ABSTRACT
Stroke is more common in older patients; when it occurs in younger persons the causes may be slightly different. If adequately investigated, a cause can be ascertained in significant proportion of younger patients with stroke. Dissection of the internal carotid artery is an important cause of stroke in this age group and probably accounts for about 20% of cases. An association with elevated plasma homocysteine has been previously reported. We report a case of spontaneous internal carotid artery dissection associated with raised plasma homocysteine in a twenty-two year old, previously healthy man.
ABSTRACT
Percutaneous endoscopic gastrostomy (PEG) has become a widely practised procedure to maintain long-term nutrition in patients with a variety of medical conditions. Incidence of infection and the usage of prophylactic antibiotic continue to remain an area of debate. Guidelines in gastroenterology on antibiotic prophylaxis published by the British Society of Gastroenterology recommend the use of prophylactic antibiotic prior to placement of PEG tube (1). There has been an alarming rise in the incidence of MRSA, which has jumped from a reported 2% in 1992 to about 42% in 2001 in England & Wales. Use of antibiotic may lead to emergence of MRSA in debilitated patients requiring PEG feeding. This audit addresses some of the problems encountered in a small district general hospital.
