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Archive for the ‘Practice’ Category

By: Martha Linden, PA, The Independent
Tuesday, 4 November 2008

Nearly 4,000 new cases of mental health disorder were diagnosed last year among armed services personnel, according to figures published today.

Mental health statistics released by the Ministry of Defence showed 3,917 new cases of armed services personnel assessed to have a mental disorder in 2007 by the MoD’s department of community mental health.

A breakdown of the statistics showed that, in line with the first nine months of last year, there were no statistically significant differences in the rates of overall mental disorder between those who had deployed to Iraq or Afghanistan and those who had not deployed during the last quarter of 2007.

But the figures showed a significantly higher rate of post-traumatic stress disorder (PTSD) among those who had deployed to Iraq and Afghanistan compared with those who had not deployed to these countries.

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By: Harriet Shawcross, PA, The Independent
Tuesday, 28 October 2008

A former head of the Islamic Medical Association sent a homophobic letter to a magazine for GPs, saying gay people needed the “stick of law to put them on the right path”, the General Medical Council heard today.

Dr Muhammad Siddiq was working as a GP at the Walsall Teaching Primary Care Trust when he wrote the letter to Pulse in July last year.

A GMC fitness to practise panel, in Manchester, heard Dr Siddiq’s letter read: “There is punishment and fine if you throw rubbish or filth on the streets, the gays are worse than the ordinary careless citizen, they are causing the spread of illness and they are the root cause of many sexually-transmitted diseases.

“They need neither sympathy nor help, what they need is the stick of law to put them on the right path.”

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By: Jeremy Laurance, Health Editor, The Independent
Friday, 26 September 2008

Almost one in five health trusts are delivering poor quality care outside normal office hours, the most comprehensive investigation into urgent and emergency services has concluded.

The Healthcare Commission also found that proportion of out-of-hours calls categorised as “urgent” varied from under 4 per cent to more than 32 per cent between services, “raising questions” over consistency.

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13 May 2008, The Independent.

He laughs and plays like any one-year-old. But a rare condition means Ceri Hughes won’t see her son’s face light up with joy.

“Moebius syndrome was first described in 1888 by a German neurologist called Paul Julius Moebius. It is a rare condition and although it is always obvious from birth, it is often not diagnosed until the infant is many weeks or even months old.

  • The main problems include paralysis of the muscles that control movements of the face and eyes.
  • The paralysis happens because the nerves that make these muscles move, called the seventh and sixth cranial nerves, are abnormal.
  • The abnormality always involves the nerves before the baby is born and doctors do not always know how it has happened.
  • Sometimes a magnetic resonance imaging [MRI] brain scan will show a defect in the brain stem, but often the MRI scan is normal.”

Children with Moebius syndrome may also have other problems, including involvement of other cranial nerves and particularly those involved with hearing, tongue movements and feeding. Children may also have malformations of one or both hands or arms, and, less frequently, of the feet or legs.

“Some children may also have slow development and learning difficulties when they start school,” says Dr Appleton. “Currently, there is no treatment that can make the facial muscles move normally or correct any limb malformations, but there are medical and surgical treatments that can improve the movement of the eyes.”

As there are so few people with this condition, the best source of practical information has been other parents and people with the syndrome whom I have met through the Moebius Research Trust (MRT). The idea of the research trust was hatched after two families, from different ends of the country, met at a conference held by the Moebius Support Group.

It became apparent that…..

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BMJ 2008;336:841-842 (19 April).

Editorials
By: Paul Kinnersley, reader, Adrian Edwards, professor, Department of Primary Care and Public Health, Cardiff University.

Complaints against doctors:
Could be reduced by identifying and remedying poor communication skills early on.

Clinical communication skills are at the heart of medical practice, and poor performance is an important factor in the origins of complaints and litigation. A recent study from Canada shows that poorly performing doctors can be identified early in their careers and possibly given targeted support and appropriate further training.

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BMJ 2008; (16 February).
Practice by: Dr Rebecca Greenhalgh, radiology specialist registrar et al, University College Hospital, London.

  • Imaging plays an important role in elucidating the cause of anal pain when the diagnosis is not clinically apparent.
  • Endoanal ultrasound is an increasingly available, relatively inexpensive, quick and safe technique providing high resolution images of the anal sphincter complex, and intersphincteric space, but it is limited by a relatively small field of view
  • Magnetic resonance imaging, although not universally available, affords much greater anatomical coverage than endoanal ultrasound and can also image the perirectal tissues and lumbar-sacral spine, facilitating diagnosis of conditions beyond the anal canal
  • In the case of perianal sepsis, preoperative magnetic resonance imaging may be indicated in clinically suspected complex or recurrent disease to guide surgery, reducing the risk of future recurrence

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