Medicine and Health Sciences Commons^™

Low-Rate Tens As An Effective Treatment For Pelvic Pain - A Retrospective Case Report, Michelle Allyn, Ryan Kamieneski

Internet Journal of Allied Health Sciences and Practice

Purpose: Chronic pelvic pain (CPP) affects 27% of the world’s female population. The purpose of this case report was to investigate the use of low-rate transcutaneous electrical nerve stimulation (TENS) for pain relief in a woman with CPP. Few studies have investigated the effects of low-rate TENS on gynecological-related pelvic pain. Methods: A 21-year-old woman presented with a six-month history of pelvic pain and decreased quality of life. Persistent pain led the patient to seek physical therapy treatment. Single-channel low-rate TENS (five hertz frequency, 250 microseconds phase duration) was provided for 30 minutes daily at the maximum tolerated intensity, for …

Risk Factors Of Hypertension And Association With Familial Factors Among Patients Attending A State Hospital In South-Western Nigeria, Ismaheel A. Azeez, Banke I. Yusuf, Magbagbeola D. Dairo

Internet Journal of Allied Health Sciences and Practice

Purpose: This study aimed to assess the determinants of hypertension and its association with familiar factors among patients attending a specialist hospital in Nigeria. Methods: This was a cross-sectional study of 350 patients recruited from the general outpatient clinic of the hospital with computer-generated simple random sampling techniques. Data were analysed by SPSS version 23. Correlation analysis and chi-square tests were used to determine the association of relevant variables. Poisson regression was used to assess the predictors of the number of days of physical activities per week. Linear regression and logistic regressions were done to determine the determinants of hypertension. …

Healthcare Experience Impact On First-Year Physician Assistant Students’ Communication Self-Efficacy, Joseph Tocco, Sara Maher, Sara Lolar

Internet Journal of Allied Health Sciences and Practice

Purpose: Healthcare experience (HCE) is required by most physician assistant (PA) programs for application, but it is not known what role HCE might play in the success of PA students. Communication skills are an important trait for a successful clinician, and previous HCE might lead to an improved ability to communicate with patients. This study examined the relationship between PA students’ healthcare experience (HCE) and their communication self-efficacy (SE). Methods: First-year PA students from Michigan PA programs were eligible to participate in an anonymous electronic survey. A previously validated survey to assess communication SE was used. HCE was assigned into …

Cytomegalovirus Esophagitis In An Immunocompromised Patient, Adya A. Ali, Sheela Anasseri, Jaafar Abou-Ghaida, Leslie Walker, Tye Barber

HPD Articles

Cytomegalovirus (CMV) can present with end-organ disease (EOD), particularly in patients with a CD4 cell count <50/mm3. While EOD in immunocompromised patients commonly presents as CMV retinitis (30%) and CMV colitis (5-10%), CMV esophagitis is rare. CMV is the third most common infectious esophagitis following Candida and Herpes Simplex. CMV esophagitis presents with odynophagia, dysphagia, and abdominal pain. Endoscopic exam may reveal large, linear distal esophageal ulcers. Histopathology or serology studies are diagnostic, though serology may be unreliable in the extremely immunosuppressed. Current treatment consists of antivirals such as ganciclovir and valganciclovir. Esophageal disease due to CMV carries a poor prognosis in the immunocompromised. We present the case of a 56-year-old male with a medical history of HIV/AIDS and stage III rectal squamous cell cancer who presented with shortness of breath, weakness, and chronic diarrhea. His HIV was previously well-controlled on antiretroviral therapy. However, due to his malignancy, he was undergoing treatment with chemotherapy and radiation. Initial labs revealed a CD4 count of 42. His clinical course consisted of Escherichia coli septicemia, new-onset atrial fibrillation with a rapid ventricular response, worsening pneumonia, possible metastasis, progressive diarrhea, and potential oropharyngeal candidiasis. Despite several broad-spectrum antimicrobial regimens, he remained symptomatic with new complaints of dysphagia and odynophagia. Eventually, the appearance of vesicular lesions on the lips and a repeat CD4 count of 13 garnered a suspicion of HSV or CMV. This complicated case highlights the necessity for a high index of suspicion of rare manifestations of CMV EOD in an immunocompromised patient presenting with confounding …

