Clin Med
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There is increasing concern about the inappropriate use of alcohol by teenagers and young adults. The objective of this study was to assess the practicality of developing an alcohol education programme for school pupils delivered by medical students. The study design was of a prospective, observational, interventional cohort study. ⋯ Over a three-year period, 60 medical students provided alcohol education sessions to 1,780 high school pupils (aged 13-15 years) within seven schools in Wales. Strongly positive feedback was obtained from all stakeholders and all schools asked to be included in future programmes. In conclusion, medical student-delivered teaching of alcohol education programmes to school pupils appears to be feasible and welcome by schools, teachers, pupils and medical students.
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It is recognised that physicians can face difficulty in identifying the aetiology of an episode of loss of consciousness. This lesson reports the case of a patient who was diagnosed with epilepsy in 2008 after presenting with ‘funny turns’ and had more than 100 further blackouts before a correct diagnosis of sinus node disease was made in 2010. ⋯ Diagnostic and management strategies are discussed for patients presenting with loss of consciousness. Physicians are reminded of the difficulty in distinguishing cardiovascular syncope from epilepsy in such patients and the broader principle of questioning a diagnosis in those who do not appear to respond to treatment.
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This lesson describes a case of tuberous sclerosis presenting with confusion and agitation. The condition is briefly reviewed and learning points are emphasised for clinicians encountering similar presentations.
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The UK has recognised the important role its health professionals play in achieving the Millennium Development Goals. For doctors to contribute to these efforts without detracting from domestic service and training commitments presents a challenge. ⋯ Furthermore, the knowledge and skills required to make contributions to global health are not sufficiently served by existing training. A model for a national curriculum and tiered qualifications in global health is proposed, based on rigorous appraisal and mentoring to complement the training pathways for UK specialisation, allowing doctors to add global health skills at a level appropriate for their career plans.
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Leishmaniasis is an uncommon infectious disease in the UK with a variety of clinical presentations. Physicians should remember to consider this diagnosis in patients with an appropriate travel history (including the Mediterranean basin) and seek help with diagnostics from a specialised parasitology laboratory. Treatment regimens may be unfamiliar to the general physician, and thus should also be discussed with an expert.