Medicine and Health Sciences Commons^™

Comparing The Trends Of Postpartum Depression Screening Scores During And Before The Covid-19 Pandemic, Elif S. Duran, Dung Dang, Tony Ogburn

Research Colloquium

Introduction: Postpartum depression includes major and minor depressive disorder affecting women in the time period after childbirth. The studies reviewed in our literature found that the COVID-19 pandemic has increased the risk of postpartum depression for women. Our study location, the Rio Grande Valley is one of the hardest hit locations by the COVID-19 pandemic in the United States. Our patient population is also one with the higher risk factors for postpartum depression. As such, we are expecting the psychological impact of the pandemic to be even more magnified and thus, actions need to be taken to support the vulnerable …

Got Milk...Alkali Syndrome?, Naba Asif

Research Colloquium

Milk alkali syndrome is a form of hypercalcemia caused by excessive calcium intake. Symptoms include hypercalcemia, metabolic alkalosis, and acute kidney injury. Milk alkali syndrome was considered a rare cause of hypercalcemia due to the emergence of histamine blockers in the 1970s and reduced need for antacids to treat peptic ulcer disease We describe a 69 year old male who presents to the hospital with elevated calcium levels concerning for malignancy. After extensive lab work and examination, it was found that the patient was simply consuming too many calcium containing products. After adequate hydration and treatment, the patient was discharged …

Stec-Hus; Unusual Presentation In An Elderly Female, Nazish Khan, Ashika A. Chacko, Himabindu Kolli, Nevin A. Varghese

Research Colloquium

Background: Hemolytic uremic syndrome (HUS) is a multisystem disease presenting as renal impairment, microangiopathic hemolytic anemia (MAHA) and thrombocytopenia with a peak incidence of 2.1 cases per 100,000 persons/year in general population.

Case Description: 81-year-old female with history of Diabetes, presented to us with non-bloody emesis and loose stools. Labs on admission were significant for WBC 17000, Hb 12.5, PLT 241, BUN 74, Cr 8.9 and Lactate 12. She was admitted for severe metabolic acidosis and acute renal failure attributed to metformin use and undifferentiated shock.

Patient developed acute worsening of respiratory status due to increasing acidosis requiring intubation. Bicarbonate …

Anticancer Drug Screening Using Invitro Cell Proliferation Assay, Kristopher L. Ezell, Kyle Doxtater, Samantha Lopez, Sophia M. Leslie, Justin Wendel, Kamaldeep Paul, Vijay Lauxmi, Manish Tripathi

Research Colloquium

Introduction: In this presentation cell proliferation methods and how they are related to screening for effective chemotherapy drugs will be reviewed. Cancer in its most basic form is the unchecked mass dividing of cells while normal apoptosis is not undertaken for various reasons, some of which that have yet to be discovered. By these means’ tumors form that inhibit the functions of the organs it is residing in and the effected cells may metastasize and spread throughout the body. For this reason, chemotherapy drugs must be assessed through introduction into working strains of cultured cancer cells that are then screened …

Hepatoblastoma In A Patient With Goldenhar Syndrome, Naba Asif, Arturo Suplee, Samina Akhtar, Asif Zamir

Research Colloquium

Goldenhar Syndrome (GS), also known as oculo-auricular vertebral syndrome, is a congenital defect that occurs in 1 of 5,000 births characterized by the underdevelopment of the ears, soft palate, lip, and mandible due to an anomaly of the first and second branchial arches. Hepatoblastoma is the most common primary liver tumor in the pediatric population. However, it is still considered a rare malignancy because liver cancers only account for 1% of childhood cancers. Most children with hepatoblastoma are asymptomatic, however we describe a 2-year-old girl with Goldenhar Syndrome diagnosed with hepatoblastoma after experiencing abdominal pain and constipation. Findings from the …

Acute Aseptic Meningoencephalitis Due To Covid-19 In An Otherwise Healthy Patient: A Case Report, Shyama Appareddy, Norma Moncayo, Ronkino T. Mccoy, Jared Sperling, George Huddleston, Raza L. Kahn

