Flagship Journal

Smeeta Sinha National Clinical Director for Renal Medicine, NHS England, UK; Consultant Nephrologist, Northern Care Alliance NHS Foundation…

After being diagnosed with cancer, patients embark on a journey that involves ongoing treatments, and regular visits to healthcare…

Patients with chronic kidney disease (CKD), especially those on chronic haemodialysis (HD), have a higher incidence of nosocomial…

Multiple myeloma (MM) is a disease characterised by the clonal expansion of malignant plasma cells in the marrow, leading to anaemia…

Sickle cell disease (SCD) is a genetic condition caused by mutations in the haemoglobin (Hb) gene, resulting in various complications. One…

HIV is an epidemic in Kenya. Females living with HIV (FLHIV) have an eight-fold increased risk of a pregnancy-related death compared to…

I am interested in family medicine and primary healthcare because primary healthcare is the first gatekeeper in the community…

Mycobacterium tuberculosis causing glomerulonephritis (GN) is a rare occurrence, and its association has been seldom reported…

IgAN, which can lead to CKD and kidney failure, is the most common form of primary glomerulonephritis, predominantly…

Many patients experience impairment following a stroke, including motor or cognitive impairment, urinary incontinence, dysphagia…

First described by German physician Peter Emil Becker in the 1950s, Becker is an X-linked genetic recessive disorder. Like Duchenne…

Methotrexate is a common first-line treatment for rheumatoid arthritis, yet its widespread and habitual usage often leads physicians…

While awareness of the issues facing women leading up to, during, and following the menopause has increased in recent years…

Renal cell carcinoma (RCC) is the most common primary tumour originating from the kidney, and accounts for more than 90% of all renal…

Obesity is a major risk factor for the development of Type 2 diabetes (T2D), with the prevalence of both increasing in a parallel manner…

The optimal dressing is still unclear, despite hypospadias being one of the most prevalent surgical operations. Children’s dressing for…

A spontaneous subcapsular hepatic haematoma (SHH) is both a rare and potentially life-threatening condition. Although the pathogenesis of…

One of the many extra-hepatic manifestations of hepatitis B virus (HBV) infections is vasculitis. While the classic HBV-associated…

Obesity, defined as a BMI greater than or equal to 30 kg/m2, is a condition with rising incidence around the world that contributes…

When I started out way back in the 1980s, addiction was predominantly dealt with by psychiatrists in hospitals, psychiatrists…

Leprosy, also known as Hansen’s disease, is a chronic granulomatous infection. It is non-fatal and slowly progressive. Its causative…

This continuing medical education-accredited symposium, held at the 2023 International Society for Thrombosis and Haemostasis (ISTH)…

The deficiency of arylsulfatase A due to the mutations in the ARSA gene is the cause of a rare inherited lysosomal storage disease…

With a pre-specified aim of improving the standard of care of those living with intermittent catheter use, a roundtable discussion led by…

The climate crisis is a health crisis that has the potential to cause significant morbidity and mortality to human populations…

It is essential to address psychological health, particularly post-traumatic stress disorder (PTSD), among patients who have recovered from…

The first thing is probably the holistic approach to care. Primary care provides care for people for a large part of their life…

Obesity has become a serious public health issue worldwide, with its prevalence steadily increasing. The potential consequences of this…

Vitiligo is an autoimmune disorder characterised by the loss of melanocytes, resulting in white, depigmented cutaneous macules…

This study examines the interrelationships between macroeconomic factors, inflation and vaccination rates, and ranks countries’ efficiency in combating the pandemic based on their health-economic factors.

There are two major categories of lung functional disorders, including restrictive and obstructive lung diseases. Restrictive lung disease…

I undertook my university courses at University Hospitals, and at several other hospitals in Belgium, but I also had some training in…

Tuberculosis (TB), rightly referred to as an ancient disease, has affected humans for thousands of years, the first drafted reference…

My interest in cancer research was sparked during my experience in the Undergraduate Research Opportunity Program (UROP) as an…

Chronic kidney diseases (CKD) are very prevalent in Central America, particularly in El Salvador. Mesoamerican nephropathy (MN) is a CKD diagnosis that almost exclusively affects young male agricultural labourers.

This review of the ‘Elevating Aesthetics’ symposium held at the International Master Course on Aging Science (IMCAS) 2023 shares insights…

Any haemoptysis exceeding 100 mL/hr, causing abnormal gas exchange/airway obstruction or leading to haemodynamic instability is defined as life-threatening or massive haemoptysis…

Lupus enteritis is a rare and poorly understood cause of abdominal pain in patients with systemic lupus erythematosus (SLE)…

A spectrum of various pathophysiological processes associated with a progressive worsening in estimated glomerular filtration rate (eGFR)…

Carbapenem-resistant Enterobacteriaceae (CRE) is defined as Enterobacteriaceae that are resistant to the carbapenem group of antimicrobials.

