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Postquam fuerite satis decocta generic cymbalta 30mg without a prescription, tere in mortario cum auxungia cheap cymbalta 20 mg fast delivery; post argentum uiuum pone cumf oleo et cum aceto ing quo cocta sit enula distem- pera discount 30mg cymbalta with mastercard. Nota quod si quisj hoc unguento se unxerit buy cymbalta 20 mg amex,k aquam frigidam teneat in ore, ne dentes ledantur ab argento uiuo, quod fluit circumquaque. Nota quod quando uolueris faciem dealbare, de isto ad quantitatem fabe accipe et distempera cum aqua frigida, et pauca inter manus fricando et cum ambabus manibus faciem illinimus,h prius tamen faciem lauemusi cum aqua et sapone. Deinde cum aqua frigida aspergimus et pannum subtilem superponimus,j siue in mane siue in sero hoc fiat. Postea pulueriza et distempera cum aqua rosacea, et cum bombace uel pannoc lineod subtilissimo illinimus, et inducit ruborem faciei. Mulieri satis albe naturaliter facimus colorem rubeum,e si rubore careat, ut submentita uelf palliatag specie albedinis color rubeus quasi naturalis appareat. Take root of the elecampane, clean it and cut it very finely, and cook it in the vinegar. Then put in the quicksilver with the oil and with the vinegar in which the dissolved elecampane has been cooked. Note that if anyone31 should anoint him- or herself with this ointment, let him/her keep cold water in his/her mouth lest the teeth be damaged by the quicksilver, which flows around every which way. On Whitening the Face [] For whitening the face, take root of bistort and clean it, and root of cuckoo-pint. Grind them in a mortar with animal grease and mix them with warm water, and strain through a cloth. And in the morning gently remove the water, pour- ing in fresh water; water made from honeysuckle as well as from roses is the best thing for this. This is done to repress [the herbs’] harsh properties lest they cause lesions to the face. On the sixth day, having thrown out the water, expose [the mixture] to the sun and let it dry, and afterward take three parts of white lead and a fourth of camphor, and one dram each of borax and gum arabic. Note that when you wish to whiten the face, take from this [mixture] a quantity the size of a bean and mix it with cold water and, rubbing a little between the hands, with both hands we anoint the face, but first we should wash the face with water and soap. Then we sprinkle [the face] with cold water and we place on it a very delicate cloth; this should be done either in the morning or in the evening. On Making the Face Red [] For making the face red, take root of red and white bryony and clean it and chop it finely and dry it. Afterward, powder it and mix it with rose water, and with cotton or a very fine linen cloth we anoint the face and it induces redness. For the woman having a naturally white complexion, we make a red color if she lacks redness, so that with a kind of fake or cloaked whiteness a red color will appear as if it were natural. On Treatments for Women  For Removing Wrinkles [] For wrinkled old women, take stinking iris, that is gladden, and extract its juice, and with this juice anoint the face in the evening. And in the morning the skin will be raised and it will erupt, which rupture we treat with the above- mentioned ointment in which root of lily is employed. On Freckles of the Face [] For freckles of the face which occur by accident, take root of bistort and reduce it to a powder, and cuttlefish bones and frankincense, and from all these things make a powder. And mix with a little water and then smear it, rubbing, on the hands34 in the morning, rubbing them with rose water or water of bran or with breadcrumbs until you have removed [the freckles]. On Stench of the Mouth *[] For