eLetters

263 e-Letters

  • Cardiac involvement in HIV infected people in Cameroon
    Divine Nzuobontane

    Dear Editor

    We welcome Barbaro’s very pertinent comments; especially concerning HAART therapy and HIV associated heart disease. Like many developing countries, HAART therapy has only recently been introduced in Cameroon, and access to the treatment is still very limited. Until now, it has therefore been difficult to collect any data on the metabolic and cardiovascular complications of HAART therapy in Cameroon. How...

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  • Dorsalis pedis arterial pulse: palpation using a bony landmark
    Jonathan C Hobson

    Dear Editor

    We read with interest the article by Mowlavi et al.[1] and agree that the palpation of pedal pulses is a useful clinical tool. Therefore any attempt to standardise the technique of palpation must be applauded.

    Using the ‘navicular’ method, the authors palpated 78% of pulses in a group of patients under the care of the surgical team. Unfortunately they do not describe the past medical h...

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  • Enchephalitis due to dengue infections
    G.N. Malavige

    Dear Editor

    Dengue haemorrhagic fever (DHF) is one of the leading causes of morbidity and mortality in the tropical and subtropical countries. Although, the dengue virus when compared to other arboviruses do not cause significant central nervous system involvement it can be an important cause of encephalitis and Encephalopathy when taking in to account the large epidemics that occur due to the virus.

    DHF i...

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  • Unusual ECG in pulmonary embolism
    Bimal K. Agrawal

    Dear Editor

    Diagnosis of Pulmonary embolism is very challenging and any clue from anywhere is worth mentioning. In this regard Dr Athar's above case report is very interesting. But there are certain points in discussion which needs reappraisal.

    In the report authors have mentioned that QT was prolonged when the patient had developed pulmonary embolism which was expected considering the fact that heart rate...

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  • Cardiac involvement in HIV-infected people in Cameroon
    Giuseppe Barbaro

    Dear Editor

    The article by Nzuobontane et al.[1] reports the involvement of the cardiovascular system in an african country, reflecting the condition we observed some years ago before the introduction of HAART.[2] The introduction of HAART has significantly modified the course of HIV disease, with longer survival and improved quality of life. Although there is no evidence from prospective studies to suggest th...

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  • What counts is inspiring confidence
    Santhosh Rajagopal

    Dear Editor

    The contents of the letter evoked a similiar chord in me. Last year, I had the mortification of seeing my father in a comatose state after a sudden onset of Meningitis. He himself was and is a practising Paeditrician and the other son of his, my elder brother is also a doctor. That night I was alone with him and saw him deteriorate overnight from an ordinary "flu" to full blown Meningitis. We had an anxi...

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  • Diagnosis
    Dr.Vaijayanti.Shashi Bapat
    Dear Editor

    This is a case of Tuberculous Mediastinal lymphadenopathy with a left sided tuberculous pleural effusion.

  • Gestational diabetes mellitus: screening in subsequent pregnancies
    Minakshi Rohilla

    Dear Editor

    I read with interest the report of an unusual case of gestational diabetes mellitus (GDM) in early pregnancy in two successive pregnancies by Shankar et al.[1] Authors have rightly emphasized the importance of the early screening of GDM at first antenatal visit in women with history of GDM in previous pregnancies or with a strong family history of diabetes mellitus. In fact, an early detection...

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  • Should inexperienced trainees be delivering acute medical services?
    Ieuan H Davies

    Dear Editor

    Earlier this year your journal published an article by Smith and Poplett [1] which discussed the findings of a questionnaire that had been answered by newly qualified pre-registration house officers and senior house officers. The questions concerned various aspects of basic acute medical care. The results suggested significant gaps in knowledge and understanding of both the signs and immediate managem...

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  • Causes of osteolysis
    Shirish G Dubey

    Dear Editor

    I complement the authors on an excellent case. Could I however, point out that in the table on causes of osteolysis, there is no mention of crystal arthropathy. Calcium pyrophospahte dihydrate(CPPD) and basic calcium phosphate (BCP) associated crystal arthritis are known to cause osteolysis in a small no of patients. These would form part of the differentail diagnosis for any patient with this presentat...

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