335 e-Letters

  • Bilateral psoas abscesses due to mycobacterium tuberculosis from retroperitoneal lymph nodes in an HIV positive man
    Kathir Yoganathan

    We would like to report a case of bilateral psoas abscesses in a 35 year old African man with HIV infection. He developed fever, night sweats, lower back pain and weight loss in June 2003. His HIV was diagnosed in March 2003 and his CD4 count was 88 cells/mm3 and HIV RNA level was 400,543 copies /ml. He was commenced on combination antiretroviral therapy with zidovudine, lamivudine and efavirenz. The chest radiograph was...

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  • Biopsy may be affordable from non-healing or discharging sinus
    Mohammed Naim

    In any case of non-healing discharging sinus anti tubercular therapeuic trail may be always commendable, but,small tissue biopsy is also affordable from sinus margin and should not be omitted as a tool for final diagnisis including in the case of controlled diabetics.

    Conflict of Interest:

    None declared

  • Mental illness that is difficult to classify diagnosis leads to prognosis
    Osama hammer

    To; Artemis Igoumenou, Maria G Turri, Raana Din, and Harvey Gordon As I can see that this patient has been with long standing history of multiple axis diagnosis which is been used in DSM diagnosis ,he is been treated with various medications. He is currently 56 years which means that his care plan should be in line with his current health ,age and presentations. As he is clearly presenting with early changes in his int...

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  • Fatal pulmonary embolism during polyvinyl alcohol particles following therapeutic embolisation: successful resuscitation with veno-arterial extracorporeal membrane oxygenation
    Franz J. Wiedermann, MD, DEAA, FCCP

    Dear Sir,

    Wijeyaratne and co-authors report on a case with fatal pulmonary embolism of polyvinyl alcohol particles following therapeutic embolisation of a peripherial arteriovenous malformation(1).

    The citation that there is one other report of acute 'pulmonary hypertension' following transcatheter embolisation is not total correct. It was a circulatory arrest ( pulmonary embolism grade IV) which requir...

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  • Penile retraction in non psychiatric patients
    Mohammed Naim

    Editor Sir:

    In the middle age, Asian Caucasian males frequently present with the complaints of (1) penile retraction into pelvis leaving glans penis at pubic arch, (2) feeling of mass or heaviness in pelvic urethra, (3) discomfort requiring the patient to repeatedly pick the glans under garments to pullout the penis to get relieved. Examinations in such cases show evidence of prostate enlargement (80% cases) with o...
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  • Coeliac plexus block for Gastro Esophagel Reflux plain
    Rakesh Biswas

    Hi Dr Wu and Dr Mueller,

    Thanks for your excellent case report. I have a patient of proven refractory reflux pain even after fundoplication .

    Do you think coeliac plexus or other blocks may help in such situations? What other such interventions may help to relieve his reflux pain?

    What happened to your patient's pain after 11 weeks?

    Would be grateful for your response to these queri...

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  • Axial, Sagittal, or Coronal?
    Osama SM Amin

    Thanks to the author and his colleagues. Two notes only:

    1. Figure 2 is a sagittal, not a coronal MRI view.

    2. The addition of "T2-weighted" to the phrases of both figures would be helpful; the surrounding CSF signal is hyper-intense. Many doctors don't know how to interpret the brain MRI images and we should deliver the information as complete as possible.

    Conflict of Interest:

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  • Harm Reduction
    jason d gough

    As a former iv drug user of some 20 years I can certainly confirm the existence of needle fixation and its considerable prevelence amongst iv drug users.

    Commonly this expresses itself in withdrawing and injecting blood after the injection of drugs, known as "flushing". It is more readily seen in longer term iv users or for those who finding a vein involves a lot of stabbing about and then a release from the pain...

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  • Incontinence and mood disorder
    Dr Osama Hammer

    I really congratulate the hard work which was done to report this case as we all know that we have some in patients presenting in our psychiatric inpatients/community with incontinence .we always seek the medical help to roll out any underlying cause for the incontinence. However if we study the pathogeneses of incontinence and the depression it purely eradicate our doubt ,that with severity of illness the more 5HT2A in...

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  • The common is common!
    Osama SM Amin

    Dear Editor

    We are thankful to Lonergan and his colleagues for reporting this very interesting case of stroke that has been linked to sunitinib therapy. I have a few notes:

    1. The very first thing is the age of the patient? How old is he?

    2. The author did mention that the patient had several risk factors for ischaemic stroke, but he linked this stroke mainly to sunitinib. What evidence points...

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