Digital Commons Network^™

Alopecia As An Early Clinical Marker For Azathioprine Induced Myelosuppression: A Case Report, Nilanjana Dutta , Final Year Mbbs, Dr. M Suresh Babu , Professor, Dr. Subramanian Ramaswamy , Professor, Dr. Mahabaleshwar Mamadapur , Assistant Professor

Digital Journal of Clinical Medicine

Azathioprine is a pro-drug and is metabolized by the TPMT enzyme in the body. In South Asians, Azathioprine is known to cause alopecia and bone marrow suppression in patients with TPMT enzyme deficiency. In India, the prevalence of TPMT mutation varies from 1.2- 10%. A new mutation was detected in 2014, NUDT15 whose incidence varies from 8.5-16%. Patients with mutation in both TPMT and NUDT15 develop myelosuppression faster. In our case, alopecia manifested as the first clinical feature of Azathioprine myelosuppression. Physicians need to recognize early clinical clues (alopecia) to avoid the impending development of myelosuppression and to look for …

Scope And Limitations Of Chatgpt In Research And Academic Writing, Shyam Pyare Singh, Imran Ahmed Khan, Shaila Kumari Mitra

Digital Journal of Clinical Medicine

Background: ChatGPT has proven to be an invaluable tool, enabling human-like interactions, and facilitating knowledge exchange. It possesses the ability to generate coherent and contextually relevant responses based on the input it receives. In essence, ChatGPT responds to anything in a conversational manner and provides an output that looks like human writing. However, with the rapid advancement of medical research, there is an increasing concern that ChatGPT may be abused to create articles devoid of clinical reasoning and critical thinking.

METHODS: A through literature search was conducted on PubMed and Google scholar to find relevant article according to objective.

RESULTS: …

Management Of Extracranial Schwannomas In Head And Neck Region - An Observational Study, Sambit Shubham Behera, Krishna Arpita Sahoo, Chinmaya Sundar Ray, Shreyas V, Nandigam Nithin Kumar

Digital Journal of Clinical Medicine

ABSTRACT

Background: Schwannomas, benign tumors arising from Schwann cells, often manifest as slow-growing lesions in the peripheral nerve sheath. While typically asymptomatic, they can affect cranial and peripheral nerves. Surgical excision is the primary treatment, but preserving nerve function poses challenges.

Methods: This retrospective study analyzed 12 cases of benign head and neck schwannomas diagnosed at Department of ENT, SCB Medical College, Orissa, India between 2021 and 2023. Data encompassed patient demographics, tumor characteristics, diagnostic methods, surgical approaches, histopathology, and follow-up outcomes. Pre-operative investigations included Fine Needle Aspiration Cytology, Ultrasonography, and imaging.

Results: Predominantly middle-aged and male patients presented with …

To Compare The Efficacy Of Oral Deflazacort, Oral Prednisolone And Inhaled Budesonide In The Treatment Of Salbutamol Refractory Acute Asthma In Children, Santosh Kondekar, Unmesh Dev M, Surbhi Rathi, Gulrej N. Shaikh

Digital Journal of Clinical Medicine

Abstract

Background: A 22-month open-label randomized comparative study was conducted at tertiary care centre attached to medical college in metropolitan city in Maharashtra from Dec 2011 to Oct 2013, aiming to compare the effectiveness of three corticosteroid treatments - oral deflazacort, oral prednisolone, and inhaled budesonide in managing salbutamol-refractory asthma in children aged 1-14 years.

Methods: 90 afebrile children were equally allocated to the different treatment arms. Treatment arm A received oral Deflazacort (1mg/kg/day alternate day), treatment arm B received oral prednisolone (1mg/kg/day), and treatment arm C received budesonide inhaler (100 mcg/puff twice a day) for seven days, along with …

A Real World Study Of Adherence To Insulin In Diabetic Humans-Stadium Study, Dipsanker Chatterjee, Subham Das

Digital Journal of Clinical Medicine

Background:

With an ever-increasing prevalence of diabetes, lack of adherence to insulin treatment in even a small percentage of patients is a major issue and can lead to significant burden on the healthcare system. This survey analysis seeks to investigate the insulin adherence patterns to identify the factors associated with medication adherence.

Methodology:

The current cross-sectional survey was conducted among diabetes patients on insulin treatment. A list of questions about insulin adherence was provided to the participants in the study and the responses were recorded. The data was analysed using Graph Pad Prism.