Research Colloquium

Several studies have shown the extrapulmonary manifestations of COVID-19 disease caused by the SARS-CoV2 virus. Although extrapulmonary manifestation to the heart, kidney, blood, and skin are common, neurological and cerebrovascular manifestations are rare with most of these cases being described in patients who also have the pulmonary manifestation of the disease. Here we present the case of an 18 year-old male with no prior history of respiratory symptoms who presented to the emergency department with altered mental status. Neurology was consulted and the patient was started empirical on ceftriaxone, vancomycin, dexamethasone, and acyclovir for meningoencephalitis. Urine drug screen, head CT, …

A Case Of Chorea-Hemiballism In The Presence Of Labile Glucose Levels, Bhargavi Akkineni, Karina Torres

Research Colloquium

Introduction: Uncontrolled blood glucose is notorious for inflicting multi-organ pathologies. One such pathology, chorea-hemiballism, has been reported in individuals who exhibited either hyperglycemia or hypoglycemia, and although rare, it is debilitating and calls for active management.

Case Description: A 50-year-old female, with a past medical history of anemia, chronic kidney disease, type 2 diabetes mellitus, and hypertension, presented to the emergency room with acute onset chorea-hemiballism. Patient reported experiencing abnormal movements for two weeks prior to her ER visit, but otherwise denied prior episodes of movement disorders. On physical examination, patient displayed generalized jerky choreiform movements of upper and …

Disseminated Cryptococcosis In Solid Organ Transplant Recipient, Sonal V. Jha, Tomas V. Gonzalez, Chelsea H. Chang

Research Colloquium

Introduction: Invasive fungal diseases (IFD) have an overall incidence of 3.1% in solid organ transplant (SOT) patients.1 Although rare, they result in high mortality, likely due to a delay in treatment caused by inherent delay of fungal culture-based diagnosis.2-5 Cryptococcus are the third most common cause of fungal infection in SOT patients. 6-7

Objective: Here we present a unique case of disseminated cryptococcosis in a patient who underwent kidney transplantation with rapid symptomatic onset and presence of perinephric and perihepatic abscesses. The findings presented may inform clinicians of the potentially unusual manifestations of common fungal infections in solid organ transplant …

A Rare Case Of Takotsubo Cardiomyopathy In An Elderly Lady During Hospital Stay, Himabindu Kolli, Ashika A. Chacko, Pooja Maknoor, Nazish Khan, Timothy Heath

Research Colloquium

Introduction: Takotsubo Cardiomyopathy (TTC) is an acute, reversible form of left ventricular systolic dysfunction, most often triggered by a sudden physical, or less commonly emotional event. Here, we describe a patient who developed Takotsubo Cardiomyopathy during her hospital stay.

Case Description: 74-year-old Hispanic lady, a nursing home resident presented to the ED with altered mental status. She was admitted for septic shock due to UTI. Echocardiogram demonstrated normal systolic function, with 60-65% LV ejection fraction. After initiation of antibiotic therapy, she showed clinical improvement with resolution of shock.

On day 8 of hospitalization, patient became emotionally upset and her clinical …

Sickle Cell Anemia In Hispanic-Americans In South Texas: Two Case Reports, Ashika A. Chacko, Shadi Jafari-Esfahani, Nevin A. Varghese

Research Colloquium

Introduction: Sickle cell anemia and traits are well described in the African-American population. Hispanic Americans are an underappreciated community affected by Sickle cell disease, where it affects about every 1 in 16300 live births compared to 1 in every 365 African-American births.Hence, it is essential to acknowledge the incidence in Latin American origin people to provide competent and specific care to these populations.

