Medicine and Health Sciences Commons^™

A Case Of Cannabis Smoking Induced Leukocytosis, Ramiro A. Rodriguez Jr., Rukayat Akande, Nevin Varghese

Research Colloquium

Background: Leukocytosis relates to infections, malignancies, stress response, and multiple intoxicants. Like other intoxicants, cannabis smoking can result in a persistent leukocytosis. Here we report a case of cannabis-induced leukocytosis.

Case Presentation: A 20-year-old Hispanic female with a history of anxiety disorder presented with 3-days of nausea, vomiting, and colicky abdominal pain. She endorsed heavy marijuana smoking as self-medication and compulsive hot showers for symptom relief. She was admitted for oral intake intolerance, concerning for cannabis hyperemesis syndrome. Her history demonstrated multiple admission for cannabis hyperemesis syndrome during which she demonstrated a leukocytosis which improved with abstinence of marijuana. Her …

Understanding An Inflammatory Pathway In Diabetic Retinopathy, Reanna R. Rodriguez

Research Symposium

Diabetic Retinopathy (DR) is the leading cause of blindness in the U.S. However, not much is known of its molecular pathway and how it attributes to increases in inflammatory response in the eye. One avenue we will investigate is the transforming growth factor beta (TGFB) signaling pathway and its effect of vascular endothelial growth factor (VEGF) secretion and cell viability. VEGF is the hallmark that exacerbates DR progression in prolonged diabetes. Some major concern that have arisen are the underlying effects of oxidants and antioxidants in elevating VEGF secretion in diabetes. In attempt to learn more, we evaluated how an …

In Vitro Evaluation Of Phthalimide Derivatives Against Cancer Cell Lines, Crystel A. Sierra Rivera, Muhammad Kashif, Lenci Karina Vazquez Jimenez, Gildardo Rivera Sanchez, Alfredo Juarez Saldivar, Alma Delia Paz Gonzalez, Alejandro Zugasti Cruz

Research Symposium

Los cánceres de pulmón, próstata e hígado se encuentran entre los más prevalentes en los hombres. El cáncer de mama, de cuello uterino y de tiroides se encuentran entre los más prevalentes en mujeres (OMS, 2019). El tratamiento del cáncer generalmente incluye quimioterapia y radioterapia; sin embargo, los medicamentos contra el cáncer disponibles tienen una selectividad baja y causan efectos adversos graves, como nefrotoxicidad, neurotoxicidad y mielosupresión (Matsuo et al., 2010). Por tanto, el diseño y desarrollo de compuestos como nuevos agentes anticancerígenos frente a los tipos de cáncer de mayor incidencia son de vital importancia en el campo de …

Characterization Of Epithelial Growth Factor Transcripts Identified In Crotalus Atrox Venom, Ivan Lopez, Ying Jia

Research Symposium

Epithelial Growth Factor (EGF) is the primary source in regeneration and stimulation of essential fibroblasts cells commonly found in epithelium. Studies have shown that snake venom components are becoming a growing factor in treating illnesses such as cancer, muscular dystrophy, chronic pain, blood pressure, blood clotting, etc. EGF in human cells contains a promising quaternary structure that can bind to snake venom metalloproteinases, proposing a means of activating biochemical responses through protein-protein interactions to regulate unwanted cellular functions. This supports promising research in achieving a greater understanding of regulation along cellular pathways through ligands, increasing the likelihood of targeting unwanted …

Mortaparibplus- A Novel Anticancer Small Molecule Abrogating Mortalin-P53 Interaction In Cancer Cells, Anissa N. Sari, Ahmed Elwakeel, Jaspreet K. Dhanjal, Vipul Kumar, Durai Sundar, Sunil C. Kaul, Renu Wadhwa

Research Symposium

Background. The cessation of tumor cell growth through cell cycle arrest and apoptosis is determined by p53, a tumor suppressor protein. However, the interaction between mortalin-p53 within cytoplasm/nucleus leads to the inactivation of p53 transcriptional activation function. The disruption of mortalin-p53 complex has been suggested as an approach for developing a potential anticancer drug.

