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The British Journal of Medical Practitioners has adopted a “Continuous Publication” model from the beginning of year 2010 publishing articles online as soon as they are peer-reviewed and copy-edited. This provides faster publication of articles for the authors and a quicker access for readers. The BJMP website will now beupdated regularly
DIAGNOSIS AND MANAGEMENT OF STABLE COPD Diagnosis: To make a diagnosis of COPD an obstructive deficit must be demonstrated on spirometry in patients over the age of 35 years with risk factors (mainly smoking) and signs and symptoms of the disease 4. Signs and Symptoms: Progressive dyspnoea on exertion. Chronic cough. Chronic sputum production. Wheeze. CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. HYPERGLYCAEMIA AND MYOCARDIAL INFARCTION Prevalence and risk of hyperglycemia. Acute hyperglycaemia is common in patients with ST- elevation myocardial infarction (STEMI) even in the absence of a history of type 2 diabetes mellitus (DM). Hyperglycaemia is encountered in up to 50% of all STEMI patients, whereas previously diagnosed DM is present in only 20% to 25% of STEMIpatients 2
EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. THE LOST MIRENA: WHAT INVESTIGATIONS ARE REQUIRED ? AN The Mirena intrauterine system (IUS) has been licensed as a contraceptive in the UK since May 1995. Recent National Statistics suggest the Mirena IUS is used by only 1% of women aged 1649 years who are currently using contraception.1 The Mirena IUS now also has a licence for the management of idiopathic menorrhagia2 and may therefore be used by women who do not require contraception. MANAGEMENT OF DROOLING OF SALIVA After initial assessment, a management plan can be made with the patient. The person/ carer should understand the goal of treating drooling is a reduction in excessive salivary flow, while maintaining a moist and healthy oral cavity. Avoidance of xerostomia (dry mouth)is
A CASE OF BILATERAL SWELLING OF THE HANDS IN AN ELDERLY Abstract. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare clinical syndrome, commonly seen in elderly patients who present with dorsal pitting edema of the hands and has a dramatic response to steroids, suggesting a benign nature. BJMP.ORG | BRITISH JOURNAL OF MEDICAL PRACTITIONERSCURRENT ISSUEUPCOMING ISSUEARCHIVESUBMIT MANUSCRIPTABOUT BJMPGUIDANCE TOAUTHORS
The British Journal of Medical Practitioners has adopted a “Continuous Publication” model from the beginning of year 2010 publishing articles online as soon as they are peer-reviewed and copy-edited. This provides faster publication of articles for the authors and a quicker access for readers. The BJMP website will now beupdated regularly
DIAGNOSIS AND MANAGEMENT OF STABLE COPD Diagnosis: To make a diagnosis of COPD an obstructive deficit must be demonstrated on spirometry in patients over the age of 35 years with risk factors (mainly smoking) and signs and symptoms of the disease 4. Signs and Symptoms: Progressive dyspnoea on exertion. Chronic cough. Chronic sputum production. Wheeze. CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. HYPERGLYCAEMIA AND MYOCARDIAL INFARCTION Prevalence and risk of hyperglycemia. Acute hyperglycaemia is common in patients with ST- elevation myocardial infarction (STEMI) even in the absence of a history of type 2 diabetes mellitus (DM). Hyperglycaemia is encountered in up to 50% of all STEMI patients, whereas previously diagnosed DM is present in only 20% to 25% of STEMIpatients 2
EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. THE LOST MIRENA: WHAT INVESTIGATIONS ARE REQUIRED ? AN The Mirena intrauterine system (IUS) has been licensed as a contraceptive in the UK since May 1995. Recent National Statistics suggest the Mirena IUS is used by only 1% of women aged 1649 years who are currently using contraception.1 The Mirena IUS now also has a licence for the management of idiopathic menorrhagia2 and may therefore be used by women who do not require contraception. MANAGEMENT OF DROOLING OF SALIVA After initial assessment, a management plan can be made with the patient. The person/ carer should understand the goal of treating drooling is a reduction in excessive salivary flow, while maintaining a moist and healthy oral cavity. Avoidance of xerostomia (dry mouth)is
A CASE OF BILATERAL SWELLING OF THE HANDS IN AN ELDERLY Abstract. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare clinical syndrome, commonly seen in elderly patients who present with dorsal pitting edema of the hands and has a dramatic response to steroids, suggesting a benign nature. LATEST DIAGNOSIS AND MANAGEMENT OF DIVERTICULITIS A colonic diverticulum is defined as a sac-like protrusion of mucosa through the muscular component of the colonic wall 1. The terms “diverticulosis” and “diverticular disease” are used to express the presence of diverticula without associated inflammation. While the term “diverticulitis” indicates there is inflammation ofa
HYPERGLYCAEMIA AND MYOCARDIAL INFARCTION Prevalence and risk of hyperglycemia. Acute hyperglycaemia is common in patients with ST- elevation myocardial infarction (STEMI) even in the absence of a history of type 2 diabetes mellitus (DM). Hyperglycaemia is encountered in up to 50% of all STEMI patients, whereas previously diagnosed DM is present in only 20% to 25% of STEMIpatients 2
INTRACTABLE YAWNING AND FLUOXETINE Isolated cases of intractable yawning have been reported with citalopram 2 fluoxetine, citalopram and sertraline 3 in the literature .Excessive yawning can cause injury to Temporo-Mandibular Joint (TMJ) 4. Paroxetine has also been shown to cause intractable yawning 5. Yawning possibly helps in thermoregulation and is an unconsciouseffort by
ELECTROCONVULSIVE THERAPY (ECT): IMPORTANT PARAMETERS Introduction. Electroconvulsive therapy (ECT) is an effective treatment for some individuals with severe neuropsychiatric illness. It is widely used to treat certain psychiatricdisorders, particularly major depression. 1,2 ECT involves applying a brief electrical pulse to the scalp after the patients are administered muscle relaxants and general anaesthesia. 3 This pulse excites the brain EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME (POTS Partial dysautonomic (PD) POTS (also referred to as Neuropathic POTS) is the predominant form.1, 2 This is a mild peripheral autonomic neuropathy, characterized by inadequate peripheral vasculature constriction in the face of orthostatic challenge. Female predominance is seen with 5:1 female to OFTEN OVERLOOKED NEUROPSYCHIATRIC SYNDROMES IN PARKINSON’S Conclusion and implications. The management of PD is often complicated because of the diverse factors underlying its aetiology. Dopaminergic, serotonergic, noradrenergic and cholinergic pathways are involved. 57 Clinicians are generally competent in recognising the more common disorders such as depression, psychosis and cognitive impairment associated with PD though there is a CHEMICAL AND PHYSICAL RESTRAINT USE IN THE OLDER PERSON Definition of restraint: a device or medication that is used to restrict a patient’s voluntary movement. Prevalence of physical restraints: up to 17% in acute care settings. Prevalence of chemical restraints: up to 34% psychotropic drug use in long term care facilities. Complications of restraints: include documented falls, decubitus ulcers, fractures, and death. PERIOPERATIVE HYPERTENSIVE CRISIS. THE ANAESTHETIC Introduction. Hypertension is the most common risk factor for perioperative cardiovascular emergencies. Acute episodes of hypertension may arise due to the aggravation of a pre-existing chronic hypertensive condition or as de novo phenomena 1.. Emergency, anaesthesia, intensive care and surgery are among the clinical settings where proper recognition and management of acute hypertensive BJMP.ORG | BRITISH JOURNAL OF MEDICAL PRACTITIONERSCURRENT ISSUEUPCOMING ISSUEARCHIVESUBMIT MANUSCRIPTABOUT BJMPGUIDANCE TOAUTHORS
