Medical Websites

Navigating Medical Sites  

"Search engines, newsgroups, Websites, journals- anything and everything related to medicine is out there. All that you now need is this handy Webguide to smoothly navigate you to the area of your choice"

            The major attraction of the Web for doctors is that  it contains a wealth of medical information that is increasing daily – seems like it is the world’s  largest medical library, open round -the-clock. However, this vastness is its Achilles’ heel as well, because the information is not organized logically  or systematically. Hardly surprising, considering the fact that the Web is a free-for-all jungle- anyone can publish whatever they want on it  This means that for every one good site, there are likely to be 10 awful ones. With thousands of medical sites, it’s easy to get lost in this maze. This section  will serve as a tourist guide, and show you some of the Web’s highlights, so that when you actually start exploring on your own, you know where to go and how to get what you want.

MEDICAL GATEWAYS OR PORTALS 

One of the best  medical portal is Medical Matrix, at www.medmatrix.org , which describes itself as a " ranked, peer-reviewed, annotated, updated, clinical medicine resource” This site also includes links to news, full text/ multimedia, abstracts, textbooks, major Websites,  practice guidelines, cases, images, CME, patient education, directories, educational materials and forums, all classified according to the medical speciality. Each site is reviewed by practicing clinicians and rated on a scale of 1-5 *****as well, so that you can go the best four-star sites, rather than wade through hundreds of poor quality pages. Medical Matrix has done the groundwork well, is  well organized and very comprehensive. It also offers an excellent option for clinical searches, which allows you to search multiple databases through a single from.

            Health on the Net Foundation at www.hon.ch is a non-profit organization, based in Geneva, Switzerland. Its mission is to build and support  the international health and medical community on the Internet so that the potential benefits of this new communications medium may be realized by  individuals, medical professionals, and healthcare providers. It also offers a medical search engine called Med Hunt. The results of this search are very detailed , because not only are they annotated and reviewed, they also provide information about when the site was visited, and how many links it has. This is very useful, because sites that are updated regularly are active and more valuable than older sites, which often end up providing unreliable information or ‘dead’ links (which do not work) since the Internet changes so rapidly.

            Web Doctor - The Internet Navigator for Physicians, at www.gretmar.com/webdoctor/home.html is a comprehensive index of Internet medical resources which include links to Websites, books, articles, journals, CME, databases, patient information and mailing lists arranged both by diseases and by speciality, with a short review of each.

            Some of the other medical portals are :

            Yahoo at http://dir.yahoo.com/health/medicine  is considered one of the more famous directories on the Internet as Yahoo has an excellent collection for medicine as well. However, the listing is not complete or comprehensive- and neither is it ranked or rated.

            MEDLINEPLUS at www.nlm.nih.gov/medlineplus is run by the National Library of Medicine at the National Institute of Health, USA. This site is a virtual encyclopedia of research work, journal articles, databases and health organizations. Though primarily designed for patients  MEDLINEPLUS can connect physicians to just about any major source on clinical trials and laboratory research.

            Martindale’s Health Science Guide – 1999 at www.ci.lib.uci.edu/HSG/Medical.html is a “Multimedia Specialized Information Resource “ containing thousands of  teaching files, medical cases, multimedia courses/ textbooks, multimedia tutorials, databases and movies. This ‘virtual’ medical center is classified and includes subjects on nursing, nutrition, pharmacy, veterinary and public health centers as well.

            MedNets is a search-engine super site, at www.internets.com/mednets/index.html and focuses on providing good medical search engines, including its own Copernic, which is designed to provide the same “searchability” found in 20 medical search engines.

            Health Web at www.healthWeb.org/index.html

            Diseases, Disorders and Related Topics at www.mic.ki.se/Diseases/index.html

            UltraSearch, the ultimate medical information finder at www.mdchoice.com/index.asp

            The Doctor’s Guide to the Internet at www.docguide.com/

            Among the better Indian medical portals are:

            www.meditimes.com

            www.indiandoctors.com

            www.drgill.com 

          http://health.drksm.com 

            Once you have started exploring the Net, either through a general/medical search engine or a medical portal, there are thousands of sites that you could possibly visit. For the sake of convenience, Dr.KSM have categorized the sites, with a review of the best sites, as well as a mention of some other good ones too.

MEDICAL NEWS

The Intelihealth Professional Network from the john Hopkins University offers news from the Reuters Health Service for physicians at http://ipn.intelihealth.com/ipn/ . You need to register for this, but registration is free. If you like, they will also e-mail you the medical news headlines daily, so that you can keep up-to-date with what is happening in the world of medicine. This will ensure you are one step ahead of your patients, who will most probably read the same news the next day in their daily newspaper. The news articles are archived so that you can search for the topic of your interest.

            Healtheon at http://www.healthcenter.healtheon.com/headlines_index.html  also offers daily medical news. Since it is written for the patient in non-technical language, it is much easier to understand This is also very useful in explaining recent advances to patients and students.

            Another useful site for health and medical news is Medserv Medical News at www.medserv.dk/index.html .

MEDICAL PRODUCTS, EQUIPMENTS AND SUPPLIES

The Internet Medical Products guide at http://www1.medmarket.com/product_guide.cfm/home.htm   by Med Market provides a searchable list of companies and medical products. The guide is intended as a resource for health care professionals, providing them with an efficient tool for obtaining up-to-date information on the latest products, and products for clinical testing.

            There is also a Directory of Medical Product Manufactures/Suppliers at http://www1.medmarket.com/index.cfm , which is divided into biotech, diagnostic, medical device and pharmaceutical sections.

MEDICAL CONFERENCE LOCATORS

Internet databases can locate medical conferences by region, topic, and date. Physicians often plan a holiday around a  conference; hence this is an available and up-to-date resource allowing them to search for events on a particular topic. For example, a conference to take place in Florida during the summer can be very valuable, Doctors can also plan to attend conferences that will help enhance their continuing education.

