Detecting and handling suspected plagiarism in submitted manuscripts
J R Coll Physicians Edinb. 2021 Jun;51(2):115-117. doi: 10.4997/JRCPE.2021.201.NO ABSTRACTPMID:34131662 | DOI:10.4997/JRCPE.2021.201 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Durga Prasanna Misra Vinod Ravindran Source Type: research

Challenges to the UK medical education during the COVID-19 pandemic
J R Coll Physicians Edinb. 2021 Jun;51(2):118-119. doi: 10.4997/JRCPE.2021.202.NO ABSTRACTPMID:34131663 | DOI:10.4997/JRCPE.2021.202 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Mairi Scott Iqbal Malik Source Type: research

Exercise: the panacea in management of many ills. Now is the time to engage
J R Coll Physicians Edinb. 2021 Jun;51(2):120-122. doi: 10.4997/JRCPE.2021.203.NO ABSTRACTPMID:34131664 | DOI:10.4997/JRCPE.2021.203 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Mark Jacunski Peter Melville Graeme P Currie Source Type: research

Plurality of governance - the transparency of definitions
J R Coll Physicians Edinb. 2021 Jun;51(2):123-124. doi: 10.4997/JRCPE.2021.204.NO ABSTRACTPMID:34131665 | DOI:10.4997/JRCPE.2021.204 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Michael Deighan Fiona Aitken Source Type: research

Ambulatory pneumothorax management in a district general hospital
CONCLUSION: This single-centre study shows that ambulatory pneumothorax management with the PV is feasible and associated with inpatient bed savings. Complication rates are less than previously described.PMID:34131666 | DOI:10.4997/JRCPE.2021.205 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Avinas Aujayeb Source Type: research

Antimicrobial sensitivity patterns of enteric fever in Pakistan: a comparison of years 2009 and 2019
This study aimed to identify the evolving antimicrobial sensitivity patterns of Salmonella species causing enteric fever and its implications on the clinical prescribing of antimicrobials.METHODS: This was a retrospective descriptive study conducted at a university hospital. Antimicrobial resistance was defined in terms of non-resistant, multidrug resistant (MDR) and extended drug resistant (XDR) as per WHO guidance. Data were collected from the years 2009 and 2019. Chi squared was applied to test for statistical significance (p
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Khurram Saleem Sana Zafar Aqeela Rashid Source Type: research

A retrospective analysis of emerging rabies: a neglected tropical disease in Sarawak, Malaysia
CONCLUSION: The lack of public awareness of the implication of animal bites and the immediate management in rabies-endemic regions are factors contributing to high rabies mortality.PMID:34131668 | DOI:10.4997/JRCPE.2021.207 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Benjamin Ng Han Sim Benjamin Ng Wei Liang Wong Sheau Ning Shanthi Viswanathan Source Type: research

Acute pancreatitis secondary to hypertriglyceridaemia caused by undiagnosed type 2 diabetes
We present three cases presenting to hospital with pancreatitis secondary to hypertriglyceridaemia. Hypertriglyceridaemia in all three were secondary to undiagnosed and uncontrolled type 2 diabetes. Early treatment of hypertriglyceridaemia can prevent morbidity and mortality. Diagnosing type 2 diabetes in this context can result in optimisation of glycaemic control, and hence improve hypertriglyceridaemia and reduce the risk of recurrent attacks of pancreatitis.PMID:34131669 | DOI:10.4997/JRCPE.2021.208 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Arous Khaqan Atif Munir Miqdad Haider Source Type: research

Isolated oculomotor nerve palsy secondary to acute sinusitis
We describe a case of a 64-year-old male with a two-day history of left-sided ptosis associated with one week of nasal congestion and frontal sinus pain. Examination revealed ptosis with left pupil mydriasis. Uncontrasted computed tomography and angiography of the head demonstrated neither intracranial vascular abnormalities nor acute lesions; however, it did show mucosal thickening in the left frontal sinus, ethmoid air cells and left maxillary sinus, indicating potential obstruction of the left ostiomeatal complex. The sinusitis was treated with intranasal steroids, xylomethazoline and nasal douching. The patient reporte...
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Stephanie Jade Larcombe Duncan Street Benjamin Wright Source Type: research

