Medicine and Health Sciences Commons^™

The Hidden Dangers Of Cocaine: A Rare Case Of Necrotic Penile Ulcer, Roy Kondapavuluru, Khairiya Haj-Yahya, Elimar Gonzalez, Victor Tran, Roque Mifuji, Luis Rosas

Research Colloquium

Introduction: Cocaine is a strong central nervous system stimulant that is highly addictive with a wide potential for abuse as a recreational drug. The use of cocaine in an estimated 3 million Texans and 560 million Americans, has led to a growing health care hazard with many detrimental effects. Physiologically, cocaine causes significant vasoconstriction often leading to venous occlusion with subsequent ulceration and necrosis of mucosal membranes. Although cocaine is typically abused by inhalation or intravenous routes, few cases of injection into the genital region have been reported as means of abuse, leading to priapism, vasculitis, and in some cases …

Elevated Troponin Levels And Seizures Associated With Synthetic Cannabinoid Use: A Case Report, William Reckley, Kennedy Olson, Roy Kondapavuluru, Elimar Gonzalez, Victor Tran, Anthony Alanis, Andres Suarez Parraga

Research Colloquium

Introduction: Marijuana is the most commonly used illicit drug in the U.S. and the third leading cause of drug-related emergency room visits. It is known to have potential long-term negative effects on health, particularly impacting the neurological and cardiovascular systems. The most common associated issues include strokes and myocardial infarctions; however, there have been very few documented cases of seizures and coronary vasospasms following synthetic cannabinoid use in adolescents and young adults. In this case, we describe a young woman who came to the emergency room with altered mental status and seizures, along with elevated troponin levels and subtle EKG …

Pulmonary Fibrosis As A Presentation Of Short Telomere Syndrome: Case Report, Roy Kondapavuluru, Jian Garcia Cruz, Sreejith Pillai, Andres Suarez Parraga

Research Colloquium

Introduction: Short telomere syndrome (STS), also known as accelerated aging syndrome, is an inheritable gene mutation resulting in decreased telomere length causing high cell turnover of organ systems such as skin, bone marrow, liver, hair, lungs, and immune system. Due to diverse clinical manifestations, STS poses a diagnostic challenge, with bone marrow failure and idiopathic pulmonary fibrosis being frequent manifestations. The inherited form of STS demonstrates genetic anticipation occurring at an earlier age with more severe manifestations in the affected progeny. We present a rare case of inherited STS in a young patient with severe pulmonary fibrosis.

Case Presentation: A …

Tc-Ptp Overexpression In Mouse Skin Is Linked To Enhanced Epidermal Differentiation In Response To Tumor Promoter Tpa Exposure, Jared Hensley, Smaran Marupudi, Lindsey Shim, Bilal Hafeez, Dae Joon Kim

Research Colloquium

Background: Maintaining a balance between keratinocyte proliferation and differentiation is essential for epidermal homeostasis. Disruption of this balance can lead to hyperplasia and cancer. Epidermal homeostasis is regulated by various signaling pathways, including those mediated by reciprocal regulation between protein tyrosine kinases and protein tyrosine phosphatases. T-cell protein tyrosine phosphatase (TC-PTP), encoded by the PTPN2 gene, is one such phosphatase known to inhibit epidermal cell proliferation through the direct dephosphorylation of STAT3, a key transcription factor involved in cell survival and proliferation following exposure to chemical toxicants. Our previous studies have demonstrated the crucial role of TC-PTP in the prevention …

Vegf In Diabetic Retinopathy And Age-Related Macular Degeneration, Justin Z. Heckman, Andrew Tsin, Sophia Villa

Research Colloquium

Vascular Endothelial Growth Factor is a growth factor that plays a significant role in angiogenesis and vascular permeability. This paper dives into the development of diabetic retinopathy and age-related macular disease and focuses on the molecular pathway that VEGF goes through as the diseases progress. Diabetic retinopathy can progress from non-proliferative diabetic retinopathy into the more aggressive proliferative diabetic retinopathy through a series of molecular changes. In non-proliferative diabetic retinopathy hyperglycemia damages microvasculature and can lead leads to retinal vascular permeability, pericyte loss, microaneurysms, and acellular capillary formation. As the disease progresses, hypoxia leads to the production of VEGF which …

