Scurvy in children with autistic spectrum disorder : not such a rarity

Scurvy is an uncommon nutritional deficiency that results from low serum levels of vitamin C (ascorbic acid). Part of human history since ancient times, its incidence rapidly decreased following the discovery by Sir James Lind that citrus fruits can prevent it. Despite this scurvy still exists today within certain predisposed groups. We report three cases of scurvy that presented within a short time frame to the Paediatric Department in Mater Dei Hospital (MDH), Malta. All three children were known to have autistic spectrum disorder (ASD) with restricted diets. A high index of suspicion together with appropriate history and examination can lead to timely diagnosis of this disease. In children deemed at-risk of developing scurvy we recommend routine screening for low serum levels of vitamin C.peer-reviewe

The need for gastroscopy in early cirrhotics : a retrospective analytical study

The aim of this study was to predict which Child-A cirrhotic patients would not have oesophageal varices at endoscopy. This is a retrospective study that reviewed 59 Child-A cirrhotic patients under the care of a gastroenterology firm. All gastroscopy reports (97 episodes in total) undergone by these patients were analysed. Patients were classified into 3 groups namely absent varices (AV) group: no oesophageal varices seen at endoscopy, small varices (SV) group: small oesophageal varices seen, banded varices (BV) group: moderate/large oesophageal varices requiring banding. In this study the varices were graded as per UK guidelines that is small varices being ones which collapse to inflation of the oesophagus with air, moderate varices do not collapse and large varices occlude the lumen.1 Patient demographics, a platelet count and spleen size on imaging at the time of endoscopy were also noted. Statistical differences between the 3 groups were then analysed using ANOVA. Our results showed that most of the patients were middle aged males. Furthermore, there was a statistically significant difference in platelet count and spleen size between the three groups (p values: 0.008 and 0.035 respectively). A noteworthy finding was that none of the patients who required banding had a normal spleen size (spleen < 12 cm). Having said this, due to considerable overlap between the three groups, further recommendations could not be proposed.peer-reviewe

Acquired unilateral Brown Syndrome in newly diagnosed Systemic Lupus Erythematosus

Brown Syndrome is a congenital or acquired ocular movement disorder that is known to be a rare complication of Systemic Lupus Erythematosus (SLE). We report a case of acquired Brown Syndrome in an adolescent girl with newly diagnosed SLE which responded well to oral prednisolone.peer-reviewe