Barefoot Science Insoles Promotion and Shop

10th July, MDGH Library, 10am until 2pm

barefoot_scienceThe Barefoot Science team will be presenting their products on Thursday, 10 July on the 2nd floor of New Alderley House.

This is an internationally patented product showcasing “the only insoles in the World that have the ability to rebuild weak foot muscles and as a consequence, eliminate / reduce your physical aches and pains.”

Discount available for East Cheshire NHS Staff 

More information available at


Peter Mekhail, Simon Ward; et al; European Journal of Trauma and Emergency Surgery; May 2014

A recent publication from Mensa Study Group including Peter Mekhail, Simon Ward of East Cheshire Trust.

Risk stratification, management and outcomes in emergency general surgical patients in the UK


The Royal College of Surgeons of England (RCS) published guidance in 2011 setting standards for the management of emergency surgical patients with the aim of reducing surgical mortality. These suggested the presence of a consultant surgeon and anaesthetist, and transfer to a higher level of care postoperatively for all patients deemed high risk.


This prospective multi-institutional study sought to evaluate whether adherence to these standards was associated with reduced mortality.

Download the full-text using the title link at the top of this post.

Nausheen S.; Roberts A.J.; Wakefield N.; et al; BJOG; April 2014

Mode of delivery and perineal injury following primary obstetric anal sphincter injury
Citation: BJOG: An International Journal of Obstetrics and Gynaecology, April 2014, vol./is.
121/(228), 1470-0328 (April 2014)
Author(s): Nausheen S.; Roberts A.J.; Wakefield N.; Canavan L.; Dinardo L.

Abstract: Introduction Obstetric anal sphincter injury (OASI) complicates 1% of vaginal deliveries. It is believed that 60-80% of women are asymptomatic following OASI repair at 12 months but studies have shown that 17-24% developed worsening of faecal symptoms after a second vaginal delivery. The risk of recurrent OASI is believed to be 5-7 fold higher in women with a previous OASI, however the true recurrence is not exactly known due to various confounding factors. Methods We conducted a retrospective review of deliveries in two maternity units in the Mersey Deanery (UK), between 2007 and 2012 (29 706 deliveries). We identified 176 women who had sustained an OASI in a previous pregnancy who went on to have a subsequent delivery, (188 subsequent deliveries).The primary outcomes studied were mode of delivery and perineal injury sustained in the subsequent delivery.

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Noorullah O.; Lekharaju V.P.; Din I.U.; Klcova J.; Cross T.; Evans J.; Sturgess R.; Palmer D.; Kumar P.; O’Grady E.; Stern N.; Journal of Hepatology, April 2014,

An external validation of the hepatoma arterial-embolisation prognosis (HAP) score: The Liverpool experience 

Citation: Journal of Hepatology, April 2014, vol./is. 60/1 SUPPL. 1(S401-S402), 0168-8278 (April 2014)

Author(s): Noorullah O.; Lekharaju V.P.; Din I.U.; Klcova J.; Cross T.; Evans J.; Sturgess R.; Palmer D.; Kumar P.; O’Grady E.; Stern N.

Abstract: Background and Aims: Most hepatocellular carcinomas (HCCs) have palliative treatment. Trans-arterial embolisation (TAE) or chemoembolisation (TACE) are used with variable results. The HAP score was recently described to determine patients likely to benefit from
TAE or TACE. We report our experience with TAE and TACE to assess whether the HAP score was valid for our cohort of patients. Methods: Retrospective review of cases given TAE or TACE in Liverpool, UK (2006-2013). HAP score [1 point each for albumin <36 g/dl, AFP >400 ng/ml, bilirubin >17 mumol/l, tumour diameter >7cm. HAP A = 0 points,
B = 1, C = 2, D> 2].

Source: EMBASE

Nausheen S.; Clare A.; BJOG: An International Journal of Obstetrics and Gynaecology, April 2014

Case series: Uterine rupture, a district general hospital experience in the UK

BJOG: An International Journal of Obstetrics and Gynaecology, April 2014, vol./is. 121/(141-142), 1470-0328 (April 2014)

Author(s): Nausheen S.; Clare A.

Abstract: Background Uterine rupture is a rare obstetric emergency associated with significant adverse fetal and maternal outcomes. In high-income countries, the incidence is very low in women with an unscarred uterus at <2 in 10 000. However, the risk is increased in women who have had a previous caesarean section. They must be counselled during pregnancy about their options for mode of delivery, either elective repeat caesarean section or vaginal birth (VBAC). The RCOG advises that women should be informed of the risk of uterine rupture as 22-74/10 000 deliveries, and the ACOG quote a rate of 0.5-0.9%. This risk is increased by induction of labour or other uterine scars, such as inverted T or classical segment scars. Cases This series presents seven patients with uterine rupture seen at a UK district general hospital over a 3-year period between 2010-2013. During this period, we had 6049 deliveries, 732 of whom will have had a previous caesarean section. Less than half of these women opted for elective repeat caesarean section and so 417 women chose a VBAC. This gives a local rate of term scar rupture of 1.1% in women. In these patients the rupture was not always associated with excessive pain or CTG abnormalities. The diagnoses were made prior to the onset of labour as well as in labour and postnatally. One woman who did not realise she was pregnant and presented to accident and emergency in a state of shock. An ultrasound revealed a fetus in abdomen. During labour, rupture occurred with and without syntocinon augmentation and one case presented postnatally when she had a retained placenta.

Full Text: Available from Wiley in BJOG: An International Journal of Obstetrics and Gynaecology


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