Medical Review Journal Issue 4 (February 2024) ECIM

BRINGING INNOVATION TO LIGHT

Medical

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Review Journal Issue 4 - February 2024 Journals Featured from the members

Update On what has happened in the past months

Contents Introduction Editor’s Note Committee Hierarchy

Journals Side Effects and Potential dangers of not drinking water - Jordan How placebos affect people and their bodies - Elliot ADHD - Young Balanced Diet - Jesslyn Chemotherapy & how it affects the body - Laekeisya Dextrocardia - Carvy Eating Disorder - Bianca Lung Disease - Khai Zhe How to Improve Eyesight - Rin Healthy Tooth Guidebook - Damon Clinical Trial - Young Depression - Young

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Benefits of Donating Blood - Kheeshan Clean Reps, Healthy Steps - Brayden Importance of Vaccination - Stella Diabetes - Sunny Radiation Therapy - Hung Placebo Effect - Jia Xin Childhood Cancer - Crystl Fentanyl - Steven

Updates Enrolling of new members Presentation: Mental Wellness in the Modern World CPR & First-Aid Education at the Nursing House Presentation: Addiction: Why it’s hard to stop

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Editor’s Note Welcome to the 4th Issue, February 2024 Journal from the Medical Review Society

Hello Everyone!! This is Young, the current president of the Medical Review Society and an editor of our society’s 4th journal.

Our society was established in February of 2021 and this journal will be the memorial of the 3rd anniversary of our society.

However, it is an honour to publish our new journal containing our members’ research on various topics and events we held together.

So, please enjoy reading our journal! :) 2024.02.04

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Young-Gyoum Park

Medical Review Journal

Committee Hierarchy President Young-Gyoum Park Vice President YeJun (Damon) Yoon

Journal Department

Core Action Team

Khai Zhe Lim Bianca Lim Carvy Ooi Jia Yee

BRAYDEN SHIU NAM HO

Graphic Design Team

DAIDUY HUNG NGUYEN JIA XIN LEE

Noelle Maryam Savarimuthu Rin Ueda

Emilly Lau Jie Yee JESSLYN HUEY QI ENG YEON-WOO (STELLA) CHO YUNSEON (SUNNY) LEE

Ad & Public Relations Department

CRYSTL ANN MANISHA LAMA

Kheeshan Karpal Singh Deo Yunseo (Steven) Lee

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Jordan

iety Medical Review Soc

How placebos affect people and their bodies

#1. What is a placebo?

Placebos are a medical practice of giving a patient "fake" treatment often not having any real active substances inside

#2. How are placebos used?

Researchers may use placebos to "test" new drugs on patients but they are given a sugar pill. But patients don't know it's a sugar pill and results show that they belive the medicine given works and they feel better

#3. How do they work?

Researches believe that as long as the person believes that the treatment will have a positive effect on them it will work as their brain can send out endorphins to relive pain

#4. Are there negatives?

No. As long as the person does not require any real medical help placebos will not affect people physically negatively, unless they belive it will be bad for them then they may feel nauseas

#5. The benefits It allows doctors to give patients that belive they have a problem but don't pills that cost little to none so it costs cheaper for the patients and it allows them to feel better

Elliot

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Young

THE IMPORTANCE OF A

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BALANCED DIET

Jesslyn

WHAT IS2IT?

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Having a balanced diet gives your body the correct nutrients to function correctly. This includes eating protein, fats, carbohydrates, vitamins and minerals In suitable amounts

5 A DAY Fruit and vegetables are a good source of fibre, vitamins and minerals. and should make over a thrid of what you eat everyday. 5 portions is recommended ofr a variety of fruits or vegetables and it can be juiced, canned,frozen or dried

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HOW? Learning how to have a balanced diet is crucial to our health. This is why we should familiarise ourselves with the food pyramid as well as have annual checkups to ensure your body is healthy. a good way to portion our plate eating a hand size of furits or vegetables, a palm size of carbs and protein and a thumb size of fats

4 DEFICIENCY DISEASES A lack of certain nutrients can also lead to many different deficiency diseases such as rickets and anaemia. this causes many side effects that can hinder your quality of life.

LIMIT SATURATED FAT, SALT AND SUGAR Too much saturated fat increase the amount of cholestrol in yur blod which can lead to heart disease. High sugar diet can lead to tooth decay and obesity. excess amounts of salt can raise blood pressure and cause strokes.

