Post-stroke seizure and post-stroke epilepsy are common causes of hospital admissions, either as a presenting feature or as a complication after a stroke. They require appropriate management and support in long term. With an increasingly ageing population, and age itself being an independent risk factor for stroke, the incidence and prevalence of post-stroke seizure and post-stroke epilepsy is likely to increase. This article examines aetiology, clinical presentation, and presents a management outline of these conditions with particular focus on adults. The aim of this review article is to provide the clinicians with background information and recommendations.

Background: Many factors are associated with medication non-adherence in Parkinson's disease (PD), including complex treatment regimens, mood disorders and impaired cognition. However, interventions to improve adherence which acknowledge such factors are lacking. A phase II randomised controlled trial was conducted investigating whether Adherence Therapy (AT) improves medication adherence and quality of life (QoL) compared with routine care (RC) in PD. Methods: Eligible PD patients and their spouse/carers were randomised to intervention (RC plus AT) or control (RC alone). Primary outcomes were change in adherence (Morisky Medication Adherence Scale) and QoL (Parkinson's Disease Questionnaire-39) from baseline to week-12 follow up. Secondary outcomes were MDS-UPDRS (part I, II, IV), Beliefs about Medication Questionnaire (BMQ), EuroQol (EQ-5D) and the Caregiving Distress Scale. Blinded data were analysed using logistic and linear regression models based on the intention-to-treat principle. Results: Seventy-six patients and 46 spouse/carers completed the study (intervention: n = 38 patients, n = 24 spouse/carers). At week-12 AT significantly improved adherence compared with RC (OR 8.2; 95% CI: 2.8, 24.3). Numbers needed to treat (NNT) were 2.2 (CI: 1.6, 3.9). Compared with RC, AT significantly improved PDQ-39 (À9.0 CI: À12.2, À5.8), BMQ general harm (À1.0 CI: À1.9, À0.2) and MDS-UPDRS part II (À4.8 CI: À8.1, À1.4). No significant interaction was observed between the presence of a spouse/carer and the effect of AT. Conclusion: Adherence Therapy improved self-reported adherence and QoL in a PD sample. The small NNT suggests AT may be cost-effective. A larger pragmatic trial to test the efficacy and cost-effectiveness of AT by multiple therapists is required. What's known• Non-adherence to medication is prevalent in Parkinson's disease (PD).• Various interventions have been widely investigated in chronic conditions for improving adherence.• Very few studies of interventions to improve medication adherence have focused on PD.• Adherence Therapy (AT) is a novel approach to maximising adherence that has shown benefit in other chronic conditions. What's new• This randomised controlled trial is the first to investigate AT in PD.• Adherence therapy significantly improved both medication adherence and quality of life in people with PD. Specifically, patients who received AT reported improvements in mobility, activities of daily living, emotional wellbeing, cognition, communication and body discomfort.• General beliefs about medication also significantly improved in those who received AT compared with controls.

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Eighteen of 67 patients who underwent cystometry for assessment of incontinence had a urinary tract infection 72 hours later. Though four of the 18 had an infection prior to cystometry, the true postcystometry infection was still high at 21%. Clinical details and urodynamic studies on these patients showed no correlation with sex, mobility, mental score, random blood sugar, renal function, initial residual volume of urine, previous pelvic operations or the type of bladder abnormality diagnosed on cystometry. The elderly and males with a high residual volume seemed more susceptible to infection. Thus cystometry carries a definite risk of infection even under optimal conditions and should not be undertaken lightly or without arrangements to follow up patients.

The educational role of grand rounds in continuing medical education of junior hospital doctors is unclear. In this article, the authors examine the benefit for junior doctors of attending grand rounds by assessing a groups' knowledge a week before, and 4 days after a grand round. The scores obtained were compared between pre- and post-grand round periods and between grand round attenders (fully or partly) and non-attenders.