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Beyond Breathless: Unravelling The Enigma Of Pulmonary Arteriovenous Malformations, Sri Mounya Jampala, Jagadish Kumar K Dr., Manjunath V G, Nandish H R

Digital Journal of Clinical Medicine

Pulmonary Arteriovenous Malformations (AVMs) are abnormal connections between the pulmonary arteries and veins, leading to a direct shunting of blood without passing through the normal capillary bed. These AVMs can be associated with a rare genetic disorder called Hereditary Hemorrhagic Telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome. HHT is an autosomal dominant disorder characterized by the development of fragile telangiectasias in various organs, including the skin and mucous membranes. These telangiectasias are prone to bleeding, leading to recurrent nosebleeds and mucocutaneous bleeding. In patients with HHT, the most common site of AVMs is in the lungs. Pulmonary AVMs can cause …

Stroke: A Neurological Complication In Covid-19., Abhigna M, Vikram Patil

Digital Journal of Clinical Medicine

No abstract provided.

A Study On The Prevalence Of Vitamin B12 Deficiency In Eastern Indian Type 2 Diabetes Mellitus Patients With Peripheral Neuropathy On Metformin Presenting To A Tertiary Care Hospital, Ajay Hanumanthu, Soumik Goswami, Kavya Bhadrapura Thimmegowda, Nilanjan Sengupta, Arjun Baidya, Pranab Kumar Sahana

Digital Journal of Clinical Medicine

Introduction:

The association between long-term metformin use in type 2 diabetes mellitus (T2DM) and low vitamin B12 levels has been proven and screening for the same is recommended by American Diabetes Association (ADA) guidelines. The potential of the deficiency to cause or worsen diabetic peripheral neuropathy (DPN) in T2DM patients has been investigated in previous studies. However, the prevalence estimates of vitamin B12 deficiency in T2DM patients treated with long term metformin and having established DPN is lacking in our country. The aim of our study was to estimate the prevalence of vitamin B12 deficiency in T2DM patients with DPN …

Meningitis In Hiv Positive And Negative Patients: A Comparative Demographic Profile., Sridhar Amalakanti, Jyothi Priya Jillella, Krishna Sagar Gajula

Digital Journal of Clinical Medicine

Background: Meningitis is a serious infection in HIV patients claiming millions of lives across the world. Comparative studies of meningitis in HIV positive and negative patients are scarce. Methods: We performed a comparative study of the demographic features of meningitis in HIV positive [116] and HIV negative [218] patients at a tertiary hospital over a period of four years. Results: In HIV seropositive patients the percentage of women was lesser [29.6% vs. 42.5%], the proportion of students was lesser [4.8% vs.14%], but the proportion of professionals was higher [17.5% vs. 10.8%] when compared to HIV seronegative group. Even though Tuberculosis …

Covid-19 Vaccine Effectiveness In Preventing Severe Infections And Mortality Among Patients In Kerala, India., Surag Mk, Sarin S. M, Sarosh Kumar K K, Udaya A

Digital Journal of Clinical Medicine

ABSTRACT

Background:

India has a top status among world countries, related to the COVID-19 mortality that had crossed the 3-lakh level. The second wave of COVID19 had ravaged the world countries, created havoc of the highest order, leaving many hapless, thanks to the low availability of oxygen, ICU facilities, vaccines and counselling prospects.

There is a lack of information about how COVID-19 vaccines have affected mortality in specific geographic areas.

Method:

A Retrospective record-based design. Patients were matched for age, sex, ethnicity, co-morbidities and grouped into fully immunized, partially immunized and non-immunized.

The primary outcome was in-hospital deaths and secondary …

The Trichobezoar Enigma: Untangling The Intricacies Of Rapunzel Syndrome, Debabrata Sahu, Dr Rajkishor Sahu

Digital Journal of Clinical Medicine

Rapunzel Syndrome is a rare manifestation of trichobezoar, characterized by the presence of hair strands extending beyond the stomach and into the duodenum. Trichobezoars typically develop in individuals with a history of trichotillomania, a compulsive behavioral disorder involving hair-pulling, combined with trichophagia, the ingestion of hair. While trichobezoars predominantly form within the stomach, their occurrence in the jejunum is infrequent. This condition is more commonly observed in adolescent females.

