Short Communication

Atypical presentation of congenital pneumonia: Value of lung ultrasound

A term neonate was transferred from a Local Neonatal Unit to our surgical Neonatal Intensive Care Unit on Day 2 due to abdominal distension with radiological appearances suggestive of intestinal obstruction. He was born by Caesarean section with no risk factors for sepsis.

Research Article

Muscle growth and control of production of sarcomere components

Abstract

This presentation gives a description of the muscle and sarcomere followed by the main content summarized.

 

Review Article

Alcoholism and its implications for the dental team, an update and review of the literature

Abstract

Precis: This Literature review is intended to provide dental practitioners with an update of the implications that Alcoholism poses to them.
Statement of the problem: Alcoholism raises several distinct problems for dental professionals.

Case Report

Ipratropium induced bronchoconstriction in a young Asthmatic: A case report

Acute severe Asthma is a common paediatric emergency managed according to the BTS and SIGN guidelines. They recommend that if initial β2 agonist treatment bears no response, frequent Ipratropium Bromide doses can be given every 20-30 minutes [1]. We present a case of paradoxical br...

Research Article

A retrospective cohort study to evaluate the relationship of airway hyperresponsiveness to type 2 biomarkers in persistent asthma

Abstract

Airway hyperresponsiveness (AHR) is a hallmark of persistent asthma measured using direct or indirect airway bronchial challenge testing. The purpose of this study is to investigate the putative relationships between type 2 inflammatory biomarkers, airway ge...

Review Article

Systematic review and meta-analysis of drug induced liver injury secondary to biologic medications in inflammatory bowel disease

Abstract

Introduction: Drug-induced Hepatotoxicity and biologic drugs have historically been challenging in IBD. We aim to study the prevalence of hepatotoxicity in adult patients using biologic medications.

Methodology: With the guidelines desc...

Research Article

Suicidal behaviors as a risk factor among heroin addicts with comorbid depression: A comparative study

Abstract

The main purpose of the present study was to find out the differences on suicidal ideation, hostility, hopelessness and negative self-evaluation among heroin addicts with comorbid depression. After reviewing the literature, it was hypothesized that heroin ad...

Review Article

New insights from cardiac muscle applied to skeletal muscle

I have recently described the origin of the second Ca2+ binding in the triggering of contractile activity in cardiac myofibrils that is the origin of the Ca2+ Hill coefficient of 2 for the ATPase. This site is not a simple protein binding site and cannot be measured by 45Ca2+ binding. The m...

Mini Review

Three visionaries for HRT

When a woman consults a doctor about Hormone Replacement Therapy (HRT), the first concern is that there is an increased risk of breast cancer with HRT. And this sole reason might be the reason for refusing the offer of HRT. However, this practice has minimal basis and evidence to support it...

Short Communication

Reactive Oxygen spray as prophylaxis for COVID-19 infection

Viral transmission of SARS-CoV-2, the virus causing COVID-19 is very high within households despite self isolation [1,2]. Transmission of the virus is thought to be similar to that of influenza.

Mini Review

Hormones and depression in women

It is well known that depression is more common in women than in men with more prescriptions for antidepressants, hospital admissions for depression and suicide attempts. However another aspect to be considered is that depression is different in women than men because women have depressive ...

Rapid Communication

Audit of the effect of non-nasal specific scoring on the Postoperative SNOT22 questionnaire

Abstract

The Sino-nasal outcome test (SNOT22) has been widely adopted in clinical practice and has been declared as the most suitable sinonasal outcome scoring system. It is simple disease specific encompassing 22 symptoms reflecting health burden of the rhino- logic...

Research Article

Clinical characteristics in STEMI-like aortic dissection versus STEMI-like pulmonary embolism

Abstract

Dissecting aortic aneurysm with ST segment elevation, and pulmonary embolism with ST segment elevation are two of a number of clinical entities which can simulate ST segment elevation myocardial infarction.

