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When Fever And Thrombocytopenia Are Not Infectious: A Case Of Vitamin B12 Deficiency Mimicking Tropical Fever, Ram Arvind Viswanathan Dr

Digital Journal of Clinical Medicine

Vitamin B12 deficiency is classically associated with megaloblastic anaemia and neurological manifestations; however, atypical presentations continue to pose diagnostic challenges. Fever in association with thrombocytopenia often prompts evaluation for infectious aetiologies such as dengue, malaria, or sepsis, particularly in tropical settings. We report a case of vitamin B12 deficiency presenting with pyrexia and isolated thrombocytopenia, initially suspected to be an infectious illness. Extensive evaluation failed to reveal an infective cause, and subsequent haematological workup demonstrated megaloblastic changes with low serum vitamin B12 levels. Remarkably, the patient showed rapid defervescence and normalisation of platelet counts following parenteral vitamin B12 therapy. This …

The Role Of Physicians In Society: Perspectives From First-Year Mbbs Aspirants, Jesymol Joy, Dr Rashmi S, Amogha Shree, Dr Sunil Kumar D

Digital Journal of Clinical Medicine

Background: Physicians occupy a pivotal role in society as healers and communicators, with ethical leadership embedded in professional practice. In India, this role is evolving in response to changes in healthcare systems, increasing commercialization, and shifting societal expectations. Understanding how medical students perceive the physician’s role at the onset of medical education is vital for early professional identity development.

Objectives: To assess the motivations, perceptions, and values of first-year MBBS students regarding the societal roles, qualities, and responsibilities of physicians.

Methods: A cross-sectional study was conducted among 430 first-year MBBS students at a tertiary medical college in Mysuru, Karnataka, using …

Stones, Bones, And Hormones: A Multisystem Presentation Of Primary Hyperparathyroidism Due To Parathyroid Adenoma, Gadgesh B, Varsha Tandure, Nandini K, Chandana Srinath

Digital Journal of Clinical Medicine

Primary hyperparathyroidism is an endocrine disorder characterized by excessive secretion of parathyroid hormone, most commonly due to a solitary parathyroid adenoma, resulting in hypercalcemia and multisystem involvement [1]. Although many patients are diagnosed incidentally, delayed recognition may lead to severe renal, skeletal, gastrointestinal, and cardiovascular complications.

We report the case of a 44-year-old male who presented with sepsis and acute kidney injury, later found to have hypercalcemia with nephrocalcinosis, chronic calcific pancreatitis, skeletal deformities, and markedly elevated parathyroid hormone levels. Imaging localized a parathyroid adenoma, and the patient underwent successful parathyroidectomy with significant biochemical and clinical improvement.

This case emphasizes …

Clinical Correlates And Predictors Of Suicide Attempt Severity In Elderly Patients: A Cross-Sectional Study From South India, Rajamani Siddamallappa, Kiran Kumar Kadarappa Dr, Megha C N

Digital Journal of Clinical Medicine

Background: Suicide in late life is a major yet under-recognized public health problem in low- and middle-income countries. Elderly suicidal behaviour reflects interactions between psychiatric morbidity, substance use, psychological distress, intent, and method selection. Indian data examining these factors comprehensively remain limited.

Objectives: To assess psychiatric morbidity, hopelessness, suicide intent, planning patterns, methods, and independent predictors of suicide attempt severity among elderly suicide attempters.

Methods: This cross-sectional study included 75 elderly individuals (≥60 years) admitted following a suicide attempt to a tertiary care hospital in South India. Depression severity, hopelessness, and suicide intent were assessed using Beck’s Depression Inventory-21 (BDI-21), …

Family Mental Health – A Case Report, Vikrant Arora, Medha Kosireddy, Mathumitha Ananth, Kishor M. Manohar Rao

Digital Journal of Clinical Medicine

Psychiatric illness in India is estimated to be 15% as per National Mental Health Survey 2015-16.  Mental health challenges within families, especially depression, anxiety disorders that are not common and when unaddressed exert cascading effects on all members, disrupting emotional cohesion, relational functioning, and socioeconomic stability. There are few case reports on entire family presenting to psychiatry department.