            At www.medicalconferences.com, you can search for the conference most suited to your educational needs by title, date, location and keywords. You can also search selected conferences for details of main topics, keynote speakers, specialist workshops, social programmes and deadlines for call for Papers. It’s also possible to register online and get an immediate response.

            MediConf(R) at www.mediconf.com/mcnfnext.html also provides a searchable database of international conferences.  

GUIDELINES AND PROTOCOLS

            The National Guideline Clearinghouse at www.guidelines.gov/index.asp, produced by the Agency for Health Care Policy and Research (AHCPR) offers a comprehensive list of evidence-based clinical practice guidelines for physicians, which suggests to doctors the best treatment protocols for common problems. New guidelines are posted on a weekly basis. Not only does this site allow you to browse through guidelines for various conditions: it also offers you a search engine to pinpoint information about recommended protocols for a specific disease. A search on Hepatitis B, for example, yields 30 separate guidelines dealing with immunization, screening and treatment. You  can even compare different protocols suggested by different authorities.

            If you need a more international perspective, The New Zealand Guidelines Group has put up an excellent library of guidelines at www.nzgg.org.nz/library.htm.

            Especially useful for doctors practicing in smaller towns is the Standard Treatment Guidelines and Essential Drugs List for South Africa at www.hst.org.za/pubs/edl/edlinfo.htm.  

MEDICAL BOOKSTORES

            The most famous online bookstore is www.amazon.com, and they have an excellent collection of medical books as well. The site is a pleasure to visit. Not only is it very well laid out, so that it’s fun ‘browsing’ through the aisles, but most books carry reviews, so that you can decide whether or not the book is worth buying. Most reviews have been written by readers, and help you evaluate the quality of the book. The site also automatically suggests additional titles you might want to look at, depending upon your interests. The titles are well classified, so it’s easy to find the books you’d like to buy. The major problem is that the only way to order online is through an international credit card.

            There are other specialized online medical bookstores as well. Medsite books at www.medbookstore.com , First Internet Medical Bookstore at www.fimb.com/FrontPage.html and  The Online Discount Medical Bookstore at www.discountmedbooks.com/ .  In addition to offering books, most online bookstores sell CD-ROMs and medical supplies (such as stethoscopes) as well. Many offer discounts and special sales, so it’s worth comparing price before deciding where to shop. However, you also add shipping costs to any purchase you make- and this can total up to a pretty penny, since the books are shipped from USA.  

MEDICAL HUMOUR 

If you believe laughter is the best medicine, then you should visit Medtoons, which has a collection of medical cartoons at www.towerpublishing.com. You can also find a collection of medical cartoons, poking fun at doctors, by India's leading  cartoonist, Dr. Hemant Morparia, (a practicing radiologist) at www.healthlibrary.com/humour/index.htm. Humour Links at www.plasticsurgerydirect.com/links-ps/HumLink.html  offers links to medical humour sites, but many of these links are broken or do not function anymore, as the site is probably not actively maintained.

PUBLIC HEALTH IN INDIA  

            An  interesting initiative to network people interested in improving public health in India has been taken by Dr. Yadav of Public Health Today at http://education.vsnl.com/publichealthtoday/ . This offers a monthly newsletter, as well as access to an electronic mailing list of like – minded people. While this Website it still in its infancy, it does provide a forum for public health professionals in India to get in touch with each other. The mailing list also has subscribers from outside India who are interested in the state of public health in this country.

DIRECTORIES OF DOCTORS AND HOSPITALS

AMA-On-Line Doctor Finder at www.ama-assn.assn.org/aps/amahg.htm provides information on virtually every licensed physician in the United States, including more than 650,000 doctors of medicine (MD) and doctors of osteopathy(DO). All physician credential data have been verified for accuracy and authenticated by accrediting agencies, medical schools, residency training programs, licensing and certifying boards, and other data sources.

            Other directories of doctors and hospitals are:

Hospital Locator at www.hospitalselect.com/curb_db/owa/sp_hospselect.main  for hospitals in the USA.

Hospital Web at http://neuro-www.mgh.harvard.edu/hospitalweb.shtml   

MEDICAL IMAGES

If you need to use images and illustrations for presentations and lectures, there are a number of them available via the internet; even as more are being added.

These images can be easily downloaded. Although copyright should be observed, images are generally royalty free. However, images are often large files and they could take a long time to download. One may also need to review many images before finding the right one, or else you can spent a lot of time just locating it! 

            Medical slides at www.medslides.com is probably the best site for slides. You ought to register, though the use of slides is free. Medslides provides valuable, up-to-date and easy-to-use medical information in a concise slide presentation format. This could revolutionize the way medical information is exchanges and shared over the Internet. You can also contribute to this superb collection by uploading you educational materials, so that you can help teach doctors form all over the world!           

            HON media Gallery offers a searchable database of medical movies and images which includes x-rays, movies of surgery and other areas of interest to medical professionals and students at www.hon.ch/Media/media.html  

            Photo Rounds at www.mdchoice.com/photo/photos.asp provides a superb group of clinical cases with images- you can test your clinical skills as well by trying to spot the diagnosis!  

            Perspectives on Disease at www.pathguy.com/lectures/perspect.htm offers a springboard to a superb collection of medical images on the Web. This is a good place to start your hunt if you are looking for a specific image.

MEDICAL DATABASES 

While Medline is the most famous medical database, there are other good databases online as well, which are worth exploring. OMIM, the Online Mendelian Inheritance in Man at http://www3.ncbi.nlm.nih.gov/omim/  is an astonishing resource: it is a continually updated searchable database of all known human genetic disease! The entries are quite complete and even come with journal references as well as images of birth defects and clinical syndromes.  

            The National Health Information Database, at http://nhicnt.health.org/  developed by the Office of Disease prevention and health promotion, includes over 1000 organizations and government offices in the USA that proved health information upon request. Entries include contact information, abstracts, and information about publications and services.   