The formation of bezoars within the gastrointestinal tract is typically attributed to anatomical changes. However, in cases where no such anatomical abnormalities are present, psychiatric disorders like trichotillomania can lead to …

Modified Electroconvulsive Therapy As Maintenance Treatment, Jatin Kumar, Kishor M, Murali M R

Digital Journal of Clinical Medicine

Depression is the most common psychiatric condition that significantly affects the quality of life of individual affected with it and it can present with various signs and symptoms. It usually presents with persistent and pervasive sadness of mood, anhedonia, sleep disturbance, reduced appetite, reduced concentration, multiple somatic symptoms, and suicidal thoughts. In this case report a 61-year-old gentleman presented with sadness of mood, loss of interest, sleep disturbance, multiple body aches, and abdominal pain which varied from 2 to 6 weeks. He had failed to respond to multiple classes of antidepressants, mood stabilizers, and antipsychotics. However, he would respond well …

Cerebral Venous Thrombosis In Pregnancy : A Case Report, Dr Sumuk M S Sr, Dr Anupama Marnal B A Sr, Dr Mamatha S Professor And Head Of The Department, Poornima M Associate Professor

Digital Journal of Clinical Medicine

Cerebral venous thrombosis (CVT) is a rare complication encountered in pregnancy. Symptoms of CVT include headache, limb paresis, seizures , disturbed consciousness , visual disturbances. We present our 25 years old pregnant patient who presented with unsteadiness of gait , weakness and numbness of all four limbs, vomiting headache , giddiness due to which it was difficult for her to perform her daily activities. After the differential diagnostic examinations, we recognised cerebral venous thrombosis. After anti-coagulant treatment , the symptoms resolved. We would like to convey that such symptoms in pregnant women we should always think of CVT.

Relationship Between Femoral Artery Intima-Media Thickness And Atherosclerosis In Patients With Chronic Kidney Disease- A One Year Hospital-Based Cross-Sectional Study, Dr. Somashekhar Sogi, Dr. Ravi Sarvi, Dr. Pradeep Goudar, Dr. Mallikarjun Karishetti, Dr.V.V Hattiholi, Dr.Meenakshi Sarvi

Digital Journal of Clinical Medicine

Introduction: Chronic kidney disease (CKD) is one of the leading causes of morbidity and mortality worldwide. CKD and Peripheral arterial disease both independently increase the risk for cardiovascular disease (CVD) events and contribute significantly to morbidity and mortality. There is limited data about the co-relation between ultrasound measures of the femoral artery in peripheral vascular disease (PVD) & renal functional status. This research hence will help us in the establishment of a relationship between femoral intima-media thickness (fIMT) with CKD. Also, IMT assessment might help in earlier detection of atherosclerotic plaques & hence PVD.

Materials and methods: A cross sectional …

Hyperdiploid Chromosomes In Patients With B Cell Acute Lymphoblastic Leukemia, Anjali Shastry

Digital Journal of Clinical Medicine

Introduction: Hyperdiploidy (more than 50 chromosomes) is an important cytogenetic abnormality found in B cell acute lymphoblastic leukemia (B cell ALL). The presence of hyperdiploidy > 50 is considered to be a good prognostic marker since it has increased sensitivity to standard chemotherapy. Patients with hyperdiploidy have the longest disease-free survival compared with any other cytogenetic group.

Aim of study:

To estimate prevalence of hyperdiploid chromosomes in patients with B cell ALL through conventional karyotyping and Fluorescent in situ hybridization (FISH).

Materials and methods:

Retrospective study was done on 200 bone marrow samples diagnosed with B cell Acute lymphoblastic leukemia …

Dengue Fever With Normal Platelet Count In A Patient With Β-Thalassemia Trait: A Case Report, Pankaj Kumar Jain, Manoj Seval, Vikas Meena, Rajesh Yadav

Digital Journal of Clinical Medicine

Dengue fever is an arboviral infection typically characterized by thrombocytopenia and hemoconcentration. However, hematological manifestations may differ in patients with underlying hemoglobinopathies. We report a case of 18-year-old female diagnosed with dengue fever (IgM ELISA positive), presented with persistent fever, vomiting, and myalgia. Laboratory evaluation revealed moderate microcytic anemia (Hb 9.7 g/dL, MCV 54.7 fL) with a low Mentzer index (8.7). High-performance liquid chromatography confirmed β-thalassemia trait (HbA2 4.6%). Contrary to the typical presentation of dengue, the patient had elevated platelet counts at admission (584,000/µL), which remained within normal to high range during hospitalization. This case highlights that dengue infection …

