129 e-Letters

published between 2016 and 2019

  • Re:Regional anesthesia and traumatic extremity fracture - can they safely coexist?
    Raghavendra Mrarappa Ganeshan

    Thank you very much Mr M.A Warner for reviewing our article and sharing your views from the same. We do agree with your suggestion that, there in no 'strong' correlation between the use of peripheral nerve blockage and delay in diagnosis of acute compartment syndrome following surgical procedures on extremities. Among the reported cases of peripheral nerve blockage use in extremity surgeries and where the compartment syn...

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  • A case of misdiagnosis: chronic fluoride intoxication?
    Declan T Waugh

    [Apologies for late edits to letter submitted yesterday, please note there are 3 new references addressing hepatotoxicity of fluoroquinolones that were not in orginal letter].

    Lugg et al (2015) reported a case study of a 16 year old girl born who presented with signs of chronic joint pain, dizziness and non-specific abdominal pains after consuming 3 cups per day of imported herbal green tea (as tea bags) for a p...

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  • Claims of effects of green tea without analysis for tea contamination
    Uli Jung

    I have read with surprise the case report which makes rather wide sweeping claims about green tea being of health concern. After a quick literature review there have been rare cases after prolonged ingestion of green tea extract - but none ever analyzed the extract for components besides green tea. It is not a secret that there are problems with food safety in china, especially pesticide use, so making claims about the p...

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  • Misleading sentence in Summary
    Shawn Weldon

    In the summary of this article is the following:

    "Only following specific questioning did she reveal that she had, in the preceding 3 months, regularly consumed internet ordered Chinese green tea, which contained Camellia sinensis."

    My issue with this sentence is the word "contained". Chinese green tea, or any other true tea, must come from Camellia sinensis.

    The word "contained" gives the imp...

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  • Green tea toxicity?
    Jeffrey B. Blumberg

    Lugg et al. present a case of acute hepatitis in a 16-year old girl and, using the CIOMS/RUCAM scale, conclude the probable cause as a 3-month exposure to a Chinese green tea ordered via the internet. Other case reports have associated an idiosyncratic hepatoxicity with green tea though other factors, including adulterants, can contribute to its causality (Blumberg et al.). Regrettably, like many of these reports, this on...

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  • Response to eLetter submitted to BMJ Case Reports
    Ramnik V Patel
    We are grateful for your comments in our images in medicine article in BMJCR entitled "'Neonatal duodeno-duodenostomy and missed duodenal stenosis with windsock deformity: a rare intraoperative error of technique and judgement by an unwary surgeon"1 We agree that finding bile in what is considered a distal segment of an atretic duodenum does not exclude all possible pathology. We are in agreement with your statement that duodena...
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  • Bifid bile duct duodenal web bypass
    Dimitrios Sfoungaris

    Indeed, this is a very interesting case illustrating that a positive intraoperative sign (finding bile in what is considered a distal segment of an atretic duodenum) does not exclude every possible pathology. However, I am still not convinced about the underlying pathology in this case. In my opinion, a perforated duodenal windsock web would allow a greater amount of air to pass through (and more gas appearing in the ab...

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  • Re:Metastatic lung cancer, an interesting stroke mimic - Authors reply.
    Hew D. Torrance

    Dear Dr Artul,

    Thank you for your question and kind comments regarding the case report. The mass seen is the same as in the Computerised Tomography (CT) and the Magnetic Resonance (MR) images. It is an isolated, large (3x2.5 cm) mass lesion. The CT was taken almost 48 hours prior to the MR as the patient had been incorrectly diagnosed and triaged to the stroke unit. As a result this time-frame may account for c...

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  • Metastatic lung cancer, an interesting stroke mimic
    Suheil Artul

    Dear author Nice case This case emphasizes the importance in differentiation between vasogenic edema of white matter due to SOL and edema due to stroke. The vasogenic edema due to SOL in general doesn't respect the anatomy and in the other hand edema due to stroke in general yes it respect the anatomy of the vessels territory and anatomical lobes. However I have one question: Is the mass seen in the CT is the same mass...

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