Cutaneous squamous cell carcinoma (SCC) contributes to 20% of non-melanoma skin cancers and early diagnosis is vital to reducing…

Initially, I was student in endocrinology; however, after some years, I understood that the holistic approach to complex patients…

General practices in the UK are under immense pressure. Research has been conducted on the complexity of current consultations ​and the use of electronic consultations…

I was inspired to go into geriatric medicine in the late 1980s and early 1990s, when I was a registrar in medicine in Newcastle, UK. I worked with some truly inspirational geriatricians at the time, which I think was a major factor in my decision.

Iron deficiency anaemia (IDA) is a global health problem affecting both developing and developed countries, particularly in Asia. Nutritional deficiency, menstrual blood loss, and chronic gastrointestinal blood loss are the common causes of IDA.

Severe asthma (SA), chronic rhinosinusitis with nasal polyps (CRSwNP), and eosinophilic granulomatosis with polyangiitis (EGPA) are three conditions driven by IL-5 and eosinophilic inflammation. As these conditions have high use of healthcare services, as well as lifestyle and psychological burdens, well-tolerated treatment to achieve optimal control is key.

Setting the scene, Bakris defined CKD as a reduction in kidney function (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2), alongside the presence of albuminuria (≥30 mg/day) as an indication of kidney damage.

Chemotherapy-induced neutropenia is a frequent, severe, adverse haematological complication of myelosuppressive and immunosuppressive cytotoxic chemotherapy treatment.

An estimated 65 million people worldwide have moderate or severe chronic obstructive pulmonary disease (COPD), an umbrella term used to describe a group of progressive lung diseases that obstruct airflow such as emphysema and chronic bronchitis. Smoking contributes to an estimated 90% of COPD cases, as the harmful chemicals produced during tobacco combustion damage the lungs and airways. Although smoking cessation is the only intervention shown to improve COPD prognosis in smokers, many patients who try to quit continue to smoke.

Metabolic acidosis is characterised by a primary decrease in the serum bicarbonate concentration, a secondary decrease in the arterial partial pressure of CO­2, and a reduction in blood pH. Metabolic acidosis, acute or chronic, may have deleterious effects on cellular function and cause increased morbidity and mortality.

Dr Imran Ahmad. Consultant Anaesthetist and Deputy Clinical Director for Theatres, Anaesthetics and Peri-operative Medicine, Guy’s and St Thomas’ NHS Foundation Trust, UK; President, Difficult Airway Society (DAS); Honorary Clinical Lecturer, King’s College London, UK.

Measurement of fluid biomarkers of neurodegeneration is an emerging approach offering improved diagnostic accuracy of neuropsychiatric conditions, particularly for atypical presentations. This article reports a case where the diagnosis of delirium with dementia was revised based on biomarker analysis, enabling treatment of a primary mood disorder with resolution of recurrent disabling psychiatric symptoms.

Peter Gill | Staff Paediatrician and Associate Scientist, The Hospital for Sick Children and SickKids Research Institute, Toronto, Canada; Assistant Professor, Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Canada

Damian Roland | Head of Service, Children’s Emergency Department, Leicester Royal Infirmary, UK; Honorary Professor, Population Health Sciences, University of Leicester, UK

In the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), Alzheimer’s disease (AD [named after the German psychiatrist and neuropathologist, Alois Alzheimer, who first described it]), is considered as a major or mild neuro-cognitive disorder…

Chronic pelvic pain (CPP) affects up to 25% of females of reproductive age, and 15% of all females worldwide. It is a common complaint of females visiting the gynaecology outpatient department.

This case report aims to unveil the possible differentials and processes involved in the diagnosis of marantic endocarditis…

Caseous mitral annular calcification (CMAC), sometimes called liquefaction necrosis of mitral annular calcification (MAC), is a rare variant of MAC, a chronic degenerative process that progresses with age.

Primary hypothyroidism is a frequent presentation in primary care, and is treated with levothyroxine sodium tablets once daily in the morning in the fasting state.

Polyacrylamide hydrogel (PAHG) Bulkamid® (Axonics, Irvine, California, USA) was introduced in Europe as a promising periurethral bulking agent for the treatment of female stress and mixed urinary incontinence in 2006.

The harmful effects of cigarette smoke on human health are well documented and supported by evidence from preclinical, clinical, and epidemiological studies. Cigarette smoking damages multiple organs and leads to 8 million global deaths per year from direct use and passive exposure of cigarette smoke to non-smokers.