Results:

Around 23.2 and 18.6 % of …

Internet Addiction: A Growing Threat: A Cross-Sectional Among The Undergraduate Medical Students Of Tertiary Care Hospital, Mysuru, Rakesh M, Diksha Goswami, Sunil Kumar D, Shwethashree M

Digital Journal of Clinical Medicine

Background: The internet has quickly become a part of our lives, impacting every part of our existence. Its use has expanded beyond simply being a communication tool and a source of information. The objective of the study is to assess the prevalence of Internet addiction among the Undergraduate medical students of Mysuru.

Methods: This cross-sectional study was conducted among 255 medical students of a Tertiary care Hospital, Mysuru for three months from September 1^st to November 30^th,2023. Data was collected using a semi-structured questionnaire. The semi-structured questionnaire covered details of demographic data and twenty questions of the …

Placenta Accreta Spectrum Disorder As First Trimester Pregnancy Termination Complication; Case Series, Sindhu Kumari, Poornima M

Digital Journal of Clinical Medicine

Placenta Accreta Spectrum (PAS) disorder is rare (2% according to ACOG) condition of pregnancy when the placenta grows deeply into myometrium. This leads to failure of placenta to separate normally from myometrium after delivery and leads to massive hemorrhage. The PAS is classified as PA (Placenta Accreta), PI (Placenta Increta) and PP ( Placenta Percreta), on basis of depth of trophoblastic invasion. Increase in no. of cesarean sections, increasing the incidence of PAS. Cesarean scar on uterus promotes placental tissue to invade deeply in subsequent pregnancy. Antenatal scanning and color imaging can detect PAS, at a very early stage. Here …

Dental Conditions In Patients With Psychiatric Disorders – A Pilot Study, Viraj Borgamwar, Kishor M, Ashwini Ts, Pradeep Kumar P C

Digital Journal of Clinical Medicine

Background: Individuals with mental illness are vulnerable to developing many physical health issues, as their oral health deteriorates due to poor self-hygiene associated with mental illness. Therefore, this pilot study was undertaken to assess the dental status of individuals with mental illness.

Method: This cross-sectional study involved 61 psychiatric patients recruited from psychiatry department. Psychiatric diagnosis was finalized as per ICD 10 criteria and dental conditions were assessed by consultant dentist.

Results: The study included 61 patients, with 31 (51%) men and 30 (49%) women aged 18 to 60 years. Most patients (54%) were urban residents, and 46% were rural. …

Gender Equality– A Sustainable Development Goal In Progress At A Medical College And Hospital In South India, Mr. Manoj S M, Kusuma Kasapura Shivashankar, Suma M. Natraj, Praveen Kulkarni

Digital Journal of Clinical Medicine

Background: Gender Equality is one of the most important SDG and attaining it will ensure a peaceful, prosperous and a balanced world with equal opportunities for both women and men. The Indian scenario in the field of women education has changed with mindset of most parents undergoing a paradigm shift and many girls are encouraged to attend schools, colleges and women are allowed to work. Considering the above shift, our study intended to find out if the same was true and SDG-5, Gender Equality was attained or in progress at our medical college and hospital and hence the study.

Methods: …

The Balm Framework Of Clinical Excellence: An Adoptable Model For Sub-Saharan Africa., Taoreed Adegoke Azeez

Digital Journal of Clinical Medicine

Clinical excellence is the ability to provide rigorous, evidence-based, and rewarding care to the right patients. The BALM (brilliance, attitude, leadership, and materials) framework is a novel model for adjudicating clinical excellence. There are a few models and frameworks for evaluating clinical excellence, but each has its flaws and does not consider the peculiarities of economically-challenged regions such as sub-Saharan Africa. Coincidentally, such low-resource areas have an urgent need for a framework to assess clinical excellence because of their low health-related indices. The five-step mode of professional excellence is a well-recognised tool and was the model upon which the BALM …

Alkaptonuria Presenting With Back Pain: A Diagnostic Dilemma, Arnav Salar, Dyuksha Arora, Mahabaleshwar Mamadapur

Digital Journal of Clinical Medicine

Alkaptonuria is a rare inborn error of metabolism due to a deficiency of homogentisate 1,2 dioxygenase, resulting in homogentisic acid accumulation in tissues. It is characterised by homogentisic aciduria, ochronosis, and arthritis. We hereby discuss a 46-year-old male who presented with progressive lower back pain and polyarthralgia for ten years, initially diagnosed as ankylosing spondylitis. Characteristic skin pigmentation, ochronosis, and radiological findings led to the correct diagnosis of alkaptonuria. This case highlights the importance of considering alkaptonuria as a differential diagnosis for chronic back pain and arthritis, mainly when sacroiliac joints are spared, and ochronosis is present. While no cure …

