eLetters

113 e-Letters

published between 2004 and 2007

  • Dilemmas for overseas doctors
    Sumit Kapadia

    Dear Editor,

    We read with great interest the informative review article on current dilemmas in overseas doctors' training [1]. The recent restrictions on working hours have lead to an increase in the number of training posts. However, there still remains a large imbalance between the number of candidates passing the PLAB examinations and the number of training posts available to them. There have been anecdotal r...

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  • The biological age should be considered
    Jayan Mannath

    Dear Editor,

    The authors have clearly conveyed the valuable message that age is not a criteria to avoid performing any appropriate investigations. However, certain factors should be considered before planning an invasive investigation like colonoscopy.

    1) The biological age and comorbidities should be of prime importance rather than the chronological age. In this study it is not clear about the comorbid...

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  • Wishing to make contact with the Bazalgette family
    Julian Boulnois

    This is a very long shot - my great grandfather was Joseph's personal assistant, and I would welcome opportunity to make contact with the Bazalgette family as I have H Percy Boulnois' diaries.

  • Anaerobic glycolysis in acute liver failure
    Richard G Fiddian-Green

    Dear Editor,

    Might both the hyperdynamic circulation and encephalopathy in acute liver failure be the products of decompensated anaerobic glycolysis? That is to say might the most morbid metabolic defect be an inability to recycle lactate and the other by-products of anaerobic glycolysis such as glutamine? If so might outcome from acute liver failure be averted by addressing the problem?

    Anaerobic gl...

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  • Grounds for abandoning "diabetes" as a diagnosis?
    Richard G Fiddian-Green

    Dear Editor,

    Unlike peripheral tissues where insulin promotes, and indeed is necessary for cellular glucose uptake and utilisation, that is not true for the brain and presumably, therefore, peripheral nerves. The inference is that changes in the rate of glucose uptake by the brain and peripheral nerves are a function of its concentration in blood and are driven by mass action independently of insulin. In which ca...

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  • Author's reply
    Davinder P Sandhu

    Dear Editor,

    The PLAB test is, by itself, not a powerful discriminator of competitiveness. 80% of IMGs pass PLAB Part 2. PLAB is set at the level of a first year SHO and designed to assess the ability of IMGs to work safely in a first UK appointment. It is no surprise that IMGs will be more successful than home graduates in passing PLAB as the former cannot proceed without this qualification. Popular specialt...

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  • Plight of IMGs
    Abu R Vasudevan

    Dear Editor

    Sandhu's article on IMGs made interesting reading,[1] but gives the reader a lop sided view of the prevalent training environment for an IMG. The USMLE, the entry level exam for those who seek training in the United States, contentwise is much the same as the National Boards that the US medical graduates take. In contrast, the PLAB is a much tougher exam with published evidence that far fewer UK gradu...

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  • Old drugs – new uses
    Johan Haux

    Dear Editor

    The review on thalidomide in a fine way illustrates how different diseases may respond to the same drug, and why.[1] In addition to the conditions discussed in the review, thalidomide has also been evaluated in patients with cardiac congestion.[2] The rationale behind that is that TNF-a and other cytokines are involved in the pathogenesis for this condition too, however, the picture is complex and we h...

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  • Communication skills should be second nature
    Bimal K Agrawal

    Dear Editor

    Communication between people is essential in every walk of life, especially so between a doctor and his/her patient. Breaking bad news, talking to an angry patient or relative, dealing with a tearful person - a good doctor does all these himself/herself. In medicine, good communication leads to a healthy doctor-patient relationship and a positive health outcome. But often it is seen that these vital i...

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  • Response to Sudhindran
    Vineet Jain
    Dear Editor

    I would like to thank Sudhindran[1] for his interest in our study. He is right in stating that our sample size is a bit small for study of DVT. This is due to the fact that the number of patients who can afford a replacement athroplasty in our country is still small. This study was done to document the fact which we have been observing otherwise, we always felt that the incidence of DVT is not as high in our popu...

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