85 e-Letters

published between 2005 and 2008

  • Cardiovascular risk in the South Asian population
    Dr.Srijit Das

    The article titled ‘Cardiovascular risk in South Asians’ by Ramaraj et al initiates a healthy debate on the prevalence of cardiovascular disease in the South Asian countries(1). The authors are to be congratulated for a meticulous survey of the literature to find all relevant papers in cardiovascular diseases. The authors wrote about the ‘thrifty gene hypothesis’ which definitely suggests an interaction between genetic p...

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  • Re: Carpal tunnel - Are non-operative interventions effectively utilised?
    Frank D Burke

    The authors thank Henke Giele for his contribution to this discussion. We are pleased to see that he allows for some delaying of a curative operation in isolated cases when the inconvenience of the procedure and its recovery are untimely. He goes on to state that there is a correlation between severity of post-operative complaints and chronicity of symptoms and cites three papers that come to that conclusion. However...

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  • Critical review
    Joe Schrieber

    To the Editor,

    We read with interest the paper entitled “Evaluation of the need for endoscopy to identify low-risk patients presenting with an acute upper GI bleed suitable for early discharge” Postgraduate Medicine Journal December 2007; 83: 768-722. The aim of this paper was to audit the safety of two similar protocols used to manage low-risk upper GI bleeding within one trust in Leeds. Both protocols advised...

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  • Carpal tunnel - Are non-operative interventions effectively utilised?
    Henk Giele

    Yes, the poor use of non-operative interventions (as reported in this article) does indeed seem to be the effective use of these interventions that (the authors themselves acknowledge) are not curative but merely delay the curative operation.

    On both economic and patient parameters it is more economic to proceed directly with the curative intervention than waste resources and time attempting non-curative inter...

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  • Involvement of talus in amyloidosis
    Dr.Srijit Das

    Dear Editor,

    We read with much interest the article ‘Pathological fracture of the talar neck associated with amyloid deposition’ by Christafi et al., which was published in the 2007; 83; 749 issue (1). The case appears to be interesting. Since, the case appears to be related to primary amyloidosis, involvement of kidney, other viscera, carpal and tarsal bones is not uncommon. One would be eager to know if there...

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  • Treatment of Acute Adrenal Crisis.
    Robert James

    Adrenal crisis is a medical emergency. If suspected treatment should be started as soon as possible. Every emergency physician should be familiar with adrenocortical insufficiency—a potentially life-threatening entity. The initial diagnosis and decision to treat are presumptive and are based on history, physical examination, and, occasionally, laboratory findings. Delay in treatment while attempting to confirm this diag...

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  • The evidence applies to all individualised herbal medicine
    Peter H Canter

    In reply to Dr Koprowski's letter, we would like to point out that the absence of rigorous evidence supporting the efficacy of individualised herbal medicine shown by our systematic review remains fact - regardless of how the various types of individualised herbal medicine are categorised. If we had examined only individualised traditional oriental herbal medicine, we would have found even less evidence. If there is "act...

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  • A startling inadequacy in the links between the review evidence and the authors’ conclusions.
    Ally Broughton

    Response to: R Guo, PH Canter, E Ernst. A systematic review of randomised clinical trials of individualised herbal medicine in any indication. Postgrad Med J 2007;83:633-637

    From: Ally Broughton Bsc (Hons) MNIMH Director of Research for, and Member of, the National Institute of Medical Herbalists (NIMH) Contact: ally.broughton@blueyonder.co.uk

    I am a trained herbal practitioner of 12 years and teach resea...

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  • Oriental Medicine Doctors Licensed As Primary Care Providers in the U.S.
    E.J. Koprowski

    Thank you, Peter Canter, for your e-letter in the Postgraduate Medical Journal.

    We find it somewhat shocking that you think herbal medicines are no better than a "placebo." This belies the facts.

    In America, in states like Florida, acupuncturists are licensed as "acupuncture physicians" and are considered by medical regulatory authorities to be primary care practitioners, who can also dispense herbs, a...

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  • Testis cancer
    Srijit Das

    I enjoyed reading the article on 'testis cancer' by Khan et al.I agree with the authors that the survival rate has increased over the past few years.The authors have rightly pointed out the role of chromosome in causing such anomalies while the primordial germ cells are undergoing cell division.While going through the risk factors,I would certainly like to highlight the exposure of dyes and paints.The dyeing agents are kn...

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