The mystery of 'saturation gap' and falsely normal G6PD: a case of primaquine-induced haemolysis in Plasmodium vivax malaria infection
We present a case of primaquine-induced methaemoglobinaemia and haemolytic anaemia in a patient with falsely normal qualitative G6PD result during initial presentation, which was complicated with clinical sequelae of thrombosis. Further investigations showed moderate degree of G6PD deficiency. Our patient responded well to vitamin C and a modified weekly regimen of primaquine with no evidence of malaria relapse.PMID:34131671 | DOI:10.4997/JRCPE.2021.210 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Andy Sing Ong Tang Xin Yin Soo Siaw Tze Yeo Nor Ainiza Mansor Lee Ping Chew Hock Hin Chua Source Type: research

Hypokalaemic rhabdomyolysis as initial presentation of primary aldosteronism
J R Coll Physicians Edinb. 2021 Jun;51(2):149-152. doi: 10.4997/JRCPE.2021.211.ABSTRACTRhabdomyolysis is a clinical syndrome characterised by the destruction of skeletal muscle with subsequent leakage of intracellular muscle contents into the systemic circulation. It is commonly caused by trauma, strenuous physical activities, medications, illicit drug use, toxins, infections and electrolyte abnormalities. It can manifest as myalgia, muscle weakness, or myoglobinuria with or without acute kidney injury. Severe hypokalaemia leading to rhabdomyolysis is a rare initial presentation of primary aldosteronism, with limited case ...
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Aye Chan Maung Ann Kwee Kerwen Lee Phong Ching Source Type: research

Atypical interstitial granuloma annulare: a possible uncommon systemic manifestation of atrial myxomas
J R Coll Physicians Edinb. 2021 Jun;51(2):153-155. doi: 10.4997/JRCPE.2021.212.ABSTRACTA 73-year-old man presented with lower back pain and bilateral palmar lesions. Urine culture grew Streptococcus agalactiae and C-reactive protein was raised. He was treated with antibiotics for urinary tract infection with suspected pyelonephritis. An echocardiogram ordered to look for infective endocarditis was suggestive of a left atrial myxoma. He subsequently developed an acute right common iliac artery embolus, which resolved with conservative management. He underwent a successful open-heart left atrial mass and appendage resection,...
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Mahesh Dhakal Wei Chen Yeoh Sean Kwang Howe Leow Source Type: research

A case of metastatic primary cardiac angiosarcoma
We report a 49-year-old Southeast Asian woman diagnosed with metastatic primary right atrial angiosarcoma (PCA) and the difficulties encountered in this diagnosis and its subsequent management. Diagnosis of PCA is often delayed due to non-specific clinical presentation of patients. These tumours often present once metastatic spread has occurred, restricting treatment options and leading to very poor prognosis. Patients undergo a multidisciplinary team (MDT) approach involving chemotherapy, radiotherapy and, if eligible, surgery, but evidence-based treatment guidelines have yet to be established due to the rarity of the tum...
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: C Intrator T A Muhammad S Gu B Lambourne A C Thompson Source Type: research

Case of erythema multiforme/Stevens-Johnson syndrome: an unusual presentation of COVID-19
J R Coll Physicians Edinb. 2021 Jun;51(2):160-161. doi: 10.4997/JRCPE.2021.214.ABSTRACTDermatological manifestations of COVID-19 are rare, with fever ,dry cough, breathlessness, loss of taste and myalgia constituting most of the symptoms spectrum. However, these rare skin manifestations may be the only presentation of COVID-19 as in our presented patient. It is therefore prudent to be aware of such presentation in asymptomatic COVID-19 patients, as this is important for early diagnosis and hence taking appropriate preventive measures.PMID:34131675 | DOI:10.4997/JRCPE.2021.214 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Abdelnassir Abdelgabar Mohammed Elsayed Source Type: research

Racoon eyes sign in a multi-system disease
J R Coll Physicians Edinb. 2021 Jun;51(2):162-163. doi: 10.4997/JRCPE.2021.215.NO ABSTRACTPMID:34131676 | DOI:10.4997/JRCPE.2021.215 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Rachel Clements Saikat Dhar Source Type: research

Superior sagittal sinus thrombosis masquerading as intracerebral and subdural haemorrhage
J R Coll Physicians Edinb. 2021 Jun;51(2):164-165. doi: 10.4997/JRCPE.2021.216.NO ABSTRACTPMID:34131677 | DOI:10.4997/JRCPE.2021.216 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Nicola Walker Sameer Kalgaonkar Chris Isles Source Type: research

Yellow nail syndrome
J R Coll Physicians Edinb. 2021 Jun;51(2):166-167. doi: 10.4997/JRCPE.2021.217.NO ABSTRACTPMID:34131678 | DOI:10.4997/JRCPE.2021.217 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Abheek Sil Atanu Chandra Biswajit Banik Surajit Kumar Biswas Uddalak Chakraborty Source Type: research

