Diseases Commons^™

The Impact Covid-19 On The Healthcare Industry’S Systems And Policies: A Case Study, Jameyshia Franklin

West Chester University Doctoral Projects

People worldwide experienced some impacts from the 2019 Coronavirus at various degree. The healthcare industry worldwide was significantly affected by the high volume of patients being infected with the Coronavirus. The COVID-19 virus brought on several challenges for the healthcare industry and the federal government in the United States. Hospitals operated under severe circumstances to treat sick COVID-19 patients and keep their employees safe from contracting the disease. Government mandated social distancing, mask wearing, and cancelation and closing of services to assist with stopping the spread of the virus. This study aimed to identify how the pandemic affected the healthcare …

Perspectives On The Use Of Molecular Hiv Data For Public Health, Margaret Watson

College of Graduate Studies: Theses & Dissertations

Background. Effective HIV treatment and pre-exposure prophylaxis can drastically reduce the risk of acquiring HIV and prevent most future transmission, but these advances are not accessible to many who could most benefit from them. Advances in use of molecular sequence data to inform prevention efforts, paired with supportive interventions, have the potential to identify clusters of rapid HIV transmission and focus prevention resources toward areas of highest need. Although molecular cluster detection has been successfully used in other areas of public health, advocates for people with HIV have raised concerns about the application of this approach because of HIV …

Clonal Diversity, Antibiotic Resistance, And Virulence Factor Prevalence Of Community Associated Staphylococcus Aureus In Southeastern Virginia, Katelyn D. Cranmer, Mohan D. Pant, Suzanne Quesnel, Julia A. Sharp

EVMS School of Health Professions Faculty Publications

Staphylococcus aureus is a significant human pathogen with a formidable propensity for antibiotic resistance. Worldwide, it is the leading cause of skin and soft tissue infections (SSTI), septic arthritis, osteomyelitis, and infective endocarditis originating from both community- and healthcare associated settings. Although often grouped by methicillin resistance, both methicillin-resistant (MRSA) and methicillin-sensitive (MSSA) strains are known to cause significant pathologies and injuries. Virulence factors and growing resistance to antibiotics play major roles in the pathogenicity of community-associated strains. In our study, we examined the genetic variability and acquired antibiograms of 122 S. aureus clinical isolates from SSTI, blood, and urinary …

Prospective Investigation Of Insomnia Symptoms And Sleep Duration As Risk Factors For Stroke Incidence And All-Cause Mortality In U.S Adult, Wendemi Sawadogo

Theses and Dissertations

Background and Objectives: Stroke is the second leading cause of death in the world. In the United States, on average, someone has a stroke every 40 seconds and someone dies as a result of stroke every 3.5 minutes. Identifying modifiable risk factors of stroke is therefore a public health priority. The purpose of this study was to investigate the extent to which insomnia symptoms and sleep duration contribute to stroke incidence, all-cause mortality, and explore potential causal pathways.

Methods: The Health and Retirement Study (HRS) and the REasons for Geographic And Racial Differences in Stroke (REGARDS) study were …

Identification Of Novel Biosynthetic Gene Clusters Encoding For Polyketide/Nrps-Producing Chemotherapeutic Compounds From Marine-Derived Streptomyces Hygroscopicus From A Marine Sanctuary, Hannah Ruth Flaherty

Honors Theses and Capstones

Nearly one out of six deaths in 2020, around ten million people, were caused by cancer, making it a leading cause of death worldwide (WHO, 2022). This major public health issue, in addition to the rise of multidrug-resistant (MDR) pathogens, provides a high demand for the discovery of new pharmaceutical drugs to be used clinically to treat these conditions. The Streptomyces genus accounts to produce 39% of all microbial metabolites currently approved for human health, indicating its potential as an important species to study for antimicrobial and anticancer agents. The long linear genome of Streptomyces contains specialized sequences known as …

Combatting Bacterial Infections: The Efficacy Of Poly-Gamma-Glutamic Acid On The Prevention Of Nasopharyngeal Infections Among Individuals With Cleft Lip And Palate, Florence Pun

Scripps Senior Theses

Cleft lip and palate (CLP) is a medical condition where children are born with an unfused lip and palate. While surgery is required to fuse the lip and palate, there are other conditions that children with CLP face after surgeries, such as otitis media (OM), speech impediments, and difficulty breathing. Particularly, OM occurs frequently in individuals with CLP because the tensor veli palatini muscles cannot open the Eustachian tube frequently and ventilate the middle ear properly, even after surgery. This thesis is a research proposal to evaluate whether γ-PGA can be used in nasal washes to safely prevent nasopharyngeal infections …

Modeling The Spread Of Covid-19 In Spatio-Temporal Context, S.H. Sathish Indika, Norou Diawara, Hueiwang Anna Jeng, Bridget D. Giles, Dilini S.K. Gamage

Mathematics & Statistics Faculty Publications

This study aims to use data provided by the Virginia Department of Public Health to illustrate the changes in trends of the total cases in COVID-19 since they were first recorded in the state. Each of the 93 counties in the state has its COVID-19 dashboard to help inform decision makers and the public of spatial and temporal counts of total cases. Our analysis shows the differences in the relative spread between the counties and compares the evolution in time using Bayesian conditional autoregressive framework. The models are built under the Markov Chain Monte Carlo method and Moran spatial correlations. …