With informed consent a city-based middle-class family of non-consanguineous origin, where the 40-year-old female, presented with intractable limb pains and health anxiety, she had multiple consultation in last few months and her 48-year-old husband also had with episodic pains, irritability and her …

From Controversy To Comeback: The Renewed Role Of Pralidoxime In Op Poisoning, Dr Sanaa Jain, Dr Savitha V, Dr . Shashidhara K C

Digital Journal of Clinical Medicine

Organophosphorus compounds are commonly used as pesticides in agriculture, but they are responsible for approximately one-third of suicide deaths in Asian countries.The symptoms of organophosphate (OP) poisoning vary over time and are categorized into three phases: Acute Cholinergic Crisis (minutes to 24 hours), Delayed Phase (24 hours to 2 weeks), which may include intermediate syndrome, coma, and extrapyramidal symptoms, and Late Phase (OPIDP). Treatment typically involves Atropine, Pralidoxime, and symptomatic management, including airway support and mechanical ventilation.

Ropinirole-Induced Sleep-Related Behavioral Disturbances And Psychotic Symptoms In Parkinson's Disease: A Case Report, Kareena Arora, Akshatha C. J, Rajesh Raman, Vikrant Arora, Bindu Annigeri, Megha Sadashiv

Digital Journal of Clinical Medicine

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized primarily by motor symptoms such as bradykinesia, rigidity, and tremor. Though commonly associated with motor symptoms but can also present with significant non-motor symptoms such as sleep disturbances, psychosis, and cognitive decline. These symptoms may arise spontaneously or be medication-induced. We present the case of a 53-year-old male with Parkinson’s disease who developed nocturnal behavioural disturbances and psychotic features, likely secondary to dopaminergic agonist medication. Symptom resolution followed adjustment of antiparkinsonian medications and the introduction of antipsychotic medication

Unusual Case Of Pelvic Fracture Urethral Distraction Defect, Varuni Pragya, Madhukesh Rudramurthy, Siddalinga Murthy G

Digital Journal of Clinical Medicine

INTRODUCTION

Urinary bladder ruptures are an uncommon injury, occurring in less than 1% of all blunt abdominal trauma. Extraperitoneal bladder ruptures are generally associated with pelvic fractures and usually managed nonoperatively but open surgery is required when these injuries are associated with additional trauma to structures like prostate and urethra.

CASE PRESENTATION

We report our experience with a 32-year-old male who suffered a head on collision with a four-wheeler while driving a two-wheeler in a road traffic accident. He presented to the hospital with abdominal and pelvic pain, difficulty in passing urine and swelling of the scrotum. His X Ray …

Comparison Of Post Operative Analgesia Between Dexmedetomidine Versus Clonidine As Adjuvant To Ropivacaine In Ultrasound Guided Adductor Canal Block In Arthroscopic Knee Surgeries: A Randomized Controlled Study, Shwetha Arun, Archana B N, Dr. Shivakumar G Pofessor And Hod, Devika Lekshmi S

Digital Journal of Clinical Medicine

The current study evaluated the analgesic efficacy of dexmedetomidine versus clonidine as adjuvants to 0.2% ropivacaine in ultrasound-guided adductor canal block. Effective postoperative pain management is essential for early mobilization and improved recovery following arthroscopic knee surgeries. Sixty ASA I–II patients aged 20–60 years undergoing elective arthroscopic knee procedures were randomized into two groups: Group D received ropivacaine 0.2% 30ml with dexmedetomidine 100 mcg, and Group C received ropivacaine 0.2% 30ml with clonidine 150 mcg. Duration of analgesia, pain scores, sedation levels, hemodynamic changes, and rescue analgesic requirements were recorded. Group D demonstrated significantly prolonged analgesia (18.08 ± 0.514 h) …