Case Description: Case 1: A 28-year-old Latin-American lady with sickle cell anemia, multiple transfusions, and exchange transfusion in the past presented with complaints of lower back and lower extremity pain. The patient got admitted with acute sickle …

Antibiotic Stewardship In Skin And Soft Tissue Infections, Shah Z. Ali, Stephen Gore, Jose E. Campo Maldonado

Research Colloquium

Introduction: Skin and soft tissue infections (SSTIs) are characterized by microbial invasion of the skin layers and are common in various healthcare settings. A study conducted between 2005-2010 in the United States, found a combined total of 2.3 million cases of SSTIs in ambulatory and inpatient settings. This was higher than the rates of pneumonia and urinary tract infections during the same time period. Another study found that between 2000 and 2012, there was a 40% increase (2.4 million to 3.3 million) in cases of SSTIs. Our aim is to study the primary uses of vancomycin and piperacillin/tazobactam and their …

Impact Of Multimedia Interventions For Musculoskeletal Health Amidst Covid-19 Pandemic, Kevin J. Orellana, Tarek Yamout, Guillermo Ramirez, Paul Treviño, Erick M. Santos, Letitia Bradford

Research Colloquium

Lower extremity joint pain is a leading cause of disability and immobility in the United States. Movement is Life seeks to educate and empower patients to break the cycle that immobility starts in efforts to improve musculoskeletal and overall emotional and physical wellbeing. Studies in the past have described the correlation that exists between using Movement is Life education materials as well as a home exercise program to improve lower extremity pain and overall health short term but did not account for confounding factors during the COVID-19 pandemic. The effect of the COVID-19 pandemic on health goes beyond patients that …

Femoral Neck Fracture Management In The Young Patient: A Case Review, Luis Berrios, Kevin J. Orellana, Michael Lago, Frank Gerold

Research Colloquium

Introduction:The optimal management of femoral neck fractures in the young patient remains controversial. Although there are universally accepted principles, there remains some variability in the optimal timing of surgery and method of fixation. In general, surgery should be performed on an urgent or emergent basis when feasible to decrease peri-operative complications, length of stay, and most importantly the ultimate likelihood of avascular necrosis. However, it is important to note that the preference toward a specific method of fixation remains heterogeneous among orthopedic surgeons.(1)

The purpose of this study is to present our preferred technique for treatment of displaced femoral …

A Puzzling Case Of Glutamic Acid Decarboxylase 65 (Gad65) Neurologic Syndrome, Areeb Masood, Nina Appareddy, Raul Tovar Castro, Zan Shareef, Laura Garcia

Research Colloquium

Autoimmune encephalitis (AE) is a rare group of neurological disorders in which antibodies are directed against intracellular or surface antigens. The incidence of AE ranged from between 0.4-1.2 per 100,000 person-years between 1995 and 2015. A subset of these autoimmune encephalitides that target glutamic acid decarboxylase (GAD) are termed anti-GAD related neurological disorders. GAD is the rate-limiting enzyme involved in the synthesis of GABA from glutamate, and is expressed in neurons of the cerebral cortex, cerebellum, and hippocampus. In addition, it is found in the B-islets of the pancreas, epithelial cells of the fallopian tube, and spermatocytes of the testes. …

Rare Case Of Prosthetic Joint Infection Caused By Salmonella Enterica - A Case Report, Carlos Ramos, Shyama Appareddy, Peter J. Gonzalez

Research Colloquium

Introduction: Collectively, over 1 million total knee arthroplasties (TKA) and total hip arthroplasties (THA) are performed in the United States each year. In 2010 it was estimated that 1.58% of the United States general population has received a TKA. Prosthetic joint infections (PJI) are the most common indication for a TKA revision1 . In total, S. aureus is responsible for about 50% of all prosthetic joint infections, and about 15% are caused by gram negative pathogens2 .

Objective: This is a case report which describes the presentation and clinical course of a 59-yearold female with Salmonella enterica septic arthritis of …

Factor V Leiden And Its Association With Vascular Disease And Treatment In A Latino Patient, Adriana Saavedra-Simmons, Daniel Aragon, Irma Huayanay, Brandon Cantazaro

Research Colloquium

Introduction: Factor V Leiden (FVL) is the most common hereditary thrombophilia, and a single amino acid mutation renders Factor V resistant to inactivation by Activated Protein C resulting in a prothrombotic state. The association between FVL and vascular disease has been reported and debated. We present a case of a patient with FVL and its repercussion on medical treatment.

