Digital Commons Network^™

Anesthetic Management Of Pregnant Patients With Cardiac Disease: A Literature Review, Esther Choi, Cohen Chong, Audrey Arona

Research Day

Introduction:

Cardiovascular disease is one of the leading causes of maternal morbidity and mortality worldwide. The number of pregnancies complicated by cardiac disease has increased due to improved survival among patients with congenital heart disease, delayed maternal age, and the increasing prevalence of cardiovascular disease in the general population. Furthermore, physiologic cardiovascular changes during pregnancy, such as increased cardiac output, expanded plasma volume, and decreased systemic vascular resistance, can exacerbate underlying cardiac pathology and create significant anesthetic challenges during labor and delivery. Appropriate anesthetic management is therefore essential to maintain hemodynamic stability and optimize maternal and fetal outcomes.

Methods:

A …

Direct Amygdala Projections To Auditory Cortex: An Anterograde Mapping Study, Munir Yusuf, William Michel, Diana Peterson

Research Day

Introduction:

The amygdala is part of the limbic system and determines the importance of sensory information. Although it is not considered part of the auditory system, it still sends direct connections to the auditory cortex. The role of this direct, anterograde amygdalo-auditory pathway is not fully understood.

Methods:

To study this connection, anterograde tracers were injected into the amygdala of adult rats to label axons that travel to the auditory cortex. The auditory cortex was then examined to determine where these fibers terminated and which types of neurons they contacted. In addition, a literature review was conducted to find previous …

Community Rx: The Abcs Of A Doctor’S Visit, A Bilingual Health Navigation Workshop For Underserved Communities, Sharon Lackwood, Marisela Benitez, Kayla Hasty, Ty’Tiaunna Thomas, Martin Medina, Matthew Shelnutt

Research Day

Introduction:

Limited health literacy remains a major contributor to healthcare disparities, particularly among rural, uninsured, migrant, and Spanish-speaking populations. Many individuals report anxiety and confusion about how to schedule appointments, complete paperwork, understand costs, and communicate effectively with physicians. To address this gap, Community Rx developed a bilingual, student-led workshop titled The ABCs of Your Doctor’s Visit, designed to demystify the healthcare encounter and improve patient confidence, appointment preparedness, and navigation skills. The curriculum aligns with broader Community Rx goals of empowering underserved populations while fostering empathy and professional identity development among osteopathic medical students

Methods:

This ongoing, community-engaged initiative …

Cardiometabolic Risk Factor Burden And Early Cardiovascular Disease Onset Among Asians: Insights From The Nih All Of Us Cohort And Georgia Oasis, Riya S. Patel, Anirudh Veludhandi, Thomas Last

Research Day

INTRODUCTION: Cardiometabolic risk factors including diabetes, obesity, and smoking are major contributors to cardiovascular disease (CVD), yet the cumulative impact of multiple risk factors on age of onset across cardiovascular phenotypes remains incompletely defined. Cardiovascular risk patterns in Asian populations may differ from those in the general population, and the influence of cumulative cardiometabolic risk burden on early disease remains insufficiently characterized. Understanding how cardiometabolic risk burden influences early cardiovascular disease among Asians may help identify high-risk individuals and guide prevention strategies.

OBJECTIVES: To determine whether increasing cardiometabolic risk factor burden is associated with earlier cardiovascular disease onset among Asians …

Histologic Heterogeneity In Bladder Neoplasia: Identification Of Coexisting Urothelial Dysplasia, Papillary Lesions Of Low Malignant Potential, And Muscle-Invasive Urothelial Carcinoma, Maxwell Trettin, Yousra Abo-Elhamd, Aidan Huckestein, Byron Her, Xiunely Ricano Cadenas, Shiv Dhiman, Rasheed Agboola, Neveen Said

Research Day

BACKGROUND: Urothelial bladder carcinoma (UBC) accounts for approximately 90% of bladder cancers with a male to female prevalence of 3:1. Established risk factors include exposure to tobacco smoking, and environmental and occupational exposure to polycyclic aromatic hydrocarbons and aromatic amines. Additional risk factors include air pollution, advanced age, and occupational exposure to carcinogens present in dyes, paints, petroleum products, and metals. UBC are recognized for their heterogeneous characteristics due to urothelial epithelium exhibiting diverse transcriptional and mutational profiles that evolve within the tumor microenvironment. Additionally, bladder cancers are often found to be multifocal, highlighting the importance of thorough examination of …

