Digital Commons Network^™

Rainflakes, Ripples, And The Moonlit Ocean, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Raindrops, ripples, and a moonlit sky evoke not just poetic imagery but also profound physiological and psychological responses from deep inside. In a kaleidoscope of colors, rain flakes spiral down like whispers from the cosmos, each droplet a tiny universe reflecting the dreams of wandering souls. They dance upon the surface of puddles, sending ripples that shimmer like liquid silver, weaving a tapestry of sound that resonates with the heartbeat of the earth. As moonlight drips softly from the sky, each moondrop creates a symphony of luminescent echoes, cascading through the air like stardust, inviting us to lose ourselves in …

Lewy Glacier, João Guilherme Bochnia Küster

HCA Healthcare Journal of Medicine

This poem explores the complex intersection of memory, identity and the challenges imposed by Lewy body dementia, using the metaphor of a lost expedition traversing an isolated icy landscape. A profound sense of solitude reflects the disconnection that accompanies the dementia and tremors that follow, while also highlighting the danger of memory loss with mythological sirens representing its perilous allure (with some inspiration from The Odyssey). Through vivid imagery and lyrical language, it delves into the complexities of cognitive decline, providing an artistic reflection on dementia and offering a unique view of the emotional landscape of those affected by …

A Blood-Based Test For Colorectal Cancer Screening, Joshua Cullison

HCA Healthcare Journal of Medicine

Within the United States (US), colorectal cancer (CRC) remains the fourth most common malignancy and is responsible for over 50 000 deaths annually, second only to lung cancer in cancer mortality. Despite increased public awareness and increasing screening rates, the US remains far below the 80% screening mark set by the National Colorectal Cancer Roundtable at 59%. The addition of non-invasive blood-based tests for CRC screening could potentially increase screening rates and lower CRC deaths.

I performed a PubMed search using the search term “blood-based colorectal cancer screening.” I was particularly interested in articles that looked at Shield, which is …

A New Application For Bolt Cutters In Urogynecology: Challenging Removal Of An Impacted Pessary, Carolyn M. Payne, Courtney B. Ritchie, Tanaz R. Ferzandi

HCA Healthcare Journal of Medicine

Background

Pessaries are commonly used to treat pelvic organ prolapse. While these devices generally pose negligible risk, serious morbidity can be associated with neglected use.

Case Presentation

A 91-year-old woman began to experience acute pain related to an impacted pessary. An Exam in the operating room under anesthesia revealed that the pessary was deeply embedded within the vaginal canal and was noted to have a hard metal wire under a rubber exterior. An intraoperative orthopedic consult was obtained to facilitate discussion and selection of tools outside the typical gynecological scope to remove the pessary. A combination of bolt cutters and …

Staphylococcal Scalded Skin Syndrome In Melanated Skin: A Pediatric Case Report, Aleah Lafrancis-Ream, Scott Gutovitz, Hannah Chotiner

HCA Healthcare Journal of Medicine

Background

Staphylococcal scalded skin syndrome (SSSS) is a dermatologic emergency that most commonly affects young children, requiring prompt recognition and treatment to avoid severe symptoms and fatal sequelae. It is characterized by a desquamation of the skin caused by exotoxins produced by the Staphylococcus aureus species and may present differently in melanated skin.

Case Presentation

Our case describes a 6-month-old Black infant girl who presented to the emergency department with SSSS that was unrecognized on 2 prior encounters. This delay in diagnosis and the misapplication of topical antibacterial agents and steroids may have contributed to the worsening of her symptoms …

A Colorful Enigma: A Case Of Orange Palpebral Spots In A 63-Year-Old Woman, Obarikanemi Nwogu, Karl Kellawan

HCA Healthcare Journal of Medicine

Background

The thin, vascularized skin of the eyelids makes them prone to irritation and discoloration, potentially revealing underlying issues, such as subcutaneous deposits, and an abundance of pigments like carotenoids and lipofuscins. First described in 2008 by Assouly et al, orange palpebral spots (OPS) present as painless orange-yellow lesions on the upper eyelids, primarily affecting White women with Fitzpatrick skin types I to III. Despite various hypotheses, the exact cause of OPS remains elusive, with no established links to malignancy or systemic illnesses.