Molecular Target And Circuitry Underlying The Preclinical Effects Of Psychedelics In Models Of Opioid Use Disorder, Alaina M. Jaster

Theses and Dissertations

Opioid use disorder (OUD), like other substance use disorders (SUD), is characterized by maladaptive behavioral allocation away from other rewarding aspects of life following prolonged use, as well as large rates of relapse. While pharmacotherapies exist for OUD, they tend to only target the opioid receptors rather than the underlying mechanisms behind the maladaptive behaviors. Serotonin (5-hydroxytryptamine; 5-HT) is involved in modulation of cravings and regulation of motivational reward-related behaviors, thought to be due to a top-down processing method of external and internal stimuli. Serotonin 2A receptors (5-HT_2AR) are widespread throughout the brain and most densely populate layer …

Assessing The Perceived Impact Of A Local, Community-Engaged Mural Project On Preservice Art Educators In Foundational Coursework, Caitlin M. Black

Theses and Dissertations

This qualitative study merged the methodological frameworks of qualitative case study and narrative inquiry (Sonday et. al, 2020) to assess the perceived impact of a local, community-engaged mural art project (Mending Walls) on undergraduate preservice art educators in foundational coursework. The study was grounded in existing research in three areas: community-engaged murals, community-engaged pedagogy, and community-engaged teacher preparation. These concepts were used to frame the study and provide further rationale for the inquiry. The purpose of this case study was to understand how undergraduate preservice art educators perceived the impact of using a local, community-engaged mural project (Mending Walls) in …

Demonstrated Sensitivity, Kate Crankshaw

Theses and Dissertations

Flameworking is a tedious process that demands all of your attention and focus. Making multiples of a shape in this process allows my body and mind to fall into a rhythm. During these times, it allows my anxious mind to be quieted and helps me dive into processing past memories, trauma, and grief. It is commonly suggested in Dialectical Behavioral Therapy practices to find an activity to do that is both physical and repetitive to work through grief. This stimulates the physical and mental parts of the body, both areas where the effects of grief and trauma are held. Relaxing …

The Impact Of A Parent-Only Pediatric Obesity Intervention Program On Quality Of Life In Racially Diverse Children, Taylor Vashro

Theses and Dissertations

Pediatric obesity has been associated with significant decrements in pediatric quality of life (QOL) comparable with severe pediatric diseases such as cancer. Parenting interventions have yielded health benefits for children with obesity; however, few studies have investigated the impact of parent-focused interventions on QOL in children with overweight and obesity. This study investigated the impact of a 6-week intensive parenting intervention program on the QOL of 5-12 year old, predominantly Black children with overweight and obesity. Parents were randomized into either the parenting intervention (NOURISH+) or a control group, and QOL, as well as variables related to child and parenting …

Examining Genetically-Informed Etiologic Models Of Co-Occurring Posttraumatic Stress Disorder And Recreational Cannabis Use Among College Students, Terrell A. Hicks

Theses and Dissertations

The college years encompass a period of increased risk recreational cannabis use (RCU), as well as a time of increased risk for trauma exposure and developing posttraumatic stress disorder (PTSD). Given the high co-occurrence between RCU and PTSD, and the potentially negative consequences of the two (e.g., worse academic outcomes), there is a need to understand the etiologic mechanisms of these commonly co-occurring conditions. Two primary phenotypic models exist: self-medication model (i.e., PTSD to RCU) and the high-risk model (i.e., RCU to PTSD). To date, there are two existing studies longitudinally examining the etiologic models proposed to explain co-occurring RCU …

Correlates Of Current Tobacco Use Among Cancer Survivors: Examining The Role Of Posttraumatic Growth And Family Conflict, Kendall Fugate-Laus

Theses and Dissertations

Cancer survivors who use tobacco are at a greater risk of death and poor health outcomes. Although tobacco use during cancer survivorship is associated with poor psychosocial functioning, it is relatively unknown how tobacco use is associated with other variables important to cancer survivorship, such as family functioning and posttraumatic growth. Thus, the current study aims to contribute to this gap within the literature by investigating the association between family conflict, posttraumatic growth, and current tobacco use status among cancer survivors. Participants were recruited from Virginia Commonwealth University’s Massey Comprehensive Cancer Center and eligible to participate if they received any …

The Five Senses: Fundamentals In Acting Training, Landon A. Nagel

Theses and Dissertations

ABSTRACT

THE FIVE SENSES: FUNDAMENTALS IN ACTING TRAINING

A thesis submitted in partial fulfillment of the requirements for the degree of MFA Theatre Pedagogy at Virginia Commonwealth University

by

LANDON NAGEL

Thesis Chair: Aaron Anderson, PH.D.

