Volume 2 - Issue 2

Scottish Universities Medical Journal 2013: Volume 2, Issue 2

Please find below the list of articles and their abstracts. Individual articles can be downloaded from the links provided.

Download entire SUMJ Vol2 - Issue 2 as a PDF





Connecting Mental & Physical Health (Editorial)

Kevin Barr (Deputy Editor, Scottish Universities Medical Journal)

Editorial for Volume 2 Issue 2 of the Scottish Universities Medical Journal.

Cite this article as:
Barr K (2013). Connecting Mental Health & Physical Health. Scottish Universities Medical Journal. 2 (2). p. 3


Transient loss of consciousness - first ever seizure? Tips for the Acute Receiving Unit

Peter M Fernandes (Clinical Lecturer in Neurology, University of Edinburgh) & Richard J Davenport (Consultant Neurologist & Honorary Senior Lecturer, University of Edinburgh)


Transient loss of consciousness (TLOC) in adults is a common presenting symptom to the Acute Receiving Unit, with an epileptic seizure a potential cause. A first ever generalised epileptic seizure is not uncommon, with a lifetime prevalence of approximately one in 20 people. However, as epileptic seizures are only one cause of TLOC, it is important for doctors to be able to distinguish between seizures and the other causes of TLOC. In this article we provide practical advice on how to do this.

Cite this article as:
Fernandes PM & Davenport RJ (2013). Transient loss of consciousness – first ever seizure? Tips for the Acute Receiving Unit. Scottish Universities Medical Journal. 2 (2). p. 5-12


Common Mental Health Conditions in Primary Care

Fiona Carver (Lecturer in Mental Health Nursing, Edinburgh Napier University) & Fiona Jones (3rd year in mental Health Nursing, Edinburgh Napier University)


Common mental health problems particularly depression and anxiety are frequently found in primary care settings. Depression can range from mild to severe but even in less severe cases can cause problems with normal functioning. Anxiety regularly manifests itself with depression but anxiety disorders, of which there are several, are also likely to disrupt normal life. There are several treatments for these conditions both pharmacological and psychological. Severe mental illness (SMI), generally bipolar disorder and schizophrenia, is also managed by primary care health professionals therefore it is essential these professionals are aware of how these conditions may present and the current treatments available.  Bipolar disorder, a serious mood disorder, is often under-diagnosed in primary care that has implications for the individual’s care and treatment. People with schizophrenia are often monitored by primary care health professionals although liaison and referral to secondary services is recommended for both these SMIs.  A holistic recovery focused approach to care is recommended.

Cite this article as:
Carver F & Jones F (2013). Common Mental health Conditions in Primary Care. Scottish Universities Medical Journal. 2 (2). p. 13-19


Approaching Geriatric Patients: The Frequent Fallers

Nabil Aly (Consultant Physician, University Hospital Aintree) & Inte H Malik (Consultant Physician, Caithness General Hospital, Wick)


Falls and fall related injuries are common medical problems experienced by older adults. Most falls have multiple causes resulting from a complex interplay of predisposing and precipitating factors in a person’s environment. Recurrent falls, defined as more than two falls in a six-month period, should be evaluated for treatable causes using effective fall prevention strategies. The frequency of falling is related to the accumulated effect of multiple disorders superimposed on age-related changes. Multi-factorial interventions targeting identified risk factors, exercises for muscle strengthening combined with balance training, and withdrawal of psychotropic medication are among the most effective fall prevention strategies. 

Cite this article as:
Aly N & Malik IH (2013). Approaching Geriatric Patients: The Frequent Fallers. Scottish Universities Medical Journal. 2 (2). p. 20-27


How can an academic mentor improve support of tomorrow's doctors?

Fiona Robertson (4th year MBChB, University of Dundee), Chloe Donaldson (4th year MBChB, University of Dundee), Robert Jarvis (Academic Mentor, Dundee Medical School & General Practitioner) & David Jeffrey (Former Academic Mentor, Dundee Medical School & Retired Palliative Care Consultant)


Three years ago Dundee University Medical School created a post of a part-time academic mentor to strengthen support for students. The experience of the first two years of this post is described. Students give their views on aspects of the mentor’s role that they found helpful and describe some of the barriers to seeking support. Finally we look forward with suggestions on how the role of mentor could be developed in future to improve student support.

Cite this article as:
Robertson F, Donaldson C, Jarvis R & Jeffrey D (2013). How can an academic mentor improve support of tomorrow's doctors? Scottish Universities Medical Journal. 2 (2). p. 28-38


A Child with a Limp - A Clinical Approach

Robert Humphreys (Paediatric Orthopaedic Physician, NHS Fife)


Limp is a common presentation in Paediatrics. Fortunately for the majority it will represent a benign problem that settles with minimal or no intervention. It may be as simple as poorly fitting new shoes or a verruca. However, in amongst the self limiting problems are relatively rare but potentially devastating diagnoses such as joint infection or malignancy. To have a reasonable chance of picking up on these at an early stage requires a thorough approach to every limping child. This article will review the key points that are important to consider when approaching a child with a limp.

