JRSM Open

OBJECTIVE: Reports identify that sexual harassment is troublingly pervasive in the NHS. Active bystander training (ABT) has been promoted to address sexual harassment, alongside other forms of poor behaviour, discrimination, and harassment. We explore ABT across all English NHS Trusts and determine whether the programmes address sexual misconduct in the training content. DESIGN: Freedom of Information requests asking whether Trusts offer ABT, and if so, about the programme content and delivery, and to NHS England on centrally commissioned ABT...

A 31 year old woman was referred to the medical team for further investigation of intractable hiccups and vomiting. Initial investigations including blood tests, endoscopy and CT imaging did not identify any cause of symptoms. Following multidisciplinary team review, serial MRI Head imaging was arranged, which revealed progressive posterior fossa signal abnormality with involvement of the area postrema. In combination with a positive serum Aquaporin-4 antibody result, this helped establish a diagnosis of Neuromyelitis Optica Spectrum Disorder (NMOSD)...

A 74-year-old female with a background of rheumatoid arthritis, managed with weekly methotrexate, was admitted with; oedema, dyspnoea, cachexia and jaundice. Bloods revealed pancytopenia, hyperferritinaemia, hyperbilirubinaemia, hypoalbuminaemia and hypofolataemia. Imaging showed a large right-sided pleural effusion, requiring therapeutic aspiration, and splenomegaly. Bone marrow aspirate revealed haemophagocytosis. Differential diagnoses included methotrexate toxicity (MTXT) and haemophagocytic lymphohistiocytosis (HLH)...

INTRODUCTION: Prostate cancer and pancreatic cancer are often complex pathologies that affect millions of patients worldwide. However, the incidence of a distant collision metastasis of both malignancies remains a rare and often poorly documented incidence. CASE PRESENTATION: A 75-year-old male patient with past history of prostate cancer on maximal androgen blockade was recently diagnosed with pancreatic cancer for which he underwent radical surgical resection of pancreas with curative intent...

OBJECTIVES: To study the prevalence of COVID-19 health protective behaviours before and after rules eased in England on the 19th July 2021. DESIGN: Observational study pre (12th -18th July) and post (26th July-1st August) 19th July, and a cross-sectional online survey (26th to 27th July). SETTING: Observations occurred in supermarkets (n = 10), train stations (n = 10), bus stops (n = 10), a coach station (n = 1) and a London Underground station (n = 1)...

These atypical presentations of colonic perforation illustrate the importance of considering acute intra-abdominal pathology when subcutaneous emphysema is identified.

Rectal malignant melanomas (RMM) are remarkably uncommon, the rectal location represents less than one percent of all rectal cancer. Because of its low global survival rate, the surgical strategy is a subject of controversy for attaining a r0 resection. the palliative treatment is also debateable, but recently; radiotherapy and immunotherapy became the preferred treatment and offer the best outcome. to ensure r0 resection, abdominoperineal resection (apr) is considered the main surgical option, but because of its morbidity and functional limitations, local excision techniques such as endoscopic mucosal resection (emr) combined with chemoradiotherapy are being increasingly performed to preserve the quality of life and reduce local recurrence rate...

Use of antipsychotic drugs has been associated with increased risk of venous thromboembolism in several observational studies with unclear mechanism. We present a case of a patient who experienced a significant event of venous thromboembolism after a few months exposure to atypical antipsychotic drug for his bipolar mood disorders.

To assess the quality of Indian clinical practice guidelines (CPG)s for the management of cardiovascular conditions, MEDLINE, Embase, Google Scholar and websites of relevant medical associations and government organisations were searched, from inception until August 2020, to identify Indian CPGs for the management of cardiovascular disease (CVD) conditions, produced in or between 2010 and 2019. Excluded were CPGs that were not specific to India, focused on alternative systems of medicine, of non-CVD conditions (even if they included a component of CVD), and those related to the electronic devices, cardiac biomarkers, or diagnostic procedures...

Transcatheter aortic valve replacement (TAVR) is an alternative treatment for selected patients with severe aortic valve stenosis who are at high risk for conventional surgery. Critical stenosis of left main coronary artery as a late complication after TAVR is quite rare.

