This Month’s IMJ

January 2019, Vol 112, No. 1


Organ Donation in Young Infants

JFA Murphy


The Role of the Pharmacist in a Multi-Disciplinary Atrial Fibrillation Clinic

C. Mc Auliffe, E. Morrissey, M. Vaughan, D. Moore, R. Collins


Original Papers

Diagnostic Yield of Routine EEG in Adults with Active Epilepsy

R.N. McGinty, D.J. Costello, P. Kinirons, B. McNamara

McGinty et al report that 68 patients with epilepsy had a total of 171 routine EEGs of which 54.4% were normal, 24.6% non-specific, and 21.1% captured abnormalities.  The authors state that the findings point to the limited diagnostic usefulness of serial routine EEGs in patients with active epilepsy.

Obstetric Anal Sphincter Injuries: A Survey of Clinical Practice and Education among Ob-stetricians and Gynaecologists in Ireland

M. Abdelrahman, M. Geary, M. Eogan

Abdelrahman et al state that obstetric anal sphincter injuries (OASIS) occur in 2% of vaginal births.  The authors circulated a questionnaire to consultant obstetricians and trainees about education and management of the injury. The majority of the obstetricians prescribe antibiotics and laxatives and arrange physiotherapy.  A need for further training was highlighted.

A Profile of Psychiatric In-Patient Admissions With No Fixed Abode (NFA) 2007-2016

A. Daly, S. Craig E. O’ Sullivan

Daly et al report that there were 2,176 psychiatric admissions among individuals with no fixed abode in the period 2007-16.  73.4% were male, and 49.1% were under 35 years.  75.5% were single and a similar proportion were unemployed.  The commonest diagnoses were schizophrenia 28.5%, and drugs/alcohol 27.1%.

Table 1 Characteristics of 2,176 admissions with NFA as accommodation status to psychiatric hospitals andunits, 2007-2016

What Really Matters to You? A Study of Public Perspectives on General Practice in Ireland

J. Brennan, M. Bourke, R. O’Donnchadha, A. Mulrooney

Brennan et al undertook a structured interview with 10 patients.  The themes were the GP as a person and general practice as a service.  The patients liked the GP being a person not a doctor.  Positive qualities were being patient, open, smiley, nice, approachable, trustable, and interested.  Negative traits were ‘cold’ and ‘doctor’.  In relation to the practice, the important considerations were cost, convenience, and time.

The Burden of Severe Lactational Mastitis in Ireland from 2006 to 2015

F. Cooney, N. Petty-Saphon

The authors report that the admission rate for lactational mastitis was 24.4 per 10,000 live births.  The rate increased from 22.7 per 10,000 (2006) to 30.9 per 10,000 (2015). The authors urge that early effective management is important in order to minimize the risks of complications.

Table 1 Admissions undergoing procedures for breast abscess by year from 2006 to 2015 in Ireland

Occasional Pieces

The Current State of Cycling Infrastructure in Dublin and Copenhagen; A Comparison of Cycling Infrastructure in 8 Radial Routes into the City Centre of Dublin and Copenhagen

R. Conway, J. Morrow, R. Brennan, C. Mulvey, C. ÓhAiseadha

Conway et al state that much of the benefit of cycling has been lost with the proportion travelling by bike falling from 7.3% (1986) to 2.2% (2011).  In Dublin 26.7% of major commuter routes were marked with painted cycle lanes, 48.7% were shared with bus lanes, 8.5% had no marking for either bus or cycle lane, and 16.1% were cycle tracks.  I Copenhagen, 11.6% were painted cycle lanes, 0% were shared with bus lanes, 11.1% had no marking for either bus or cycle lane, and 77.2% were cycle tracks.

Figure 1. Map of commuter routes studied in Dublin , with colour-coded key.

Case Reports

“Semenly” Harmless Back Pain: An Unusual Presentation of a Subcutaneous Abscess

L. Dunne, E. Murphy, R. Rutledge

Dunne et al describe a 33 year old male who presented with severe low back pain.  Physical examination revealed an erythematous papule on his right upper limb.  He disclosed that he had injected his own semen monthly for 18 months as a ‘cure’ for back pain.  The patient was treated with intravenous antibiotics.

Figure 1. Cellulitis and oedema of the right forearm

Figure 2. Plain film x-ray of the right upper limb showing subcutaneous emphysema with associated soft tissue swelling and oedema

Case Series

Hyperammonaemia in Neonates and Young Children: Potential Metabolic Causes, Diagnostic Approaches and Clinical Consequences

S. Giva, J. Finnegan, P. Ihidero, G. Maguire, B. Power, I. Knerr, A. Monavari

Letters to the Editor

10-Year Review of B Pertussis Related Paediatric Intensive Care Unit Admissions

P. Delaney, S. Crowe

Meningococcal Diseases: Post Men C Vaccination Era

 B. Ramly

An Elderly Patient with a Diaphragmatic Hernia Presenting as Decompensated Heart Failure

C. Kennedy, G. Gullo

Permanent Childhood Hearing Loss in Ireland: Diagnostic Yield from Aetiological Evaluation in a Paediatric Clinic

J. Balfe, E. Curtis C. O’Neill

Continual Professional Development

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