Chemotherapy 10

& ho

Chemotherapy is the use of strong drugs to d systemic treatment because the drugs travels th spread (metastasised) to parts of t

OVERVIEW

While chemotherapy drugs are powerfu kill rapidly growing cancer cells, they ca healthy cells. This may cause a variety o

Intramuscular Injection (IM): The drugs are d shot directly into muscle in your hip, thigh, o fatty part of your arm, leg, or stomach, just b Intra-arterial (IA): The drugs go directly into th feeding the cancer, through a needle, or soft, th Intraperitoneal (IP): The drugs are delivered t cavity, which contains organs such as your li stomach, and ovaries. It is done during surge tube with a special port that is put in by y Intrathecal (IT) chemotherapy: Medicine is in cerebrospinal fluid (CSF), which is found surrounding the spinal cord and the Intravenous (IV): The chemotherapy goes dire Topical: You rub the drugs in a cream form Oral: You swallow a pill or liquid that ha

HOW IS CHEMOTHERAPY ADMINISTERED?

ow it affects the body

Medical REVIEW JOURNAL

destroy cancer cells in the body. Chemo is considered a hroughout the body, and can kill cancer cells that have he body far away from the original (primary) tumor .

ul enough to an also harm f side effects:

hair loss mouth sores lower blood cell count digestive distress decreased urination livered with a red urine arm, or in the bone loss neath the skin. poor coordination and tired muscles he artery that is n tube (catheter). swollen hands and feet the peritoneal brain fog ver, intestines, anxiety and depression y or through a hot flashes and menopause your doctor. weak heart njected into the n the area nausea and vomiting brain. discoloured and cracked nails ctly into a vein. loss of appetite nto your skin. sexual dysfunction the drugs. skin sensitivity SIDE EFFECTS Author : Laekeisya Rao

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Dextrocardia What is dextrocardia?

Types of dextrocardia:

Isolated dextrocardia Dextrocardia situs inversus Dextrocardia situs inversus totalis Dextrocardia with heterotaxy Dextrocardia and other congenital heart defects Tetralogy of Fallot Pulmonary stenosis Dextrocardia and Kartagener syndrome

In dextrocardia, the heart is positioned on the right side of the chest instead of its normal position on the left side.

Dextrocardia on its own does not usually cause problems, but it tends to occur with other conditions that can have serious effect on the hear, lungs and other vital organs.

Dextrocardia Symptoms:

Breathing problems Cyanosis (bluish skin due to not enough oxygen in the blood) Failure to grow and gain weight Fatigue, especially when feeding Frequent sinus or lung infections Jaundice (yellow skins and eyes) Pallor (very pale skin)

Can a person live with dextrocardia?

A person can live with dextrocardia for a long time, but the outlook varies based on other diagnoses.

Babies born with isolated dextrocardia (no defects or syndromes) have a normal life expectancy.

However, babies born with heart defects or genetic syndromes may need treatments or surgeries to manage those conditions.

Carvy

EATING DISORDERS What is it?

Eating disorders are serious health conditions that affect both physical and mental health. If not treated effectively, it could cause long-term problems, and in some cases, death. The most common eating disorders are anorexia, bulimia and binge-eating disorders.

How does it happen?

Family History Frequent dieting and starvation eating disorders are symptoms of starvation, which affects the brain and can lead to mood swings, anxiety, and most commonly, reduced appetite can be caused by stress, and, or bullying

Types of Disorders Anorexia unhealthy low body weight, intense fear of gaining weight, and a view of weight and shape that is not realistic including cutting out limiting calories, and/or vomiting after eating.

Bulimia episodes of bingeing, followed by episodes of purging. involves being pre-occupied with weight and body shape, with severe and harsh selfjudgment of personal appearance Binge-eating disorder eating food in a short amount of time. ( not followed by purging ) feel guilty, disgusted, and ashamed after eating, which leads them to limit their food Avoidant/restrictive food intake disorder extremely limited eating, or not eating certain foods may lead to problems with growth, development, and functioning in daily life. don’t fear gaining weight or body size, instead, they fear what it may do to them, or not interested in eating common in younger children

Statistics of People Who Have Disorder 2.7% of teens will experience an eating disorder in their lifetime.

13% of adolescents will develop an eating disorder by the age of 20.