Methods. A screening of a high-content chemical library was performed to determine a molecule with mortalin-p53-interaction disrupting characteristics. After four-rounds of visual assays, we discovered a triazole derivative (4-[(1E)-2-(2-phenylindol-3-yl)-1-azavinyl]-1,2,4-triazole, named Mortaparib^Plus) with a potential ability of disrupting mortalin-p53-complex. In this study, we recruited …

Characterization Of Prostate Cancer In Transgender Women, Simita Gaglani, Rajveer Purohit, Ashutosh Tewari, Dara Lundon, Natasha Kyprianou

Research Symposium

Background: The risk of developing prostate cancer (PC) in transgender women is unknown. Many patients are unaware that the prostate is not removed during male-to-female surgical transition. It is unclear what the exposure of estrogens and androgen blockers in these transgender patients has on the prostate. Our aim was to examine and characterize the different presentations of PC in published cases and augment this with an additional case series from one institute.

Methods: A retrospective review of prospectively maintained medical records was performed identifying features of PC diagnoses in transgender women. These included age, duration of feminizing hormone therapy, PSA …

Identification Of Tectorigenin As A Natural Pro-Hypoxia Compound: Implications In Modulation Of Cellular Differentiation And Senescence, Mallika Khurana, Renu Wadhwa, Sunil Kaul

Research Symposium

Background: Hypoxia, a suboptimal level of oxygen, evokes stress response in cells and activated hypoxia signaling has been largely established as a pro-metastasis and pro-angiogenic factor for tumor cells. On the other hand, age-related neurodegenerative disorders are characterized by hypoxic environment, accumulation of molecular garbage and induction of premature senescence. Several recent studies have reported anti-stress impact of the intermittent induction of hypoxia signaling in these cells.

Methods: Screening of a phytochemical library using Hypoxia Responsive Element (HRE) driven luciferase as a reporter was carried out to identify hypoxia-modulating phytochemicals. Activation of HIF-1a (master regulator of hypoxia signaling) was validated …

Validated Rp-Hplc Method For Simultaneous Estimation Of Ofloxacin And Racecadotril In Bulk And Combined Pharmaceutical Formulations, Debashree Debasish Das, Pooja Chawla

Research Symposium

Combined drug dosage forms are highly used since they can target more than one disease. For Ofloxacin and Racecadotril in bulk and combined dosage form a simple ,accurate and precise stability indicating simultaneous method was developed and validated by RP-HPLC (in isocratic system ) as per ICH Q₂ R₁ and FDA guidelines. This method was carried out by waters X bridge stainless steel C₁₈ Column (250mm X4.6mm,5 micro meter) packed with ODS as stationary phase and methanol : acetonitrile :water (40:40:20 ) as mobile phase. As the pKa of both OFL and RAC are strong acidic mobile …

Differential Cortical Monoamines Release During Exercise In Rats Chronically Implanted With Microdialysis Probes, Christine G. Gerin

Research Symposium

Physical exercise is known to positively influence mood, to reduce anxiety and to improve reaction to stress. Cerebral monoaminergic systems are thought to underly the neurochemical influence of exercise on mood and behavior. We hypothesized that beneficial effects of exercise can be shown by variations of neurotransmitters release in the cerebral cortex. We aimed at demonstrating that there is a temporal relationship between release of plasma and cerebral monoamines (A, NA, 5-HT, DA) and spontaneous running exercise in rats. Ten Spague Dawley rats (250 g) were chronically implanted (for up to 39 days) with a left common carotid cannula and …

Ethical Issues And Standards Of Responsible Research Conduct And Monitoring In An Adventist Institution Of Higher Learning - The Babcock Experience, Kayode O. Ogunwenmo, Godswill N. Anyasor, Grace O. Tayo

Adventist Human-Subject Researchers Association

Ethical issues and standards of responsible research conduct involving human participants are important considerations in any institution of higher learning and in particular Adventist institutions. Research conduct and ethics are reviewed and approved before they begin by the Babcock University Health Research Ethics Committee (BUHREC)

Case Report And Review: Promethazine ("Purple Drank") Abuse, Riya Tandra, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

A 23 year old female was brought to the Emergency Department by EMS for confusion and aggressive behavior. The friends told EMS that the patient had been ingesting "purple drank" and that she had told her friends that she made the concoction with promethazine and opiate cough syrup with some vodka added. She mixed it in a carbonated soda. “Purple Drank” or “Lean” is a combination of codeine promethazine hydrochloride and soda or alcohol that has frequently been misused since the 1990s. This paper aims to highlight the recent resurgence of promethazine abuse occurring in the United States as well …

