Medicine and Health Sciences Commons^™

A Case Of Dress Syndrome Following Recurrent Hardware-Related Knee Infection: Diagnosis, Management, And Recovery, Cooper Alden Josephs, Himani Patel, James Everhart

South Atlantic Division GME Research Day 2025

No abstract provided.

A Rare Case Of Vulvar Endometriosis, Taylor Penny, Shelby Freeberg, Brittany Stofko

South Atlantic Division GME Research Day 2025

No abstract provided.

Impact Of Fluid Balance On Clinical Outcomes In Icu Patients W. Pulmonary Arterial Hypertension, Geran Maule, John Rickards, Abdallah Rayyan, Moh'd Alamin Daise, Kobina Essilfie-Quaye, Peters Okonoboh

North Florida Division GME Research Day 2025

No abstract provided.

A Rare Case Of Cutaneous Vulvar Leiomyoma Complicated By Postoperative Hematoma Formation, Ariel Moskowitz, Kimberly Udell

North Texas Research Forum 2025

Leiomyomas are benign, well-circumscribed, monoclonal smooth muscle tumors. While leiomyoma of the uterus are exceedingly common, soft tissue leiomyomas are rare and often misdiagnosed. While excisional therapy is the mainstay of treatment, wide vulvar excisions can cause significant discomfort and disfigurement of the vulva. Here we present a unique case of a vulvar hematoma excision complicated by hematoma formation. A 39-year-old female presented to the ambulatory gynecology clinic with a 4-month history of an enlarging vulvar mass. On exam, a 4-cm mass was seen arising from the right upper labium. Office biopsy showed a well-circumscribed spindle cell lesion without nuclear …

Schistosoma Mansoni Infection Causes Consistent Changes To The Fecal Bacterial Microbiota Of Mice Across And Within Sites, Mariam A. Mhanna, David T. Gauthier, Lisa M. Shollenberger

Biological Sciences Faculty Publications

Eggs of Schistosoma mansoni are produced by adult female worms in mesenteries of infected hosts. Eggs can cross the intestinal barrier and form granulomas in the tissue or breach and exit the host through fecal excretion. These interactions may affect the host microbiome assemblages. Given the potential for schistosomal alteration of host gut microbiome and subsequent effects on the fecal bacterial composition, it is important to conduct controlled microbiome studies on model animals. While pursuing these studies, it is important to take into account the different conditions in which microbiome studies are conducted and their consequent impacts on variability and …

Hemifacial Spasm Due To Dolichoectasia Of Vertebral And Basilar Arteries, Meena Iyer, Shasthara Paneyala Dr.

Digital Journal of Clinical Medicine

Dolichoectasia refers to the non-focal dilatation and tortuosity of arteries, primarily affecting the vertebral and basilar arteries due to severe tunica intima degeneration. It is associated with genetic predisposition and atherosclerosis, leading to vessel wall weakening. Patients may remain asymptomatic or develop neurological deficits due to mass effect. We report a case of a 60-year-old male presenting with hemifacial spasm secondary to vertebral artery dolichoectasia. Magnetic Resonance Angiography (MRA) revealed ectatic and tortuous basilar and vertebral arteries, with the left vertebral artery compressing the left facial nerve complex. Using Smoker’s criteria, a diagnosis of dolichoectasia was confirmed. Dolichoectasia-induced hemifacial spasm …

Comparison Of The Effectiveness Of Preoperative Dexmedetomidine Nebulization Versus Lignocaine Nebulization In Attenuation Of Stress Response During Direct Laryngoscopy And Endotracheal Intubation In Elective Surgeries Under General Anaesthesia: A Randomised Control Study At A Tertiary Care Hospital, Mandya, Sumayya E., Kiran A V., Santhosh M C B., Shivakumar G

Digital Journal of Clinical Medicine

Introduction: Direct laryngoscopy and tracheal intubation are known to provoke harmful stimuli that can lead to transient, unpredictable, and variable hemodynamic alterations, primarily due to heightened sympathoadrenal activity.¹ Various pharmacological agents have been explored to mitigate this stress response; however, none have emerged as optimal.²

Aim: This study aims to compare the effects of nebulized dexmedetomidine in comparison to nebulized lignocaine on the hemodynamic stress response during direct laryngoscopy and tracheal intubation, including any adverse effects in patients undergoing general endotracheal anesthesia.

