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Scottish Medical Journal

Graeme Jk Guthrie, Thomas Johnston, Anne Ewing, Russell Mullen, Stuart A Suttie, Pradeep V Patil
BACKGROUND AND AIMS: Diagnostic laparoscopy is commonly performed for diagnosis of right lower abdominal pain and its use is increasing in the emergency setting. Some studies have reported that diagnostic laparoscopy and laparoscopic appendicectomy have advantages over conventional surgery. Many emergency surgeons now perform diagnostic laparoscopy for both clinically diagnosed appendicitis and when the diagnosis is in doubt. The aim of the present study was to assess whether the use of diagnostic laparoscopy is justified and safe for those admitted with right lower abdominal pain...
January 10, 2019: Scottish Medical Journal
N A Bradley, E D Kennedy, M Asif
BACKGROUND: Increased availability of routine investigations results in significant over-investigation, burdening patients with unnecessary tests as well as increasing cost. We aimed to identify the extent of monitoring of liver function tests in lung resections, and to ascertain whether any impact on clinical decision-making occurred. METHODS: Cases were identified using theatre records coded as "lobectomy/bilobectomy" in the three-month period 20 June 2017 to 20 September 2017...
January 8, 2019: Scottish Medical Journal
Emma Samia-Aly, Jerome Ha, Suresh Sagili
BACKGROUND AND AIMS: This report aims to illustrate a case of self-inflicted ocular and orbital injury, resulting in severe tissue loss and ophthalmoplegia in a patient with no known history of mental illness. METHODS AND RESULTS: A 71-year-old male initially presented to the emergency department with significant tissue loss from his left upper and lower lids, orbital tissue loss and complete ophthalmoplegia, after reportedly tripping and falling onto his desk. He subsequently attended the emergency department on two further occasions with similar injuries, affecting the same and contralateral eye, whilst maintaining a traumatic cause for his injuries...
December 24, 2018: Scottish Medical Journal
John Larkin
No abstract text is available yet for this article.
February 2019: Scottish Medical Journal
Rabia Miray Kisla Ekinci, Sibel Balci, Mahir Serbes, Gulsah Duyuler Ayçin, Dilek Dogruel, Derya Ufuk Altintas, Mustafa Yilmaz
INTRODUCTION: Henoch Schönlein purpura is characterised by palpable purpura, abdominal pain, arthritis/arthralgia, often with a self-limiting course. Herein, we report a patient with recurrent Henoch Schönlein purpura and severe gastrointestinal involvement, successfully treated with methotrexate. CASE PRESENTATION: A 12-year-old boy was admitted to our department with palpable purpura, abdominal pain and arthralgia. Since gastrointestinal complaints were severe, systemic steroids were administered, with tapering of dosage...
November 19, 2018: Scottish Medical Journal
S J Goodwin, L J Irwin, G J Irwin
BACKGROUND: The predictable order of appearance of elbow secondary ossification centres in children is important in interpreting elbow radiographs, most commonly in the context of trauma. The usual sequence of appearance of these ossification centres is given by the acronym CRITOL, but exceptions have been described and are recognised as normal variants. AIM: To investigate the extent to which the appearance of the elbow secondary ossification centres follows a predictable sequence, and to establish the incidence of exceptions to the usual CRITOL order...
November 14, 2018: Scottish Medical Journal
J F Maempel, F Z Maempel
PURPOSE: The purpose of this study was to describe and characterise spinal fractures sustained by watercraft occupants due to splashdown of light watercraft when riding over uneven water surfaces. METHODS: A retrospective review of all patients presenting with these injuries to St Luke's and Mater Dei state hospitals in Malta over a 10-year period was undertaken to determine patient demographics, the nature of spinal injuries sustained and the incidence of any associated extra-spinal injuries...
November 14, 2018: Scottish Medical Journal
A Morrow, F Ahmad, C Steele, M McEntegart, D Murdoch
BACKGROUND AND AIMS: Anti-platelet and anti-thrombotic therapy are well-established treatments in acute coronary syndromes. Highly sensitive assays have diminished the positive predictive value of troponin in acute coronary syndromes and increased the importance of the clinical assessment in interpreting positive results. This cohort study sought to investigate over-treatment of non-coronary troponin rises and associated adverse outcomes. METHODS AND RESULTS: We reviewed 223 consecutive patients presenting to Queen Elizabeth University Hospital, Glasgow, with suspected acute coronary syndromes over a six-week period...
November 14, 2018: Scottish Medical Journal
Sevda Diker, Ömer Diker
Taxanes are a group of cytotoxic anti-cancer agents used in the treatment of solid tumours. The neurotoxic adverse effects of docetaxel and paclitaxel, including optic neuropathy, are well known. Cabazitaxel is a new generation taxane showing lesser drug resistance when compared with previous ones. Optic atrophy due to the use of cabazitaxel has not been previously reported. Herein, we report a patient with prostate cancer who developed optic atrophy after cabazitaxel treatment.
November 5, 2018: Scottish Medical Journal
Colin Goudie, Jennifer Burr, Andrew Blaikie
BACKGROUND AND AIMS: Idiopathic intracranial hypertension is a clinical syndrome of intracranial hypertension with normal cerebrospinal fluid in the absence of a mass lesion or hydrocephalus on brain imaging. Headache is the most common symptom of idiopathic intracranial hypertension, and about 10-15% of patients suffer from irreversible visual impairment. Previous estimates of the annual incidence of idiopathic intracranial hypertension vary worldwide from 0.03 to 2.2 per 100,000. The major risk factor implicated in idiopathic intracranial hypertension is body mass...