stench of the mouth caused by a disorder of the stomach, let the tips of myrtleberry be ground and cooked in wine until reduced by half and, with the stomach having been purged, let the wine be given to drink. On Removing Redness of the Face [] For removing redness from the face, we put on leeches35 of various colors, which are in reeds, but first we wash with wine the place to which they ought to adhere; they are usually placed around the nose and ears on both sides. For Veins in the Face [] For veins which appear in the nose or on the face, we apply to the place three parts soap and a fourth part pepper, [all] powdered, and we cure it in the above-mentioned manner. Recipe oliba- num, masticem,f ceram, oleum, picem grecam, galbanum, aloen, absinthium, arthimesiam, peritariam, rutam, saluiam. Terantur herbeh et in- fundatur oleum et misceaturi super ignem, et cum fuerit in suppremo calidum, oleum coletur et iterum igni apponatur, et cum incipietj bullire apponaturk cera, et postea ceteral pulueri[vb]zata et decocta colentur et superponan- tur. Et nota quod loco cancroso folia hedere siluestris satis ualent in uino decocta et superposita. Later we spread around rose oil during the night and she will be freed in a short time. For Black Teeth [] For black and badly colored teeth, take walnut shells well cleaned of the interior rind,which is green,36 and we rub the teeth three times a day, and when they have been well rubbed, we wash the mouth with warm wine, and with salt mixed in if desired. On Treating Cancer [] We wash a cancer wherever it is in the body, and we sprinkle over it a powder made of cumin and green copper. And when it has become necrotic, we foment it as befits a dried-out, afflicted place. We anoint it with this oint- ment: Take frankincense, mastic, wax, oil,Greek pitch, galbanum, aloe, worm- wood, mugwort, pellitory-of-the-wall, rue, and sage. Let the herbs be ground and let the oil be poured in and mixed upon the fire, and when it is exceedingly hot, strain the oil and place it again upon the fire, and when it begins to boil let the wax be added. Afterward let the other things, which have been powdered and cooked, be strained and added. The sign of thorough cooking is when a drop placed upon marble stays there and hardens. And note that leaves of wild ivy, cooked in wine and laid upon the cancerous place, work very well. On Fissures of the Lips [] There are some women who suffer from fissures of the lips, and this on account of the excessive embraces of their lovers and their kisses with their lips rubbing between them. We treat these women with an ointment made of fleawort or with the unguent made from lily. Hiis autem illinimus labia cum melle, et postea picem grecam pulueri- zatam superaspergimus. Secundum magistrum Ferrarium,45 accipe magnam nucem et decoque sub cinere eta nucleum tere, et fissure appone apposito tartaro et sanabitur. Facimuse eis recipere uinum in ore in quo bullieritf zinziber, galangam, et post ablutionem circa dentes puluerem olibani superaspergimus,g et cumh eodem uino facimusi osj abluere hiisk qui habent palatum excorti- catum, et post alumen cum zucchara46 apponamus. Puluis zinziberis, pi- retri, et cynamomi decoquimus in uino et facimus gargarizare, et puluerem horum calidorum apponimus uuule. Pulueres uerod etiame predictos in posterioribus facimus insufflare per nares ne tume- scant. Accipe albu- minab ouorum51 et distempera cum aqua in qua coctum sit pulegium et huius- modi herbe [rb] calide et panno nouo linic intinctod bis uel ter in diee uuluef ¶a. On Treatments for Women  [] Likewise there are other women who suffer fissures caused by the air and the wind and similar causes. For these, then, we anoint the lips with honey, and afterward we sprinkle on powdered Greek pitch.

