Following a stroke, patients may have deficits that affect their ability to drive. The Royal College of Physicians recommend that health professionals provide advice to promote adherence to Driver and Vehicle Licensing Agency (DVLA) guidelines. The authors surveyed 46 participants who had had a stroke at least 1year ago to determine whether they received and complied with current advice. When compared to those who did not receive advice, those who did were significantly more likely to obtain medical permission before driving, but there were no significant differences in the frequency with which they complied with other recommendations. Many who notified the DVLA benefited from an assessment. Driving status and advice should be recorded in medical records and hospital staff should emphasize the positive benefits that may follow assessments and compliance with current guidance.

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Human herpes virus-6 (HHV-6) is a DNA virus with two known subtypes A and B. It is unique as its genome integrates into that of humans and is transmitted through the germ cells to the progeny, which is the major mode of vertical transmission (86%) compared to transplacental transmission (14%). 1 Chromosomally integrated HHV-6 (ciHHV-6) is diagnosed by the detection of HHV-6 DNA in hair follicles and/or nail clippings while it will be absent in transplacental infection. 2 We present a neonate who presented in shock after birth, was diagnosed with ciHHV-6Aassociated myocarditis and was successfully treated with artesunate, an antimalarial drug with antiviral properties.

We present a 3-year-old child with Budd Chiari syndrome having idiopathic complete occlusion of all three major hepatic veins and small hepatic venules. Adequate antegrade flow in right hepatic vein was established by transfemoral balloon angioplasty followed by stenting of the same. Long term antiplatelet therapy was instituted. Medium term follow up reveals satisfactory antegrade flow and regression of symptoms. This strategy highlights an effective nonsurgical approach of restoring physiological pattern of hepatic sinusoidal blood flow in Budd Chiari syndrome.

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