126 e-Letters

published between 2000 and 2003

  • Steering wheel spin?
    Michael D Simmons

    Dear Editor

    Nigam and Cutter totally fail to present evidence to justify the claim that “Welsh emergency vehicles examined exhibited an unacceptable level of bacterial contamination”.[1] What is more, a press release from the editorial team to local newspapers led Madeline Brindley of The Western Mail to write, “Dirty ambulances infested with huge amounts of harmful bacteria are carrying seriously ill patients to hos...

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  • Authors' response to emails
    K.M. Marya

    Dear Editor

    I read with interest the short report by Dr F O’Leary. The idea of this interesting study is very relevant in the current scenario of rapid information technology.

    Computers and specifically the internet has provided the medical fraternity a innovative tool in the context of the swiftness of distribution of published manuscripts in a plethora of available journals. This is further substanti...

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  • Re: Recurring theme
    William Sargent

    Dear Editor

    In the younger age group syptoms are as useful as any diagnostic test so it would be reasonable to treat accordingly remembering that chlamydia may masquerade as dysuria so a sexual history should be sought.

  • Is asymmetrical dislcotion really rare: Indian jeep drivers :unusual mode
    Soineet Agarwal

    Dear Editor

    We read the article by Lam et al. with interest.[1]

    The authors have described the mode of trauma with different vehicles hitting the patient in opposite directions leading to asymmetric dislocations. This means the dislocotions occurred at different times. We have seen such cases with Indian drivers who don't wear seat belts or any other protective apparatus. Due to overcrowding, they sit wi...

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  • Rare injury: unusual mode of trauma
    Dr. Soneet Aggarwal

    Dear Editor

    We read this article with interest. The authors have described the mode of trauma with different vehicles hitting the patient in opposite directions leading to asymmetric dislocations. This means the dislcotions occurred at different times. We have seen this in indian drivers who don't wear seat belts or any other protective wear. Due to overcrowding, they are sitting with one knee hanging out of the win...

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  • Simple aspiration of spontaneous pneumothorax using the anterior approach: complication rate
    Stewart S Chan

    Dear EDitor

    I read with interest the report of Rawlins and colleagues,[1] which gave account of 3 cases in which life threatening haemorrhage was associated with anterior needle aspiration of pneumothorax.

    The authors commented that data on complications of needle aspiration in spontaneous pneumothorax were limited. They cited one study on traumatic pneumothorax in which needle aspiration was associated with...

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  • Further large multi-specialty clinical trials are needed before accepting PEP monitor as a standard
    Himanshu Sharma

    Dear Editor

    We read the article by Brookes et al. with great interest. [1] The work was well conducted and the authors should be appreciated for the study. The need for continuous, non-invasive and reliable respiratory rate monitoring has long been recognised. The continuous respiratory monitoring of the spontaneously as well as compromised breathing patients in the emergency and inpatient hospital practi...

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  • There is more to assessing severity than PEFR
    Andrew P Webster

    Dear Editor

    The paper by Harvey and colleagues is a slightly overdramatic. In their audit they found that PEFR was not regularly recorded in the notes. However this does not mean that the assessment of patients is unsafe. Asthma severity as they point out is based on a number of physiological and clinical parameters. PEFR is used as a measure of severity but it has a severe limitations as it requires a good techniqu...

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  • Recurring theme
    Ray McGlone

    Dear Editor

    The use of dipsticks in A&E has been looked at extensively. The underlying problem is the lack of a "gold standard" in that microscopy is not a 100% reliable and apparent positive cultures on MSUs can be due to contamination whilst getting an MSU.

    Using Strip Testing we were able to demonstrate a predictive value for a negative result of 96.4%, but we were using 4 parameters (blood,protein,...

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  • Haemorrhage after pneumothorax aspiration
    Fiona C Rae

    Dear Edito

    I read with interest the case reports on massive intrathoracic haemorrhage after aspiration for spontaneous pneumothorax.

    It has always been my understanding that the reason for continuing to use the second intercostal space, mid-clavicular line (2ICS MCL) approach for these patients is more to do with convenience and ease of approach than for any scientific reason. Aspirating 2 litres may take c...

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