Objective: <...

Review Article

Protecting teeth and gums during rigid endoscopy of the upper aerodigestive tract: Our experience with a disposable, mouldable and rigid thermoplastic mouthguard

Direct rigid pharyngoscopy, laryngoscopy and oesophagoscopy are very common procedures in the Otolaryngology-Head & Neck department, both for diagnostic and therapeutic purposes.

Case Report

A case series review of patients with Thrombocytopenia and Absent-Radii syndrome (TARS) and their management during pregnancy

Abstract

Bleeding diatheses due to platelet-related disorders can present challenges to treating clinicians especially in the context of peri- and post-partum patients in the obstetric setting. TARS is an inherited disorder characterised by reduced bone marrow platel...

Research Article

Management of acute tongue swelling

Abstract

Background: Tongue swelling often presents as an acute upper airway obstruction.
Aim: To present a case series of patients presenting with an acute tongue swelling sharing our experience in managing these patients.&l...

Review Article

The mechanisms of cardiac myopathies, a kinetics approach: Leading review

The normal adult heart is a well maintained machine that has a mechanism for growth replacement of the sarcomere that is lost by natural degeneration. This process ensures the heart has the strength of contraction to function correctly giving blood supply to the whole body.

Opinion

Why are more otorhinolaryngology surgeons dying from Covid-19 than any other surgical specialty?

Covid-19 infection is caused by the coronavirus SARS-CoV-2. This has resulted in the present pandemic from which thousands of people have died including many front-line health care workers. Of the surgeons who have died from covid-19 it would appear that otorhinolaryngology surgeons have ma...

Review Article

Complicated grief in the DSM-5: Problems and solutions

The Diagnostic Statistical Manual of Mental Disorders volume 5 (DSM-5) is the influential textbook published in 2013, by the American Psychiatric Association, as a guide to psychiatric diagnosis. It helps to ensure that doctors are consistent in their use of diagnostic terms.

Research Article

Influence of adverse socio-emotional risk factors on the physical and mental health needs of children and young people in public care of a South-West England local authority

Abstract

Introduction: There is increasing published evidence confirming the long-term adult mental and physical health impact of childhood exposure to adverse events including different forms of abuse and family dysfunction. Looked-after...

Research Article

Tooth erosion and the role of pepsin reflux

Abstract

Objective: The purpose of the study was to evaluate if there is a link between salivary pepsin levels and tooth erosion. Also, to determine if gastroesophageal reflux disease (GERD) is responsible for much of the tooth erosion se...

Case Report

Diagnostic imaging in congenital adrenal hyperplasia – how does it help?

Summary

The phenotypic manifestation of congenital adrenal hyperplasia (CAH) is variable, and this largely depends on the extent of 21-Hydroxylase enzyme deficiency. In non- classic CAH (NCCAH), the clinical features predominantly reflect the androgen excess rather t...

Research Article

Staff experiences of the REFOCUS intervention to support recovery in mental health: A qualitative study nested within a cluster randomized controlled trial

Abstract

Background: The REFOCUS intervention was a whole team, complex intervention, designed to increase the recovery support offered by community based, mental health staff. The intervention consisted of two components: Recovery promot...

Short Review

The Psychology of the Common Cold and Influenza: Implications for COVID-19

Abstract

Research on psychological risk factors for upper respiratory tract illnesses (URTIs) has been conducted for over fifty years. Early studies failed to control for exposure and also often relied on self-report rather than clinical and virological assessment. A...

Research Article

Atypical manifestations of pulmonary embolism

Abstract

Pulmonary embolism (PE) is an age-related disorder which is potentially fatal, but frequently misdiagnosed. However, the true prevalence of pulmonary embolism is unknown. Inaccurate estimates of PE prevalence might, in part, be attributable to underrecogniti...

Review Article

Fetal Alcohol Spectrum Disorders – What does it mean?