Utility of Simulation via Instant Messaging - Birmingham Advance (SIMBA) in medical education during COVID-19 pandemic
J R Coll Physicians Edinb. 2021 Jun;51(2):168-172. doi: 10.4997/JRCPE.2021.218.ABSTRACTBACKGROUND: Simulation via Instant Messaging - Birmingham Advance (SIMBA) aimed to improve clinicians' confidence in managing various clinical scenarios during the COVID-19 pandemic.METHODS: Five SIMBA sessions were conducted between May and August 2020. Each session included simulation of scenarios and interactive discussion. Participants' self-reported confidence, acceptance, and relevance of the simulated cases were measured.RESULTS: Significant improvement was observed in participants' self-reported confidence (overall n = 204, p
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Georgia Morgan Eka Melson Meri Davitadze Emma Ooi Dengyi Zhou Thia Hanania Wentin Chen Lucretia Thomas Isabel Allison Michael Ding Parisha Blaggan Cai Ying Ng Nia Evans Emily Warmington Eloise Radcliffe Vina Soran Rachel Nirmal Kristien Boelaert Rachel Co Source Type: research

Psychological impact of cadaveric dissection on first-year medical students
CONCLUSIONS: Results showed that students who perceived the dissection situation as threatening and anxiety inducing were more likely to test positively for ASD symptoms. A major limitation of the study was that it did not measure whether these symptoms reduced with repeated exposure to cadaver dissection or how symptoms changed over time.PMID:34131680 | DOI:10.4997/JRCPE.2021.419 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Ambreen Zubair Satia Waheed Faryal Shuja Source Type: research

UK internal medicine training in the time of COVID-19
J R Coll Physicians Edinb. 2021 Jun;51(2):177-183. doi: 10.4997/JRCPE.2021.220.ABSTRACTCOVID-19 has had a significant impact on internal medicine training in the UK. Many unprecedented changes have been made to prioritise the care of affected patients. The medical workforce was re-shaped, training programmes were disrupted, Membership of the Royal College of Physicians (MRCP) examinations were cancelled and their format changed on re-commencement, teaching programmes were suspended and delivery methods amended, out of programme (OOP) opportunities deferred, non-COVID related research halted, trainee progression impacted an...
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Sana Sharrack Caroline Ann Zollinger-Read Miriam Faith Cox Mohamed Gamal Shiha Soon Hoo Song Source Type: research

The birth of British geriatric medicine and its struggle for survival as a medical specialty
J R Coll Physicians Edinb. 2021 Jun;51(2):184-191. doi: 10.4997/JRCPE.2021.221.ABSTRACTGeriatric medicine in Britain was born in the setting of a former poor law workhouse in London. Its early pioneers developed models of geriatric services and instigated research into the diseases pertinent to older people. Government initiatives championed the establishment of geriatric units but denied geriatric medicine the status of a clinical medical specialty. Despite an unfavourable image within the medical profession, medical services for older people flourished under the National Health Service to become one of the largest groups...
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Alistair Ritch Source Type: research

Time to take care: fighting HIV with health promotion in Edinburgh, 1983-1996
J R Coll Physicians Edinb. 2021 Jun;51(2):192-198. doi: 10.4997/JRCPE.2021.222.ABSTRACTDuring the 1980s and 1990s, Edinburgh and the Lothians suffered significantly high rates of HIV infections, considered to be the result of a high proportion of intravenous drug users sharing injecting equipment. This young, sexually active cohort had the potential to pose a threat to the wider population via heterosexual spread, and hence measures were required to prevent, where possible, a second wave of the epidemic. A coalition of health professionals, local authority groups and voluntary organisations consequently acted by producing ...
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Phoebe Johnstone Louise Williams Andreas K Demetriades Source Type: research

Shielding, use of masks and hand hygiene: could this be the answer to winter pressures?
J R Coll Physicians Edinb. 2021 Jun;51(2):199-207. doi: 10.4997/JRCPE.2021.223.NO ABSTRACTPMID:34131684 | DOI:10.4997/JRCPE.2021.223 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Michael Avoseh Ben Messer Alison Armstrong Milind Sovani Source Type: research

