A case of femoral hernia in a young male

Femoral hernia is an extremely rare condition in infants and children, and is rarely diagnosed before operation. A reducible lump in the groin of a child is by far most commonly that of an inguinal hernia. Conditions which one must bear in mind when confronted with a swelling in the groin in a young child are enlisted. Furthermore, a case report of a child with a one year history of a painful lump in the right inguinal region is described. He underwent two surgeries, wherein the first operation it was thought to be a small reducible right inguinal hernia, and a very small inguinal hernia was excised with no repair being performed. In the second operation the lump was found to be a femoral hernia.peer-reviewe

Auenbrugger and Laennec : two pioneers who have demarcated the development of western thoracic medicine

With the publications in 1761 of Giovan Battista Morgagni’s (1682-1771) ‘De sedibus et causis morborum’ (On the Sites and Causes of Diseases),1,2 pathological anatomy became a science in its own right. Morgagni’s aim was to try and correlate the symptoms of a disease as it developed with findings at post mortem.3 Although this found immediate application in surgical disorders, where lesions were often visible and palpable, it was not thought to be equally useful in cases of internal ailments as long as physicians were unable to explore what was happening to internal organs during life.4 This was made possible with the clinical diagnostic procedures pioneered by Leopold Auenbrugger (1722-1809) and by René Théophile Hyacinthe Laënnec (1781-1826).peer-reviewe

Altered pulmonary function in bronchial asthma

Asthma has attracted a great deal of attention over the centuries both because it is common and because of its frequent dramatic manner of presentation (Ellul-Micallef, 1976). Up to comparatively recently, knowledge of physiological changes occurring in asthmatic patients, both during an attack and following therapy has been scanty. Over the past few years various tests have been developed enabling the clinical pulmonary physiologist and the chest physician to measure a number of different variables. It is only by considering all the changes in pulmonary function which take place in this condition that a reasonably clear picture can be obtained and a rational approach to therapy instituted. In this article discussion of altered pulmonary function in asthma includes changes in airway resistance, lung volumes, lung elastic recoil pressure, pulmonary diffusing capacity and arterial blood gas tensions and pulmonary gas exchange.peer-reviewe

“Ir-riċerka hija r-ruħ tal-Università”

L-ewwelnett nixtieq nirringrazzja lil Dr Alfred Sant ta' l-istedina li għoġbu jagħmilli. Jiena u hu iggradwajna kważi tletin sena ilu flimkien mill-istess istituzzjoni, hu mill-fakultà tax-xjenza u jien mill-fakultà tal-mediċina. Meta rċevejt l-istedina ħabbilt ftit rasi, għaliex ma kienx hemm indikat is-suġġett li xtaquni niddiskuti. Forsi ma kinitx tkun idea ħażina kieku l-meeting seta' jkun ftit iżjed strutturat, għalkemm is-sessjoni ta' dal-għodu kienet interessanti ħafna, smajna bosta ideat fuq ħafna affarijiet. Mhux qed ngħid bi kritika, imma naħseb kienet tinħoloq forsi aktar direzzjoni u diskussjoni. Ma kontx naf jekk għandix nitkellem fuq l-Università, fuq l-edukazzjoni Universitarja, fuq mediċina, jew fuq edukazzjoni medika. Bosta mill-kelliema ta' qabli diġà messew dawn is-suġġetti. Meta kelliem ikun minn ta' l-aħħar, ikollu ċerti vantaġġi iżda jkollu wkoll ċerti żvantaġġi. Il-vantaġġi jkunu li jkun ftit jew wisq sema' x'ingħad qabel, jispera li dak li tkellmu qabel ħallewlu xi ħaġa xi jgħid u jkun jista' b'xi mod jikkonkludi. L-iżvantaġġ hu li n-nies jibdew jagħjew u jsiru aktar irritabbli. Issa niġu għall-punt. Qiegħed hawn f'kapaċità personali. Dawn l-aħħar ħames snin kont l-ewwel viċi-chairman u mbagħad chairman tal-kumitat fuq Higher Education and Research tal-Kunsill ta' l-Ewropa fi Strasbourg. Ġejt f'kuntatt mill-qrib ma' Universitajiet fl-Ewropa bil-problemi kollha tagħhom. Allura se nipprova nitkellem fil-qosor kemm jista' jkun fuq l-Università bħala istituzzjoni, fuq l-Università mhux tagħna biss. X'inhuma l-problemi li Universitajiet ser ikollhom fis-seklu li ġej?peer-reviewe

Asthma : a new look at an old disease

Asthma has attracted a great deal of attention over the centuries probably because its clinical manifestations of breathlessness and wheezing present themselves in such a dramatic manner. A historical outline of this anomaly sets off the introduction of this article. Key factors in relation to asthma are thereafter discussed; its etiology and pathogenesis, immunological aspects, pharmacological mediators, non-immunological mechanisms, respiratory infection, psychological factors and pathology. The etiology and pathogenesis of this condition is still far from clear in certain areas and a lot of work still remains to be done to try and unravel this problem.peer-reviewe

Alveolar cell carcinoma

Symptoms of alveolar cell carcinoma, a lung cancer, usually tend to occur rather late due to the slow progression of the tumour. The tumour may remain localized for long periods, even for years. The incidence of symptoms increases with extension of the lesion. Productive cough, breathlessness, chest pain and weight loss are common complaints, occasionally patients may present with hemoptysis, pyrexia or joint pains. One feature that is often stressed is the production of copious watery sputum, but this is in fact an inconstant finding and when it is present the carcinoma is usually advanced beyond surgical treatment. Finger clubbing may be an early sign. This type of lung cancer has a much better prognosis than other forms if the diagnosis is made early when the lesion may be resectable.peer-reviewe

Pharmacogenetics of asthma therapeutics

Asthma is recognised to arise from complex interactions between environmental exposure and disease-susceptibility genetic contributions.1 Pharmacological management of the condition aims to relieve symptoms, decrease airway hyperresponsiveness, and optimize the quality of life in patients. Inter-patient variability in the clinical responses to anti-asthma drugs is a recognized factor that may confound therapeutic outcome.peer-reviewe

Clinical and financial consequences of setting up an asthma clinic at St. Luke’s Hospital

The effects of setting up an asthma clinic were assessed in an audit study. A comparison was made between the quality and quantity of medication used by patients before and after attending the asthma clinic. The number and severity of exacerbations during a six month period before and a six month period after attending were also assessed. The cost of treatment before and after was also calculated. In 14% of patients, occupational factors, drugs or underlying lung disease were significant contributors to asthma. The number of acute episodes of severe asthma were reduced from 98 to 47, with hospital admissions falling from 26 to 1. Pulmonary function (%FEV1) improved in the group as a whole with the number of patients having their best FEV above 80% improving from 44 to 71. In spite of the expense of high cost drugs and the running costs of the clinic there were substantial savings largely from the reduced number of hospital admissions. The calculated annual cost fell from Lm 22,769 to Lm 10,654.peer-reviewe

Pulmonary infarction in healthy young males

It is widely recognised that the elderly immobilised, sick, traumatised or postoperative patient is the most likely candidate to develop pulmonary embolism and infarction, and that the risk increases in direct proportion to the duration of the illness and to the age of the patient. Over the past few years, a number of autopsy studies have stressed the high incidence of deep venous thrombosis and pulmonary embolism in individuals who are otherwise normal. Unfortunately, many clinicians have been slow to appreciate this point and fail to recognise the condition unless well-established predisposing factors are present. This paper reports the findings in four young male patients who developed pulmonary infarction in the absence of obvious precipitating causes.peer-reviewe