Materials and Methods: Informed consent was obtained from 60 patients aged 18 to …

Lymphoma Chronicles: Insights From A Distinct Hodgkin's Lymphoma Case Report, Srirangam Shankaralingam, Vibha Nagaragatta

Digital Journal of Clinical Medicine

Hodgkin lymphoma (HL) is a kind of lymphatic malignancy distinguished by the presence of Reed-Sternberg cells. It often manifests as painless lymphadenopathy and systemic symptoms (B symptoms and can affect a variety of lymphoid tissues. The causes of HL are complicated and include genetic predisposition, environmental conditions and viral infections, particularly the Epstein-Barr virus (EBV). The diagnosis is primarily based on histological evaluation of lymph node samples, with immunophenotyping assisting classification. Herein, we report a case of classical Hodgkin’s lymphoma (HL) in an otherwise healthy 31-year-old male who had a mass per abdomen for a year and recently noticed a …

Felt Need For Psychiatry Clubs In Medical Colleges To Enhance Teaching-Learning, Aditya Rao, Sheryl Agarwal, Sharanya Bose, M Kishor

Digital Journal of Clinical Medicine

Mental health competence is critical for medical graduates, yet in India the treatment gap for common mental disorders remains substantial, with prevalence estimates indicating up to 80.4% of unmet need. Recent reforms under the Competency-based Medical Education (CBME) curriculum have expanded psychiatry training; however, deficiencies in applied skills, preventive psychiatry, and communication remain. Psychiatry clubs have been proposed as supplementary, student-led platforms to address these limitations. This cross-sectional study assessed the perceived need for psychiatry clubs among undergraduate medical students and explored their potential role in enhancing teaching–learning. A structured online survey was administered to 94 students across different phases …

Localized Reticulate Hyperpigmentation From Heater Use: A Case Of Erythema Ab Igne, Chitwan Kaur Ghuman, Monish Yarlagadda, Ashwini P K

Digital Journal of Clinical Medicine

Background: Erythema ab igne (EAI) is a reticulated, hyperpigmented dermatosis resulting from prolonged exposure to infrared radiation insufficient to cause burns. While increasingly rare due to central heating, it remains relevant in vulnerable populations, particularly the elderly and immobilized.

Case Summary: We report the case of an 83-year-old bedbound female who developed characteristic pigmentary changes over her right upper and lower limbs due to chronic proximity to a room heater.

Conclusion: Awareness of EAI is crucial to prevent unnecessary investigations and to emphasize the importance of appropriate thermal environment modifications, especially in bedbound geriatric patients.

Extracapsular Excision Of Retroperitoneal Ancient Schwannoma: A Case Report, Mayur Chaure, Shital Dharamkhele, Keval Dhone, Imran Ahmed Khan

Digital Journal of Clinical Medicine

Schwannomas are tumors originating from Schwann cells in the nerve sheath. They are generally solitary and encapsulated, but they are rarely seen in the retroperitoneal region. We report a 40-years-old woman with dull aching pain for two months without urinary symptoms. Following imaging studies, a well-encapsulated, retroperitoneal mass complicated with intratumoral bleed and necrosis was found.

Complete surgical resection was performed with preservation of adjacent viscera. The histopathology report confirmed the tumor as an ancient schwannoma. Careful preoperative surgical planning and meticulous surgical skill, along with the application of ERAS protocol, are essential to prevent morbidity and mortality. No evidence …

Prevalence Of Depression Among Type 2 Diabetes Mellitus Patients In Urban Mysuru – A Cross-Sectional Study, Jesymol Joy, Renuka M, Chiranjeevi G S

Digital Journal of Clinical Medicine

Background: Depression is a significant comorbidity among individuals with Type 2 Diabetes Mellitus (T2DM) adversely affecting disease management and overall quality of life. Diabetes and depression have a bidirectional relationship, where poorly managed diabetes increases the risk of depression, and depression exacerbates diabetes-related complications. Depression contributes to poor glycemic control, decreased adherence to treatment, increased risk of diabetes-related complications, and higher healthcare utilization.

Objectives: To determine the prevalence of depression and its associated factors among Type 2 Diabetes Mellitus patients in urban Mysuru.