Medicinally Privileged Natural Chalcones: Abundance, Mechanisms Of Action, And Clinical Trials, Sophia M. Villa, Justin Z. Heckman, Debasish Bandyopadhyay

Research Colloquium

Chalcones have been utilized for centuries as foods and medicines across various cultures and traditions worldwide. This paper concisely overviews their biosynthesis as specialized metabolites in plants and their significance, potential, efficacy, and possibility as future medicines. This is followed by a more in-depth exploration of naturally occurring chalcones and their corresponding mechanisms of action in human bodies. Based on their mechanisms of action, chalcones exhibit many pharmacological properties, including antioxidant, anti-inflammatory, anticancer, antimalarial, antiviral, and antibacterial properties. Novel naturally occurring chalcones are also recognized as potential antidiabetic drugs, and their effect on the GLUT-4 transporter is investigated. In addition, …

Literature Review: Exploring The Efficacy Of Minimally Invasive Surgery (Mis) Techniques In Spinal Fusion For Degenerative Spondylolisthesis, Yolanda V. Gutierrez, Blake Martin, Joshua Nwose, Robert H. Ablove

Research Colloquium

Introduction: Spine diseases and degeneration of the spine are common causes of back pain. One common cause of back pain is spondylolisthesis which is the slipping of a vertebral body disc. A subtype of spondylolisthesis is degenerative spondylolisthesis which commonly occurs due to wasting of the intervertebral disc leading to an unstable spine. In patients with a lack of neurological issues, conservative treatment is recommended. If conservative treatment is ineffective, surgery is deemed the next step, involving decompression of and fusion of the vertebrae. Minimally invasive surgery (MIS) techniques have emerged in the last decade. This systematic literature review aims …

The Impact Of Diabetes Mellitus On The Severity Of Alzheimer’S Disease In Hispanics In The Rio Grande Valley, Maria Camila Gonzalez Tovar, Kelsey Baker

Research Colloquium

Alzheimer’s disease is becoming more prevalent worldwide, leading to a growing demand to understand its risk factors and their impact on disease progression. Notably, Diabetes Mellitus has emerged as a significant risk factor to the development of Alzheimer’s disease, given its association with cognitive impairment. Due to its pathophysiology, Diabetes Mellitus could potentially contribute to the progression of Alzheimer’s disease. This study involved a detailed chart review of Hispanic patients diagnosed with Alzheimer’s disease within the past five years, some of whom also had a preexisting diagnosis of Diabetes Mellitus. This study formed two cohorts: Alzheimer patients without Diabetes Mellitus …

Deciphering Tumorigenesis: Pathophysiological Roles Of Reactive Oxygen Species In Glioblastoma, Maria Camila Gonzalez Tovar, Alex Zuo

Research Colloquium

Background. Reactive oxygen species (ROS) play a significant role in activating multiple signaling pathways for cellular proliferation but can be influential in tumorigenesis. We explore how ROS can be used to aid the advances of therapeutic interventions for glioblastoma, a highly aggressive and reoccurring brain cancer.

Methods. Over 30 of the most recent and relevant studies were extensively reviewed to determine the significance and implications of ROS in the pathophysiology of glioblastoma.

Results. ROS are essential for cell signaling. At low levels, ROS have been seen to promote tumorigenesis by inducing cell proliferation, which indirectly causes the tumor microenvironment to …

Utrgv Som Stroke Prevention Education Program, Briana Gonzalez Digrazia, Mia Rose Schmolze, Chantal Uzoma, Paul Digrazia, Maria Camila Gonzalez Tovar

Research Colloquium

Purpose: The UTRGV SOM Stroke Prevention Education Program is a patient education initiative for uninsured patients in Hidalgo County, where the prevalence of the five major risk factors for strokes, like diabetes and hypertension, are especially high. Texas Medical Association student members collaborated with the UTRGV SOM Area Health Education (AHEC) Scholars program, which aims to help reduce the significant shortage of primary health care providers in rural and medically underserved communities in the Rio Grande Valley.

