Buttock necrosis following uterine artery embolization: A case report.

INTRODUCTION AND IMPORTANCE: Fibroid is a very common benign tumor of the uterus for which uterine artery embolization is one of the treatment modalities of choice. Uterine artery embolization (UAE) is a minimally invasive procedure used in the management of fibroids, nowadays mostly performed by interventional radiologists. A rare complication of the procedure is buttock necrosis which has been observed in this case. If not identified at an early stage, it may result in extensive damage to a large surface area of the skin hence this case report is of clinical relevance as it is essential to be aware of the complications of UAE and be cautious. CASE PRESENTATION: Our report is regarding a 37-year-old female who presented to the emergency department with a gradually increasing excruciatingly painful lesion on the left buttock 12 days after undergoing a uterine artery embolization. Examination revealed a necrotic lesion involving 40 % surface area of the left buttock. CLINICAL DISCUSSION: There are a few other such cases reported in literature. All these cases, including ours, prove that buttock necrosis is an established complication which is highly possible following uterine artery embolization. This complication is likely due to reflux of embolic material into gluteal artery. CONCLUSION: This case warranted extensive debridement and plastic surgery referral for skin grafting. Although a rare scenario, being a dangerous and distressful one for patients, ability to recognize this complication at an early stage will aid in the management and mental well-being of the patient.

Stress and Inflammatory Bowel Disease: Clear Mind, Happy Colon.

Inflammatory bowel disease (IBD) is a condition whose prevalence in the general population worldwide is increasing at an exponential pace. Many risk factors affect the incidence, progression, and overall outcome of IBD, one of them being psychological stress. This study examined the relationship between psychological stress and inflammatory bowel disease. A search for relevant studies was conducted using PubMed, Google Scholar, ResearchGate, and SCOPUS. A systematic review was conducted on the relevant articles after critical appraisal. This article mainly focused on studies that evaluated the presence of inflammatory markers observed in individuals who have been diagnosed with IBD and have high levels of psychological stress. It also assessed if lowering an individual's psychological stress could help improve the outcomes of IBD. Psychological stress can have a detrimental effect on individuals diagnosed with IBD. There is a need to conduct studies that can further confirm the association between psychological stressors, mental health conditions, and IBD. We should also encourage medical practitioners to educate patients who have been diagnosed with IBD regarding the benefits of stress reduction.

Is Isotretinoin in Acne Patients a Psychological Boon or a Bane: A Systematic Review.

Acne vulgaris is a frequently encountered dermatological condition in clinical practice. Isotretinoin is one of the drugs prescribed for this condition. However, it is unclear whether the use of this drug worsens or improves the psychological effects in an acne patient and whether it is advisable to use this drug commonly. This systematic review aims to assess the relationship between Isotretinoin and psychiatric side effects in acne patients. A literature search was conducted using PubMed, Cochrane, and Google Scholar databases in accordance with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Articles published within the last 10 years were taken into account and a review was conducted on the relevant articles after critical appraisal. Nine studies were finalized for discussion and out of the nine studies, two studies concluded that Isotretinoin could cause psychiatric effects. Five studies showed no association between them. Two studies unexpectedly found that psychiatric symptoms improved because of Isotretinoin use. Lack of adequate sample size and absence of randomized controlled trials are the limitations of this study. To conclude, Isotretinoin can be prescribed as a treatment option for severe acne despite some evidence of link with psychiatric effects. However, bearing the side effects in mind, a detailed evaluation before initiating the drug and a thorough monitoring while using the drug should be done as a standard practice in order to be on the safer side.

Doxycycline Therapy for Abdominal Aortic Aneurysm: Inhibitory Effect on Matrix Metalloproteinases.

Abdominal aortic aneurysm (AAA) is a life-threatening condition associated with smoking, aging, atherosclerosis, and destruction of the connective tissue in the abdominal aortic wall. Disturbances in the synthesis and degradation of matrix metalloproteinase (MMP) have been known to contribute to the development of AAAs. The only available treatment of AAA is surgical repair. Doxycycline, a tetracycline analog, is thought to have an inhibitory effect on MMPs. Knowing the effect of doxycycline, there may be some favorable effects of the drug to reduce the growth of small AAAs and avoid the need for invasive treatment. This article aims to determine the relationship between doxycycline and the MMPs to prevent the growth of small AAAs. We conducted our review using online resources such as PubMed, Google Scholar, The Journal of Vascular Surgery, and ResearchGate. The result of our study supports the effect of doxycycline in preventing the growth of small AAAs. We conclude that therapeutic treatment with doxycycline in patients with small AAAs can prevent the growth of aneurysms, life-threatening aneurysm rupture, and reduce the need for expensive, invasive treatment.