Digital Commons Network^™

Understanding Doxycycline-Induced Phototoxicity, Setareh Khani, Sydnee Jackson, Darya Khani, Rekha Yesudas

Research Day

Introduction: Doxycycline is a tetracycline-class antibiotic that inhibits bacterial protein synthesis by binding to the 30s ribosomal subunit, thereby preventing bacterial growth. It has a broad spectrum of clinical indications including treatment of Chlamydia infections, Lyme disease, Anthrax, Rickettsia, Atypical pneumonia, Staph aureus, Cholera, Acne vulgaris, and Traveler’s diarrhea, as well as malarial prophylaxis. Although generally well tolerated, effective and affordable, doxycycline is associated with several mild adverse effects like gastrointestinal distress and photosensitivity. One clinically significant adverse reaction is phototoxicity which occurs following exposure to ultraviolet radiation. In doxycycline-induced phototoxicity, the drug absorbs UV light and generates reactive oxygen …

The Comparative Efficacy Of Mediterranean And Dash Dietary Patterns In Cardiovascular Disease Prevention: The Role Of Intensive Behavioral Counseling, Angel Edwards, Jennifer H. Shaw

Research Day

Background: Cardiovascular disease (CVD) remains the leading cause of global mortality, and poor dietary patterns represent a major modifiable risk factor. The Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets are evidence-based nutritional strategies for cardiovascular risk reduction; however, long-term effectiveness is often limited by suboptimal adherence when interventions rely solely on passive education rather than structured behavioral support.

Objective: To evaluate the comparative efficacy of the Mediterranean and DASH dietary patterns in CVD prevention and to examine the impact of intensive behavioral counseling on adherence and long-term clinical outcomes.

Methods: A structured PubMed search was conducted for English-language, …

Literature Review: Long-Term Effects Of Circumcised Neonates Vs Uncircumcised Neonates, Jada M. Glenn, Daphne Mlachila

Research Day

INTRODUCTION:

Circumcision is a widely practiced procedure, but as research has progressed, its value beyond a purely cosmetic or cultural purpose has come into question. Outside  of a religious context, circumcision has been popularized by the belief that it has significant medical benefits that justify the permanent removal of the foreskin in a neonate. These benefits include, but are not limited to, a reduction in urinary tract infections, transmission of sexually transmitted diseases, and penile cancer. However, recent studies have shown that these reductions are minimal, especially in countries where AIDS is no longer an epidemic. Other studies have also …

Imperforate Hymen With Bicornate Uterus In An Adolescent Patient, Cheau Williams, Daniel Santiago, Catherine Cravey, Danielle Rosenzweig, Ebony Isagba, Mykala Jackson, Sabirah Smith, Alexandria Neal

Research Day

A thirteen-year old patient presenting with chronic pain and amenorrhea was evaluated for ongoing discomfort and worsening symptoms. Pelvic examination showed a vaginal protrusion consistent with imperforate hymen and imaging was consistent with significant hematocolpos. Hymenectomy was performed and a bicornuate uterus was revealed in postoperative imaging.

This case report adds to the medical literature exploring the diagnosis of imperforate hymens which occur in 0.1% of female neonates and may co-occur with a bicornuate uterus (0.4% prevalence in females). It provides a perspective on the rarity of the incidence of imperforate hymen patients with another genitourinary anomaly. It also challenges …

Unique Combination Of Scapula Fracture And Pectoralis Major Tear Sustained During Static Line Airborne Operations: Case Report, Kimberton Porter, Mykala Jackson, Kenneth Nelson, Jeffrey Hoffmann

Research Day

Scapular fractures are rare and often managed in a non-operative fashion. This report includes a case of a 35 year old active duty male who sustained a critically comminuted scapular body fracture with an isolated pectoralis major tendon tear whilst participating in a static line parachute jump. The patient presented with new onset left shoulder pain, inflammation, and functional loss but did not show any signs of associated systemic trauma. On imaging, there were scapular fragments that were displaced as well as a proximal pectoralis major rupture. Given the severe degree of displacement and the occupational demands of the patient, …

Postpartum Vulvar Hematoma: A Common Obstetric Complication, Ruhdeep Randhawa, Allison Tresner, Christine Lurie

Research Day

Introduction:

Vulvar hematoma is a collection of blood in the soft tissue called the vulva. Branches of the pudendal artery supply the smooth muscle and loose connective tissue. Vulvar hematomas are a common obstetric complication, but they can occur in non-obstetric settings as well due to trauma. During the birthing process, direct injuries, such as episiotomy, vaginal laceration repairs, or instrumental deliveries, and indirect injuries, such as extensive stretching of the birth canal during vaginal delivery, can lead to vulvar hematoma formation. Risk factors for vulvar hematoma formation include episiotomy, prolonged second stage of labor, macrosomia, anticoagulants, hypertensive disorders of …