Small Bowel Obstruction In The Setting Of Sclerosing Encapsulating Peritonitis: A Case Report, Zain Ismail, Amaan Ismail, Oscar Acosta, Rebecca Ann Gill

Research Day

Small bowel obstruction (SBO) is a common surgical emergency that is the result of an incomplete or total blockage of the intestinal lumen, resulting in proximal dilation with contents and gas. Untreated SBO may result in vascular compromise leading to tissue ischemia, necrosis, or perforation. The most common causes of SBO include adhesions, hernias, malignancy and chronic inflammatory conditions. SBO can be further classified into patterns of single adhesive bands or matted adhesions. Work-up of SBO begins with CT imaging to visualize the extent of bowel obstruction followed by conservative management with bowel rest, IV fluids, and NG tube decompression. …

Isolated Unilateral Central Ray Deficiency In A Term Newborn: Distinguishing Symbrachydactyly From Amniotic Band Sequence, Mauricio Soto, Rachael Bonitatibus, Stephanie Suarez, Kevin Bhagratie, Anthony Adetomiwa

Research Day

Introduction

Congenital hand anomalies may arise from intrinsic malformations of limb development or extrinsic disruptive processes. Distinguishing symbrachydactyly—a failure-of-formation malformation—from amniotic band sequence (ABS)—a constrictive disruption—is essential, as pathogenesis, prognosis, and management differ substantially. Although both may present with absent digits, characteristic morphologic patterns allow reliable clinical differentiation. We present a term neonate with unilateral central hand deficiency to highlight key diagnostic features distinguishing these entities in the newborn period.

Methods

A retrospective descriptive case review was conducted of a term male neonate with an isolated upper extremity anomaly. Prenatal records, delivery documentation, newborn examination findings, and postnatal radiographic imaging …

Surgical Management Of An Unusually Large Uterine Leiomyoma With Cervical Dilation In A Reproductive-Age Woman, Oscar Acosta, Lisandra Chinea, Emily Kate Reagin, Neha R. Vangimalla, Daniel York

Research Day

Introduction: Uterine leiomyomas are common benign tumors, with a 70–80% prevalence among women of reproductive age. While many are asymptomatic, larger fibroids can cause pelvic pressure, abnormal bleeding, anemia, and organ compression. Rarely, leiomyomas prolapse through the cervical canal, causing complex distortions and surgical challenges. Management depends on symptoms, size, location, and reproductive goals. For women wishing to preserve fertility, myomectomy is preferred. This case report details the surgical management of a large prolapsing leiomyoma and highlights key intraoperative considerations treatment.

Methods: This study was conducted as a case report supplemented by a structured review of current scientific literature. Relevant …

Anatomical Variation Of Lateral And Medial Circumflex Femoral Arteries Identified During Cadaveric Dissection, Misha Ul-Islam, Nathan Sagasser, Danait W. Gebreselassie, Abigail Blank, Abeeha Choudhary, Jada Daniel, Christian Butler, Sofia Garcia, Emranul Huq

Research Day

Introduction: The common femoral artery (CFA) is the principal arterial supply to the lower limb and a critical landmark in surgical, orthopedic, and interventional procedures. Typically,  the CFA gives rise to the deep femoral artery (DFA) and continues distally as the superficial femoral artery (SFA). The lateral circumflex femoral artery (LCFA) and medial circumflex femoral artery (MCFA) most commonly originate from the DFA. However, documented anatomical variations in the femoral arterial branching patterns underscore the importance of recognizing deviations that may influence clinical decision‑making.

Objective: This study describes two rare anatomical variations identified during routine cadaveric dissection in which three …

Feasibility Of Transcranial Magnetic Stimulation For Treatment-Resistant Depression In Rural Healthcare Settings: A Case Series, Posey Kent, Brandon Krout, Kennedy Johnson, Jodeci Mitchell, Hania Hashmi, Blessing Adeyemo, Ashlee Cook

Research Day

Introduction

Major depressive disorder (MDD) is one of the most common mental health disorders world- wide, with up to one-third of patients experiencing treatment-resistant depression despite adequate pharmacologic therapy. Transcranial Magnetic Stimulation (TMS) is an FDA-approved, noninvasive treatment shown to improve depressive symptoms in treatment-resistant depression. However, access to advanced psychiatric interventions remains limited in rural communities due to provider shortages, transportation barriers, and socioeconomic challenges. Despite established efficacy in urban and academic settings, limited data exist on the feasibility and real-world outcomes of TMS implementation in rural healthcare settings. The purpose of this study is to highlight the feasibility …

