Doctors have no ethical obligation to provide futile treatment. This has been true since the time of Hippocrates who warned physicians not to treat patients who were “overmastered by their disease.” This principle remains valid today but, as the Society for Critical Care Medicine notes, it is difficult to identify treatment as absolutely futile in all but a few clinical situations. Far more com...

ous couple (first cousins once removed) of Italian ancestry. The family history was unremarkable and the pregnancy had been uneventful. Clinical examination showed marked micrognathia, a normal neck and trunk, and shortening of all four limbs, the lower being more severely affected than the upper. The shortening was progressive, from proximal to distal, the fingers were bud-like (fig 2), the lo...

Objective: The authors report a rare case of giant thoracic meningocele causing acute respiratory compromise, treated with a ventriculoperitoneal shunt. Case Report: We report the case of a 36-year-old with severe scoliosis status post repair over a decade ago, neurofibromatosis type I, and a known large meningocele in the left thoracic cavity, presenting with new acute respiratory compromise. ...

Wilson’s disease aka progressive hepatolenticular degeneration is an unwonted genetic disorder of copper metabolism. Though its pathogenic inception lies within the hepatobiliary system, the brunt of relentless copper accretion is borne across a multisystemic terrain. The complex symptomatology of this syndrome mandates a high index of suspicion as left undiagnosed it has a tenacious progressio...

A 66-year-old male ex-smoker with hypertension, type 2 diabetes mellitus and dyslipidaemia was admitted due to a non-ST segment elevation myocardial infarction. The catheterisation depicted an extensive and calcified disease: chronic total obstruction of the right coronary and severe disease with a giant aneurysm at the first marginal branch as the culprit vessel. After discussion, the right co...