Journal of the Royal College of Physicians of Edinburgh

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Pancreatic exocrine insufficiency (PEI) is an under-diagnosed condition. Untreated PEI can result in developing gastrointestinal symptoms and long-term complications including weight loss, nutrient deficiencies, sarcopenia and osteoporosis. Current best practice recommends testing for PEI in certain disorders including chronic pancreatitis, cystic fibrosis, pancreatic cancer and post-pancreatic surgery. However, there is increasing evidence that PEI is associated with a number of conditions in addition to the aforementioned diseases...

BACKGROUND: Physician-led thoracic ultrasound (TUS)-guided biopsies provide a prompt route to tissue diagnosis in pleural and peripheral lung malignancies. This retrospective study reviews the diagnostic performance and safety of this approach in a UK District General Hospital. METHODS: Time to biopsy, diagnostic yield and complication rate were analysed in a cohort of 49 patients undergoing ultrasound-guided tissue sampling between September 2019 and December 2022...

No abstract text is available yet for this article.

While now known globally as Scotland's national poet, in November 1781 the daybook of surgeon Charles Fleeming simply records him as 'Robert Burns, Lint Dresser'. Discovered in the 1950s, the daybook documents Fleeming's treatment of Burns during a period of illness which would have a profound impact on the poet's life and creative output. The book's discovery added to the theories about the nature of Burns's illness, often at odds with Burns's own later descriptions. This paper presents a fresh examination of Burns's treatment, challenging those theories by considering Fleeming's prescriptions in the context of key medical authorities of the time...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Whipple's disease is a multisystemic chronic infectious condition caused by Tropheryma whipplei ( T. whipplei ). Though characterised often by insidious weight loss, diarrhoea, and arthralgia, three other distinct manifestations can be observed, namely localised disease, acute infection and asymptomatic carriage. The diagnosis relies on histopathological examination of duodenal biopsies and polymerase chain reaction analysis of the 16S rRNA gene for T. whipplei. We report the case of a middle-aged man admitted for etiologic investigation of prolonged, migrating, and inflammatory arthralgias and subsequent development of gastrointestinal symptoms...

No abstract text is available yet for this article.

A dermatology consult was sought for a 34-year-old female who presented with repeated vomiting and loss of weight, quantified to be around 13 kgs over the preceding 4 months. Examination revealed strictly unilateral callosities and few superficial erosions over the right distal hand, third and fourth metacarpophalangeal joints, and interphalangeal joints of the second digit, consistent with Russell's sign in bulimia nervosa. History of binge eating followed by purging by forced vomiting was found on dietary history...

No abstract text is available yet for this article.

Drug-induced aseptic meningitis (DIAM) or chemical meningitis following spinal anaesthesia has rarely been reported. DIAM is caused by meningeal inflammation due to intrathecally administered drugs or secondary to systemic immunological hypersensitivity. We hereby present a case of a young adult with aseptic meningitis following neuraxial anaesthesia possibly provoked by bupivacaine. The initial cerebrospinal fluid (CSF) picture revealed neutrophilic pleocytosis and normal glycorrhachia. CSF culture was negative...

No abstract text is available yet for this article.

Haemophagocytic lymphohistiocytosis (HLH) is a rare, aggressive, excess immune activation syndrome. Diagnosis can be challenging due to its several clinical mimics including sepsis. There are multiple aetiologies of HLH; in adults, it is most commonly triggered by infection, malignancy, drugs and autoimmune processes. Failure to rapidly diagnose and treat this condition can be fatal. The management of HLH includes identifying and removing the trigger, supportive management and immunosuppression. Identifying the trigger is essential to inform the most appropriate type of immunosuppression...

'Collegiality' comes from the Latin term 'Collegium', which essentially refers to a community of individuals bounded by their collective pursuit of a common goal. The concept has historical roots in both organised religion and academia, with its use subsequently extended to various industrial and corporate settings including healthcare. Nowadays, 'collegiality' has become a common buzzword adopted by the medical fraternity - often deemed as having a polite and respectful demeanour, maintaining cordial work relationships and being a team player who demonstrates willingness to help others and avoid speaking ill of fellow colleagues...

No abstract text is available yet for this article.

INTRODUCTION: Dengue is a major international health concern prevalent in tropical and sub-tropical countries. There are a paucity of studies on the relationship of hepatic complications with inflammatory parameters in dengue infection. PATIENTS AND METHODS: Single-centre observational study was conducted at the tertiary care centre in North India. Patients (>12 years) diagnosed with dengue infection between August and November 2021 were enrolled in the study...

Hypothyroidism is an endocrine disorder which occurs due to a deficiency of thyroid hormones. Hoffmann's syndrome is a rare complication of hypothyroidism - presenting as hypothyroid myopathy. We describe the case of a 20-year-old lactating female patient, with known case of hypothyroidism (diagnosed during her pregnancy and having discontinued treatment following delivery), presenting with complaints of pain, swelling of bilateral calf muscles with cramps in bilateral lower limbs for 1 day. Symptoms of muscle pseudohypertrophy with muscle stiffness are relatively rare in subclinical hypothyroidism and hence, it is important to identify and diagnose this rare condition, and to initiate appropriate treatment...