Prostate cancer accounts for 13% of all new cancer diagnoses in the UK. Urosymphyseal fistulas are a rare complication that can occur post-radiotherapy and surgery for prostate cancer. Patients often present with non-specific symptoms such as suprapubic tenderness, poor mobility, recurrent urinary infections, and difficulty passing urine. These can be difficult to diagnose clinically and extremely problematic and debilitating for patients. The management of these patients is often complex and requires input from urology, orthopaedics, and microbiology. At present, there are no clear guidelines for diagnosing these conditions. Recommended investigations include blood tests, urine culture, and imaging. The preferred imaging modality is pelvic MRI. This article explores three rare cases of such complications and the classic imaging findings on CT and MRI to aid the diagnosis of urosymphyseal fistula.
Introduction: Fat necrosis can occur in any area rich in fatty tissue. It occurs due to aseptic saponification of the fat by lipases. The most common site of it is the breast. Case Presentation: This article reports the case of a 43-year-old woman that came into the orthopedic outpatient department with a history of two masses, one on each buttock. The patient had a history of surgical excision of adiponecrotic mass from the right knee a year back. All the three masses appeared around the same time. Ultrasonography was done to surgically excise the left gluteal mass. The histopathology of the excised mass then confirmed subcutaneous fat necrosis. Discussion and Conclusion: Fat necrosis can also be found in the knee and buttocks, and that too without any definite etiology. Imaging and biopsy can help with the diagnosis. It is necessary to familiarize oneself with adiponecrosis so as to differentiate it from other grave conditions that it mimics, such as cancer.
Background: Iron deficiency anemia (IDA) is described as decrease in the hemoglobin and/or the amount of red blood cells in the blood due to iron insufficiency in the body. The aim of the study was to measure the efficacy and tolerability of iron sucrose in iron deficiency anemia in pregnant women.Methods: This was the prospective study of 50 pregnant women with iron deficiency anemia (Hb- 5 g/dl to 8 g/dl) between 20-34 weeks of gestation, who were given intravenous iron sucrose as per their requirements and follow up measurement of Hb was done.Results: Mean rise in Hb was seen by 2.2 g/dl. Minor side effects were seen in 6 out of 50 participants. Conclusions: Parenteral iron sucrose therapy can be used effectively and safely in pregnant women with iron deficiency anemia
We read with great interest the article by Haider et al which provided an insight into using Multiple Mini Interviews (MMI) as an assessment method at medical school. 1 We appreciate the author's effort and as UK medical students who have participated in both MMI & traditional interviews, we would like to share our opinion.Haider et al reported that 75% of candidates and 95% of assessors preferred MMI to traditional interviews. 1 Whilst all interviewers had an experience of traditional interviews, it would have been beneficial to have data regarding how many candidates had previous exposure to traditional interviews. For many candidates, the MMI may have been their first-ever interview. As a result, we believe it makes it difficult to compare the two interview methods in this study. We recommend including a traditional interview station along with MMI stations to allow comparison.Furthermore, whilst it is completely acceptable to include only MMI or standard interviews as part of the selection process, we believe a hybrid model as highlighted by Zaidi et al will be more beneficial to implement initially. 2 This can address concerns highlighted by students such as not enough time to discuss particular issues in detail and fast-paced questioning. Moreover, whilst MMI allows students to showcase their well-roundedness, it only provides a snippet of the candidate's personality. Traditional methods allow an in-depth understanding of the individual.Additionally, Bing-you et al mention certain steps that should be considered when implementing MMI such as rigorous training for faculty before implementation and contingency plans which have not been addressed in this study. 3 This is crucial due to the complexity of MMI and can help deal with unforeseen circumstances in the future.Finally, one of the issues highlighted by the interviewers was the length of MMI stations. 1 We recommend having 5-7 mins stations instead of 9 mins. This is something we have experienced during our MMI at UK medical schools. It has worked very well however the questions and phrasing need to be carefully selected. The study did not mention which questions were asked in the eight stations and it would have been useful to have this information.To conclude, we appreciate this study highlights the reliability and acceptability of MMI as an assessment method. The findings are important, and we have Correspondence: Dharti Patel
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