Rhabdomyolysis complicating the antepartum or peripartum period is not a commonly reported finding and where they occur, it can be life-threatening. The problem with rhabdomyolysis during pregnancy or labour is the potential harmful systemic and local effects it can cause. These includes cardiac arrhythmias, acute kidney injury, clotting problems in severe cases [1]. To the fetus, foetal distress or foetal demise could be the end-result where timely management is not initiated [2].
Familial hypocalciuric hypercalcemia is a rare clinical condition of persistently elevated serum calcium and reduced urinary calcium levels with an autosomal dominance inheritance pattern to the three out of four large types of this condition known. This rare condition goes largely undiagnosed as patients are largely asymptomatic and where symptoms are present, other causes of hypercalcemia are considered first. Hyperparathyroidism, super-imposing on FHH, is an even rarer occurrence. We present the case of an adult male with an initial provisional assessment of FHH, which was later confirmed with a genetic study. He went on to develop hyperparathyroidism (with evident enlarged parathyroid glands on Sestamibi parathyroid scan done, and an eventual histologic diagnosis of parathyroid adenoma after surgery). It remains to be established if this is an incidental occurrence or if there is a causal relationship between FHH and an onward development of parathyroid hypertrophy or adenoma(ta).
Handover is a high-risk exercise. As the number of doctors in hospitals vary between shifts, continuity of care must be secured from many professionals down to a few. Literature has repeatedly shown that handover time is when the greatest number of medical errors occur [1]. Tasks may be inefficiently handover over, mis-represented or forgotten entirely. We have shared perspectives from a quality improvement (QI) project undertaken at the William Harvey Hospital, Kent, United Kingdom towards ensuring safe and smooth handover of medical tasks between shifts at the acute medical department in this hospital.
Processes and procedures in intensive care units and during anaesthetic delivery are centered around ensuring patient safety. This article aims to shed light on a rare possible mechanism for inadvertent iatrogenic hypoglycaemia as can affect critical care specialists or anaesthetists in the line of service delivery and recommendations have been suggested.
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