The British Journal of Medical Practitioners has adopted a “Continuous Publication” model from the beginning of year 2010 publishing articles online as soon as they are peer-reviewed and copy-edited. This provides faster publication of articles for the authors and a quicker access for readers. The BJMP website will now beupdated regularly
DIAGNOSIS AND MANAGEMENT OF STABLE COPD Diagnosis: To make a diagnosis of COPD an obstructive deficit must be demonstrated on spirometry in patients over the age of 35 years with risk factors (mainly smoking) and signs and symptoms of the disease 4. Signs and Symptoms: Progressive dyspnoea on exertion. Chronic cough. Chronic sputum production. Wheeze. CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. HYPERGLYCAEMIA AND MYOCARDIAL INFARCTION Prevalence and risk of hyperglycemia. Acute hyperglycaemia is common in patients with ST- elevation myocardial infarction (STEMI) even in the absence of a history of type 2 diabetes mellitus (DM). Hyperglycaemia is encountered in up to 50% of all STEMI patients, whereas previously diagnosed DM is present in only 20% to 25% of STEMIpatients 2
EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. THE LOST MIRENA: WHAT INVESTIGATIONS ARE REQUIRED ? AN The Mirena intrauterine system (IUS) has been licensed as a contraceptive in the UK since May 1995. Recent National Statistics suggest the Mirena IUS is used by only 1% of women aged 1649 years who are currently using contraception.1 The Mirena IUS now also has a licence for the management of idiopathic menorrhagia2 and may therefore be used by women who do not require contraception. MANAGEMENT OF DROOLING OF SALIVA After initial assessment, a management plan can be made with the patient. The person/ carer should understand the goal of treating drooling is a reduction in excessive salivary flow, while maintaining a moist and healthy oral cavity. Avoidance of xerostomia (dry mouth)is
A CASE OF BILATERAL SWELLING OF THE HANDS IN AN ELDERLY Abstract. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare clinical syndrome, commonly seen in elderly patients who present with dorsal pitting edema of the hands and has a dramatic response to steroids, suggesting a benign nature. BJMP.ORG | BRITISH JOURNAL OF MEDICAL PRACTITIONERSCURRENT ISSUEUPCOMING ISSUEARCHIVESUBMIT MANUSCRIPTABOUT BJMPGUIDANCE TOAUTHORS
The British Journal of Medical Practitioners has adopted a “Continuous Publication” model from the beginning of year 2010 publishing articles online as soon as they are peer-reviewed and copy-edited. This provides faster publication of articles for the authors and a quicker access for readers. The BJMP website will now beupdated regularly
DIAGNOSIS AND MANAGEMENT OF STABLE COPD Diagnosis: To make a diagnosis of COPD an obstructive deficit must be demonstrated on spirometry in patients over the age of 35 years with risk factors (mainly smoking) and signs and symptoms of the disease 4. Signs and Symptoms: Progressive dyspnoea on exertion. Chronic cough. Chronic sputum production. Wheeze. CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. HYPERGLYCAEMIA AND MYOCARDIAL INFARCTION Prevalence and risk of hyperglycemia. Acute hyperglycaemia is common in patients with ST- elevation myocardial infarction (STEMI) even in the absence of a history of type 2 diabetes mellitus (DM). Hyperglycaemia is encountered in up to 50% of all STEMI patients, whereas previously diagnosed DM is present in only 20% to 25% of STEMIpatients 2
EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. THE LOST MIRENA: WHAT INVESTIGATIONS ARE REQUIRED ? AN The Mirena intrauterine system (IUS) has been licensed as a contraceptive in the UK since May 1995. Recent National Statistics suggest the Mirena IUS is used by only 1% of women aged 1649 years who are currently using contraception.1 The Mirena IUS now also has a licence for the management of idiopathic menorrhagia2 and may therefore be used by women who do not require contraception. MANAGEMENT OF DROOLING OF SALIVA After initial assessment, a management plan can be made with the patient. The person/ carer should understand the goal of treating drooling is a reduction in excessive salivary flow, while maintaining a moist and healthy oral cavity. Avoidance of xerostomia (dry mouth)is
A CASE OF BILATERAL SWELLING OF THE HANDS IN AN ELDERLY Abstract. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare clinical syndrome, commonly seen in elderly patients who present with dorsal pitting edema of the hands and has a dramatic response to steroids, suggesting a benign nature. LATEST DIAGNOSIS AND MANAGEMENT OF DIVERTICULITIS A colonic diverticulum is defined as a sac-like protrusion of mucosa through the muscular component of the colonic wall 1. The terms “diverticulosis” and “diverticular disease” are used to express the presence of diverticula without associated inflammation. While the term “diverticulitis” indicates there is inflammation ofa
HYPERGLYCAEMIA AND MYOCARDIAL INFARCTION Prevalence and risk of hyperglycemia. Acute hyperglycaemia is common in patients with ST- elevation myocardial infarction (STEMI) even in the absence of a history of type 2 diabetes mellitus (DM). Hyperglycaemia is encountered in up to 50% of all STEMI patients, whereas previously diagnosed DM is present in only 20% to 25% of STEMIpatients 2
INTRACTABLE YAWNING AND FLUOXETINE Isolated cases of intractable yawning have been reported with citalopram 2 fluoxetine, citalopram and sertraline 3 in the literature .Excessive yawning can cause injury to Temporo-Mandibular Joint (TMJ) 4. Paroxetine has also been shown to cause intractable yawning 5. Yawning possibly helps in thermoregulation and is an unconsciouseffort by
ELECTROCONVULSIVE THERAPY (ECT): IMPORTANT PARAMETERS Introduction. Electroconvulsive therapy (ECT) is an effective treatment for some individuals with severe neuropsychiatric illness. It is widely used to treat certain psychiatricdisorders, particularly major depression. 1,2 ECT involves applying a brief electrical pulse to the scalp after the patients are administered muscle relaxants and general anaesthesia. 3 This pulse excites the brain EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME (POTS Partial dysautonomic (PD) POTS (also referred to as Neuropathic POTS) is the predominant form.1, 2 This is a mild peripheral autonomic neuropathy, characterized by inadequate peripheral vasculature constriction in the face of orthostatic challenge. Female predominance is seen with 5:1 female to OFTEN OVERLOOKED NEUROPSYCHIATRIC SYNDROMES IN PARKINSON’S Conclusion and implications. The management of PD is often complicated because of the diverse factors underlying its aetiology. Dopaminergic, serotonergic, noradrenergic and cholinergic pathways are involved. 57 Clinicians are generally competent in recognising the more common disorders such as depression, psychosis and cognitive impairment associated with PD though there is a CHEMICAL AND PHYSICAL RESTRAINT USE IN THE OLDER PERSON Definition of restraint: a device or medication that is used to restrict a patient’s voluntary movement. Prevalence of physical restraints: up to 17% in acute care settings. Prevalence of chemical restraints: up to 34% psychotropic drug use in long term care facilities. Complications of restraints: include documented falls, decubitus ulcers, fractures, and death. PERIOPERATIVE HYPERTENSIVE CRISIS. THE ANAESTHETIC Introduction. Hypertension is the most common risk factor for perioperative cardiovascular emergencies. Acute episodes of hypertension may arise due to the aggravation of a pre-existing chronic hypertensive condition or as de novo phenomena 1.. Emergency, anaesthesia, intensive care and surgery are among the clinical settings where proper recognition and management of acute hypertensive BJMP.ORG | BRITISH JOURNAL OF MEDICAL PRACTITIONERSCURRENT ISSUEUPCOMING ISSUEARCHIVESUBMIT MANUSCRIPTABOUT BJMPGUIDANCE TOAUTHORS
The British Journal of Medical Practitioners has adopted a “Continuous Publication” model from the beginning of year 2010 publishing articles online as soon as they are peer-reviewed and copy-edited. This provides faster publication of articles for the authors and a quicker access for readers. The BJMP website will now beupdated regularly
