Sunday, September 29, 2013

Vancouver Citation Style

What is Vancouver citation style?

Vancouver citation style is the way writing references in the academic publications. It is one of the most common citation styles used in medicine or medical publications.
When medical synopses/proposals, theses/dissertations, original articles, review articles, case reports, editorials, short communications or other medical publications are prepared, references or citations are needed both as in-text and as reference list in the end.

Why Vancouver reference style is called so?

Vancouver style originates its name from the meeting held in Vancouver BC (Canada) in 1978. Later on, the meeting gave birth to the establishment of International Committee of Medical Journal Editors (ICMJE).

How to cite a journal article in Vancouver reference style?

In Vancouver style references, the following sequence is followed:

Authors name/s. Title of the article. Name of journal Year of publication;Volume number(Issue number):Page number/s.


Authors: While writing authors' names, write the last name first and then the initial/s of the first and middle (if middle name is present) names in capital letters. Separate authors' names with a comma and a space. Use the word "et al" after 6 authors if authors are more than 6 in number.
Article title: Write the full title of the article. Only capitalize the first letter of the first word of the journal title or the first letter of any important word in the title.
Journal name: Write the name of the journal in the short form. Search on PubMed to check the short names of different medical journals. There is no punctuation mark after the journal name except a space.
Year of publication: Write the year of the journal.
Volume and Issue numbers: Write the volume number of the journal. Write the issue number enclosed in the small brackets.
Page numbers: While writing the page numbers, write full number of first page and short number of the last page after dash. For example, if the article covers the pages from 311 to 314 on the journal manual, it will be written as 311-4. In this example, it is understood that the last page is 314.
Punctuation marks: Be careful about the punctuation marks and spaces while making a reference. Check the example for punctuation marks and spaces. (Punctuation marks are red and high-lighted in the illustration).


Irshad M, Malik M, Furqan A. Intravenous paracetamol in pediatrics: A global perspective. Anaesth Pain & Intensive Care 2012;16(3):311-4.


Illustration! (Click to enlarge the image)

Vancouver Reference Style

Now check the screenshot of the article shown on the website (to enlarge the image, click on it).

Click to enlarge the image

Dr. Muzammil Irshad, MBBS

Keywords: Vancouver citation style, Vancouver reference style, Citation format, Citation style, Medical journal citation, International Committee of Medical Journal Editors, ICMJE

Saturday, September 28, 2013

Splenectomy for Idiopathic Thrombocytic Purpura (ITP)

What is idiopathic Thrombocytic purpura?

Idiopathic thrombocytic purpura or Immune thrombocytopenic purpura (ITP) refers to reduced number of platelets in the blood circulation of which no apparent exogenous etiologic factors are known.
The most common acute ITP is most common in children while chronic ITP in the adults.

What is splenectomy for ITP?

Splenectomy for ITP may be indicated along with other idiopathic thrombocytic purpura treatment strategies such as good rest, avoiding trauma and drugs, platelet transfusion and steroid therapy. Splenectomy for ITP offers effective rate of 70-80% of the cases.
Most of the medical students, when they are asked about the indications of splenectomy in ITP, cannot tell the correct answer. So, we decided to write the indications of splenectomy in idiopathic thrombocytic purpura.

What are the indications of splenectomy for ITP?

  • The patients sustaining severe thrombocytopenia (less than 10,000 platelets) who fail to respond steroid therapy up to six weeks.
  • Relapse of the disease during steroid therapy for ITP.
  • Patients having platelet count of less than 30,000/ul up to three months of regular treatment of ITP.
Keywords: Idiopathic thrombocytic purpura, Immune thrombocytopenic purpura, ITP,
diopathic thrombocytic purpura treatment, ITP children, steroid therapy

Friday, September 27, 2013

Ileostomy Reversal Operation

Dr. Muzammil Irshad, Dr. Khalid Javed,
Dr. Add-ur-Rehman (left to right)
Dr. Khalid Javed is a post-graduate registrar (PGR) and medical officer (M.O.) in surgical ward (when he was in surgical ward 5) at Nishtar Hospital Multan. He is a slick and smooth surgeon (PGR), observes cool and calm personality. He is one of the jolly persons in ward 4 (NHM).
I use to enjoy his puns. Today, he performed ileostomy reversal operation through laprotomy as the previous operation notes were not available. The operation went smooth and easy. No doubt he is learning better surgical skills.

What is ileostomy?

Ileostomy is an artificial opening in the bowel which diverts feces and flatus to the exterior where they can be collected into a bag and then discarded. In 1952, Brooke described the eversion technique and thus ileostomy creation and care was revolutionized.
Additionally, trained nurse enterostomal therapists are helping a lot to educate and care for the patients with ostomies. Usually, ileostomy is made in right lower abdominal region (right iliac fossa).

What are the indications of ileostomy operation?

  • Severe inflammation or obstruction of the gut distal to stoma
  • Ulcerative colitis
  • Familial adenomatous polyposis
  • Total colonic Hirschsprung’s disease
  • Total colectomy for carcinomas
  • Crohn’s disease (occasionally)
  • Multiple ileal perforations
  • Ileal gangrene
  • Distal fistula
  • Distal sepsis

Ileostomy reversal operation

What are types of Ileostomy?