Theatre Graduate Program Director, Department of Theatre

The following is presented as a tool for new acting teachers, students and potentially parents. It identifies and explores the fundamental lessons that I believe are necessary inside a beginning acting studio, inspired by that which I believe is necessary when raising a young child. Rather than focusing on one particular technique, system or method - I …

Analysis Of Referrals To Trauma Psychology And Subsequent Development And Proof-Of-Concept Study Of Provider Mental Health Training At A Level I Trauma Center, Samantha Mladen

Theses and Dissertations

Introduction: Millions of people are traumatically injured each year, with a significant portion going on to develop negative mental health sequelae. Many Level I trauma centers are integrating psychologists to provide acute assessment and intervention to patients at risk for poor outcomes. However, medical providers receive very limited training in how to best refer patients to mental health services and may benefit from such education.

Objective: To characterize current patterns of referral to trauma psychology at a Level I trauma center and to develop, refine, and test proof-of-concept for a new training for referring providers.

Method: One year of patient …

Motivations And Conflicts In Prison Medical Contracting, Meagan D. Sok

Theses and Dissertations

State correctional departments are responsible for all medical care incarcerated individuals require. Many systems outsource their medical

State correctional departments are responsible for all medical care incarcerated individuals require. Many systems outsource their medical program. Literature indicates that many of these contracts experience significant issues that negatively impact state resources, including both personnel and money.

This dissertation explores the relationship between prison administrators' motivations and the structure, outcomes, efficiencies, and partner conflicts that arise in the contractual process. Using a framework developed from Incomplete Contract Theory, Contracts as Reference Points Theory and the concept of “essential tension,” this dissertation hypothesizes …

Strength Scaling A Generic Upper Limb Musculoskeletal Model To Represent Individuals With Paraplegia, Yeajin Cho

Theses and Dissertations

Musculoskeletal (MSK) modeling and simulation of human movement is needed to estimate biomechanical quantities which cannot be directly measured, including muscle and joint contact forces during wheelchair propulsion. When accurate representation of an individual's muscle strength and musculoskeletal anatomy is needed, a generic upper limb MSK model can be scaled, or a subject-specific model can be developed. A generic MSK model can be scaled with regard to strength to represent an individual nonimpaired adult or child based on limb lengths and muscle volumes, or other techniques. Developing a subject-specific model requires MSK and physiologic data typically derived from medical imaging …

Goals Of Care Identification Tool In The Surgical Icu/Neuro-Critical Care Unit: A Tool Exploration, Brandon P. Nugent

Nursing Doctoral

Background: Ischemic strokes affect nearly 795,000 people yearly. Approximately 20% of patients with an acute ischemic stroke (AIS) will need an intensive care unit (ICU) admission, and less than 20% of these patients have a good neurological outcome at six months. In patients with AIS goals of care (GOC) discussions are required to ensure care remains goal concordant. There continues to be a gap of GOC discussions and documentation in the ICU, for which the cause can be multifactorial, but identification of patients in need remains one of the leading factors. Methods: This was a two-stage quality improvement project implemented …

Qvoices: Queer Voices In Oncology Igniting Change Through Empowered Stories Of Survivorship, Viktor Clark

Theses and Dissertations

Background: Each year in the United States there are roughly 2 million new cancer diagnoses, with over 600,000 deaths due to cancer. The National Cancer Institute developed a six-stage cancer control continuum framework ranging from etiology to survivorship to organize the cancer experience. Sexual and gender minorities (SGM) are comprised of multiple communities representing ~23.6 million adults in the US, SGM face disparities at each stage of the cancer control continuum. This study emphasizes three stages, prevention, detection, and treatment. Engagement in prevention can prevent or prolong cancer, early detection through engagement in cancer screening improves cancer trajectories and compliance …