Case Presentation

A 63-year-old woman, with a medical history including basal and squamous cell carcinoma, diabetes mellitus, …

An Unusual Presentation Of Lichen Planus Pigmentosus Inversus Responsive To Topical Tacrolimus: A Case Report, Valeria J. Gonzalez-Molina, Sujitha Yadlapati, Michael R. Hohnadel, Rick Lin

HCA Healthcare Journal of Medicine

Background

Lichen planus pigmentosus inversus (LPPI) is a rare variant of lichen planus pigmentosus (LPP), characterized by sharply defined violaceous-brown to gray macules, papules, patches, or plaques primarily affecting the intertriginous and flexural areas. Unlike LPP, which predominantly affects Fitzpatrick skin types III to IV in sun-exposed areas, LPPI spares these regions and has been predominantly reported in White and Asian patients.

Case Presentation

We discuss a 66-year-old man with Fitzpatrick skin type III who presented with a year-long history of mildly itchy, hyperpigmented plaques on the inframammary folds. These plaques developed after being hospitalized for a chronic urinary tract …

Hughes-Stovin Syndrome: A Case Report Of A 24-Year-Old Male With Pulmonary Aneurysms And Deep Vein Thrombosis, Clara Liu, Zhiyin Li, Supriya Bhupathy, Bradley Todd Andersen, Andrew Hwang

HCA Healthcare Journal of Medicine

Background

Hughes-Stovin Syndrome (HSS) is a rare vasculitis characterized by pulmonary artery aneurysms (PAAs) and peripheral venous thrombosis. Anticoagulation, the standard treatment for venous thrombosis, is often contraindicated in HSS due to the risk of fatal pulmonary hemorrhage, especially since mortality rates of patients with a history of hemoptysis are reported at 50%-100% from PAA ruptures, yet treatment guidelines are limited due to the condition’s rarity with fewer than 90 reported cases globally. This report highlights the complex management decisions required.

Case Presentation

A 24-year-old man with a 3-month history of PAAs, left lower extremity deep vein thrombosis (DVT), and …

Wilson’S Disease Psychosis In A Young Man With Autism Spectrum Disorder: A Case Report And Focus On Management, Landon C. Sowell, Barbara L. Gracious

HCA Healthcare Journal of Medicine

Introduction

Wilson's disease is a rare autosomal recessive disorder, affecting approximately 1 in 30 000 individuals and is characterized by abnormal copper accumulation in the body, primarily affecting the liver and brain. Psychiatric manifestations as a first presentation, particularly psychosis, are less commonly recognized resulting in failure to begin treatment early in the course of the disease. This case report highlights a patient that presented to the hospital with psychosis, who was later diagnosed with Wilson’s disease. This case underscores the importance of considering organic causes in first-episode psychosis.

Case Presentation

An 18-year-old man with a history of autism spectrum …

Masld-Induced Hyperammonemia With Atypical, Restricted Diffusion Pattern Suggesting Mixed Metabolic And Hypoxic-Anoxic Injury, Renu Thomas, Nhuchau Tiffany Nguyen, Daniel Bao, Jonathan Tang, Uzma Ali, Damon Cao

HCA Healthcare Journal of Medicine

Background

Hepatic encephalopathy is a common cause of altered mental status for patients with decompensated cirrhosis. Their conditions typically improve with high-dose laxatives; if not optimally treated, can develop neurologic sequelae like cerebral edema and herniation. In severe cases, despite normal systemic oxygenation, hyperammonemia may result in mixed restricted diffusion patterns that partially resemble those seen in hypoxic-anoxic brain injury.