Case Description: A 64-year old Hispanic man with a past medical history of coronary artery bypass grafting, Type 2 diabetes mellitus, hypertension and severe peripheral vascular disease with history of left above the knee amputation presented to the emergency department with …

Renal Artery Stenosis As A Cause Of Acute Kidney Injury In A Post-Kidney Transplant Patient, Nghia Nguyen, Mourad M. Alsabbagh, Brandon Cantazaro

Research Colloquium

Introduction: The most common complication of kidney transplantation is allograft dysfunction, which can present as acute kidney injury (AKI). Here, we report a case of transplant renal artery stenosis (TRAS) presenting with acute elevation in creatinine in concomitant with resistant hypertension.

Case Presentation: A 69-year-old African American male with history of end stage renal disease status post living unrelated kidney transplant presented for evaluation of worsening kidney function. Past medical history included hypertension, diabetes mellitus type 2, coronary artery disease. Physical exam was significant for blood pressure 164/85, bilateral crackles, lower extremities edema. Blood work showed creatinine 3..8 mg/dL (up …

Case Report: Recurrent Bell’S Palsy And Genetics, Dakota Bigham, Adam Kvinta, Heriberto Cantu

Research Colloquium

Background: Bell’s palsy, also known as Idiopathic Facial Paralysis (IFP), is a generally common condition, occurring up to 20-30 cases per 100,000 individuals in the general population. Its occurrence can be influenced by a variety of factors such as exposure, immunocompromised states and genetic susceptibility. While uncommon, Bell’s Palsy can recur spontaneously in up to 15% of patients. Here, we present a case of chronically recurrent Bell’s palsy in an individual, and explore the possibility of a genetic component.

Case Presentations: Our case involves a 39 year old woman with no significant past medical history who presented with a one …

Case Report: Levamisole-Induced Vasculitis After Cocaine Ingestion, Dakota Bigham, Adam Kvinta

Research Colloquium

Background: Levamisole, a common anthelmintic, is estimated to be present in up to 70% of the cocaine found in the United States. The exact mechanism of interaction between Levimasole and cocaine use is unknown. One such complication of ingestion of Levimasole contaminated cocaine is Levimasole Vasculitis. Here we report a case of the clinical presentation of Levimasole Vasculitis, and the emphasis on proper and thorough history taking when arriving at a diagnosis.

Case Presentation: Our case begins with a 71-year-old male with a history of COPD, hyperthyroidism, and polysubstance abuse who presented to the hospital with weakness, neck stiffness, chest …

Prevalence Of Liver Cirrhosis And Its Association With Obesity Among Mexican Americans: An Evidence Synthesis, Alexa Perlick, Abaigeal Thompson, Colton Wayne, Angel Rendon, Jose E. Campo Maldonado

Research Colloquium

Introduction: Chronic liver disease is the 6^th and 7^th leading cause of death in Hispanic men and Hispanics, respectively.¹ In contrast to other causes of liver disease, the prevalence of nonalcoholic liver disease has been growing as is diabetes and obesity.²

Objective: There is a paucity of data regarding the prevalence of cirrhosis for Mexican Americans in South Texas. The aim of this evidence synthesis is to investigate the prevalence of cirrhosis in Hispanic populations and its relationship with obesity.

Methods: PubMed was used to perform a thorough literature search on September10, 2020. The terms “liver …

Development And Validation Of A Predictive Model For Childhood Mortality After A Traumatic Brain Injury: Analysis Of The National Trauma Data Bank, Jooby Joy, Axel Moreira, Kevin Chorath, Karthik Rajasekaran, Alvaro Moreira

Research Colloquium

Introduction: Traumatic brain injury (TBI) is a significant cause of morbidity and mortality in children. While most TBI-related admissions are mild, identifying early predictors of poor outcome may assist clinicians with timely medical decisions and effective triage utilization.

Objective: We sought to develop and validate a clinical tool for predicting in-hospital death in children after a traumatic brain injury.