Case Report Highlights Disproportionate Health Outcomes Of Rheumatoid Arthritis In Patients Of Lower Socioeconomic Status, Victoria Pfennig, Karen Vega

Research Day

Introduction

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that affects the synovial lining of joints and may lead to progressive joint destruction, disability, and premature mortality if inadequately treated. Increasing evidence demonstrates that social determinants of health, particularly socioeconomic status (SES), significantly influence disease outcomes in patients with RA. Studies have shown that individuals of lower SES experience higher disease activity scores, greater physical disability, and poorer quality of life compared with patients of higher SES. Additionally, lower SES has been associated with longer delays between diagnosis and initiation of disease-modifying antirheumatic drugs (DMARDs), contributing to disease progression …

Health Care Practitioners’ Self-Reported Knowledge, Skill Level, And Confidence In Evaluating And Treating Lymphedema And Lymphatic Dysfunctions With Individuals Who Are Pregnant Or Post-Partum, Gem Johnson, Shelley Dicecco, Ria Lewis-Strange, Diana Mehrez

Research Day

The management of lymphedema during pregnancy presents a complex clinical challenge driven by significant physiological shifts, including a 40–50% increase in plasma volume and mechanical obstruction by the gravid uterus. However, current practice relies precariously on oncology-centric models that fail to address these unique hemodynamic demands due to a critical lack of evidence-based guidance. The aim of this study was to investigate the self-reported knowledge, skill levels, and confidence of international health care practitioners regarding the evaluation and treatment of lymphedema in the pregnant and post-partum population.

A mixed-methods international survey was distributed to lymphedema practitioners worldwide in 10 languages …

Acute Salpingitis Presenting As Small Bowel Obstruction, Hayden E. Evans, Nasir L. Abbasi, Audrey Arona

Research Day

Introduction: Small bowel obstruction (SBO) is most commonly caused by postoperative adhesions, hernias, or malignancy. While adhesions typically arise from prior abdominal surgeries, gynecologic inflammatory conditions represent a rare but important etiology. Salpingitis, a manifestation of pelvic inflammatory disease (PID), can lead to pelvic adhesions but is an uncommon cause of mechanical SBO. Recognition of gynecologic sources of SBO is important for proper management and timely surgical intervention. We present a case of acute salpingitis resulting in adhesive band formation between the fallopian tube and the sigmoid colon, leading to mechanical SBO requiring operative management.

Case Presentation: We report the …

Epigenetics Programming Of T2dm Risk In The South Asian Community And Its Implications For Clinical Practice, Arpita Harapanahalli, Shalini Patibandla, Francis Jenney

Research Day

Background: Type 2 diabetes mellitus (T2DM) occurs at disproportionately higher rates among South Asian populations compared with other ethnic groups, posing significant challenges for disease risk and clinical management. South Asians are also predisposed to central adiposity, demonstrating greater visceral fat accumulation even at lower body mass index levels, which contributes to increased insulin resistance. From a clinical perspective, understanding these genetic and epigenetic influences is incredibly important for improving prevention and adapting care for South Asian communities.

Objectives: This review aims to examine current evidence on epigenetic mechanisms contributing to T2DM risk in South Asian communities and its implications …

The Use Of Manual Therapy For Thoracic Spine Symptoms: A Scoping Review, Grace Wolf, Gabrielle Hoffman, Daniel W. Mackie, Scott Lowe

Research Day

Introduction/Background:

Manual Therapy, including Osteopathic Manipulative Medicine (OMM), Manual Physical Therapy, and chiropractic, is frequently applied to the thoracic spine; however, no published review examines the role of manual therapy in treating thoracic spine symptoms. Literature reviews indicate that much of the research focused on thoracic spine manual therapy is focused on outcomes for other body regions, in particular the cervical spine and upper extremities.

The purpose of this research is to determine what evidence exists to show the effect of manual therapy on musculoskeletal thoracic symptoms. Additionally, gaps in the research and directions for future inquiry will be identified. …

Uremic Striatopallidal Syndrome: A Rare Cause Of Hyperkinetic Movement Disorder In End-Stage Renal Disease, Cohen Chong, Esther Choi, Bhavi Purohit

Research Day

Introduction

Uremic striatopallidal syndrome (USPS) is a rare neurologic complication of end-stage renal disease (ESRD) characterized by bilateral basal ganglia dysfunction and hyperkinetic movement disorders, which may manifest as chorea, dystonia, or parkinsonian features. The underlying pathophysiology is not fully understood but is thought to involve metabolic derangements, uremic toxin accumulation, and disruption of basal ganglia function. Because its presentation can mimic medication-induced symptoms, primary neurodegenerative conditions, or other metabolic encephalopathies, USPS may be underrecognized and misdiagnosed, leading to delays in appropriate management.