November 5, 2018: Scottish Medical Journal
John Larkin
No abstract text is available yet for this article.
November 1, 2018: Scottish Medical Journal
Bella Smolen, Johad Khoury, Yaacov Baruch, Tarek Saadi
INTRODUCTION: Numerous conditions may cause liver lesions, solitary or multiple, benign or malignant. It can be crucial to establish the correct diagnosis. Splenosis is a rare condition that may result from the spillage of cells from the splenic pulp following abdominal trauma, accidental lesions to the spleen during operation or elective splenectomy. These splenic 'implants', which are often multiple, can be located anywhere in the peritoneal cavity, although they are most often found in the left upper quadrant of the abdomen...
October 31, 2018: Scottish Medical Journal
Iain McPherson, Stephen T McSorley, Elizabeth Cannings, Christopher J Shearer, Andrew Bc Crumley
INTRODUCTION: Dropped gallstones are gallstones lost in the abdominal cavity during cholecystectomy. They are a rare occurrence and often cause minimal long-term issues. However, it is recognised that dropped stones can cause intra- or extra-abdominal sepsis. We present three cases below which highlight this. CASES: All three cases describe patients presenting for laparoscopic cholecystectomy, Cases 1 and 2 post-gallstone pancreatitis and Case 3 for gallbladder stones...
October 29, 2018: Scottish Medical Journal
Shahzaib Rehan, Harvey J Pynn, Ian Williams, Daniel S Morris
The effects of high altitude on the human vascular system are well described. This case demonstrates an interesting combination of vascular complications at high altitude which were both life- and sight-threatening. In May 2017, during an attempt on Mount Everest, a 58-year-old man was forced to descend from 8000 m because of adverse weather. He suffered significant frostbite of his right hand, later requiring termination of the distal phalanx of one of the affected digits. He also experienced increasing breathlessness and went on to develop pleuritic chest pain...
October 25, 2018: Scottish Medical Journal
Rachel Ab Thomas, Julie-Ann Empey, Subodh Seth, Joseph Crozier
Background and aims An accurate body weight is vital for safe dosing of many drugs. Weight is often unavailable for emergency admissions and an estimation is used. Emergency Department staff are poor at estimating patient weight, but no data existed for surgical admissions. This study assesses the reliability of weight estimation by patients and healthcare workers. Methods and results All emergency surgical patients admitted during one week were approached. If consented, four healthcare workers (consultant, foundation doctor, nurse, support worker) independently estimated their weight...
October 18, 2018: Scottish Medical Journal
Kerry A Vaughan, Michael J McKirdy, John G Meara
Our current global health structure has not yet evolved to do what the world needs of it. Despite significant advances in some areas of public health over the past few decades, disparities in health have worsened in many areas. The historical approach of global health governance to health issues has been overwhelmingly led by vertical, single disease efforts. Yet, this structure cannot effectively implement broad-reaching international development goals set forth by the United Nations. The solution requires a rapid evolution of the present health system conceptualisation...
October 18, 2018: Scottish Medical Journal
Kate E Bugler, Mark S Gaston, James E Robb
Background and aims Cerebral palsy is the commonest long-term physical disability in children with a prevalence of between 1.77 and 2.11/1000 live births. In 2013, the Cerebral Palsy Integrated Pathway Scotland (CPIPS) surveillance programme was introduced in all 14 Health Boards in Scotland and provides a standardised musculoskeletal examination of the spine and lower limbs. The purpose of this study was to report the prevalence, subtypes, motor classification and motor ability of children with cerebral palsy in Scotland...
October 18, 2018: Scottish Medical Journal
Burak Olmaz, Mehmet Cingoz, Emin Akdogan, Sedat G Kandemirli
Introduction Pott's puffy tumour is characterised by frontal bone osteomyelitis accompanied by subperiosteal abscess. It can be further complicated by intracranial extension of the infectious process. Case presentation A 12-year-old boy initially presented with signs and imaging findings of pan-sinusitis. Despite antibiotic therapy, there was progressive swelling of the forehead region. Subsequent imaging studies revealed osteomyelitis of frontal bone, subcutaneous abscess and extension into intracranial space...
October 6, 2018: Scottish Medical Journal
MohammadMahdi Saeidinejad, Sally Kardash, Laura Connell
Current European League Against Rheumatism guidelines strongly recommend considering the use of polysaccharide pneumococcal vaccine in all patients with autoimmune inflammatory rheumatic diseases. However, a previously published case series reports of reactions to 23-valent pneumococcal polysaccharide vaccine in patients with Behcet's disease. The purpose of this report is to present a similar case of a systemic adverse reaction in a patient with Behcet's disease to 23-valent pneumococcal polysaccharide vaccine...
September 25, 2018: Scottish Medical Journal
Ibrahim Ibrahim, Bilal Ibrahim, Guo Liang Yong, Maria Coats, Zorica Vujovic, Michael Sj Wilson
Background Determining the possibility of pregnancy and the documentation of pregnancy status are important considerations in the assessment of females of reproductive age when admitted to hospital. Objectives Our aim was to determine the adequacy of the documentation of pregnancy status and possibility of pregnancy across multiple surgical specialties. Materials and methods A prospective audit of surgical specialties (general, orthopaedics, urology, vascular, maxillofacial, ENT, gynaecology and neurosurgery) within NHS Tayside, in May 2015...
September 25, 2018: Scottish Medical Journal
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