3.8% of female, and 1.5% of male, adolescents will struggle with an eating disorder.

Prevalence rates of eating disorder diagnoses increase with age. .3% to .6% of adolescents will struggle with anorexia nervosa. .9% of teens will be diagnosed with bulimia nervosa.

1.6% of teens will engage in binge eating disorder symptoms and behaviors.

5 to 22.5% of adolescents will be diagnosed with Avoidant Restrictive Food Intake Disorder (ARFID).

In a study conducted by the Youth Risk Behavior Surveillance System (YRBSS), “6.2% of girls and 2.8% of boys reported vomiting or taking laxatives in the past month to lose or maintain weight.”

When to see a doctor

If you have problem eating behaviors that cause you distress or affect your life or health, or if you think you have an eating disorder, seek medical help.

PRESENTED BY: Bianca

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14 LUNG DISEASES

An insight to a vital organ and its problems

Khai Zhe

Bronchitis When the bronchial tubes of the lungs get inflamed (mucus is also present) Tubercolosis Contagious form of lung disease (E.g: by coughing) This disease is caused by a bacteria called Mycobacterium tuberculosis

Emphysema A lung condition that enlarges the alveoli (air sacs), damaging it and causing shortness of breath

How To maintain your

Eyesight Give your eyes rest If you spend time at the computer or focusing on any one thing, you sometimes forget to blink and your eye can get fatigued. So try to look away about 20 feet in front for 20 seconds.

Maintain your blood pressure level You can increase the number of red blood cell by eating foods in key nutrients. Such as seafoods and eating red meats.

Rin

Maintain a healthy weight Being overweight or obese increases your risk of developing diabetes and other conditions which can lead to vision loss.

Clean your hands before you put your contact lenses To avoid the rick of infection always wash your hands to prevent bacteria to enter.

Quit smoking Smoking is bad for your eyes and rest of the body. It will increased rick of developing age-related mascular degeneration and optic nerve damage.

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HEALTHY TOOTH GUIDEBOOK

HYGIENE

Damon

Probably the only, and the best way to have a healthy teeth is to brush them frequently, at least twice a day.

Furthermore, the use of floss or mouth washing liquid could help keeping your oral environment clean.

DISEASES

Neglecting oral hygiene leads to the development of bacteria on your tooth, which will gradually eat away your teeth and cause cavity.

Cavity can cause you intense neuralgia, and can severely disturb your daily life,

SYMPTOMS When a teeth experience a cavity, it will be sensitive to hot or cold foods, or when you’re chewing on a hard food.

Tooth cavity can also be shown by having a bad breath.

PREVENTION In addition to brushing your teeth daily, it is good to limit the consumption of sweets or any extremely hard foods.

Regularly visit a dentist who will examine each tooth and treat it before it starts any cavity develops excessively.

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18 CLINICAL TRIAL Process of Clinical Trial

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Phase 0 trials: Pharmacodynamics and pharmacokinetics An exploratory phase that helps provide clinical information for a new drug at an earlier phase.

This phase: is conducted early in phase 1 involves very limited human exposure has no therapeutic or diagnostic intent, being limited to screening and microdose studies

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Phase 1 trials: Screening for safety After phase 0, there are four more phases of trials in humans. These often overlap.

Phases 1 through 3 take place before a license is granted.

Phase 1 guidelines involve: between 20 and 80 healthy volunteers verification of the most frequent side effects of the drug finding out how the drug is metabolized and excreted

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Phase 2 trials: Establishing effectiveness If phase 1 studies do not reveal unacceptable toxicity levels, phase 2 studies can begin.

This involves: between 36 and 300 participants collecting preliminary data on whether the drug works in people with a certain disease or condition controlled trials to compare those receiving the drug with people in a similar situation who are receiving a different drug or a placebo continued safety evaluation studies of short-term side effects

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Phase 3 trials: Final confirmation of safety and effectiveness If phase 2 has confirmed the effectiveness of a drug, the FDA and sponsors will discuss how to conduct large-scale studies in phase 3.

This will involve: between 300 and 3,000 participants gathering further information on safety and effectiveness studies of different populations examining various dosages to determine the best prescription amount using the drug in combination with other drugs to determine the effectiveness After this phase, the complete information on the new drug is submitted to the health authorities.

Review meeting If the FDA approves the product for marketing, post-marketing requirements and commitment studies are conducted.

