Summary Background The peptide hormone kisspeptin is essential for human reproduction, acting on the hypothalamus to stimulate gonadotrophin‐releasing hormone (GnRH) secretion. Kisspeptin is currently being evaluated as a novel therapeutic for women with infertility. However, some animal studies suggest that kisspeptin may also stimulate growth hormone (GH), prolactin and thyroid‐stimulating hormone (TSH) secretion, with implications for its safety; no previous study has investigated whether kisspeptin stimulates these pituitary hormones in humans. Aim To determine whether kisspeptin‐54 modulates GH, prolactin and TSH secretion in healthy women. Design and participants Prospective, single‐blinded, placebo‐controlled, one‐way crossover study. Five healthy women received 7 days of twice‐daily subcutaneous bolus vehicle (month 1) or 6·4 nmol/kg kisspeptin‐54 (month 2). Measurements Serum samples were analysed post hoc for GH, prolactin and TSH. Results Mean serum GH, PRL and TSH did not change during the first 4 h following kisspeptin‐54 injection when compared with vehicle. The mean frequency or amplitude of GH pulses (which influence GH function) did not change acutely following kisspeptin‐54 injection when compared with vehicle. No chronic changes in serum GH, PRL or TSH were observed over the 7‐day period of twice‐daily kisspeptin‐54 injections when compared with vehicle. Conclusion While we cannot exclude any effect of kisspeptin‐54 on GH, prolactin or TSH secretion, we observed no significant changes in these hormones at a dose of kisspeptin‐54 administration known to stimulate gonadotrophin secretion in a small study of healthy women. These data have important implications for the potential of kisspeptin to treat patients with infertility.

Objectives To test a novel, low‐cost, home‐made model for needle aspiration of PTA. To ascertain whether simulation‐based teaching using this model was superior to lecture‐based teaching in increasing confidence and reducing anxiety relating to PTA aspiration. To assess whether there was an improvement in outcomes for PTA patients at one hospital following the delivery of a simulation‐based training session using our model. Methods We designed two teaching sessions for junior doctors starting work in ENT: a simulation‐based teaching session using a low‐cost home‐made simulation model and a lecture‐based teaching session covering the same content. We asked the participants to complete pre‐ and post‐session surveys regarding confidence and anxiety levels and analyzed this data. We also retrospectively collected data over 3 months for patients referred to ENT with suspected PTA and assessed their outcomes. We assessed patient outcomes before and after the delivery of a simulation‐based training course using our model. Results Simulation‐based teaching using our model was shown to be associated with a statistically significant increase in junior doctors' confidence levels. Reaccumulation and reattendance rates for PTA following aspiration were 16.67% and 22.7% respectively preintervention and 0% and 7.14% respectively postintervention. Conclusion A regular simulation‐based teaching session should be introduced using a PTA aspiration model for junior doctors as it leads to increased confidence levels, and reduced reaccumulation and recurrence rates of PTA. Level of evidence Level 4.

ObjectiveTo ascertain whether simulation-based teaching is superior to lecture-based teaching for an induction programme using a home-made induction model.MethodsA simulation-based induction programme was designed and separate lecture-based teaching covering the same content was organised for junior doctors. The junior doctors were asked to complete pre- and post-induction surveys regarding confidence and anxiety levels. The skills taught included microsuction, flexible nasendoscopy, and anterior and posterior nasal packing. Structured interviews were conducted after the programme to gain qualitative data for analysis. The trainees’ knowledge retention was compared using a standardised written assessment one month after the session.ResultsSimulation-based teaching using the induction model was associated with a statistically significant increase in confidence levels and reduction in anxiety levels, and was associated with greater knowledge retention.ConclusionA regular simulation induction programme should be introduced using the induction model, as it leads to better knowledge retention and increased confidence levels.

A 4-month-old boy presented with a cystic swelling at the floor of the mouth causing acute airway compromise. The only previous history of note, was a tongue tie release at 3 days old. CT scan suggested a dermoid cyst with extensive floor of mouth abscess. He had an excision of the cyst and drainage of the superimposed abscess and made a good recovery. The histology report revealed a dermoid cyst which is a rare diagnosis in a child, particularly within the oral cavity. Early treatment is required to remove these lesions especially when they cause airway compromise or swallowing difficulties. This is the first case to our knowledge which suggests tongue tie release procedures causes a predisposition to the development of dermoid cysts in the oral cavity.