            The combined health information Database, CHID, at http://chid.nih.gov/simple/simple.html  provides information on health-related studies and research in USA.  

            Sadly, in India, doctors, hospitals and the state have been slow in getting online; as a result there is little information about India health and medicine. However, there are searchable databases about the world of India medicine at www.healthlibrary.com/india_file. Though it does seem very incomplete at present, hopefully the situation wills improve as more and more Indians get wired!  

BIOMEDICAL RESEARCH 

For doctors who would like to explore related fields, especially that of biomedical research, one of the best resources is Biomednet at www.bmn.com – the Internet community for Biological and Medical Researchers. This has an excellent e-zine called HMS Beagle at http://news.bmn.com/hmsbeagle/ which covers topics on biological  science, medicine/health, and biotech/pharmaceutical ,as  well as loads of information on research careers, in addition to poems and cartoons about the basic biomedical sciences.

LAW & MEDICINE 

Most doctors prefer not to think or talk about negligence and malpractice. However, it is a fact of life that mishaps will occur, and you will need to know what to do to protect yourself.  

            The law or Medical negligence by Dr. Chulani at www.healthlibrary.com/reading/law/index.htm provides valuable information on what doctors need to know about the laws in medical practice. Another useful book is the medical Profession and consumer protection act by Dr. Jagadish Singh at www.helathlibrary.com/reading/mpcpa/index.htm, which helps to clear a lot of doubts and confusion over how this law is applied to doctors and patients. Medical Risk management: Preventive Legal strategies for health care providers at http://plague.law.umkc.edu/aspen/aspen.html  is a full-text online book, which gives tips on how to avoid medico-legal problems!  

CLINICAL TRIALS 

If you need to find current information on experimental or investigation procedures, the best starting point is a collection of databases of NIH-supported clinical trials that are available at http://clinicaltrials.gov/ct/gui/c/r 

CenterWatch Clinical Trials Listing Service at www.centerwatch.com/main.htm also has an international  listing of clinical research trials.

MEDICAL STUDENTS

As a medical student, if you need information and didn’t know where to ask, then these sites could be your answer! The interactive medical student Lounge at www.medstudents.net/imsl.html has information on practically anything and everything the medical student would like to know (including information on basic sciences, clinical science, financial aid, residency and physical fitness).  

            Web rounds at www.wwilkins.com/esources/rounds/ is a well-designed site, which offers clinical quizzes and multiple choice questions- if you answer correctly, could win a prize online as well!  

            Applying for a Residency in the USA at http://www.geocities.com/ResearchTriangle/Lab/8987/matching.html  is packed with information on how to go about this arduous process, and is a useful insider’s guide to everything you need to know about ECFMG, USMLE, CSA, ERAS and NRMP.  If you don’t need to know, then don’t worry about what the acronyms stand for. If you do need to know, then check out the Website!  

            The Educational commission for Foreign Medical Graduates at www.ecfmg.org/  provides more information on the Exchange visitor Sponsorship Program and International Fellowship Program and International Fellowships inn medical Education.

             Another interesting site for Medical Students is Medico's Links section at http://health.drksm.com , where you can find all the links for  subjects in MBBS and all the websites a Medical Student need to surf.

ALTERNATIVE MEDICINE

Worldwide, there has been a resurgence of interest in alternative medicine. Even if you are an allopathic doctor, instead of rejecting the concept, it would be worth your while finding out the other treatment options your patients  may be exploring. It may be possible to learn to combine the best of both worlds to offer patients what is now called ‘intergrative medicine’.  

            Alternative and Complementary medicine Topics at www.people.virginia.edu/~pjb3s/Complementary_Practices.html provides an extensive index to the alternative medicine Websites. The index covers over 50 topics, presenting a smorgasbord of alternative therapy options – including many you may never have heard o like ‘amma therapy’ and ‘cryogenic medicine’!  

            Two other useful link sites are the Alternative Medicine Homepage at www.pitt.edu/~cbw/altm.html and the Holistic Healing Web page at www.holisticmed.com .  

            The alternative and Complementary Medicine Center from Health World online at www.healthy.net/clinic/therapy/ is also worth a look.            

            Unfortunately, a number of Alternative medicine sites are commercial sites, put up by clinics in order to lure patients. In order to help separate the wheat from the Chaff, it’s worth visiting Quackwatch at www.quackwatch.com

HOMEOPATHY

Considered the best homeopathic resource on the Internet the Website at www.homeopathyhhome.com/ has everything about homeopathy as well as comprehensive links to other resources. Here one can even find complete text books on homeopathy, including classics such as Hahnemann's Organon of Medicine, Homeopathic Materia Medica by William Boericke, MD, and Kent’s Repertory of the Homeopathic Materia Medica.

DENTISTRY 

The dental Database at www.webdental.com/ which calls itself the world’s premiere dental resource, is a truly complete resource for all dentists. However, since the site is based in the US, most of the information presented is designed for US dentists. This site has comprehensive directions of dentists, dental equipment, laboratories, equipment manufactures, photography, supplies, publications, books, journals, magazines, professional associations, conventions and meetings, as well as on how to run a Dental Office. This is a one stop shop for all dentists looking for information on the Net. Since it is a commercial site, there is a lot of banner advertising, which could be distracting. There is a simple keyword to help search for material within the 200 documents available on this site. There is also a very interesting series of articles regarding the creation, promotion and marketing of dental related Websites which would interest Web savvy dentists!  

For Indian dentists, www.dentalindia.com provides information from an Indian perspective. However, like most Indian sites, it’s still very incomplete, because basic data about health and medicine in India is still lacking.

JOBS & CAREERS ONLINE 

Looking for a job? The physicians Employment at www.physemp.com/default.htm provides over 2,000 job listings – however, most of these posts are in the USA.  