Dysphagia is defined as “any disruption to the swallow sequence that results in compromise to the safety, efficiency, or adequacy of nutritional intake.” Dysphagia may have an oropharyngeal or oesophageal cause, resulting in delayed transit of liquids or solid food from the mouth to the stomach.

Fox emphasised that PD is one of the fastest-growing neurological disorders. Disability and deaths related to it have more than doubled from 1990–2015. Its prevalence is expected to grow exponentially by 2040, affecting approximately 12.9 million individuals worldwide.

People with migraine, and individuals with other neurological conditions, have suffered in multiple aspects during the COVID-19 pandemic. This paper will discuss the factors that impacted the neurology department.

NDM includes a group of rare hereditary neuromuscular disorders caused by mutations in the genes that encode sodium or chloride muscle channels.1 Myotonia is the hallmark symptom of NDM and presents as muscle stiffness, often associated with pain, fatigue, and weakness, which can limit function.

Adult-onset idiopathic focal dystonia is the most common type of primary dystonia, and adult-onset idiopathic cervical dystonia (AOICD) is its most prevalent phenotype.

This clinical treatment modality was applied to 62 diabetic ulcers on lower extremities for which surgeons had been advised amputation.

This review focuses on the state-of-the-art EGFR-TKIs in the treatment of metastatic NSCLC…

Thrombocytopenia (TCP) is the second most common haematological finding in pregnancy next to anaemia. It carries a risk for both the mother and the fetus, associated with substantial maternal or neonatal morbidity and mortality. However, a specific therapy, if instituted promptly, improves the outcome for affected patients and their offspring. In patients in India, TCP during pregnancy is an underexplored condition.

To the authors’ knowledge, only two cases of gastric gastrointestinal stromal tumours after Roux-en-Y gastric bypass have been reported in medical literature, it is an extremely rare condition to occur after bariatric surgery…

Since the detection of the first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant causing COVID-19 infections in South Africa in November 2021, there have been a few population-based reports to suggest that the clinical severity and presentation of this variant is different to previous COVID-19 surges.

Metabolic syndrome (MetS), also known as an insulin resistance syndrome, has been related to higher blood pressure outside of the normal range, insulin resistance, and increased fasting glucose levels.

A 54-year-old male tested positive in late February on a screening COVID-19 test performed after a family member’s test had become positive. A few weeks later, they presented to the emergency room at a different hospital centre with shortness of breath and fever.

Abnormalities of the umbilical cord are very common in pregnancy. These include marginal insertion, velamentous cord insertion, umbilical cord true knot, umbilical torsion, and many more.

Osteoarthritis (OA) is the fastest growing cause of disability worldwide, but, with few proven therapeutic options, it is an underserved condition. With increasingly ageing populations contributing to a rising global prevalence, this unmet need only threatens to worsen in the coming years.

At least 60% of females worldwide will experience at least one UTI in their lifetime.4 An array of pathogenic bacteria, both gram-negative and gram-positive, can cause the infections, although in uUTIs, Escherichia coli (E. coli) is the predominant pathogen.

Hospitalisation rates for acute bacterial skin and skin structure infection (ABSSSI) are rising and represent a large pharmacoeconomic burden as treatment may involve an extended number of days of antibiotic therapy.

Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder with an incidence of 1 in 3,000–5,000.

Kakkar opened the symposium by highlighting the burden of thrombotic disease in patients with cancer with a discussion of data from the Global Anticoagulant Registry in the FIELD – Venous Thromboembolism (GARFIELD-VTE) registry.

Despite therapeutic advances, the prognosis of non-small cell lung cancers (NSCLC) is still very poor, especially when first diagnosed at later stages involving metastases. NSCLC classification can be aided by identifying genetic, molecular, and histological subtypes that are important biomarkers in treatment selection. The majority of targeted therapies are now first-line treatment options for eligible patients with advanced stages of NSCLC.

Chronic kidney disease (CKD) is a progressive condition that can lead to kidney failure and the requirement for renal dialysis or transplantation. Early-stage CKD is often missed because the disorder is initially asymptomatic; hence, many patients with CKD already have symptomatic advanced disease (Stages G4–G5) at the time of diagnosis. This is an important issue because the drugs available for the treatment of CKD are most effective when given during the early stages of the disease (Stages G1–G3).

Patients can present with chief complaints and symptoms that differ from the eventual diagnoses. The differences between aetiologies versus complications must be appreciated through careful evaluation and use of clinical investigations, laboratory testing, trial of hypotheses, and clinical gestalt.

Yann Le Cam Chief | Executive Officer, EURORDIS-Rare Diseases Europe. The conference happens every 2 years and the purpose is to formulate strategies at a national, international, and European level. The conference also provides an opportunity to look at legislative and non-legislative policies and learn about the latest research. The scope is broad, covering the entire spectrum of rare diseases.