Case Report: Nosocomial Digital Eczema From Surface Cleansing Bleach, James Espinosa, Umar Sannoh, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a healthcare provider who developed hand eczema, predominantly on the first digit and thumb of the right hand, in association with contact with the surface of a desk and mouse pad at work. The eczema abated on days off and was exacerbated within hours of work. The diagnosis was made of hand eczema from surface cleaning bleach. It was noted that several other healthcare providers had developed similar symptoms. The patient's eczema was confirmed by a dermatologist and was successfully treated with topical triamcinolone and emollient cream to the affected areas. Prevention by adhesive strip …

Body Dysmorphic-Induced Androgenic Anabolic Steroids Usage And Its Association With Mental Health Outcomes: A Systematic Review, Ahmed Gawash, Hasan Zia, David Lo

Rowan-Virtua Research Day

This systematic review on body dysmorphic disorder (BDD), anabolic-androgenic steroid (AAS) use, and mental health outcomes aim to examine the relationship between them. While looking at prior research, it has been suggested that individuals with BDD may be more likely to abuse AAS due to their preoccupation with appearance but, unfortunately, AAS use may worsen mental health issues in this population and exacerbate the issue. This systematic review will also discuss treatments that will help mitigate the effects of AAS on individuals with BDD. The review will include only published literature from a variety of databases such as PubMed, Scopus, …

Characterization Of Antibiotic Susceptibility Profiles Of Extensively- And Pan-Drug Resistant Acinetobacter Baumannii Clinical Isolates, Rachel Carr, Justin Halim, Rebecca Fliorent, Henry Fraimow, Dejan Nikolic, Valerie Carabetta

Rowan-Virtua Research Day

Acinetobacter baumannii is an opportunistic pathogen common in intensive care units (ICUs), particularly among immunocompromised individuals. Nosocomial A. baumannii infections have become increasingly problematic in recent years, as these bacteria rapidly acquire antibiotic resistance, leading to the emergence of multidrug, extensively drug and pan drug-resistant (MDR, XDR, and PDR, respectively) isolates. Recently, Cooper University Hospital (CUH) experienced a large increase in highly drug-resistant A. baumannii infections, which had a mortality rate of 60%. Oftentimes, physicians had to turn to combinations of drugs with no experimental verification or historically shelved antibiotics, such as the polymyxins, in a desperate attempt to save …

Brief Review: Iv Fluid Choice In The Emergency Department, Kaywan Saed, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Normal saline and balanced crystalloids, such as lactated Ringer's (LR) and Plasma-Lyte A, are commonly used in the emergency setting for fluid resuscitation. However, there has been growing interest in recent years in whether balanced crystalloids may be superior to normal saline, particularly in critically ill patients.

Normal saline has been the traditional fluid of choice for decades due to its widespread availability, low cost, and presumed safety. However, normal saline has a high chloride concentration (154 mmol/L), which can lead to hyperchloremic metabolic acidosis and other adverse effects, such as renal vasoconstriction and reduced renal blood flow.

In contrast, …

Brash Syndrome Case Report And Brief Review, Kelly Schuitema

Rowan-Virtua Research Day

BRASH syndrome is an acronym that stands for bradycardia, renal failure, AV node blocker, shock and hyperkalemia. The syndrome is precipitated by synergism from AV nodal blocking agents and hyperkalemia. The combination of the AV nodal blockade and renal failure leads to a cycle of severe bradycardia and hyperkalemia. We will discuss a case of BRASH syndrome with a 68 year old female who presented with generalized weakness and was found to be hypotensive, bradycardia, in acute renal failure with hyperkalemia likely related to metoprolol and amlodipine use.

Case Report: Anaphylactic Reaction To Magnesium Sulfate, Nicholas Coan, Kelly Schiers, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 65-year-old female who prior to being discharged from the hospital developed an anaphylactic reaction after receiving an intravenous magnesium sulfate infusion. After extensive literature review, there are few documented hypersensitivity reactions documented. This case report is to highlight a known human response, anaphylaxis, but in response to the repletion of an essential electrolyte to human life, magnesium.

Case Report And Review: Hawthorne Root Toxicity, James Espinosa, Darren Finn, Alan Lucerna

Rowan-Virtua Research Day

Here we present the case of a patient who purchased a hawthorn root product, Raiz de Tejocote, for weight loss purposes. The side effect profile seen, including a positive digoxin level, are consistent with hawthorn root. This case reinforces the importance of asking a patient about all medications, including over the internet medications.

