Medical Journal News

New testimony gathered by the BMA details instances of physician associates (PAs) and anaesthesia associates (AAs) making incorrect clinical decisions, dangerously prescribing medication, introducing themselves as doctors, and taking part in surgical procedures for which they were not qualified.1The BMA said that the scale of the evidence it had gathered through an online reporting portal between November 2023 and February 2025 showed that the NHS had failed in its duty to ensure patient safety. The 600 reports of serious concerns gathered by the BMA have been submitted as evidence to the government commissioned Leng review.23 But the BMA said that the NHS must introduce urgent interim measures while the review is ongoing, including an immediate halt to recruitment of PAs and AAs, implementation of the BMA’s safe scope of practice and supervision guidance,4 and an immediate investigation into PAs and AAs being placed on doctor rotas.The BMA has now published...

This man in his early 70s presented with a two year history of an itchy rash on his lower limbs. He had initially had a diagnosis of psoriasis and was treated with topical clobetasol propionate. Although the itch improved with this treatment, the rash persisted and worsened. On examination, there was clearly demarcated erythema on both feet and lower legs, and thickening, deformation, and discoloration of the toenails (fig 1). Fungal cultures of the skin identified Trichophyton rubrum, and the diagnosis was revised to tinea incognito with onychomycosis.bmj;389/apr03_7/e082105/F1F1f1Fig 1Tinea incognito refers to a superficial dermatophyte infection that has been inappropriately treated with topical steroids, leading to an atypical clinical appearance.1 This patient was treated with itraconazole (200 mg twice a day for seven days each month) orally for six months, and topical antifungal cream twice a day for one month, with substantial clinical improvement. This case highlights that tinea incognito...

The studyKhalaf Z, Bush A, Saglani S, et al. Influence of age on clinical characteristics, pharmacological management and exacerbations in children with asthma. Thorax 2024;79:112-119.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/schoolchildren-with-asthma-face-different-risks-at-different-ages/

Countries across Africa are facing more frequent and concurrent infectious disease outbreaks, straining pandemic surveillance and control systems amid cuts to aid. These challenges warrant empowered leadership from the Africa Centres for Disease Control and Prevention (Africa CDC), rapid capacity building, and new financing initiatives.The Africa CDC recently recommended maintaining mpox as a public health emergency of continental security owing to intense spread and the emergence of a new highly transmissible clade Ia variant.1 Mpox remains uncontrolled in 22 countries, with weekly cases tripling between August 2024 and February 2025.1 Vaccine supplies, surveillance systems, and health services are insufficient, exacerbating the risks to public health.Concurrent outbreaks of Ebola, Marburg, measles, cholera, and other diseases add further strain to fragile health systems. In January 2025, Tanzania reported a Marburg outbreak with 100% case fatality rate.2 Also in January a new disease outbreak in the Democratic Republic of the Congo (DRC) affected...

A child was found to have noticeably decreased vision in his left eye during a routine optometry examination after showing normal vision six months previously. He did not self-report any eye symptoms (such as redness, pain, or tearing), headache, or dizziness, and had no personal or family history of eye diseases or other medical conditions. His parents reported that a green laser pointer (wavelength 532 ±10 nm, maximum output power <50mW, Class III) had been purchased six months previously and the patient had been playing with it frequently. The patient reported looking directly at the laser pointer light on several occasions. He did not report that anyone else had shone the laser into his eyes. There was no history of trauma to either eye.On examination, his best corrected visual acuity was 20/32 in the left eye and 20/20 in the right eye. Fundus colour photography showed multifocal, yellowish, faceted lesions...

Mortality in surgeryMore than 10 years ago, a survey in The BMJ drew attention to higher mortality in people who had elective surgical procedures carried out on Friday or over the weekend compared with Monday (BMJ doi:10.1136/bmj.f2424). A study in Ontario, Canada finds something similar. Among 400 000 patients undergoing 25 common surgical procedures, adverse postoperative outcomes, including death, re-admission, and long and short term complications, were 5% commoner in patients who underwent surgery on Fridays (JAMA Netw Open doi:10.1001/jamanetworkopen.2024.58794).Pandemic anniversary photographsThe New York Times marks the 5th anniversary of the covid-19 pandemic with a collection of photographs that capture some of the weirdness and tragedy of the period (https://www.nytimes.com/2025/03/10/world/asia/covid-anniversary-photos.html). Another piece in the same newspaper reminds us that, although we still don’t know how the pandemic started, inquiry and debate about its possible origins have been stifled rather than encouraged (https://www.nytimes.com/2025/03/16/opinion/covid-pandemic-lab-leak.html). Minerva was alarmed to learn that experiments with...

The General Medical Council is appealing to the High Court against a decision by a medical practitioners tribunal to suspend a consultant for 12 months for a “one-off” rape of a young woman instead of striking him off the register.1Aloaye Foy-Yamah was a consultant in acute medicine at Blackpool Victoria Hospital but was dismissed after the tribunal handed down its determinations on the facts last November. The woman, who was a friend, reported the assault, which happened in 2018, to the police, who investigated but did not prosecute Foy-Yamah. But the tribunal decided on the balance of probabilities that the rape, which he denied, had taken place while the woman was staying at his home.The GMC’s lawyer had asked the tribunal to erase Foy-Yamah from the register. The tribunal decided, however, that his “misconduct came right up to the line of erasure but fell just short of crossing it.” The...