eLetters

154 e-Letters

published between 2013 and 2016

  • Trousseau's sign at the emergency department
    Arvind Ganesh Kulkarni

    The Trousseau's sign as described here is usually indicative of Hypocalcemia as was evident in this patient. However its sensitivity as well as specificity may not be that high as referred in the case report. It can be induced by hyperventilation leading to respiratory alkalosis even in so called normal healthy persons. This patient did have hypocalcemia as well as hypomagnesemia and hypokalemia in addition all probab...

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  • Case of CML lymphoid blast crisis presenting as bilateral breast masses
    Arvind Ganesh Kulkarni

    This is an interesting case. However the postulation proposed by the authors that a case of CML going into blast crisis of Lymphoid variety appears to be slightly far from reality. Knowing that haemopoetic stem cells can develop in any cell variety it is possible that the cells described could morphologically resemble Lymphoblasts but are in fact better labeled as Undifferentiated Blasts. The patient had many symptoms of...

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  • Haemophilia A related haematoma. management in resourse constrained settings
    Arvind Ganesh Kulkarni

    Haemophilia A is not so uncommon in India but perhaps remains unnoticed or non cared for because of the non availability of the replacement therapy or the cost factors for the therapy. This patient appears to have a milder form of the condition as no mention has been made about the frequency with which he requires the replacement of factor VIII, although it has been mentioned that at some stage the levels were less than...

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  • Successful treatment of recurrent rectal prolapse using three Thiersch sutures in children
    Jean-Luc Faucheron

    We read with interest the article from Chauhan Kashif et al, entitled "Successful treatment of recurrent rectal prolapse using 3 Thiersch sutures in an 8-year-old boy" [1] and would like to add some comments. The authors proposed a novel technique of Thiersch procedure using three sutures that included one non absorbable polypropylene suture to successfully treat a re-recurrent full-thickness rectal prolapse in an 8- year-old...

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  • Opportunity for a "one health" approach overlooked?
    Anne Fawcett

    To Whom It May Concern

    "Lick of death: Capnocytophaga canimorsus is an important cause of sepsis in the elderly"1 describes an excellent outcome thanks to an elegant diagnostic work up and excellent treatment. However, I believe the headline "Lick of death" is unnecessarily fear-mongering and unwarranted (the patient, after all, did not die). Additionally, while the authors should be congratulated for educating...

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  • 7q11.23-q21.2 microdeletion: 2 years follow-up
    George T. Vasileiadis

    As reported in the original article, the developmental assessment at 13.5 months (adjusted for prematurity) showed a global developmental delay.

    Bayley III assessment at 24.8 months (adjusted for prematurity) confirmed the global developmental delay affecting cognitive, communication and motor domains (percentile ranks: 0.4, 4, 0.4, respectively). The passive tone of his upper extremities was symmetrical bilat...

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  • Gastrointestinal bleeding secondary to trimethoprim-sulfamethoxol induced vitamin K deficiency
    Arvind Ganesh Kulkarni

    The combination of trimethoprim and sulafamethoxole has been used for the prophylaxis of malaria for over several decades. While the development of vitamin K deficiency due to this drug combination is theoretically possible, it is not very common. There are many risk factors for vitamin K deficiency, such as diet, interactions with other drugs and basic liver function. To state that this drug combination caused vitamin K...

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  • Spleen and gone? An interesting case of fever in a young man
    Arvind Ganesh Kulkarni

    The spleen can become infected as a result of septicemia, especially in immunodeficient patients. On some occasions, it can also get infected in immunologically competent patients. The spleen is known to undergo infarction in situ and may subsequently become infected. In addition, it could undergo sequestration and get infected under a variety of situations, without producing any significant symptoms and clinical findings. It...

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  • Biotin-Thiamine-Responsive Basal Ganglia Disease Can mimic Acute Disseminated Encephalomyelitis
    Katharine M Forrest

    I read this article with interest as we too made a diagnosis of post-streptococcal acute disseminated encephalomyelitis with basal ganglia swelling in a female aged 11, who had presented with altered conscious level and dystonia, with similar distribution of basal ganglia lesions on MR brain imaging. However, a diagnosis of Biotin-Thiamine-Responsive Basal Ganglia Disease was considered, and homozygous SLC19A3 mutation was conf...

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  • Are EBV- associated acute acalculous cholecystitis and EBV-associated cholestatic hepatitis with reactive gall bladder wall thickening synonymous?
    Varun Kapur

    Dear Editor, We read with interest, the case report written by Dr. Magdalani et al., "Acute Acalculous cholecystitis in a Lebanese girl with primary Epstein- Barr viral infection" in the British Medical Journal Case Reports published on 18 April, 2016.

    The authors describe a case of a previously healthy, 16 year old girl, who presented with history of 10 day fever, sore throat, and upper abdominal pain. She app...

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