July

I enjoyed “Sixteen diseases not to miss in the office,” by Dr Ian L. Mitchell in the March issue of the BCMJ (2006;48[2]:84-85). Point number 7, regarding myocardial infarction, struck a chord with me as a practising emergency physician (EP). I absolutely agree with Dr Mitchell’s description and inclusion and wanted to add a point on the means of transportation to the local emergency department.

In his recent letter (BCMJ 2006;48:66), Dr Timothy Rowe took issue with my assessment of results of the controlled trial of a 20 µ-ethinyl estradiol oral contraceptive (OC) in perimenopause.[1] I stand by what I said: therapy with OC in perimenopausal women does not significantly improve hot flushes or quality of life.[2]

I noted with interest the title, “Sixteen diseases not to miss in the office” in the March BCMJ (2006;48[2]:84-85) and made a partial list of my own before reading this worthwhile article.

The top two on my list were celiac disease and hemochromatosis. These not uncommon conditions are easily missed.

—Donald Lang, MD
Courtenay

See responses to this letter

In Dr James Miles’ unreflective volley against complementary and alternative medicine (CAM), entitled “Snake oil revisited: For doctors’ eyes only” (BCMJ 2006;48[1]:20-21), he suggests that the entire world outside pharmaceutical and surgical therapies is “unscientific.” We believe this is not so.