requiring admission to ICU. Case report: A 33 year old male presented with a fifteen-hour history of vomiting, diarrhoea, and lower abdominal pain one week after a holiday in Portugal. He had no significant past medical history. On examination he had a tanned appearance, and was tender with guarding and rebound in the right iliac fossa. Rovsing’s sign was positive. He proceeded to theatre where...

Petrification of the auricle is a recognized and distinct pathological entity. This involves ossificationorcalcification of the auricular cartilage resulting in hardening of the auricle which is clinically evident on palpation and can be confirmed through radiological imaging. The aetiology of this unusual phenomenon is varied and includes both local and systemic causes. Systemic conditions ass...

Addisons disease is a relatively rare endocrine disorder thatgenerally results from slow progresss deficiency in the adrenal cortex. The psychiatric symptoms at onset of are typically represented by depressive state and instinctive disorders, which may be confused with etiology, delay diagnosis, and/or constitute circumstance for discovery this disease. Furthermore, occurrence psychotic disorde...

Introduction: APECED (Autoimmune Polyendocrinopathy Candidiasis Ectodermal Dystrophy) is an autosomal recessive disease characterized by the association of autoimmune endocrine involvement, mucocutaneous candidiasis and ectodermal tissue involvement. Observation: We report case 2 brothers from a 2nd degree consanguineous marriage with history deaths in siblings for whom diagnosis syndrome was r...

SIR, We write in response to an editorial in Rheumatology defining what is known and what remains to be learned about fatigue in RA [1]. Repping-Wuts et al. [1] recognize fatigue as a common and severe complaint, having a major impact on the quality of life in patients with RA. They emphasize that doctors often underestimate this effect and also that the issue is usually raised by patients rath...

We report a case of a fifty-year-old male who was admitted with a three month history of increasing weakness, prostration, decreasing appetite and inability to swallow. The patient was a chronic alcoholic, unemployed, and of very poor socioeconomic background. The patient was initially investigated for upper GI malignancy, Addisons disease, bulbar palsy and other endocrinopathies. Concurrent ma...

Introduction Patient populations in psychiatry can have low cortisol for many reasons such as adrenalitis, secondary adrenal insufficiency and poor compliance with glucocorticoid replacement therapies. A literature review 2005 highlighted the prevalence of neuropsychiatric features those cortisol. Unfortunately, this has received little to no attention wider hypocortisolaemia is often overlooke...

Chronic vomiting is a common and frequently complex problem in dogs. Vomiting can be caused by both primary gastrointestinal diseases (e.g. infectious, inflammatory, parasitic, anatomic (obstructive, bones), drug-related or nutritional) and by extra-gastrointestinal (GI) diseases, such as endocrinopathies (e.g. addisons disease), metabolic disease (e.g. renal failure), inflammatory or other liv...