The FDA uses these studies to collect further safety, efficacy or optimal use of information about the product.

WHAT IS DEPRESSION? Young-Gyoum Park A common and serious medical illness that negatively affects how you feel, the way you think and how you act

Types of Depression Anxious distress Mixed Features Melancholic Features Atypical Features Psychotic Features Catatonia Peripartum Onset Seasonal Pattern

Treatment: Psychotherapy : treating depression by talking about your condition and related issues with a mental health professional Identify negative beliefs and behaviors and replace develop positive interactions with others Find better ways to solve problems Regain a sense of satisfaction and control in your life Learn to set realistic goals for your life Develop the ability to tolerate and accept distress using healthier behaviors

Other Disorders That Cause Depression Symptoms Bipolar I and II disorders Cyclothymic disorder Disruptive mood dysregulation disorder Persistent depressive disorder Premenstrual dysphoric disorder Other depression disorders

Treatment: Medications Selective serotonin reuptake inhibitors (SSRIs) Serotonin-norepinephrine reuptake inhibitors (SNRIs) Atypical antidepressants Tricyclic antidepressants Monoamine oxidase inhibitors (MAOIs)

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Kheeshan

Brayden

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22 Vaccination IMPORTANCE OF

Stella

What is vaccination?

Vaccination is a crucial aspect of public health, preventing the spread of infectious diseases and safeguarding communities. Explore the vital role of vaccination in maintaining a healthier world

How does it work?

When a person is vaccinated, the immune system is exposed to harmless pieces of the pathogen, such as proteins or weakened viruses. This exposure triggers the immune system to create antibodies and develop immune memory, enabling a faster and more effective response if the person encounters the real pathogen.

Vaccine Myths vs. Facts

Vaccine Side Effects

Vaccines Contain Harmful Ingredients Fact: Vaccine ingredients are carefully selected to ensure safety and efficacy. Common components include weakened viruses or bacterial proteins, stabilizers, and preservatives in minimal amounts.

Extensive testing is conducted to ensure the safety of each vaccine.

Vaccine Myths vs. Facts Natural Infection Is Better Than Vaccination Fact: Natural infection can lead to severe illness, complications, and, in some cases, death. Vaccination provides a safer way to build immunity without the risks associated with the diseases themselves. It also helps prevent the spread of infectious agents within communities.

Common side effects of vaccines are usually mild and short-lived. These may include: Pain or Swelling: at the injection site.

Fatigue or Mild Fever: as the body builds an immune response.

Headache or Muscle Pain: temporary discomfort that resolves quickly.

Vaccine Myths vs. Facts Once Vaccinated, There's No Need for Boosters?

Some vaccines require booster doses to maintain immunity over time. Boosters help strengthen and prolong the effectiveness of the immune response. Staying up-to-date with recommended booster shots is essential for long-term protection.

Success Stories Smallpox Eradication Perhaps the most significant success in the history of vaccination was the complete eradication of smallpox.

Through a global vaccination campaign led by the World Health Organization (WHO), the last known natural case of smallpox occurred in 1977, and the disease was officially declared eradicated in 1980.

Conclusion: Empowering Communities through Vaccination Vaccination is the cornerstone of public health, providing a proven defense against infectious diseases.

By dispelling myths, understanding potential side effects, and celebrating successes, we empower communities to make informed choices. Together, let's embrace the power of vaccination, shaping a future where preventable diseases are rare, and global health thrives.

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INNOVATIONAL TREATMENTS Novo Nordisk’s innovational Ozempic and Wegovy Denmark’s pharmaceutical company, Novo Nordisk, has introduced their brand new and sensational remedies.

Wegovy a weekly injection which stimulates insulin to release, lowers the blood glucose level Ozempic an injectable treatment for type-2 diabetes ← reduces appetite Additional Advantages Also reduces the potential of stroke and heart attack Further impacts Discouraging other food company’s profit (e.g. Pepsi, Cocacola, or other zero calorie food companies) Use of fuel ← decreases the fuel cost of airport and other transportation It impacts the entertainment industry ← reduces the desire to drink/smoke

DESCRIPTION A type of cancer treatment uses high doses of radiation (gamma rays) to kill cancer cells and shrink tumors. it damages the cell by destroying the DNA beyond repair so it is unable to divide itself