LATEST DIAGNOSIS AND MANAGEMENT OF DIVERTICULITISTERMS & CONDITIONSGUIDANCE TO AUTHORSEDITORIAL BOARDUSER ACCOUNTLOGIN A colonic diverticulum is defined as a sac-like protrusion of mucosa through the muscular component of the colonic wall 1. The terms “diverticulosis” and “diverticular disease” are used to express the presence of diverticula without associated inflammation. While the term “diverticulitis” indicates there is inflammation ofa
HYPERGLYCAEMIA AND MYOCARDIAL INFARCTION Prevalence and risk of hyperglycemia. Acute hyperglycaemia is common in patients with ST- elevation myocardial infarction (STEMI) even in the absence of a history of type 2 diabetes mellitus (DM). Hyperglycaemia is encountered in up to 50% of all STEMI patients, whereas previously diagnosed DM is present in only 20% to 25% of STEMIpatients 2
INTRACTABLE YAWNING AND FLUOXETINE Isolated cases of intractable yawning have been reported with citalopram 2 fluoxetine, citalopram and sertraline 3 in the literature .Excessive yawning can cause injury to Temporo-Mandibular Joint (TMJ) 4. Paroxetine has also been shown to cause intractable yawning 5. Yawning possibly helps in thermoregulation and is an unconsciouseffort by
CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical CLOZAPINE INDUCED MYOCARDITIS: ATYPICAL PRESENTATION AND Introduction . Clozapine is an atypical antipsychotic, it is the treatment of choice for treatment resistant schizophrenia and more effective than conventional neuroleptic medications. DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. RISK OF BREAST CANCER DUE TO HYPERPROLACTINEMIA CAUSED BY Introduction. Prolactin is a polypeptide hormone that is secreted by lactotrophs of the anterior pituitary gland. Prolactin secretion shows a circadian rhythm 1, with highest levels occurring during the night and the nadir occurring during the afternoon and eveningThe best known function of prolactin is the stimulation and maintenance of lactation. A CASE OF BILATERAL SWELLING OF THE HANDS IN AN ELDERLY Abstract. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare clinical syndrome, commonly seen in elderly patients who present with dorsal pitting edema of the hands and has a dramatic response to steroids, suggesting a benign nature. BJMP.ORG | BRITISH JOURNAL OF MEDICAL PRACTITIONERSCURRENT ISSUEUPCOMING ISSUEARCHIVESUBMIT MANUSCRIPTABOUT BJMPGUIDANCE TOAUTHORS
The British Journal of Medical Practitioners has adopted a “Continuous Publication” model from the beginning of year 2010 publishing articles online as soon as they are peer-reviewed and copy-edited. This provides faster publication of articles for the authors and a quicker access for readers. The BJMP website will now beupdated regularly
LATEST DIAGNOSIS AND MANAGEMENT OF DIVERTICULITISTERMS & CONDITIONSGUIDANCE TO AUTHORSEDITORIAL BOARDUSER ACCOUNTLOGIN A colonic diverticulum is defined as a sac-like protrusion of mucosa through the muscular component of the colonic wall 1. The terms “diverticulosis” and “diverticular disease” are used to express the presence of diverticula without associated inflammation. While the term “diverticulitis” indicates there is inflammation ofa
HYPERGLYCAEMIA AND MYOCARDIAL INFARCTION Prevalence and risk of hyperglycemia. Acute hyperglycaemia is common in patients with ST- elevation myocardial infarction (STEMI) even in the absence of a history of type 2 diabetes mellitus (DM). Hyperglycaemia is encountered in up to 50% of all STEMI patients, whereas previously diagnosed DM is present in only 20% to 25% of STEMIpatients 2
INTRACTABLE YAWNING AND FLUOXETINE Isolated cases of intractable yawning have been reported with citalopram 2 fluoxetine, citalopram and sertraline 3 in the literature .Excessive yawning can cause injury to Temporo-Mandibular Joint (TMJ) 4. Paroxetine has also been shown to cause intractable yawning 5. Yawning possibly helps in thermoregulation and is an unconsciouseffort by
CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical CLOZAPINE INDUCED MYOCARDITIS: ATYPICAL PRESENTATION AND Introduction . Clozapine is an atypical antipsychotic, it is the treatment of choice for treatment resistant schizophrenia and more effective than conventional neuroleptic medications. DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. RISK OF BREAST CANCER DUE TO HYPERPROLACTINEMIA CAUSED BY Introduction. Prolactin is a polypeptide hormone that is secreted by lactotrophs of the anterior pituitary gland. Prolactin secretion shows a circadian rhythm 1, with highest levels occurring during the night and the nadir occurring during the afternoon and eveningThe best known function of prolactin is the stimulation and maintenance of lactation. A CASE OF BILATERAL SWELLING OF THE HANDS IN AN ELDERLY Abstract. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare clinical syndrome, commonly seen in elderly patients who present with dorsal pitting edema of the hands and has a dramatic response to steroids, suggesting a benign nature. LATEST DIAGNOSIS AND MANAGEMENT OF DIVERTICULITIS A colonic diverticulum is defined as a sac-like protrusion of mucosa through the muscular component of the colonic wall 1. The terms “diverticulosis” and “diverticular disease” are used to express the presence of diverticula without associated inflammation. While the term “diverticulitis” indicates there is inflammation ofa
COMBINATION THERAPY FOR TREATMENT RESISTANT SCHIZOPHRENIA Olanzapine-amisulpiride combination may be a choice in pre-clozapine clinical situations and in cases where clozapine fails. Keywords: resistant schizophrenia, combination, clozapine, olanzapine, amisulpiride. Abbreviations: SCZ- schizophrenia. Schizophrenia (SCZ) is a chronic relapsing and remitting disorder with a lifetimeprevalence of 4 per
EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. BRADYARRHYTHMIAS ASSOCIATED WITH THE OBSTRUCTIVE SLEEP Abstract. Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of global morbidity that is predicted to become the third most common cause of death worldwide by the year 2020 1.Obstructive sleep apnoea syndrome (OSAS) is also highly prevalent and is estimated to affect 5% of adults in western countries 2.The co-existence of both COPD and OSAS in the same patient is termed the NON-PHARMACOLOGICAL MANAGEMENT OF INSOMNIA Introduction: Insomnia is chronic inability to obtain the amount of sleep needed for optimal functioning and well-being. Insomnia has received much attention in last few decades, since it has become a growing and complex problem in our society. 1 Insomnia is defined as the chronic complaint of difficulty initiating or maintaining sleep, early awakening, and interrupting or non-restorative sleep. MANAGING PATIENT EXPECTATIONS THROUGH UNDERSTANDING HEALTH Introduction. The continuous growth in patient numbers and needs poses several challenges for medical professionals and support staff within the National Health Service (NHS). 1 Health care services are under financial strain in the light of the changing demographic structure of the UK population that requires improved access to health services. . Managing patient satisfaction represents THE LOST MIRENA: WHAT INVESTIGATIONS ARE REQUIRED ? AN The Mirena intrauterine system (IUS) has been licensed as a contraceptive in the UK since May 1995. Recent National Statistics suggest the Mirena IUS is used by only 1% of women aged 1649 years who are currently using contraception.1 The Mirena IUS now also has a licence for the management of idiopathic menorrhagia2 and may therefore be used by women who do not require contraception. SENSITIVITY, SPECIFICITY AND DIAGNOSTIC EFFICIENCY OF Abstract. Background: Many biochemical markers have been used for detection of alcohol abuse, but each of them has clinical limitations. Sialic acid (SA) has been suggested as a new potential marker of excessive alcohol consumption. Aim: To compare the sensitivity, specificity and diagnostic efficiency of serum Sialic acid with other traditional markers like AST (Aspartate amino transaminase CHEMICAL AND PHYSICAL RESTRAINT USE IN THE OLDER PERSON Definition of restraint: a device or medication that is used to restrict a patient’s voluntary movement. Prevalence of physical restraints: up to 17% in acute care settings. Prevalence of chemical restraints: up to 34% psychotropic drug use in long term care facilities. Complications of restraints: include documented falls, decubitus ulcers, fractures, and death. BJMP.ORG | BRITISH JOURNAL OF MEDICAL PRACTITIONERSCURRENT ISSUEUPCOMING ISSUEARCHIVESUBMIT MANUSCRIPTABOUT BJMPGUIDANCE TOAUTHORS
