340 e-Letters

  • 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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  • tell me about the prevention of calciphylaxis?
    Ftima Imran

    Dear author ,

    thanks for sharing such a good case report, but is there any way we can prevent calciphylaxis ? or serial checking the calcium levels could do the job? thanks.

    Conflict of Interest:

    None declared

  • Internal laryngocoele and referred otalgia
    Faisal A Arshad

    Is it not a possibility that this patient coincidentally had an internal laryngocoele and otalgia of a different cause?

    You mentioned that she had dried blood in her external auditory canal/tympanic membrane, where you able to find a reason for this? Could this or the underlying reason for this have contributed to her pain?

    Just because her otalgia resolved over the same 3 month time period, that her...

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  • Addition of a relevant reference to a case report
    Idit Maharshak

    Dear Editor,

    I have read the well written case report "Missile launch pad: an unusual consequence of airbag deployment" by Davies et al.

    I believe that my article published in Cornea in 2005 (see details below), should be part of the reference list for this case report.

    Best wishes, Idit Maharshak

    Cornea. 2005 Jan;24(1):110-1. Airbag-induced bilateral corneal graft dehiscence.

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  • "Images In"...but what did these images add?
    Osama S.M. Amin MD, FACP

    Dear Editor,

    Sethiya et al presented a constellation of solid neurological signs in a middle-aged male.

    1. The author did not add a differential diagnosis list for this constellation?

    2. The MRI images do not "teach" anything. The right image is an axial T2 FLAIR one while the left image is a sagittal T2-weighted one. Hyper- or hypo-intense signals in the mesencephalon on these films; the p...

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  • Re:B12 and neurology
    Mohammed Naim

    Yes, brain regression is known in certain infiltrative and degenerative conditions, but, the problem as raised by Prof Agrawal S and Nathani S here is, that Ursula von Schenk et al from Germany, when first reported brain regression due to B12 deficiency followed by recovery shortly on therapy, it contradicted the very concept of atrophy and regression. And to the non radio/imaging experts it appeared simply that two ima...

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