Patients with Parkinson’s disease resort to complementary therapy and non-prescribed medication in the hope of improving their quality of life. In the US 40% of patients with Parkinson’s disease reported the use of at least one form of complementary therapy for Parkinson’s disease. Data for the UK are limited. A structured questionnaire was administered to consecutive patients attending a Parkinson’s disease clinic. Patients were excluded if they were cognitively impaired, if they were living in an institution, or if they declined to take part. The participants were asked about current and previous use of complementary therapy in general and Parkinson’s disease in particular and were presented with an extensive list of complementary therapies and non-prescribed medications. The response rate was 90% and 80 patients met the inclusion criteria. Fifty four per cent (n=44) reported the use of at least one form of complementary therapy or non-prescribed medication either for Parkinson’s disease or for some other indication, of whom 31 (38.7% of the total sample) used it solely for the treatment of Parkinson’s disease. The most commonly used complementary therapies for Parkinson’s disease were massage (n=9) and aromatherapy (n=8). Non-prescribed medication was mainly used for indications other than Parkinson’s disease and the commonest drugs used were simple analgesics (n=7), cod liver oil (n=5), and multivitamins (n=4). The use of complementary therapy for Parkinson’s disease correlated significantly (Pearson’s r=0.44, p=0.01) with a younger age at diagnosis of Parkinson’s disease. Comorbidity correlated significantly with complementary therapy use for indications other than Parkinson’s disease (Pearson’s r=0.29, p= 0.01). The use of complementary therapy for Parkinson’s disease in this UK based clinic closely mimics that in the US. Non-pharmacological complementary therapy is mainly used for Parkinson’s disease, while non-prescribed medication is more commonly used for other indications.

Background and objective:Scurvy, caused by vitamin C deficiency, first described by Hippocrates, is known to many as ‘The Pirates’ Disease’. Although a disease rarely acknowledged in modern medicine, we present 2 cases of elderly gentlemen found to have scurvy, who improved significantly on treatment.Methods:This study presents a case report of 2 patients undergoing rehabilitation at Karin Grech Hospital in Malta, noted to have signs and symptoms of vitamin C deficiency. Vitamin C levels were found to be low and thus supplementation was administered.Results:After a few weeks, a significant improvement was noted in level of frailty, mood, bleeding tendency, and gum health.Conclusions:The modern doctor must keep this ancient disease in mind, as it presents insidiously with debilitating repercussions, particularly in older people who are at a higher risk. It is easily treatable once detected.

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This 75-year-old woman was woken by sudden-onset left-sided neck and shoulder pain. As she walked a few steps, her legs gave way and she collapsed. Her feet felt 'dead', with the right side feeling worse, and she felt pins and needles over both upper limbs. She had no headache, loss of consciousness, chest pain or palpitations. She had a past history of large joint osteoarthritis, cervical radiculopathy and essential hypertension. Two months previously, she had fallen to the ground while standing on a chair and had, in the process, hit the back of her head. She had suffered no immediate ill effects from this. She was on doxazosin, lisinopril and diclofenac. She lived alone and was normally fully mobile and independent.