prosthetic hip joint infection after dental treatment.

Introduction: is a Gram-positive bacteria and a normal component of oral flora. It is also found in dental plaques, endodontic abscesses and can rarely cause more serious infections.

Case Presentation: We describe a prosthetic hip joint infection in an 81-year-old fit and healthy man due to who underwent a prolonged dental intervention two days earlier without antibiotic prophylaxis.

Management of pinna haematoma study (MaPHaeS): A multicentre retrospective observational study.

Objectives: To assess current variation in the management of pinna haematoma (PH) and its effect on outcomes.

Design: Multicentre retrospective observational record-based study.

Setting: Eleven hospitals around the UK.

Glucose-6-phosphate dehydrogenase deficiency: an unusual cause of acute jaundice after paracetamol overdose.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the commonest human enzyme defect causing haemolytic anaemia after exposure to specific triggers. Paracetamol-induced haemolysis in G6PD deficiency is a rare complication and mostly reported in children. We report the first case (to the best of our knowledge) of acute jaundice without overt clinical features of a haemolytic crisis, in an otherwise healthy adult female following paracetamol overdose, due to previously undiagnosed G6PD deficiency.

Technical tip: tightrope fixation of neer type II distal clavicle fracture supported by a case series.

Background: We present a case series of 3 patients who underwent a novel technique of tight rope fixation for Neer type II distal clavicle fracture.

Material And Methods: 2-3 cm incision was made lateral to the fracture site moving inferomedially. Part of the distal end of clavicle was exposed close to fracture site and further dissection was carried out to reveal the coracoid process.

Dropping of instrument by scrub team during hip and knee arthroplasty - Does patient's size matters?

Background: Medical literature suggest that Hip and Knee replacement surgery takes far more time to conduct in overweight and obese patients than in general population. Reasons for increase in operating time in obese patient are difficult positioning, more bleeding from fatty tissue and difficult retraction. One very interesting and to our knowledge never reported cause of increased operating time in obese patients undergoing hip and knee arthroplasty is accidental dropping of instruments onto the floor by operating team.

Entwinement of sciatic nerve around a total hip prosthesis following closed reduction of dislocated total hip replacement.

The usual causes of injury to sciatic nerve during total hip replacement are intraoperative direct nerve injury, significant leg lengthening, improper retractor placement, cement extravasation, cement-related thermal damage, patient positioning, manipulation and postoperative hematoma. We present a case of early sciatic nerve injury with entrapment of sciatic nerve around the prosthetic femoral neck following repeated manipulation of dislocated total hip replacement. This case emphasises the importance of soft tissue in dealing with orthopedic problem.

Internal quality control: best practice.

There is a wide variation in laboratory practice with regard to implementation and review of internal quality control (IQC). A poor approach can lead to a spectrum of scenarios from validation of incorrect patient results to over investigation of falsely rejected analytical runs. This article will provide a practical approach for the routine clinical biochemistry laboratory to introduce an efficient quality control system that will optimise error detection and reduce the rate of false rejection.