Acute onset quadriparesis can be a manifestation of a variety of neurological and metabolic conditions. We report the case of a 47‐year‐old alcoholic gentleman who presented with acute onset weakness of all four limbs associated with hypokalemia and very high blood glucose (hyperosmolar nonketotic diabetes—HNKD) detected for the first time. He was confirmed as having type 2 diabetes (detectable insulin and C‐peptide levels) and his quadriparesis completely resolved on potassium replacement and treatment with insulin. HNKD is discussed along with the possible mechanisms of hypokalemia in this patient presenting with reversible limb weakness as an initial manifestation of type 2 diabetes. Copyright © 2002 John Wiley & Sons, Ltd.

There is insufficient evidence to support the routine use of endotracheal adrenaline in patients with respiratory arrest secondary to asthma.

tantalisingly useful literature not readily available in any British library, from such titles as the Indiaii ]ooroal of Oplhthalniology or J7ounmal of tze Teoenessee Medical Associatioo. Photocopying? Marvellous invention! Never has so much been copied by so many but, I suggest, used by so few. Beware the siege mentality that requires a copy when, previously, reading, digesting, and a few notes would have sufficed. Copyright? Hideous piece of legislation, but, sadly, ours was the lone voice against it as it went through parliament and we are left with the unenviable task of making its impracticalities work. As for licences, Drife is presumably referring to higher education: negotiations between the Copyright Licensing Agency and the NHS broke down long ago and we remain bound by two legal principles-namely, one-person-one-copy for self service copying and one signed declaration form for every copy made on behalf of a reader by library staff. We do not like these restrictions or the extra paperwork they create either, but we have no choice.

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