Notes

Plastic as well as quantitative genetic divergence reflect environment gradients between wild, fragmented numbers associated with Impatiens capensis.
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder which can have a strong impact on patients' quality of life including influence on various social aspects and psychological ramifications. The aim of the study was to assess the prevalence and consequences of IBS in medical students and junior doctors in Malta.

An online survey was sent out to all medical students enrolled at University of Malta and all doctors training with the Malta Foundation Programme.

The prevalence of IBS was 17.7% (total number =192), with 6.2% being previously diagnosed with IBS and the rest (11.5%) having symptoms consistent with IBS according to the Rome IV criteria. There was no statistically significant difference in BMI and in activity level as determined by the Godin Leisure-Time Exercise Questionnaire between IBS and non-IBS group.Absenteeism was significantly commoner in students/ doctors with IBS (47.1%) than in those without IBS (9.5%; p=0.0001). Of those previously diagnosed with IBS, 66.7% self-medicated compared to 45.4% of those diagnosed through the questionnaire. 71.6% of those in the IBS group tried dietary modification as to control their symptoms.On the Kessler 6 Distress scale, 91.2% of the IBS group had a score >6, with 44.1% having a score >13. The mean Visceral Sensitivity Index Score was 40.1 (95% CI 33.6 - 46.6).

IBS is prevalent, yet under-recognized, in medical students and junior doctors. Measures should be instituted for timely, confidential detection and management of IBS and its related psychological consequences.
IBS is prevalent, yet under-recognized, in medical students and junior doctors. Measures should be instituted for timely, confidential detection and management of IBS and its related psychological consequences.
Based in Belfast, the Royal Victoria Hospital is the only Major Trauma Centre in Northern Ireland. Due to the COVID-19 pandemic, on 23rd March 2020, Northern Ireland was placed into 'lockdown' with the majority of the population advised to "stay at home". The objective of this paper is to identify what effect the lockdown restrictions had on the workload of the Major Trauma Service at the Royal Victoria Hospital.

Patients were identified at the orthopaedic trauma meetings and from direct referral to the Major Trauma Service (MTS). Patients admitted and seen by the MTS from 23/03/20, the day lockdown was announced, to 29/05/20, when restrictions were partially lifted, were included in the analysis. Admissions data from this time period was then compared to admissions data from the same period in 2019 (23/03/19 - 29/05/19).

When comparing pre-lockdown and lockdown groups there was an overall decrease of 26% in admissions to the MTS (n=57 vs n=42). Road Traffic Accidents were reduced by 53% (n=31 vs n=15) and falls from >2m were reduced by 29% (n=21 vs n=15).

Overall the number of admissions to the major trauma service was reduced during the lockdown period. A significant proportion of the reduction may be a result of social restrictions that reduced volume of traffic on Northern Irelands roads. Further study of future lockdowns and including admissions data of other MTCs in the UK would allow us to draw more robust conclusions.
Overall the number of admissions to the major trauma service was reduced during the lockdown period. A significant proportion of the reduction may be a result of social restrictions that reduced volume of traffic on Northern Irelands roads. Further study of future lockdowns and including admissions data of other MTCs in the UK would allow us to draw more robust conclusions.
Nasal trauma is the most common facial injury worldwide. Prompt assessment allows for recognition of injuries requiring surgical intervention in the form of nasal bone manipulation. The literature is unclear to what extent patients undergoing conservative management subsequently require surgical intervention.

A retrospective chart review of all patients presenting with nasal injury between July 2017 and July 2018 who underwent conservative and surgical management was undertaken. Re-referral and subsequent surgical intervention were documented.

In a cohort of 390 patients with nasal injury 229 patients underwent conservative management. Average age was 29 years. Males comprised 60% of our conservative cohort and 81% of the manipulated cohort. 8.3% of patients managed conservatively and 12% of those undergoing manipulation were re-referred.

Nasal trauma assessment is a significant workload for an ENT unit. Conservative management is appropriate following clinical assessment and does not lead to increased intervention compared with those who are surgically manipulated.
Nasal trauma assessment is a significant workload for an ENT unit. Conservative management is appropriate following clinical assessment and does not lead to increased intervention compared with those who are surgically manipulated.
Possibly In the UK there are currently over 26,000 patients admitted to hospital for acute pancreatitis per annum and the incidence is rising. 55% of patients consult the internet for information regarding their medical condition. As the number of people using the internet has increased 57% since 2006, it is increasingly important for medical professionals to direct patients to accurate online sources of information. GNE-140 This paper aims to evaluate the quality of information available online for acute pancreatitis.

The term 'acute pancreatitis' was searched using http//www.google.com, http//www.bing.com, and http//www.yahoo.com. The top 10 results of each of these websites were assessed using the University of Michigan consumer health website evaluation checklist.

Of the 30 websites found, 4 were excluded from the evaluation. Within the 26 evaluated websites there was high variability in website quality. However, the authors would have used 18 of the websites again for the purpose of finding out informationnts using the internet, medical professionals should recommend good quality websites to their patients. Engaging in this process could improve the consenting process as patients would be better informed. Good quality websites allows patients to explore conditions by themselves, with a re-consultation facilitating further discussion. Failure to engage in internet-based information risks patients making misinformed decisions due to bias and conflict of interest.
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