Methods: A community-based cross-sectional study was conducted among 300 Type 2 Diabetes mellitus patients >18 years of …

Allergic Bronchopulmonary Aspergillosis In Pediatric Asthma : A Diagnostic Challenge Mimicking Tuberculosis, Praveen Das, Santosh Kondekar, Surbhi Rathi

Digital Journal of Clinical Medicine

Allergic bronchopulmonary aspergillosis (ABPA) is a rare hypersensitivity reaction to Aspergillus fumigatus, more commonly observed in adults and patients with cystic fibrosis. It can, however, present in pediatric asthmatics with refractory symptoms, leading to diagnostic challenges due to overlapping features with other pulmonary diseases, including tuberculosis. ABPA should be considered in children with uncontrolled asthma and atypical radiologic features, especially when unresponsive to standard therapies. Early recognition and appropriate management are critical to prevent irreversible lung damage and improve quality of life.

Pregnancy-Related Delusional Beliefs In Midlife And Late-Life Women: A Case Series, Dyuksha Arora, Ashita Adarsh, Kishor M. Manohar Rao, Anand R, Soumya Rajshekar Patil, Akshatha Cj

Digital Journal of Clinical Medicine

Pseudocyesis and delusional pregnancy represent rare but clinically significant presentations across psychiatric practice. While pseudocyesis involves a false belief of pregnancy accompanied by physical manifestations, delusion of pregnancy refers to a fixed belief of being pregnant despite clear contrary evidence. Both conditions pose considerable challenges as they involve close consultation and liaison between Obstetrics & Gynaecology and Psychiatry. There are a few studies from tertiary care general hospitals in India. Here we report two case series.

Case 1: A 43-year-old married woman from a rural background with an 8-year history of recurrent depressive disorder and dysthymia, presented with 3 months …

One Airway, One Disease In Pregnancy: A Prospective Observational Study On The Correlation Between Upper And Lower Airway Inflammation In Pregnant Women, Durga K, Yuvarajan S

Digital Journal of Clinical Medicine

Background: The well-established "One Airway, One Disease" concept recognizes the deep physiological and pathological connections between conditions affecting both the upper and lower respiratory tracts, most notably allergic rhinitis and asthma. During pregnancy, a woman's body undergoes significant immunological, hormonal, and physiological changes, which can profoundly influence and modulate existing or emerging airway inflammation.

Objective: This prospective observational study was designed with the primary objective of meticulously evaluating the correlation between upper and lower airway inflammation in pregnant women. We aimed to achieve this by assessing a range of clinical symptoms, objective functional parameters, and specific inflammatory markers.

Methods: We …

Comparision Of Buprenorphine Versus Butorphanol As An Adjuvant To Intrathecal Hyperbaric Bupivacaine For Elective Infraumbilical Surgeries : A Randomised Control Study At A Tertiary Care Hospital, Mandya, Surabhi C A, Dr. Kiran A V. Associate Professor, Dr. Shivakumar G Pofessor And Hod, Umesh N P

Digital Journal of Clinical Medicine

Introduction: Spinal anaesthesia is the most popularly performed procedure in the field of anaesthesiology. Hyperbaric bupivacaine, the local anaesthetic most commonly used, has limitation as its effect lasts only for 1.5-2 hours. Hence a lot of adjuvants have been tried to enhance the analgesic effect of bupivacaine.^[2] Opioids remain the mainstay among the various adjuvants to local anesthetics in spinal anaesthesia primarily by virtue of its various properties such as reducing the dose of local anaesthetic, minimizing side effects, and prolonging the duration of anaesthesia.^[3]

Aim: This study aims to compare the sensory and motor characteristics …

Diagnosis Of Hypertensive Disorders In Pregnancy, Rebecca Horgan, Yara Hage Diab, Maged Costantine, George Saade, Baha Sibai

Department of Obstetrics & Gynecology Faculty Publications

Hypertensive disorders of pregnancy, including chronic hypertension, superimposed preeclampsia, gestational hypertension, and preeclampsia, affect 10-20% of pregnancies and are a significant cause of maternal and perinatal mortality. The incidence of these disorders is rising due to factors such as advanced maternal age, obesity, assisted reproductive technology, and increased rates of preexisting comorbidities. Differentiating pregnancy-associated hypertension from pre-existing chronic hypertension is challenging, as the overlap between the two may be broadening due to the changing demographics of the pregnant population. This review critically evaluated the evidence regarding the current time periods recommended to make a diagnosis of a hypertensive disorder of …

Systemic Therapy Targeting Psoriatic Inflammation Is Associated With Decreased Incidence Of Dementia: An Observational Retrospective Cohort Study, Madison P. Olexson, Ana Ormaza Vera, Chunghwan Ro, Clinton W. Enos