Comparison Of Axillary Lymph Node Size In Cadavers With And Without A History Of Breast Cancer, Adam E. Davis, Harshita Yepuri, Julia Girgis, Sara Kurtovic, Celeste Pak, Erek Arsiniega, Jasdeep Singh, Michael B. Roberts, Shelley Dicecco

Research Day

Axillary lymph nodes play a critical role in breast cancer metastasis and staging. While imaging and surgical studies provide indirect assessments of nodal involvement, few investigations have directly compared lymph node size in breast cancer and non-cancer populations using cadaveric dissection. In this study, twenty-nine female cadavers, including eight with a history of breast cancer and twenty-one controls, were dissected to collect axillary lymph nodes from six anatomical chains: central, humeral, infraclavicular, parasternal, pectoral, and subscapular. Lymph node area (mm²) was measured, and statistical outliers (z ≥ 3) were excluded from analysis. Welch’s t-test was performed to compare overall lymph …

Glp-1 Receptor Agonists And Fertility. Metabolic And Direct Reproductive Mechanisms In Obesity-Related Infertility, Noor Alnourachi, Julie Al Mir, Audrey Arona

Research Day

Introduction

Obesity is a major modifiable risk factor for reproductive dysfunction and is associated with anovulation and polycystic ovary syndrome (PCOS) in women, as well as hypogonadism and impaired semen quality in men. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), originally developed for the management of diabetes and obesity, have demonstrated potential reproductive benefits that extend beyond weight reduction. GLP-1 receptors are distributed throughout key components of the reproductive axis, including the hypothalamus, pituitary, gonads, and endometrium, suggesting possible direct effects on reproductive tissues. This review synthesizes current evidence regarding the mechanisms and clinical outcomes through which GLP-1 RAs may enhance …

Genetic Architecture Of Coronary Atherosclerosis Across European, African, And Admixed American Populations Using All Of Us Research Program Data, Kensley Philemond, Jodeci L. Mitchell, Thomas J. Last

Research Day

Introduction:

Coronary atherosclerosis, the underlying pathology of most coronary artery disease, is characterized by the accumulation of lipid-rich plaques within the coronary arteries, leading to increased cardiovascular risk. Established genes such as LDLR highlight the importance of lipid metabolism in disease pathogenesis, yet population-specific genetic contributors in African and Admixed American populations remain poorly understood. Identifying additional genetic contributors may improve our understanding of disease mechanisms and support more equitable cardiovascular risk prediction tools.

Methods:

We analyzed Genome Wide Association Study (GWAS) summary statistics from the All of Us Research Program using the All-by-All Research Browser to identify genetic variants …

Treatment Of Sacrococcygeal Dislocation Using Ultrasound-Guided Injection And Osteopathic Manipulative Medicine: A Case Report, Christopher Luz, Rajay Dockery, Alizé Berrios, Johnny Suzuki

Research Day

INTRODUCTION: Chronic sacrococcygeal dislocation is an uncommon source of long-lasting tailbone pain, often following a fall or other direct injury. Because the coccyx varies widely in shape and alignment from person to person, identifying a clinically meaningful displacement can be difficult, and imaging findings do not always match the severity of a patient’s symptoms. Standard conservative measures such as postural changes, cushions, physical therapy, and medication may help only partially when joint irritation or instability persists.

OBJECTIVES: This report describes a patient with ongoing pain from sacrococcygeal displacement who improved with a combined approach of ultrasound-guided injection and osteopathic manipulative …

Organ-Specific Patterns Of Metastatic Spread In Malignant Melanoma: A Comparative Study Of Cadaveric Specimens, Nadine Belony, Sydney E. Williams, Joshua Owolabi, Rasheed Agboola

Research Day

Introduction

Malignant melanoma is an aggressive malignancy with a high propensity for hematogenous metastasis, frequently involving highly vascular organs such as the lungs and liver. Histopathologic evaluation remains essential for distinguishing true metastatic spread from secondary organ injury due to systemic disease. This study compares organ-specific histological findings in two cadavers with documented malignant melanoma to evaluate patterns of metastatic involvement and associated tissue pathology.

