Crohn disease in Nepal: true rarity or gross underdiagnosis?

The authors describe an unusual case of Crohn’s disease in Nepal. Unusual on two accounts – Crohn’s disease appears to be virtually unknown in Nepal and this case presented with bowel perforation. Exploring both these factors, this case report makes for very interesting reading and reminds us that we only see what we look for. […]

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Dental anxiety and eating disorder

An upsetting case of a young girl from Cornwall who died of dehydration and starvation due to an eating disorder has been reported in the news. http://news.bbc.co.uk/1/hi/england/cornwall/7893485.stm She developed symptoms after her ‘milk teeth’ became loose. They were removed under general anaesthesia but she then refused to eat. The coroner has returned a ‘narrative verdict’ […]

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Doctors revive patient using powerful magnet

Transcranial magnetic stimulation is a non-invasive method for stimulating the brain and, in particular, the cerebral cortex. It uses a powerful electromagnet to generate a strong magnetic field that induces electrical current in the brain in much the same as direct stimulation with electricity. First described in 1985,1 it is being investigated for many conditions […]

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Report of successful forequarter amputation

Medecins Sans Frontieres (MSF) surgeon David Nott provided a very public case report of successful forequarter amputation this week. http://www.msf.org.uk/surgery_by_text_message_20081203.news What made this extraordinary was that he and the patient were in Congo, he had never performed the procedure before and he received instructions on how to do it from a surgical colleague in the […]

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Haemorrhagic transformation of a recent silent cerebral infarct during thrombolytic stroke treatment

This case report highlights the challenge of radiology interpretation in acute cases especially where effective treatment is time critical. Often an investigation will have an obvious abnormality that accounts for the presenting symptoms but elsewhere, in an unrelated part of the scan, another abnormality may be present. Even in experienced teams such other findings may […]

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Iatrogenic vitamin K deficiency and life threatening coagulopathy

This is a reminder of an important clinical lesson that highlights the risk of vitamin K deficiency in the critically ill. The authors give a thorough account of the presentation, possible consequences and literature review in this case making it a rewarding and educational report. I note with interest the reviewer’s comments about not wanting […]

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