Department Dermatology Faculty Publications

[Introduction] To the Editor: Psoriasis, an immune-mediated chronic inflammatory skin disorder, has been implicated in cognitive impairment and dementia.1, 2, 3 Emerging evidence suggests that systemic inflammation contributes to neuroinflammation and resultant cytokine-driven neurodegeneration, although findings remain inconclusive.1, 2, 3 While systemic therapies such as biologics and conventional disease-modifying antirheumatic drugs are routinely used in psoriasis management, their role in modulating dementia in this population remains underexplored, with research yielding mixed results.1, 2, 3 We conducted a large-scale, retrospective cohort study to investigate the relationship between psoriasis and dementia and whether systemic treatments for psoriasis impact this association.

Estimating Per-Infection Cost And Burden For Dengue And Zika As A Function Of Antibody-Dependent Enhancement, Christopher M. Kribs

Mathematics Faculty Publications - Archive

The complex immune interactions produced by the tetravalent dengue vaccine Dengvaxia have foregrounded the important role of antibody-dependent enhancement (ADE) in dengue infection. Some evidence exists that ADE may extend beyond the four dengue serotypes to Zika, a closely related flavivirus transmitted by the same mosquito species as dengue, and may also account for the increased severity of some cases. Estimates of the public health impact of dengue vaccination may then need to include its effects on the transmission of Zika in addition to dengue. This study gathers primary references to build estimates of per-case economic cost and disease burden …

Translating Cardiovascular Clinical Practice Guidelines On Nutrition Therapy: Validation Of The Portfolio Diet Toolkit For Healthcare Providers, Gabrielle Viscardi, Sahba Eskandari, Alyssa Chen, Nicholas Chiang, Meaghan E. Kavanagh, Songhee Back, Micheal Vallis, Mary J. Scourboutakos, Vasanti S. Malik, Cyril W.C. Kendall, David J.A. Jenkins, John L. Sievenpiper, Laura Chiavaroli

Department of Family and Community Medicine Faculty Publications

Background

Cardiovascular disease (CVD) remains a leading cause of death in Canada. Although the Portfolio Diet, a dietary pattern of cholesterol-lowering foods, is supported by CVD clinical practice guidelines, its uptake in clinical practice remains limited. This study assessed the content and face validity of a healthcare provider (HCP)-facing toolkit (infographic and video), designed to support implementation of the Portfolio Diet.

Methods

HCPs were recruited for a 2-round evaluation. They assessed the toolkit using a questionnaire. Content validity of the infographic was assessed using a 4-point Likert scale (1 = irrelevant to 4 = extremely relevant) and face validity of …

Reducing Unnecessary Antibiotics For The Treatment Of Urinary Tract Infections, Megan A. Carullo

West Chester University Doctoral Projects

Urinary tract infections (UTIs) are among the most common infections in women and are often a reason for prescribing antibiotics. Appropriately treating these infections is vital to prevent significant health concerns such as pyelonephritis or sepsis. Providers commonly prescribe antibiotics as a preventive measure, but incorrect usage can lead to unnecessary use of antibiotics. This is a large concern for the medical community, given the increased rates of antibiotic resistance. This quality improvement project aimed to answer the following research question: In women with recurrent UTIs (rUTIs), does presumptive treatment compared to standard treatment upon confirmed infection increase the number …

Pathogenesis And Pathophysiology Of Celiac Disease, Kendall N. Reece

Undergraduate Honors Theses

Celiac Disease is an allergic response to foods that contain the protein gluten. Celiac Disease is classified as an autoimmune disorder, which specifically deteriorates the villi of the jejunal segment of the small intestine. Specific topics analyzed within this thesis include some physical attributes of Celiac Disease such as weight loss, diarrhea, dermatitis herpetiformis, etc. The basis of classification is discussed and the negative effects Celiac Disease has on the body, such as malabsorption, vitamin deficiencies, and damage to the villi. Diagnostics such as biopsy and blood tests, treatments both experimental and adhering to a gluten-free diet are discussed. Origination …

Enhancing Health Literacy Using Video Education And The Teach-Back Method For Hypertension And Diabetes Mellitus Type 2, Shelly-Ann M. Malcolm-Padilla

