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Issue 8 - Starting a business at Med School, what's new this week & Norton's back in the corner...

Hello all! Welcome to the eighth instalment of our weekly dose. This week, I'm looking at starting a
Issue 8 - Starting a business at Med School, what's new this week & Norton's back in the corner...
By Pulsenotes • Issue #8 • View online
Hello all!
Welcome to the eighth instalment of our weekly dose. This week, I’m looking at starting a business in medical school (following on from our recent LIVE Q&A), Sam’s shouting about what’s new this week @pulsenotes and Norton’s back in his medical corner talking about SBP… enjoy!
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Starting a business in Med School
Starting a business is a great way to develop new skills...
Starting a business is a great way to develop new skills...
So you’re interested in starting a business? You’ve seen all 17 seasons of Dragon’s Den and spent more time watching the Apprentice than you like to acknowledge - but where do you actually start!?
We originally came up with the idea for Pulsenotes in our fourth year of med school (yes, it’s taken this long!). Starting a business boils down to three steps: the PROBLEM, your SOLUTION & WHY?
  1. Identify a problem - This can be any problem or unmet need that individual’s will spend their time or money to solve. For us this was the lack of good quality, consistent and well-presented medical revision materials on the internet. A good place to look for problems is every day life… what things annoy you (and maybe others?), can you identify inefficiencies?
  • Find (or build) a solution - Think of as many solutions as you can. Filter down and prototype. Remember, your solution needs to be desirable, feasible and viable.
  • Why? - Starting a business is not easy and places enormous demands on your time and energy. You need to be clear with yourself why you want this? Furthermore, the timing needs to be right - you don’t want business to negatively impact your studies!
Starting a business is a great way to develop new skills… For me, a fundamental understanding of coding / web design is a must - it’s the way business is now conducted. Work on your basic design and social media skills (YouTube is a great resource for this!).
There are a wealth of resources and funding available to help budding entrepreneurs. University Entrepreneur societies, business innovation groups, SETsquared, Shell LiveWIRE and lot’s more! Surround yourself with like-minded people and get involved!
Final words
Starting your own business can be an incredibly rewarding experience. Here’s some of the lessons we’ve learnt over the years…
  • Don’t wait - You don’t need lot’s of funding or permission to start!
  • Understand business basics - There are lot’s of great free resources available, a great podcast I listen to is Seth Godin’s Start-up School.
  • Start SMALL - Start small and get out there! You need a product, not the perfect product!
  • Don’t go alone - Everything is just more fun with friends - it goes for business too!
  • Failures will happen - It’s not going to be plain sailing, expect failures along the way…
  • Expectations - Be clear in your mind why YOU want to do this and be realistic with your expectations!
For more info, check out our Q&A video - starting a business!
Got a question? Message me on twitter! @plasticsreg
Benjamin Smeeton @plasticsreg
What's new this week?
Upcoming events - Join our Facebook Community for all the details!
Upcoming events - Join our Facebook Community for all the details!
LIVE events - what we’ve got coming up…
We’re providing FREE LIVE WEBINARS over the summer. This is what we’ve got lined up for the week ahead:
  1. Wednesday 24th June 10:00 BST - Pulsenotes LIVE: Sarcoidosis. Norton’s back to tackle this exam classic!
  2. Friday 26th June 11:00 BST - Pulsenotes LIVE: Parkinson’s Disease. Our neurology lecture series (in association with SMILE) starts with Parkinson’s Disease.
  3. Sunday 28th June 17:00 BST - LIVE Q&A: Intercalation. Join us for another LIVE Q&A with the Pulsenotes Team (Doctors Ben, Norton, Sam & Abhi). In this episode, we’ll be focussing on INTERCALATION.
Remember - recordings of all these LIVE events will be available for members that aren’t able to make it!
New topics…
We’ve been extra busy this week (well, Norton has). We’ve added a number of beautiful video lectures to our library:
  • Tuberculosis with Norton
  • Hyperthyroidism with Norton
  • Hypothyroidism with Norton
Our notes library keeps growing (we’ve just hit 157 topics!) and this week we’ve added all of these:
Norton's Corner
Spontaneous bacterial peritonitis (SBP)
SBP is one of the more common complications associated with chronic liver disease.
Ascites - fluid within the peritoneal cavity
Ascites - fluid within the peritoneal cavity
Patients with chronic liver disease (CLD) can become sick. Really sick. They are high risk of developing bacterial infections. When a bacterial infection occurs within ascites (fluid within the peritoneal cavity), we call it SBP.
The actual pathogenesis of SBP is highly debated. Theories suggest direct bacterial translocation across the bowel wall or haematogenous spread of bacteria in the context of an immunosuppressed state. Liver disease is well known to cause immune dysfunction.
SBP may present in a number of ways including peritonitis (i.e. abdominal pain), hepatic encephalopathy, as an upper gastrointestinal bleed, acute kidney injury or overt sepsis. It complicates ~10% of inpatient admissions with decompensated CLD and requires early recognition and treatment - this is because of the high morbidity and mortality associated with SBP; one year survival after SBP is only 30-50%!
So what do we do when suspect SBP? The key is an ascitic TAP -trans-abdominal paracentesis.
An ascitic TAP involves inserting a small green needle into the abdomen and taking a sample of ascitic fluid. This can be sent for urgent analysis in the lab. SBP is defined as an ascitic fluid white cell count >250/mm3 that is predominantly neutrophilic (i.e. the majority of the white cells seen are neutrophils).
Treatment for SBP is broad-spectrum antibiotics (e.g. third-generation cephalosporin) unless sensitivities for a particular bug are available. They are often given on suspicion (i.e. before the ascitic TAP) to prevent any delay in treatment. Following an episode of SBP, patients require prophylactic oral antibiotics to reduce the risk of it developing again!
Remember, SBP is a serious bacterial infection - so don’t forget the TAP!
Benjamin Norton (@medicalreg)
Final words
Remember to get in contact with any questions, suggestions, or topics that you wish to be covered!
Thanks for reading, remember to tell your friends, and see you next week!
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