (RDA) for Vitamin C. This property makes pears a good source of antioxidants, which protects the body against free radicals produced as a byproduct of the body’s normal metabolic process. In addition, it boosts the immune system and promotes healing from cuts and bruises. Pears are also considered a great source of dietary fibre mostly in the form of Pectin (40%), which is a soluble dietary fibre. This property makes pears a great laxative and may help reduce cholesterol and the risk of colon cancer. Studies have shown that people with food allergies may benefit greatly from pears because they are low in salicy-

late and benzoate. Both of these substances are known to induce reactions such as urticaria, asthma and angioedema. Furthermore, it is useful in treating inflammation of mucus membranes, colitis, chronic gallbladder disorders, arthritis and gout. Not only is it a delicious fruit to consume, it has numerous nutritional as well as medicinal values, which makes it a great food to consume on a regular basis. - Soheil Souri

Energy: You can get quick and natural rosis. source of energy from pear juice, due Pregnancy: The high content of folate largely to its high amounts of fructose (folic acid) prevents neural tube defects and glucose. in infants. Fever: The cooling effect in pear is exShortness of Breath: The summer heat cellent in relieving fever. Best way to may cause children to have shortness of bring a fever down quickly is by drinking breath with excessive phlegm. Drink a big glass of pear juice. pear juice during this period to help clear Immune Booster: The anti-oxidant nu- the phlegm. trients in pears are critical in building up Throat Problem: The pears are in seayour immune system. Drink pear juice son during the summer for a reawhen you feel a cold coming. son. Drinking pear juice every morning Inflammation: Pear juice has an anti- and night helps to cool your body down inflammatory effect and helps relieve during this time. It nourishes the throat sufferers of much pain in various inflam- and helps prevent throat problems. matory conditions. Vocal Chord: Boil two Chinese pear Osteoporosis: Pears contain high level juice with some raw honey and drink of boron. Boron helps the body to retain warm. This is extremely healing for the calcium, thus prevents or retards osteopo- throat and the vocal cord.


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Food break...

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hat should I eat for dinner tonight? Even though you can calculate the functional residual capacity of the human lung, at times this question seems to be more challenging. It is hard to find time in the busy schedule of a medical student to eat a balanced diet and have access to a variety of meal options, especially in the Caribbean. But eating KFC or Domino’s for lunch every day is not the answer. Here are some quick, medical student-friendly ideas for meals when time is not on your side. Please note, all of the ingredients to these recipes can be found down the street at good old Super J.

Pita Pizza

Olives Feta cheese (or whatever type of shredded cheese you can find) Ragu pizza sauce (if you can’t find pizza sauce, regular tomato pasta sauce will work just fine)

3 ounces of your favorite type of cheese (or whatever type you could find at Super J) 1 thinly sliced tomato Ground pepper ½ cup of basil leaves

Directions: Spread the pita with the pizza sauce. Cover it with feta cheese and place sliced olives on top. Bake the pizza for 5 minutes on low heat or until cheese is melted. The toaster oven in the IAU cafeteria is perfect for making these.

Directions: Heat a nonstick pan over medium heat. Coat one side of all 4 slices with the margarine. Place two bread slices, buttered side down, on the pan. Top with cheese, then sliced tomato, pepper and fresh basil leaves. Top with the remaining two bread slices (buttered side up). When bottom side is golden (2-3 minutes), flip sandwiches over and grill until other side until golden (2-3 minutes). Cut each sandwich and serve.