COVID-19 vestibular neuritis (CVN) in a healthcare worker: a rare complication of COVID-19 infection
J R Coll Physicians Edinb. 2021 Jun;51(2):199-207. doi: 10.4997/JRCPE.2021.224.NO ABSTRACTPMID:34131685 | DOI:10.4997/JRCPE.2021.224 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Thirunavukkarasu Arun Babu Manuj Kumar Sarkar Vijayan Sharmila Source Type: research

It is all about who you know: disparities in opportunity
J R Coll Physicians Edinb. 2021 Jun;51(2):199-207. doi: 10.4997/JRCPE.2021.225.NO ABSTRACTPMID:34131686 | DOI:10.4997/JRCPE.2021.225 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Sofian Youssef Source Type: research

Are aptitude tests the solution to widening participation during COVID-19?
J R Coll Physicians Edinb. 2021 Jun;51(2):199-207. doi: 10.4997/JRCPE.2021.226.NO ABSTRACTPMID:34131687 | DOI:10.4997/JRCPE.2021.226 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Luke Cameron Read Source Type: research

Author's reply
J R Coll Physicians Edinb. 2021 Jun;51(2):199-207. doi: 10.4997/JRCPE.2021.227.NO ABSTRACTPMID:34131688 | DOI:10.4997/JRCPE.2021.227 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Jennifer Cleland Kathrine Gibson Smith Source Type: research

What type of stroke do people on direct oral anticoagulants suffer?
J R Coll Physicians Edinb. 2021 Jun;51(2):199-207. doi: 10.4997/JRCPE.2021.228.NO ABSTRACTPMID:34131689 | DOI:10.4997/JRCPE.2021.228 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Helen Thomas Win Mar Soe Vedamurthy Adhiyaman Indrajit Chattopadhyay Source Type: research

The end of the bedside clinical round?
J R Coll Physicians Edinb. 2021 Jun;51(2):199-207. doi: 10.4997/JRCPE.2021.229.NO ABSTRACTPMID:34131690 | DOI:10.4997/JRCPE.2021.229 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Yelson Pic ón-Jaimes Ivan Lozada-Mart ínez Luis Rafael Moscote-Salazar Tariq Janjua Source Type: research

Putting spin on the great gamble
J R Coll Physicians Edinb. 2021 Jun;51(2):199-207. doi: 10.4997/JRCPE.2021.230.NO ABSTRACTPMID:34131691 | DOI:10.4997/JRCPE.2021.230 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Jennifer Cleland Peter Johnston Source Type: research

Bridging the culture gap: it is time to address the cultural differences for the newly appointed overseas doctors in the NHS
J R Coll Physicians Edinb. 2021 Jun;51(2):199-207. doi: 10.4997/JRCPE.2021.231.NO ABSTRACTPMID:34131692 | DOI:10.4997/JRCPE.2021.231 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Anna Zonato Mustafa Jalal Source Type: research

Snakebites - prevention is better than cure
J R Coll Physicians Edinb. 2021 Jun;51(2):199-207. doi: 10.4997/JRCPE.2021.232.NO ABSTRACTPMID:34131693 | DOI:10.4997/JRCPE.2021.232 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Christopher J Graham Source Type: research

Detecting and handling suspected plagiarism in submitted manuscripts
J R Coll Physicians Edinb. 2021 Jun;51(2):115-117. doi: 10.4997/JRCPE.2021.201.NO ABSTRACTPMID:34131662 | DOI:10.4997/JRCPE.2021.201 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Durga Prasanna Misra Vinod Ravindran Source Type: research

Challenges to the UK medical education during the COVID-19 pandemic
J R Coll Physicians Edinb. 2021 Jun;51(2):118-119. doi: 10.4997/JRCPE.2021.202.NO ABSTRACTPMID:34131663 | DOI:10.4997/JRCPE.2021.202 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Mairi Scott Iqbal Malik Source Type: research

Exercise: the panacea in management of many ills. Now is the time to engage
J R Coll Physicians Edinb. 2021 Jun;51(2):120-122. doi: 10.4997/JRCPE.2021.203.NO ABSTRACTPMID:34131664 | DOI:10.4997/JRCPE.2021.203 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Mark Jacunski Peter Melville Graeme P Currie Source Type: research

Plurality of governance - the transparency of definitions
J R Coll Physicians Edinb. 2021 Jun;51(2):123-124. doi: 10.4997/JRCPE.2021.204.NO ABSTRACTPMID:34131665 | DOI:10.4997/JRCPE.2021.204 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Michael Deighan Fiona Aitken Source Type: research