Pulmonary Hemosiderosis In A Young Child Presenting With Recurrent Respiratory Illness And Refractory Anemia: A Case Report, Praveen Das, Ratnapriya Chowdhry, Neha Bhongale, Poonam Wade

Digital Journal of Clinical Medicine

Pulmonary hemosiderosis (PH) is a rare cause of diffuse alveolar hemorrhage in children and often presents with nonspecific respiratory symptoms and refractory iron‑deficiency anemia. We report a 2.5‑year‑old girl with recurrent lower respiratory tract infections, severe transfusion‑dependent anemia, failure to thrive, and persistent bilateral pulmonary infiltrates since infancy. Bronchoalveolar lavage demonstrated hemosiderin‑laden macrophages, confirming pulmonary hemosiderosis. Further evaluation revealed C‑ANCA positivity and PR3‑ANCA negativity, raising suspicion for an ANCA‑associated vasculitis; however, there was no renal, ear‑nose‑throat, or other systemic involvement, and a lung biopsy could not be performed. The child was managed with systemic corticosteroids with clinical improvement. This case …

State Social Benefit Schemes For Women In Continuity Of Psychiatric Care: A Case Report, Mathumitha A, Kishor M. Manohar Rao Professor

Digital Journal of Clinical Medicine

Mental health disorders are a major global public health challenge. The disorders affect over a billion people worldwide, while depressive and bipolar spectrum disorders also contribute substantially to disability and reduced quality of life. According to the World Health Organization, major depression alone affects more than 300 million people globally and is considered a leading cause of years lived with disability. Beyond clinical morbidity, mental illnesses exert a profound economic impact, with depression and anxiety accounting for an estimated USD 1 trillion annually in lost productivity worldwide, while the overall global economic burden of mental disorders is projected to reach …

Comorbid Psychosis In The General Population, Mariam Sankoh

Theses and Dissertations

Psychosis is a complex psychiatric phenotype characterized by substantial heterogeneity in symptom presentation, psychosis diagnosis, comorbidity patterns, and genetic architecture across diverse populations in the general population. Despite advances in psychiatric epidemiology and genomics, important gaps remain in understanding how psychosis symptoms and psychosis-related diagnoses manifest across racial and ethnic groups and how evolutionary genomic factors may contribute to disease risk and cross-ancestry genetic prediction. This dissertation, Characterizing Comorbidity in Psychosis in the General Population, integrates epidemiological, psychometric, and evolutionary genetic approaches to examine psychosis across diverse populations.

Aim 1 examined racial and ethnic differences in psychosis comorbidity patterns …

The Impact Of Medicaid Policy Limitations On Access To Eating Disorder Treatment: Uncovering The Consequences Of A System Built To Fail, Meghan Frost

DSW Capstone Projects

Individuals who rely on Medicaid face major barriers when trying to access eating disorder (ED) treatment, reflecting broader patterns of structural disadvantage in publicly funded health care. Research shows delayed diagnosis, limited access to ED specialists, and frequent denials for recommended services. These gaps occur because Medicaid policies do not match the needs of evidence based ED care, resulting in delayed or incomplete care for many individuals with eating disorders.

This issue is highly relevant to social work practice because the policies shaping these barriers are complex and difficult for clients and ED providers to navigate. Social workers across clinics, …

Treatment Manual For Nonsequential Format. Two Part Program For Symptom Self-Management (12 Session Course & Support Group For Booster Dose Of Course)., Robin Kay Buccheri, Louise Nigh Trygstad, Martha D. Buffum

Nursing and Health Professions Faculty Research and Publications

This is the Treatment Manual for NonSequential Format: Two-Part Program for Symptom Self-Management of Auditory Hallucinations: 12 Session Course & Support Group for Booster Dose of Course

Investigation Of Differences Between Perception Of Cell Phone Usage And Actual Cell Phone Usage Among Adolescents In Senior And Freshman Grade Levels, Benjamin Bouffard

