Osteosarcopenia has been proposed as a syndrome in a subset of frail individuals at higher risk of falls, fractures and institutionalization. In this paper, we will go over the translational aspects of sarcopenia and osteoporosis research and highlight outcomes from different interventions. In addition, preventative measures and therapeutic interventions that can benefit both muscle and bone simultaneously will be analysed also. A new holistic concept called Osteosarcopenia School will be presented. This new concept is based on counselling and education of patients as part of a rehabilitation program, aiming to reduce the risk of social isolation, falls and fractures, and subsequent disability through muscle strengthening and balance training. In this patient group, the combination of pharmaceutical treatments and specific exercise programmes are essential to counteract the consequences of osteosarcopenia. Finally, educational programmes targeting patient functionality through social reintegration may have a substantial impact on their daily living activities and overall quality of life.

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Introduction: Intrathecal Baclofen (ITB) treatment in the UK is judged based on a criteria outlined in the Clinical Commissioning Policy:ITB treatment document issued on April 2013.1 The criteria include patient who has chronic, severe, diffuse spasticity and/or dystonia of spinal or cerebral origin which renders them a full time wheelchair user or bed bound. The main purpose of the policy is to ensure equal access to health services and health outcomes achieved in line with the Health and social Care Act 2010. However, a recent review of the NHS England records between 2009 to 2014 in order to evaluate the improvement in provision of ITB services demonstrated that ITB provision has not changed over that period.2 Conclusion and Discussions:The main reasons for no improvement in the ITB service provision were attributed to: • Poor service coordination and management between different specialities including rehabilitation, neurosurgery and/or neurologists. • Continuing inadequate resources and funding of healthcare particularly rehabilitation services.• Increasing demand on rehabilitation services to respond to requirements of the acute services.• There is a skepticism in a new technology involving a permanent implantation due to fear of harm and the concern of plentiful complications despite high level evidence of its cost effectiveness. • There is increase in challenge of setting up new services and its scrutiny due to the current global economic down turn. • Reduced awareness of the non rehabilitation healthcare professionals of the effectiveness of ITB.• Increased cost of the service level agreements of neurosurgical services with district general hospitals to provide priority services of acute emergency life saving procedures. • Also the very strict criteria used by commissioners to justify funding for referral to ITB service for implantation and follow up refilling.

INTRODUCTION: Peripheral facial nerve palsy is a common occurrence in both the emergency room and the neurology outpatient clinical setting. It is usually treated pharmaceutically in the acute phase, with per os methylprednisolone, anti-herpetic agents and topical ocular ointments.