Case Presentation

A 61-year-old woman with cirrhosis secondary to metabolic dysfunction-associated steatotic liver disease, scleroderma, and rheumatoid arthritis presented to the emergency room with altered mental status. She was admitted to the intensive care unit (ICU) and was intubated due …

Presentation Of Cutaneous Large B-Cell Lymphoma, Leg Type, Francisca I. Valenzuela, Michael R. Hohnadel

HCA Healthcare Journal of Medicine

A man over the age of 89 presented with 2 violaceous, ulcerated plaques on his left lower leg, which developed over a 4-month period following a fall. The patient reported the initial formation of a solitary lump, which gradually enlarged and began bleeding a few weeks before his clinic visit. A histological examination of 2 biopsy samples revealed a dermal proliferation of large, severely atypical lymphoid cells with mitotic figures. Immunohistochemistry showed positivity for CD20, Bcl2, Bcl6, and MUM1, with cytokeratin 20 (CK20) negativity and a high percentage (80%-90%) of C-MYC positivity, which was consistent with a primary cutaneous diffuse …

Optimal Local Impedance Parameters For Catheter Ablation Of The Cavo-Tricuspid Isthmus In Atrial Flutter Patients: A Retrospective Analysis, Yamann Sahlool, Yann Dacquay, Saro Avedikian, Jeong Hwan J. Kim, Ali Sovari

HCA Healthcare Journal of Medicine

Background

Atrial flutter is a common arrhythmia, and catheter ablation offers a potentially curative intervention. However, there is a continued desire to enhance the procedure’s efficiency and safety to optimize patient outcomes. Recently, local impedance (LI) has garnered attention as a novel approach to optimizing ablation procedures. The parameters of LI change when associated with durable ablation lesions for cavo-tricuspid isthmus (CTI) which remains poorly defined. This study aims to address this gap through analysis of gathered data.

Methods

We conducted a retrospective data analysis of 121 consecutive patients who underwent local impedance-guided catheter ablation of the CTI for typical …

Postoperative Urinary Retention After Hernia Repair: A Randomized Controlled Trial Identifying Patients At Risk And Assessing The Incidence After Tamsulosin Pretreatment, Brandon M. Epps, Evelyn Coile, Margaret Carey, Oliver Whipple, Robert Kelly, Christopher Senkowski, James Garber

HCA Healthcare Journal of Medicine

Introduction

Postoperative urinary retention following hernia repair is a common complication, with its incidence ranging from 2%-30%. Treatment typically consists of a 5-alpha-reductase inhibitor, like tamsulosin. The goal of this study was to identify whether pretreatment with tamsulosin 7 days prior to an elective hernia repair reduced the rate of postoperative urinary retention.

Methods

A single institution randomized controlled trial was conducted with 140 patients. Patients were randomly assigned to either a control or treatment group, with all patients completing a pre- and postoperative International Prostate Symptom Score (IPSS). The inclusion criteria were men with no history of tamsulosin usage …

The Top Twenty-Five Most Influential Articles In Surgery For Colorectal Cancer, Dana Poloni, Andrew Anklowitz, Fred Kobylarz, Christina Monaco Poloni, Ankit Dhiman, Pamela Burgess, Andrew Schlussel

HCA Healthcare Journal of Medicine

Background

This article provides surgical trainees with a ranked list of the foundational literature that guides the contemporary surgical management of colorectal cancer and shows the evolution of surgical techniques in the field.

Methods

We assessed the surgical literature using the Web of Science and other ranking systems to create a ranked list of published articles on colorectal cancer surgery.

Results

We compiled a ranked list of the top 25 articles in the surgical management of colorectal cancer, based on the citation density score (mean number of citations per year) and the individual author H-index. The mean density score of …

Role-Playing For Rehabilitation: Enhancing Empathy Among Juveniles In Correctional Facilities, Nina Permatasari, Muhammad Arsyad, Muhammad Andri Setiawan, Hendro Yulius Suryo Putro, Muhammad Fajar Riva’I, Wiwik Widyanti

