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Re: Does the world need a new inhaled insulin?

Posted in Diabetes at Tue, 02 Sep 2014 13:41:05

cfabluenose

Posts: 7
Joined: 15 Feb 2013

As a diabetic, I would prefer inhaled to injected insulin.  It's not really a matter of needle phobia but administering a dose would be far more convenient.  There would be no need to fiddle around with injection equipment, disinfecting (and exposing) the injection site and no needles to discard.  You could take your insulin on a park bench, sitting in the airport lounge, etc.  Sign me up.

Re: What's your diagnosis? Pigmentation and confusion.

Posted in General clinical at Tue, 02 Sep 2014 13:22:24

jamilhussain

Posts: 15
Joined: 30 Dec 2009

Based on the clinical presentation Addison's disease is at the top of differntial diagnosis. I shall keenly await for the final diagnosis.

Re: Good Samaritan Acts

Posted in Medicolegal at Tue, 02 Sep 2014 13:03:12

NandaKar

Posts: 44
Joined: 24 Nov 2012

In a noble mind for a noble profession any help is worthy, I would forget the legal issue ,I'll help anyway I can. Lawyers should stay away from "Life - Saving " issue in Good Samaritan Acts at a public place  . We made the acts and we made the lawyers , so we should choose the limitations of the lawyers and the acts .    

he point where

Posted in General clinical at Tue, 02 Sep 2014 12:37:08

vironicanica

Posts: 1
Joined: 02 Sep 2014
 
 
I just got the game and when I went into the options that allows us to change the keys, it pops up a warning telling us what 
 
to not change. I repetitively pressed the "enter" key to close the warning pop-up. When the pop-up disappeared, I noticed 
 
that I was still pressing "enter" to the point where, on the first column, it said "delete" then on the second column: 
 
--------- 
 
A friend of mine didn't have that happen to him but for me, it basically removed the enter key and all I can do on the 
 
Stepmania is move the keys up and down, I cant access any of the listed in order to change what was removed or edited. 
 
I tried uninstalling the game various times but nothing really happened, I also tried scanning through my laptop and I found 
 
nothing that would help me recover the "enter" key. 
 
 
 
 
 
 
 
 
 
 
 

Re: Ashya King case: breakdown of communication?

Posted in News & media at Tue, 02 Sep 2014 10:24:12

Pat Harkin

Posts: 50
Joined: 26 May 2010

I agree with the sentiment that the family must be beside themselves with worry. According to the press (so please take this with a LARGE pinch of salt, whatever the BMA recommend) they 1) went to Spain to sell a property there in order to 2) fund proton beam theray in the Czech republic.

In order to do (1) they did not need the child with them, and while I have no direct knowledge of the property market in Spain I believe it is stagnant at present. Anyone who has tried to buy or sell a property knows what a tedious, drawn out process it is. It woudl therefore seem to me that they have removed the child from hospital care for an unknowable period of time - surely the sensible move would have been for one of the parents (or the eldest brother with power of attorney) to travel to Spain and arrange the sale while the child remained in hospital.

The media have repeated many times that "proton beam therapy is not available in the UK on the NHS". This statement is true, but misleading. There are no proton beam therapy centres in the UK, but the treatment CAN be provided on the NHS, which will fund treatment abroad. I must presume that the child's NHS doctors did not feel referral for this was appropriate.

Re: Doctors aren't supposed to die and certainly not in the saddle

Posted in General at Tue, 02 Sep 2014 10:12:34

Pat Harkin

Posts: 50
Joined: 26 May 2010

I can only think of one colleague who died "in harness" though I know a couple who retired early on health grounds. One man I worked with made it to retirement, but died unexpectly in his sleep before collecting his first pension cheque. He was a dyed-in-the-wool Socialist and I like to think he'd have been pleased to contrbute to the system for 40 years without ever being a burden on it!

Re: Breast is best - but are we doing enough to support it?

Posted in General clinical at Tue, 02 Sep 2014 09:53:31

Abi Blumenthal

Posts: 10
Joined: 27 Jun 2010

I have been very lucky that breastfeeding was pretty smooth sailing for me which may be partly down to having very large nipples (TMI?) but also partly that my mother is a midwife and therefore I had lots of support on hand if I needed it. The idea that community midwives are not responsible for supporting breast feeding because they discharge women at 14 days is absolutely bonkers! If breast feeding is not established by then then it can be corrected with a lot of hard work but the key time is in the first 4 hours after birth!!!! Skin to skin and being shown how to get the baby to latch in those early hours is crucial. I think a lot of problems arise because nobody helps women that early and then by the time it becomes clear there are problems, mum and baby are exhausted and therefore end up supplementing with formula and saying they don't have enough milk. I understand community midwives are overstretched but surely whilst the women are still in hospital there are enough resources for more support? Community midwives will have to support crazy homebirthers like myself but hopefully a lot of the work for women who birth in hospital will have been done.