UROP Posters

This study investigates the difference between the perception of cell phone usage and actual cell phone usage among teenagers in the ninth and twelfth grade levels. Existing literature focuses largely on the effect of screen usage on different aspects of health, including mental health and developmental changes in children. However, the relationship between the perception of screen time and actual screen time use has not been extensively studied. In this study, 111 freshmen and seniors at the Woodbridge Academy Magnet School in Woodbridge, New Jersey completed two online surveys. The first asked for their estimation of daily screen time over …

Effects Of Differential Stress And Mental Health On Substance Use Among College Students, Avdi S. Avdija, Arif Akgul

Sociology & Criminal Justice Faculty Publications

Substance use among college students is often seen as a coping mechanism for some students who are prone to extreme stress, depression, or anxiety. Multiple forms of stress become the leading factors that push students toward substance use. This study tests the effects of college stressors, depression, and anxiety on substance use among college students. The results are based on the data that were collected using a 101-item questionnaire administered to 302 college students at a public university in the Midwest U.S.A. Using Logistic Regression as the primary data analysis technique, the findings of this study show that social stressors …

Finding Harmony: Music Therapy As An Adjunct In Acute Psychosis, Brandon Szwydky, Rebecca Low, Nelay Govan, Marcus Decarvalho

South Atlantic Division GME Research Days 2026

No abstract provided.

A National Evaluation Of A Novel Quality Measure Of Emergency Behavioral Health Care., Martin Wegman, Marshall Johnson, Hannah Cortero, Natalia Badillo-Velez, Crystal Bharat, Sanket Patel, Caroline Mills, Des'ree Garvin

South Atlantic Division GME Research Days 2026

No abstract provided.

Quick Improvement In Delirium In A Patient With Parkinson's Disease Through Rectally Administered Carbidopa/Levodopa: A Case Report, Emil Philip, Carol Elsakr, Tyler Kilgore

South Atlantic Division GME Research Days 2026

No abstract provided.

Startle Habituation And Vagally Mediated Heart Rate Variability Influence The Use Of Emotion Regulation Strategies, Xiao Yang, Fang Fang, Angela Ximena Babb

Psychology Faculty Publications

Emotion regulation refers to the processes through which people modulate their emotional experiences and expressions, and difficulties in these processes underpin many forms of psychopathology. According to the process model, emotion regulation encompasses five classes of strategies, commonly grouped into antecedent-focused strategies (e.g., cognitive reappraisal) and response-focused strategies (e.g., expressive suppression). These strategies involve both explicit and implicit processes, which can be objectively assessed using physiological indices. The present study examined the effects of startle habituation and vagally mediated heart rate variability (vmHRV) on the use of cognitive appraisal and suppression. Forty-nine college-aged participants were recruited, and their resting heart …

Maternal Child Maltreatment And Intimate Partner Violence: Effects On Perceptions Of Infant Temperment And The Mediating Role Of Emotion Regulation And Responsiveness, Jewelian N. Fairchild, G. Anne Bogat, Amy K. Nuttall, Alytia A. Levendosky, Joseph S. Lonstein, Maria Muzik

Psychology Faculty Publications

Purpose

Maternal adverse experiences, such as maltreatment in childhood and later intimate partner violence (IPV) during pregnancy, can disrupt the mother-child relationship and influence maternal perceptions of infant temperament. The present study explored how these adversities influence mothers’ views of their infants’ temperaments and examined the role of maternal emotion regulation and responsiveness to their infants as mediators of these relationships.