The British Journal of Medical Practitioners has adopted a “Continuous Publication” model from the beginning of year 2010 publishing articles online as soon as they are peer-reviewed and copy-edited. This provides faster publication of articles for the authors and a quicker access for readers. The BJMP website will now beupdated regularly
LATEST DIAGNOSIS AND MANAGEMENT OF DIVERTICULITISTERMS & CONDITIONSGUIDANCE TO AUTHORSEDITORIAL BOARDUSER ACCOUNTLOGIN A colonic diverticulum is defined as a sac-like protrusion of mucosa through the muscular component of the colonic wall 1. The terms “diverticulosis” and “diverticular disease” are used to express the presence of diverticula without associated inflammation. While the term “diverticulitis” indicates there is inflammation ofa
EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME (POTS Partial dysautonomic (PD) POTS (also referred to as Neuropathic POTS) is the predominant form.1, 2 This is a mild peripheral autonomic neuropathy, characterized by inadequate peripheral vasculature constriction in the face of orthostatic challenge. Female predominance is seen with 5:1 female to INTRACTABLE YAWNING AND FLUOXETINE Isolated cases of intractable yawning have been reported with citalopram 2 fluoxetine, citalopram and sertraline 3 in the literature .Excessive yawning can cause injury to Temporo-Mandibular Joint (TMJ) 4. Paroxetine has also been shown to cause intractable yawning 5. Yawning possibly helps in thermoregulation and is an unconsciouseffort by
CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical HYPERGLYCAEMIA AND MYOCARDIAL INFARCTION Prevalence and risk of hyperglycemia. Acute hyperglycaemia is common in patients with ST- elevation myocardial infarction (STEMI) even in the absence of a history of type 2 diabetes mellitus (DM). Hyperglycaemia is encountered in up to 50% of all STEMI patients, whereas previously diagnosed DM is present in only 20% to 25% of STEMIpatients 2
DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. RISK OF BREAST CANCER DUE TO HYPERPROLACTINEMIA CAUSED BY Introduction. Prolactin is a polypeptide hormone that is secreted by lactotrophs of the anterior pituitary gland. Prolactin secretion shows a circadian rhythm 1, with highest levels occurring during the night and the nadir occurring during the afternoon and eveningThe best known function of prolactin is the stimulation and maintenance of lactation. BJMP.ORG | BRITISH JOURNAL OF MEDICAL PRACTITIONERSCURRENT ISSUEUPCOMING ISSUEARCHIVESUBMIT MANUSCRIPTABOUT BJMPGUIDANCE TOAUTHORS
The British Journal of Medical Practitioners has adopted a “Continuous Publication” model from the beginning of year 2010 publishing articles online as soon as they are peer-reviewed and copy-edited. This provides faster publication of articles for the authors and a quicker access for readers. The BJMP website will now beupdated regularly
LATEST DIAGNOSIS AND MANAGEMENT OF DIVERTICULITISTERMS & CONDITIONSGUIDANCE TO AUTHORSEDITORIAL BOARDUSER ACCOUNTLOGIN A colonic diverticulum is defined as a sac-like protrusion of mucosa through the muscular component of the colonic wall 1. The terms “diverticulosis” and “diverticular disease” are used to express the presence of diverticula without associated inflammation. While the term “diverticulitis” indicates there is inflammation ofa
HYPERGLYCAEMIA AND MYOCARDIAL INFARCTION Prevalence and risk of hyperglycemia. Acute hyperglycaemia is common in patients with ST- elevation myocardial infarction (STEMI) even in the absence of a history of type 2 diabetes mellitus (DM). Hyperglycaemia is encountered in up to 50% of all STEMI patients, whereas previously diagnosed DM is present in only 20% to 25% of STEMIpatients 2
INTRACTABLE YAWNING AND FLUOXETINE Isolated cases of intractable yawning have been reported with citalopram 2 fluoxetine, citalopram and sertraline 3 in the literature .Excessive yawning can cause injury to Temporo-Mandibular Joint (TMJ) 4. Paroxetine has also been shown to cause intractable yawning 5. Yawning possibly helps in thermoregulation and is an unconsciouseffort by
CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical CLOZAPINE INDUCED MYOCARDITIS: ATYPICAL PRESENTATION AND Introduction . Clozapine is an atypical antipsychotic, it is the treatment of choice for treatment resistant schizophrenia and more effective than conventional neuroleptic medications. DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. RISK OF BREAST CANCER DUE TO HYPERPROLACTINEMIA CAUSED BY Introduction. Prolactin is a polypeptide hormone that is secreted by lactotrophs of the anterior pituitary gland. Prolactin secretion shows a circadian rhythm 1, with highest levels occurring during the night and the nadir occurring during the afternoon and eveningThe best known function of prolactin is the stimulation and maintenance of lactation. A CASE OF BILATERAL SWELLING OF THE HANDS IN AN ELDERLY Abstract. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare clinical syndrome, commonly seen in elderly patients who present with dorsal pitting edema of the hands and has a dramatic response to steroids, suggesting a benign nature. LATEST DIAGNOSIS AND MANAGEMENT OF DIVERTICULITIS Summary points: CT scan is the gold standard means of investigation for acute diverticulitis and helps classify the stage of disease. Evidence to support outpatient treatment of uncomplicated diverticulitis is beginning to appear, however hospital admission and treatment with broad spectrum intravenous antibiotics is often required and is highly effective. POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME (POTS Partial dysautonomic (PD) POTS (also referred to as Neuropathic POTS) is the predominant form.1, 2 This is a mild peripheral autonomic neuropathy, characterized by inadequate peripheral vasculature constriction in the face of orthostatic challenge. Female predominance is seen with 5:1 female to MANAGEMENT OF DROOLING OF SALIVA After initial assessment, a management plan can be made with the patient. The person/ carer should understand the goal of treating drooling is a reduction in excessive salivary flow, while maintaining a moist and healthy oral cavity. Avoidance of xerostomia (dry mouth)is
COMBINATION THERAPY FOR TREATMENT RESISTANT SCHIZOPHRENIA Olanzapine-amisulpiride combination may be a choice in pre-clozapine clinical situations and in cases where clozapine fails. Keywords: resistant schizophrenia, combination, clozapine, olanzapine, amisulpiride. Abbreviations: SCZ- schizophrenia. Schizophrenia (SCZ) is a chronic relapsing and remitting disorder with a lifetimeprevalence of 4 per
