Clin Med
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It is recognised that physicians can face difficulty in identifying the aetiology of an episode of loss of consciousness. This lesson reports the case of a patient who was diagnosed with epilepsy in 2008 after presenting with ‘funny turns’ and had more than 100 further blackouts before a correct diagnosis of sinus node disease was made in 2010. ⋯ Diagnostic and management strategies are discussed for patients presenting with loss of consciousness. Physicians are reminded of the difficulty in distinguishing cardiovascular syncope from epilepsy in such patients and the broader principle of questioning a diagnosis in those who do not appear to respond to treatment.
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Leishmaniasis is an uncommon infectious disease in the UK with a variety of clinical presentations. Physicians should remember to consider this diagnosis in patients with an appropriate travel history (including the Mediterranean basin) and seek help with diagnostics from a specialised parasitology laboratory. Treatment regimens may be unfamiliar to the general physician, and thus should also be discussed with an expert.
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All physicians who are training young doctors of the future recognise the current challenge of doing this in the NHS. The recently published Temple Report documents the challenge and some of the solutions. ⋯ This paper sets out the history, structure and purpose of LFGs, describes what happens during a LFG meeting in both open and closed sessions and presents feedback of learning from two years in action across 11 acute trusts in the South East Coast (SEC) strategic health authority area. The experience of trainers in SEC is that the local faculty group structure and associated processes is one strand in the more effective delivery of education in the current NHS environment.