eLetters

25 e-Letters

published between 2012 and 2015

  • Unpreparedness
    David Levine

    Newly qualified doctors can expect to be as prepared as their undergraduate training allows. For the initial management of acutely ill patients, perhaps involving practical procedures, we have to ensure that training and assessment of both students and doctors occur, as far as possible, under similar conditions to those in which doctors will work. 4 days of shadowing help but are not enough. The reality for many newly...

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  • "Xanthelasma palpebrarum -a cutaneous sign of increased cardiovascular risk"-still a misunderstanding
    Gopal Chandra Ghosh

    Xanthelasma palpebrarum ia a sharply demarcated yellowish flat plaque om the upper and lower eyelid, mostly near the inner canthus.In a prospective study done in Copenhagen University revealed that xanthelasme palpebrarum predict risk of myocardial infarction, ischaemic heart disease, severe atherosclerosis, and death in the general population[1].In present study which is a cross-sectional study revealed that xanthelasma...

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  • Natriuretic peptide levels must be interpreted in the light of clinical probability of heart failure
    oscar,m jolobe

    Given the recognition that "choosing appropriate thresholds[for serum natriuretic peptide] is problematic"(1), the best diagnostic strategy for obtaining maximum diagnostic "mileage" from natriuretic peptide levels might be that of interpreting any given result in the light of whether the patient has high, medium, or low clinical probability of heart failure. For that to come about, instead of reinforcing the idea that "In...

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  • Perception
    Russell D Brown

    I can well remember my feelings of unpreparedness in both the areas that current graduates identify as feeling most unready for.

    However, I suspect that having this perception is not a bad thing. I hope that they are able to maintain such a degree of insight and use it to the advantage of their patients and themselves in the long term.

    Should I be asked, I would encourage them to think on it in terms of...

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  • Hazards inherent in the use of either nonsteroidals or paracetamol
    oscar,m jolobe

    Notwithstanding the absence of robust evidence to justify the use of antipyretic analgesics either for reducing patient discomfort or for reducing morbidity and mortality in febrile illnesses(1), it is only in recent times(2)(3) that the issue of drug-related mortality has been adressed in patients receiving either nonsteroidal anti-inflammatory drugs(NSAIDs) or paracetamol for febrile illnesses. Due to insensible losse...

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