This Month’s IMJ

November/December 2018 Vol 111, Number 10 


Doolin Lecture 2018: Dr. Austin O’Carroll: ‘Eradicating Stigma as a Barrier to Access’ Saturday 8th Dec 2018.

JFA Murphy


Prevention of Mother-to-Child Transmission in Patients with Chronic Hepatitis B Virus Infection and High Viral Loads

C.A. McCormick, P.A. McCormick

Pneumothorax in Newborns: Needle, Less Damage Done?

M.C. Murphy, C.P.F. O’Donnell

Mental incapacity for treatment decisions: Where do doctors stand?

 B.D. Kelly, R. Murphy, A. Curley, R.M. Duffy, S. Fleming

Original Papers

Academic Background of Irish Orthopaedic Trainees

M. Nugent

Nugent reports a survey of the academic standards among Irish orthopaedic trainees.  74% (38/51) participated.  All had commenced or completed a higher degree. 69% had at least one peer reviewed paper and  66% intend to have a clinical career. 34% plan on a part clinical, part academic career.

A Cross-Sectional Study of Antibiotic Prescribing for Childhood Upper Respiratory Tract Infections in Irish General Practice

F. Maguire, M.E. Murphy, M. Rourke, F. Morgan, G. Brady, E. Byrne, M.E. O’Callaghan

Maguire et al report on 1,007 under-6 children presenting with an URTI.  Antibiotic prescribing rates have decreased since the introduction of free GP care.  The reduction is as follows; 70% to 50% for daytime services, 72% to 60% for out-of-hours services. Following the introduction of free GP care more children presented with minor illness which did not require an antibiotic.

Ultrasound as a Diagnostic Tool in Pediatric Distal Forearm Fractures

A.S. Ahmed, A.E. Abdelhady, B. McNicholl

Ahmed et al compared the efficacy of ultrasound with standard radiography in the diagnosis of wrist fractures in children.  30 children had a confirmed fracture on x-ray, while ultrasound identified 28 of the fractures.  The 2 missed fractures on ultrasound were diagnostically insignificant.

X-ray of wrist

Ultrasound of wrist

Human Papilloma Virus- Associated Head and Neck Cancer: A 21st Century Pandemic; Assessing Student Awareness and Knowledge

F.G. Kavanagh, A.T. McNamara, O. Fopohunda, I.J. Keogh 

Kavanagh et al state the human papilloma virus (HPV) is a causal agent for head and neck cancers (HNC).  1,494 students were surveyed.  63% had never heard of the term HNC and 45% had never heard of HPV.  69% did not know how one could be exposed to HPV, and 84% were unaware of the association between HNC and HPV.

Attitudes and Knowledge of Healthcare Professionals Regarding Organ Donation. A Survey of the Saolta University Health Care Group

E. Umana, O. Grant, E. Curran, P. May, A. Mohamed, J. O’Donnell

Umana et al report a survey of health care professional (HCP) knowledge.  There were 139 respondents.  93% of HCPs were willing to donate their organs.  64% understood the term donation after brain death, 49% understood the term donation after circulatory death. 

Figure 1: Which of the following can be donated after death in Ireland?


Drain Usage in Head and Neck Surgery: A National Survey of Thirty-five Surgeons across Ten Unit

E. Keane, C.W. Fitzgerald, D.A. Smyth, M.B. Nataraj, E. Lang, L.J. Skinner, M.J. Donnelly

Keane et al surveyed 27 ENT surgeons regarding the use of drains after head and neck surgery.  The use of a drain depended on the particular surgery.  For total thyroidectomy 12/27 used drains and for hypoglossal duct cyst excision 24/27 used drains.  For submandibular gland excision 24/27 used drains and for parotidectomy 23/27 used drains.

Fig 1: Graph depicting drain use in thyroid procedures (%).
Total thyroidectomy n=12/27, hemithyroidectomy n=12/27, hypoglossal duct cyst excision n=24/27

Fig 2: Pie charts depicting drain use in salivary gland surgery (%).
Submandibular gland excision n=24/27, parotidectomy n=23/27


An Audit of Paediatric Organ and Tissue Donation in Ireland

L. Marshall, I. Hennessey, C. Lynch, C. Gibbons, S. Crowe

Marshall et al report that 36 children organs or tissue heart valves over a 11 year period 2007-2018.  There were 13 organ donations between 2007-2012 and 23 donations between 2013-2017.  The most frequently donated organs were kidneys followed by liver and heart.  Among the 52 kidneys donated, the one year survival rate of donor grafts was 96%, with rates of 94% for hearts and 81% for livers.

Table 1: Overview of organ & tissue valve donor demographics & mechanism of injury


Occasional Pieces

Child & Adolescent Emergency Mental Health Crisis: A Neglected Cohort

F. McNicholas

Case Reports

Canis Caveat (Beware of the Dog) – Septic Shock Due To Capnocytophaga Canimorsus Contracted From A Dog Bite

S.M. O’Shaughnessy, L. Broderick, J. Walsh, K. Schaffer, A. Westbrook

O’Shaughnessy et al describe a 61 year old male who developed septic shock, liver failure and splenic infarction following a dog bite on his left calf. The causal organism was C. canimorsus which resides in the oral cavity of dogs and cats.  He required intensive care and debridement of skin necrosis at the bite site.

Case Series

Operative Management of Perinatal Lumbar Disc Herniation and Cauda Equina Syndrome: A Case Series

D.P. Ahern, D. Gibbons, M. Dodds, M. Timlin, N. Cassidy, S. Morris, K. Synnott, J.S. Butler

Aherne et al describe 6 cases of cauda equine syndrome (CES) related to pregnancy.  Among the clinical features were back pain, lower limb radiculopathy, lower limb weakness, urinary retention, and saddle anaesthesia.  All the patients underwent discectomy/decompression of the lumbar disc herniation.

Figure 1. MRI images of Case D showing a large right-sided L5-S1 paracentral disc herniation.

Short Reports

The Irish Language in General Practice in the Donegal Gaeltacht

J. Houston

Houston surveyed the use of the Irish language in general practices in the Donegal Gaeltacht.  Among 100 patients, 46 were fluent Irish speakers.  Of these 46, 80% use Irish with general practice staff and 57% stated that Irish was their preferred language to discuss their health care.

Figure 1: ‘The Irish Language in Medical Practice’ Survey (English language version)

Letters to the Editor

Lack of National Consensus for the Molecular Investigation of Myeloproliferative Neoplasms: Part 2

S. Langabeer

Pulmonary Rehabilitation: Getting back the “Joie de Vivre”

M. Kooblall, D. Lawlor

A Response to: “A Cluster of Paediatric Invasive Group A Streptococcal and Chicken Pox Infections”

A. Cassidy, J. McBrien

Vitamin Deficiency and Systemic Failure: The Case For Greater Focus On Wernicke-Korsakoff Syndrome

D. McGlacken-Byrne, E. Wallace


Continual Professional Development

Please take our quiz (link below), at the Irish Medical Organisation to earn extra CPD/CME points.