Knowledge, Attitudes, And Practices Among Health Care Professionals In A Tertiary Care Teaching Hospital, Mysuru, Rakesh M, Dr Sunil Kumar D, Dr Shwethashree M, Kodeeswaran M, Aradhya M. Gowda

Digital Journal of Clinical Medicine

ABSTRACT

Background: Biomedical waste (BMW) refers to waste generated during the diagnosis, treatment, or immunization of humans or animals, posing risks to health and the environment if not managed properly. Proper knowledge, attitudes, and practices (KAP) among healthcare professionals are essential for effective BMW management. This study assessed the KAP of healthcare workers regarding BMW in a tertiary care teaching hospital.

Methods: A cross-sectional study was conducted among 149 healthcare professionals at a private medical college from April 10 to May 10, 2023. Participants were selected using simple random sampling, including consultants, postgraduates, interns, nursing staff, laboratory technicians, and housekeeping …

Psychiatric Morbidity In Perinatal Women And Its Outcome In A Tertiary Care Hospital, Lakshmi Velayudam, Prathap Talwar, Kishor M, Harshitha Padmanabha

Digital Journal of Clinical Medicine

Background: Pregnancy and postpartum are a period of vulnerability in a women’s life for developing mental health problems. Perinatal psychiatric illness has various adverse outcome on maternal, neonatal and child health.

Objective: To study the prevalence of psychiatric disorders and its outcome among women in the perinatal period.

Method: It is a prospective study conducted at a tertiary care hospital where antenatal and postnatal women were screened for psychiatric disorder using patient health questionnaire-9 (PHQ-9) and Edinburgh Post Natal Depression Scale (EPDS) respectively. Total of 140 women diagnosed with psychiatric disorder were followed up for a year and outcome …

The Pros And Cons Of Systematic Review And Meta-Analysis: Methodological Insights And Future Directions, Malik Maaz Ahmad, Imran Ahmed Khan, Harish Chandra Tiwari

Digital Journal of Clinical Medicine

Systematic reviews (SR) and meta-analyses (MA) are the highest level of evidence in the hierarchy of scientific evidence which aggregate data from various studies, offering a comprehensive overview of a particular topic. This approach reduces the influence of isolated studies that may have small sample sizes or unique biases, leading to more robust conclusions. By combining data from multiple studies, the overall sample size is increased enhancing the statistical power and precision of the results. The value of SR and MA is often compromised by the poor quality of the primary studies they include, which can lead to misleading conclusions. …

Exploring The Elective Experience: A Review Of The "Adult Psychiatry" Elective At A Medical College, Dyuksha Arora, Kishor M

Digital Journal of Clinical Medicine

This review delves into the motivations, experiences, and perceived advantages and disadvantages of undertaking the 'Adult Psychiatry' as an elective at JSS Medical College. Experiences from four students, two from the 2019 batch and two from the 2020 batch, provide a comprehensive overview of their elective.

A Rare Case Of Early Onset Vitamin B6 Dependent Epilepsy, Rohit Thorat, Qudsiya Ansari, Kailas Randad, Vinaya Singh, Akash Sarkate

Digital Journal of Clinical Medicine

Pyridoxine dependent epilepsy (PDE) is a rare seizure disorder which manifests in neonatal period, but can be manifested in early infancy also. Seizures are seen in the first month of life in the classical form, but in the atypical form they don't show up until later in life, sometimes as late as three years old. It has an autosomal recessive inheritance caused by mutation in ALDH7A1 gene, causing deficiency of alpha-aminoadepic semialdehyde dehydrogenase commonly known as antiquitin (ATQ). Its deficiency leads to accumulation of metabolites, which causes deficiency of functional form of pyridoxine. The seizures are non-responding to antiepileptic medications, …

Clozapine And Modified Electroconvulsive Therapy (M-Ect) In Treatment Resistant Schizophrenia (Trs) – A Case Report, Kareena Arora, Kishor M, Murali M R, Suhas K Mr

Digital Journal of Clinical Medicine

Schizophrenia is psychiatric disorder affecting less than 1% of population that can be devastating, characterized by positive, negative and cognitive symptoms. This can lead to significant functional impairment. Despite intensive and ongoing research, outcomes from best-practice treatment are often suboptimal. Unfortunately, not all the patients respond to antipsychotic medications. Overall estimates suggest that one-fifth to one-half of patients have treatment resistant schizophrenia (TRS).

TRS include failure sequential trial of two different antipsychotics with sufficient dose, duration and adherence as a minimum criterion. TRS represents major clinical challenge.