Buletin Konseling Inovatif

This study examines the effectiveness of role-playing-based counseling services in enhancing empathy among children at Juvenile Rehabilitation Center Class I Martapura. Employing a quantitative approach, the research utilized a one-group pre-test post-test experimental design to measure changes in empathy levels before and after the intervention. A total of 32 children participated in the study. Data were collected using two instruments: the Empathy Scale and the Role-Playing Engagement Questionnaire. The intervention consisted of structured role-playing sessions designed to improve both cognitive and affective components of empathy. Data analysis using paired sample t-tests revealed a statistically significant increase in empathy scores, with …

Bibliometric Analysis: Publish Or Perish And Vosviewer For Research Trends On Online Violence (2023–2025), Indriyana Rachmawati, Widya Juwita Sari, Sesya Dias Mumpuni

Buletin Konseling Inovatif

Cases of online violence have become increasingly widespread since the end of the COVID-19 pandemic, during which individuals began to grow dependent on the digital world. The digital realm has become a fundamental aspect of human life, bringing with it new forms of online violence. Online violence such as threats, hate speech, harassment, and bullying has emerged as a new weapon to control, isolate, and even torment affected victims. However, only a small body of literature has explored the changing nature of online violence following COVID-19. This study aims to review the literature on patterns of online violence post-pandemic, focusing …

Harmonizing Hope: An Idea Of Music Therapy Interventions For Schizophrenia, Dominikus David Biondi Situmorang

Buletin Konseling Inovatif

Schizophrenia is typified by a wide range of symptoms, such as delusions, hallucinations, cognitive decline, and social disengagement. Even with improvements in pharmaceutical and psychosocial therapy, many people with schizophrenia still require supplementary treatment methods due to their chronic symptoms and functional limitations. Utilizing music's therapeutic capacity to address a variety of symptoms and enhance general well-being, music therapy has emerged as a possible supplementary intervention for schizophrenia. In this study, the author used a literature review with a Critically Appraised Topic (CAT); this research is a summary of the best available evidence regarding the focused aims. This CAT looks …

Integrating Islamic-Based Behavioral Activation With Buya Hamka's Tazkiyatun Nafs To Reduce Social Media-Induced Anxiety Among University Students, Dosi Juliawati, Hengki Yandri, Farid Imam Kholidin, Rasmita Rasmita, Daflaini Daflaini, Yatti Fidya

Buletin Konseling Inovatif

The pervasive use of social media has led to a growing concern regarding social media-induced anxiety among university students. This study aims to integrate Islamic-based Behavioral Activation with the concept of Tazkiyatun Nafs, defined as the purification of the soul or self-purification, as proposed by Buya Hamka, to reduce this anxiety among university students. The method employed is a Single-Subject Experimental Design involving three participants from IAIN Kerinci, all of whom exhibited the highest scores of social media anxiety. Data were collected using the Social Media Anxiety Scale (SMAS) and analyzed through visual data analysis. The results indicate that all …

Peaceful School Counselors For School Violence In The Digital Era, Ahmad Yusuf Sobri, Nur Mega Aris Saputra, Dzulkifli Abdullah

Buletin Konseling Inovatif

The problem of violence that occurs in the world of education is a manifestation of the incomplete realization of schools as safe places. One strategy to make this happen is through the implementation of peace education in schools that involves all school members. School counselors are one of the key roles needed for the implementation of peace education in schools. This study aims to find out the role of school counselors in implementing peace education in schools. The study is a systematic literature review using the PRISMA stages. Fifteen academic articles were selected based on the main keywords: peace education …

The Role Of Self-Management Techniques For Reducing Gadget Addiction: Empowering Students Toward Healthier Digital Habit, Dian Ari Widyastuti, Lucky Resta Widias Putri

Buletin Konseling Inovatif

This study aims to examine the effectiveness of individual counseling using self-management techniques in reducing gadget addiction among students. The research employed an experimental approach with a single-subject design (SSD). One participant, a student from Yogyakarta, Indonesia was selected through purposive sampling. Data were collected using observation guidelines and a gadget addiction scale. Data analysis in single-subject research emphasizes individual data, and therefore, this study utilized visual analysis through graphical representations. The results of the visual analysis indicated a reduction in gadget addiction, as demonstrated by the A-B-A design graph. Based on these findings, it can be concluded that individual …