TMA and AHEC students from multiple disciplines like medicine, dietetics, nutrition, and exercise studies offered specific techniques (i.e. home workout programs and culturally …

Use Of Digital Cadaveric Digital Atlases To Improve Student Performance In Neuroanatomy, Kevin A. Garcia Valdez, Anesu Karen Murambadoro, Kory Deshawn Punch, Megan W. Szobody, Tori Sayers, Nina Mourao, Blake Martin, Tyler Torres, Juan Torres, Natasha N. Quailes, Neharika Penmetcha, Sriya Gullapalli, Lois F. Baldado, Isabella Rodriguez, Arjun Bellamkonda, Sridhar Srinivasan, Xiaoqian Fang, Bharathi Shrikanth Gadad, Ricardo Belmares

Research Colloquium

Background: The use of digital platforms to teach various subjects in the pre-clerkship curriculum is a fast-developing field, but their utility compared to traditional in-person didactics is unclear. Partly fueled by the recent demand for remote learning materials and ever-burgeoning access to artificial intelligence, the drive has been to develop materials to meet the demands of the digital age. Our goal is to evaluate the efficacy of the use of a digital atlas to improve learning outcomes in the field of neuroanatomy, namely developing skills in interpreting imaging studies featured on summative examinations. Literature has shown that the implementation of …

Pre-Hospital Stroke Time Intervals In The Rio Grande Valley, Kelsey Baker, Elio E. Garcia Sosa

Research Colloquium

Background and Introduction: Stroke continues to be a significant cause of mortality in the United States. Despite advancements in acute stroke treatments such as thrombolytic therapy and endovascular procedures, many patients remain unable to benefit from these interventions due to delays in receiving treatment. Healthcare professionals have made substantial efforts to improve 'door to needle' times, the interval between a patient's arrival at the hospital and the administration of thrombolytic therapy, yielding promising outcomes. However, a critical gap persists: the time interval from the onset of stroke symptoms to when patients actually present at a healthcare facility. This study aims …

Late Tamponade After Coronary Artery Bypass Grafting, Jian Garcia Cruz, Roy Kondapavuluru, Diana Othon Martinez, Julio Perez Rodriguez

Research Colloquium

Introduction: Pericardial effusion (PE) incidence can go up to 85% after cardiac procedures, however, not every pericardial effusion causes hemodynamic instability. Progression to Pericardial Tamponade (PT) occurs in 0.1 to 8.8% and may be either early (within 24 h post-cardiac surgery) or late (presenting within a week post-procedure). Both presentations may be attributed to anticoagulant use, inadequate mediastinal drainage, coagulopathy, post-pericardiotomy syndrome (recurrent pericardial effusion).

Patient presentation time might be misleading, as pericardial effusion’s clinical symptoms are varied, ranging from asymptomatic, to shortness of breath, chest pain or discomfort, hypotension, tachycardia, or other non-specific symptoms like cough, fever, and malaise. …

Multiple Intracardiac Thrombi In A Patient With Ischemic Cardiomyopathy, Jian Garcia Cruz, Julio Perez Rodriguez

Research Colloquium

Introduction: Ischemic cardiomyopathy is defined by the American Heart Association (AHA) as cardiomyopathy caused by ischemic heart disease. The most common complication of ischemic cardiomyopathy is systolic congestive heart failure. Heart failure patients are in a hypercoagulable state that predisposes them to develop intracardiac thrombus. The incidence of LV thrombus in patients with dilated cardiomyopathy and sinus rhythm is 13% with the clot in the left atrial appendage in 68% of these cases. The thrombus formation results from impaired blood flow within the 4 chambers of the heart and can present as a life-threatening complication of end stage heart failure. …

Cardiac Tamponade Secondary To Purulent Pericarditis With Mrsa, Jian Garcia Cruz, Julio Perez Rodriguez

Research Colloquium

Introduction: Methicillin resistant Staphylococcus aureus (MRSA) is a nosocomial pathogen that causes severe morbidity and mortality worldwide. MRSA pericarditis is a rare life-threatening condition that can cause purulent pericarditis with only 7 cases having been reported so far. Several reasons why a patient may develop MRSA pericarditis are healthcare-associated infection, weakened immune system, invasive procedures and spread from other infections. Although not typically associated with tamponade, if MRSA were to cause an infection in the pericardial space, it could potentially lead to inflammation and fluid accumulation, resulting in tamponade. We present a case of a woman that developed tamponade secondary …

Understanding Hip Pain Through Social Media: An Initial Overview Of An International Web-Based Survey, John M. Gaddis, Ryan Bialaszewski, Bretton Laboret, Erika Shults, Joel Wells

Research Colloquium

Aims: In the adult population hip pain is often triggered by mechanical anatomic differences including hip dysplasia, femoroacetabular impingement (FAI), Perthes disease and osteoarthritis. We aimed to understand the adult experience of hip pain and develop a comprehensive hip-pain survey using a web-based REDCap platform via social media. This paper outlines our survey and analyzes the demographic composition and characteristics of our sample population.