Correlation Between Gut Biomarkers And Depression, Jianle Gao

Rowan-Virtua Research Day

The correlation between the gut-microbiota- brain axis and mental state in the context of mental disorders such as Major Depressive Disorder (MDD), Schizophrenia, etc. has been well studied. Production of inflammatory and non-inflammatory metabolites by the gut- microbiota directly and indirectly affects the brain and mood. Therefore, colonization by maladaptive, pro-inflammatory bacteria may cause mood dysregulation and depressive features. Metabolites from these bacteria can be quantitatively analyzed for use as biomarkers of Major Depressive Disorder. Biomarkers studied include: serotonin, dopamine, butyrate, acetate, and propionate.

The Effects Of Prenatal Buprenorphine Exposure On The Neurobehavioral Development Of The Child, Zaineb Zubair, Maryam Zubair, Juan Alonso, Abdullah Zubair

Rowan-Virtua Research Day

Background: Current guidelines for pregnant women with substance use disorder advise prenatal maintenance of opioid agonist therapy with either buprenorphine or methadone. Despite this rise in prenatal opioid agonist therapy, little is known about the effect of prenatal buprenorphine on the neurobehavioral development of the child. This poses the question: does buprenorphine have a long-lasting effect on the central and peripheral nervous system development and behavior of children who were exposed prenatally?

Methods: A comprehensive literature review identified articles relating to prenatal buprenorphine and neurobehavioral outcomes. Article searches were conducted on PubMed and Dynamed. Publications from 2002 through November 2021 …

Comparison Of Clinical And Radiographic Efficacy Of Particles Versus Nbca/Onyx In Middle Meningeal Artery Embolization For Chronic Subdural Hematoma, Jane Khalife, Mohamed Salem, Victoria Wong, Allen Karimov, Brian Jankowitz, Jan Karl Burkhardt, Hamza Shaikh, Daniel Tonetti, Pratit Patel, Tudor Jovin, Ajith Thomas

Rowan-Virtua Research Day

Different embolic materials are utilized in MMA embolization of chronic subdural hematoma per operators’ discretion. We aim to compare the clinical and radiographic efficacy of different embolic materials in a pooled retrospective cohort of two US centers.

Growing Use Of Xylazine As An Adulterant In Opioids And Its Effects, Oluwapelumi Oluwo

Rowan-Virtua Research Day

Xylazine, according to the National Institutes of Health (NIH), is a non-opioid tranquilizer used in veterinary medicine. Although this drug has not been approved for human use, it can be linked to an increase in opioid overdose deaths due to its role as an adulterant in drugs like fentanyl.

Xylazine was detected in drugs involved in 41% of all opioid-involved unintentional deaths and in 44% of all unintentional overdose deaths with fentanyl involved in the year of 2021 in Philadelphia.

Research Personnel Exposure To Carbon Dioxide During Euthanasia Procedures, Devon Nealer, Felicia Reibstein, Jennifer Bendorf, Emily Lafferty, Stephanie Ramborger, Taylor Swift, Jacqueline O'Malley, Thomas Boyle

Rowan-Virtua Research Day

Carbon dioxide (CO2) is a commonly used euthanasia agent in animal facilities. This procedure is carried out by replacing oxygen with carbon dioxide in animal cages, thus providing a quick and painless method of euthanasia. Unfortunately, there has been limited research on the potential effects of human exposure to CO2 during euthanasia procedures.

Following a previous carbon dioxide exposure study in the vivarium at Rowan SOM in 2016, the CO2 cylinders and euthanasia chambers have been relocated to room 153 Science Center and the vivarium has adopted a localized exhaust that helps remove the contaminant at the source.