Methods: Data was collected for children (≤18 years) from the National Trauma Data Bank between the years of 2007 to 2015. We included children who sustained any TBI, defined as: (i) open and closed skull fractures, (ii) cerebellar, cortical, or brain …

A Natural Near-Infrared Fluorescent Probe For Cancer Cell Imaging, Benilde E. Adriano, Nycol M. Cotto, Neeraj Chauhan, Meena Jaggi, Subhash C. Chauhan, Murali M. Yallapu

Research Colloquium

Introduction: Near-Infrared (NIR) fluorescence-based imaging is a noteworthy and safer strategy for cancer cells/tissues imaging compared to radiological imaging. NIR fluorescence offers deep tissue penetration and have minimal obstruction by autofluorescence and photon scattering [1]. There are several NIR dyes including indocyanine green (ICG) [2] and IR-1061 [3] that allow high-resolution tissue imaging. However, these dyes possess some low-quality characteristics which limit their use, namely photo instability, toxicity, poor water solubility, and short half-lives [4]. Therefore, more efficient and effective alternatives are urgently required to provide the desired clinical outcomes. Chlorophyll (Chl) is a natural dietary NIR fluorescence emitting …

Aids-Associated Kaposi's Sarcoma Complicated With Covid-19, Adriana Saavedra-Simmons, Veronica Salazar

Research Colloquium

Introduction: Several studies have not found a significant increase in risk of poor outcomes in people with HIV (PWH) who are coinfected with COVID-19. However, the majority of PWH in the studies were stable with their highly active antiretroviral therapy (HAART) regimen. We present a case of AIDS-associated Kaposi’s sarcoma (KS) with superimposed COVID-19 infection.

Case Description: Our patient is a 21-year old Hispanic male with recent diagnosis of HIV-1 who presented to the ED with generalized facial swelling and right lower extremity edema associated with shortness of breath (SOB) and palpitations. He denied fever, chills, weight loss, chest pain, …

Development Of Targeted Drug Delivery System To Improve Immunotherapy In Pancreatic Cancer, Poornima Devi Shaji, Ana Martinez Bulnes, Nirnoy Dan, Subhash C. Chauhan, Sheema Khan, Murali M. Yallapu

Research Colloquium

Introduction: About 95% of tumor arises from epithelial cell lining ducts known to be pancreatic ductal adenocarcinomas, with less than 5-7% survival rate. Unfortunately, little progress has been seen in the outcomes of patients with PDAC as tumor develops high desmoplasia and chemo-resistance to chemotherapeutic drugs, such as gemcitabine (Gem). Immunotherapy has shown promising results in other cancers but limited response in pancreatic cancer due to desmoplasia and fibrotic tumor microenvironment. A recently identified mucin, MUC13 is aberrantly expressed in pancreatic tumors but not in normal pancreas. Due to its high membrane expression, MUC13 may serve as an excellent target …

Novel Therapy Targeting Mutant-Krasg12d And Galectin-1 In Pancreatic Cancer, Ana I. Martinez Bulnes, Nirnoy Dan, Poornima Devi Shaji, Swathi Holla, Murali M. Yallapu, Sheema Khan

Research Colloquium

Introduction: Although, surgical resection and chemotherapy are the gold standard for treating Pancreatic Ductal Adenocarcinoma (PDAC), low patient survival rate remains the problem. The activating point mutation of the KRAS on codon-12 is present in 70–95% of PDAC cases and so far, no success has been achieved to inhibit KRAS. KRASG12D regulates cell proliferation, differentiation, apoptosis. Recent preliminary and published studies show high Galectin-1 (Gal-1) levels in both pancreatic cancer and stromal cells, which modulate tumor microenvironment and metastasis. Additionally, genetic deletion of gal1 inhibits metastasis and improves survival in KRAS mouse model of PDAC (1). Therefore, our objective is …

Hepatoprotective Role Of Cucurbitacin D On Benzo[A]Pyrene Induced Liver Injury, A. Rodriguez, Mohammed Sikander, Shabnam Malik, M. Vela, Fathi T. Halaweish, Meena Jaggi, Sumeet S. Chauhan

Research Colloquium

Background: Epidemiological findings show the strong correlation of co-morbidity factors including smoking with the development and progression of liver cancer. Moreover, benzo[a]pyrene, a main component of tobacco smoke, is extremely carcinogenic and contributes to liver injury as well. Cucurbitacin, chemically classified as triterpenes, have shown diverse biological activities including potent antioxidant, anti-inflammatory and anti-cancer activities. However, their hepatoprotective activities are not completely understood.