Clozapine is the only drug approved for TRS as it is the drug …

Osteochondroma At Unusual Location Causing Deformity (Metacarpal): A Rare Case Report, Pranshu S. Panwar, Prakash M, Purushothama Sastry, Gurumurthy B, Punith N, Ravi H. S

Digital Journal of Clinical Medicine

INTRODUCTION: Osteochondroma is benign tumors of bone which usually occurs in long bones. Common locations proximal tibia, distal femur and proximal humerus. Metacarpals are rarely affected.

Case Report: Patient, 10 years old/boy came to JSS hospital with complaint of swelling and deformity over left hand for 2 years. After relevant clinical examination and radiological investigation, patient was diagnosed with synostoses of 5^th metacarpal with 4^th metacarpal. Patient was taken up deformity correction and intra-op patient was diagnosed as exostoses of 5^th metacarpal. Post-op radiograph was taken. After 1-month ex-fix was removed. After 4 months follow up, deformity …

Internet Gaming Disorders Amongst Medical Undergraduates In Tamil Nadu, India - A Cross Sectional Study, Rejee Sneha Ebanezer, Sumedha K, Murugan V

Digital Journal of Clinical Medicine

Abstract

Background: Internet Gaming Disorder (IGD) or internet-related gaming addictions are characterized by severely impaired control over gaming affecting routine activities, followed by several psychological, physical and social issues. Budding medical undergraduates who are future health professionals might have positive effects on their studies and career goals when saved from internet gaming addictions. Hence, this study aimed to identify the proportion of medical undergraduate students and interns with internet gaming disorders studying in a private medical college and tertiary care hospital.

Setting: A tertiary care Hospital and Medical College, Tamil Nadu, India

Study design: Cross – sectional study.

Participants: Medical …

High Stakes And Hidden Risks: A Case Series On Pathological Gambling In Context With Affective Disorders And Substance Abuse, Avni Gupta, Namita Deka, Mahesh Kumar

Digital Journal of Clinical Medicine

Background: Pathological gambling is a non–substance-related addictive disorder, characterized by persistent preoccupation with gambling, impaired control, and continuation despite negative consequences. It is associated with financial losses, social and occupational dysfunction, and psychiatric comorbidities, including affective and substance use disorders. Although international prevalence estimates range from 1–2%, research in India remains limited, particularly with the rise of online gambling.

Methods: We report a case series of three individuals presenting to a tertiary-care psychiatry outpatient department with pathological gambling. Clinical assessments included detailed psychiatric evaluation, mental status examination, and psychometric assessments using the Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory …

God Poezii 2024, Victor Fet

Biological Sciences Faculty Research

Fet, V. (ed.). God poezii 2024 [Year of Poetry 2024]. Kyiv: Drukarskii dvir Oleha Fedorova. 2024. 620 p.

The third volume of the *Year of Poetry* annual has once again brought together over 100 authors from various countries. “We all speak and write in Russian—a language disgraced by the invaders... Only the word that remains untainted will outlive both the current disgrace and this utter hell.” (Anatoly Liberman). We are proud that this anthology is being published in Kyiv for the third time. No matter what we write about, the hearts and verses of those who cannot remain silent—from every …

Evaluation Of Post Operative Pain After Obturation Using Two Different Types Of Sealer: A Randomized Clinical Trial, Sara Amin, Mohamed Kataia, Hala Khalil

International Arab Journal of Dentistry

Objective: This study aims to assess the impact of bioceramic and resin based sealers on post endodontic pain after endodontic treatment performed in single visit.

Methods: In this study, forty patients in need of endodontic therapy were chosen. single visit endodontic treatment was done for the patients but obturated using two different types of sealers: in Group 1: AH Plus sealer was used and in Group 2: EndoSequence BC sealer Hiflow was used. Post endodontic pain was measured for 12,24,48 and 72 hours postoperatively.

Results: Both sealer groups’ post-endodontic pain levels did not significantly differ from one …

"The Internet Is Forever": Evaluating Eraser Laws As A Viable Legislative Solution To The Sharenting Epidemic, Madeline Sands Finlayson

Colorado Technology Law Journal

No abstract provided.