Prenatal alcohol exposure is one of the most important causes of preventable cognitive impairment in the world. The developing neurological system is exquisitely sensitive to harm from alcohol and there is now also substantial evidence that alcoh...

Review Article

Artificial Intelligence in the healthcare of older people

Abstract

Clinical applications of Artificial Intelligence (AI) in healthcare are relatively rare. The high expectations in relation to data analysis influencing general healthcare have not materialized, with few exceptions, and then predominantly in the field of rare...

Mini Review

Angiotensin II type 1 receptor and the activation of Myosin Light-Chain Kinase and Protein Kinase C-βII: Mini Review

Summary

The involvement of the angiotensin II type 1 receptor in the Frank-Starling Law of the Heart, where the various activations are very limited, allows simple analysis of the kinase systems involved and thence extrapolation of the mechanism to that of angiotensi...

Research Article

The importance of gestational age in first trimester, maternal urine MALDI-Tof MS screening tests for Down Syndrome

Abstract

Background: The proposal that MALDI-ToF mass spectrometry could be used as a direct, rapid and affordable diagnostic tool in clinical laboratory medicine has moved from a theoretical possibility to a reality for Microbiology. Sev...

Letter to the Editor

Hot cholecystectomy

Letter to Editor

Acute cholecystitis is a common general surgery disease which may require hospital admission. Delayed or early cholecystectomy is the definitive treatment. Availability of theatre slots may postpone cholecystectomy for weeks. I am writing this letter...

Case Report

Foley catheter balloon tamponade as a method of controlling iatrogenic pulmonary artery bleeding in redo thoracic surgery

Abstract

Background: Pulmonary artery bleeding secondary to iatrogenic injury is a troublesome intraoperative complication. The likelihood of encountering this complication is significantly higher in redo surgery for a number of reasons, ...

Case Report

Stercoral perforation: A rare case and review

Abstract

We present a 54-year-old male with abdominal pain, Vomiting and weight loss since 5 months. Perforation was noted at recto-sigmoid junction and underwent Hartman’s procedure with end colostomy. Histology of sigmoid colon confirmed a Stercoral perfo...

Short Communication

Triathlon challenge – from craggy to crazzy a different kind of pain management program

Abstract

Sea swim (2.4 mile), bike ride (112 mile) and Marathon (26 mile), all in one day!
There are lessons that the 7.8 million UK Chronic Pain patients can learn from the world of endurance sports, and vice versa [1]. The training, psychological tools...

Opinion

The science of enduring pain. What can athletes and chronic pain patients learn from each other?

Opinion

“It isn’t the mountains ahead to climb that wear you out; it’s the pebble in your shoe.” Muhammad Ali

What mind strategies can an endurance athlete use to get their body that bit further or faster,...

Research Article

Single-centre real world experience of the Mynx Femoral closure device in patients undergoing percutaneous coronary intervention

Abstract

Background: Vascular closure devices are routinely used following femoral artery access to perform percutaneous coronary interventions (PCI). A number of devices are available on the market. We have reported previously on our exp...

Review Article

Urine Leak Following Kidney Transplantation: An Evidence-based Management Plan

Abstract

Care of kidney transplant recipient remains complex and long-term graft survival is not seen in every transplant recipient. Due to reduced supply and increased demand of human organs, more transplants are carried out using marginal grafts on emergency lists....

Case Report

Septic arthritis of left shoulder in pregnancy following minor hand injury

Septic arthritis of the shoulder joint is rare and might affect around 3% of the general population [1]. A delay in diagnosis may increase morbidity and lead to bone and cartilage destruction [2]. Septic arthritis is an unusual complication of pregnancy and can progress to permanent arthrop...

Case Report

A Case-Study of the Anatomy of a Miscommunication: Why colleagues as patients develop complications?

Abstract

This is an anatomy of a miscommunication, written by the patient, a medical school professor and his orthopaedic consultant, who was also a colleague leading to a series of misunderstandings. This raises the practical question of who is responsible for effec...