Objective: In the present study, we investigated the cytoprotective activity of novel analog of cucurbitacin, cucurbitacin D, against benzo[a]pyrene-induced liver injury in human HepG2 cells.

Method: Proliferation, clonogenicity, migration, invasion, Western blotting and qPCR analysis were conducted …

Pharmacological Restoration Of Pkd1: A Novel Strategy For Prostate Cancer Therapy, Mohammed Sikander, Shabnam Malik, A. Rodriguez, Aditya Ganju, Bilal B. Hafeez, Fathi T. Halaweish, Subhash C. Chauhan, Meena Jaggi

Research Colloquium

Background: Prostate cancer has poor prognosis owing to late diagnosis and ineffective multimodal clinical treatment. Extensive efforts are ongoing to establish methods that can resolve the expression of genes implicated in disease development and treatment. Previously, we reported that Protein Kinase D1 (PKD1), a serine threonine kinase, controls a number of tumor suppressor functions including cell aggregation, cell motility, cell proliferation, and cell invasion. Thus, PKD1 is considered as an emerging therapeutic target for prostate cancer treatment.

Objective: To investigate the restoration of PKD1 by a pharmacological modulator ormeloxifene, which showed well-defined PK/PD and safety profiles in humans.

Methods: Proliferation, …

Mucin 13 Expression Correlates With Tumor Development In Hepatocellular Carcinoma, Shabnam Malik, Mohammed Sikander, Deepshikha Pande Katare, S. Mishra, S. K. Jain, P. Khan, Subhash C. Chauhan, Meena Jaggi

Research Colloquium

Background: Hepatocellular carcinoma (HCC) has a poor prognosis due to ineffective therapeutic modality and lack of early diagnostic marker. Accumulating studies have shown that elevated expression of mucin 13 as potential oncogene and predictive biomarker for various cancer. However, very little is known about its expression and function for development and progression of HCC Objective: To investigate mucin 13 expression in chemically induced hepatocellular carcinoma model.

Methodology: Diethyl nitrosamine (DEN) and 2-Acetylaminofluorene (2-AAF) induced method was employed for the development of hepatocellular carcinoma in Male Wistar rats. Serum and tissues were collected at regular interval of time and routinely validated …

Severe Hypokalemia Secondary To Distal Renal Tubular Acidosis In A Hispanic Man, Aramide Mikhail Tijani, Himabindu Kolli, Suneet Johal, Maria Najam, Fatimah Bello, J. M. Paredes

Research Colloquium

Introduction: Renal tubular acidosis is a rare renal disorder that can cause severe electrolyte imbalances which can be life threatening.

Case: A 21-year-old man presented to the ED on account of generalized weakness and body aches of one day duration. He reported no past medical history other than a previous episode of similar symptoms with improvement after IV hydration and electrolytes replacements about 2 months prior. He was not taking any medications and denied vomiting, diarrhea nor any significant family history. He admitted to alcohol and marijuana use.

Physical examination was significant for reduced muscle power, tone, and reflexes in …

Assessing The Mental Health Of Older Hispanic/Latinx Adults: Focus On The Impact Of The Hispanic Cultural Value Of Fatalismo On Depressive Symptomatology, Anna J. Prado, Amie Bostic, Mario Gil

Research Colloquium

Introduction: The impact of depression in older Hispanic/Latinx adults in the United States is poorly understood. The influence of the deeply embedded Hispanic/Latinx cultural value of fatalismo, referring to the belief that one’s future is predetermined and related to feelings of helplessness, has been found to negatively impact their psychological health [1, 2]. The present study explores the association between the Hispanic/Latinx cultural value of fatalismo and mental health.

Objective: To contribute to the identification and understanding of psycho-social-cultural determinants of depression in the Hispanic/Latinx population.

Methods: Using data from the Health and Retirement Study (HRS) …