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Reading has been a source of joy to man since several hundreds of years. The invention of paper made books widely available and libraries became commonplace. But now the situation is slowly but surely changing. Paper and books are becoming costlier and the popularity of the electronic media is increasing. Medical books and libraries also face competition from the electronic media. The MEDLARS, an excellent example of this technological revolution is now available all across India through the National Informatics Centre and it appears to be very cost effective decision for even peripheral hospitals to acquire a MEDLARS facility.
The printed book has been man's closest friend from times immemorial. The joy of curling up with one's favourite book, even when one is indisposed, is known to all of us. One can browse through the pages of a book for hours together, picking up odd bits of useful information, at one's own pace. Printed books are permanent records, accessible at all times. Initially, ‘books’ consisted of stone tablets of various sizes. Later papyrus was used till the Chinese invented paper. As books became more and more popular it became necessary to have a central place where interested persons could access them. Thus libraries came into being, the Sumerians in the 27th century bc being credited with the establishment of the first organized library. Initially, such libraries were the privilege of a select few, the rich and the aristocratic, in the society. Later, when governments realized the importance of mass education, books became available to the common man through public libraries. All over the world, libraries exist which cater to specialized and general needs of the people in the region. Membership in most libraries continues to be free, or very nominal. They continue to provide endless hours of joy to millions of readers.
Notwithstanding the many advantages of books and libraries, there are some drawbacks which cannot be ignored. The costs of quality paper and of printing have soared sky high all over the world. Books have become very costly, so much so that even paperbacks cannot be purchased by the interested but impecunious reader. Some of the better equipped libraries have such tight security systems that gaining entrance to them makes breaking into Fort Knox seems like child's play. This puts off many a potential user. Anyone who has tried to become a member of some of the libraries maintained by foreign missions will surely bear this out. Another feature that reduces the popularity of libraries is the fact that most of the reference books cannot be borrowed for home use. While libraries are justified in restricting the issue of such books, it can hardly satisfy the serious reader. Not that issue of books is a happy solution. How many times do we go to the library to find that the particular textbook or journal we want is unavailable because it has been issued to someone else only the other day? Lastly, the very explosion of printed books has had an unexpected negative effect. There are simply too many books on every subject. Our present day life leaves us with little time to sift through tons of written material to get what we want.
Enter, the electronic library. In what appears to be the solution to all problems listed above, computerized books and periodicals have started devouring their printed counterparts. It is not difficult to visualize the future bibliophile indulging his passion to the full without as much as getting out of his house. Today, for the cost of half a dozen good books, one can access a thousand periodicals, by investing sensibly in computers. The MEDLARS (MEDical Literature Analysis and Retrieval System) is an excellent example of this technological revolution. Some 3600 medical journals are now available on-line through this system created by the National Library of Medicine, Bethesda, USA. It comprises of 28 databases, and is the most extensively used biomedical information system in the world. It covers published and unpublished information in all areas of medicine including dentistry, nursing, cancer, AIDS, toxicology, population and health planning and administration.
The National Informatics Centre (NIC) at New Delhi is the Indian centre for MEDLARS. NIC has a nationwide network called the NICNET. Through any of the NICNET setups in the country, MEDLARS can be accessed. The doors are then open to an ever increasing volume of information. And one need not wade through mountains of accumulated material to get at a particular subject. Based on the Medical Subject Headings (MeSH) of the Index Medicus, the search for any topic can be done quickly. All one has to do is feed in the key words of the subject or article of one's interest, and the computer will instantaneously search through available listings which now date back to 1966. Within a few moments, the computer will inform the user of the available number of articles containing the catch words. One can then browse through the captured abstracts, select the appropriate references and print them, Till a few months back, this facility was provided free of charge by the NIC. Now a nominal charge of Rs 50/- has been introduced for a maximum of fifty references. A recently introduced facility called ADONIS helps to get printouts of the full text of the articles, for additional charge. At present, however, ADONIS does not cover the entire spectrum of journals available in the MEDLARS. About 500 scientific and medical journals are covered by ADONIS, and the system is available on CD-ROMs. A service similar to ADONIS is the PROQUEST. On this system one can do a search and, if the document is available in electronic form, the computer will indicate the CD-ROM disc in which it is present. On inserting that disc the article under search will automatically appear on the screen page after page. Part or whole of the article can then be printed out. By applying to the NIC headquarters at Delhi, any hospital can get a MEDLARS facility installed. A computer of minimum PC-AT 386 configuration is required. Also necessary are a telephone line to access the local NIC set up, and a modem. NIC conducts 2-day familiarization courses for doctors in MEDLARS methodology. These courses are free and are held periodically in the major cities.
Even in the present type of library set up, catalogues of books and periodicals are now automated. They are much easier and faster to use than the conventional card catalogues. With new technology, libraries of the not so distant future will be quite different from the ones we are used to at present. The reader will probably not be required to go to the library building but may instead be able to read journals, text books and reference books from the convenience of his own desk, or arm-chair. He will read what he wants from the screen, and print out articles of his interest. What is more, he will be able to cart his ‘library’ around wherever he goes. Already important and popular periodicals like the British Medical Journal and the Lancet, not to mention a number of American publications, are available on the electronic format. The economics of publishing is bound to sway future publications in favour of electronic rather than paper formats. It will not be long before more and more journals become available in electronic form, and a time may come when some of them will be available only in this modern form. The step taken by many leading foreign journals in requesting authors to send their manuscripts on floppies is a firm indication of the changing trends in publication.
We have to think seriously in terms of gearing ourselves to meet the needs of the future. Our libraries will have to learn to adapt to this sea change in the world of publishing. The time is ripe to introduce MEDLARS facility in all our major hospitals at the earliest. The expected cost of setting up a MEDLARS facility from scratch (including the cost of a computer) is about 75,000/-. After this one-time expenditure, the running costs will be negligible. But the benefits for trainees and specialists alike will be far from negligible. The library of the future will be a compact affair, with vintage material on printed paper, modern publications on an electronic platform more efficient and easy to use than today's version. And above all else, information will be available at all times, night or day, week after week.