I absolutely agree people face far too much stigma for bottle feeding. In this day and age, with clean water supplies there are so many worse things one could do for one's child but if a woman wants to breastfeed, we should be doing far more to help her.

Re: Should doctors be forced to apologise to patients when they get things wrong?

Posted in News & media at Tue, 02 Sep 2014 02:14:19

ashi

Posts: 10
Joined: 28 Feb 2009

doctors should not be forced to apologise if one voluntarily apologises then it is differ nt.No one will do any such thing  intentionally.The person is under lot of stress all that is needed to support such person in crissis&later the team to work togather to avoid any mistakes in future .forcing to  apologise esp if a junior will result in loss of confidence&self respect  such a person will comit more mistakes

Re: chronic atrial fib

Posted in Cardiology at Tue, 02 Sep 2014 01:49:51

Dr.Chid

Posts: 614
Joined: 21 Feb 2012

In Response to Re: chronic atrial fib:[QUOTE]Her thank you for ur replay and cooperation as you request thyroid profile is normal and her echo also normal. However,I read on clinical evidence site it is a useful site that betablockers a're not good for hypertensive patients above sixty as first line but her in this case she is chronic atrial fib the question confused me can we use betablockers after what are evidence proved at the web site. also the patient is with low risk of stroke as I think should we use antcoagulation. the website clinicalevidence says that they don't know any evidence about the use of anticoagulants affects the mortality and morbidity. Again the lower limb oedema was caused by the use of the ccb I need to know the alternative drug suitable for her case. also what is it opinionabout betablockers and anticoagulants Thanks
Posted by amr0100[/QUOTE]

Thank you for your reply.

Dr.Chid

 

Re: 2.5 biological parents!

Posted in General clinical at Mon, 01 Sep 2014 14:43:18

John D

Posts: 3188
Joined: 01 Feb 2010

Did I misspeak myself, Dundee?  My "nibble" was on the global risk of genetic, in this case mitochondrial genetic, disease.   If that had been my partner's lot, and she agreed, I'd take the opportunity!  Lucky for us, we only have a single genetic condition between us, which isn't life shortening, ony life altering.

I think that in the case of egg cytoplasm donation then this is "Evolution in action", as much as it is with a handicapped child that is unlikely to reproduce.   That gene line ends, but thanks to modern science, with the birth of a healthy baby.

JOhn

Re: Trapped lingual frenulum

Posted in General clinical at Mon, 01 Sep 2014 13:05:15

johnmck

Posts: 42
Joined: 14 Feb 2009

Pedant? Hurmph

But thanks for your responses. In Response to Re: Trapped lingual frenulum:[QUOTE]

In Response to Re: Trapped lingual frenulum:[QUOTE]

tortuous , that's not a challenge to take it further  !! In Response to Re: Trapped lingual frenulum:[QUOTE]

I made no enquiret regarding the particulars but there was no evidence of a bridle     In Response to Re: Trapped lingual frenulum:...

 


Posted by johnmck[/QUOTE]

 


Posted by johnmck[/QUOTE]

Good conversation is the following of tangential paths and soaring on a flight of ideas.

Conversation with pedants is Roman Road; conversation with interesting people is a rope ladder across a gorge.

Odysseus

 


Posted by Odysseus[/QUOTE]

 

Re: Do more, and lose weight

Posted in General clinical at Mon, 01 Sep 2014 11:23:52

AnneG

Posts: 360
Joined: 18 Mar 2014

It's interesting that those who commue by train are more likely to be thinner... I get the train to work and rarely get a seat - is it better to stand and be immobile rather than sit and be immobile?! 

More e-cigarette Use in US 'Non-smoking" Students

Posted in Respiratory medicine at Mon, 01 Sep 2014 11:01:51

DundeeChest

Posts: 1433
Joined: 15 Apr 2010

The BMJ reports that 3 times more non-smoking students are using e-cigarettes in 2013 than 2011.  Should we be worried?  

Some reports suggest that eCigarettes are not a 'gateway' to smoking actual cigarettes, but this study shows that more young people now intend to start smoking, as the prevalence of eCigarette smoking increases.  