The-Best-Grilled-Cheese-You’ve-Ever-Had Ingredients: 4 slices of bread (this recipe serves 2…so be nice to your roommate today) 2 teaspoons margarine

- Elizabeth Pollock

Ingredients: 1 pita (you can also use a bagel or tortilla wrap)

Mark Dukshtein’s Shrimp Po Boy Ingredients (serves 4): 20-25 large, uncooked shrimp ¾ cup cornmeal ¾ cup flour 1 tablespoon Cajun seasoning 1 teaspoon salt 2 eggs, beaten Peanut or vegetable oil for frying 1 tablespoon cayenne pepper 4 Sandwich rolls 2 tomatoes ½ head of lettuce For the sauce: ¼ cup mustard, preferably Dijon or Creole 1 ¼ cup mayo (a small size jar is usually enough)

1 teaspoon pickle juice (vinegar is okay) 1 teaspoon hot sauce (Tabasco, St.Lucia DAM Hot for extra spice) 1 tablespoon paprika 1 tablespoon Cajun seasoning 1 teaspoon jalapeño juice Directions: For the remoulade, mix all the ingredients together in a bowl and set aside for 30+ minutes (the longer you wait the better the sauce will be; do NOT refrigerate right away). Set up two bowls, one with the beaten eggs, and one mixed with the flour, cornmeal, Cajun seasoning, salt and cayenne pepper. Dump all the dry ingredients in a zip-lock bag and shake

well. Next, remove the tails and de-vein the shrimp. The easiest way to do this is to slice the shrimp from the head to the tail down the middle so the shrimp form a butterfly shape. Set your stove on medium heat and add enough oil to fill approximately ¼ inch of the pan. Sprinkle some flour in the pan and when it starts to fizzle, you are ready to fry your shrimp. Take the shrimp, dip them in egg and tap off any extra egg drippings. Coat your shrimp in the cornmeal-flour mixture on all sides. Fry the shrimp for about 2-3 minutes on each side, until they are a yellow-brown color. Once the shrimp is cooked, assemble your sandwich, apply sauce, and enjoy!


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Fun Page !!! Pipe Burst in a Doctor’s House A pipe burst in a doctor’s house. He called a plumber. The plumber arrived, unpacked his tools, did some mysterious plumber-type things for a while, and handed the doctor a bill for $600. The doctor exclaimed “This is ridiculous, I don’t even make this much money!” The plumber replied, “Neither did I when I was a doctor.” “Correct. And in the case of a cardiac arrest, every second counts. Who can tell me why? Anyone? Clock’s ticking.”

ANN’S SUDOKU

“It’s OK, this is a teaching hospital. Some people just have to learn that the hard way.”

T HE

SYNAP SE


ISSUE

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Memoirs of

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First Taste of a “Mini” Exam

Medical School

L

ooking back at my first semester, one of the most memorable moments was the day of my first

mini. Unlike my undergraduate school, which had one giant, final exam at the end of the semester so that students stay enrolled, pay for the course, and fail miserably, IAU provides us with frequent feedbacks on student’s academic progress in a torturous form of bi-weekly “mini” exams. Before I share my past experience, I must clarify the meaning of "mini" in St. Lucia - I ordered mini French fries, and it was not mini! Similarly, my first semester “mini” exam lasted 4 hours, and I don’t consider that mini. Even though we knew that it was “only” a first mini exam, which was supposedly

wanted to do well. You know, getting the first footstep right was important for all us. We all studied hard. A couple of us stayed in the library until midnight and pretty much lived off of Domino’s pizza. Surprisingly, I had constant diarrhea in spite of my fiber-deficient diet. Really, I didn't remember studying that hard for my undergrad exams. But it felt good. It felt good to bond with my colleagues, to share the excruciating regret of not memorizing materials on a daily basis; it felt good to console each other by quizzing each other, and to taste the bitterness of confusing blood vessels and nerves. Seriously, why would the same artery/vein/nerve have different names? Is it like raisins and grapes, or prunes and plums? I suppose different names of arteries for different regions may be useful for surgery.

