Diabetes Treatment

Treatment of Type 2 Diabetes Mellitus A Bhattacharyya People with type 2 diabetes mellitus (DM) are characterized by a resistance to insulin and a relative, as opposed to absolute, insulin deficiency. At least initially, and often through out their lifetime, they do not need exogenous insulin for survival. Thus although insulin may be required for […]

Vignettes needle in foot

Diabetes Vignettes, Needle in foot! A Bhattacharyya, Frank Webb A 62 year old patient with type 2 diabetes mellitus on insulin for the last 10 years was referred to our multidisciplinary foot clinic with cellulites of the right foot (figure1). He noted pain and discomfort for 7 days. There is no clinical evidence of osteomyelitis. […]

Obstetrics Graves

Obstetric Difficulties due to Grave’s disease A Bhattacharyya, JD Wright, PA Vice A 14 year old girl was referred to the paediatrician with symptoms of hypothyroidism. She had a smooth diffuse goiter with dysthyroid eye disease.(Proptisis, lid lag and lid retraction). Hyperthyroidism was confirmed biochemically (Protein bound iodine 18.8, normal 5-8 ug). She was treated […]

HONK Type1DM

Hyperosmolar Nonketotic State in a patient with Type 1 Diabetes Mellitus A Bhattacharyya, A Howell, A Lakhdar Dreschfeld described the major comas in diabetes mellitus in an address to the Manchestor Medical Society in 1881 as three different syndromes: Diabetic Collapse, The alcoholic form of diabetic coma and Coma from acetonemia. He described diabetic collapse […]

Thyroid Treatment

Treatment of Thyroid Diseases A Bhattacharyya and HM Buckler. The treatment of thyroid diseases is relatively straightforward. True thyroid problems should be distinguished from sick euthyroid syndrome and due consideration, should be given to the patient’s age, gender, family and wishes in making treatment decisions. Treatment of thyroid diseases falls in to three main categories. […]

Aetiology pathology Thyroid

The Aetiology and Pathology of Thyroid Disease A Bhattacharyya and PG Wiles The Thyroid gland is one of the largest endocrine organs, weighing approximately 15-20g in adults. The gland is composed of closely packed sacs, called acini or follicles, which are invested with a rich capillary network. The interior of the follicle is filled with […]

Adrenocortical crisis electrocardiogram

Screening for genetic haemochromatosis in blood samples with raised alanine aminotranferase M Bhavani, D Lioyd, A Bhattacharyya, J Marples, P Elton, M Worwood In the UK approximately 1 in 140 people are homozygous for the C282Y mutuation of the HFE gene and are at risk from iron overload caused by genetic haemochromatosis (GH). Early detection […]

Diabetic Ketoacidosis in non-insulin-dependent diabetes mellitus

by SC Sharma , A Bhattacharyya Journal of Royal Society of Medicine 1998:Vol 91;34-5 Diabetic ketoacidosis can have devastating consequences if not managed promptly and effectively. Usually it is regarded as a complication of insulin-dependent diabetes mellitus. Here we report its development in two patients with longstanding non-insulin-dependent diabetes mellitus.

Autoimmune Thrombocytopenic Pupura in a Splenectomized Patient

by A Bhattacharyya, SC Sharma International Journal of Clinical Practice 1998:52;508-9 Splenectomy remains a treatment in patients with autoimmune thrombocytopenic purpura (ATP) who fail to respond adequately to conservative treatment. We report on a 78 year old man who developed ATP after splenectomy performed six years earlier for iatrogenic injury to the spleen during hemicolectomy. […]

Heart failure with fludro-cortisone in Addison’s disease

by A Bhattacharyya, DJ Tymms Journal of Royal society of Medicine 1998:91;433-4 Autoimmune destruction of adrenal cortex causes Addison’s disease and demands lifelong replacement of glucocorticoids and mineralocorticoids. We report a patient with a normal heart who developed heart failure on replacement fludrocortisone.