Methods

Using data from a longitudinal study of highly stressed, vulnerable women, 355 mothers retrospectively reported on their own childhood maltreatment, as well as their experiences of IPV and emotion regulation during pregnancy. Maternal responsiveness was coded using mother-infant …

Advancing Models Of Ptsd-Aud Comorbidity: Protocol For A Multimethod Framework Using Genetics And Ecological Momentary Assessment, Elizabeth A. Stinson, Samhita Lellapalli, Sage E. Hawn, Natalie Merrill, Lance M. Rappaport, Christina M. Sheerin, Vasiliki Michopoulos, Silviu-Alin Bacanu, Roseann E. Peterson, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), which are moderately heritable, frequently co-occur and contribute to significant public health burdens, particularly among economically disadvantaged urban communities. There are noted sex differences in PTSD and AUD outcomes, with evidence suggesting women have heightened susceptibility to stress-related alcohol use. Preliminary PTSD-AUD ecological momentary assessment (EMA) findings support bidirectional associations across clinical outcomes. However, no studies to date have used PTSD-AUD comorbidity models as organizing frameworks to examine the temporal ordering and stability of within-person symptom dynamics underlying the maintenance or exacerbation of PTSD and AUD symptoms, including bidirectional and …

I Can't Stop: The Effects Of Psychological Climate For Overwork On Recovery Experiences, Jeffrey Drake Terry, Konstantin P. Cigularov

Psychology Faculty Publications

Recovery experiences are important for many health and well-being outcomes. One potential threat to an individual's recovery experiences in the workplace is psychological climate for overwork. The purpose of the present study was to examine the relationship between psychological climate for overwork and recovery experiences. Using a multi-wave research design (N = 202), we found that psychological climate for overwork had direct effects on psychological detachment and indirect effects on psychological detachment and relaxation through cognitive workaholism and work-recovery guilt. These results suggest that psychological climate for overwork may contribute to an individual's experience of cognitive workaholism and work-recovery guilt, …

Examining The Factor Structure And Subgroup Invariance Of The Deliberate Denial Of Disordered Eating Behaviors Scale, Lindsay Howard, Sage Hawn, Kayla D. Pitchford, Riley Mcgrath, Aubri Farniok, Arturo Sesma, Kristin E. Heron

Psychology Faculty Publications

The denial, concealment, or omission of disordered eating behaviors has received limited attention in the eating disorder literature, partly due to the lack of reliable and valid measures. This study re-examined the factor structure of the Denial of Disordered Eating Behaviors Scale (DDEBS-12) and tested measurement invariance across gender identity, racial identity, and levels of disordered eating in a non-clinical undergraduate sample (N = 3285). Confirmatory factor analyses did not support the original unidimensional structure. Instead, a seven-item model assessing denial of dietary restriction demonstrated the best fit and was renamed the DDEBS-restriction. The revised scale showed good internal consistency …

Cross-National Longitudinal Insights Into College Alcohol Beliefs And Consequences: The Role Of Food And Alcohol Disturbance, Javiera A. Hernandez Puelma, Katherine A. Berry, Luke Herchenroeder, Alison Looby, Adrian J. Bravo, Christopher C. Conway, Fermín Fernández-Calderón, James M. Henson, Lee Horgarth, Manuel I. Ibáñez, Debra Kaminer, Matthew Keough, Oleg Medvedev, Laura Mezquita, Yanina Michelini, Generós Ortet, Ricardo Pautassi, Matthew R. Pearson, Angelina Pilatti, Mark A. Prince, Jennifer P. Read, Verónica Vidal Arenas, Cross-Cultural Addictions Study Team

Psychology Faculty Publications

The present study examined the mediational role of FAD-intoxication (i.e., restricting calories to increase or quicken alcohol intoxication) in the relationship between college alcohol beliefs (CABs) and negative alcohol-related consequences. A sample of 2543 student drinkers from six countries completed the baseline survey, and 505 drinkers completed at least one follow-up. Two models examined whether frequency of FAD-intoxication mediated the relationship between CABs and alcohol-related problems, and structural invariance testing was conducted across sex and countries. FAD-intoxication was concurrently and prospectively associated with greater endorsement of alcohol-related consequences and significantly mediated the effects of CABs on alcohol-related consequences. The relationship …