Methods: The survey link was active from October 1, 2023, to May 1, 2024, on social media platforms. Respondents consented to the study before beginning. Responses were anonymous and only unique surveys were analyzed. The comprehensive …

Unveiling The Impact Of Phosphate On Skeletal Muscle Dysfunction In Chronic Kidney Disease, Hiram Garcia, Sowmya Duddu, Erik Hinojosa, Model Zerfu, Nathaniel L. Alvarez, Mohammad Razzaque, Alex Zuo

Research Colloquium

Background: Chronic Kidney Disease (CKD) is characterized by progressive decline in renal function that ultimately culminates in the inability of the kidneys to effectively maintain homeostasis. The kidneys are a key regulator of phosphate, with other organs assisting in regulation including the skeletal system. In CKD, reduced kidney function leads to hyperphosphatemia. While its impact on the skeletal system is moderately studied, its effects on skeletal muscle are less reviewed. In our literature review, we aim to describe the effects of phosphate in the context of patients who have CKD while providing clinical context for this deserving population. We describe …

The Burden Of Diabetes Mellitus In The Medically Underserved Rio Grande Valley, John M. Gaddis, Elias Arellano, Kassandra Pulido, Tyler Torres, Dominic Chau-Zanetti, Natasha Quailes, Andres Suarez Parraga

Research Colloquium

Introduction

Diabetes mellitus (DM) encompasses metabolic disorders characterized by elevated blood sugar. This study aimed to evaluate the prevalence and associated metrics of DM in the Rio Grande Valley (RGV), a low-income and medically underserved region in the United States, and compare these metrics to the national averages from 2012 to 2022.

Methods

A retrospective cross-sectional analysis was conducted using publicly accessible data from the Centers for Medicare and Medicaid Services (CMS). Metrics analyzed included DM prevalence, average principal cost, rates of emergency department visits, hospitalizations, screenings, and prevalence of obesity. Data from the RGV counties were compared to national …

Periacetabular Osteotomy: An Analysis Of Social Media To Determine The Most Common Questions Asked By The Periacetabular Osteotomy Population, John M. Gaddis, Ryan Bialaszewski, Bretton Laboret, Joel Wells, Adina Stewart

Research Colloquium

Background: Social media has become an increasingly popular resource for patients and a platform to share one’s experiences. Patients undergoing periacetabular osteotomy (PAO) may gravitate towards social media for support, guidance and understanding. The aim of this study was to investigate Facebook, Instagram and Twitter to further understand what the most common preoperative and postoperative questions patients undergoing PAO are asking.

Methods: Facebook, Instagram and Twitter were queried consecutively from February 1, 2023 to November 23, 2011. Facebook was searched for the two most populated interest groups; “Periacetabular Osteotomy (PAO)” and “Periacetabular Osteotomy Australia”. Instagram and Twitter were queried for …

Sex-Dependent Gene Expression Alterations In Social Defeat Stress Model Of Major Depression Disorder, Juan Diego Torres, Javier Vargas Medrano, Anapaula Themann, Elias Arellano Villanueva, Nina Mourao, Megan W. Szobody, Tori Sayers, Sriya Gullapalli, Tyler Torres, Sridhar Srinivasan, Anesu Karen Murambadoro, Kory Deshawn Punch, Kevin Valdez Garcia, Nikhilesh Anand, Kelsey Baker, Sergio Iniguez, Bharathi Shrikanth Gadad

Research Colloquium

Introduction: Major Depression Disorder (MDD) is a prevalent, recurrent, and chronic disorder that represents a leading cause of disability worldwide. Millions are affected with symptoms that go from constant sadness to even suicidal thoughts. In the U.S., major depression and fatal suicide have increased by 57.4% among adolescents and young adults. Myelin and inflammation-related genes have been found to play a role in individuals with MDD.