Methods

Tissue samples from the lung, kidney, and liver were obtained from two cadavers: cadaver 10 (50-year-old White male with malignant melanoma) and cadaver 12 (77-year-old White male with malignant melanoma of the left lower …

When C5 Takes The Road Less Traveled: An Intramuscular Course Through Anterior Scalene In A Prefixed, Pass-Through Brachial Plexus, Camille Rios Anzola, Yousra Abo-Elhamd, Tyrese Claridge-Rogers, Maxwell Trettin, Dev Desai, Andrew Jimenez, Emranul Huq

Research Day

BACKGROUND: The brachial plexus (BP), formed by the ventral rami of C5-T1, provides sensory and motor innervation to the upper extremities. Classically, the BP roots pass between the anterior and middle scalene muscles within the interscalene triangle. However, anatomical variation is common due to the complex arrangement of cervical nerve roots and branches. Variants, such as a nerve root penetrating the anterior scalene muscle, may predispose individuals to nerve compression and may complicate procedures such as interscalene nerve blocks. Recognition of these variations is important for surgical, anesthetic, and imaging procedures involving the neck and shoulder. This report describes a …

Making Menopause Manageable: A Literature Review And Practical Guide For Clinicians On Menopause Education, Regan Flagg, Emily Rein, Joy Zarandy

Research Day

INTRODUCTION

Menopause is the natural cessation of female reproductive function, accompanied by a wide range of symptoms. Medical training in menopause is widely varied. Resultantly, resident and attending physicians report a varying degree of comfortability in having in depth conversations regarding symptom management and how to best address patient questions. Our goal is to provide primary care physicians with an easy-to-use guide that can bring awareness to the importance of this topic as well as strengthen the confidence of the providers using it. Upon concluding this project, we hope to reach more women, reduce stigma, educate, and support patients in …

Glp-1 Agonists And Total Knee Arthroplasty Outcomes: A Systematic Review, Rolanda Willacy, Regan Burgess, Simran Rai, Lucy Fisher, Tegshjargal Baasansukh, Damon Ross, Nia Dudley, Jane Boyle, Marvin Dingle

Research Day

Introduction

Optimizing outcomes in total knee arthroplasty (TKA) is a priority in orthopaedics. Glucagon-like peptide 1 receptor agonists (GLP-1 RA) help control blood sugar in diabetics and promote weight loss in obese patients. Studies show they contribute to decreased complications and improved outcomes after orthopedic surgery, but there are inconsistencies regarding its safety and efficacy. Some studies demonstrate reduced infection, readmission, and wound complications in diabetic patients, while others raise concerns about delayed healing, malnutrition, and increased complication rates among non-diabetics. This review evaluates the association between perioperative GLP-1 RA use and postoperative outcomes in TKA.

Methods

A systematic review …

Zoonotic Streptococcus Equi Subspecies Epidemicus Bacteremia With Prosthetic Joint Injection And Dvt In An Elderly Patient: A Case Report And Literature Review, Bhavik Singh, Zoë M. Rushetsky, Zoheb I. Sulaiman, Eileen M. Raynor

Research Day

Introduction

Streptococcus equi subspecies zooepidemicus (SEZ) is a beta-hemolytic group C streptococcus commonly found in the upper respiratory tract of horses and other animals. Although SEZ is a frequent cause of equine “strangles,” human infection is exceptionally rare and associated with direct animal contact or consumption of unpasteurized animal products. Human SEZ infections have been reported to present with bacteremia, septic arthritis, endocarditis, or meningitis—particularly in immunocompromised individuals—but involvement of prosthetic joints is scarcely described in the literature. This case highlights an unusual zoonotic presentation of SEZ bacteremia in an elderly male with frequent equine exposure that was complicated by …

Prevention Of A Transradial Amputation With Hyperbaric Oxygen Therapy Following A Radial Arterial Thrombus: A Case Report, Zachery Casella, Dallin Lindahl

Research Day

Case Description/Objective: A 70 y.o. right-handed M who presented to the ED with acute on chronic congestive heart failure that led to ventricular fibrillation (VF) arrest followed by Pulseless Electrical Activity (PEA) that was subsequently complicated by a left radial artery thrombus. Patient developed compartment syndrome that required a fasciotomy and was high risk for transradial amputation. Patient works as a carpenter and did not want to lose his hand; he elected to undergo limb salvage that included Hyperbaric Oxygen Therapy (HBOT) at Emory Midtown.

