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BMJ 1994; 309 doi: (Published 24 December 1994) Cite this as: BMJ 1994;309:1747

The Christmas “clacker”

A 44 year old occasional drinker presented to the accident and emergency department at 5 30 am on New Year's Day.

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A sensation at the back of his throat was causing a slight discomfort on breathing. On examination his uvula was found to be swollen. He had suffered the same problem on Christmas Day morning the previous year, the common factor being alcohol consumption during the previous evening.

It is well known that alcohol consumption triggers or worsens snoring. Overindulgence causes muscle hypotonia and depression of the arousal mechanisms, leading to many people sleeping flat on their backs rather than on their sides. This narrows the airway and leads to a tendency to obstruction. If a kick in the back from a disgruntled partner does not rectify the situation and the “comatose” state persists then forced inspiration through a narrowed airway causes repeated trauma of the uvula and swelling. —DAVID R STRACHAN, register in otolaryngology, Hull Royal Infirmary, Hull, HU3 2JZ

It's not cricket

A boy aged 11 presented with a painful right arm after throwing a cricket ball. Examination revealed tenderness over the upper aspect of the right arm. Radiographs of the arm showed a fracture of the upper humerus due to a benign bone cyst.

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The patient was referred to the fracture clinic and was treated conservatively. He is receiving regular follow up to …

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