Widening is a predictive factor of bucket handle tear in tibial plateau fractures.

Background: It is well known that tibial plateau fractures have an association with soft tissue injuries. However, as far as the authors are aware, there has been no literature specifically on the incidence of bucket handle meniscal tears in patients with tibial plateau fractures. Bucket handle tears are often symptomatic and amenable to repair if detected early.

Risks and management of antiepileptic drug induced skin reactions in the adult out-patient setting.

Adverse cutaneous reactions caused by mostly aromatic antiepileptic drugs (AED) affect 50.000 people a year in the United Kingdom (UK; incidence 75.7/100.

How to design and deliver a local teaching program.

Teaching is an invaluable aspect of any medical or surgical career. Many trainees will find themselves delivering teaching at several stages in their career and in this "How to" article we explain how to design, set up, and deliver a successful teaching program, as well as how to evidence this in your portfolio.

A review of the musculoskeletal manifestations of sarcoidosis.

Sarcoidosis is a systemic disease of unknown aetiology that is characterized by granulomatous inflammation that can develop in almost any organ system. Musculoskeletal manifestations are seen in up to one-third of patients, ranging from arthralgia through to widespread destructive bone lesions. Inflammatory tendon lesions and periarticular swelling are more common than true joint synovitis.

Hemophagocytic lymphohistiocytosis responding to withdrawal of gluten: a case report.

Background: This is the first documented case of a patient with hemophagocytic lymphohistiocytosis in association with coeliac disease. There was complete clinical and biochemical remission of hemophagocytic lymphohistiocytosis following the introduction of a gluten-free diet.

Case Presentation: A 7-year-old white girl presented with fevers and maculopapular rash with a recent history of tonsillitis.

Apparent asystole: are we missing a lifesaving opportunity?

The use of ultrasonography is rapidly expanding in emergency medicine. Real-time assessment offers clues to prompt diagnosis and creates opportunities for speedy intervention. We present a case of 'cardiac monitor asystole' that proved to be ventricular fibrillation on ultrasound examination.

Routine histological analysis of a macroscopically normal gallbladder--a review of the literature.

Background: 70,000 cholecystectomies were performed in the United Kingdom in 2011-2012. Currently it is standard practice to submit all gallbladder specimens for routine histology to exclude malignancy. The aim of this systematic review was to establish whether a normal macroscopic appearance to the gallbladder at the time of cholecystectomy is sufficient to rule out malignancy and therefore negate the need for routine histology.

'Out of hours' adult CT head interpretation by senior emergency department staff following an intensive teaching session: a prospective blinded pilot study of 405 patients.

Aim: Cranial CT is the gold standard for the investigation of intracranial emergencies. The aim of this pilot study was to audit whether senior emergency physicians were able to report CT head scans accurately and reliably having attended structured teaching.

Materials And Methods: Senior emergency physicians attended a 3 h teaching session.

Skin imaging: is it clinically useful?

Non-invasive skin imaging techniques have proliferated over the last decade. Whilst most have a research role, some are routinely used in dermatology clinics. Of these, the skin surface microscope (dermatoscope), a diagnostic aid for pigmented lesions, has had most clinical impact.

Drugs in pregnancy. Drugs to avoid.

Drugs given in pregnancy can adversely affect the fetus in many ways. Anxiety about birth defects is a major parental concern during pregnancy. Doctors, midwives and their patients often seek information about the potential teratogenicity of drugs that are taken by, or prescribed for, the pregnant woman.

Management of pregnancy in antiphospholipid syndrome.

Pregnant women with APS are at high risk of maternal and fetal pregnancy complications. Multidisciplinary teams expert in this condition should coordinate management. Even with current management strategies, the risk of maternal thrombosis, fetal loss, or other adverse obstetric outcomes remains.

Elective forceps delivery and extradural anaesthesia in a primigravida with portal hypertension and oesophageal varices.

The use of extradural analgesia to avoid straining in a primigravida with portal hypertension and secondary oesophageal varices is described, together with a discussion of the advantages and disadvantages of this approach.

The influence of suture material on vaginal vault granulations following abdominal hysterectomy.

A questionnaire was circulated to 1147 members (consultant status) and fellows of the Royal College of Obstetricians and Gynaecologists to survey the current management of the vaginal vault following abdominal hysterectomy. Of the 56% who responded, the majority (87%) routinely close the vault. An interrupted mattress suture is used by 60%, a continuous suture by 43% and the Lembert suture by 2%.