Improving Value In Colorectal Cancer Care: An Economic Analysis Of Enhanced Recovery Protocols At A Community Hospital, Lexi Frankel, Amalia D. Ardeljan, Ali Rashid, Abhishek Nair, Kazuaki Takabe, Omar M. Rashid

HPD Articles

Background: Enhanced recovery protocols (ERPs) have been shown to improve the outcomes of gastrointestinal cancer care, leading to reduced morbidity of gastrointestinal treatment and reduced delays in systemic therapy. ERP implementation has also previously shown a reduction in length of stay (LOS) without changing the readmission rate; however, the economic cost associated with these measures has not yet been quantified. The aim of this study was to evaluate the economic costs of ERP implementation for colorectal cancer at a community hospital. Methods: The Diagnostic Related Group (DRG) codes were used to assess costs associated with the hospitalizations of cases in …

Post-Hysteroscopy Ruptured Tubo-Ovarian Abscess With Atypical Bacteremia: A Case Report, Jillian H. Linck, Wanda I. Torres, Shailja T. Dayal

HPD Articles

Hysteroscopies are commonly performed in the diagnosis and treatment of patients with abnormal uterine bleeding. Current research suggests a low rate of all types of complications following hysteroscopies. The rate of infectious complications has been reported as exceptionally low. We present a case of tubo-ovarian abscess with Escherichia coli bacteremia and eventual abscess rupture in a 51-year-old gravida 3, para 2012 (G3P2) woman who underwent a hysteroscopy with concurrent polypectomy. The patient had no risk factors that have historically been attributed to the development of post-hysteroscopy infection, such as a history of pelvic inflammatory disease or endometriosis. The patient also …

Quadruple Valve Replacement In Carcinoid Heart Disease: A Case Report, Maria Beyer, Rishabh Kasarla, Seth Shoap, Erik Beyer

HPD Articles

This report details a rare case of left-sided carcinoid heart disease (CHD). In CHD, vasoactive substances released from carcinoid tumors cause fibrous tissue formation on the right side of the heart. These substances are usually inactivated by monoamine oxidase A in the lungs, safeguarding the left side of the heart. Exceptions include the presence of a patent foramen ovale (PFO), pulmonary metastasis, or elevated serotonin levels. Intriguingly, our patient exhibited significant left-sided involvement without these factors, ultimately requiring a quadruple valve replacement surgery. After eight months post-operation, the patient is stable with no cardiovascular complications. This rare case of CHD, …

The Therapeutic Potential Of Targeting Cardiac Rgs4., Giselle Del Calvo, Teresa Baggio Lopez, Anastasios Lymperopoulos

HPD Articles

G protein-coupled receptors (GPCRs) play pivotal roles in regulation of cardiac function and homeostasis. To function properly, every cell needs these receptors to be stimulated only when a specific extracellular stimulus is present, and to be silenced the moment that stimulus is removed. The regulator of G protein signaling (RGS) proteins are crucial for the latter to occur at the cell membrane, where the GPCR normally resides. Perturbations in both activation and termination of G protein signaling underlie numerous heart pathologies. Although more than 30 mammalian RGS proteins have been identified, each RGS protein seems to interact only with a …

Thyroid Predictors Of Postpartum Mood Disorders, Sean Backer, Janeta Yancheva, Camelia Garcia, Deepesh Khanna

HPD Articles

Postpartum mood disorders (PMD) are currently among the leading causes of maternal postpartum morbidity and mortality. PMD include the conditions of postpartum blues (PB), postpartum depression (PPD), and postpartum psychosis. The pathogenesis of PMDs are ambiguous, and there are no reliable prenatal predictive markers despite current research efforts. Even though reliable indicators have not been found, leading ideas suggest an etiology of hormonal fluctuations. Although thyroid markers have long been linked to psychiatric disorders such as major depressive disorder (MDD), how they correlate with PMDs is still unclear. This study aimed to evaluate the pathophysiological link between thyroid function, PMDs, …

The Development Of Fat Embolism Syndrome (Fes) And Multiple Small Pulmonary Emboli Following Open Reduction Internal Fixation (Orif) Of A Left Femur Fracture: A Case Report, Aaron Hacker, Dylan S. Irvine, Scott Macdougal, Imani Thornton

