Medical science, drawn into focus.

Diabetes Mellitus type I

Overview Type 1 diabetes is B-cell destruction leading to absolute insulin deficiency. It accounts for 5-10% of all diabetes. Type I diabetes is divided into two types: Immune mediated and idiopathic. The traditional paradigm is of childhood onset with acute symptoms of DKA. Diabetes:  A group of metabolic diseases in which there are high blood…

Gout

Overview Gout is a common inflammatory arthritis that is increasing in prevalence. Gout (monosodium urate crystal deposition disease) is characterized biochemically by extracellular fluid urate saturation. Tends to occur earlier in life in men than women, and is rare in childhood. Prevalence is increasing. It is associated with many serious comorbidities such as hypertension, chronic kidney disease,…

Sickle Cell Anaemia

Overview Sickle cell anaemia is an autosomal recessive disorder causing production of abnormal ß-globin chains. A single amino acid is substituted in the ß-globin chain (Glu to Val at position 6). This results in the production of HbS (haemoglobin Sickle) rather than HbA. The common variants of sickle cell disease are: Sickle cell anaemia (SS…

Anorectal Disease

Overview Anorectal conditions are a common presentation in the primary care setting. A history and physical examination usually will determine the etiology. Physical examination includes visual inspection, digital rectal examination, and anoscopy Anal Fissure More info on   Anal fissures Anal Abscess More info on  Anal Abscess Haemorrhoids More info on  Haemorrhoids Other anorectal disease…

Basic Calcium Phosphate Disease / Milwaukee Shoulder Syndrome

Overview Basic Calcium Phosphate (BCP) disease is a crystal-associated arthropathy characterized by deposition of BCP crystals in periarticular and intra-articular tissues. A severe clinical presentation of BCP disease is Milwaukee Shoulder Syndrome, which typically affects elderly women, leading to rapid joint destruction, massive rotator cuff tears, and non-inflammatory joint effusion. It often involves the shoulder,…

Infective Endocarditis

Overview Infective endocarditis is a condition which occurs in the setting of bacteraemia whereby endothelial surfaces of the heart, such as valvular structures, become infected. It can present acutely or subacutely, and is often associated with fevers, new heart murmurs, constitutional symptoms and embolic phenomena. The classical organism associated is Staphylcoccus aureus, however there are…

Toxic Multinodular Goitre

Overview Toxic Multinodular Goitre (TMNG) is the second most common cause of hyperthyroidism caused by a long-standing goitre and/or iodine deficiency which results in an increased risk of mutation and consequent TSH-independent autonomic function of thyroid nodules to produce excess thyroid hormones. Common clinical manifestations include hyperthyroidism and a painless thyroid goitre with palpable nodules.…

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