Hopefully, Indian hospitals will soon start using the Internet to look for doctors to fill in the vacant slots in various hospitals.

SPECIALITIES

Depression  

www.nimh.nih.gov/ is the Website of the National Institute of Mental Health. The content on the site is very neatly divided into for practitioners, for researchers, for the public and such other sections. The ‘For Practitioner’ section offers research reports and other valuable information like article alerts, publications, research and statistics, and so on. With the help of these, you can keep up-to do date on the diagnosis and treatment of mental disorders. And with materials you can download, you can help educate your patients about their disorders too.  

The Depression and Anxiety information resource and education Center at www.fhs.mcmaster.ca/direct/ is divided into Depression Information Center, Physician Information Center and Anxiety Information Center. Although many of the sections are under construction, those which are active give useful information on articles, drug interactions, clinical features and so on.  

            The Depression Info Center at www.mhsource.com/depression/ has comprehensive medical news on depression. Click on medical information and you will be taken to the page of Psychiatric times, where all articles can be sorted by title, by author, by date or by CME credits. Although most of the site caters to patients, it is worth visiting for this features alone.  

            For information on depression and epilepsy visit www.cnsindia.com . You can register for free to access the diagnosis and management by Indian psychiatrists in the section on Indian write-ups, and get a second opinion from a panel of psychiatrists. Global perspectives brings you relevant news and reviews from around the world, and with directory search you can find a psychiatrist in you neighborhood, There are links to other resources on the net, a section that answers FAQs about medico legal affairs, real-life case studies, as well as information on forthcoming events, CMEs and conferences. The site has a good concept, but it lacks extensive information in some sections.  

Diabetes Mellitus   

The National Diabetes Education Initiative (NDEI) at www.ndei.org/ is a multicomponent educational program on type 2 diabetes that is designed for endocrinologists, diabetologists, primary care physicians, and other healthcare professional, Literature alert is very useful to keep in touch with the latest happenings articles are archived by date, journal and by topic. Physician’s Focus has data on all topics related to diabetes, educational slides on some of them and patient alerts (useful only for physicians in the US). You can also access CME notes and know about diabetes related medical meetings.  

            As a doctor treating diabetes, you are asked often about alternative Therapies for diabetes. If you would like to know more about these topics, turn to www.alternativediabetes.com/homepage.shtml . It aims to provide credible, complete and current information about alternative approaches to diabetes treatment, including herbal, dietary, nutritional and other strategies. 

            www.atdiabetes.com/diabetes/ has an excellent customizable Medline search. So, no matter what you’re looking for, it throws up related documents.  

            www.diabtetesdigest.com/ is the Web site of the largest circulated Diabetes magazine in the US. It has tips on medicine, nutrition, exercise, foot care and other topics of interest to patients suffering from Diabetes. This is a great place to refer newly diagnosed patients of Diabetes, and those who want more information about their disease. They can subscribe to a free monthly e-mail newsletter, read back issue and even avail of free stuff like recipe books, log book for recording values etc.  

            You could also visit www.diabetes.ca/ and www.aace.com, which is the Website of the American Association of Clinical Endocrinologists, It’s a very good site, but at a steep registration price.  

            www.endocrineindia.com has information on diabetes and thyroid for both patients and doctors alike. This site gives you the complete Indian perspective on management of Diabetes. To access the medical professional’s pages, you need to register, but registration is free. There are articles on diagnosis and management by Indian endocrinologists in the section you can refer your cases to panel of eminent endocrinologists. Global perspectives brings you the latest news and reviews from the world of diabetes to your desktop, while directory search allows you to find an endocrinologist in your neighborhood. There are links to other diabetes resources on the Net and to a Website about obesity. There is a section that answers FAQs about medico-legal affairs. There are real-life case studies, as well as information on forthcoming events, CMEs and conferences. The site is well designed and has a good concept. Although it needs more information in some of these sections.

Epilepsy  

www.neuroguide.com/ is probably the best place to start of you are looking for information about epilepsy or any other neurological disorder. It is a searchable and browsable index of neuroscience resources available on the Internet. There’s so much information crammed into this site that it will take you a while to discover all that it of information, and we suggest you explore it.  

            The Website of the American Epilepsy Society at www.aesnet.org/ aims to promote research and education for professionals dedicated to the prevention, treatment and cure of epilepsy. There’s plenty of stuff for continuing education: CMEs, downloadable files for residents, downloadable PowerPoint slides, clinical meeting abstracts and highlights. Teleconsult audio tapes and programs for neurology nurses- there’s something for everyone here. For members there are full text  abstracts from journals, but membership isn’t free. There are articles on patient care, drug alerts, and a section on new developments and practice management too. Site changes and updates tell you about the recently added and updated pages so that you can directly go to those pages if you visit the site often.  

            www.epilepsynse.org.uk/ is the Website of the National Society for Epilepsy. They have a comprehensive range of information about epilepsy, covering both the medical aspects and the aspects of living with the condition. There is easy-to-understand information on epilepsy, which can be handed out to patients. There is also the possibility of ordering CD-ROMs, books, and leaflets. However, the site is quite UK-centric.

Gastroenterology

The website of the online journal of digestive health at www.gastronews.com/ is probably the most comprehensive source on the Web for information about the GI Tract and liver. Go directly to the professional section, register for free, and you can then explore news, journals, events, product information, discussion groups and other online resources. Each section covers many topics in depth: for e.g.. The journals section has a dozen different online journals, as well as mention of articles of interest from other journals. The discussion group allows you to exchange your ideas and experiences to discuss topics of common interest with other professionals. Related sites take you to images, databases, educational resources and case-studies. Overall, a very clean well designed site that loads quickly.  

            www.asge.org/index.jsp is the website of the American society for Gastrointestinal Endoscopy. Their official journal, Gastrointestinal  Endoscopy, is available online with full text of all articles from 1994 through the present. However, only abstracts are for free, you would need to pay for full text articles. The clinical updates, fortunately, are posted in their entirely. Non-members can also access their vast online resource database, and read past issues of the AGSE newsletter.