I heard John Britton talk at the Summer BTS in July - he was convinced that eCigarettes should be prescribable, available free on the NHS, and by being skeptical we are preventing smokers from quitting.  But if we're helping smokers quit at the expense of starting up even more....?

Re: Should we be recommending plant-based diets to people with or at risk for diabetes?

Posted in Diabetes at Mon, 01 Sep 2014 10:35:03

Dr.Chid

Posts: 614
Joined: 21 Feb 2012

Vegetarian diet with milk ,low fat  improves glycemic control in Type II DM.Vegetables to be avoided are plantain both green and riped one,coconut,roots of any type if main diet is Rice .

Here in South India ,Rice is added three times for lunch or dinner.That should not be.No additions are allowed and in its place green vegetables in boiled form to be taken which will,be filling to the stomach.Youghurt(Curd) without cream canbe taken or as butter milk.of course sugar in any form not allowed ,only for  treatment of Hypoglycemic symptoms.

Vegetarian breakfast  in South India includes, Iddale,Dosa and Pongal.all thes are made up of rice and lentles.Sometimes these items can be taken for Dinner.For DM patients we limit the number.I

if the PC can monitor Pt's above diet  ,the treatment outcome is good.

Vyvanse dosing

Posted in General clinical at Mon, 01 Sep 2014 08:30:20

Adhddoc

Posts: 9
Joined: 19 Jun 2014

There seems to be disagreement in the literature if Vyvanse 20 is equivalent to 5mg of ritalin or 10mg of ritalin. Any thoughts?

Re: Poll archive 25/8/2014 to 1/9/2014

Posted in doc2doc feedback at Mon, 01 Sep 2014 08:04:25

AnneG

Posts: 360
Joined: 18 Mar 2014

Should doctors be forced to apologise to patients if they make a mistake?

YEs - 125 votes (46.5%)

No - 122 votes (45.4%)

Don't know - 22 votes (8.1%)

Re: Investigative reporting; garbage in = garbage out. Raising the bar.

Posted in General clinical at Mon, 01 Sep 2014 07:49:58

Odysseus

Posts: 4137
Joined: 24 Feb 2009

In Response to Re: Investigative reporting; garbage in = garbage out. Raising the bar.:[QUOTE]

It's not just in special investigation business that a request can be cursory, or collaborative.

At my Anaesthesia Clinic, I always welcome referrals from certain surgeons, who set out the problems, the ideal operation, any lesser options, including no operation.  Not ony easier to give an opinion on anaesthesia risk, but more rewarding, in contrast to the letters that say, "Can't lie flat. For general anaesthesia?"

John


Posted by John D[/QUOTE]

As a student of Ecclesiastes, tell me Oh Sage and Moderate John  why do the crummy and dodgy doctors survive as long as the Sons of Due Diligence , and why do they get away with blue murder and malpractice, make more money and slither through the byways and alleyways of medicine just fine and drive home in their Porches while humbler and more honest men florish no better, and die no richer? 

There is nothing new under the sun. All is vanity. 

Odysseus

 

Re: what caused this cardiac arrest?

Posted in Cardiology at Sun, 31 Aug 2014 12:49:39

Maxim

Posts: 179
Joined: 14 Dec 2010

As well as agreeing with all John D's points I would offer a few more:

The immediate cause of the cardiac arrest is hardly a mystery; it's interesting that we rarely ask this question in detail when a 95 year old person dies at home.  Every death is a cardiac arrest and the final common pathways are relatively few.  Very small perturbations may be enough in extreme old age when, eventually, everyone dies of a cardiac arrest. 

When a causative chain of events is being considered, my experience is that details are vital and we get misled by talk in generalities.  There may well have been urosepsis but was there real evidence for this or was it a catch-all diagnosis (like ATS or TIA)  when the presentation was, for example, confusion, fever and abdominal pain that might have been caused by a perforated viscus or mesenteric infarction.

Similarly, 'approprately treated' or 'apparently getting better' without recall of the BP or blood results can hide a range of other possibilities.

I make these points not to be gratuitously critical but because many life-threatening conditions present  non-specifically in old age and it becomes important to attend to the details and accuracy in order to avoid being caught out or to avoid other errors.  The same principles apply whether examining the course of events at the time or in retrospect. 