While the …

Perioperative Ketamine Use For Post Mastectomy Pain, Alessia Cooney, Jaylyn Thompson, Naomi Watkins-Granville

Rowan-Virtua Research Day

PMPS is defined as chronic neuropathic pain following breast cancer procedures in the ipsilateral arm, chest wall, axilla or shoulder.1-3 Approximately 20 to 50% of post mastectomy patients suffer from Post Mastectomy Pain Syndrome (PMPS).1 With more than 3.8 million breast cancer survivors, due to advances in treatment, there is increased importance in findings ways to better manage the quality of life of breast cancer survivors.1,4 Ketamine induces analgesic effects through its non-competitive antagonism of NDMA receptors.5 Low doses of ketamine infusion (20–30 mg x h−1) have been shown to produce analgesia in neuropathic pain states with benefits lasting up …

Comparative Analysis Of The Effects Of Actual Versus Assumed Opioid Experience On The Regulation Of Ventral Striatal Opioid Receptor Gene Expression, Indu Mithra Madhuranthakam, Martin Job

Rowan-Virtua Research Day

Rationale: We conducted experiments to assess the effect of prior opioid experience on gene expression changes. We compared the current experimenter-imposed short versus extended-access conditions of opioid self-administration and developed a new quantitative method to determine their effectiveness in identifying the role of opioid experience in regulating opioid receptor expression levels in the ventral striatum (VS) using an oxycodone self-administration/abstinence model.

Methods: In this study, male Sprague-Dawley rats (n=36) were trained for 20 days to self-administer oxycodone at 0.1 mg/kg/infusion under short access (n=15, or saline as controls n=3, for 3h/day) or extended access (n=15, or saline as controls n=3, …

Case Report: Ocular Capsaicin Toxicity With Chemosis From Jalapeño Peppers, Duwayne Campbell, James Espinosa, Eric Maddock, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

A 42 year old female presented to an Emergency Department (ED) with the abrupt onset of left eye pain, tearing and eye redness of a one hour duration. Her symptoms were due to ocular toxicity from contact exposure to capsicum, through preparation of Jalapeño peppers.

Maldi-Tof Ms Based Proteomic Fingerprinting Of Total Serum Plasma For Somatic Pain Syndromes, Isaiah Pinkerton, Venkateswar Venkataraman

Rowan-Virtua Research Day

There are racial and ethnic disparities regarding pain management within the United States, and that disproportionately affects women of color. There is also a fundamental lack of information regarding the biological mechanism by which pain sensitization and perception occurs, and how it could be affected by both neurologic and somatic pain syndromes.

Methods: Research was performed on principal electronic scientific databases including Google Scholar, PubMed, and Embase with search terms “MALDI-TOF”, “ESI-MS”, “Pain”, and “Biomarkers”, as well as other modifiers to narrow the literature search.

Results: Studies on comparison between MALDI-TOF and other traditional analysis platforms, including Electrospray Ionization (ESI-MS), …

Case Report: Epinephrine-Containing Topical Anesthetic Gel Inducing Systemic Epinephrine Toxicity, Md Fateha, Philip Willsie

Rowan-Virtua Research Day

Systemic epinephrine toxicity is a rare complication following inadvertent or excessively large or rapid subcutaneous, intramuscular or intravenous administration. Signs and symptoms of epinephrine toxicity include rapid onset of transient agitation, hypertension, tachycardia, lactic acidosis, and dysrhythmias with potentially fatal consequences. In this case report, we present a 33-year-old female who experienced epinephrine toxicity following the use of a topical anesthetic cream containing lidocaine and epinephrine. The patient had multiple applications to her chest before and during tattoo placement which led to tachycardia, elevated blood pressure, headache, chest pain, nausea, vomiting, and anxiety. The patient was brought into the ED …

Chemical Restraints In The Emergency Department, Nicholas Noffsinger

Rowan-Virtua Research Day

Chemical restraint is a critical intervention used in emergency departments to manage acutely agitated or violent patients. It involves the administration of medication to induce sedation and control behavior, with the goal of ensuring patient and staff safety while allowing necessary medical interventions to be performed. However, the use of chemical restraints necessitates close observation of vital signs and any potential side effects, as well as careful consideration of patient-specific considerations.

Management And Considerations In The Usage Of Txa In Hemorrhagic Trauma Patients, Matthew Petterson, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Tranexamic acid is a synthetic reversible competitive inhibitor that exerts its action on plasminogen, preventing plasmin formation and deterring fibrinolysis.1 Current FDA-approved indications of TXA include heavy menstrual bleeding and short-term blood loss prevention in patients with hemophilia following tooth extraction.1 TXA has more recently been utilized in the management of massive hemorrhagic trauma patients despite this being an off-label use. While TXA has shown promise as a hemostatic agent for this patient population, considerations in the pre-hospital and hospital settings must be examined for its integration into massive hemorrhage protocols.