Thursday, September 26, 2013

Guedel Airway Indications, Insertion and Risks

What is Guedel Airway?

Guedel airway is a medical device used to keep the airway patent. It is also known as orophareyngeal airway. Oropharyngeal airway (OPA, oral airway) prevents the tongue from falling backward and obstruction of the airway. When a person is unconscious the muscles of jaw are relaxed allowing the tongue to fall back. In this situation, Guedel’s airway is necessary to avoid the complication of tongue fall back.

Guedel's Airway

How to insert Guedel airway?

Airway management is vitally necessary for the life of every patient. Oropharyngeal airway is inserted in the patient’s mouth upside down. It means during Guedel airway insertion, it is directed upward and then is rotated through 180 degrees, allowing easy airway insertion and assurance of secured tongue.

Guedel airway sizes:

Guedel's airway are of various sizes. Colour coded airway sizes are available, from infant to adult.

Guedel airway sizes

Guedel airway sizes

Wednesday, September 25, 2013

Introduction to Rheumatic Diseases

What are rheumatic diseases?

Rheumatic diseases are the painful conditions of joints in the body. Millions of people are suffering from these conditions (diseases) all over the world. Often, these conditions start with the symptoms of pain and swelling in the joints and muscles. Joint pain (arthritis) is the commonest symptom with which the patients usually present to the practitioner or rheumatologist. Lots of rheumatic diseases have been discovered till date. Common rheumatic diseases include:
  • Osteoarthritis
  • Rheumatoid arthritis
  • SLE (systemic lupus erythematosus)
  • Soriatic arthritis
  • Ankylosing spondilytis (sacroiliac joint involvement at the base of the vertebral column)
  • Sjogren's syndrome
  • Gout
Rheumatoid Arthritis (Source:

Rheumatic heart disease is the condition when joint and heart manifestations present together.

What is the treatment of rheumatic diseases?

When we talk about the treatment of rheumatic diseases, along with proper medication regular exercises, healthy diet, stress education and rest play an important role to subside the conditions. Rheumatic disease treatment includes analgesics (like NSAIDS are helpful and usually the patients are put on these drugs), steroids, DMARDS (Disease-Modifying Anti-Rheumatic Drugs), monoclonal antibodies ( infliximab, adalimubab etc.), and etanercept. Additionally, physiotherapy is playing great role in the management of these conditions. Also, home remedies such as healing agrimony bath, healing Scot’s pine bath, Comfrey tincture are also in, in some areas of the world. Moreover, rheumatoid arthritis diet is also considered as a part of the treatment.

Rheumatoid arthritis (Source:

Key words: Rheumatoid arthritis treatment, Rheumatoid arthritis diet, NSAIDS, DMARDS

Monday, September 23, 2013

What is inpatient drug rehabilitation?

What is inpatient drug rehabilitation?

Drug rehabilitation refers to a form treatment for the patients who are addicted to certain psychoactive agents or substances such as heroin, cocaine, alcohol and many others. In other words, it is an attempt to stop the substance abuse that leads to social, psychological, economical, and physical problems.

What types of drug rehabilitation are available?

Drug rehabilitation includes various programs such as:

  • Inpatient drug rehabilitation
  • Outpatient drug rehabilitation
  • Local support groups
  • Extended care centers
  • Addiction counseling
  • Sober houses
  • Mental health care

What is inpatient rehabilitation?

Inpatient drug rehabilitation works at physical, psychological and emotional levels. In this treatment program, medical or health care professionals are always at hand to help you cease your drug abuse. Your physical dependency is abolished through certified medical detox facility. Detox facility helps you avoid overdose of the drug and decreases the risk of drug abuse relapse. Detox program can take weeks to months in order to achieve its goal.

Inpatient drug rehabilitation treatment also offers you psychological therapies like Cognitive-behavioral and multidimensional family therapies to combat with certain conditions such as anxiety, depression and bipolar disorder. It is very important to support the emotional aspect of the patients while they are under treatment. Inpatient drug rehabilitation treatment is one of the most effective ways to help the patients with their emotional situations.

Some patients may be addicted to prescription drugs. Inpatient drug rehabilitation also provides certain special therapies to help such patients. They offer such beneficial drugs that affect the same area of the brain that is affected by the abused prescription drugs.

Keywords: Drug rehabilitation, Inpatient drug rehabilitation, Detox facility, types of drug rehabilitation

What is flail chest?

What is flail chest?

Flail chest is a condition in which three or more ribs break at two points either on the one side of the chest or both sides of the sternum. In this way, the broken ribs have no attachment to the rest of the rib cage. So, the paradoxically moving chest after chest trauma refers to flail chest.

How to manage flail chest?

In minor cases where the patient is stable, the patient is observed with good analgesia and oxygenation until the flail segment stabilizes.
In severe cases, positive pressure ventilation can be required.

What are the complications of flail chest?

  • Pneumonia
  • ARDS (adult respiratory distress syndrome)
  • Need for mechanical ventilation
  • Respiratory failure
  • Death
  • Longer hospital stay
Click to enlarge the image.

 Keywords: Flail chest, Broken ribs, Chest trauma,

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