able 1. Primary features of each rosacea subtype and their specific therapies 4
Rosacea subtype	Clinical features	Therapies available
Erythematotelangiectatic	Transient erythema and persistent centrofacial erythema with or without telangiectasia.	Topical brimonidine Oral isotretinoin Laser/light therapy
Papulopustular	Persistent centrofacial erythema with transient centrofacial papules and/or pustules	Topical metronidazole/ azelaic acid/ivermectin Oral doxycycline/erythromycin/minocycline Oral isotretinoin
Phymatous	Thickened skin and irregular surface nodularities, most commonly involving the nose (rhinophyma) though it can involve other facial convexities and the ears as well	Oral isotretinoin Surgical intervention
Ocular	Foreign body sensation in the eye; burning or stinging sensation; dryness; itching; ocular photosensitivity; blurred vision; scleral telangiectasia; and/or periorbital oedema	Eyelid hygiene and lubricant eye drops Topical cyclosporin/metronidazole Oral doxycycline/azithromycin

BOX 1. CONCUSSION CLINICAL DOMAINS

Somatic	Headache Nausea/Vomiting Sensitivity to light/noise Visual problems Fatigue Dazed, Stunned Dizzy, Balance problems
Cognitive	Feeling mentally 'foggy' Feeling slowed down Answer questions slowly Forgetful of event Repeats questions Drop in academic performance
Emotional	Irritability Sadness/Depression Personality change Anxiety/Panic More emotional Less emotional (apathy)
Sleep	Drowsy Sleeping more Sleeping less Difficulty falling/staying asleep

Post partum contraception

Here are six key contraception tips for optimal postpartum care:

Initiate discussion of ongoing contraceptive needs while the patient is still pregnant and encourage her to communicate these to her clinical attendants Provide an evidence-based discussion of the pros and cons of various contraceptive methods — taking care to counter prevailing misconceptions If the choice is oral contraception, provide her with a prescription so that she can commence this immediately postpartum. It is a detail often overlooked at hospital discharge If the choice is for an IUD or implant, then ensure that she takes the device along to the hospital with her. Few hospitals or outpatient departments have these devices on hand or provide them cost-free. If she does not bring one along, she is likely to be rescheduled even if there are no contraindications to insertion at the time Be aware of the virtues of bridging contraception. If access to her preferred contraceptive method is likely to be delayed, then provide her with something until she can get it — such as the POP, DPMA or COCP, if she is not breastfeeding Encourage her to come back to discuss her options before simply stopping a method which is not suiting her.

A mnemonic for rheumatic fever: Jones major criteria: JONES:

• Joints (polyarthritis)
• Obvious (i.e. cardiac criterion: carditis)
• Nodules (subcutaneous)
• Erythema marginatum
• Sydenham’s chorea

If you see a right bundle branch block (RBBB) on an ECG,  look also for a left anterior fascicular block (LAFB).

ECG findings of left anterior fascicular block (LAFB):

• Left axis deviation, i.e. mean frontal QRS axis between -30 and -90 degrees;
• qR in aVL and usually I;
• rS in III and aVF.

Kerley B lines on the chest x-ray of a patient not responding to management of pulmonary edema? Think lymphangitic carcinomatosis.

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