Emergency medicine journal : EMJ
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Full-shift working by senior house officers (SHOs) is well recognised as a definite constraint to effective group learning, as it is practically impossible to gather all team members together for teaching sessions at any given time. Provision of a robust weekly teaching programme is further compromised in units where relatively few doctors participate in the rota in any case. Although practical skills tuition will always demand an intensive, hands-on learning environment, teaching in relation to case-based discussion, clinical problem solving and other group activities may well be suited to more innovative methods.
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Cavernous sinus thrombophlebitis is a clinically rare but fatal disease that progresses rapidly. Its initial presentation is always neglected by emergency physicians, until typical symptoms and signs are noted or thin-slice brain CT results obtained, by which time it is already too late. ⋯ Blindness of the left eye was the outcome. High suspicion, accurate diagnosis and aggressive antibiotic treatment are emphasised.
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Injuries to teeth can be very distressing for patients. Prompt treatment is essential. ⋯ The alveolus (tooth bearing portion of bone) and/or the tooth may be damaged. Segmental fractures involve multiple teeth and the supporting alveolar bone.