Re: scrotal scan in young child

Posted in Radiology at Sun, 31 Aug 2014 09:23:54

Odysseus

Posts: 4137
Joined: 24 Feb 2009

Tell us more. I  know nothing of infant hydroceles other than hydrocele is usually misspelled as hydrocoel, 

Odysseus

Re: CV / LinkedIn / Web Profiles and telling lies

Posted in Medicolegal at Sat, 30 Aug 2014 13:25:24

DuaneF

Posts: 1446
Joined: 09 Dec 2011

Great Subject Area Gents;

 

I Hate Facebook,  in much of America facebook is touted as a tool, rather myself and others call it a Social Pacifier!   Indeed many have called it the Losers club!   Linkedin serves a purpose,  I use it to network with Professionals in my area, and specialists outside my expertise area, IE -Virology, Nano-technology, etc.  Honesty should be the starting point of everything in life,  although it seems modern day people consider it old fashioned.    I suppose it falls to the interviewer of the job, to discern the validity of the person being hired,  indeed it is hard to pretend to know about chemistry without knowing about ethers, and covalent bonds,  polypeptides, and  radionucleotides,  pretending will cause one to sweat when asked these questions thereby destroying the False CV in a few seconds!!

 

DuaneF

Re: Tier 4 dependent, want to apply for ct1?

Posted in Careers at Sat, 30 Aug 2014 10:53:33

John D

Posts: 3188
Joined: 01 Feb 2010

I know nothing, but a Google search reveals that Tier 4 is a classification for applicants for UK entrance visas, and a dependent is a family member dependent on that visa applicant.  Tier 4 applies to students so Amc is the child or other dependent of a student.   From your post, Amc, you are an already qualified doctor, still in training.

But in my ignorance, it would be worng for me to say, let alone advise any further.    Amc, you mention UKBA, the Uk Border Agency, and I'm sure that they are best source for your advice.  To know about equivalence of your qualifications and training so far, perhaps the Royal College of your specialty?

JOhn

 

 

Re: Diabetic neuropathy.

Posted in Diabetes at Sat, 30 Aug 2014 08:50:10

neuromedicine

Posts: 588
Joined: 23 May 2012

Which is better for diabetic painful neuropathy - carbamezepine or pregabalin. Pl contribute.

Re: diabetic dementia.

Posted in Diabetes at Sat, 30 Aug 2014 08:46:54

neuromedicine

Posts: 588
Joined: 23 May 2012

 What are the cognitive domains affected by diabetic dementia.pl share.

Re: Case to diagnose

Posted in Neurology at Sat, 30 Aug 2014 08:40:16

neuromedicine

Posts: 588
Joined: 23 May 2012

I think it is not neurological disorders but may be functional.

Re: Is it time to take another look at shaken baby syndrome?

Posted in Medicolegal at Sat, 30 Aug 2014 06:28:48

Skipper

Posts: 22
Joined: 04 Apr 2013

 

Tissue Scurvy – Not Shaken Baby

Abstract

Parents and Carers are often falsely accused of injuring a child asserting that unexplained bruises, fractures, retinal and subdural haemorrhages with ischaemic encephalopathy, the so called “Triad” are signs of physical abuse. However these features can be the result of Tissue Scurvy, a disorder of Vitamin C metabolism in which Vitamin C, although abundant in the plasma, is unable to enter the cell because of a lack of Insulin which is necessary to conduct the transfer of the Vitamin C into the cell. The cause is an autoimmune reaction which destroys the Insulin-producing Beta cells of the Pancreas in some genetically susceptible children. Here it is shown that the evidence of the Prosecution Experts alleging death from the Shaken Baby Syndrome was demonstrably flawed.  The diagnosis Shaken Baby Syndrome is false and an innocent man was incarcerated.  This irrational diagnosis should be abandoned.
 

Introduction

Mr Darryl Elliot was convicted for the murder of Amelia Bowmar on the evidence of doctors who alleged Amelia was Shaken to death. The basis of this allegation was the presence of a subdural haematoma, swelling of the brain with ischaemic changes and haemorrhagic contusions in the cortex of the right and left superior frontal gyri of the brain. The brain and spinal cord showed evidence of old and recent injury which was attributed to “Non-accidental Injury”. 

 

The situation in which the carers of the child could offer no explanation for fractures, bruises, retinal and cerebral haemorrhages with ischaemic encephalopathy was given the name “Shaken Baby Syndrome” in 1971 by a neurosurgeon Dr Guthkelch, who unsurprisingly, could offer no other explanation for the lesions in these children and incredible as it may seem nor could the doctors in the UK who reported on Amelia Bowmar a year ago.

 

Amelia had a disorder of the coagulation system as shown by a raised INR of 1.3,(NR 0.89 - 1.2) an APTT of 39.6.(NR 25-35 sec) which would explain the brain and other haemorrhages but the evidence  was ignored by the doctors alleging murder, who were obviously uninformed in relation to the interpretation of these and other Laboratory results. (The NR was not provided in the original report and has been added by me from my personal knowledge as a Haematologist.)