Pain Management  

www.pain.com/ claims to have 'A world of information on pain' And, rightly so. It is one of the most comprehensive sites on this subject. Right at the start, it has very neatly divided its information into ‘for professionals and for consumers’. It has distinct categories of cancer pain, intervention pain management,  regional anesthesia, migraine/headache pain, and peri-operative pain. Each of these categories is subdivided into CMEs library, related Internet links, and forums and chat rooms. There are even expert interviews, news and full text online journals. The CMEs are full text and free. The online resources are also neatly classified into associations, publications, bookstores, studies, and so on. Overall a very well designed and easy to navigate site for professionals involved in pain management. www.oncolink.upenn.edu/specialty/pain/ is the site of University of Pennsylvania Cancer Center. It has some very useful tips for pain management, especially cancer pain. You can subscribe to an e-mail discussion group, read book reviews, feature articles, latest news and visit other related sites by following links from this page. It even has a compilation of a list of Internet-wide e-mail discussion groups (list servers) relating to various areas of cancer, which you can subscribe to.  

            Although meant primarily for patients, www.wellweb.com/pain/pain.htm has certain sections with useful information for doctors as well. What’s new deals with latest development in the fled of pain management.  

            Pain link at www.edc.org/painlink/ is a virtual community of health professionals working in institutions that are committed to alleviating pain. It is an initiative of Education Development Center, Inc. Although Indian institutions can not join the EDC project you could check out the features and news articles and search through a vast resource database. The online database has a very detailed search facility, but the results obtained are poor: they simply have minimal descriptions of sources.

Thyroid  disorders  

There are many Websites which have thyroid – related information, but the ones which are thyroid-specific, most of them talk to patients. There are few good sites for doctors looking for information on the thyroid.

            For a very basic revision about thyroid disorders you could visit www.synthroid.com/. This Website is developed by Knoll Pharmaceuticals for their product Synthroid (Levothyroxine). The Healthcare Providers section of the Website provides a concise review of thyroid disease. The prevalence of thyroid disease, its signs and symptoms, and the pathophysiologic consequence of untreated thyroid disease are considered. The available tests of thyroid disease are considered. The available tests of thyroid function are discussed: and treatment of patients with levothyroxine is examined.

            The Thyroid Home page at www.thyroid.com/index.htm is dedicated to providing thyroid patients and their families with accurate and helpful information about thyroid disease. However, the Physician Information section provides links to articles, associations, books and online services.

            You could also visit:

www.thyroidmanager.org/

www.thyroid.org/

www.ngdy.org/medical.htm

Anesthesia  

Anesthesiology and Critical Care Resources on the Internet at www.eur.nl/FGG/ANEST/wright/contents.html is a huge index of online resources. It is almost large enough to merit a separate index for the index.

            The Virtual Anesthesia Text book at www.virtual-anaesthesia-textbook.com/ is a global resource for the benefit of all Anesthesia care providers. Its existence is the result of a collaborative effort from many people around the world. Its goal is to provide a comprehensive listing of all the known Web Pages that relate to the practice of anesthesia.

            The Global Textbook of anesthesia at http://gasnet.med.yale.edu/gta/  is also a valuable reference source.

Cardiology  

Cardioguide at www.cardioguide.com/cardio/ is an excellent resource for cardiologists. It acts as a launch pad to thousands of Website that have been classified and catalogued systematically, so you can browse through the areas of your interest. It also offers links that are classified according to cardiology subspecialties ranging from electrocardiography to catheterization to nuclear cardiology to transplantation, links to cardiology organizations, as well as the A to Z of cardiological disorders-aortic aneurysm to Wolff-Parkinson-White Syndrome. There is also a cardiology search engine to help find details on the Net with ease. A particularly nice feature is a Medline search engine specifically designed for cardiology and useful if you find that you retrieve too many references with a regular Medline search. This option basically limits the search to key cardiology journals, so that you get only references which are likely to be  useful to cardiologists.

            The American College of Cardiology at www.acc.org and the American Heart Association at www.amhrt.org are packed with valuable content.

Oncology 

For accurate, accessible information cancer treatment, prevention and detection, OncoLink at http://cancer.med.upenn.edu is excellent. A service of the University of Pennsylvania Cancer Center in Philadelphia, the site provides detailed information on the latest developments in cancer research for cancer patients as well as for physicians. Yet another site is http://cancer.net .

Dermatology  

The Internet Dermatology Society at http://telemedicine.org  offers a wealth of valuable content and is a ‘must visit’ site for all dermatologists. Along with providing a global overview of Internet dermatology resources, it also offers a Dermatology Knowledge Builder, The Internet Teledermatology Expert Triage, Access to Dermatology Lectures, Global Dermatology Grand Rounds, Dermatology Mailing Lists, as well as an Electronic Textbook of Dermatology at http://telemedicine.org/stamford.htm . You can also join the Internet Dermatology Society online so that you remain updated with advances in this field. Membership also allows interested dermatologists to share their clinical experience with colleagues from all over the world.

            DermGuide at www.dermguide.com/derm/ offers a comprehensive collection of well-organized links for dermatologists. These are well classified, and each link has a short description, so you get a rough idea of its content.

The  American Academy of Dermatology is online at www.aad.org/

The Dermatology Medical Education Website at www.meddean.luc.edu/lumen/MedEd/medicine/dermatology/melton/title.htm  also includes a superb Dermatology Atlas from acne to xanthomas at www.meddean.luc.edu/lumen/MedEd/medicine/dermatology/melton/atlas/htm

General Surgery 

The Online Atlas of Surgery at www.bgsm.edu/surg-sci/atlas/atlas.html provides a concise  description of surgical technique, including instrumentation, positioning, room set up, anatomy, dissection and repair, and is illustrated with black and white images.  

