Postgraduate medical journal
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An 80 year old man, who relied on a home based meals-on-wheels service was admitted to hospital with non-specific symptoms, but had clinical and biochemical evidence of scurvy. Subsequently, all new admissions (n=37) to the department over a three week period were assessed for evidence of undernutrition. ⋯ The commonest symptom associated with vitamin C deficiency was anorexia, but overall, there was a paucity of clinical signs associated with vitamin C deficiency. The possible associations of vitamin C deficiency in the elderly are discussed.
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In less than ideal situations wounds have to be closed without extensive cleaning using sterile adhesive strips (Steristrips). This prospective analyses the efficiency of this technique and compares it to the more conventional approach. ⋯ This technique, while contradicting the "sacred tenets" of wound closure, is a cheap, quick, and effective alternative to routine closure of traumatic wounds in a casualty department.
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Significant numbers of presentations to the emergency department were found to relate to low voltage electrical injury, for which there was no widely accepted management protocol. It was decided to examine the outcome of patients after low voltage electrical injury with particular reference to electrocardiogram (ECG) changes and to evaluate a protocol for managing these injuries in order to optimise the management of patients after electrical injury. A prospective observational study was done over three years of 212 consecutive presentations to the emergency department of Mount Isa Base Hospital with a four year follow up after implementation of the revised protocol. ⋯ Asymptomatic patients with a normal ECG on presentation do not need ECG monitoring after low voltage electrical injury. Patients with significant symptoms or ECG changes should be admitted for monitoring and observation. In view of the high proportion of workplace related injuries occupational health measures such as "triple gloving" should be mandatory for high risk groups.
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A rare case of intramuscular lipomatosis of the tongue with intramuscular invasion in a 42 year old man is presented. The literature is reviewed and the clinical features, pathology, and treatment are discussed briefly.