HPD Articles

Fat embolism syndrome (FES) is a rare but potentially life-threatening complication that can occur following orthopedic procedures, such as long bone fracture repairs. FES is caused by the release of fat globules into the bloodstream, leading to the obstruction of blood vessels and subsequent tissue damage. Pulmonary embolism (PE), a condition in which a blood clot travels to the lungs, is another potential complication of orthopedic procedures due to the mobilization of blood clots during surgery. We report the case of a 56- year-old female who presented to the emergency department with a left femur fracture following a mechanical fall …

A Review Of Federal And Statewide Guidelines And Their Effects On Orthopedics, Johann Braithwaite, John M. Tarazi, Joshua Gruber, Jarret Boroniec, Randy Cohn, Adam Bitterman

HPD Articles

In the past three decades, the use of opioids has risen tremendously. Pain was named the “fifth patient vital sign” in the 1990s, and from that point, opioid usage has continued to grow throughout the 2010s leading to its recognition as a crisis. The United States is responsible for 80% of the global opioid usage while only accounting for less than 5% of the global population. Previously opioids were mostly used to treat acute pain, however, opioids have been most recently used to manage chronic pain as well. The opioid crisis has presented new challenges in treating pain while preventing …

Platelet-Rich Plasma’S Effects In Patients With Androgenetic Alopecia: A Scoping Review, Viktor Kunder, Cristina Munoz, Judd Ivan Palonpon

HPD Articles

Androgenetic Alopecia (AGA), the most common form of hair loss in both males and females, is characterized by the progression of large, pigmented terminal hair to thin, fine vellus hair. In recent years, there has been growing interest in exploring Platelet-Rich Plasma (PR) as a therapeutic option for AGA. PRP is a mixture of numerous cytokines and growth factors that have shown the ability to facilitate wound healing and collagen development. PRP is a mixture of numerous cytokines and growth factors that have shown the ability to facilitate wound healing and collagen development. Utilizing the databases PubMed, Medline EBSCO, and …

An Incidental Finding Of A Glucagon-Like Peptide 1 (Glp-1)-Induced Acute Kidney Injury: A Case Report., Andy Espino Aleman, Erik Aleman Espino, Claudia Aleman Oliva, Hamlet Monteagudo, Odalys Frontela

HPD Articles

Acute kidney injury (AKI) involves a rapid decline in kidney function, classified into prerenal, intrarenal, and postrenal causes. Drug-induced AKI's complex pathophysiology includes altered hemodynamics, inflammation, crystal deposition, hemolysis, and rhabdomyolysis. This report details a 42-year-old female with hypertension and diabetes who, following a dog bite, exhibited reduced kidney function (GFR: 16 mL/min/1.73m

The Effect Of A Psychologically Informed Video Series To Treat Adolescents' Patellofemoral Pain: A Randomized Controlled Trial., Mitchell Selhorst, Jessica Hoehn, Laura Schmitt, Jason Benedict, Alicia Fernandez-Fernandez

HPD Articles

OBJECTIVE: To test whether a series of brief, psychologically informed educational videos added to physical therapy improved function among adolescents with patellofemoral pain (PFP). The secondary aims were to assess pain and psychological beliefs.

DESIGN: A double-blinded randomized controlled trial.

METHODS: Sixty-eight adolescents with PFP were randomly assigned to view brief, psychologically-informed videos (n=34) or control videos (n=34) in addition to usual care physical therapy. The psychologically-informed videos targeted fear-avoidance beliefs, kinesiophobia, and pain catastrophizing. The control videos conveyed basic anatomy, biomedical factors, and lower extremity mechanics. Outcomes were assessed at baseline, three weeks, six weeks (primary endpoint), and three …

Developmental Approaches To Chronic Pain: A Narrative Review, Nikita P. Patel, Chad M. Bates, Aakash Patel

HPD Articles

Chronic pain, which can potentially develop from acute pain, subacute pain, or breakthrough pain, is generally defined as pain persisting for greater than three months with minimal relief. Chronic pain can be associated with a myriad of medical conditions. It is also one of the most common causes of disability, physical suffering, depression, and reduced quality of life. Treatment can vary depending on the underlying pathophysiology and can involve physical therapy, non-pharmaceutical approaches, pharmaceutical drugs, and invasive procedures. Currently available pharmaceutical agents have been effective for short-term management of chronic pain conditions, but few options address chronic pain with long-term …