Information about laparoscopic surgery is at www.laparoscopy.com - including excellent pictures and video clips.

Trans Web is a Website all about transplantation and donation at www.transWeb.org/default.htm  and offers a wealth of information, for both transplant surgeons and patients.

PLink, offers a collection of links for plastic surgery at www.nvpc.nl/plink/.

The American Society of Colon and Rectal Surgeons has its Website at www.fascrs.org/

Archives of surgery online is at http://archsurg.ama-assn.org/  

ENT

Dr. Quinn’s Online Textbook of  Otolaryngology at www.utmb.edu/oto/grnds.dir/grnds.html is a superb resource for ENT surgeons. The heart of this site is an extensive collection of superb articles on a wide variety of topics of interest to ENT surgeons, presented as Grand Rounds. These range from common topics such as Otosclerosis and Facial Paralysis to uncommon problems such as Flaps for Facial Defects to Paragangliomas. Grand Round are a format which are very popular for teaching postgraduates in US hospitals, and these have been presented by the Residents and Faculty of the Department of Otolaryngology of the University of Texas Medical Branch. Each Grand Round presents comprehensive state of the art information on the selected topic. Since this information comes from a well-respected educational institute, it is reliable, up-to-date and free of advertising.

            The purpose of the Guide to Otolaryngology on the Internet at www.bcm.tmc.edu/oto/others.html is to serve as an excellent catalogue of educational otolaryngology sites and is maintained by an ENT Surgeon!

            Practical ENT for Primary Care Physicians at http://icarus.med.utoronto.ca/carr/manual/outline.html   offers basic online textbook of what every family physician needs to know about common ENT problems.

Radiology  

To find out more about this area of science, cheek out www.radiology.com . An excellent, well-designed site, it offers a one-stop shop for all radiologists. The site is constantly  updated and is divided into different sections. In the section, ‘Case of the Week’ you can learn and test your knowledge with teaching cases and a selection of online lectures on radiology; in the ‘Second Opinion’ section, you can solicit help on difficult cases by accessing expert radiologists in 14 different areas. Also present is a directory of vendors for equipment, services and supplies. It also has links to imaging journals, societies, Web resources and newsgroups, as well as a scientific exhibit gallery, which offers an online global archive for the most significant scientific posters and exhibits in medical imaging.

            Other radiology sites worth visiting are at www.radcenter.com and www.refindia.net

Pediatrics 

The General Pediatrician's View of the Internet at www.generalpediatrics.com provides a starting point for pediatricians by identifying and linking to the high quality General Pediatrics Websites that can teach, illuminate, and inspire. When selecting a site, www.GeneralPediatrics.com  uses a process of peer review by accreditation to ensure that only high quality sites are included, so that the emphasis is on quality rather the quantity. To become accredited, a site must clearly display four core credentials.

a. Authorship, including the author’s name, affiliation, and credentials.

b. Attribution of facts through the listing of references.

c. Disclosure of site ownership and sponsorship.

d. Currency of the site by listing dates of content posting and updating.

            Unfortunately, the sites have not been reviewed, but since they have been selected  so carefully, each is worth visiting . The listing is comprehensive, and classified into the following  sections: Textbooks, Policy Statements and Clinical Practice Guidelines, Evidence Based Medicine Resources, Case Studies and Patient Simulations, Common Problems by Discipline, Patient Education Information, Journals, Professional Societies, Continuing Medical Education Courses and Internet Directories and Search Engines. This site is plain vanilla, and being primarily educational in content, there is no advertising or distracting graphics, so that it does its job of guiding pediatricians looking for information on the Net well.

            PEDINFO  is an Index of the Pediatric Internet, found at www.pedinfo.org and provides a complete coverage of useful links for Pediatricians.

 The Pediatric Database (PEDBASE) a www.icondata.com/health/pedbase/index.htm contains excellent descriptions of over 550 common and rare pediatric illnesses, from Aarskog syndrome to Zellweger’s syndrome. A specially nice feature is that you can download the entire database on to your own computer as shareware, free of charge, so that you have a comprehensive electronic textbook of pediatrics on your own hard disk!

            The Vanderbilt Pediatric Interactive Digital Library at www.mc.Vanderbilt.Edu/peds/pidl/index.htm is a complete pediatric encyclopedia.

Obstetrics and Gynecology  

Obgyn.net at www.obgyn.net is a superb  portal for all gynecologists. Well-designed and easy to  surf, the graphics are a pleasure. What is unusual here is that the site has  adopted an   international viewpoint quite a refreshing change from most other medical Website designed in the USA.

            Obgyn .net is very comprehensive and is constantly updated. There is a superb section for women as well This means that you can refer your patients to the same site if they want more information on any topic.

            The site’s online medical journal, Female Patient, is designed for the practicing gynecologist with information that can be put to immediate clinical use. There are also online videos- here one can watch a laparoscopy or 3-d ultrasound.

Obgyn.net also hosts the mailing list, obgyn-1 and relays live chat sessions, hosted by experts on many different topics. Also available are free Web page and free Medline search.

Orthopedics  

Orthogate at www.orthogate.org is an orthopedic gateway site supervised by the Internet Society of Orthopedic Surgery and Traumatology. The concept of the gateway is that from here in no more than three clicks you should be able to reach any of the resources on the orthopedic Internet which you would like. Since this is an educational site, run by a group of orthopedic surgeons who have donated their time, computer and  Servers to the Orthogate project, there is no advertising. In order to assess the quality of the Websites it selects, Orthogate uses the OMNI advisory group for evaluation Criteria and also subscribes to the HON code principles of the Health on the Net foundation. This enables it to focus on quality and comprehensiveness in order to improve the standard of orthopedic information on the Internet. You can also read and subscribe to the Orthopod e-mail list at this site. Orthopod is an international academic mailing list for discussion, collaboration, sharing ideas and the dissemination of research in orthopedics and trauma surgery for orthopedic surgeons.