Cite this article as:
Humphreys R (2013). A Child with a Limp - A Clinical Approach. Scottish Universities Medical Journal. 2 (2). p. 39-42


Regenerative Neurology - The Future

Fraser Brown (Intercalating Medical Student, University of Edinburgh)


The concept of regenerating the nervous system is not a new one- one hundred years ago, in 1913, Santiago Ramón y Cajal established the central dogma of the emerging field of neuroscience: “In the adult centres, the nerve paths are something fixed, ended, and immutable.” Cajal himself speculated whether the science of the future would ever be able to reverse this “harsh decree”. It is the aim of Regenerative Neurology to do so.

Regenerative Medicine aims to replenish or replace damaged or abnormal cells, organs and tissues to establish normal function. Regenerative Neurology is the application of these principles in the context of neurological disease- its application may take many forms, including: implantation-based techniques;  “self-repair” therapies and generation of diseased tissue models. These three concepts will likely form the basis of the future of Regenerative Neurology. In this essay the current progress and the trajectories they may follow in the future will be explored.

Cite this article as:
Brown F (2013). Regenerative Neurology - The Future. Scottish Universities Medical Journal. 2 (2). p. 43-46


Principles Underpinning the Treatment of Cancer with Drugs

Faith J Dalgaty (Academic Foundation Doctor, NHS Tayside)


There are many approaches to the treatment of cancer including radiological, surgical, the use of pharmaceuticals and various combinations of the above. The treatment of cancer is also continually changing with the arrival of new scientific discoveries. Currently the choice of treatment and management is individualised depending on cancer/tumour type, disease staging and treatment aims, such as intent for palliation or cure.

There are various types of pharmaceuticals used in the treatment of cancer; these include chemotherapy agents and specific targeted treatments of cancer including monoclonal antibodies and tyrosine kinase inhibitors. Here we explore the rationale behind the treatment of cancer with drugs, by discussing the principles of chemotherapy and the use of targeted treatments in haematological and breast malignancies.

Cite this article as:
Dalgaty FJ (2013). Principles Underpinning the Treatment of Cancer with Drugs. Scottish Universities Medical Journal. 2 (2). p. 47-52


Breaking Bad News - Pointers and Pitfalls

Mandy Barnett (Associate Clinical Professor in Medical Education, Warwick Medical School & Honorary Consultant in Palliative Medicine, South Warwickshire Foundation Trust)


Breaking bad news (BBN) is a frequent and challenging task for clinicians, with the majority of consultants reporting that they do so at least once a week. Whilst discussing a cancer diagnosis or approaching end of life situations is probably foremost in the mind of a medical student or junior doctor, it is unlikely that you will be asked to lead in this type of consultation at this point in your career. However, the definition of BBN is much broader. In this article Dr Mandy Barnett notes a few key pointers that will help you approach BBN consultations in your role as a junior doctor.

Cite this article as:
Barnett M (2013). Breaking Bad News: Pointers and Pitfalls. Scottish Universities Medical Journal. 2 (2). p. 53-57


Identification and treatment of wearing off in Parkinson's disease

James M Fisher (St5 Geriatric Medicine, Northumbria Healthcare NHS Foundation Trust) & Richard W Walker (Consultant Physician and Honorary Professor of Ageing & International Health, Northumbria Healthcare NHS Foundation Trust)


Parkinson’s disease (PD) is a neurodegenerative disorder classically characterised by motor symptoms. In recent years there has been increased recognition of the non-motor symptoms of PD. ‘Wearing off’, worsening of a patient’s symptoms before the next dose of their medication is due, may be seen with advancing disease. Management of wearing off may include modification of a patient’s levodopa medication regimen or prescription of an additional agent. The onset of such motor complications may be delayed by the use of levodopa-sparing agents or by keeping levodopa doses to a minimum. Wearing off may be evaluated via patient histories, diaries, rating scales or questionnaires. The efficacy of these assessment methods is however limited by recall bias and their inherent subjectivity. A number of potential objective methods of symptom assessment in PD have been explored, with body-worn accelerometers showing the most potential. The application of advanced computational algorithms to the data captured by accelerometers may enable the complexity of human movement to be appreciated. Such technology may, in future, allow objective identification of wearing off and thus provide the clinician with vital additional information on which to base clinical decisions.

Cite this article as:
Fisher JM & Walker RW (2013). Identification and Treatment of Wearing off in Parkinsons Disease. Scottish Universities Medical Journal. 2 (2). p. 58-63