The Medical Joyworks Monthly


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Issue #18 (March 2021)


Dear Reader,

The new Moderna and BioNTech-Pfizer SARS-COV2 vaccines are revolutionary. They take the virus’s mRNA instructions for making the crown-like protein that is used to enter human cells, stimulating an immune response that is proving to be effective and safe. What is more, the technology promises to accelerate modifications to these vaccines with relative ease.
We are fortunate that the results from this 20+ year research effort in mRNA technologies are available to us now. But there is more that we can build upon, especially with regards to information dissemination, production, procurement negotiations, distribution and delivery.

For instance, in an effort to improve their purchasing power, EU member states handed the negotiation to the EU. That was smart; except that the EU later acted like many negotiators: seeking "home-field" advantage, they negotiated from Brussels, behind closed doors, and restricting the release of the final terms to the public. This limited their ability to identify and resolve potential issues post deal-closure, including production shortfalls. Now, aside from many court challenges, countries are scrambling to find alternatives on their own.

Negotiation logistics, including time schmoozing among the parties, could have helped prevent this chaos. Instead of Brussels (or online), it would have been preferable to meet at the vaccine makers' HQs and operating centers, learning more about their structures and capabilities. Production and distribution challenges are more easily understood when one has a more tangible exposure to these matters.

Giving priority to “barrier breaking” advantage over “home-field” advantage when choosing a negotiation site is just one example of how negotiation theory and contract management practices are advancing. If we are to keep up with the advances in the life sciences, we will also need to make progress elsewhere.

All the best, 

Miguel Angel Molina
Chief Operating Officer
Medical Joyworks


The latest from MJ

  • In this month's edition of Meet Your IMB, Dr. Abdulmajeed Mohamad shares his personal experiences as a general surgeon, a telling perspective on this very physician field.
  • The MJ International Medical Board is seeking specialists to join as peer-reviewers for the following specialties: general surgery; orthopedic surgery; pediatrics; obstetrics and gynecology; neurosurgery; intensive care; critical care; psychiatry; urology; neurology; nephrology; endocrinology; and pulmonology. Join the program at:  
  • Finally, we are excited to announce MJ's sponsorship of the 2021 Annual Student Conference of the Royal Medical Society of the University of Edinburgh. In a first, the Society will be having its event online, on March 13th, 2021. Aside from demonstrating to students how they can safely improve their skills with Clinical Odyssey, we will also be offering product discounts and raffling a free Clinical Odyssey account among event participants. You can take part in this conference by registering at:
  •  If you would like to have your organization explore Clinical Odyssey, let us know.
    That's it for now. Stay healthy, and curious!


International Medical Board Members

Name: Dr. Abdulmajid Mohamad MS, ARAB BOARD GS, MRCS Eng, FRCS Ed
Speciality: General Surgery
Designation: Senior Clinical Fellow in General Surgery
Work institute: Rotherham General Hospital NHS Foundation Trust, UK
Graduated from: Faculty of Medicine, Damascus University, Syria
What attracted you to your specialty?
A lot of things, really. Since the early years of my medical career I could already appreciate how surgeons conveyed tremendous confidence to peers and patients, as well as sharp decision making skills. Then there is the beauty of the human body’s anatomy. Also, as a surgeon one deals with life threatening situations and acute emergencies often.

What have you learned about your specialty solely from experience?
General surgery is the mother of all surgical specialties. I have worked in various countries and hospitals, and in each instance I have witnessed how the general surgeon is the one who assumes the load of critically ill surgical patients, stabilizing them and allocating them to a specific subspecialty. Additionally, polytrauma patients are usually under the care of general surgeons at the start of their care and recovery process.

What is a common misconception associated with your field of study?
People often view surgeons as technicians rather than physicians (a misconception I have noticed among internists especially). This could not be further from the truth. Surgeons, and surgery, is a fine art within the medical field.

What is your biggest research interest today?
My greatest interest is emergency, non-trauma surgery. I have moved my practice to eastern countries, and this topic is quite relevant to this geography given the wide range of acute presentations of bowel disease.

What publication/research are you most proud of?
There really is nothing that I can talk about.

In your opinion, what is the greatest challenge in your field today?
One of the greatest challenges I find is being able to rapidly follow updates in medicine, particularly with regards to the introduction of new technologies and trends for less invasive procedures. As doctors, we are quite busy managing teams, patients and all kinds of documentation involving patient care.

What will be a game-changer innovation in your field?
I think innovations such as minimal access approaches for things like laparoscopy and endoscopic surgery; robotic surgery; and interventional radiology will all have a significant impact given their pace of development and importance to the general population.

How has MJ helped advance your professional objectives (in terms of teaching, research, management, personal development, etc.)?
Peer-reviewing your work has allowed me to keep an eye on medical problems that are more common, which is great. This serves as an encouragement to stay up to date with recent advances in these areas – not just in my primary area of focus. 


Q&As from our user community

Clinical Sense: Communal (Community-Acquired Pneumonia)

Q: This patient has community acquired pneumonia (CAP). Why are we assessing his blood urea nitrogen (BUN) levels?
A: An increased BUN is a sign of renal hypoperfusion; this indirectly reflects the severity of CAP. BUN is also used in the CURB-65 and PSI severity scoring scales. These help determine suitability for outpatient or inpatient management.

Please read the following article for more details: The-role-of-albumin-level-and-blood-urea-nitrogen-albumin-ratio-in-prediction-of-prognosis-of-community-acquired-pneuomonia
If you would like to play this scenario or join the conversation, go to the Clinical Sense app in your mobile device.

Prognosis: Your Diagnosis: Stretching out (Dilated Cardiomyopathy)

Q:  This patient with dilated cardiomyopathy (DCM) has moderate mitral regurgitation (MR) as well. Instead of the DCM, couldn't the MR be the cause of his atrial fibrillation (AF)? If so, wouldn't this be valvular AF?
A: The MR seen in this patient is most likely a complication of DCM; it is unlikely to be the root cause of the AF—but it might be contributing by worsening the already existing atrial dilation.

Do note that "valvular AF" is a specific term that indicates AF associated with severe mitral stenosis or existence of a mechanical valve. This is important when deciding which type of anticoagulant the patient should be started on.
If you would like to play this scenario or join the conversation, go to the Prognosis: Your Diagnosis app in your mobile device.


Recently released stories

Stormed - Play it free online
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Icteric - Play it in Clinical Odyssey
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... and more.
That's all for now!

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