 

Their preoccupation with the Shaken Baby Syndrome hypothesis also ignored the elevation of the level of Glucose in the blood and the presence of Glucose in the urine of Amelia. Both these features are manifestations of an Autoimmune response to antigenic stimulation as I have explained [1].  In this case it was the vaccines given to Amelia a few days prior to her falling ill which initiated the process.

 

Vaccines caused the problem and Darryl Elliot was blamed. There is a simple solution to this problem- a “skin prick test” before administering the vaccine to determine vaccine sensitivity in the child. The test should be mandatory. .

 

Until the Medical Profession realizes that the Shaken Baby Syndrome is a fabricated diagnosis without a shred of scientific evidence, they are going to continue to falsely accuse innocent people and deceive the Judiciary.

Mr Justice MacDuff sentencing Darryl Elliott for the murder of his partner’s baby Amelia Bowmar said,  “You have been convicted, on overwhelming evidence, of the murder of Amelia Bowmar, a little girl of 14 months whose care had been entrusted to you by your partner; her mother. Your job was to look after and protect her but, instead, she died at your hands.

It is clear to me that because you perceived her to be misbehaving, or perhaps because you had to deal with her when she was sick, or just because you lost your temper at something wholly unconnected with her behaviour, you so violently and deliberately shook her as to the catastrophic injuries from which she died. Only you know exactly what went on inside that house on July 28 last year.

I accept that this was a spur of the moment loss of temper and also that you did not intend to kill. I also accept that you were immediately full of remorse – although that remorse has to be seen alongside an attempt to distance yourself from what you did, and a failure to acknowledge your responsibility. Your failure to tell the truth in those early hours meant that the medical teams spent time investigating other possible causes. I am satisfied that Amelia was so seriously compromised that she would have died anyway. But you were not to know that.”

The Judge was obviously completely deceived by the evidence of the doctors and the “overwhelming evidence” he refers to when analysed is demonstrably “overwhelming incorrect” as demonstrated here.

 

                        --------------------------------------------------------------------------

                                               

 Dr P  H T Cartlidge

                            Specialist Field Paediatrics

 

 Dr P  H T Cartlidge in his evidence said, “in my opinion the head injury was not caused by a fall from the seat of the settee and I struggle to conceive how Amelia could have climbed higher”. He goes on to say “the mechanism of non-accidental head injury causing an acute encephalopathic illness, acute subdural bleeding and retinal haemorrhages is thought to be shaking, an impact or a combination of both. In shaking a child is often grasped around the chest and shaken.

 

  Squeezing the chest impairs the return of blood to the heart and thereby causes an increase in venous blood pressure. This in turn causes engorgement of the veins that traverse the subdural space on the surface of the brain. Shaking the child and/or hitting the child’s head on a firm object leads to marked accellaration-decellaration forces that rupture these engorged veins, resulting in subdural haemorrhage  The same shearing forces generated by shaking-impact can damage the parenchyma of the brain and also the spinal cord and cord roots”.

 

Comment

Dr Cartlidge gives an accurate account of the mainstream opinion of the Shaken Baby Syndrome which ignores crucial biochemical evidence such as Increased Glucose in the Blood (Hyperglycaemia), Abnormal Liver Function Test, Abnormal Coagulation Tests and Glycosuria (sugar in the urine) proving an Autoimmune Disease – TISSUE SCURVY.  The Shaken Baby Syndrome is unscientific speculation.

 Read this article. Autoimmunity and Non-Accidental Injury in Children, Clinical Medicine Research. Vol. 2, No. 3, 2013, pp. 40-44. doi: 10.11648/j.cmr.20130203.15

Abstract
Background: The Shaken Baby Syndrome conceived by Guthkeltch to explain bruises, fractures, retinal and cerebral haemorrhage and encephalopathy in children, called the “triad”, can be explained by an autoimmune reaction to antigens in a genetically susceptible child. Method: Children diagnosed as suffering from Non-accidental injuries were investigated for evidence of immune response reactions following mandated vaccination and childhood illnesses. Results: It was found in all the cases reported here the response to antigenic stimulation damaged the Beta cells in the Pancreas causing Hypoinsulinaemia which inhibited the cellular uptake of Vitamin C resulting in liver dysfunction, failure of carboxylation of the Vitamin K dependent proteins resulting in haemorrhages and fractures associated with the “triad”. Conclusion: Fractures, retinal and subdural haemorrhages and encephalopathy in children – is an autoimmune response to antigenic stimulation in a genetically susceptible individual. Common antigens are the mandated vaccines, viral bacterial and parasitic infections. Keywords Shaken, Baby, Non-accidental, Injury, Triad \

