45 e-Letters

published between 2008 and 2011

  • Exercise Testing To Risk Stratify Patients with WPW Pattern
    Arunkumar Panneerselvam
    To the Editor: I read with interest the article by Liu A et al (1). The authors have described the management of asymptomatic patient with electrocardiographic (ECG) evidence of pre-excitation. Certain aspects of this report needs to be highlighted. Asymptomatic patients with ECG evidence of pre-excitation of the ventricles are labelled as Wolf-Parkinson-White (WPW) pattern. On the contrary patients with documented tachyarrhythmia...
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  • abdominal perforation and decubitus view
    mahesh masand

    A very interesting case report but a common omission seen again in this report as is seen in real life in the wards . Any x -ray for an acute abdomen should always include both the domes of diaphragm which I cannot see in the AP view in figure A (only left dome visible) as compared to B where both domes are clearly visible ( unless it was done originally but cut off in the view shown here in this report) whic...

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  • wpw syndrome
    Naresh K Bansal

    A quick review of the condition helps keep the condtion in mind and help decision making

    Conflict of Interest:

    None declared

  • Diagnosing Aortic Dissection
    John A. Chambers

    This case report about aortic dissection is a good reminder to always consider this condition in acute chest pain particularly in patients with hypertension or a connective tissue disorder such as Marfans, SInce using this blood test as a rule out investigation in recent years we have made the diagnosis increasingly early in our institution.. A Google search revealed 5040 hits. Doctors have been missing this diagnodis for...

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  • Erythrocytosis versus polycythaemia in Eisenmenger syndrome: not a conundrum
    Matina Prapa

    We should comment on the case report by Liu et al. highlighting the difficulties in treating patients with Eisenmenger syndrome(1). The haematological complications of cyanotic congenital heart disease are well described in literature, since the systematic description of the condition by Paul Wood in 1958(2). This paradoxical state of affair between bleeding and thrombotic diathesis continues to puzzle us. Bleeding, typical...

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  • Comments
    Sajal De

    I read with interest the recently published case report by Frazer and coworker.1 History of decompensated alcoholic liver disease with gross ascites and presence of right sided pleural effusion raise the clinical suspicion of hepatic hydrothorax. The transudative nature of pleural fluid confirms this diagnosis. In absence of any cytological analysis of pleural fluid (total and differential count) it is difficult to understa...

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  • Differential diagnoses for Roth spots
    Leo Sheck

    Thank you to the authors for providing an interesting case study suggesting an association between Roth spots and pyridoxine dependent epilepsy. The documented causes of Roth spots include severe anaemia, leukaemias, dysproteinaemia, HIV retinopathy and endocarditis (Kanski, 2002).

    Within the manuscript, infection has been ruled out as the cause of Roth spots. However, details on tests regarding the other diff...

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  • A response to the editorial blog on case-report: Tracheal fistula associated with bevacizumab 20 months after mediastinal radiation
    Leo Sheck
    Historically, the use of novel treatments, sometimes still in clinical trials, has led to significant breakthroughs in the management of incurable conditions. Highly active antiretroviral therapy (HAART) for HIV is a success story of modern medicine. But in the not so distant past (1988), HIV patients faced with certain death, campaigned for the fast-tracking of public access for drugs still in clinical trials at an attempt to sa...
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  • Letter to the editor on the use of tocilizumab in GCA
    Leo Sheck

    I would like to congratulate the authors on the publication of this case report. Long term treatment of giant cell arteritis (GCA) with prednisone in elderly patients is problematic with significant side effects. An effective steroid sparing agent will help clinicians in the long term management of GCA patients.

    Although this case report provides compelling evidence that TCZ is likely to be beneficial in the tr...

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  • Interesting Case
    Mohammed Naim

    Editor Madam, it is very interesting case where the Lymphoblasts appeared to cross over the blood brain barrier to appear in the CSF or a leak from adjoining bone or capillary contributed it, and more interestingly blast cells in CSF spared rest of the brain and nerves while preferentially deposited in retinal layers formed by optic nerve, like of the previous cases cited in the report. If any other significant reason ap...

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