Maternal confidentiality: an ethical,professional and legal duty

This paper will briefly discuss the duty of confidentiality from an ethical, legal, and professional perspective, especially maternal confidentiality where any analysis should consider the consequences for the patient, the fetus and the father. We will explain why patient confidentiality is considered vital and delineate the ways in which the General Medical Council and the laws of England and Wales protect the rights of patients to privacy. We will also discuss situations where breaches are permissible or mandatory and remind clinicians of traditional challenges that exist in trying to maintain patient privacy. We will consider the issue of confidentiality in the age of the internet.     

Assessment of depression and anxiety in adult cancer outpatients: a cross-sectional study

Background  

The prevalence of anxiety and depressive disorders in cancer patients and its associated factors in Pakistan is not known. There is a need to develop an evidence base to help introduce interventions as untreated depression and anxiety can lead to significant morbidity. We assessed the prevalence of depression and anxiety among adult outpatients with and without cancer as well as the effect of various demographic, clinical and behavioral factors on levels of depression and anxiety in cancer patients.     

Failure of Closed Reduction After Dislocation of Austin Moore Hemiarthroplasty: An Analysis of Risk Factors : A 6-Year Follow-Up Study

The aim of this study was to determine the factors associated with failure of closed reduction of dislocated Austin Moore hemiarthroplasty for subcapital neck of femur fracture. There were 44 (1.8%) cases of dislocation for a 6-year period. There were 28 females and 12 males, and mean age was 85.6 years. Thirty-two patients (80%) had redislocations, and 13 patients (40%) required 2 or more closed reductions. Twenty-eight patients subsequently had a Girdlestone arthroplasty. Dementia and a previous failed closed reduction were associated with a higher failure rate (P = .03 and .04, respectively). Failed close reduction patients also had a higher 6-month mortality rate (P = .04). Closed reduction after Austin Moore hip dislocation has a higher failure rate significantly in patients with dementia and are associated with a higher mortality rate. We believe closed reduction should be avoided in these groups of patients, and Girdlestone procedure was considered after initial first dislocation.     

The Role of FSH and TSH in Bone Loss and Its Clinical Relevance

Osteoporosis, a global health problem, is now frequently recognized to be secondary to alterations in the pituitary-bone axis. This review examines the current evidence for how dysregulation of the pituitary-bone axis leads to osteoporotic bone loss. Specifically, perimenopausal bone loss in the context of follicle-stimulating hormone action, and hyperthyroid bone loss in the context of thyroid-stimulating hormone action are explored. From the reviewed scientific findings, recommendations for early diagnosis and better clinical management of bone loss are made.