                                    ------------------------------------------------------------

                                   

Dr S J Hamilton, Forensic Pahology Unit Leeds

 

Dr S J Hamilton, Forensic Pahology Unit Leeds who, with his colleague Dr Malcomson, performed the Postmotem examination on Amelia also gave evidence for the prosecution in which he stated “having considered all the findings with respect to the death of Amelia, it is my opinion that she as(sic) died of a head and spinal injuries. Neuropathology has revealed recent injuries including subdural bleeding, axonal injury in the medulla and spinal nerve roots, and fresh bleeding within older contusions within the brain itself. There is also evidence of older injury including older subdural bleeding and cerebral contusions. These are indicative of at least one, but possibly more than one, episode of significant head trauma. These neuropathological appearances are entirely consistent with non-accidental injury also referred to as paediatric head injury or sometimes “Adult Induced Injury”. Although some authors have proposed theoretical models that would indicate a natural single underlying cause leading to the finding of subdural haematoma brain swelling and retinal haemorrhage to my knowledge these theoretical models have not been accepted by the Courts. The presence of this combination of findings is entirely consistent with a traumatic etiology. The lack of external injury means that it is not possible to state that there has been an impact to the head, although the possibility of an impact that has not left an external injury must exist”.

 

Comment

I am one of the authors that “have proposed theoretical models that would indicate a natural single underlying cause leading to the finding of subdural haematoma brain swelling and retinal haemorrhage”. Amelia had an elevated Blood Glucose and Glucose in her Urine, features which confirm a diagnosis of Tissue Scurvy as reported in the manuscript below.

 

 

Title

Tissue Scurvy and the Triad”

Abstract.

The Triad, characterized by bilateral retinal haemorrhages, diffuse cerebral haemorrhage and hypoxic ischaemic encephalopathy is conventionally thought to result from trauma caused by violently shaking a child by a parent or carer. The shaking is said to cause a to and fro movement of the brain in the skull leading to injury to the neurons, disruption of the cerebral veins and trauma to the retinal vessels. Vigorous shaking of a child has never been observed and an alternative explanation for these changes was sought. Here it is shown that Tissue Scurvy, an autoimmune disorder which has specific and consistent biochemical features of Hyperglycaemia and Liver Dysfunction as shown by abnormal Liver Function Tests, is the cause of the lesions.

A child diagnosed as being the victim of the Shaken Baby Syndrome was tested for evidence of Tissue Scurvy and both Hyperglycaemia and Abnormal Liver Function were demonstrated. It is concluded that these results provide conclusive evidence that the Shaken Baby Syndrome is a form of Tissue Scurvy in which encephalopathy is caused by damage to neurons in the cervical spinal column causing hypoxia, which leads to ischaemic encephalopathy and the other features of the triad.

                       

                                    ----------------------------------------------------                                                                              Dr Jayamohan Jayaratnam                       

                                    Consultant Paediatric Neurosurgeon                                                                                                                                                                         

Dr Jayamohan Jayaratnam discussed all the available evidence including the fact that Initial blood clotting tests show some raised clotting times with an INR of 1.3, an APTT of 39.6  and an APTT ratio of 1.3.  With support from the evidence of  Dr AL SARRAG  concluded “in my view this sufficient support for my already formed view that there is likely to have been a traumatic explanation for Amelia’s collapse. In view the globalized findings of ischaemia, it was hard to place exactly what may have occurred. However with the focal injuries described by Dr AL SARRAG, in view of the absence of external signs of injury and in view of the bilateral severe ophthalmology findings, I believe it is highly indicative that a non-impact traumatic injury otherwise known as a shaking type injury has occurred to Amelia”.

 

Comment

    Dr Jayamohan clearly identifies an abnormality of the clotting mechanism and then, for no reason whatever, chooses to ignore it as a cause of the bleeding in the skull and elsewhere. His illogical conclusion needs to be further investigated by his governing body for the safety of others with similar coagulation profiles.

 Others may suffer the same fate as Darryl Elliot if he continues to hold this view.

                                                --------------------------------------------    

 

                                   

Dr Neil Gordon Stoodley

Consultant Neuroradiologist

 

Dr Neil Gordon Stoodley Consultant Neuroradiologist concluded his assessment of the situation with the remark “I cannot think of a biologically plausible mechanism that would potentially directly link any event occurring toward the end of May 2012 and Amelia’s presentation with a severe (indeed fatal)” encephalopathic illness at the end of July.