I Am Who I Am, Yifei Kong

Theses and Dissertations

I am Who I am

By Yifei Kong, MFA

My thesis research focuses on my cultural background and history as a Chinese woman. I explore the control and restraint of women from ancient times and highlight feminism. Traditional Chinese hair accessories reflect a type of control over women. Unlike traditional Chinese hair accessories, which use a lot of precious metals and precious stones, my work uses recycled aluminum cans. That is an exploration of contemporary jewelry materials and a reflection of women's independent right to choose. With my pieces, women can use their preferred colors without considering their class and …

Frozen By Worry And Fatigue? A Mixed Methods Approach To Understanding The Lived Experiences Of Freezing Of Gait, Sarah M. Ghose

Theses and Dissertations

This study utilized a mixed methods emergent, phenomenological approach to (1) understanding the lived experience of freezing of gait for individuals diagnosed with Parkinson’s Disease and (2) determining the role of anxiety and sleep in freezing of gait outcomes. Participants included 13 adults diagnosed with Parkinson’s Disease (N=14 for qualitative data, N=13 for quantitative data; 23.1% female-identifying, 76.9% male-identifying) who were predominantly white (92.3%) with an average age of 69 years (SD = 6.73 years). Data collection consisted of semi-structured interviews, self-report measures, actigraphic sleep data, and salivary alpha amylase biomarker collection. Results are organized into …

The Role Of Sleep And Social-Ecological Supports In The Association Between Racial Discrimination And Cardiometabolic Risk In Black Youth, Jelaina R. Shipman-Lacewell

Theses and Dissertations

Black youth are at an increased risk for poor short and long-term cardiometabolic health, including obesity, hypertension, and type 2 diabetes. Racial discrimination and poor sleep are theorized as key factors contributing to cardiometabolic health. While adult studies support sleep as a pathway through which discrimination is associated with health, there is a critical gap in our knowledge of this pathway in youth. Socio-ecological supports may protect Black youth against stressors, including racism. However, studies of the protective nature of these factors in Black youth have primarily focused on psychological and behavioral outcomes. Thus, the current study built upon previous …

From Suicidal Ideation To Suicide Attempt: Clarifying The Role Of Painful And Provocative Events, Mallory Stephenson

Theses and Dissertations

The Interpersonal-Psychological Theory of Suicide hypothesizes that capability for suicide is acquired in part through exposure to physically painful and/or fear-inducing experiences, referred to as painful and provocative events (PPEs). Studies of PPE exposure offer an opportunity to characterize potential targets for suicide prevention and inform efforts to identify individuals at elevated suicide risk. However, the literature on PPE exposure and risk for suicidality has been limited by a reliance on cross-sectional designs, lack of genetically informed research, inclusion of risk-taking behaviors as potential PPEs, and focus on risk over resilience. In this dissertation, we aimed to address these knowledge …

The Influence Of Flavor On The Abuse Liability Of A Heated Tobacco Product And Its Feasibility As A Menthol Cigarette Substitute, Augustus White

Theses and Dissertations

Heated Tobacco Products (HTPs) purport to expose people that use cigarettes to fewer of the harmful or potentially harmful constituents of tobacco while still delivering reinforcing amounts of nicotine (Auer, Concha-Lozano et al., 2017). An exemplar of the HTP class, IQOS, and its three varieties of “HeatSticks” have been authorized by the Food and Drug Administration (FDA) as “Modified Risk Tobacco Products” (MRTP). However, as the FDA is planning to ban menthol as a characterizing flavor in cigarettes, questions remain regarding whether characterizing flavors should be permitted in HTPs (FDA, 2022e). New evidence regarding HTP abuse liability (i.e., the likelihood …

Penalized Interpolating B-Splines And Their Applications, Kylee L. Hartman-Caballero

Theses and Dissertations

One of the most studied data analysis techniques in Numerical Analysis is interpolation. Interpolation is used in a variety of fields, namely computer graphic design and biomedical research. Among interpolation techniques, cubic splines have been viewed as the standard since at least the 1960s, due to their ease of computation, numerical stability, and the relative smoothness of the interpolating curve. However, cubic splines have notable drawbacks, such as their lack of local control and necessary knowledge of boundary conditions. Arguably a more versatile interpolation technique is the use of B-splines. B-splines, a relative of Bézier curves, allow local control through …

“I Know What Nothing Means”: Nostalgia, Hope, And The Postmodern Search For The Sublime, Kathryn L. Donati

Theses and Dissertations

Amid simultaneous crises of self, nation, digital citizenship, global health, climate change, and socio-political polarization, to name but a few of the catastrophes that seem to define life in the global West in the twenty-first century, where do we find hope? Do we find it at all? Is there any hope to be found? These are the questions that serve as the genesis for this undertaking in which I locate the origin of these crises far before the events of the 2016 and 2020 elections, far before even the panic of Y2K. I begin my examination of hope in contemporary …