The Lasting Effects Of Covid-19 On The Progression Of Metabolic Dysfunction-Associated Steatotic Liver Disease, Sean Backer, Deepesh Khanna

HPD Articles

It is estimated that around 30% of the population living in Western countries has metabolic dysfunctionassociated steatotic liver disease (MASLD), a spectrum of pathology (not attributed to alcohol/substance intake) initiated by steatosis and progression toward inflammation and irreversible fibrosis metabolic dysfunction-associated steatohepatitis (MASH). With inflammation being a key component of the transition to MASH, it raises the question of whether the ongoing COVID-19 pandemic, which has notoriously induced hyperinflammatory states, may influence the progression of MASLD. Specifically, it remains unclear if the potential chronic sequelae of COVID-19 in patients who recovered from it may increase the predisposition for MASH. Since …

Post-Activation Performance Enhancement Through Variable Loading Maintains Power Output Over Five Sets In Highly Trained Athletes, Robert Rocanelli, Morgan Siegel, Pedro Yunes, Pete Bommarito, Monique Mokha

Journal for Sports Neuroscience

The goal was to examine the acute effects of five sets of variable loading (VL) on the post-activation performance enhancement (PAPE) response during a live training session in highly trained athletes. PAPE is the phenomenon where acute improvements in power production in light loaded movements occur post near maximal loaded muscle contraction. PAPE may be induced with VL where resistance in the form of chains or bands is added to the bar as it displaces in the concentric phase. Participants were American football players from a variety of field positions (n=12, height =188 ± 0.01 cm, total body mass = …

Predictors Of Pharmacy Students' Attitudes About The Therapeutic Use Of Psilocybin, Nm Mahmudul Alam Bhuiya, Robin J. Jacobs, Karina Wang, Yiqun Sun, Brenda Nava, Luke Sampiere, Akhila Yerubandi, Joshua Caballero

HPD Articles

Background Psilocybin has been studied for its potential therapeutic benefits, particularly for the treatment of psychiatric disorders such as anxiety, depression, and obsessive-compulsive disorder. While more research is needed as psilocybin-assisted therapy becomes more prevalent, future pharmacists will probably be involved at some level. At present, pharmacists receive minimal training on psilocybin, and little is known about their attitudes toward its use for medical purposes. Findings from recent clinical studies have attempted to establish the safety and medical efficacy of psilocybin, leading to an increased interest in therapeutic psilocybin use in the United States. This study aimed to assess if …

Inferior Vena Cava Thrombus Associated With Renal Cell Carcinoma With An Atypical Radiological Presentation: A Case Report, Kareem Elgendi, Mohamadhusni Zarli, Sohaib Ahmed, Nicole Szell

HPD Articles

Renal cell carcinoma (RCC) is characterized by the development of kidney masses, which can lead to various long-term complications. Among the extrarenal manifestations associated with RCC, the formation of a thrombus within the inferior vena cava (IVC) is particularly prevalent due to the substantial tumor burden imposed by the kidneys. In this report, we present an exceptional case involving an 80-year-old male patient who presented with an intravascular thrombus within the inferior vena cava (IVC), which originated from RCC. The diagnosis of RCC was conclusively established through core needle biopsy and subsequent tumor marker staining. Remarkably, despite the confirmation of …

Health Issues Among Nepalese Youth: A Literature Review, Veenah Stoll, Naomi Edwin, Kripa Dahal, John Barnes, Miranda Pfautsch, Lahana Maharjan, Cyril Blavo

HPD Articles

Nepal is one of the world's least-developed countries. Nepalese children are often vulnerable to a lack of resources which leads to suboptimal levels of health in turn. This review article aims to identify health issues and inequities faced by school-aged children greater than five years old in Nepal. A comprehensive search of the literature was conducted in PubMed and Global Health databases to gather relevant studies. Inclusion and exclusion criteria were applied to select appropriate articles, and 35 full-length articles were reviewed in-depth. The literature supports the association between inadequate resource distribution among Nepalese children and poorer health outcomes compared …