FACTORS AFFECTING TREATMENT

FOLLOW UPS You might have regular follow up appointments at the radiotherapy department or at your original hospital. How often you go varies from one hospital to another. But as you recover from the treatment you won't need to go so often.

there are a lot of factors that can affect treatment such as: type of cancer, size of tumor and its location as well as age

RADIATION THERAPY HOW RADIOTHERAPY WORKS

RISKS Hair loss at treatment spot difficulty swallowing and breathing Nausea, vomiting, diarrhea Dry mouth, thickened saliva, sore throat

a machine aims high-energy beams into your body called a linear accelerator. the linear accelerator moves around you. It delivers radiation from several angles

SCANS

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The therapy team will use scans to map out your custom radiation plan.

These might include CT scans or MRIs. During these scans, you will lie in the treatment position wearing the mask or mold made for you.

Hung

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THE PLACEBO EFFECT AKA THE “DUMMY” EFFECT

Jia Xin

WHAT IS THE PLACEBO EFFECT? Placebo” in Latin means “I will please”. It refers to a medication that is expected to be real, however in reality it has no therapeutic effect.

It is often used as a control in drug testing trials.

HISTORY OF PLACEBOS The use of placebos can be traced back to ancient healing practices, where rituals and ceremonies are held alongside the intake of substances with no known therapeutic effect, believing that they have healing powers.

HOW DOES PLACEBO EFFECT WORK? The placebo effect normally can have a psychological impact on the patient. It helps by involving the mind to influence the body to release chemicals that can result to pain relief and improved symptoms.

？

HOW ARE PLACEBOS USED NOWADAYS

Placebos are now used in double-blind trials to eliminate bias and to act as a control so that the true efficacy of a new treatment can be assessed.

COMPOSITION OF PLACEBOS Placebos are normally designed to be inert, such as: Sugar pills Inert inhalers Saline solution (Sterile salt water) Sham surgeries ( making incision without actually performing surgery)

CONCLUSION The placebo effects showcases the interplay between the mind and body.

The power of belief and positive mindsets in influencing health outcomes are shown, leading to real physiological improvements.

Crystl

Childhood Cancer TYPES OF CANCER FOUND IN CHILDREN CANCER IS A LEADING CAUSE OF DEATH IN ALL CHILDREN AND ADOLESCENTS. EACH YEAR, AROUND 400,000 CHILDREN BETWEEN THE AGES OF 0 AND 19 YEARS OLD DEVELOP VARIOUS FORMS OF CANCER, AS STATED BY THE WORLD HEALTH ORGANIZATION (WHO). HOWEVER, THERE ARE THREE CANCERS THAT ARE MOST COMMONLY FOUND DEVELOPED.

LEUKEMIA LEUKEMIA IS A TYPE OF CANCER THAT AFFECTS THE BLOOD AND BONE MARROW. IN A HEALTHY BODY, BLOOD CELLS ARE PRODUCED IN THE BONE MARROW, BUT IN LEUKEMIA, THERE IS AN ABNORMAL INCREASE IN THE NUMBER OF WHITE BLOOD CELLS. THESE ABNORMAL CELLS CROWD OUT NORMAL BLOOD CELLS, AFFECTING THE BODY'S ABILITY TO FUNCTION PROPERLY.

BRAIN AND OTHER CENTRAL NERVOUS CANCERS BRAIN AND CENTRAL NERVOUS SYSTEM TUMORS IN CHILDREN ARE ABNORMAL GROWTHS OF CELLS IN THE BRAIN OR SPINAL CORD. SYMPTOMS MAY INCLUDE HEADACHES, VOMITING, AND CHANGES IN BEHAVIOR. TREATMENT OFTEN INVOLVES SURGERY, CHEMOTHERAPY, AND RADIATION. EARLY DIAGNOSIS AND ADVANCES IN TREATMENT HAVE IMPROVED OUTCOMES FOR MANY PEDIATRIC PATIENTS.

LYMPHOMA LYMPHOMA IN CHILDREN IS A TYPE OF CANCER AFFECTING THE LYMPHATIC SYSTEM. IT OFTEN PRESENTS AS PAINLESS SWELLING OF LYMPH NODES. TREATMENT INVOLVES CHEMOTHERAPY AND SOMETIMES RADIATION. WITH ADVANCEMENTS IN THERAPY, THE PROGNOSIS FOR PEDIATRIC LYMPHOMA HAS SIGNIFICANTLY IMPROVED, LEADING TO HIGHER SURVIVAL RATES.

