118 e-Letters

published between 2010 and 2013

  • Antibiotic prophylaxis fore dental treatment
    Audoen Healy

    In this BMJ case report the authors make conclusions which would shame a medical or dental undergraduate student. They dismiss the long term epidemiological data which demonstrates no increase in incidence of or mortality from infective endocarditis since the introduction of the NICE guidelinesseveral years ago, using a highly spurious explanation suggesting that dentists are somehow identifying the most at risk patients...

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  • Importance of a good history and physical examination
    Ashish Pathak

    Dear Editor, This case demonstrates the importance of accurate history taking combined with imaging. However, the authors have discredited the importance of history in the case report. Studies have proven the importance of symptom clusters in predicting testicular torsion. The triad of a) previous trauma, b) pain attacks, and c) nausea and vomiting along with absence of urinary complaints has high sensitivity and positiv...

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  • Chlorhexidine application to vaginal mucosal membranes before birth to decrease GBS
    Judy Cohain

    This article is extremely relevant in light of the recent increase in use of chlorhexidine to achieve GBS negative vaginal cultures at the end of pregnancy.

    "Gynahex" from a company called "Concept" is selling an aqueous vaginal gel with 1% chlorhexidine. It is inserted vaginally twice a day for 8-10 days to result in a negative GBS culture. Then the woman continues to apply the gel vaginally once a day until l...

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  • Spinal epidural abscess treated with antibiotics alone
    Vengalathur G. Ramesh

    I read with interest the case report of "Spinal epidural abscess treated with antibiotics alone" by Pathak et al. This patient had presented with paraparesis and incontinence of bladder and bowel, which by itself is an indication for emergency surgery. Such a case should not be managed medically. It is a surprise that the patient had recovered. But this should not mislead the clinician into managing all the acute spinal...

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  • shoulder dimples
    Diana L Jackson

    I too have dimples in both shoulders. I have never met or heard of anyone else having them, not even a family member. Until 2 years ago when my youngest grandson was born. He has them on both shoulders as well. This report is the first I've seen on this and hope to learn more. Thankyou

    Conflict of Interest:

    None declared

  • ..
    Joyce Schoenmaker

    Impressive story and inspiring for a lot of people I think. This case report again shows that mindfulness-based cognitive therapy is a really effective way of treatment for this particular, persisting disorder and should surely be investigated further!

    Conflict of Interest:

    None declared

  • Hyponatremia is not same as TURP syndrome
    Yushi U. Adachi

    We read with great interest the case report by Demirel (1) et al. in the journal. The authors described the case showing severe hyponatremia and critical hypoxia during transurethral resection of the prostate (TURP) surgery in the patient under general anaesthesia. TURP syndrome is initiated by absorption of irrigating fluid (2) and is characterized by decreasing a serum sodium concentration, inducing cardiovascular depr...

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  • Gallstone ileus and fatal gallstone coleus: the importance of the second stone
    Zakiuddin G. Oonwala

    This case report is interesting and revealing for 2 reasons. Gall stone ileus is usually due to benign fistula due to pressure necrosis and duodenal wall eroding through. Gall stone gets impacted in the terminal ileum and cannot pass the so called physiological ileo caecal valve. In this case the gall stone got impacted in (1)the decending colon and not in the terminal ileum and the cause of the fistula turned out to be(2)...

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  • The male vagina is a more accurate term than prostatic utricle.
    Vincenzo Puppo

    The prostatic utricle is a cul-de-sac of the prostatic urethra and extends backward and slightly upward for a very short distance within the middle lobe of the prostate. It is composed of fibrous tissue, muscular fibers, and mucous membrane. The prostatic utricle is 10-12 mm long, sometimes it is 20-25 mm, rarely it is 6-8 cm long.1 It is located in the seminal colliculus (i.e. veru montanum): this is a prominence of the...

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  • Old is Still Gold
    pablo garcia

    A clear exposition of the case using a simple drawing to explain the image. In depth and summarised investigation on the subject. Practical tips for a general surgeon's practice usefull to avoid serious injuries.

    Conflict of Interest:

    None declared