Assessing Non-Invasive Imaging Devices To Detect Temperature Differentiation And Lymphatic/Venous Flow To The Head And Neck During Head Down Tilt, Supine, And Sitting Positions The Niid Study (Non-Invasive Imaging Device), Matthew Melin, Heather Hettrick, Frank Aviles, Johanna Pannunzio, Nathan Sirkis, Chantel Hubbard, Patrick Hardigan, Sabrina Ginsburg, Harvey N. Mayrovitz

HPD Articles

Under the influence of standard developmental physiology on the Earth’s surface (1 gravity equivalent known as “1G”), 70% of body fluids reside below the level of the heart.Fluid shifts towards the cephalic region during microgravity have also been speculated to contribute towards spaceflight associated neuroocular syndrome (SANS).Although a significant barrier to spaceflight, the underlying mechanism of SANS is not well understood, partially due to the spaceflight environment and limited medical capabilities including invasive diagnostic testing. Thus, non-invasive approaches to studying real-time fluid shifts in weightlessness could serve as critical areas of research to further SANS study and effective countermeasure protocol …

Severe Covid-19 Infection In An Infant With 8p Inverted Duplication/Deletion Syndrome: Is Vaccination Still A Debate?, Andrew M. Joseph, Monica Karas, Ernesto Joubran, Yaseen O. Ramadan, Blakley A. Fowler

HPD Articles

Despite having a milder course of coronavirus disease 2019 (COVID-19) in comparison to adults, children are at risk for more significant complications, including acute neurological, renal, respiratory, and cardiovascular complications. Acute complications can manifest as encephalopathy, renal injury, interstitial pneumonia, and heart failure. However, the most severe complication is multisystem inflammatory syndrome in children, which often requires intensive care to manage the subsequent respiratory failure. Moreover, children with comorbidities such as chronic lung disease, neurological disorders, and cardiovascular disease are at an elevated risk of morbidity and mortality. Here, we present the case of an 11- month-old white female patient, …

The Effects Of Inhaled Anesthetic Agents On Long-Term Cognitive Decline, Viktor Kunder, Matthew Tayem, Sneh Parekh

HPD Articles

Background: Anesthesia is generally considered safe, but studies have shown the potential relationship between anesthetic agents and dementia after surgery. Several studies have pointed out how the commonly used anesthetic drugs induce cytotoxicity, ultimately leading to neurodegeneration and even Alzheimer's Disease (AD). Specifically, inhaled anesthetics such as isoflurane, sevoflurane, and desflurane have been shown to impact the neurophysiology of the brain. However, there is no established relationship between aesthetics and long-term postoperative cognitive decline.

Objective: The objective of this study is to explore the available research on anesthetic agents and the potential role that they have played in postoperative cognitive …

Supporting Vulnerable Older Adults With Telehealth Through Wellness Calls And Tablet Distribution During Covid-19: Quality Improvement Project, Sweta Tewary, Nicole J. Cook, Marie Dezine, Oksana Shnayder, Naushira Pandya

HPD Articles

BACKGROUND: Loneliness, social isolation, and lack of technical literacy are associated with poorer health outcomes. To help improve social connection during the COVID-19 pandemic, Nova Southeastern University's South Florida Geriatric Workforce Enhancement Program partnered with a community-based organization to provide educational resources to promote telehealth services.

OBJECTIVE: This study aimed to provide educational resources to older adults with limited resources and promote the use of telehealth services in this population.

METHODS: Through this pilot project, we contacted 66 vulnerable older adults who expressed interest in telehealth support through wellness calls, with 44 participants moving on to participate in tablet usage. …

A Narrative Review Of The Many Psychiatric Manifestations Of Neurosyphilis: The Great Imitator, Baneet Kaur, Deepesh Khanna

HPD Articles

Neurosyphilis is an infection of the central nervous system caused by the spirochete, Treponema pallidum. New syphilis infections have been increasing around the world each year. This disease was much of a concern in the pre-penicillin era, where when left untreated many cases progressed to tertiary syphilis which can commonly manifest as neurosyphilis. Of particular interest, neurosyphilis has been linked to masquerading itself as various psychiatric conditions. This narrative review focuses on exploring psychiatric manifestations of neurosyphilis as well as the importance of screening in psychiatric settings and clinicians maintaining high clinical suspicion of the disease. A systematic search …