The aim of the course is to enable the students to understand common problems in psychiatry cymbalta 60mg line. Teaching activities comprise of both theoretical and clinical learning which will be delivered via lectures buy discount cymbalta 30mg line, audiovisual sessions buy 60 mg cymbalta with amex, problem-solving learning buy 40 mg cymbalta overnight delivery, clinic sessions and case presentation. Each student will be supervised by a lecturer, who will monitor his/her progress via clinical attendance, logbook and supervisor’s report. Students will be assessed through continuous assessment and end of course examinations. This course aims to expose students to the primary health care and relevant ethical issues. Students will be trained to identify patients who need further care and referrals. Theory will be taught in the form of lectures and seminars, and clinical learning will be applied through laboratory training in clinical skills, role-play, clinic and problem-solving sessions. The aim of the course is to enable the students to understand common problems in ophthalmology. Teaching activities comprise of both theoretical and clinical learning which will be delivered via tutorials, seminars, ward rounds, clinic and operation theater sessions, problem- 49 solving learning and community service Students will be assessed through continuous assessment and end of course examinations. The aim of the course is to enable the students to understand common problems in Otorhinolaryngology. Teaching activities comprise of both theoretical and clinical learning which will be delivered via seminars, ward rounds, problem-solving learning, clinic and operation theater sessions and case presentation. The students are given the flexibility to choose their clinical placement either in or outside the country. Through this course, students will be exposed to the comprehensive management of patients while being supervised by field supervisors determined by the authority of the selected hospitals. Students will be assessed based on case write-up, logbook and single best answer questions. At the end of the course students should know and are exposed to the basic principles of Traditional Malay, Chinese, Indian and Complementary Medicine such as Homeopathy and others. The method of teaching is through lectures, demonstrations in traditional and complementary medicine clinic registered with the Ministry of Health, Malaysia, self-study, debate, presentation and writing cases. Students will be guided on how to take the history of patients receiving Traditional and Complementary treatment and selection of suitable cases. Emphasis is placed on the integration of basic science, clinical diagnosis and treatment of modern medicine / allopathy with knowledge of Traditional and Complementary Medicine. List of text/reference books (a) Main references : Integrative Medicine: Principles for Practice by Benjamin Kligler & Roberta Lee (2004). The aim of the course is to enable the students to understand and manage problems in Paediatrics. The sense of team spirit and professional etiquette in paediatrics will 51 also be instilled into the students. The learning will be delivered via seminars, tutorials, practice in the ward rounds, bedside teachings, clinic sessions and case presentation. Students are expected to clerk and follow the management of all patients under their care. Each student will be given a supervisor, who will monitor his/her progress via clinical attendance, logbook and supervisor’s report. Students will be assessed through continuous assessment and end of course assessment. The main objectives of this posting include ability to gain clinical skills (diagnosis and management) in managing surgical problems. In this posting, we expect the student to gain effective communication and professional with patient, colleagues and public by using clinical cases as continuous learning process. Theoretical teaching includes presentations of topics common to surgical patients in tutorials. The students are also expected to clerk their own patients in the ward and follow-up in their management and progress. The main objectives of the posting are to consolidate medical knowledge and clinical skills in internal medicine by emphasizing on the clinical management. Clinical teaching is in the form 52 of long case, short case, oncall duty, guided internship training and bioethics case discussion. Students are evaluated by continuous assessment, case report and end of posting examination. It is a platform to prepare the graduates to be adequately trained in the common problems as well as emergency cases in Obstetrics and Gynaecology. The students are expected to develop a level of clinical judgement to enable referral of patients to more experienced colleagues when necessary. The sense of team spirit and professional etiquette in Obstetrics and Gynaecology will be further instilled into the students. Teaching activities comprise of seminar, problem solve learning, ward rounds or bed-side teaching, clinic session, case presentation, witnessing operations and on calls. Students are expected to clerk and follow the management of all patients under their care. Each student will be given a supervisor, who will monitor his/her progress via clinical attendance, logbook and supervisor’s report. Students will be assessed through continuous assessment and end posting examinations. Hutchinson’s Clinical rd Method, An Integrated Approach To Clinical Practice, 23 edition. The aim of the course is to enable the students to understand and manage problems in Orthopaedics. The sense of team spirit and professional etiquette in orthopaedics will also be instilled into the students. The theoretical learning will be delivered via 53 lectures and seminars whilst the clinical teaching will include the practice in the ward rounds or bedside teachings, clinic sessions and case presentation. Students are expected to clerk and follow the management of all patients under their care. The aim of the course is to enable the students to understand and manage problems in psychiatry. The learning will be delivered via seminars, practice in the ward rounds, clinic sessions problem based learning and case presentation. Students are expected to clerk and follow the management of all patients under their care.