Seeing my colleagues studying motivated me and it felt good. We all studied until we started hallucinating roads as anterior and superior divisions of brachial plexus on our way back home. Now I am in the second semester, about to grind hard for NBME, while I am still recovering from Dr. James’ biochemistry marathon. What is a better way to recover from the week's exhaustion other than to have a can of Monster? Stay motivated and work hard like you did for the first mini - NBME is just around the corner. Let us remember the attitude and the goal that we set in the beginning of this semester. Let us finish this long marathon strongly and taste the sweet nectar of triumph! - Ann Kwon

IAU in the Spotlight! We’ve Been Making News... Thanks to the overwhelming success of all the endeavors we undertook in the last few semesters, IAU has constantly found a place in the news. Our Blood Drive and our Student Mentor Day, amongst many other events, received stupendous support from the media. Here is a collage of a few of the coverage we’ve garnered. If you wish to read these articles in detail, please visit the IAU website Additionally, they are also available at the websites of the leading St. Lucian newspapers, St. Lucia Star and The Voice.


References

Howes, O. (1999). Hypochondriasis: an overview with reference to medical students. StudentBMJ, 7: 394-436.

Pg. 5 MTS- http://blog.lib.umn.edu/ nordv009/myblog/medical% 20student%20syndrome.jpg

Neuroplasticity

Hunter, R., Lohrenz, J., & Swartzman, A. (1964). Nosophobia and hypochondriasis in medical students. Journal of Nervous & Mental Health, 130 (2): 147-152.

Pg. 8 CRT-http:// www.daviddarling.info/encyclopedia/P/ pacemaker.html

Pinel, John P.J. Biopsychology. 2011. Boston, MA. Allyn and Bacon Cardiac Resynchronization Therapy Does cardiac resynchronization therapy improve survival and quality of life in patients with end-stage heart failure? http://www.ncbi.nlm.nih.gov/ pubmed/18541605 Hosenpud, Jeffrey D. Congestiv heart failure. Chapter 36: Biventricular Pacing in Congestive Heart Failure. Boon et al: Davidson’s Principles & Practice of Medicine. 20th Edition. Chapter 18: Cardiovascular diseases: http://www.studentconsult.com/ content/default.cfm? ISBN=9780443100574&ID=HC01816 9 Medical School Syndrome

PubMed Health. (2011). Hypochondriasis. Accessed on June 9, 2011 from www.ncbi.nlm.nih.gov/ pubmedhealth Puddester, D. (2008). Imagined illnesses. CMAJ, 178(7): 819-820. Spitzer, Gibbon, Skodol, Williams, & First. (1994). Psychology in action. Diagnosis and Treatment of Mental Illness. Chapter 11. Pp 1-3 Pictures reference Pg. 3 Amsa picture from amsa.org Pg. 4. HIP-http:// media.photobucket.com/image/ recent/Mbuur/Raised-finger.png

Pg 10. Pyrus http:// upload.wikimedia.org/wikipedia/ commons/6/68/Pyrus_Boscs.jpg Pg 11. Neuroplasticity- http:// margiewarrell.com/wp-content/ uploads/image01.jpg Pg 13. Food Break -http:// static.freepik.com/free-photo/stockicon-hungry-emoticon-vector_189937.jpg Pg.14. Fun Page - http://api.ning.com/ files*hLrdHIcJh2BkPx9se6H4wQGE4c PPC5XBX8XP8lPqIhtw7eVX4UYGe H-0sOo-Irm8pvfqwGPraKdwrLPeNir -9kU2v8S09s LAug ing_Face_bigger1.gif

International American University College of Medicine

St. Lucia Campus 3rd Floor Daher Building Vieux-fort, St. Lucia, WI Phone: 758-454-3421 to 24 Fax: 758-454-3425

U S Office 5999 Summerside Drive, Suite 220 Dallas, Texas, USA 75252 Phone: 9724849700 Fax: 9724849970 Website: http://www.iau.edu.lc

Editor-in-Chief Co –Editors

Charles Vining

Himashini Parera, Ann Kwon, Elizabeth Pollock

Staff and Faculty Advisors

and Omoyeme Edaki

Ninitha Hamza Koya Sibi Gopalakrishnan Sulal Mathai James Villanueva

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