Methods

A retrospective review of clinical findings, laboratory data, imaging studies, and hospital course was performed for …

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

Research Day

Introduction

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

Methods

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

An Atypical Presentation Of Acute Myeloid Leukemia (Aml), Ruhdeep Randhawa, Allyson Pel, Eric Mbua, Jermaine Robinson, Kayla Batchelor

Research Day

Introduction:

Acute myeloid leukemia (AML) is a clonal proliferation of immature myeloid precursors called myeloblasts. Common presenting symptoms include recurrent infections, fatigue, fever, anemia, and bruising. AML primarily affects older adults with a worse prognosis due to advanced age. Leukemia cutis is a rare extramedullary manifestation caused by dermal infiltration of leukemic cells. These cutaneous lesions may mimic benign dermatologic conditions and thus delay diagnosis. This case highlights the clinical course, diagnosis, and outcomes of AML presenting as leukemia cutis, providing invaluable insights for clinicians in the primary care setting to have a high index of suspicion of malignancy and …

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

Research Day

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

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

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

Research Day

INTRODUCTION

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

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

Research Day

Introduction

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

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

Research Day

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

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

This case was identified incidentally during an autopsy at …

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

Research Day

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

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

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

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

Research Day

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

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

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

Research Day

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

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

Integrating Mental Health Screening Into Pediatric Rehabilitation: Bridging Gaps In Comprehensive Care, Chloe D. Pak, Anvitha Kaguturu, Andrea Mann

Research Day

Introduction: Children with physical disabilities experience high rates of psychiatric comorbidities, such as anxiety and depression, which have the potential to influence the course and outcomes of their rehabilitation. Although there is an increasing prevalence of psychiatric conditions in the pediatric population, access to mental health services for children remains low.

Objective: This literature-based review aims to examine the existing approaches towards mental health screening in pediatric rehabilitation settings, analyze how psychiatric comorbidities are being addressed, and determine what barriers are currently preventing the full integration of mental health screening in the care of children needing physical rehabilitation.

Methods: A …

Emergency Symphysiotomy For Severe Shoulder Dystocia, Humza Omar, Linda Al-Sabbah, Audrey Arona

Research Day

Introduction: Shoulder dystocia is an obstetric emergency that occurs when the fetal anterior shoulder becomes impacted behind the maternal symphysis pubis after delivery of the head. This is a time-sensitive condition that can result in neonatal hypoxia, brachial plexus injury, and significant maternal morbidity. When standard obstetric maneuvers fail and cesarean delivery is not feasible or possible, symphysiotomy may be considered as a last resort intervention.  This procedure involves surgical division of the pubic symphysis cartilage to widen the pelvic diameter and relieve the bony obstruction. This case describes a 28-year-old woman whose vaginal delivery was complicated by severe shoulder …

Anterior Lumbar Interbody Fusion With And Without Posterior Fixation In Isthmic Spondylolisthesis, Courtney Green, Joy Zarandy

Research Day

Introduction: Isthmic spondylolisthesis is caused by a pars interarticularis defect, leading to posterior tension band failure and anterior vertebral translation. This multifactorial defect is commonly associated with stress fractures and repetitive lumbar hyperextension during adolescence. It most often affects L5-S1, though other levels may be involved. While pars defects can be unilateral or bilateral, slippage typically occurs in bilateral defects. The degree of vertebral translation is classified by the Meyerding system, ranging from Grade I (< 25%) to Grade IV (>75%).

Most patients with isthmic spondylolisthesis remain asymptomatic; however, some present with chronic low back pain and radicular symptoms. Initial management is conservative including …

Menopause And Musculoskeletal Injury Risk: Beyond Estrogen—A Hormone–Tissue–Load Mismatch Model, Mustafa Ansari, Faisal Hussain, Mutasem Shopon, Hanfa Ajmal, Mueez Asif, Sharon David

Research Day

Menopause represents a critical physiologic transition characterized by a significant decline in circulating estrogen levels, which has profound effects on the musculoskeletal system. Estrogen plays an essential role in maintaining bone homeostasis, collagen synthesis, and connective tissue elasticity. As estrogen levels fall during menopause, women experience accelerated bone mineral density loss, alterations in tendon and ligament biomechanics, and an increased susceptibility to musculoskeletal injuries. Despite the growing aging female population, the relationship between hormonal changes, tissue biomechanics, and injury risk remains underrecognized in clinical practice.