BRADYARRHYTHMIAS ASSOCIATED WITH THE OBSTRUCTIVE SLEEP Abstract. Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of global morbidity that is predicted to become the third most common cause of death worldwide by the year 2020 1.Obstructive sleep apnoea syndrome (OSAS) is also highly prevalent and is estimated to affect 5% of adults in western countries 2.The co-existence of both COPD and OSAS in the same patient is termed the NON-PHARMACOLOGICAL MANAGEMENT OF INSOMNIA Introduction: Insomnia is chronic inability to obtain the amount of sleep needed for optimal functioning and well-being. Insomnia has received much attention in last few decades, since it has become a growing and complex problem in our society. 1 Insomnia is defined as the chronic complaint of difficulty initiating or maintaining sleep, early awakening, and interrupting or non-restorative sleep. SENSITIVITY, SPECIFICITY AND DIAGNOSTIC EFFICIENCY OF Abstract. Background: Many biochemical markers have been used for detection of alcohol abuse, but each of them has clinical limitations. Sialic acid (SA) has been suggested as a new potential marker of excessive alcohol consumption. Aim: To compare the sensitivity, specificity and diagnostic efficiency of serum Sialic acid with other traditional markers like AST (Aspartate amino transaminase CHEMICAL AND PHYSICAL RESTRAINT USE IN THE OLDER PERSON Definition of restraint: a device or medication that is used to restrict a patient’s voluntary movement. Prevalence of physical restraints: up to 17% in acute care settings. Prevalence of chemical restraints: up to 34% psychotropic drug use in long term care facilities. Complications of restraints: include documented falls, decubitus ulcers, fractures, and death. THE LOST MIRENA: WHAT INVESTIGATIONS ARE REQUIRED ? AN The Mirena intrauterine system (IUS) has been licensed as a contraceptive in the UK since May 1995. Recent National Statistics suggest the Mirena IUS is used by only 1% of women aged 1649 years who are currently using contraception.1 The Mirena IUS now also has a licence for the management of idiopathic menorrhagia2 and may therefore be used by women who do not require contraception. GLOBAL HEALTH AND THE 10/90 GAP Activists claim that only 10 per cent of global health research is devoted to conditions that account for 90 per cent of the global disease burden – the so-called ‘10/90 Gap’. 5 They argue that virtually all diseases prevalent in low income countries are ‘neglected’ and that the pharmaceutical industry has investedalmost nothing in
COVID-19, DIAGNOSTIC DIFFICULTIES AND ACUTE PSYCHOSIS Abstract. Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or COVID-19, has emerged as an epidemic contributing to more than 247,000 deaths worldwide as of 4 th May 2020. It commonly presents with respiratory and occasionally gastrointestinal symptoms. Here we describe a rare case of COVID-19 presenting with acute psychosis which was also complicated by a false negative DIAGNOSIS AND MANAGEMENT OF STABLE COPD Diagnosis: To make a diagnosis of COPD an obstructive deficit must be demonstrated on spirometry in patients over the age of 35 years with risk factors (mainly smoking) and signs and symptoms of the disease 4. Signs and Symptoms: Progressive dyspnoea on exertion. Chronic cough. Chronic sputum production. Wheeze. SENSITIVITY, SPECIFICITY AND DIAGNOSTIC EFFICIENCY OF Abstract. Background: Many biochemical markers have been used for detection of alcohol abuse, but each of them has clinical limitations. Sialic acid (SA) has been suggested as a new potential marker of excessive alcohol consumption. Aim: To compare the sensitivity, specificity and diagnostic efficiency of serum Sialic acid with other traditional markers like AST (Aspartate amino transaminase MANAGEMENT OF DROOLING OF SALIVA After initial assessment, a management plan can be made with the patient. The person/ carer should understand the goal of treating drooling is a reduction in excessive salivary flow, while maintaining a moist and healthy oral cavity. Avoidance of xerostomia (dry mouth)is
INTRACTABLE YAWNING AND FLUOXETINE Isolated cases of intractable yawning have been reported with citalopram 2 fluoxetine, citalopram and sertraline 3 in the literature .Excessive yawning can cause injury to Temporo-Mandibular Joint (TMJ) 4. Paroxetine has also been shown to cause intractable yawning 5. Yawning possibly helps in thermoregulation and is an unconsciouseffort by
ACUTE REVERSIBLE CARDIOMYOPATHY DUE TO METHAMPHETAMINE Introduction. Methamphetamine and related compounds are the most widely abused drugs in the world after cannabis 1.Methamphetamine is asynthetic stimulant
EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical CHEMICAL AND PHYSICAL RESTRAINT USE IN THE OLDER PERSON Definition of restraint: a device or medication that is used to restrict a patient’s voluntary movement. Prevalence of physical restraints: up to 17% in acute care settings. Prevalence of chemical restraints: up to 34% psychotropic drug use in long term care facilities. Complications of restraints: include documented falls, decubitus ulcers, fractures, and death. DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. COVID-19, DIAGNOSTIC DIFFICULTIES AND ACUTE PSYCHOSIS Abstract. Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or COVID-19, has emerged as an epidemic contributing to more than 247,000 deaths worldwide as of 4 th May 2020. It commonly presents with respiratory and occasionally gastrointestinal symptoms. Here we describe a rare case of COVID-19 presenting with acute psychosis which was also complicated by a false negative DIAGNOSIS AND MANAGEMENT OF STABLE COPD Diagnosis: To make a diagnosis of COPD an obstructive deficit must be demonstrated on spirometry in patients over the age of 35 years with risk factors (mainly smoking) and signs and symptoms of the disease 4. Signs and Symptoms: Progressive dyspnoea on exertion. Chronic cough. Chronic sputum production. Wheeze. SENSITIVITY, SPECIFICITY AND DIAGNOSTIC EFFICIENCY OF Abstract. Background: Many biochemical markers have been used for detection of alcohol abuse, but each of them has clinical limitations. Sialic acid (SA) has been suggested as a new potential marker of excessive alcohol consumption. Aim: To compare the sensitivity, specificity and diagnostic efficiency of serum Sialic acid with other traditional markers like AST (Aspartate amino transaminase MANAGEMENT OF DROOLING OF SALIVA After initial assessment, a management plan can be made with the patient. The person/ carer should understand the goal of treating drooling is a reduction in excessive salivary flow, while maintaining a moist and healthy oral cavity. Avoidance of xerostomia (dry mouth)is
INTRACTABLE YAWNING AND FLUOXETINE Isolated cases of intractable yawning have been reported with citalopram 2 fluoxetine, citalopram and sertraline 3 in the literature .Excessive yawning can cause injury to Temporo-Mandibular Joint (TMJ) 4. Paroxetine has also been shown to cause intractable yawning 5. Yawning possibly helps in thermoregulation and is an unconsciouseffort by
ACUTE REVERSIBLE CARDIOMYOPATHY DUE TO METHAMPHETAMINE Introduction. Methamphetamine and related compounds are the most widely abused drugs in the world after cannabis 1.Methamphetamine is asynthetic stimulant
EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical CHEMICAL AND PHYSICAL RESTRAINT USE IN THE OLDER PERSON Definition of restraint: a device or medication that is used to restrict a patient’s voluntary movement. Prevalence of physical restraints: up to 17% in acute care settings. Prevalence of chemical restraints: up to 34% psychotropic drug use in long term care facilities. Complications of restraints: include documented falls, decubitus ulcers, fractures, and death. DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. COVID-19, DIAGNOSTIC DIFFICULTIES AND ACUTE PSYCHOSIS Abstract. Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or COVID-19, has emerged as an epidemic contributing to more than 247,000 deaths worldwide as of 4 th May 2020. It commonly presents with respiratory and occasionally gastrointestinal symptoms. Here we describe a rare case of COVID-19 presenting with acute psychosis which was also complicated by a false negative INTRACTABLE YAWNING AND FLUOXETINE Isolated cases of intractable yawning have been reported with citalopram 2 fluoxetine, citalopram and sertraline 3 in the literature .Excessive yawning can cause injury to Temporo-Mandibular Joint (TMJ) 4. Paroxetine has also been shown to cause intractable yawning 5. Yawning possibly helps in thermoregulation and is an unconsciouseffort by
DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical BRADYARRHYTHMIAS ASSOCIATED WITH THE OBSTRUCTIVE SLEEP Abstract. Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of global morbidity that is predicted to become the third most common cause of death worldwide by the year 2020 1.Obstructive sleep apnoea syndrome (OSAS) is also highly prevalent and is estimated to affect 5% of adults in western countries 2.The co-existence of both COPD and OSAS in the same patient is termed the LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. CHEMICAL AND PHYSICAL RESTRAINT USE IN THE OLDER PERSON Definition of restraint: a device or medication that is used to restrict a patient’s voluntary movement. Prevalence of physical restraints: up to 17% in acute care settings. Prevalence of chemical restraints: up to 34% psychotropic drug use in long term care facilities. Complications of restraints: include documented falls, decubitus ulcers, fractures, and death. THE LOST MIRENA: WHAT INVESTIGATIONS ARE REQUIRED ? AN The Mirena intrauterine system (IUS) has been licensed as a contraceptive in the UK since May 1995. Recent National Statistics suggest the Mirena IUS is used by only 1% of women aged 1649 years who are currently using contraception.1 The Mirena IUS now also has a licence for the management of idiopathic menorrhagia2 and may therefore be used by women who do not require contraception. RISK OF DEVELOPMENT OF OSTEOPOROSIS DUE TO DEPRESSION IN Figure 1: Fracture-free survival by Selective Serotonin Reuptake Inhibitors (SSRI) use Potential mechanisms of bone loss in depression: Depression is associated with alterations of the hypothalamic-pituitary-adrenal (HPA) axis at multiple levels, including altered secretion of hypothalamic corticotrophin-releasing hormone (CRH), as indicated by CRH levels in the cerebrospinal fluid,and change
ORAL BISPHOSPHONATES AND THE RISK FOR OSTEONECROSIS OF THE Abstract. Several recent reports have described osteonecrosis of the jaws (ONJ) associated with the use of bisphosphonates. Osteonecrosis of the jaws is recognized as a serious complication of bisphosphonate therapy, more commonly with the intravenous form of the drugs. COVID-19, DIAGNOSTIC DIFFICULTIES AND ACUTE PSYCHOSIS Abstract. Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or COVID-19, has emerged as an epidemic contributing to more than 247,000 deaths worldwide as of 4 th May 2020. It commonly presents with respiratory and occasionally gastrointestinal symptoms. Here we describe a rare case of COVID-19 presenting with acute psychosis which was also complicated by a false negative DIAGNOSIS AND MANAGEMENT OF STABLE COPD Diagnosis: To make a diagnosis of COPD an obstructive deficit must be demonstrated on spirometry in patients over the age of 35 years with risk factors (mainly smoking) and signs and symptoms of the disease 4. Signs and Symptoms: Progressive dyspnoea on exertion. Chronic cough. Chronic sputum production. Wheeze. SENSITIVITY, SPECIFICITY AND DIAGNOSTIC EFFICIENCY OF Abstract. Background: Many biochemical markers have been used for detection of alcohol abuse, but each of them has clinical limitations. Sialic acid (SA) has been suggested as a new potential marker of excessive alcohol consumption. Aim: To compare the sensitivity, specificity and diagnostic efficiency of serum Sialic acid with other traditional markers like AST (Aspartate amino transaminase CURRENT HEALTHCARE CHALLENGES IN TREATING THE BORDERLINE The recent increase in the number of patients presenting with a borderline personality disorder (BPD) in general adult psychiatry and primary care is creating pressure within the National Health Service (NHS) 1.Currently, BPD is perceived to be like an ‘epidemic’ entity, particularly in areas with a high incidence of socioeconomic deprivation.. Similarly, there is a parallel increase in ACUTE REVERSIBLE CARDIOMYOPATHY DUE TO METHAMPHETAMINE Introduction. Methamphetamine and related compounds are the most widely abused drugs in the world after cannabis 1.Methamphetamine is asynthetic stimulant
EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
GLOBAL HEALTH AND THE 10/90 GAP Activists claim that only 10 per cent of global health research is devoted to conditions that account for 90 per cent of the global disease burden – the so-called ‘10/90 Gap’. 5 They argue that virtually all diseases prevalent in low income countries are ‘neglected’ and that the pharmaceutical industry has investedalmost nothing in
CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. CHEMICAL AND PHYSICAL RESTRAINT USE IN THE OLDER PERSONCHEMICAL RESTRAINT IN NURSING HOMESCHEMICAL RESTRAINT DOCUMENTATIONCHEMICAL RESTRAINT GUIDELINESCHEMICAL RESTRAINT MONITORINGCHEMICAL RESTRAINTREGULATIONS
Definition of restraint: a device or medication that is used to restrict a patient’s voluntary movement. Prevalence of physical restraints: up to 17% in acute care settings. Prevalence of chemical restraints: up to 34% psychotropic drug use in long term care facilities. Complications of restraints: include documented falls, decubitus ulcers, fractures, and death. COVID-19, DIAGNOSTIC DIFFICULTIES AND ACUTE PSYCHOSIS Abstract. Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or COVID-19, has emerged as an epidemic contributing to more than 247,000 deaths worldwide as of 4 th May 2020. It commonly presents with respiratory and occasionally gastrointestinal symptoms. Here we describe a rare case of COVID-19 presenting with acute psychosis which was also complicated by a false negative DIAGNOSIS AND MANAGEMENT OF STABLE COPD Diagnosis: To make a diagnosis of COPD an obstructive deficit must be demonstrated on spirometry in patients over the age of 35 years with risk factors (mainly smoking) and signs and symptoms of the disease 4. Signs and Symptoms: Progressive dyspnoea on exertion. Chronic cough. Chronic sputum production. Wheeze. SENSITIVITY, SPECIFICITY AND DIAGNOSTIC EFFICIENCY OF Abstract. Background: Many biochemical markers have been used for detection of alcohol abuse, but each of them has clinical limitations. Sialic acid (SA) has been suggested as a new potential marker of excessive alcohol consumption. Aim: To compare the sensitivity, specificity and diagnostic efficiency of serum Sialic acid with other traditional markers like AST (Aspartate amino transaminase CURRENT HEALTHCARE CHALLENGES IN TREATING THE BORDERLINE The recent increase in the number of patients presenting with a borderline personality disorder (BPD) in general adult psychiatry and primary care is creating pressure within the National Health Service (NHS) 1.Currently, BPD is perceived to be like an ‘epidemic’ entity, particularly in areas with a high incidence of socioeconomic deprivation.. Similarly, there is a parallel increase in ACUTE REVERSIBLE CARDIOMYOPATHY DUE TO METHAMPHETAMINE Introduction. Methamphetamine and related compounds are the most widely abused drugs in the world after cannabis 1.Methamphetamine is asynthetic stimulant
EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
GLOBAL HEALTH AND THE 10/90 GAP Activists claim that only 10 per cent of global health research is devoted to conditions that account for 90 per cent of the global disease burden – the so-called ‘10/90 Gap’. 5 They argue that virtually all diseases prevalent in low income countries are ‘neglected’ and that the pharmaceutical industry has investedalmost nothing in
CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. CHEMICAL AND PHYSICAL RESTRAINT USE IN THE OLDER PERSONCHEMICAL RESTRAINT IN NURSING HOMESCHEMICAL RESTRAINT DOCUMENTATIONCHEMICAL RESTRAINT GUIDELINESCHEMICAL RESTRAINT MONITORINGCHEMICAL RESTRAINTREGULATIONS
Definition of restraint: a device or medication that is used to restrict a patient’s voluntary movement. Prevalence of physical restraints: up to 17% in acute care settings. Prevalence of chemical restraints: up to 34% psychotropic drug use in long term care facilities. Complications of restraints: include documented falls, decubitus ulcers, fractures, and death. CRITICAL ANALYSIS OF CASE BASED DISCUSSIONS Assessment and evaluation are the foundations of learning; the former is concerned with how students perform and the latter, how successful the teaching was in reaching its objectives. Case based discussions (CBDs) are structured, non-judgmental reviews of decision-making and clinical reasoning 1. They are mapped directly to the surgical DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. MANAGEMENT OF DROOLING OF SALIVA After initial assessment, a management plan can be made with the patient. The person/ carer should understand the goal of treating drooling is a reduction in excessive salivary flow, while maintaining a moist and healthy oral cavity. Avoidance of xerostomia (dry mouth)is
LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. THE LOST MIRENA: WHAT INVESTIGATIONS ARE REQUIRED ? AN The Mirena intrauterine system (IUS) has been licensed as a contraceptive in the UK since May 1995. Recent National Statistics suggest the Mirena IUS is used by only 1% of women aged 1649 years who are currently using contraception.1 The Mirena IUS now also has a licence for the management of idiopathic menorrhagia2 and may therefore be used by women who do not require contraception. CHEMICAL AND PHYSICAL RESTRAINT USE IN THE OLDER PERSON Definition of restraint: a device or medication that is used to restrict a patient’s voluntary movement. Prevalence of physical restraints: up to 17% in acute care settings. Prevalence of chemical restraints: up to 34% psychotropic drug use in long term care facilities. Complications of restraints: include documented falls, decubitus ulcers, fractures, and death. PERIOPERATIVE HYPERTENSIVE CRISIS. THE ANAESTHETIC Introduction. Hypertension is the most common risk factor for perioperative cardiovascular emergencies. Acute episodes of hypertension may arise due to the aggravation of a pre-existing chronic hypertensive condition or as de novo phenomena 1.. Emergency, anaesthesia, intensive care and surgery are among the clinical settings where proper recognition and management of acute hypertensive RISK OF BREAST CANCER DUE TO HYPERPROLACTINEMIA CAUSED BY Introduction. Prolactin is a polypeptide hormone that is secreted by lactotrophs of the anterior pituitary gland. Prolactin secretion shows a circadian rhythm 1, with highest levels occurring during the night and the nadir occurring during the afternoon and eveningThe best known function of prolactin is the stimulation and maintenance of lactation. MEDICINE IN PICTURES: PURPLE URINE BAG SYNDROME Purple urine bag syndrome (PUBS) PUBS is an uncommon condition with purple discoloration of the urine catheter system. This phenomenon is due to the presence of indigo and indirubin in the collected urine. PUBS was first published in 1978 4. Some academics would argue that PUBS was reported even earlier historically as an observation in Sir ORAL BISPHOSPHONATES AND THE RISK FOR OSTEONECROSIS OF THE Abstract. Several recent reports have described osteonecrosis of the jaws (ONJ) associated with the use of bisphosphonates. Osteonecrosis of the jaws is recognized as a serious complication of bisphosphonate therapy, more commonly with the intravenous form of the drugs. BJMP.ORG | BRITISH JOURNAL OF MEDICAL PRACTITIONERSCURRENT ISSUEUPCOMING ISSUEARCHIVESUBMIT MANUSCRIPTABOUT BJMPGUIDANCE TOAUTHORS
The British Journal of Medical Practitioners has adopted a “Continuous Publication” model from the beginning of year 2010 publishing articles online as soon as they are peer-reviewed and copy-edited. This provides faster publication of articles for the authors and a quicker access for readers. The BJMP website will now beupdated regularly
| BRITISH JOURNAL OF MEDICAL PRACTITIONERS Anne Bean, Melody Redman, Victoria Dachtler, Richard Dachtler & Simon Clark. Full Text. PDF. Optimizing the time of a General Practitioner by investigating the daily tasks of the on-call doctor. Gaurav Pydisetty, Mehrban Ghani & Athena Michaelides. SENSITIVITY, SPECIFICITY AND DIAGNOSTIC EFFICIENCY OF Abstract. Background: Many biochemical markers have been used for detection of alcohol abuse, but each of them has clinical limitations. Sialic acid (SA) has been suggested as a new potential marker of excessive alcohol consumption. Aim: To compare the sensitivity, specificity and diagnostic efficiency of serum Sialic acid with other traditional markers like AST (Aspartate amino transaminase THE LOST MIRENA: WHAT INVESTIGATIONS ARE REQUIRED ? AN The Mirena intrauterine system (IUS) has been licensed as a contraceptive in the UK since May 1995. Recent National Statistics suggest the Mirena IUS is used by only 1% of women aged 1649 years who are currently using contraception.1 The Mirena IUS now also has a licence for the management of idiopathic menorrhagia2 and may therefore be used by women who do not require contraception. USING MENTORING TO IMPROVE THE FOUNDATION PLACEMENT IN Types of mentoring. Buddeberg-Fischer and Herta 11 discussed various types of mentoring based on the numbers of mentors and mentees and their professional status or grade:. One to one mentoring (between a mentor and a mentee). Group mentoring (one mentor and a small group ofmentees)
CURRENT HEALTHCARE CHALLENGES IN TREATING THE BORDERLINE The recent increase in the number of patients presenting with a borderline personality disorder (BPD) in general adult psychiatry and primary care is creating pressure within the National Health Service (NHS) 1.Currently, BPD is perceived to be like an ‘epidemic’ entity, particularly in areas with a high incidence of socioeconomic deprivation.. Similarly, there is a parallel increase in LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENTLEG ULCERS PICTURESLEG ULCERS TREATMENT AT HOMELEG ULCER TREATMENT HOME REMEDY Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. A CASE OF BILATERAL SWELLING OF THE HANDS IN AN ELDERLY Abstract. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare clinical syndrome, commonly seen in elderly patients who present with dorsal pitting edema of the hands and has a dramatic response to steroids, suggesting a benign nature. PORTAL VEIN AIR EMBOLISM Gas in the portal vein is a rare and usually fatal condition, and its presence in trauma is a rare occurrence. Various terms are used to describe the condition like hepatic portal vein gas (HPVG), pneumoportogram, gas embolism of the portal vein etc. INTERVIEW WITH DR JAMES MOON Interview with Dr James Moon. Dr James Moon is a Senior Lecturer and Consultant Cardiologist at UCL and the Heart Hospital. He set up and runs the cardiac MRI department dividing his time between clinical practice and research. He is part of a team of 5 research fellows in BJMP.ORG | BRITISH JOURNAL OF MEDICAL PRACTITIONERSCURRENT ISSUEUPCOMING ISSUEARCHIVESUBMIT MANUSCRIPTABOUT BJMPGUIDANCE TOAUTHORS
The British Journal of Medical Practitioners has adopted a “Continuous Publication” model from the beginning of year 2010 publishing articles online as soon as they are peer-reviewed and copy-edited. This provides faster publication of articles for the authors and a quicker access for readers. The BJMP website will now beupdated regularly
| BRITISH JOURNAL OF MEDICAL PRACTITIONERS Anne Bean, Melody Redman, Victoria Dachtler, Richard Dachtler & Simon Clark. Full Text. PDF. Optimizing the time of a General Practitioner by investigating the daily tasks of the on-call doctor. Gaurav Pydisetty, Mehrban Ghani & Athena Michaelides. SENSITIVITY, SPECIFICITY AND DIAGNOSTIC EFFICIENCY OF Abstract. Background: Many biochemical markers have been used for detection of alcohol abuse, but each of them has clinical limitations. Sialic acid (SA) has been suggested as a new potential marker of excessive alcohol consumption. Aim: To compare the sensitivity, specificity and diagnostic efficiency of serum Sialic acid with other traditional markers like AST (Aspartate amino transaminase THE LOST MIRENA: WHAT INVESTIGATIONS ARE REQUIRED ? AN The Mirena intrauterine system (IUS) has been licensed as a contraceptive in the UK since May 1995. Recent National Statistics suggest the Mirena IUS is used by only 1% of women aged 1649 years who are currently using contraception.1 The Mirena IUS now also has a licence for the management of idiopathic menorrhagia2 and may therefore be used by women who do not require contraception. USING MENTORING TO IMPROVE THE FOUNDATION PLACEMENT IN Types of mentoring. Buddeberg-Fischer and Herta 11 discussed various types of mentoring based on the numbers of mentors and mentees and their professional status or grade:. One to one mentoring (between a mentor and a mentee). Group mentoring (one mentor and a small group ofmentees)