Case Report

A Pancreatic Neuroendocrine Tumor with an Unusual Flush

Summary

A 60-year-old man presented with an unusual history of lower limb flushing. A CT scan suggested a pancreatic neuroendocrine tumor. After a robotic distal pancreatectomy, his symptoms completely resolved. The tumor was positive for synaptophysin and chromogran...

Research Article

In at the deep end: Psychosocial aspects of developing autonomy in histopathology training

Introduction

Medical postgraduate trainees are given increasing levels of responsibility during training in the apprenticeship-model of training [1-3]. Responsibility is said to be a key driver of deep learning and understanding [4-7]. Trainees with greater levels of...

Research Article

Agricultural Residues for Future Energy Option in Sudan: An Analysis

Abstract

Like many tropical countries, Sudan has ample biomass resources that can be efficiently exploited in a manner that is both profitable and sustainable. Fuel-wood farming offers cost-effective and environmentally friendly energy solutions for Sudan, with the a...

Letter to the Editor

The Exercise continuum and the role of Doctors

Introduction

Everyone can be placed somewhere on an exercise continuum with the idle at one end and the hyperactive at the other. At both extremes, health suffers. Exercise is essential to health and managing it is the responsibility of individuals but few know what ...

Research Article

Ocular surface Rose Bengal staining in normal dogs and dogs with Keratoconjunctivitis Sicca: Preliminary fi ndings

Abstract

Dry eye or keratoconjunctivitis sicca, is commonly seen in the dog. Veterinary ophthalmologists diagnose this aqueous tear deficiency using the Schirmer tear test (STT), but this measures tear production and does not indicate ocular surface pathology. The vi...

Research Article

Quantification of the pressures generated during insertion of an epidural needle in labouring women of varying body mass indices

Abstract

Objective: The primary aim of this study was to measure pressure generated on a Tuohy needle during the epidural procedure in labouring women of varying body mass indices (BMI) with a view of utilising the data for the future dev...

Review Article

Lack of applicability of the Enterocyte Chloride ion secretion paradigm to the Pathology of Cystic Fibrosis

Summary

This review examines of the concept of a defective chloride channel in epithelial cells being a major cause of cystic fibrotic pathophysiology. The central concept of the defective chloride ion channel paradigm is that faulty CFTR protein or failed delivery o...

Review Article

Determining the use and value of social support in Telerehabiliation Interventions for individuals with Multiple Sclerosis: A narrative synthesis review

Abstract

Background: Telerehabilitation has been identified as an effective treatment that promotes exercise rehabilitation in individuals with multiple sclerosis (MS). Social support is recognised as a core element of such interventions....

Research Article

Intravitreal Ranibizumab/ Lucentis (IVTL) injections in Glaucoma patients-Intraocular Pressure (IOP) elevation and the use of Anterior Chamber Paracentesis (ACP)

Abstract

Purpose

• To assess the short term effects of intravitreal Lucentis (IVTL) on intraocular pressure in patients with ocular hypertension and glaucoma.

Research Article

Organic compositional analysis of propellant powders using monolithic material sorption extraction (MSSE)-a feasibility study

Abstract

The application of monolithic material sorption extraction, specifically MonoTrapTM, to the extraction of organic gunshot residue (OGSR) compounds from unburnt propellant powders is described. Four different MonoTraps were assessed for their capability to ex...

Research Article

Prevalence of reported drug allergy and its impact on Beta lactam use with fi nancial and health implications

Abstract

Background: While recognition and documentation of true drug allergy is critically important, most physicians acknowledge that its prevalence is likely overestimated, often on the basis of historical, sometimes anecdotal evidence...

Case Report

Direct Carotid Puncture for Flow Diverter Stent Insertion

ABSTRACT

Objective: To report our experience of direct carotid puncture and its use in the management of a large and rapidly expanding cavernous aneurysm.

Methods: A patient with a cavern...