 

The scan abnormalities are all explicable on the basis of being due to an episode of non-accidental head injury. The mechanism of the injury is likely to have involved shaking. Majority medical opinion is of the view that what is likely to be required to produce such injuries is the backwards and forward movement of the unsupported infant head pivoting on the neck. It is believed that this leads to a degree of acceleration/deceleration and rotational forces and that the consequent differential rotation of the brain and skull leads to stretching of the subdural veins which cross the subdural space and it is this which leads to bleeding in the subdural space.

 

Comment

Dr Stoodley could not “think of a biologically plausible mechanism that would potentially directly link any event occurring toward the end of May 2012 and Amelia’s presentation with a severe (indeed fatal)” encephalopathic illness at the end of July”.

 

The biologically plausible mechanism Dr Stoodley has difficulty in thinking of that would potentially directly link an event occurring toward the end of May 2012 and Amelia’s presentation with severe (indeed fatal) encepalopathic illness at the end of July is the MMR vaccine administered on 25th May 2012.

An account of the condition-TISSUE SCURVY- which doctors including Dr Stoodley are obviously unaware of is featured below. When doctors understand Tissue Scurvy can be induced by vaccines in genetically susceptible children and causes the signs and symptoms found in Amelia, they will stop diagnosing Shaken Baby Syndrome.

 

Autoimmune Tissue Scurvy Misdiagnosed as Child Abuse
 

Michael D Innis, MBBS; DTM&H; FRCPA; FRC Path. Retired Haematologist, Princess Alexandra Hospital, Brisbane, Australia

To cite this article
Michael D Innis, Autoimmune Tissue Scurvy Misdiagnosed as Child Abuse, Clinical Medicine Research. Vol. 2, No. 6, 2013, pp. 154-157. doi: 10.11648/j.cmr.20130206.17

Abstract
Requests from distressed parents and relatives seeking help after having been falsely accused by doctors of injuring their children are not uncommon. Viral and parasitic infections and vaccines cause an autoimmune disorder, Tissue Scurvy, misdiagnosed as child abuse. This report presents the evidence. Method. Relevant hospital and laboratory reports of three children were examined for evidence of Tissue Scurvy as the cause of the neurological lesions, fractures, bruises and haemorrhages found on them. Results. In all the cases in which appropriate histories and tests were done there was evidence that the doctors either misinterpreted the laboratory evidence or they were unaware of the significance of abnormal tests suggesting Tissue Scurvy as the cause. Conclusion. Some doctors are unaware of the pathophysiological processes of autoimmunity, haemostasis and osteogenesis and are misdiagnosing vaccine induced Tissue Scurvy, absence of Vitamin C within the cell, as Non-accidental Injury.

Keywords
Autoimmunity, Tissue Scurvy, Encephalomyelitis, Non-accidental Injury, Shaken Baby Syndrome

 

 

                                    --------------------------------------------------------------

 

 

                                                            Dr AL-SARRAJ

                                                Consultant Neuropathologist

Dr AL-SARRAJ provides a detailed account of the findings and concludes “the clinical history indicates presence of extensive bilateral retinal haemorrhages. These injuries, in addition to the presence of subdural haematoma and generalized ischemia (ischaemic encephalopathy) form the triad frequently seen in patients with non-accidental head injury. This is further supported by presence of subdural haematoma in the spinal cord, axonal injury in the pyramids of the medulla and axonal injury in the spinal nerve roots.

The presence of axonal injury in the pyramids and spinal nerve roots suggest head and spinal cord injury resulting from violent hyper-extension and hyper-flexion of the head and neck similar to those seen in shaking. The presence of extensive retinal haemorrhages supports this suggestion.

The pathological findings in the brain have to be considered closely with other findings of autopsy examination, radiological examination, eye examination and other investigations, before final conclusion. I will review the pathological findings in the brain and my interpretation if further information becomes available.

 

Conclusion

 Head and spinal cord injury consistent with non-accidental injury.

 

Comment

There is no conflict with Dr AL-SARRAJ’S findings but it is the interpretation of those findings which are disputed. He is evidently prepared to review his interpretation if further information becomes available and I draw his attention to the fact that Amelia had Biochemical as well as Anatomical lesions. The Biochemical lesions of Hyperglycaemia, Glycosuria, Coagulation Abnormality (INR 1,3, APTT 39.6) all suggest an Autoimmune Disorder –TISSUE SCURVY [1] which I am sure Dr AL-SARRAJ  is willing to consider.