This study reviews the current literature examining the physiologic and biomechanical consequences of menopause on …

Breaking The Cycle: Uromune Mv140 In The Prevention Of Recurrent Urinary Tract Infections (Rutis), Katrina Strand, Sia Christine, Brooklyn Myers, Kaytlin Pal, Mishel Alvarez, Christina Cologer, Vicky Mody, Shashidharamurthy Taval

Research Day

Women who experience recurrent urinary tract infections (rUTIs), defined as more than three infections per year, often face significant reduction in their quality of life, including travel and employment. Additionally, there is concern about the long-term effects of prolonged and repeated use of antibiotics, which are currently the standard for prophylaxis and treatment. Overuse often results in resistance. Multiple countries currently offer, or are in the process of developing, vaccines that can prevent rUTI. Uromune MV140 from Immunotek is one such vaccine. This study was conducted as a literature review evaluating the safety, efficacy, mechanism of action, and clinical use …

A Rare Case Of Renal Cell Carcinoma Leading To Bilateral Pulmonary Embolism, Caleb Rogers, Nick Daneshvar, Anika Procope, Christian Edwards, Jonathan Fairley

Research Day

Introduction: Renal cell carcinoma (RCC) is the most common type of adult kidney cancer. It originates in the lining of the renal tubules and typically affects older individuals. Symptoms can manifest as blood in urine, flank pain, and weight loss. Lab values include, but are not limited to, anemia, polycythemia, thrombocytosis, leukocytosis, high creatinine/BUN, and hypercalcemia. Although rare, RCC has the potential to invade the venous system and extend into the heart causing subsequent bilateral pulmonary embolism (PE). Cardiac involvement in renal cell carcinoma may remain clinically silent until drastic complications arise. This case highlights an atypical and life-threatening presentation …

Food Insecurity As A Primary Driver Of Cardiometabolic Disease Across Georgia Census Tracts, Jordan R. Howard, Thomas Last, Winston Price

Research Day

Introduction: Cardiometabolic diseases including diabetes, hypertension, and obesity remain leading causes of morbidity and mortality in the United States and disproportionately affect communities across the southeastern region. In Georgia, disease burden is concentrated in rural counties and economically disadvantaged urban areas. Public health frameworks have traditionally attributed these disparities to limited physical access to healthy food, commonly described as “food deserts,” where distance to grocery stores is presumed to constrain dietary quality and worsen metabolic health. However, growing evidence suggests that economic food insecurity may play a larger role in cardiometabolic risk than geographic food access. Few studies have evaluated …

Whole-Body Anatomical Mapping Of Infiltration In Melanoma Of Unknown Primary (Mup): The Role Of Perivascular, Lymphatic, And Neurovascular Conduits, Brianny Medina, Zoe Barrett, Luke J. Lunsford, Chenell S. Anagbo-Dowetin, Xandria L. Parker, Emily E. Rowland, Mohammad A. Afani, Rasheed Agboola, Joshua Owolabi

Research Day

Introduction: Melanoma of Unknown Primary (MUP) presents a significant clinical challenge in tracing metastatic trajectories. While hematogenous dissemination is the traditional model, this study investigates angiotropism and perineural invasion—mechanisms where neoplastic cells migrate along the external surfaces of anatomical structures. Our research suggests that melanoma acts as a "hitchhiker," utilizing the adventitia of blood vessels and the epineurium of nerves as a private highway system. This study aims to provide a high-resolution, whole-body map of infiltration, documenting how these "extravascular conduits" facilitate the colonization of major organ systems. Methods: A high-resolution post-mortem mapping was performed on a 50-year-old male decedent …

Management Of Acute Fecal Impaction In A Pediatric Patient With Repaired Anorectal Malformation, Timothy C. Demott, Dylan P. Patel, Anthony A. Adetomiwa, Woodwin M. Weeks

Research Day

INTRODUCTION:

Anorectal Malformations (ARMs) represent a complex spectrum of congenital anomalies where surgical reconstruction does not always equate to functional success. Within the Krickenbeck classification, a significant “Constipation Paradox” exists: patients with “low” or “simple” malformations, such as rectoperineal fistulas, are statistically more likely to develop severe, refractory constipation and secondary megacolon than those with complex “high” defects. Despite intact pelvic musculature and sensation, underlying dysmotility creates a high‑pressure environment conducive to stool retention. This case report demonstrates the necessity of aggressive inpatient mechanical clearing and rigorous metabolic monitoring when outpatient therapies fail to overcome colonic inertia. The following clinical …