BMJ Best Practice: Hep B update

Featured updated topic: HepatitisB

For the latest updates and best practice for hepatitis B, see the update summary below.

Best Practice writes “Most people with hepatitis B infection are asymptomatic, although some present with complications such as cirrhosis, hepatocellular carcinoma, or liver failure. Serological markers are essential in making the diagnosis and evaluating disease activity, including for differentiation of acute and chronic infection, and for identifying chronic asymptomatic carriers. Therapy for acute infection is almost always supportive care alone. However, some patients with acute infection may develop liver failure, and these patients may require referral to liver transplant centre. Therapy for chronic infection includes nucleoside/nucleotide analogues, interferon-alfa, and pegylated interferon-alfa”.  Click for more.

Plus 50 latest updated topics here.

BMJ Best Practice: MRSA

Extract from BMJ Best Practice

“This month’s topic is MRSA, one of BMJ BP’s most recently updated topics and an important cause of infection in both healthy people in the community and in people in healthcare facilities.

The prevalence of MRSA infection is increasing globally. MRSA is an important cause of infection in both healthy people in the community and in healthcare institutions, but the two presentations and therapies differ.

Children and younger adults are more commonly afflicted with community-acquired MRSA, while hospital-acquired MRSA is more common in older age groups. It is also important to distinguish MRSA colonisation from infection.

Read the brief summary of MRSA below and click the links to refresh your knowledge of its prevention, diagnosis, and treatment.

You can also review the available evidence on MRSA and find further reading here.


BMJ Best Practice modules: Focus on Labyrinthitis


A reminder to check out this excellent resource from BMJ Best Practice.  In this module looking at Labyrinthitis which if you weren’t aware is an:

  • Inflammatory condition affecting the labyrinth in the cochlea and vestibular system of the inner ear.
  • Viral infections are the most common cause of labyrinthitis. Bacterial labyrinthitis is a complication of otitis media or meningitis.
  • Typical presentation includes vertigo, imbalance, and hearing loss.
  • Diagnosis is supported by history, physical examination, and audiometry.
  • Treatment is typically symptomatic and primarily involves the use of vestibular suppressants and anti-emetics.

Best Practice is very helpful and provides further information on basics, diagnosis, treatments, follow up and recommended resources. Remember to register for an Athens account in order to gain full access to all the BMJ sites.

BMJ Best Practice looks at Assessment of Dementia



In this module Best Practice begins with an overview, then goes on to emergencies, diagnosis and finally resources relating to this increasingly common syndrome.

Assessment of dementia bp2

Dementia is a syndrome characterised by an appreciable deterioration in cognition resulting in behavioural problems and impairment in the activities of daily living. Decline in cognition is extensive, often affecting multiple domains of intellectual functioning. [1] [2]

The prevalence of dementia is approximately 1% at the age of 60 years, and doubles every 5 years, to reach 30% to 50% by the age of 85 years.
Continue reading at BMJ Best Best Practice

Finally: make sure you keep checking Google Play for the new Android version of the Best Practice App, and the app store for the updated version of the IOS Best Practice App.

Best Practice topics for July

Extract from BMJ Best Practice, looking this month, at Sickle Cell Anaemia

Sickle cell anaemia is a disease of red blood cells caused by an autosomal-recessive single gene defect in the beta chain of haemoglobin.  The characteristic crescent-shaped haemoglobin can disrupt blood flow and break. There is a predisposition for obstruction of small blood capillaries, causing painful crises, organ damage, and increased vulnerability to severe infections. Infants are screened, with findings confirmed by haemoglobin electrophoresis, FBC, reticulocyte count, and peripheral blood smear. Treatment goals include fluid replacement therapy, pain management, and symptom control.

and related conditions

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