Methods: Adolescent males and females C57BL/6 mice underwent a vicarious defeat stress (VDS) procedure in which a mouse witnessed a conspecific being defeated. VDS and control (CON) mice underwent the Social Interaction (SI) test. …

Prevalence And Economic Impact Of Osteoarthritis And Rheumatoid Arthritis In The Medically Underserved Rio Grande Valley, John M. Gaddis, Elias Arellano, Ryan Bialaszewski, Dominic Chau-Zanetti, Tyler Torres, Joel Wells

Research Colloquium

Introduction: Osteoarthritis and rheumatoid arthritis (OA/RA), two of the most common forms of arthritis worldwide, are chronic diseases affecting joints. The Rio Grande Valley (RGV) is characterized by an abundance of health disparities with previous studies showing increased rates of multiple diseases and disorders in this region. The purpose of this study was to determine both the prevalence and the risk-adjusted average total cost of OA/RA in the RGV and compare with the national average.

Methods: This retrospective, observational study utilized publicly accessible Medicare beneficiary data from 2012 to 2022. Data on OA/RA prevalence, risk-adjusted average total cost, and stratified …

Phytocannabinoids In Combination: Chronic Pain, Emmanuel Franco, Jose Rios, Laura Valdez, Andrew Tsin, Khalid Benamar

Research Colloquium

Background: Chronic pain, one of the most common reasons adults seek medical care, has been linked to restrictions in mobility and daily activities, dependence on opioids, anxiety, depression, sleep deprivation, and an overall reduced quality of life. Unfortunately, the current treatment options for chronic pain are limited, often ineffective, and have associated side effects. Better outcomes can be achieved by developing new and improved therapeutics or more immediately by identifying favorable drugs that are already available or emerging as potential new analgesics. There is a growing interest in the use of opioid-sparing analgesics, in particular medicinal cannabis, for pain management. …

Environmental Impact Of Water And Air Contaminants On Public Health, Astrid-Ines Foamkom, Luis A. Peña Marquez, Maria Sophia Malbas, Esmeralda Rodriguez, Noe Garza, Ney Alliey-Rodriguez

Research Colloquium

Background: Established literature suggests a strong relationship between exposure to air contaminants and physical health. Similarly, numerous studies have demonstrated the effects of water pollution on public health. Texas denizens are often victims of poor air and water quality, yet there are scant studies that have integrated evidence of health tolls caused by air and water pollution across the state. In this study, we assessed the relationship between particulate matter

Methods: The study used data from the 2018 Medicare and Medicaid report which displayed chronic health conditions across all counties in Texas. Additionally, the study also includes collected data on …

Unveiling The Neurological Aftermath: Pres After Cardiac Arrest, Oyinlola O. Fasehun, Jessica Daza, Sriharsha Koneru, Victor Tran, Eunbee Cho, Fatimah Bello

Research Colloquium

Background: Posterior Reversible Encephalopathy Syndrome (PRES), also known as ‘Reversible Posterior Leukoencephalopathy Syndrome (RPLS)’, is a clinical radiographic syndrome originally described by Hinchey et al in 1996. PRES has been significantly underdiagnosed due to difficulty in confirmation. As such, there is currently no epidemiological data regarding its incidence, but it has been diagnosed in all age groups with a preponderance in females. A variety of medical conditions have been implicated as causes of PRES, including severe hypertension, immunosuppressive therapy, sepsis, renal diseases and autoimmune disorders. The mechanism of PRES is thought to be related to disordered cerebral autoregulation and endothelial …

Cognitive Impairment And Hearing Loss In The Rio Grande Valley: A Retrospective Study Of Alzheimer's, Dementia, And Mild Cognitive Impairment, Victoria Elizondo, Antoinette Burrell, Chantal Uzoma, Desiree Brewer, Naya Williams, Erica Burrell-Walker, Kelsey Baker

Research Colloquium

Background: Millions of US adults experience underrecognized hearing loss, despite effective treatments. Interestingly, hearing loss has been suggested to be further exacerbated in populations of Alzheimer’s Disease. It is hypothesized that structural and functional features of auditory brain organization, which make it vulnerable to neurodegeneration, may heighten susceptibility to hearing loss, although it is unclear how ethnicity impacts its epidemiology. Here, we sought to address this gap by exploring the association between self-reported hearing loss and cognitive decline in Hispanic and non-Hispanic patients across the Rio Grande Valley (RGV).