Intervention/Methods: Patient was transferred from sister hospital to Emory Midtown to be able to start …

A Case Of Radiation-Induced Optic Neuritis (Rion) Managed With Hyperbaric Oxygen Therapy, Zachery M. Casella, Dallin S. Lindahl

Research Day

Case Description/Objective: A 58-year-old African American man with a history of left skullbase meningioma presented to the emergency department with acute bilateral vision loss on April 16. He completed external beam radiation therapy in August 2024, receiving a total dose of 50.4 Gy over one month. MRI of the brain and orbits with and without contrast supported the diagnosis of optic neuritis, most consistent with radiation-induced etiology. He was treated with intravenous methylprednisolone for five days and discharged on oral dexamethasone, pentoxifylline, and vitamin E, with instructions to initiate Hyperbaric Oxygen Therapy (HBOT) as soon as possible at Emory University …

A Rare Case Of Suspected Mayer-Rokitansky-Küster-Hauser Syndrome: A Comparative Review Of Androgen Insensitivity Syndrome, Olivia G. Deloach, Caroline R. Kebberly, Zoë M. Rushetsky, Sreehitha Sanku, Mariah Smith, Marcel Castor

Research Day

Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome and androgen insensitivity syndrome (AIS) are two distinct disorders of sexual development that can present with similar clinical features, including primary amenorrhea, an absent uterus, and typical female external genitalia.

We present the case of a 27-year-old female who died following a motor vehicle accident and was found to have congenital absence of the uterus, cervix, and upper vagina, consistent with MRKH syndrome. MRKH occurs in phenotypic females with normal ovarian function, whereas AIS presents similarly but occurs in genotypic males with absent Müllerian structures and no ovaries.

This case was identified incidentally during an autopsy at …

Evaluation Of A Blast Pressure Wave Apparatus To Model Traumatic Brain Injury In Rodents, Nolan Gillihan, Diana Peterson

Research Day

INTRODUCTION Traumatic brain injury resulting from blast pressure waves is a significant concern, particularly among military personnel. This study aims to evaluate a blast pressure wave apparatus designed to simulate human-like traumatic brain injury in rodents, assessing both physiological and behavioral outcomes.

METHODS Rodents (Long Evans rats and CB57B/SMN2 mice) were exposed to a single 20 psi blast pressure wave using the newly developed apparatus. Pre- and post-exposure assessments included several behavioral tests: tinnitus, depression, and motor function. Control groups were exposed solely to an equivalent blast sound, but not the pressure wave of the device. Data was analyzed to …

Anatomical Evidence Of Systemic Progression In Desmoplastic Small Cell Round Tumor, Kimata Thomas, Suprithi Pingle, Jamison Hay, Ansa Malik, Jared Bobeck, Amy Wang, Shelley Dicecco

Research Day

BACKGROUND: Desmoplastic small round cell tumor (DSCRT) is a rare and aggressive malignant neoplasm with characteristic intra-abdominal involvement and poor prognosis. Existing literature focuses on known presentations of DSCRT and current treatment outcomes, while cadaveric anatomical findings remain underexplored.

OBJECTIVE: This case report aims to characterize anatomical and lymphatic manifestations of advanced DSCRT through cadaveric dissection and quantitative comparison with other cadavers whose causes of death were malignant in nature.

METHODS: A cadaveric case study was conducted through anatomical dissection. Quantitative assessment included lymph node counts and measurements, evaluation of metastatic extent, and documentation of gross anatomical changes within the …

Ethics First: The Importance Of An Irb When Working With Pediatric Populations, Chloe Phillips, Katrina Strand, Brooklyn Myers, Jamie Smith, Grace Bang, Daesung Choi, Xinyu Wang, Yujin Kim

Research Day

Objective: This IRB application was approached with a unique perspective due to its focus on a complex pediatric population, which may have determinants that create healthcare disparities. These populations are particularly vulnerable, making it paramount to ensure voluntary and honest participation.