Ambulatory pneumothorax management in a district general hospital
CONCLUSION: This single-centre study shows that ambulatory pneumothorax management with the PV is feasible and associated with inpatient bed savings. Complication rates are less than previously described.PMID:34131666 | DOI:10.4997/JRCPE.2021.205 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Avinas Aujayeb Source Type: research

Antimicrobial sensitivity patterns of enteric fever in Pakistan: a comparison of years 2009 and 2019
This study aimed to identify the evolving antimicrobial sensitivity patterns of Salmonella species causing enteric fever and its implications on the clinical prescribing of antimicrobials.METHODS: This was a retrospective descriptive study conducted at a university hospital. Antimicrobial resistance was defined in terms of non-resistant, multidrug resistant (MDR) and extended drug resistant (XDR) as per WHO guidance. Data were collected from the years 2009 and 2019. Chi squared was applied to test for statistical significance (p
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Khurram Saleem Sana Zafar Aqeela Rashid Source Type: research

A retrospective analysis of emerging rabies: a neglected tropical disease in Sarawak, Malaysia
CONCLUSION: The lack of public awareness of the implication of animal bites and the immediate management in rabies-endemic regions are factors contributing to high rabies mortality.PMID:34131668 | DOI:10.4997/JRCPE.2021.207 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Benjamin Ng Han Sim Benjamin Ng Wei Liang Wong Sheau Ning Shanthi Viswanathan Source Type: research

Acute pancreatitis secondary to hypertriglyceridaemia caused by undiagnosed type 2 diabetes
We present three cases presenting to hospital with pancreatitis secondary to hypertriglyceridaemia. Hypertriglyceridaemia in all three were secondary to undiagnosed and uncontrolled type 2 diabetes. Early treatment of hypertriglyceridaemia can prevent morbidity and mortality. Diagnosing type 2 diabetes in this context can result in optimisation of glycaemic control, and hence improve hypertriglyceridaemia and reduce the risk of recurrent attacks of pancreatitis.PMID:34131669 | DOI:10.4997/JRCPE.2021.208 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Arous Khaqan Atif Munir Miqdad Haider Source Type: research

Isolated oculomotor nerve palsy secondary to acute sinusitis
We describe a case of a 64-year-old male with a two-day history of left-sided ptosis associated with one week of nasal congestion and frontal sinus pain. Examination revealed ptosis with left pupil mydriasis. Uncontrasted computed tomography and angiography of the head demonstrated neither intracranial vascular abnormalities nor acute lesions; however, it did show mucosal thickening in the left frontal sinus, ethmoid air cells and left maxillary sinus, indicating potential obstruction of the left ostiomeatal complex. The sinusitis was treated with intranasal steroids, xylomethazoline and nasal douching. The patient reporte...
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Stephanie Jade Larcombe Duncan Street Benjamin Wright Source Type: research

The mystery of 'saturation gap' and falsely normal G6PD: a case of primaquine-induced haemolysis in Plasmodium vivax malaria infection
We present a case of primaquine-induced methaemoglobinaemia and haemolytic anaemia in a patient with falsely normal qualitative G6PD result during initial presentation, which was complicated with clinical sequelae of thrombosis. Further investigations showed moderate degree of G6PD deficiency. Our patient responded well to vitamin C and a modified weekly regimen of primaquine with no evidence of malaria relapse.PMID:34131671 | DOI:10.4997/JRCPE.2021.210 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Andy Sing Ong Tang Xin Yin Soo Siaw Tze Yeo Nor Ainiza Mansor Lee Ping Chew Hock Hin Chua Source Type: research

Hypokalaemic rhabdomyolysis as initial presentation of primary aldosteronism
J R Coll Physicians Edinb. 2021 Jun;51(2):149-152. doi: 10.4997/JRCPE.2021.211.ABSTRACTRhabdomyolysis is a clinical syndrome characterised by the destruction of skeletal muscle with subsequent leakage of intracellular muscle contents into the systemic circulation. It is commonly caused by trauma, strenuous physical activities, medications, illicit drug use, toxins, infections and electrolyte abnormalities. It can manifest as myalgia, muscle weakness, or myoglobinuria with or without acute kidney injury. Severe hypokalaemia leading to rhabdomyolysis is a rare initial presentation of primary aldosteronism, with limited case ...
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Aye Chan Maung Ann Kwee Kerwen Lee Phong Ching Source Type: research

