Hector Georgiou, medical student and Co-Chair of the Imperial College School of Medicine Surgical Society, London, tells us about last month’s National Medical Student Prize Night hosted by the Surgical Society. The winners are also listed below along with the winning abstract. Well done everyone. Rhona 

The 2^nd National Medical Student Prize Night was hosted with great success by the Imperial College School of Medicine (ICSM) Surgical Society on Wednesday 12^th March 2008 at the Charing Cross Hospital, London. This is an annual event organised by the Society hosting medical students from across the nation, aiming to give them the opportunity to display their work and have the chance to win cash prizes.

This year’s event saw sixth formers and medical students from all across the United Kingdom compete in three separate competitions:

1. ‘100 Years of Science: What is the greatest development within the past century?’ - Poster Competition open to Sixth Formers
2. ‘Describe the most important development in medical and/or surgical science in the last 25 years’ - Poster competition open to Pre-Clinical medical students
3. ‘An interesting clinical case that you saw over the past 12 months’ - Oral presentation competition open to Clinical medical students

With cash prizes up for grabs, worth up to £350 each, as well as a publication on The Lancet Student, we had a massive response to our call for abstracts. Students from as far and wide as Belfast, Dundee, Cardiff, Nottingham and London entered the competition.

On the evening of the event itself, the judging panel, consisting of eminent consultants from hospitals associated with Imperial College, were very impressed with the calibre of the entrants’ work and had a very tough task in picking the winners.

After the competition, the evening featured a motivational talk entitled ‘My Journey to Surgery’ by Professor Nadey Hakim (Immediate Past World President of the International College of Surgeons and Surgical Director of the Transplant Unit at the Hammersmith Hospital).

ICSM Surgical Society would like to thank all the doctors who helped in the running of this event. Furthermore, we would like to thank all our sponsors without whom this event would not have been financially possible.

If you are interested in other events hosted by our society then please visit our website at http://www.surgicalsociety.org/. Hector Georgiou: ektoras.georgiou04@imperial.ac.uk

This year’s winners were as follows:

• Prentis Pharmacy Sixth Form Prize: Mr Kehinde Sotonwa (The London Oratory School) - X-rays
• Elsevier Pre-Clinical Prize: Mr Oliver-James Dyar (Brasenose College, University of Oxford) - RNA: The Micro-(R)-Evolution
• The Lancet Clinical Prize: Mr Veeru Kasivisvanathan (Imperial College School of Medicine) - A sparkling effusion

Here is the winning clinical abstract:

Case
A 56 year old Caucasian male, with a 12 year history of well-managed rheumatoid arthritis, presented to A&E with a 1 week history of progressive shortness of breath on exertion. Of note he had a 20 pack-year smoking history. On systems review he described no cough, sputum production or wheezing and reported no ankle swelling or weight loss. Examination findings and chest radiograph identified a large right-sided pleural effusion.

A chest drain was inserted and 1.5 litres of a sterile turbid yellow fluid were drained. A crystalline precipitate, with a distinctive sparkling satin sheen was obtained. The effusion had characteristics consistent with a diagnosis of rheumatoid pleural effusion: an exudate (5.1g/dl) with raised cholesterol (103mg/dl), LDH (1245iU/L) and white cell count (2640/mm³) and low glucose (5mg/dl) and pH (7.19) (1). Subsequently the patient underwent talc pleurodesis.

Conclusions
This case demonstrates the importance of recognising the extra-articular features of rheumatoid arthritis; in particular it shows the characteristic physical and biochemical findings of a rheumatoid pleural effusion. Furthermore, in the absence of an accepted gold-standard technique for long term management of rheumatoid pleural effusion (1), this case is the first in the English language literature to document the use of talc pleurodesis in the successful prevention of the recurrence of the rheumatoid effusion. The persistence of effusions can lead to lung fibrosis so preventing recurrence is of paramount importance (2).

(1) Balbir-Gurman A, Yigla M, Braun-Moscovici Y. Rheumatoid pleural effusion. Seminars in Arthritis and Rheumatism 2006; 35:368-378

(2) Yigla M, Simsolo L, Nahir AM. The problem of empyematous pleural effusion in rheumatoid arthritis. Journal of Clinical Rheumatology 2002; 21:180-183

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