Methods: We conducted a retrospective review of the UTHealth RGV electronic …

Pseudogout: A Rare Cause Of Pseudoseptic Arthritis - A Case Report, Yareli Durazo, Corey Haines, Elimar Gonzalez, Brandon Cantazaro, Michael Sander

Research Colloquium

Introduction: Pseudoseptic arthritis is the umbrella term designated to various mimics when they present with clinical stigmata indicative of septic arthritis. The underlying causes of these mimics can vary, depending on whether they are associated with autoimmune inflammatory arthritis or crystalline-associated inflammatory arthritis such as gout and calcium pyrophosphate deposition disease (CPPD). In clinical practice, pseudoseptic arthritis can be difficult to differentiate from infectious arthritis, leading to frequent misdiagnosis. However, key differences will exist in the joint aspirate. With septic arthritis, the synovial fluid cultures are positive. However, with pseudoseptic arthritis, the synovial fluid may appear purulent but is sterile. …

Prognostic Utility Of The Lactate/Pyruvate Ratio For Mortality In Patients With Sepsis: An Observational Study, Edgar G. Dorsey-Trevino, Olga G. Cantu-Rodriguez, Jose A. Hawing-Zarate, Grecia A. Gonzalez-Cantu, David Gomez-Almaguer, Cesar H. Gutierrez-Aguirre

Research Colloquium

Introduction: Measurement of serum lactate remains pivotal in sepsis evaluation as it is closely related to tissue hypoxia and mortality.^{1, 2} Serum lactate, however, can be elevated due to a myriad of reasons beyond hypoperfusion.³ A proposed alternative to control for serum lactate’s inherent variability is to measure pyruvate concomitantly to calculate the lactate/pyruvate (L/P) ratio.^{4, 5} As pyruvate transforms into lactate in anaerobic conditions, its value decreases in serum, increasing the L/P ratio, hence indicating an actual tissue-perfusion mismatch.⁶ Despite its clinical utility, there is a paucity of evidence evaluating the role of the L/P …

Pernicious Anemia Presenting With Pancytopenia And Hemolysis: A Case Report From South Texas, Yareli Durazo, Victor Tran, Sriharsha Koneru, Andres Suarez Parraga

Research Colloquium

Introduction: Pancytopenia is a commonly encountered hematologic entity with varying clinical presentations. It results from various disease processes ranging from simple to life-threatening. The most common cause of pancytopenia is megaloblastic anemia, and the most common causes of megaloblastic anemia are deficiencies of vitamin B9 or B12. Thus, folate and B12 deficiency should be high in the differential diagnosis when patients present with pancytopenia. Hemolytic anemia, anemia due to the shortened survival of circulating erythrocytes, often represents a more difficult diagnostic challenge for the clinician. While recognition of ongoing hemolysis is usually rapid and relatively simple, establishing the cause can …

Potential Involvement Of Srb1 In Type 1 Diabetes Associated Dyslipidemia: Characterizing Srb1 Antisense, Sowmya Duddu, Masami Shimizu-Albergine, Karin E. Bornfedlt

Research Colloquium

Background: One of the main complications of type 1 diabetes is cardiovascular disease associated with dyslipidemia, characterized by abnormally high levels of triglyceride-rich lipoproteins in the bloodstream. This imbalance could eventually lead to complications such as atherosclerosis. Liver Scavenger Receptor Class B Type 1 (SRB1) is currently being investigated for its role in type 1 diabetes induced dyslipidemia. We aim to characterize the effects of using a liver specific SRB1 antisense (GalNAc-SRB1 ASO) in non-diabetic and diabetic mice. We hypothesize that triglyceride and cholesterol levels will increase to a greater extent in diabetic mice injected with GalNAc-SRB1 ASO than in …

Rapid Response: Infantile Spasms And Low-Dose Prednisolone In A Young Child With Down Syndrome, Briana Noel Cortez, Christopher Cavazos, Aaron Carrillo, Brianna Woodliff

Research Colloquium

Background: Infantile spasms are an age-related epileptic disorder occurring in infancy or early childhood and are common in children with Down Syndrome. They have been associated with developmental delay, and thus rapid treatment of the disorder has been emphasized. First line treatments include a high dose prednisolone taper or adrenocorticotropic hormone (ACTH), of which, neither has been shown to be more efficacious in recent studies. Other less effective options include vigabatrin or high-dose pyridoxine.

Case Presentation: Our patient is a 1-year old female with Down Syndrome, who presented with concern for infantile spasms, occurring from 4-10 months of age. Episodes …