Breaking Bread & Boundaries : Finding Home In Every Bite, Steffi Ann Braganza

Theses and Dissertations

Raised outside of their “passport” countries, Third Culture Individuals (TCIs) often experience a lack of rootedness and belonging, and home is often everywhere and nowhere. Childhood food memories can provide the sense of connection and identity TCIs crave. Four Qatar-raised TCIs, from very different backgrounds share memories of their childhood comfort foods, now hybridized dishes, that reflect their unique third culture experiences. Each dish, in turn, inspired the creation of a bespoke set of cooking /dining ware designed to trigger a specific sensory memory: the sight, smell, touch, or sound associated with the original comfort dish. This specialized cooking/dining ware …

Refashioning Style From The Outside-In: A Pakistani Diasporic Response, Sidra Sohail Khawaja

Theses and Dissertations

Pakistan’s traditionalists and modernists hold opposing political, religious, social and nationalist views creating a constant tension within the culture. This tension creates a fashion industry with two extremes, one side reflecting traditional influences and the other reflecting western trends. I address the tension by analysing the craft and context of traditional Pakistani men’s clothing and incorporating traditional construction techniques into garments that reflect aspects of both points of view. In a series of five looks, I extract from influences like Persian, North Indian, Afghani, Colonial and Neo-Colonial, to generate hybridized garments that offer a new perspective, blending traditional elements with …

Examining Allostatic Load As A Biological Mechanism Linking Childhood Adversity And Pediatric Pain, Angela Pascale

Theses and Dissertations

Despite a strong literature base relating childhood adversity to pain, the biological mechanisms underlying these associations remain unclear. Theoretical and preliminary empirical evidence supports allostatic load as a potential biological mechanism, though prior studies investigating associations between childhood adversity and elevated allostatic load and/or between elevated allostatic load and poorer pain outcomes have primarily focused on adult populations and individual allostatic load indicators rather than a comprehensive index. Thus, the current study built upon prior literature by testing longitudinal relationships between childhood adversity and multiple biological indicators spanning across physiological systems (i.e., comprehensive allostatic load index) and pediatric pain outcomes …

Executive Functions Predict The Trajectories Of Rumination In Middle-Aged And Older Adults: A Latent Growth Curve Analysis, Gilaine Rui Ng, Wee Qin Ng, Hwajin Yang

Research Collection School of Social Sciences

Previous studies suggest that executive functions (EF)—a set of domain-general cognitive control processes that contribute to the regulation of emotion—are generally associated with ruminative tendencies. However, there is a dearth of research that examines how EF influences changes in rumination over time, especially in middle-aged and older adults who typically experience a decline in EF. To fill this gap in the literature, we analyzed a large-scale combined dataset from the MIDUS Refresher, Daily Diary, and Cognitive Projects. We examined the impact of EF on the trajectory of rumination across 8 days using latent growth curve analysis. We also examined age …

Covid-19 Stress And Cognitive Failures In Daily Life: A Multilevel Examination Of Within- And Between-Persons Patterns, Nadyanna M. Majeed, K. T. A. Sandeeshwara Kasturiratna, Mingyao Li, Jonathan L. Chia, Verity Y. Q. Lua, Andree Hartanto

Research Collection School of Social Sciences

The COVID-19 pandemic has claimed an extremely high number of lives worldwide, causing widespread panic and stress. The current research examined whether COVID-19 stress was associated with everyday cognitive failures, using data from a seven-day daily diary study of 253 young adults in Singapore. Multilevel modeling revealed that COVID-19 stress was significantly associated with cognitive failures even after adjusting for demographic factors, both at the within-person and between-persons levels. Specifically, individuals experienced more cognitive failures on days they experienced more COVID-19 stress (as compared to their own average levels of COVID-19 stress), and individuals who experienced more COVID-19 stress overall …

Food Standards Agency, London (2023) Estimating Financial Cost To Individuals With A Food Hypersensitivity Project Report., Ciara Walsh

Research Outputs: 2025-Present

The Food Standards Agency (FSA) is a non-ministerial government department within the United Kingdom responsible for protecting public health and protecting consumer interests in relation to food in England, Wales, and Northern Ireland. Food Hypersensitivities (FHS) is a key priority within the FSA as it is an important food-related health issue with a severe and enduring impact for people living with it. FHS includes individuals living with a food allergy, coeliac disease and food intolerance.It is the responsibility of the FSA to seek ways to understand and reduce avoidable deaths, the negative impact of FHS on both consumers and businesses, …