Atypical interstitial granuloma annulare: a possible uncommon systemic manifestation of atrial myxomas
J R Coll Physicians Edinb. 2021 Jun;51(2):153-155. doi: 10.4997/JRCPE.2021.212.ABSTRACTA 73-year-old man presented with lower back pain and bilateral palmar lesions. Urine culture grew Streptococcus agalactiae and C-reactive protein was raised. He was treated with antibiotics for urinary tract infection with suspected pyelonephritis. An echocardiogram ordered to look for infective endocarditis was suggestive of a left atrial myxoma. He subsequently developed an acute right common iliac artery embolus, which resolved with conservative management. He underwent a successful open-heart left atrial mass and appendage resection,...
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Mahesh Dhakal Wei Chen Yeoh Sean Kwang Howe Leow Source Type: research

A case of metastatic primary cardiac angiosarcoma
We report a 49-year-old Southeast Asian woman diagnosed with metastatic primary right atrial angiosarcoma (PCA) and the difficulties encountered in this diagnosis and its subsequent management. Diagnosis of PCA is often delayed due to non-specific clinical presentation of patients. These tumours often present once metastatic spread has occurred, restricting treatment options and leading to very poor prognosis. Patients undergo a multidisciplinary team (MDT) approach involving chemotherapy, radiotherapy and, if eligible, surgery, but evidence-based treatment guidelines have yet to be established due to the rarity of the tum...
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: C Intrator T A Muhammad S Gu B Lambourne A C Thompson Source Type: research

Case of erythema multiforme/Stevens-Johnson syndrome: an unusual presentation of COVID-19
J R Coll Physicians Edinb. 2021 Jun;51(2):160-161. doi: 10.4997/JRCPE.2021.214.ABSTRACTDermatological manifestations of COVID-19 are rare, with fever ,dry cough, breathlessness, loss of taste and myalgia constituting most of the symptoms spectrum. However, these rare skin manifestations may be the only presentation of COVID-19 as in our presented patient. It is therefore prudent to be aware of such presentation in asymptomatic COVID-19 patients, as this is important for early diagnosis and hence taking appropriate preventive measures.PMID:34131675 | DOI:10.4997/JRCPE.2021.214 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Abdelnassir Abdelgabar Mohammed Elsayed Source Type: research

Racoon eyes sign in a multi-system disease
J R Coll Physicians Edinb. 2021 Jun;51(2):162-163. doi: 10.4997/JRCPE.2021.215.NO ABSTRACTPMID:34131676 | DOI:10.4997/JRCPE.2021.215 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Rachel Clements Saikat Dhar Source Type: research

Superior sagittal sinus thrombosis masquerading as intracerebral and subdural haemorrhage
J R Coll Physicians Edinb. 2021 Jun;51(2):164-165. doi: 10.4997/JRCPE.2021.216.NO ABSTRACTPMID:34131677 | DOI:10.4997/JRCPE.2021.216 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Nicola Walker Sameer Kalgaonkar Chris Isles Source Type: research

Yellow nail syndrome
J R Coll Physicians Edinb. 2021 Jun;51(2):166-167. doi: 10.4997/JRCPE.2021.217.NO ABSTRACTPMID:34131678 | DOI:10.4997/JRCPE.2021.217 (Source: Journal of the Royal College of Physicians of Edinburgh)
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Abheek Sil Atanu Chandra Biswajit Banik Surajit Kumar Biswas Uddalak Chakraborty Source Type: research

Utility of Simulation via Instant Messaging - Birmingham Advance (SIMBA) in medical education during COVID-19 pandemic
J R Coll Physicians Edinb. 2021 Jun;51(2):168-172. doi: 10.4997/JRCPE.2021.218.ABSTRACTBACKGROUND: Simulation via Instant Messaging - Birmingham Advance (SIMBA) aimed to improve clinicians' confidence in managing various clinical scenarios during the COVID-19 pandemic.METHODS: Five SIMBA sessions were conducted between May and August 2020. Each session included simulation of scenarios and interactive discussion. Participants' self-reported confidence, acceptance, and relevance of the simulated cases were measured.RESULTS: Significant improvement was observed in participants' self-reported confidence (overall n = 204, p
Source: Journal of the Royal College of Physicians of Edinburgh - June 16, 2021 Category: General Medicine Authors: Georgia Morgan Eka Melson Meri Davitadze Emma Ooi Dengyi Zhou Thia Hanania Wentin Chen Lucretia Thomas Isabel Allison Michael Ding Parisha Blaggan Cai Ying Ng Nia Evans Emily Warmington Eloise Radcliffe Vina Soran Rachel Nirmal Kristien Boelaert Rachel Co Source Type: research