Peace Counseling In The Scientific Spotlight: A Bibliometric Analysis Of Global Research Trends, Wahyu Nanda Eka Saputra

Buletin Konseling Inovatif

This study aims to map global trends in peace counseling research using a bibliometric approach. Data were taken only from the Scopus database, focusing on publications containing keywords related to peace counseling, such as peace counseling, peace psychotherapy, and peacebuilding therapy. The analysis was conducted on 769 selected documents published between 1937 and 2025. The results showed a significant increase in publications since 2020, reflecting the growing need for counseling approaches that support peace and psychological well-being. Authors from various countries made different contributions, with the United States dominating the number of publications and citations, while developing countries such as …

Validation Of Micro Digital Content Model Of Project-Based Learning For Guidance And Counseling Courses In Non-Formal Education, Ella Faridati Zen, Yuliati Hotifah, Riskiyana Prihatiningsih, Nur Mega Aris Saputra

Buletin Konseling Inovatif

The research aims to produce a product in the form of a learning device for guidance and counseling courses in non-formal education in the form of micro digital based on project-based learning, which is theoretically accepted through expert testing. The development method uses the ADDIE design, with the procedures of Analysis, Design, Development, Implementation and Evaluation. The trial subjects or product assessors consist of material experts and media experts in the field of guidance and counseling. Data were collected with expert assessment instruments and analyzed using the average technique. The expert assessment of the product by material experts produced an …

Effectiveness Of Mindfulness-Based Group Counseling To Reduce Loneliness In Adolescents Victims Of Bullying, Chandra Ayu Safira, Rita Eka Izzaty

Buletin Konseling Inovatif

This research proceeds from the problems of loneliness experienced by most adolescent victims of bullying. Mindfulness is recommended as an effective way to alleviate the problem, but some school counselors have not integrated mindfulness in guidance and counseling services. Therefore, this study aimed to test the effectiveness of mindfulness-based group counseling services to reduce loneliness in adolescent victims of bullying. This quantitative research uses a quasi-experimental type with a non-equivalent control group design. The research location was at State High School 11 and 9 Yogyakarta-Indonesia, involving 20 students aged 15-18 years who were selected with purposive sampling techniques. Data were …

Integrating Banjar Cultural Values Into Premarital Counseling: A Randomized Controlled Trial On Marital Readiness In Indonesia, Jarkawi Jarkawi, Eka Sri Handayani, Sri Ayatina Hayati, Rudi Haryadi, Akhmad Rizkhi Ridhani, Nazar Hasby, Nur Ananda Puteri

Buletin Konseling Inovatif

Marriage readiness is a critical factor in ensuring long-term relationship satisfaction and resilience. In Indonesia, challenges such as rising cases of domestic violence and marital instability highlight the urgent need for more effective premarital counseling programs. However, existing interventions often lack cultural sensitivity, particularly in multicultural societies like Indonesia, which encompasses over 300 ethnic groups. This study examines the effectiveness of a culturally-informed premarital counseling program based on Banjar marital customs in enhancing marital readiness. A randomized controlled trial (RCT) was conducted with 32 engaged individuals divided into an experimental group receiving Banjar-based counseling and a control group participating in …

The Role Of Personal Responsibility And Career Planning Among Adolescents In Indonesia: A Correlational Study, Irvan Handaka, Denik Wirawati, Aprilia Setyowati, Wahyu Nanda Eka Saputra, Diki Herdiansyah, Navy Glenda Triskova, Zela Septikasari, Norimune Kawai, Rafidah Aga Mohd Jaladin

Buletin Konseling Inovatif

Personal responsibility is an individual's ability to identify and regulate one's thoughts, feelings, and behaviors and the willingness to take responsibility for the choices and resulting social and personal outcomes. Through a quantitative correlational study, this study explores the role of personal responsibility and career planning in high school students/adolescents. A total of 465 adolescent subjects from Indonesia were sampled in this study. The data collection method used instruments tested for validity and reliability in measuring personal responsibility and career planning. Data analysis was conducted using descriptive statistics to describe the level of personal responsibility and career planning and inferential …