Doctor of Nursing Practice Projects

Diabetes type 2 and hypertension are chronic illnesses that have both physical and psychological impacts on an individual. Primary care providers play an important role in the management of chronic illness, specifically type 2 diabetes and hypertension. Changing behavior with a commitment to compliance with the treatment plan and living a healthy lifestyle can decrease disease complications for both diabetes and hypertension. With the use of educational videos and the teach-back method to confirm understanding of disease management, the goal of this quality improvement project was to contribute to positive health and lifestyle change for patients, their caregivers, clinical staff, …

Effects Of Educational Intervention On Asthmatic Children, Zoe Coggins

Nursing | Senior Theses

Abstract

Children are more vulnerable to asthmatic symptoms due to the physiological immaturity of their respiratory systems. Therefore, irritants are deemed more hazardous for the pediatric population. Pollution is a growing health concern, and within the literature review, several approaches to the measurement of the impact of low air quality and educational interventions are discussed. The themes identified in the literature review are increased risk of pollution-induced exacerbation due to age, behavior, and residential proximity to emission-producing facilities. The review of the literature demonstrated how pollution is a growing public health concern, especially among the pediatric population. Interventions, reviewed in …

Distinguishing Narcolepsy Hallucinations From Drug-Induced Hallucinations In An Adolescent With Comorbidities, Avidor Gerstenfeld, Biwy Emmanuella Cadet, Salma Alkhatib, Annette Santiago

East Florida Division GME Research Day 2025

No abstract provided.

Malignant Adenomyoepithelioma Of The Breast, Cole Daisley, Susana Ferra

East Florida Division GME Research Day 2025

No abstract provided.

Life Over Limb: A Case Of Rapidly Rrogressive Necrotizing Fasciitis, Olesya A. Balashova, Adam Lerchenfeld, Rahul Ramakrishnan, Ashley Diaz, Anna Felizcek, Daniel Heller

East Florida Division GME Research Day 2025

No abstract provided.

Platypnea-Orthodeoxia Syndrome In A Case Of Septal Occlusion Device Migration, Bike Ozkan, Richard Shalmiyev, Adam Devine, Michael Pelekhach, Siddarth Kathuria, Daniel Heller, Mauricio Danckers

East Florida Division GME Research Day 2025

Introduction

Platypnea-orthodeoxia syndrome (POS) is defined by dyspnea and hypoxemia in the upright position, which improves upon recumbency. While often linked with hepatopulmonary syndrome, intracardiac etiologies, particularly a patent foramen ovale (PFO), may also be responsible. PFOs are typically managed with device closure, and while rare, device migration can occur unbeknownst to the patient with resultant critical sequelae.

Methods

Here, we present the case of an 89-year-old female with a medical history of hypertension, diabetes, and coronary artery disease status post PCI, who arrived with severe dyspnea and was subsequently intubated for profound hypoxia. A chest CT angiogram ruled out …

Mesonephric-Like Carcinoma Of The Endometrium In A 73-Year-Old Female, Cameron Summers-Powell, Carina Ferraris, Zoyla Almeida, Susana Ferra, Mirza Baig

East Florida Division GME Research Day 2025

Introduction: Mesonephric-like carcinoma (MLC) is a newly described malignant tumor that represents 1% of endometrial cancers. The etiology of this disease is currently unknown but immunohistochemical expression with GATA-3, PAX-8 and TTF-1 and lack of ER/PR positivity can aid in correct diagnosis.

Case Summary: A 73-year-old female presented to the hospital with post-menopausal bleeding, an initial hysteroscopy identified a lesion suggestive of endometrial cancer. Ultimately, the patient underwent a hysterectomy and a bilateral salpingectomy/oophorectomy. Chemotherapy ensued due to metastatic disease. At 7 months post-op, the patient appeared to be doing well.

Results: Grossly, the lesion was 5.5 cm and appeared …

Carcinoma With Osteoclast-Like Giant Cells: A Rare Histologic Variant Of Breast Cancer, Robert Bender, Makenna Bowman, Matthew Lee, Susana Ferra

East Florida Division GME Research Day 2025

Introduction: Osteoclast like giant cells (OGCs) can be found in various tissues such as the gallbladder, liver, pancreas, and thyroid. In breast cancer, the presence of OGCs is a rare finding. Currently knowledge of such cases is limited, with approximately 200 reported cases of osteoclast like giant cells (OGCs) among all breast carcinomas. Among the breast cancers that are classified as rare, those with OGCs make up only 0.5-1.2% of cases.

Case Description: An 80+ year-old female presented with a palpable left breast lesion initially suspected by mammography as a benign lesion. She eventually underwent breast core biopsy revealing hormone …