My recent articles in the Cybermed column can be best exploited if it is accessed through the Internet. Information will be better transmitted and used because of the HTML format in which it is written. O.K, what is HTML? HTML stands for Hypertext Markup Language. Its just another format for saving the data for example, .doc, .txt, .wpd. but you have to code it. It can be done in any word processor or a HTML editor software by the addition of HTML pointers, markers and style tags. Those who have used the WWW would have seen how easy it is to "jump" from one site to another by just pointing the mouse and clicking the texts that are underlined (URL, Universal Resource Locator). You can be accessing a web page in USA at one moment and with the next click you might find yourself in China or Malaysia. For those who would like to know more about it or try their hand at HTML, go to "Introduction to HTML" by Clare Sansom and Alan Mills. Alternative site or .

I know it is difficult for people to grasp the computer lingo but things are going to change and if you want to keep up with the latest medical information, it cannot be faster then being on the Internet (online). If you are involved in research, or need to know more about viral myocarditis as in the recent outbreak in Sarawak or currency exchange , telephone directory in Malaysia or weather in Tokyo or time in London, every bit of information can be a "mouse click" away. You have a library, dictionary, directory, weather "machine", banking information, etc, all in front of you in the comfort of your own home. The hurdle is getting familiar with computer, software, Internet and where to look for the needed information, once you have mastered the first three!

British Medical Journal is on the net and they have come up with a series of articles entitled "A Guide to the Internet for Medical Practitioners" written by Mark Pallen and this was about 2 years ago. It was published in four parts, 1.Introducing the Internet (BMJ No.7017) , 2.Electronic Mail (BMJ No.7018 ), 3.The World Wide Web (BMJ No.7019) and 4. Logging in, Fetching Files, Reading News (BMJ No.7020). For further reading you could try the "ABC of Medical Computing" by Nicholas Lee and Andrew Millman. Just be aware that when reading the articles, that the computer and software industry is growing at a very fast pace and some of the recommendations may not hold to be true now. Talking about journals, there are a number of journals that are accessible in the web. Some just give you the name of articles published in a particular issue, others give you the full text as well as allows one to search their archive. A list of available journals on the Internet is in one of my web pages, Medical Journals .Of course there are many more e.g. Surgical, Neurology, etc you just have to look them up yourself.

Ronald E LaPorte and his team had stunned the "journal world" by predicting "The death of the biomedical journals". (BMJ No.6991) This is a thought provoking article and it was followed by "Further down the Information Highway: Rights, wrongs, and journals in the age of cyberspace" (BMJ No.7072 ) where the editors of some leading medical journals made their comments. To complete the "picture" read "Scientist Assassinate Journals: Dec.31, 2001. Journals have been an endangered species for years. Today the last paper journal was killed. The killer? A scientist." This article can be accessed at . There are different formats including a lay version, a scientific version, an editorial version, and a hypertext comic book. What is interesting is that you can call up a form to rate the paper, as well as provide a critique. Finally, "How the Internet is Transforming Medicine" is presented in the web as a PowerPoint slide presentation - 61 slides. Several slides include text and/or hyperlinks to obtain additional information. In these article you will find Global Health Network mentioned several times.

I had contacted LaPorte and he was most informative in sending me material, one of which "Global Health Network Overview" gives a global overview of this concept. What interests me is the concept of tele-preventive medicine, more of which is available in his article. More information can be got from the Global Health Network Homepage . ( )

The recent outbreak in Sarawak (Down) has brought World attention to Malaysia. The Public Health specialist and those trained in epidemiology have a huge task in finding the primary source of this outbreak. This current outbreak "boggles" the mind in being widespread over many places in Sarawak. Epidemiologically, one should be able to link the first case to the remainder in infectious diseases, either by direct contact or through a medium, e.g. water. If this is not the case are we dealing with a toxin? There is also a possibility of over reporting either the cause of death or case. The epidemiological team would require first to confirm whether the deaths reported are due to viral myocarditis and if yes, did they present with similar signs and symptoms? Only then they will have an idea how the disease has spread. Retrospectively, a definite diagnosis by virologist would help control measures and management of patients. A system of reporting, follow-up and confirmation should be in place. We also have to be vigilant as we have a large pool of foreign workers. Information to the public should be rapid to allay fears and prevent misconception. There should be another line of information dissemination to medical staff be it in the government or private sector as soon as possible. As doctors would be contacted and consulted, they must be able to answer and answer correctly. Information on viral myocarditis, coxsackievirus, virology and other resources can be found at

There are centers that monitor outbreaks worldwide and many epidemiologists and scientists subscribe to these sites to share and mutually benefit information on emerging diseases. Below are several sites that monitor outbreaks.

You can subscribe to their services and they will place you on their email list.

To make this article interactive, please post any comments to me ( and I will try to include them as a link to the article concerned. If you have a list of resources that you would like to share, preferably with a small write up for each URL mentioned, send your bookmark as an attached document in .html format. If used, due credit will be mentioned if desired (email of individual, and name).

Till next month, Happy Surfing.

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