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1.  Why UK-trained doctors leave the UK: cross-sectional survey of doctors in New Zealand 
Objectives
To investigate factors which influenced UK-trained doctors to emigrate to New Zealand and factors which might encourage them to return.
Design
Cross-sectional postal and Internet questionnaire survey.
Setting
Participants in New Zealand; investigators in UK.
Participants
UK-trained doctors from 10 graduation-year cohorts who were registered with the New Zealand Medical Council in 2009.
Main outcome measures
Reasons for emigration; job satisfaction; satisfaction with leisure time; intentions to stay in New Zealand; changes to the UK NHS which might increase the likelihood of return.
Results
Of 38,821 UK-trained doctors in the cohorts, 535 (1.4%) were registered to practise in New Zealand. We traced 419, of whom 282 (67%) replied to our questionnaire. Only 30% had originally intended to emigrate permanently, but 89% now intended to stay. Sixty-nine percent had moved to take up a medical job. Seventy percent gave additional reasons for relocating to New Zealand including better lifestyle, to be with family, travel/working holiday, or disillusionment with the NHS. Respondents' mean job satisfaction score was 8.1 (95% CI 7.9–8.2) on a scale from 1 (lowest satisfaction) to 10 (highest), compared with 7.1 (7.1–7.2) for contemporaries in the UK NHS. Scored similarly, mean satisfaction with the time available for leisure was 7.8 (7.6–8.0) for the doctors in New Zealand, compared with 5.7 (5.6–5.7) for the NHS doctors. Although few respondents wanted to return to the UK, some stated that the likelihood of doctors' returning would be increased by changes to NHS working conditions and by administrative changes to ease the process.
Conclusions
Emigrant doctors in New Zealand had higher job satisfaction than their UK-based contemporaries, and few wanted to return. The predominant reason for staying in New Zealand was a preference for the lifestyle there.
doi:10.1258/jrsm.2011.110146
PMCID: PMC3265234  PMID: 22275495
2.  Usefulness of ultrasonography for the evaluation of cervical lymphadenopathy 
Aim
To evaluate the role of ultrasonography for differentiating cervical lymphadenopathy due to tuberculosis, metastasis and lymphoma.
Methods
Ultrasonography of the neck nodes was carried out prior to FNAC in 192 patients using a 10 mHz linear transducer. The sonographic findings were then correlated with the definitive tissue diagnosis obtained by FNAC or lymph node biopsy.
Results
The most significant distinguishing feature was strong internal echoes seen in 84% of tubercular lymph nodes. This finding was found in only 11% of metastatic nodes and absent in lymphomatous nodes. The other findings such as L/S ratio, irregular margins, hypoechoic center, fusion tendency, peripheral halo and absent hilus were helpful in differentiating reactive from diseased nodes but showed considerable overlap in the 3 groups of tubercular, metastatic and lymphoma lymph nodes.
Conclusion
Ultrasonography is noninvasive and can give useful clues in the diagnosis of cervical lymphadenopathy. It should be interpreted in conjunction with FNAC result. Ideally ultra-sonographic guided FNAC should be obtained from the sonographically most representative node. In FNAC indeterminate cases, sonographic features may obviate the need for an invasive lymph node biopsy.
doi:10.1186/1477-7819-9-29
PMCID: PMC3050765  PMID: 21356049
3.  Drug interaction leading to prolonged sedation in a postoperative high risk coronary bypass surgery patient 
Use of midazolam infusion in mechanically ventilated patient is an established practice in critical care. In our case, the use of erythromycin as a prokinetic agent for better tolerance of enteral feeding and paralytic ileus led to an interaction between midazolam and erythromycin, which resulted in prolonged and deeply sedated patient. In a critically ill patient, there is always a possibility of multiple drug interactions. It is important to understand them and they should be considered before starting new medication.
doi:10.4103/0972-5229.78230
PMCID: PMC3097546  PMID: 21633550
Erythromycin; midazolam; prolonged sedation
4.  ADAPTOGENIC ACTIVITY OF SEEDS OF TRICHOPUS ZEYLANICUS GAERTN, THE GINSENG OF KERALA 
Ancient Science of Life  1989;8(3-4):212-219.
The alchoholic extract of seeds of Trichopus zeylanicus showed a potent adaptogenic or antistress properties against a variety of stresses in both rats an dmice. The extract increased the swimming performance of normal and adrenalectomized mice. Significantly; prevented a variety of stress and chemical induced ulcerations in rats and also prevented milk-induced leucocytosis in mice. The extract further reduced the gastric secretary clume, PH and acid output in pylorusligated rat stomach. No mortalitiy was observed upto a dose of 3 g/kg per oral in mice. The study indicated that trichopus zeylanicus seeds induce a state of nonspecific increased resistance against a variety of stress induced biological changes in animals.
PMCID: PMC3336722  PMID: 22557652

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