Age and ageing
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Postherpetic neuralgia (PHN) develops in 8-24% of patients with herpes zoster. Few studies have evaluated the patient burden and treatment of PHN in general practice. ⋯ PHN causes substantial patient burden expressed as interference with daily functioning and reduced health status associated with pain severity. This burden may result in part from suboptimal management strategies and suggests a need for more effective pain management.
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Metformin is an invaluable hypoglycaemic agent. We report two cases who had symptomatic vitamin B12 deficiency related to metformin use; the mechanisms are discussed. The clinician must be aware of the possibility of metformin-associated B12 deficiency in users who suffer cognitive impairment, peripheral neuropathy, subacute combined degeneration of the cord or anaemia.
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Hyperostosis frontalis interna (HFI), symmetric thickening of the inner table of the frontal bone, is relatively common in women but very rare in men. We report the case of an elderly male patient with HFI. This patient was accompanied by primary hypogonadism, which may be related to the underlying pathogenesis of HFI.