CURRENT HEALTHCARE CHALLENGES IN TREATING THE BORDERLINE The recent increase in the number of patients presenting with a borderline personality disorder (BPD) in general adult psychiatry and primary care is creating pressure within the National Health Service (NHS) 1.Currently, BPD is perceived to be like an ‘epidemic’ entity, particularly in areas with a high incidence of socioeconomic deprivation.. Similarly, there is a parallel increase in LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENTLEG ULCERS PICTURESLEG ULCERS TREATMENT AT HOMELEG ULCER TREATMENT HOME REMEDY Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. A CASE OF BILATERAL SWELLING OF THE HANDS IN AN ELDERLY Abstract. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare clinical syndrome, commonly seen in elderly patients who present with dorsal pitting edema of the hands and has a dramatic response to steroids, suggesting a benign nature. PORTAL VEIN AIR EMBOLISM Gas in the portal vein is a rare and usually fatal condition, and its presence in trauma is a rare occurrence. Various terms are used to describe the condition like hepatic portal vein gas (HPVG), pneumoportogram, gas embolism of the portal vein etc. INTERVIEW WITH DR JAMES MOON Interview with Dr James Moon. Dr James Moon is a Senior Lecturer and Consultant Cardiologist at UCL and the Heart Hospital. He set up and runs the cardiac MRI department dividing his time between clinical practice and research. He is part of a team of 5 research fellows in DIAGNOSIS AND MANAGEMENT OF STABLE COPD Diagnosis: To make a diagnosis of COPD an obstructive deficit must be demonstrated on spirometry in patients over the age of 35 years with risk factors (mainly smoking) and signs and symptoms of the disease 4. Signs and Symptoms: Progressive dyspnoea on exertion. Chronic cough. Chronic sputum production. Wheeze. VENTILATOR ASSOCIATED PNEUMONIA Ventilator Associated Pneumonia (VAP) is defined as pneumonia occurring in a patient within 48 hours or more after intubation with an endotracheal tube or tracheostomy tube and which was not present before 1, 2.Early onset VAP occurs within 48 hours and late POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME (POTS Partial dysautonomic (PD) POTS (also referred to as Neuropathic POTS) is the predominant form.1, 2 This is a mild peripheral autonomic neuropathy, characterized by inadequate peripheral vasculature constriction in the face of orthostatic challenge. Female predominance is seen with 5:1 female to LEG ULCERS IN OLDER PEOPLE: A REVIEW OF MANAGEMENT Leg ulcers are defined as discontinuity of the epidermis and dermis in the lower limb of more than 6 weeks duration 1, 2.They are a common presentation in the elderly population and are associated with a negative impact on the quality of life of patients and they also cause a substantial burden on the health budget 3.Pathogenesis of leg ulceration is heterogeneous 4. ACUTE REVERSIBLE CARDIOMYOPATHY DUE TO METHAMPHETAMINE Introduction. Methamphetamine and related compounds are the most widely abused drugs in the world after cannabis 1.Methamphetamine is asynthetic stimulant
EATING DISORDERS IN CHILDREN AND ADOLESCENTS Eating disorders are defined as those disorders in which there is excessive concern with the control of body weight and shape, accompanied by grossly inadequate, irregular or chaotic food intake. It is widely accepted that eating disorders occur in young adults and adolescents, however, a number of reports have described series ofyoung
DEPRESSION IN OLDER ADULTS Abstract. Despite being the most common mental disorder in older adults, depression is under- recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. CHEMICAL AND PHYSICAL RESTRAINT USE IN THE OLDER PERSON Definition of restraint: a device or medication that is used to restrict a patient’s voluntary movement. Prevalence of physical restraints: up to 17% in acute care settings. Prevalence of chemical restraints: up to 34% psychotropic drug use in long term care facilities. Complications of restraints: include documented falls, decubitus ulcers, fractures, and death. RISK OF BREAST CANCER DUE TO HYPERPROLACTINEMIA CAUSED BY Introduction. Prolactin is a polypeptide hormone that is secreted by lactotrophs of the anterior pituitary gland. Prolactin secretion shows a circadian rhythm 1, with highest levels occurring during the night and the nadir occurring during the afternoon and eveningThe best known function of prolactin is the stimulation and maintenance of lactation. MEDICINE IN PICTURES: PURPLE URINE BAG SYNDROME Purple urine bag syndrome (PUBS) PUBS is an uncommon condition with purple discoloration of the urine catheter system. This phenomenon is due to the presence of indigo and indirubin in the collected urine. PUBS was first published in 1978 4. Some academics would argue that PUBS was reported even earlier historically as an observation in Sir Login | Register | Forgot?* Home
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ISSN 1757-8515
BRITISH JOURNAL OF MEDICAL PRACTITIONERS ARTICLES IN THE UPCOMING ISSUE The British Journal of Medical Practitioners has adopted a “Continuous Publication” model from the beginning of year 2010 publishing articles online as soon as they are peer-reviewed and copy-edited. This provides faster publication of articles for the authors and a quicker access for readers. The BJMP website will now be updated regularly with the latest articles and we will continue to collate published articles into archival "issues" (about 4 issues per year). EDUCATION & TRAINING: Enhancing complex communications skills in foundation doctors throughsimulation
Leila Jamal, Yathooshan Ramesh, Adam Monsell & Shivanthi Sathanandan BJMP 2021;14(1):a004Download PDF
-------------------------RESEARCH ARTICLE:
Predictors of in-hospital mortality in Covid-19: a study across two peripheral District General Hospitals in UK Nil Kamal Samanta, Samik Kumar Bandyopadhyay, Dodiy Herman, Biman Chakraborty, Adrian Marsh, Subramanian Kumaran, Lauren Burnard, Gunalan Gnanaseelan , Saoirse Gibson, Benita Florence & Saibal Ganguly BJMP 2021;14(1):a003Download PDF
-------------------------CLINICAL PRACTICE:
Upgrading of Hospital Discharge Summary Software to Optimise COVID-19 Documentation and Safeguard Infection Prevention in the Community Jack Donati-Bourne, Ning Lo, Wail Mohamed, Zain Kasmani, Masilamani Selvan & Jonathan O'Dair BJMP 2021;14(1):a002Download PDF
------------------------- EDUCATION & TRAINING: Training for anaesthetists in a new healthcare system: pathway to learning & development Purnima Narasimhan & Krishnan Melarkode BJMP 2021;14(1):a001Download PDF
------------------------- BJMP DECEMBER 2020 VOLUME 13 NUMBER 2RESEARCH ARTICLES
Replacing sugary snacks with fruit, nuts and seeds at nurses’ stations within a UK oncology unit: a pilot intervention study Robert Thomas, Madeleine Williams, Graham Smit & Angel Chater FullText
AUDITS
Sustainability and sleep management in psychiatric wards Maria Donnelly, Nieves Mercadillo & Stuart Davidson Full TextCASE REPORTS/SERIES
An Unusual Manifestation of Adenocarcinoma of Lung - Skeletal MuscleMetastasis
Sharan Badiger & Siddarthkumar Chawath Full TextDifficulties
Jian Shen Kiam & Ajay Wagle Full TextCLINICAL PRACTICE
Mixed messages: Do automated messages in General Practice tell parents they are open for unwell children in the COVID-19 era? Anne Bean, Melody Redman, Victoria Dachtler, Richard Dachtler & SimonClark Full Text
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Balancing Immune System James Paul Pandarakalam Full Text* About Us
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