eLetters

294 e-Letters

  • ? duodenal biopsy
    Hema Byrapuneni

    Dear Editor

    I read with great interest the article by Mandal and colleagues,[1] which provides an excellent introduction to duodenal biopsy in iron deficiency anemia.

    I agree that duodenal biopsy is the gold standard for diagnosing celiac disease. However, is an invasive test like duodenal biopsy necessary? There are noninvasive tests such as IgA transgluta...

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  • Chronic Obstructive Pulmonary Disease
    Oscar M Jolobe

    Dear Editor

    With reference to the article by Hurst and Wedzich, [1] the "after discharge" evaluation of a patient with chronic obstructive pulmonary disease (COPD) would be incomplete without due consideration of the possibility of treatable coexisting pathologies for which, as in COPD, cigarette smoking is a risk factor. Coronary heart disease (CHD) is a prime example, justifying evaluation of left ventricular fun...

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  • The 'good' and 'bad' bacteria
    Davidovic Mladen
    Dear Editor

    With reference to the article by Hamilton-Miller, aging mechanisms have not yet been fully understood.[1] A great number of theories have been proposed by scientists, but none of them is completely satisfactory. The problem could be found in the fact that very often we look for one deciding, definitive reason for the process of ageing. It is a sort of search for a big discovery, like a fountain of youth or s...

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  • Body packing
    Ajit Singh Kashyap

    Dear Editor

    The authors state that laxatives are to be used in management of body packers.[1] We urge caution with the use of oil based laxatives.

    Oil based laxatives may reduce the tensile strength and "burst" volume of latex products. This may prove fatal. A massive gastrointestinal release of cocaine has been reported after the administration of oil-based laxatives.[2]

    Reference

    1....

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  • Re: Alas, Alas, Animal Models!
    Alfred N Jackson

    Editor

    There is a very sad account of the fatal consequences of extrapolation of animal findings to humans, "recent experience with fialuridin ... five out of 15 patients died, two required emergency liver and kidney transplant for liver and kidney failure-this effect had not been demonstrated in four animal species."[1] This is a very sobering account of the consequences of extrapolating animal findings to humans....

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  • Alas, Alas, Animal Models!
    A G Unnikrishnan

    Dear Editor

    Jackson raises a point that is indeed relevant, and I fully agree that premature extrapolations to human therapeutics are dangerous.[1] If animals were all horses, wishes would fly! These animal studies only provide a glimpse into new possibilities and futuristic ideas. I am concerned about any other interpretation, and my opinion too is that, for the present, these findings cannot be translated into da...

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  • Why psoas abscess is ambiguous
    dr rajendra ravindra pol
    Dear Editor

    Mallick et al have rightly pointed that it requires a high degree of clinical suspicion to diagnose these kind of abscesses.[1] The presentation with lower back pain, hip pain, lower abdominal pain and a limp is well known. A diligent physical examination is essential for the prompt diagnosis of this condition.

    One of the clinical presentation is femoral neuropathy. Femoral neuropathy is u...

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  • Parkinson' disease - multidisciplinary team
    Sunku H Guptha

    Dear Editor

    I read with interest the review article by Thanvi and Lo on the long term motor complications of levodopa.[1] The authors describe the role of pulsatile stimulation of the post-synaptic dopamine receptors as a possible mechanism for these complications and describe the various strategies currently in use to prevent them. They however fail to acknowledge the role of a multidisciplinary team in the ma...

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  • More about the urine in alkaptonuria
    Tamilarasu Kadhiravan

    Dear Editor

    I would like to mention a few interesting points about the urine in alkaptonuria.[1] When testing for the presence urine sugar by Benedict's method, an alkaptonuric specimen gives a strongly positive (falsely, of course) reaction, producing an orange precipitate. However, the clue lies in the supernatant which turns black. Glucose oxidase-based test does not give a positive reaction in this setting....

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  • Alas animal models
    Alfred N Jackson
    Dear Editor

    Is it feasible to extrapolate animal findings to human medicine? We did not evolve (see http://www.kean.edu/~breid/chrom2.htm ). These chromosome numbers certainly do not support any evolutionary suppositions. Furthermore the mechanisms of meiosis serve to "fix" the chromosome numbers of sexually reproducing species. Is it not, therefore, dange...

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