eLetters

59 e-Letters

published between 2001 and 2004

  • Improper surgical technique
    Vijay Ramachandran

    Dear Editor

    In the case reported by Goyal et al. regarding the presence of a gastrointestinal tumour in a hernial sac, it appears that poor surgery is being passed off as a "lesson" to be learnt by the readers. The presence of a haematoma in an otherwise empty hernial sac should definitely alert the surgeon to the presence of strangulated bowel which has probably reduced into the peritoneal cavity. Having ma...

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  • Compassion and Communication are the key
    Huw C Morgan

    Dear Editor

    Professor Nolan deserves congratulation on his excellent editorial on the need for humanity from doctors towards patients. As someone who has been involved for years in educating Family Doctors in both the UK and developing countries I fully endorse all that he says. Experience of Family Medicine development in many developing countries confirms that where there has been no culture of compassion or comm...

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  • Tissue oxygenation - oriented Approach to patients with ARDS
    Mohamad Abdelsalam Abdelkader

    Dear Editor

    Despite the great advances in critical care medicine, the mortality of ARDS is still high. Protective ventilatory strstegy - utilizing lower tidal volumes and PEEP levels to prevent atelectatic trauma regardless of arterial oxygenation - has been used in an attempt to reduce the mortality of ARDS. Both conventional and protective ventialtory strategies concenterate more on achieving satisfactory arteria...

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  • Authors reply to Huw Morgan
    Andrew P Bond

    Dear Editor

    Dr Morgan is absolutely right about 'imaginary' conditions, there are a number of examples in obstetrics in particular.

    Greta Beresford and I have recently returned from Azerbaijan, and were most encouraged by enthusiastic, knowledgeable seminar participants, many most willing to take on board the principles of evidence-based medicine

    Andrew Bond

  • Different disease concepts in Soviet Medicine
    Huw Morgan

    Dear Editor

    Bond and Beresford's helpful article makes many important points about health care in the former Soviet Union. One thing they don't mention however is that the long years of isolation from 'Western' science have resulted in the development of disease concepts that have no definitive scientific/pathological validity, some of which involve large numbers of the population and have concomitant social and e...

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  • Is this a case of ischemic hepatitis presenting as acute abdomen??
    Ravi V Desai

    Dear Editor

    I read with interest this case of ischaemic hepatitis mimicking intestinal ischemia by Powell et al.[1]

    This patient who presented with upper GI bleeding for three days, was in hypovolemic shock as initial examination revealed tachycardia, tachypnoea, hypotension and severe anaemia. This was certainly due to an upper GI bleed from the acute duodenal ulcer found on endoscopy. The shock...

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  • Clozapine associated with myocarditis and cardiomyopathy
    Detlef Degner

    Dear Editor

    In their article, Tanner and Culling describe the risk of cardiomyopathy in clozapine treatment.[1] Kilian et al.[2] reported about 15 patients with myocarditis and cardiomyopathy out of 8000 patients treated with clozapine (0.178%) in Australia. In the European Drug Safety Program (AMSP) in Germany,Austria , and Switzerland,3 cases of myocarditis among 10,263 monitored patients with clozapine therapy...

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  • Herbal drugs: Ground realities in developing world -Suggestion by Pirmohamed has limited utility
    Vikas Dhikav

    Dear Editor

    We read this lucid and comprehensive article by Professor Pirmohamed.[1] However, the article does not take into the account the realities prevalent in developing world. Moreover, it is not applicable even in developed nations, where the active ingredients of the forumulations used by patients are unknown.[2]

    According to World Health Organization over 80% of the people in less developed nations like...

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  • Hemodialysis-Leg Cramps: The role of L-Carnitine Supplementation
    Anil K Saxena

    Dear Editor

    Painful muscle cramps occuring in long-term hemodialysis (HD) patients most often involve the lower extremities typically the gastrocnemius and the small muscles of foot and interefere with free and effective voluntry activity. They represent an extremely common and annoying problem associated with HD treatment. The HD associated muscle cramps have been estimated to occur in about 20% of the HD sessions....

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  • Oral versus parenteral vitamin B12
    Elizabeth S Nyholm

    Dear Editor

    Your correspondent (Sudhir Kumar 5 June 2003) makes some constructive comments.[1] Our study group represented a normal range of patients with vitamin B12 deficiency in a UK inner city general practice. Previous studies [2,3] satisfied us that we could treat this group with mixed aetiologies for their vitamin B12 deficiency in the same way using oral vitamin B12 1000mg tablets as replacement therapy....

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