Finally order cymbalta 30mg fast delivery, each competency and training problem was reviewed in detail by each of the task force co-directors for consistency and format cheap cymbalta 60mg on line. All members of the task force completed their assigned work at their home institutions without specific remuneration buy 20 mg cymbalta with amex. Report from an Invitational Conference Cosponsored by the Association of American Medical Colleges and the National Board of Medical Examiners buy cheap cymbalta 20mg line. Unprofessional behavior in medical school is associated with subsequent disciplinary action by a state medical board. Residents are expected to: • Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families. Residents are expected to: • Demonstrate an investigatory and analytic thinking approach to clinical situations. Residents are expected to: • Analyze practice experience and perform practice-based improvement activities using a systematic methodology. Residents are expected to: • Create and sustain a therapeutic and ethically sound relationship with patients. Residents are expected to: • Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society, and the profession; and a commitment to excellence and on-going professional development. Residents are expected to: • Understand how their patient care and other professional practices affect other health care professionals, the health care organization, and the larger society, as well as how these elements of the system affect their own practice. With guidance and direct supervision, participate in breaking bad news to patients. With guidance and direct supervision, participate in discussing basic issues regarding advance directives with patients and their families. With guidance and direct supervision participate in discussing basic end-of-life issues with patients and their families. Participate in family and interdisciplinary team conferences discussing end-of-life care and incorporating the patient’s wishes in that discussion. The role of the primary care physician in the coordination of care during key transitions (e. With guidance and direct supervision, participate in discussing basic issues regarding advance directives with patients and their families. With guidance and direct supervision participate in discussing basic end-of-life issues with patients and their families. Always treat cognitively impaired patients and patients at the end of their lives with utmost respect and dignity. Symptoms sometimes seen during end-of-life care and the basic principles of their management (e. Communication Skills • With guidance and direct supervision, participate in breaking bad news to patients. Management Skills • Appropriately assessing and treating pain when necessary with nonnarctoic and narcotic analgesics. The basics of the potential role of genetic information in diagnostic decision making. Describe the basic principles of using genetic information in clinical decision making. The basics of the potential role of genetic information in therapeutic decision making. The potential roles and limitations of genetic testing in disease prevention and early detection. Communication Skills • Counsel with regard to (a) possible causes, (b) appropriate further evaluation to establish the diagnosis of an underlying disease, and (c) the impact on the family (genetic counseling). The genetics and role of alpha-1 antitrypsin deficiency in some patients with emphysema. The basic principles of the role of genetics in dyslipidemia, particularly familial combined hyperlipidemia. The etiology of obesity, including excessive caloric intake, insufficient energy expenditure leading to low resting metabolic rate, genetic predisposition, environmental factors affecting weight gain, psychologic stressors, and lower socioeconomic status. Laboratory interpretation: Students should be able to recommend when to order diagnostic and laboratory tests and be able to interpret them, both prior to and after initiating treatment based o the differential diagnosis including consideration of test cost and performance characteristics as well as patient preferences. Communication skills: Students should be able to: • Communicate the diagnosis, treatment plan, and subsequent follow-up to the patient and his or her family. Demonstrate commitment to using risk-benefit, cost-benefit, and evidence- based considerations in the selection of diagnostic and therapeutic interventions for <>. Recognize the importance of patient needs and preferences when selecting among diagnostic and therapeutic options for <>. Respond appropriately to patients who are nonadherent to treatment for <>. Demonstrate ongoing commitment to self-directed learning regarding <>. Appreciate the impact <> has on a patient’s quality of life, well-being, ability to work, and the family. Recognize the importance of and demonstrate a commitment to the utilization of other health care professionals in the diagnosis and treatment of <>. In a time of rapidly proliferating tests, medical students must learn how to design safe, expeditious, and cost- effective diagnostic evaluations. This requires well-developed diagnostic decision- making skills that incorporate probability-based thinking. Key history and physical examination findings pertinent to the differential diagnosis. Information resources for determining diagnostic options for patients with common and uncommon medical problems. Key factors to consider when selecting from among diagnostic tests, including pretest probabilities, performance characteristics of tests (sensitivity, specificity, likelihood ratios), cost, risk, and patient preferences. The basics of the potential role of genetic information in diagnostic decision making. How critical pathways or practice guidelines can be used to guide diagnostic test ordering. The methods of deductive reasoning, forward thinking, and pattern recognition in clinical decision making. Identifying problems with which a patient presents, appropriately synthesizing these into logical clinical syndromes. Formulating a differential diagnosis based on the findings from the history and physical examination. Using probability-based thinking and pattern recognition to identify the most likely diagnoses.