Reference

1.Innis M D. Autoimmune Tissue Scurvy Misdiagnosed as Child Abuse, Clinical Medicine Research. Vol. 2, No. 6, 2013, pp. 154-157. doi: 10.11648/j.cmr.20130206.17

 

 

                                    Dr R E Bonshak

                        Consultant Ophthalmic Pathologist

 

Dr Bonshak gives a detailed account of the pathological changes seen in the eye when exposed to infection and injury and concludes “non-traumatic  injuries which might possibly cause this form  and extent of pathology include severe coagulopathy (bleeding disorder) leukaemia (with coagulopathy) septicaemia(with coagulopathy) meningitis(with coagulopathy)and catastrophic intracranial bleeding. I am not aware that these conditions have been identified”. 

 

Comment

The Hospital Records and Pathology Report of Amelia clearly showed:

1. INR (International Normalized Ratio)  1.3 (Normal Range added by me 2 - 4.5)

2. APTT(Accelerated Partial Thromboplastin Time) 39.6 sec(Normal added by me 27-35 sec)

 

Having been a Haematologist in a Teaching Hospital I HAVE REPORTED ON MANY THOUSANDS OF HAEMATOLOGICAL RESULTS. These results indicate that a Coagulopathy is present due to the reduction in the Clotting factors XII, XI, IX, and VIII and spontaneous bleeding is inevitable. It also indicates that the Liver is damaged because these factors are formed in the Liver.   

 

Dr Bonshak has the evidence of a coagulopathy he requires to conclude  “non-traumatic  injuries which might possibly cause this form  and extent of pathology ”.

 

 

Conclusion

Darryl Elliot has been found guilty of murder on the evidence of doctors not competent in interpreting the Haematological evidence which clearly indicated a Coagulopathy caused the death of Amelia Bowmar.  

 

Prior to migrating to Australia I I was one of the Pathologists working for the Coroner in The West Riding of Yorkshire.

 

 declare that I have not made any statement that I know to be untrue.

 

Michael D Innis MBBS; DTM&H; FRCPA; FRCPath

Reference

1. Michael D Innis. Autoimmune Tissue Scurvy Misdiagnosed as Child Abuse. Clinical Medicine Research. Vol. X, No. X, 2013,

 

Darryl’s letter sent to me from his prison cell

amelia had her mmr vaccine on may 23rd 2012, part from the nausea she experienced for a few days, how subtle would the vaccines have been in regards to any futher illness, 4, if amelia collapsing was due to the reaction from the mmr vaccine, would my accident of dropping her heighten the risk to her.5, if amelia had any blood disorder that caused het to bruise easily, would ( in the words of the crown prosecution) my vigorous and violent shaking  have brought on any external bruising to her upper torso,6, did my panic and subsequent shaking cause amelia more harm.7 I didnt mention to the hospital that I had shaken amelia in panic, if I had told them sooner, could it have save her life.8, medical experts did not believe my version of events, they dont beleive amelia could have entered into the condition I found her in, unless she was involved in some kind of severe head trama or nai, I beleive you have my version of the events, could you offer any explanation as to why amelias conditon turned so rapidly. 9 amelias scan at grimsby showed no abnormalities to a trainee radiologist, however, at sheffield the next day a trained radiologist saw severe abnormalities, from 18.30 on the 29th july to 10.30 on the 30th, drs didnt know about anything going on in amelias brain until a 2nd scan was done at 13.30 due to amelias pupils being a different size, how much could have gone on in her condition between 18.30 and 13.30, that the drs didnt see, would more seizures in this period of time have caused more damage to her brain, why was a trained radiologist not available in such a life threatening situation, 10, we was told they was checking for meningitis, diabetes, metabolic conditions, what else should have been explored? And if it wasnt explored, why wasnt it,11, the coagulation condition you found, how long did amelia have it, how would it or should it have been spotted, and how did it affect amelias condition, before and after she collapsed.12, what could have caused her levels of glucose to elevate and why wasn’t it spotted.13, what did glucose in her urine represent, what effect would it have had on amelia,14, plunketts report is now 14yrs old, has there been any other short fall fatalities since then. Finally, was amelias death my fault,Thank you for taking so much time out to try and answer my questions, thank you also for helping me in my struggle to clear my name, I loved  my daughter and never unlawfully harmed her in any way, not would I ever.myself and my family are truly grateful for the work you are doing for myself and amelias mum and family, they need the truth just as much as me, many thanks dr innis I am truly grateful. Darryl elliott, dated 12/03/2014”