            The Indian orthopedics Website at www.indiaoth.org/ has original and valuable information tailored for the needs of surgeons from India.

            The Wheeless’ Textbook of Orthopedics at www.medmedia.com/med.htm is a comprehensive electronic textbook of orthopedics.

Psychiatry  

Psychiatry link at www.psychiatrylink.com offers an online community that supports the research interests and clinical requirements of psychiatric care professionals.

            Another informative site on mental health is at www.mentalhealth.com/.

Nephrology  

To find out more about hypertension, dialysis and clinical nephrology, check out the site at www.hdcn.com.

Cardio-thoracic surgery  

CTSNet at www.ctsnet.org is a collaborative effort of the major cardiothoracic organizations around the world to provide a comprehensive, Web-based repository of information for surgeons.  

Heart surgery forum at www.hsforum.com is an online peer-reviewed journal in cardiothoracic surgery, which offers scientific articles, discussions, listservs, news, announcements and more from the world of heart surgery.

Neuroscience  

Neuroscience on the Internet at www.neuroguide.com/ offers a superb searchable index of neuroscience resources, which covers neurobiology, neurology, neurosurgery, psychiatry, psychology, cognitive science sites and information on neurological diseases.

Ophthalmology 

The ophthoguide at www.opthoguide.com/ophtho/ provides a comprehensive directory of links for ophthalmologists.  

            The American Academy of Ophthalmology at www.eyecare.org provides a wealth of valuable content.

DRUGS AND MEDICINES 

Rx list- The internet Drug Index at www.rxlist.com provides a world of information about medicines. The top 200 Prescriptions list represent nearly 2/3rds of all prescriptions filled in the USA. You can perform keyword searches of all Rx list monographs (nearly 300 of them) simultaneously for potential drug interactions, side effects and indications. The search engine uses fuzzy logic as well as wildcard searching, just in case your spelling is imperfect. Interestingly, there is now a section on alternative medicines as well, with information on herbs as well as ayurvedic, Chinese and homeopathic medicines. Rx board also offers Drug Specific Bulletin Boards for further discussion. 

            The Informed Drug Guide www.infomed.org/100drugs/  is an excellent compilation of the hundred essential drugs a general practitioner needs to be familiar with. It contains critically evaluated information on the selected drugs, which have been chosen in such a way that approximately 90 per cent of all the problems occurring in primary medicine can be dealt with adequately. 

            Other useful sites where one can get more information about drugs include: Pharminfo at www.pharminfo.com, www.dmcpharmacy.org/ and www.pharmweb.net.

PRACTICE MANAGEMENT 

For managing the business side of medical practice, the Physician’s Practice Digest at www.ppdnet.com is an online magazine for physicians. It features general interest articles on topic such as medical office  management. While the scope of this site is fairly limited, and very US-centric, the site is worth a visit if you are looking for articles about the non-clinical aspects of medicine, including office management, savings and retirement planning, legal issues and dealing with insurers.

PATIENT EDUCATION  

            Rx Med at www.rxmed.com provides an excellent collection of handouts, which you can use for educating patients. These fact sheets, which cover more than 400 medical  conditions ranging from acne to morning sickness to drug addiction, provide easy to read, concise information on each condition's symptoms, causes, risk factors, prevention, activity or diet restrictions, and for more serious illness, complications and prognoses. Other sites that offer patient educational materials include :

www.48hours.net

www.osu.edu/units/osuhosp/disclaim2.htm  

MEDICAL JOURNALS  

Many physicians assume that one can find all the articles from all medical journals on the web for free. However, the reality is that while most medical journals have their own Websites, very few offer free access to their content. A refreshing exception is the British Medical Journal, at www.bmj.com which has put up back issues as well as the full text of current issues on its site. You can also submit articles to the BMJ, as well as letters to the online editor through e-mail, Customized @lerts is an additional useful service which sends you e-mail every time the journal has new content that might interest you. In order to make browsing fun, the site also offers a section called collected resources which puts together collections of BMJ articles by speciality and topic.  

            Most journals offer free access on a trial basis when their Website is relatively new. The Highwire press at http://highwire.stanford.edu/  has put a number of well known journals online with temporary unrestricted access to journal articles. The journals that offer free trials are highlighted on the site.

            WebMedLit, at www.webmedlit.silverplatter.com/index.html  is  an easy way to get access to the latest medical journal articles. WebMedlit presents the articles from 22 leading medical journals in a streamlined consistent format. This includes leading medical journals like JAMA, NEJM and BMJ.

            But where are the Indian medical journals? The best so far is the Bombay Hospital Journal, which has put up the full-text of all its articles, as well as back issues, at www.bhj.org/. You can also find a list of Indian medical journals at www.qmedin.com/medsites/indianwebjournals.htm

MEDICAL TEXTBOOKS

            While the printed textbook is not likely to become obsolete for  many years, www.emedicine.com is an ambitious project, which aims to publish a complete set of free online medical textbooks. They plan to achieve this by bringing medical professionals together for providing better medical information. Each book will be written by a large group of experts from all over the world, with excellent teaching credentials. The text will then be compiled and edited so that  it is accurate, readable and up-to-date.

            These textbook can be improved or updated 24 hours a day, 365 days, a year, and allow readers unlimited downloading of thousands of x-rays, color illustrations, and pictures. E-texts also allow the reader to instantly send comments, questions, and potential new pictorial additions to the topic author, so that it is truly interactive.

            Many titles are nearing completion, and these include dermatology, medicine, surgery, neurology, ophthalmology, otolaryngology, facial plastics, pediatrics and plastic surgery.

