Australasian Medical Journal

BACKGROUND: More than 169,000 people live in residential aged care facilities (RACFs). As people age they use health services, particularly general practitioner (GP) services, more frequently but many GPs do not attend patients in RACFs. AIMS: To examine GPs' perceptions of barriers to providing care to patients in RACFs. METHODS: This study was conducted in June 2014 in the Bayside Medicare Local (BML) region in Victoria, Australia; all participants were drawn from this region...

BACKGROUND: Neck of femur (NOF) fractures are the most common injury among elderly patients and a significant burden on our healthcare system. AIMS: This study aimed toevaluate if an Australian rural hospital serviced by general surgeons can meet the established standards of care for the management of NOF fractures by undertaking surgery within 48 hours. METHODS: An audit of patients presenting to an Australian rural hospital with NOF fractures over a seven-year period...

BACKGROUND: Our study retrospectively reviewed the presentation, neuro-radiological findings, and outcomes of eight adult patients presenting at our institution with subarachnoid haemorrhage (SAH), which was subsequently proven to be due to cortical venous thrombosis (CVT). METHODS: We reviewed the case records and neuroimaging findings of eight patients diagnosed with SAH and CVT over a span of two years at our institution, a tertiary care centre in Western India...

No abstract text is available yet for this article.

Minocycline is widely used as a first-line agent for papulopustular acne, and has previously been reported as causing stains on teeth that are still forming. This article reports a case of staining to only the crowns of unerupted third molars in a girl prescribed minocycline at age 16 for papulopustular acne. We review the literature in the area of minocycline teeth staining, consider the role of minocycline as a first-line agent for papulopustular acne, and outline strategies on the prevention of minocycline teeth staining...

BACKGROUND: The progression of chronic kidney disease (CKD) can be attributed to various factors, including lack of medical services, delayed referral, lack of awareness about the disease, drugs, and financial support. AIMS: To compare the pharmacoeconomic-related direct medical and non-medical costs among hospitalised pre-dialysis and dialysis patients. METHODS: A prospective observational study was conducted on the inpatients admitted to the Department of Nephrology...

BACKGROUND: On their journey to "becoming" doctors, medical students encounter a range of health professionals who contribute to their socialisation into clinical practice. Amongst these individuals are registered nurses (RNs) in clinical practice who are often employed by medical schools as clinical tutors. These RNs will encounter medical students on campus and later in the clinical setting. AIMS: This qualitative study explored RNs' perceptions of their contribution to medical students' developing professional identities in order to provide a greater understanding of this process and ultimately inform future curriculum...

BACKGROUND: Exercise has shown positive training effects on obesity-related inflammation, however, resistance training has shown mixed results concerning adipocytokine levels. AIMS: The purpose of this pilot study was to explore the effects of resistance training on blood adipocytokine concentrations in obese youth, with specific examination of the relationship between these biomarkers and improved fitness (i.e., aerobic capacity, muscular strength). METHODS: Fourteen obese adolescents (16...

BACKGROUND: Previous studies conducted in Australian hospital settings suggest high variability in assessments, investigations, and management of diabetic foot infections and poor adherence to widely accessible evidence-based protocols and guidelines. Diabetic foot complications require a multidisciplinary approach and often involve both medical and surgical teams during inpatient care. AIMS: The aim of this clinical audit was to better understand the scope of diabetes-related foot complications, evaluate whether current assessment and management strategies are in line with best practice guidelines, and to formulate future models of care...

Lactation anaphylaxis (LA) is an extremely rare condition with only five other cases having been previously reported in the literature. Patients will exhibit cutaneous symptoms, respiratory symptoms, gastrointestinal symptoms, and/or cardiovascular symptoms. Post-partum, the drop in hormones is thought to facilitate an exaggerated histamine response. An elevated serum tryptase level performed between 15 minutes to three hours of onset of symptoms will confirm a true anaphylactic reaction. It is important to be aware of this extremely rare medical condition and its management with antihistamines...

We present an interesting case of a young man with coronary artery vasospasm complicating scombroid fish poisoning illness. The initial presentation included tachycardia and significant hypotension. A 12-lead ECG showed sinus tachycardia with marked widespread ST segment depression and ST elevation in aVR. Symptoms subsequently improved with intravenous fluid rehydration, antihistamines, and glyceral trinitrate. The underlying pathogenesis and treatment of this rarely described manifestation of the fish poisoning illness is discussed...