From Molecules To Minds: Integrative Multi-Omics In Psychiatry, Hossein Abbasi, Sage E. Hawn, Arash Javanbakht, Soraya Seedat, Kyle Bourassa, Sinead M. Sinnott, Antonia V. Seligowski, Sian Hemmings, Nathan A. Kimbrel, Alicia K. Smith, Leslie Brick, Divya Mehta

Psychology Faculty Publications

Psychiatric disorders are biologically complex conditions arising from interactions across genomic, epigenomic, transcriptomic, proteomic, metabolomic, and metagenomic layers. Single-omics approaches rarely capture more than a fraction of the variance in complex conditions, underscoring the importance of integrative multi-omics frameworks. This mini-review summarizes key methodologies and their application in psychiatric research, with a focus on systems-level integration of genomic risk scores, transcriptomic networks, and neuroimaging data to advance biological understanding of disorders such as depression, schizophrenia, and Alzheimer’s disease. We also outline the infrastructural requirements for effective multi-omics research, including standardized biobanking, Laboratory Information Management Systems, adherence to FAIR data principles, …

Early Parenting Stress And Later Abuse Risk: Dyadic Analysis Of Mediation By Maternal And Paternal Negative Attributions, Jewelian N. Fairchild, Christina M. Rodriguez

Psychology Faculty Publications

Predicting the likelihood parents will become physically abusive towards their children remains a high priority. Early parenting stress may increase the extent to which parents negatively appraise their children's behaviours, which in turn may influence their abuse risk. This study explored whether parental negative attributions mediated the association between early parenting stress and later abuse risk. A sample of 186 first-time mothers and 146 of their male partners reported on their parenting stress when infants were 6 months old and their negative attributions regarding child behaviours at 18 months. Parents' child abuse risk was assessed at age four using two …

Best Practices For Using Biological Data In Psychological Research, Sage E. Hawn, Sinead M. Sinnott, Alicia K. Smith, Kyle Bourassa, Leslie Brick, Sian Hemmings, Soraya Seedat, Arash Javanbakht, Lauren Smith, Antonia V. Seligowski, Nathan A. Kimbrel, Divya Mehta, Hossein Abbasi, Erika Wolf

Psychology Faculty Publications

Advances in statistical techniques for analyzing biological data have driven the need for larger sample sizes, which are ultimately made possible through team science efforts. Findings from these efforts have led to a significant shift in approaches to biological data collection over the past decade, from traditional approaches relying on single measures or assays collected by individual investigators in small lab-based studies to high-dimensional methodologies embedded within large cohorts or multi-site studies. These recent large scale consortium efforts necessitate careful consideration across the full data pipeline, from pre-data generation and sample collection to processing and statistical analysis, while addressing challenges …

A Real-Time Examination And Comparison Of Differentiation Among Suicidal Thinking And Affect Items In An Adolescent Sample, Elizabeth A. Edershile, Kinjal K. Patel, Annabelle M. Mournet, Richard T. Liu, Catherine R. Glenn, Evan M. Kleiman

Psychology Faculty Publications

Suicide risk assessments require individuals to differentiate among types of suicidal thoughts (e.g., passive vs. active); yet most research relies on aggregate metrics that obscure this differentiation. Indeed, more severe forms of suicidal thinking are thought to involve the simultaneous experience of multiple forms of thoughts at high intensities. The present study draws on concepts from the affect differentiation literature to (a) examine different ways to operationalize differentiation in suicidal thinking and (b) compare differentiation in suicidal thinking with differentiation in affect. Adolescents (N = 200) recently hospitalized for suicidal thoughts and behaviors completed a 28-day ecological momentary assessment …

Understanding Autonomous Sensory Meridian Response (Asmr), Cecilia Zoutewelle

A. The Science of Sound

This 7-page report with illustrations and bullet-point summaries provides an introduction to the phenomena of Autonomous Sensory Meridian Response (ASMR). Also included is a brief discussion on the benefits of ASMR for interpersonal listening.