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doi:10.1136/bmj.326.7393.830

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In today's multicultural society, doctors should be aware of the traditional medical practices of patients from different backgrounds. The pattern of bruising on the chest of this patient from Cambodia may seem alarming. In fact it is a result of the traditional Khmer practice of “coining—rubbing the skin vigorously with a coin until bruising appears. This is used to relieve aches and pain from various conditions; in this case the patient had generalised pains due to malaria.

J Fisher, clinical lecturer, Liverpool School of Tropical Medicine, Liverpool L3 5QA, Christine Briasco, project director, Chantra Chhoeum, English teacher, Health Unlimited, Ratanakiri, Cambodia

General practitioners don't have all day to counsel well people about their lifestyles, organise screening tests, and discuss the latest research on vitamin supplements and drinking. But all day is exactly what they need, says a study in the American Journal of Public Health (2003;93:635-41). Researchers calculated it would take 7.4 hours of every working day for primary care physicians in the United States to complete all the preventive services recommended for all their patients. So they don't.

A simple fortified drink, taken at school, can protect Tanzanian school children from the seasonal anaemia caused by malaria and poor diet just before …