Achieving optimal fluid balance for a patient undergoing major surgery, especially transplant surgery, has always been the lofty goal of peri-operative care,1 which often proves to be an elusive target. While keeping the patient well hydrated improves organ perfusion, being too generous with fluids can result in morbidity, such...

Hyperparathyroidism is well recognised as a clinical problem that has a myriad of presentation. The classical presenting symptoms of hypercalcaemia have been well documented but there is an even greater awareness that many non-specific symptoms like fatigue, depression and constipation are related to hypercalcaemia. This article is available only as...

Thyroid nodules are commonly seen in clinical practice. They can be detected by palpation in 5%1 of individuals and by ultrasound (US) in 19–68% of the general population.2 Most of them are benign, stable and asymptomatic, thus preferred treatments are usually non-invasive. These would include modalities ranging from percutaneous...

Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor antagonists (ATRA) are both well established drugs utilised to help retard the progression of chronic kidney diseases to end-stage renal failure (ESRF), either by reducing proteinuria or even reversing mild renal impairment and restoring normal renal function in some cases....

Paediatric choledochal cyst is an uncommon benign cystic dilatation of the biliary tree, and is more prevalent in Asia than in the West. Accepted treatment consists of complete excision of the cyst with bilio-enteric reconstruction. Left untreated, choledochal cysts can lead to significant morbidity and mortality, including spontaneous rupture,...