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Gold Ribbon Hero: Eileen

BACKGROUND

AFTER COMPLAINING ABOUT INTENSE STOMACH PAIN AND A LOW FEVER IN MID-SPETEMBER 2021, EILEEN, A SIX-YEAR OLD, WAS TAKEN TO THE EMERGENCY ROOM TO BE EXAMINED. SHE WAS THEN DIAGNOSED WITH TCELL NON HODGKINS LYMPHOMA. THIS MEANT THAT EILEEN HAD TUMOURS IN HER BODY THAT STOPPED HER FROM FIGHTING OFF DISEASES AND DISPOSING OFF TOXINS IN HER BODY.

EILEEN AND HER PARENTS WORKED CLOSELY WITH THE HEALTHCARE TEAM AT HER LOCAL HOSPITAL TO FACILITATE HER CARE. SHE HAS SINCE UNDERGONE CHEMOTHERAPY AND HER CONDITION HAS IMPROVED RAPIDLY.

CURRENTLY

WHEN HER DOCTOR WAS INTERVIEWED IN EARLY 2022 ABOUT THE RECOVERY OF EILEEN, THEY HAD COMMENTED THIS.

“Eileen’s has been fighting the good fight for 8 months now. We’ve had many ups and downs, but she always braves every single chemo, procedure, clinic visit, port access, and shots with a huge smile (after a few tears.)”

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Fentanyl What is Fentanyl?

Fentanyl is a powerful synthetic piperidine opioid primarily used as a painkiller.

Its primary clinical utility lies in pain management in cancer patients and patients recovering from painful surgery.

Fentanyl is also used as a sedative.

About Fentanyl In 1959, Fentanyl was developed

by Mr Paul Janssen.

Fentanyl is 50 times more potent than heroin and 100 times more potent than morphine.

When you take multiple doses of fentanyl, your brain adapts to the d ug, decreasing your sensitivity and making it difficult to feel pleasure from anything other than the d ug.

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Overdose and Symptoms Fentanyl and other synthetic opioids are the most common d ugs associated with overdose deaths.

More than 150 people die eve y day from overdoses involving synthetic opioids such as fentanyl.

Falling asleep or losing consciousness Slow, weak, or no breathing Choking Limp body Discolored skin

Clammy skin

Steven

Bringing Innovation to light

For more Journals, Journal 1

Journal 2 Journal 3

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Share our recent Bringing Discovery to Light : Demonstrate Passion in Science & Medicine Unlock Unrealised Skills & Values Future Collaboration

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Medical REVIEW JOURNAL

stories

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Enrolling of New Members

19th of September, 2023

“Medical Review Society provides excellent opportunities to those who want to pursue their studies in medicine-related courses. “ “We were able to successfully introduce Medical Review Society towards future doctors during the Society Fair, and also intrigued few teachers.”

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Damon Yoon

Mental Wellness in the Modern World

24th of November, 2023

“It is quite difficult to maintain mental health.

However, in this tough world, some factors would help you mentally more stable as well as cultivate your resilience and navigate the challenges you might have; For example, Kindness”

Young-Gyoum Park

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CPR & First-Aid Education at Nursing House Little Flower Learning Centre

25th of November, 2023 Hello! My name is Stella, and I would like to explain the cpr project we ran last year. I worked at RCY (Red Cross Youth) for 3 years, where I gained a lot of experience in first aid and CPR. Also, due to my personal passion for CPR, I obtained my own certification.

Now that I am in my senior year, I was looking into what I could do as a member of the Medical Review Society, and I used my experience to visit a nursery school in Malaysia, hoping to be of some help to children in poor educational environments.

Recognizing that they were still too young to properly perform CPR, we told them what they could do if a patient had a heart attack. Our main aim was to teach them that falling into panic is not helpful at all. We taught the children through acting how to find an AED, and how to call 911 with necessary information. We also had time to form groups of children and have them recreate it themselves. Planning these classes was a very unique experience for our team members.

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Stella Cho

Addiction: Why it’s Hard to Stop

26th of January, 2024

“Compulsion, craving, consequences, and control. These are the 4 factors that are exclusive to addiction, and addiction only.”

“Control is the stage that addicts try not to go to, because if they do lose control, they never come back.”

Khai Zhe Lim

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