            So far, only one book has been completed. This is on Emergency Medicine and is titled Emedicine’s Emergency Medicine. Each chapter is complete and comprehensive, and includes: treatment, workup, differential diagnosis as well as a bibliography, a link to a continually updated Medline search of the topic as well as test questions, so that you can confirm you have understood the key messages. These books also include online live videos (for example, of an echocardiogram) something no print book can provide. This site represents the future of many doctors from all over the world, the many different exciting multimedia formats (audio, video, virtual reality, 3-D) which computer technology allows, as well as the instant interactivity the internet offers, this may soon become the definitive medical textbook of the future.

            One of the most complete and concise textbooks on medicine is the Merck manual of Diagnosis and Therapy, which is celebrating its centenary with the publication of the 17^th edition. The Merck Manual is used by more medical professional’s world-wide than any other general medical textbook and has been continuously published longer than any other medical textbook in English. The 17^th and latest edition of this encyclopedic volume is available online, free of charge, at www.merck.com/pubs/mmanual/.  A superb reference source, it should be bookmarked by every doctor. The Merck Manual of Geriatrics is also online at http://Merck.com/pubs/mm_geriatrics/ 

            Another excellent reference source is the University of lowa Family Practice Handbook at www.vh.org/Providers/ClinRef/FPHandbook/FPContents.html, which provides basic information on most common clinical problems seen in practice.

ONE STOP SHOP 

Many companies have realised that doctors are busy people, who would prefer finding the clinically useful information they are looking for on the Web instantly, rather than having to wade through pages of irrelevant material. In order to satisfy this need, there are now comprehensive medical Websites that provide all the information that a doctor may need at one place.

            Some, like Physician’s Online and PDR are restricted to US physicians only. An excellent site is Medscape at www.medscape.com, which claims it has the web’s largest collection of free, full-text, peer-reviewed clinical medicine articles. You have to register, but it's free and Medscape now offers a 'speciality home page' feature that customizes  the site toward your interests when you log in. Medscape has an exam room which offers an interactive case challenge for you to text your clinical skills, conference summaries of important medical meetings,  continuing medical education credit, medical news, as well a journal scan section which provides short summaries of key articles from leading medical journals. The heart of Medscape is its unique library, which offers the full-text of many medical journals free. These include the American Heart Journal, CHEST, clinical Reviews, complications in surgery, current Medical Research and Opinion, Hospital Medicine, Journal of Invasive  Cardiology, Medscape Oncology, Physicians, News Digest and as a special bonus, when you need a break, the hilarious STITCHES, the journal of medical humor. These are all searchable as are the Medline, AIDSline and Toxline databases, so that you can find articles of your interest with ease.  

            Another superb site is www.pdr.net from the publisher of the leading American medical magazine, Medical Economics. The site is packed with information, targeted for the practicing physician. While the material is designed for doctors practicing in USA, it could be useful for private practitioners in India as well. Though one needs to register before accessing the site it is free. Doctors from India need to register as consumers, since we do not have a DEA number (Which is restricted to US physicians only). This means that access to this site is crippled, but nevertheless, there are still nuggets which are worth mining for here! Excellent online magazines include: Medical Economics- The Business Magazine of the Medical Profession, Patient Care, The Practical Journal for Primary Care Physicians, Drug Topics, Contemporary OB/GYN and Contemporary Urology. Unfortunately only older issues of these magazines have been included In the online archives, but these are still worth browsing.

THE BEST OF THE BEST 

If you  want to pick just one website, which would answer all your information needs, try out www.mdconsult.com which labels itself as “What Doctors need to know". This site provides access to the ultimate digital online medical library. The full text medical reference books which are the standard authoritative texts and cover all fields of medicine include Nelson Textbook of Pediatrics, Cecil Textbook of Medicine, Devit: Cancer: Principles & Practice of Oncology, Rakel: Conn’s Current Therapy, Rowland : Merritt’s Textbook of Neurology, Ryan: Kistner’s Gynecology: Principles and Practice, Sabiston: Textbook of surgery and Cambell’s Urology. You can search the entire collection at the same time, then pinpoint the information you need within the so summate text on the subject.  

            The site also provides access to the complete text of all the articles in the famous clinics of North America, the entire series of year Books as well as many leading journals. These include the American Heart Journals, American Journal of Obstetrics & Gynecology, Chest, Journal of Pediatrics, Medicine, Neurology, and Pediatrics, so that you are no longer restricted to abstract only. You can also search the MEDLINE database. The section on practice guidelines offers you the complete text of over 600 peer-reviewed clinical practice guidelines contributed by more than 50 medical societies and government agencies.  

            An additional  bonus is the ‘Patient Education’ section, which offers you access to any of 2,500 acclaimed patient education handouts. You can add your own comments to customize them for your practice, and then print the handout, complete with your own special instructions, practice name, and contact information!  

            The Drug Information section provides regularly updated prescribing information on over 30,000 medications from an independent drug reference source. While all the brand names are for US drugs, this is very valuable information, which allows you to find the right drug for the right problem.  

            MD consult has been laid out so that it provides answers to clinical queries, and also has a section which allows regular updates. The ‘updates’ section offers many choice. The ‘Today in Medicine’ division allows you to stay informed about the newest development in medicine. It reviews new developments from major journals, government agencies, and medical conferences, and provides you with concise clinical summaries and links to related information.  

            The ‘In this week’s Journals’ allows you to keep up with all the major weekly journals by presenting you with all the major weekly journals by presenting you with the key contents of the big six journals-JAMA,BMJ, lancet, NEJM, Archives of Internal Medicine and Annals of Internet Medicine in an easy-to-scan format, including concise article summaries which help you quickly stay abreast.  

            Clinical Topic Tours offers a new tour each week and lets you explore current thought and accepted wisdom on consequential topics in medicine through a focused collection of information from journal articles, books, drug data, practice guidelines, educational materials and useful Websites.  

Copyright © 2002 Dr. Subrahmanyam Karuturi