121 e-Letters

published between 2014 and 2017

  • case-report: Diagnostic error: what Muir-Torre syndrome has taught us
    Alphonsa Pius

    This is a well written case report and congratulations to all the authors. This article is an eye opener for all health care proffessionals . It shows how urgently we need a E-Health strategies implemented to beat the miscommunication errors. Using Information technology to communicate and highlight the important information about a patient, (specially patient history) can solve the problems to an extent. Cases like thi...

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  • Diagnostic error: what Muir-Torre syndrome has taught us
    Fiona M Curran

    This is a succint reminder that "To Err Is Human" and a refreshingly honest account of medical error which identifies the assumption held by many patients that information is complete, available to, shared amongst and read by all clinicians both before and at point of care. Undoubtedly, integrated secure electronic medical records, patient records and summary care records will realise this assumption. Meeting the challe...

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  • paradoxical coronary embolism with spontaneous recanalisation
    oscar,m jolobe

    The differential diagnosis of the association of ST segment elevation and pulmonary embolism(1) should also include paradoxical embolism involving the coronary vasculature. The fact that coronary angiography did not reveal any thrombotic occlusion, when performed 72 hours after admission, does not discount the possibility that there may have been thrombotic occlusion earlier on, and that the thrombus may have undergone sp...

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  • Lean-scaled weight as a scalar to estimate atropine dose
    John H. P. Friesen

    This case report reminds us that drug doses must be modified in obese patients. Estimating doses using total body weight risks over dosing, and using a dose based on normal body weight risks under dosing. The case reported here is important because it suggests that a widely recommended dose of atropine may be too low for obese patients and can result in paradoxical and dangerous heart block.

    The authors recomme...

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  • Diagnosis of recurrent bilateral parotitis
    Abdulla Mufeed

    The presented case of bilateral recurrent parotitis is unique and interesting. I would like to bring to your notice that such presentation of recurring bilateral parotid infections could be a classic presentation of rare autosomal recessive genodermatosis known as 'lipoid protenosis' or hyalinosis cutis et mucosae. It is characterized by wide spread deposition of homogenous hyaline like material in the skin, submucosal...

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  • uncommon case of hepatopulmonary amoebiasis
    arvind ganesh kulkarni

    Although the incidence of amoebiasis intestinal as well as extraintestinal has gone down substantially even in devloping countries the complication of intestinal amoebiasis in the form of amoebiac hepatitis before developing hepatic abscess is quite common. With the most conservative management with Metranidazol the chances of the patient developing hepatic abscess are far less unless the patient happens to be immunocomp...

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  • Dwindling clinical skills- an unforgettable lesson
    Zarshed Khan

    Hopkins et al have presented and interesting and important case highlighting the need to look for organic aetiology in new onset psychosis. Psychiatrists are medically trained doctors and GMC good medical practice requires them to keep up to date with the latest knowledge and evidence. Unfortunately very little attention is being paid in the NHS to this aspect and developing skills like leadership, management, innovations...

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  • Dabigatran does not dissolve the thrombus. Instead fibrinolytic system dissolved the thrombus.
    Thein H Oo

    Dear Editor

    I was reading with interest the manuscript of Hidekazu Takeuchi's [1]. The author believed that dabigatran dissolved the thrombus. As a consultant hematologist, I have noticed that many people including patients and practicing physicians believe that anticoagulants dissolve the clot. In reality, this is not the case. Anticoagulants never dissolve the thrombus.

    The aims of the anticoagulan...

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  • Response to "Confirmed viral meningitis with normal CSF findings"
    Thomas C Morris

    This is a very important case report as it feeds into our understanding of how to interpret test results. If the pre-test probability is high (eg. features of meningism in acute febrile illness) then negative results should be treated with an index of suspicion. No test is perfect, with both pathophysiological (eg. delayed movement of WBCs from inflamed meninges into CSF), statistical (occasional representatives from...

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  • propranolol and infantile hemangiomas
    mahesh masand

    Propranolol has now become the main stay for treatment of infantile hemangiomas even in developed countries unless it fails or the drug could not be used because of complications.This has been a matter of great relief not only for the parents/patients but the practicing doctors as well everywhere .

    Conflict of Interest:

    None declared