OBJECTIVES: To audit the transparent and open science standards of health and medical sciences journal policies and explore the impact of the COVID-19 pandemic. DESIGN: Repeat cross-sectional study. SETTING: 19 journals listed in Google Scholar's Top Publications for health and medical sciences. PARTICIPANTS: Blood, Cell, Circulation, European Heart Journal, Gastroenterology, Journal of Clinical Oncology, Journal of the American College of Cardiology, Nature Genetics, Nature Medicine, Nature Neuroscience, Neuron, PLoS ONE, Proceedings of the National Academy of Sciences, Science Translational Medicine, The British Medical Journal, The Journal of the American Medical Association, The Lancet, The Lancet Oncology, and The New England Journal of Medicine...

We present the case of a 67-year-old woman brought into the coronary care unit (CCU) with a suspected ST-segment elevation myocardial infarction (STEMI) due to lateral ST-segment elevation on her 12-lead electrocardiogram (ECG) and a significant troponin rise, but no reported chest pain and a fluctuating consciousness level. Whilst in CCU, she deteriorated further with a reduction in consciousness and sluggish pupillary reflexes, warranting urgent computed tomography (CT) of her brain, which confirmed extensive subarachnoid haemorrhage (SAH) with early evidence of hydrocephalus...

No abstract text is available yet for this article.

Objectives: This qualitative study sought to elicit the views and experiences of patients and health-care professionals to identify the factors associated with COVID-19 vaccine hesitancy among South Asians in London. Design: In-depth semi-structured telephone and virtual interviews. Setting: UK. Participants: Convenience and purposive sample of 12 individuals including patients, clinicians, and a medical receptionist...

FMF is characterised by dysregulation of the inflammatory process in the body, presenting as recurrent episodes of serositis. Patients with FMF commonly present with episodes of fever, peritonitis, synovitis, pleuritis, arthritis, and occasionally pericarditis. We present a case of a young 19-year old female, who presented to hospital four times over several months with intermittent fevers, abdominal pain and pleuritic chest pain. After being initially admitted under the surgical team, she was reviewed by the medical team who referred her for genetic testing, which subsequently confirmed the diagnosis...

The COVID19 pandemic highlighted the need for remote diagnosis of cognitive impairment and dementia. Telephone screening for dementia may facilitate prompt diagnosis and optimisation of care. However, it is not clear how accurate telephone screening tools are compared with face-to-face screening. We searched Cochrane, MEDLINE, Embase, Web of Science, PubMed and Scopus for all English language papers published between January 1975 and February 2021 which compared telephone screening for dementia/ mild cognitive impairment and an in-person reference standard, performed within six-weeks...

Hyperpyrexia syndrome in Parkinson's disease (PD) is a medical emergency requiring prompt action. This can be precipitated by numerous provoking factors, in particular withdrawal of dopaminergic medication. We report a case of a patient with PD presenting with confusion, dramatic worsening of PD symptoms and pyrexia in the context of a heatwave, potentially mediating its effect through dehydration and impaired medication absorption . Precipitous cooling and conversion of dopaminergic medication to a rotigotine patch due to drowsiness led to her rapid improvement...

Objectives: To examine sponsorship of Australian and New Zealand medical societies by healthcare companies and whether societies have policies to deal with conflicts of interest. Design: Cross-sectional study conducted in March 2022. Setting: Australia and New Zealand. Participants: Medical societies in both countries. Main outcome measures: The percent of medical societies that list sponsorship from healthcare companies on either their home webpages or the webpages of their annual meetings and/or that issue prospectuses to potential sponsors...

A 16-year old girl with Gorham-Stout disease is presented. She had progressive replacement of the bones of her left arm and shoulder girdle by fibroadipose tissue and numerous proliferated, non-neoplastic, lymphatic channels. The clinico-pathologic features of this condition are discussed, as are its possible complications and available therapeutic modalities.

This case describes a rare genitourinary presentation of a Masson's tumour, preoperatively assumed to be a dysplastic third testis.