Neratinib was developed as an irreversible catalytic inhibitor of ERBB2, which also acts to inhibit ERBB1 and ERBB4. Neratinib is U.S. Food and Drug Administration (FDA)-approved as a neo-adjuvant therapy for use in HER2+ breast cancer.

Multisystem inflammatory syndrome (MIS-C) is a challenging disease associated with COVID-19. Clinical manifestation of MIS-C may mimic many endemic illnesses of tropical and subtropical countries, making early diagnosis more difficult.

Diencephalic syndrome (DS), first described by Russell in 1951, is a rare cause of failure to thrive in infants and young children with preservation of linear growth.

THE IMPACT of climate change is clear, urgent, and formidable, with the effects of climate change on health an immediate threat to…

GLOBALLY, hospital-based care has a substantial ecological footprint. In the USA, the health sector generates approximately 10% of the…

Any filler injection requires a bespoke treatment approach and a thorough anatomy knowledge to minimise procedural risks and achieve…

Worldwide, tobacco use causes more than 7 million deaths every year, a death toll that could increase to 8 million by the end of the…

Grant Blashki- Associate Professor, Nossal Institute for Global Health, University of Melbourne, Victoria, Australia; Adjunct Associate Pr…

Karly Hampshire Medical Student, University of California, San Francisco, USA; Founder and Co-director, Planetary Health Report Card; Fell…

Clinical laboratories worldwide are implementing next-generation sequencing (NGS) to identify cancer genomic variants and ultimately…

Objective: Describe CT and MRI features of the lymphoepithelial cyst (LEC) of the pancreas.Methods: The authors identified 13 cases…

This article reviews the impact of CINV, the emetogenic risk associated with different chemotherapy regimens in solid tumours and haematologic malignancies, and guideline-based recommendations for antiemetic prophylaxis according to emetogenic risk.

Hypertriglyceridaemia pancreatitis (HGTP) accounts for 1–35% of acute pancreatitis (AP) cases.1 Acute pancreatitis is an acute…

Atopic dermatitis (AD) is the most common inflammatory skin condition, affecting 11–20% of children and 5–10% of adults…

Heart Failure and Heart Failure with Preserved Ejection Fraction prognosis in relation to treatment with SGLT2 inhibitors…

A 55-year-old African American female presented to her primary care physician (PCP), complaining of fatigue, dehydration, decreased…

Varicella Zoster reactivation and cutaneous reaction as a mRNA vaccine side effect following COVID 19 vaccination…

David Oliver shared his thoughts with EMJ on his leadership and policy experience, his passion for advocacy in healthcare, and his work in…

TWO YEARS AGO, the COVID-19 pandemic emerged and swept through the world, going on to have a profound human and health toll…

COVID 19 was first identified in late 2019 and led to a worldwide pandemic. Covid complications include thromboembolic storm…

It is clear that the delivery of advanced healthcare prolongs life. The global average life expectancy has almost doubled since 1900…

Patients with COVID 19 with associated myocardial infarction and myocarditis, requiring myocarditis treatment…

Diabetes is one of the most common chronic conditions. It affects a global population of approximately 425 million. The prevalence…

Anti-TNF drugs, adalimumab and infliximab are treatments for inflammatory bowel diseases (IBD), Chron’s disease, ulcerative colitis…

Long-term survivors of lymphoma frequently suffer relapses, such as Ewing’s sarcoma, following radiotherapy and chemotherapy…

Acquired Epidermodysplasia Verruciformis is a rare entity associated with immunodeficiency, such as kidney transplant patients…

Chronic obstructive pulmonary disease (COPD) is a multifactorial lung inflammatory disease that affects 174 million people worldwide, with…

Prediabetes is a state of hyperglycaemia, impaired glucose tolerance, and is associated with weight loss often preceding Type 2 Diabetes…

Allergy development is a complex process and depends on numerous factors, including postnatal influences, that guide the immune system…

NF1 is an autosomal dominant disorder, arising from a mutation in the gene that encodes neurofibromin. It is a tumour-predisposing…

The recent COVID-19 pandemic is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and, since its…

The therapeutic technique of endoscopic retrograde cholangiopancreatography (ERCP) has evolved as a therapeutic endoscopic technique for…

Cephalosporins, a family of bactericidal antibiotics, have side effects like penicillin due to the similarity in their basic structure…

Over the past few decades, there have been important advances in cancer therapeutics, including a shift from traditional cytotoxic…

This symposium considered the role that AI may play in the future management of patients with IBD. Firstly, Gionata Fiorino…

Despite the extensive body of evidence demonstrating the risks of tobacco, many people continue to smoke. Medical science…

The 12-lead ECG has long played the leading role in identifying the region of the heart responsible for tachycardia…