A Rare Case Of Recurrent Parathyroid Adenomas After Initial Parathyroidectomy, Grant N. Schalet, Luke Vincent, Carl Eguez, Gerardo Diaz, Mark S. Shachner

HPD Articles

Hyperparathyroidism usually presents asymptomatically with elevated levels of calcium and parathyroid hormone; this biochemical imbalance establishes the diagnosis. In 80-85% of cases of primary hyperparathyroidism, singular parathyroid adenomas occur. In rare cases, this problem occurs due to multiple adenomas, multiglandular hyperplasia, or parathyroid carcinoma. Recurrent primary hyperparathyroidism (R-PHPT), as demonstrated in this case, is defined as hypercalcemia that arises after six months of normocalcemia following initial surgery for PHPT. The aim of this report is to describe the diagnosis and management of three parathyroid adenomas in a patient, two of which occurred after an initial partial parathyroidectomy.

Cocaine-Induced Four-Extremity Ischemia Caused By A Hypercoagulable State, Victoria Echevarria, Alexandra C. Echevarria, Damian Casadesus

HPD Articles

The use of cocaine is associated with serious complications including coronary vasospasm and myocardial, renal, intestinal, and neurological ischemia. Among these feared complications lies limb ischemia which is a rare potential side effect of chronic cocaine use. We present the case of a 50-year-old female with an extensive history of cocaine use who developed ischemia in all four limbs. Imaging studies revealed pulmonary emboli, multisystem thromboses, and microhemorrhages in the brain. Laboratory studies were significant for leukocytosis, thrombocytopenia, schistocytes on blood smear, and normal rheumatologic and hematologic studies. The patient was diagnosed with cocaine-induced thrombotic microangiopathy and she was treated …

An Unusual Case Of Nonbacterial Thrombotic Endocarditis Attributable To Malignancy, Luis E. Santiago, Winy Kujundzic, Stephanie Wong, Samyukta Swaminath, Pallavi Aneja

HPD Articles

Nonbacterial thrombotic endocarditis (NBTE), also known as marantic endocarditis, is a condition characterized by the deposition of thrombi and fibrin on normal or degenerated cardiac valves in the absence of microorganisms. We report a case of a 60-year-old male with nonbacterial thrombotic endocarditis found on transesophageal echocardiogram (TEE) after a normal TEE just one month prior. Our patient presented with abdominal pain associated with poor appetite and unintentional 20-pound weight loss for one month. Chest computed tomography revealed the presence of a mass-like opacification in the right lung middle lobe with moderate pericardial effusions. A biopsy of the mass confirmed …

Massive Giant Coronary Artery Aneurysm, Maria Beyer, Seth Shoap, Erik Beyer

HPD Articles

The largest previously documented coronary artery aneurysm (CAA) in literature is recorded to be 5 x 7 cm. With the patient in this case's aneurysm measuring at 11.2 x 9.1 cm, it is significantly larger than what has been previously reported. Due to the lack of statistical data on CAAs, we propose a largescale study be undertaken to better understand presenting symptoms, size classification, and treatment options for CAAs. Our case seeks to showcase the presentation and treatment of an exceptionally large CAA in order to begin to address the significant deficit in knowledge on this topic.

A Case Of Grave’S Thyrotoxicosis-Induced Takotsubo Cardiomyopathy Presenting With Cardiac Arrest After Winning The Lottery, David Philippides, Angelina Hong, Amanda Eukovich, Ali Chaudhry

HPD Articles

Takotsubo syndrome (TTS) is a nonischemic cardiomyopathy with transient apical ballooning of the left ventricle and reduced ejection fraction that can be caused by severe emotional or physical stress, with diverse clinical presentations. This case describes a patient who went into cardiac arrest at a casino after winning the lottery. She was found to have Takotsubo cardiomyopathy, in the setting of uncontrolled hyperthyroidism. This is a very unique case of TTS presenting with cardiac arrest, and is also an uncommon example of TTS triggered by a positive rather than negative emotional life event.