Scrub typhus is an acute febrile illness caused by the intracellular parasite Orientia tsutsugamushi. Although most cases present with mild symptoms and signs and recover spontaneously, some cases can be severe with multi-organ dysfunction and a protracted course, which may be fatal if left untreated. Apart from fever and constitutional symptoms, atypical presentations allow this disease to mimic several common conditions. We report a case of scrub typhus in an 18-year-old male who presented with severe polyarthritis involving all large joints and a massive lower gastrointestinal bleed from ulcers in the terminal ileum, secondary to vasculitis in the small bowel...

Sigmoid colon diverticulosis is commonly seen in both the surgical outpatient and emergency departments. Rarely, these sigmoid diverticulum, which usually range from 2-3mm to 2cm in size, can enlarge to more than 10 times. This is due to a ball-valve type mechanism that traps colonic gas inside the sigmoid diverticulum causing it to gradually enlarge. Patients with a giant sigmoid diverticulum (GSD) must be investigated thoroughly as two per cent of patients will present with a colonic carcinoma either within or distal to the GSD...

Rasmussen's encephalitis (RE) is a rare neurological disorder of inflammatory aetiology characterised by encephalitis, intractable seizures, hemiparesis, variable motor deficits, and dementia. It is not commonly considered in the clinical differential diagnosis of a patient with a past history of a stroke-like episode presenting with status epilepticus. It is suspected mainly in children in whom the disease is more common. Here we report a case of an adult man presenting with a common symptom of seizure caused by Rasmussen's encephalitis...

BACKGROUND: Statins are a first-line drug treatment for hypercholesterolaemia. Recently there has been general public and media interest surrounding uses and side effects of statins, including memory loss. AIMS: We analysed an Australian experience in statin usage in an attempt to improve understanding of the relationship between statins and memory-related adverse events. METHODS: Total adverse events (TAE) and adverse events with single suspected medicines (SSM) for memory loss and other memory-related adverse events were searched for statin compounds from January 1992 to May 2013, using the Medicare Australia and Pharmaceutical Benefits Scheme (PBS) websites and Therapeutic Goods Administration (TGA) adverse events data...

No abstract text is available yet for this article.

An abnormal course of a nerve either through or around a muscle may yield multiple or anomalous muscle innervation. Further, if nerves are inappropriately trapped within the confines of a muscle or irregular boundaries, variant emergence of a nerve could give rise to symptoms of an entrapment neuropathy. Upon routine dissection in the Department of Anatomy at the American University of Antigua College of Medicine, bilateral variants in the emergence of the sciatic nerve from the pelvis to the gluteal compartment were discovered in an elderly adult female cadaver...

Toxicity from accidental and intentional ingestion of yellow phosphorus, ubiquitously present in fireworks and rodenticides, has recently become more frequent. Gastrointestinal, renal, neurologic, and cardiovascular manifestations are common, with mortality of 23 per cent to 73 per cent. Reports of haematological abnormalities are rare. We report only the second case of severe neutropenia secondary to selective myelosuppression in a 14-year-old girl following intentional ingestion of yellow phosphorus. Leucocyte counts recovered spontaneously without further complications...

BACKGROUND: A review of the effectiveness and outcomes in liver abscess drainage performed by different operators using percutaneous aspiration (PA) and catheter drainage (PCD), respectively, from 2008-2013 at Sir Charles Gairdner Hospital, a tertiary hospital in Australia. METHODS: Forty-two patients (29 males and 13 females; aged between 28-93 years; median age of 67 years) with liver abscesses underwent either ultrasound or CT-guided PA (n=22) and PCD (n=20) in conjunction with appropriate antimicrobial therapy...

BACKGROUND: With the emergence of metallo-betalactamases (MBL) in Pseudomonas aeruginosa (P. aeruginosa), the value of carbapenem, the drug of last resort, is being severely compromised. Curtailing the use of carbapenems becomes paramount if resistance is to be reined in. AIMS: To study the role of synergy between combinations of drugs as an alternative treatment choice for P. aeruginosa. Synergy was studied between combinations of levofloxacin with piperacillin-tazobactam and levofloxacin with cefoperazone-sulbactam by time-kill and chequerboard techniques...