Methods: Prior to recruiting or conducting a human study, research teams are required to get approval from this board, which consists of five or more members, including both those with scientific and nonscientific backgrounds, to ensure impartiality. All research personnel must also receive training in the basics of research ethics. The IRB application outlined every aspect of the project …

Gallstone Ileus 46 Years Post-Cholecystectomy Due To Duodenal Diverticulum, Jesse Kao, Jenna Fussell

Research Day

Gallstone ileus is a rare cause of small bowel obstruction that is typically seen in older females with multiple comorbidities. Gallstone ileus is most commonly caused by the passage of a gallstone through a cholecystoduodenal fistula, in the setting of chronic cholecystitis, with stone impaction most frequently seen in the terminal ileum. We present a rare case of gallstone ileus in a 51 year old female that formed 4 decades after cholecystectomy, likely due to the presence of a small duodenal diverticulum. This case highlights the need for the inclusion of gallstone ileus in the differential diagnosis for patients presenting …

A Triple-Combinatorial Approach For Multidrug-Resistant Gram-Negative Infections: Clinical And Mechanistic Insights Into Recarbrio, Pasang Sherpa, Heanose Takele, Joel John, Vicky Mody, Shashidharamurthy Taval

Research Day

The WHO has considered multidrug-resistant (MDR) bacterial infections as critical “priority 1” threats that need immediate antibiotic research and development, especially carbapenem-resistant Enterobacterales (CRE) and difficult-to-treat Pseudomonas aeruginosa. Globally, MDR infections increased by 43%, including a 67% in healthcare-associated infections and a 38% increase in community-acquired infections. It is considered as a “silent” pandemic that has existed for more than three decades. Antimicrobial resistance is predicted to cause up to 10 million deaths annually by 2050 if left untreated. Apart from high mortality, these infections lead to economic burden, with global healthcare costs exceeding USD 100 billion each year. CRE …

Fulminant Septic Shock Due To Streptococcus Pneumoniae Bacteremia Without Radiographic Pneumonia In An Immunocompetent Adult, Akash Kumar Sinha, Prasad Garimella

Research Day

Introduction

Streptococcus pneumoniae is a leading cause of community-acquired pneumonia and invasive pneumococcal disease. Pneumococcal bacteremia is typically associated with radiographic evidence of pneumonia, with pulmonary consolidation present in the majority of cases. However, invasive disease may rarely present without radiographic findings, creating a diagnostic challenge. We report a case of fulminant septic shock due to S. pneumoniae bacteremia in an immunocompetent adult without radiographic pneumonia.

Methods

This is a retrospective case review of a 48-year-old previously healthy woman who presented to the emergency department with one day of cough, sore throat, and generalized weakness. Clinical data including laboratory values, …

When Overgrowth Masks Inflammation: Juvenile Idiopathic Arthritis In Simpson-Golabi-Behmel Syndrome, Katherine Fadus, Joy Zarandy, Nancy Carnevale

Research Day

Simpson–Golabi–Behmel syndrome (SGBS) is a rare X-linked overgrowth condition characterized by pre- and postnatal macrosomia, craniofacial dysmorphism, congenital anomalies, and increased embryonal tumor risk. We present a 5-year-old male child with genetically confirmed SGBS complicated by progressive inflammatory arthritis consistent with Juvenile Idiopathic Arthritis (JIA), highlighting the diagnostic challenges that arise when structural overgrowth and autoimmune pathology coexist.

The diagnosis of SGBS was initiated prenatally after a mid-trimester anatomy scan demonstrated congenital diaphragmatic hernia and fetal macrosomia. Targeted genetic testing identified a pathogenic variant in GPC3. Postnatally, the child exhibited persistent macrosomia, macroglossia, organomegaly, renal cysts with hypertension, and repaired …

A Misdiagnosis Of Charcot Foot: A Case Report, Nasir Abbasi, Jovante Dockery, Aribah Ali, Kevin Tang, Vaishali Jadhav

Research Day

Introduction:
Charcot neuroarthropathy (CNO) is a chronic inflammatory disorder characterized by
progressive destruction of bone and joint structures, most commonly involving the foot and ankle in patients with underlying peripheral neuropathy. Diabetes mellitus is the most common associated condition, although CNO has also been reported in other neuropathic disorders. Diagnosis is frequently delayed because early CNO can mimic conditions such as cellulitis,deep venous thrombosis, inflammatory arthropathy, fractures, or ankle sprains. Physiological changes during pregnancy and the postpartum period may further obscure clinical recognition, increasing the risk of CNO.

Case Description:
A 37-year-old woman with type 2 diabetes mellitus presented during …