Objectives:To study the prevalence of urinary tract infections (UTI), or sepsis secondary to trans-rectal ultrasound-guided (TRUS) biopsy of the prostate, the pathogens involved, and patterns of antibiotic resistance in a cohort of patients.Methods:This is a descriptive study of a consecutive cohort of patients who underwent elective TRUS biopsy at King Abdulaziz Medical City Riyadh, Saudi Arabia between January 2012 and December 2014. All patients who underwent the TRUS guided prostate biopsy were prescribed the standard prophylactic antibiotics. Variables included were patients’ demographics, type of antibiotic prophylaxis, results of biopsy, the rate of UTI, and urosepsis with the type of pathogen(s) involved and its/their antimicrobial sensitivity.Results:Simple descriptive statistics were used in a total of 139 consecutive patients. Urosepsis requiring hospital admission was encountered in 7 (5%) patients and uncomplicated UTI was observed in 4 (2.8%). The most common pathogens were Escherichia coli (90.1%) and Klebsiella pneumoniae (9.1%). Resistance to the routinely used prophylaxis (ciprofloxacin) was observed in 10 of these patients (90.9%).Conclusion:This showed an increase in the rate of infectious complications after TRUS prostate biopsy. Ciprofloxacin resistance was found in 90.9% of patients with no sepsis.

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Bladder perforation due to indwelling catheters is regarded to be a very rare incident. Most cases of catheter-induced rupture were in patients with chronic catheterization due to chronic bladder diseases. An 80-year-old male with neurogenic bladder on chronic catheterization presented to the emergency room with abdominal pain and anuria. On CT, the tip of the catheter was eroding through the bladder into the peritoneum. The patient underwent a laparotomy with adhesiolysis. The tip of the Foley catheter was seen eroding through the bladder dome. A new open tip catheter was inserted per urethra to prevent the catheter tip from eroding again through the bladder wall. Bladder erosion or rupture is associated with high morbidity and mortality. Our case demonstrates the deleterious effects of chronic catheterization and the need for a high level of suspicion when dealing with such cases.

INTRODUCTION: Problem-Based Learning (PBL) was based on the fact that students must be the center of education. Problem-Based Learning (PBL) received criticism, arguing that no significant difference exist between it and conventional teaching. In our study, we examined the introduction of multiple mini quizzes after every PBL case as a method to improve student overall performance. METHODS: The study was a quasi-experimental interventional study that included 151 students from two batches (third and fourth year medical students attending respiratory and renal blocks, respectively). Each batch was divided and randomly assigned as "intervention groups" and "non-intervention" group. Intervention group was presented with mini quizzes of 10 questions each, after every PBL case. Midterm and final exam scores were compared between the two groups as a way of assessment of intervention effectiveness. RESULTS: In the respiratory block, when comparing the midterm and final results for intervention and non-intervention groups, the P value was 0.46 in the midterm and 0.59 in the final exam. In the renal block, when comparing the midterm and final results for intervention and non-intervention groups, the P value was 0.5 in the midterm and 0.32 in the final. CONCLUSION: Our study delineates the lack of objective effect on student performance measured by midterm and final exams by introducing quizzes after PBL sessions.