Hallo Kons: Web-Based Guidance And Counseling Services To Improve University Students’ Well-Being, Ratih Christiana, Silvia Yula Wardani, Suharni Suharni, Ibnu Mahmudi, Afara Dinan Sa'id Restu Aji, Shinta Rahmawati, Puspita Dwi, Alice Tonido Rivera

Buletin Konseling Inovatif

This study aims to develop 'Hallo Kons' which is an innovation of website-based guidance and counseling services to improve the well-being of students at Universitas PGRI Madiun (UNIPMA), which include four areas of guidance and counseling services, namely: personal, social, learning and career. The method in this study is research and development (R&D). The subjects of the study were website experts, UNIPMA counselors and students of UNIPMA. The data analysis used was qualitative and quantitative, with data collection techniques using assessment sheets filled out by 4 experts: consisting of 2 website experts and 2 experts in the field of guidance …

Development Of Mooc Content In Case-Method-Based Psychodynamic Counseling Courses As Online Learning Media, Rizka Apriani, Devy Probowati, Diniy Hidayatur Rahman, Faza Kasyiva Az-Zahra, Fauziah Ilmi Qonita, Nurul Ain Mohd Daud

Buletin Konseling Inovatif

The psychodynamic counseling course is one of the compulsory courses to provide students with an understanding of theories, concepts, and techniques based on psychodynamic views. With various existing goals, it shows that implementing this course requires technology-based media to support the optimal running of lectures. The MOOC (Massive Open Online Course) platform is an answer to implementing psychodynamic counseling courses with existing flexibility and accessibility. The purpose of this research is to develop content on the MOOC platform to improve the quality of learning by utilizing interactive technology and learning content can be presented dynamically using various media such as …

Keefektifan Teknik Cognitive Restructuring Untuk Meningkatkan Kejujuran Akademik Siswa Sekolah Menengah Atas, Kadek Sathya Gita Rismawan, I Ketut Gading, Luh Asli

Buletin Konseling Inovatif

A number of problems are seen as a result of poor academic honesty. This study aims to identify the efficiency of cognitive restructuring counseling in improving the academic honesty of senior high school students. By using A-B single subject reversal, the intervention was carried out by providing personal counseling using the cognitive restructuring technique. In collecting the data, we used Academic Honesty Psychological Scale, while the obtained data were analyzed using visual analysis. The findings indicate that individual counseling using cognitive restructuring is effective in enhancing students’ academic honesty. Also, positive self-perception and environment facilitate students to present high academic …

Development Of Guidebook For Rational Emotive Behavior Counseling To Improve Vocational High School Students’ Career Self-Efficacy, Imro’Atul Khasanah, Yuliati Hotifah, Indriyana Rachmawati, Augusto Da Costa

Buletin Konseling Inovatif

Career decision-making of vocational high school students is still something that does not receive serious attention and causes students to experience career decision difficulties. One of the causes of difficulty in making career decisions is students' lack of confidence in their abilities. This study aims to develop a guidebook for rational emotive behavior counseling (REBC) which is intended for school counselors. REBC counseling can help counselees to understand their cognitive conditions that lead to emotional disturbances so that counselees can change irrational thoughts and understand the consequences of their behavior. The guidebook that was developed contains material on career self-efficacy, …

Development Of Stress Management Guidebook To Prevent Academic Burnout On Vocational High School Students, Gihza Hasnutya Tahta, Arbin Janu Setiyowati, Nugraheni Warih Utami, Umi Safiul Ummah

Buletin Konseling Inovatif

Students must be aware of academic burnout, as it can reduce their learning achievement. This study aims to develop a stress management guidebook to prevent academic burnout in vocational high school students. This guidebook can be used by counselors as a reference in providing guidance services to vocational students who have problems related to academic burnout. This manual is equipped with an academic burnout scale to measure the level of student academic burnout. The development model in this study used the Borg and Gall development research design. In this study, we used five stages, consisting of pre-survey, product design, design …