A Systematic Review To Study The Global Patterns And Policies Of Hiv Harm Reduction Programs And Their Impact Among People Who Inject Drugs, Noura Shaltout, Rania Soliman, Lamia Refaey, Rim Ghazal, Mirna Atteya, Nahla Elmedany

Papers, Posters, and Presentations

Aim: This study aims to provide an updated estimate of HIV prevalence among people who inject drugs (PWID) globally, as well as investigate different policies and methods for applying harm reduction. This article focuses on the two major and the most frequently used harm reduction techniques, Syringe-Service Programs (SSPs) and Opioid Agonist Therapy (OAT). Methods: A comprehensive systematic review was undertaken across multiple international databases during the period of (August-December 2021). For studies conducted before 2005, we used data from a previous published systematic review. Thirty-six studies were included, including studies that had performed HIV testing and had a confirmed …

Marineepi: A Gui-Based Matlab Toolbox To Simulate Marine Pathogen Transmission, Gorka Bidegain, Tal Ben-Horin, Eric N. Powell, John M. Klinck, Eileen E. Hofmann

CCPO Publications

The Graphical User Interface (GUI) MarineEpi is presented as a Matlab toolbox for easily (i) constructing disease transmission models for different marine host-pathogen systems, (ii) running simulations by specifying initial conditions and model parameters, and (iii) interpreting the resulting time series of the host and pathogen population dynamics. MarineEpi users can generate models for systems in which pathogen transmission occurs through contact with infected individuals (SI), contact with dead infected individuals (SID), contact with environmental pathogens released by infected individuals (SIP), and contact with environmental pathogens released by dead infected individuals (SIPD). MarineEpi is a freely available GUI that provides …

Does The Cdc Covid-19 Exposure Assessment Criteria For Healthcare Personnel Work In A Healthcare Setting In Pakistan?, Imran Hassan, Unab Khan, Shehreen Ali, Asif Hakim, Asad Ali

Department of Family Medicine

Objective: To evaluate the real-world performance of the CDC's "Interim US guidance for risk assessment and work restriction for healthcare personnel with exposure to COVID-19" at a private healthcare system in Pakistan.
Study design: Retrospective observational study.
Place and duration of study: The Aga khan University Hospital, Karachi, and its associated healthcare facilities in all four provinces of Pakistan, from February to September 2020.
Methodology: Healthcare personnel (HCPs) assessed and tested for exposures to COVID-19 were included in the study. An exposure category was assigned to each HCP presenting with exposure to COVID-19 based on the CDC criteria. Percentage positivity …

First Bovine Vaccine To Prevent Human Schistosomiasis - A Cluster Randomised Phase 3 Clinical Trial, Allen G. Ross, Donald A. Harn, Delia Chy, Marianette Inobaya, Jerric R. Guevarra, Lisa Shollenberger, Yuesheng Li, Donald P. Mcmanus, Darren J. Gray, Gail M. Williams

Biological Sciences Faculty Publications

Objective

Schistosomiasis is a neglected tropical parasitic disease caused by blood flukes of the genus Schistosoma. Schistosoma japonicum is zoonotic in China, the Philippines, and Indonesia, with bovines acting as major reservoirs of human infection. The primary objective of the trial was to examine the impact of a combination of human mass chemotherapy, snail control through mollusciciding, and SjCTPI bovine vaccination on the rate of human infection.

Methods

A 5-year phase IIIa cluster randomized control trial was conducted among 18 schistosomiasis-endemic villages comprising 18,221 residents in Northern Samar, The Philippines.

Results

Overall, bovine vaccination resulted in a statistically significant decrease …

Livestock Cattle As A Predictor Of Schistosomiasis Transmission In Nigeria, Oyetunde T. Oyeyemi, Oluyemi A. Okunlola, Zhiqiang Fu, Yang Hong, Jun-Hu Chen, Lisa M. Shollenberger

Biological Sciences Faculty Publications

Livestock cattle have been widely linked to schistosomiasis epidemiology, but little is known about its contribution to schistosomiasis transmission in Nigeria. The aim of this study is to examine the association between prevalence of schistosomiasis and livestock cattle index in Nigeria. The study's data came from three sources: the demographic and health survey (DHS), the malaria indicators survey (MIS), and the expanded special project for the eradication of neglected tropical diseases (ESPEN). Analysis of variance, correlation, and logistic regression were used to evaluate the mean difference in schistosomiasis prevalence across geopolitical zones, the relationship between schistosomiasis prevalence and livestock cattle, …

School-Based Intervention Impacts Availability Of Vegetables And Beverages In Participants’ Homes, Erin A Hudson, Marissa Burgermaster, Sophia M Isis, Matthew R Jeans, Sarvenaz Vandyousefi, Matthew J Landry, Rebecca Seguin-Fowler, Joya Chandra, Jaimie Davis

Faculty, Staff and Student Publications

As rates of metabolic syndrome rise, children consume too few vegetables and too much added sugar. Because children tend to eat what is available at home, the home environment plays a key role in shaping dietary habits. This secondary analysis evaluated the effects of a school-based gardening, cooking, and nutrition education intervention (TX Sprouts) compared to control on the availability of vegetables, fruit juice, and sugar-sweetened beverages (SSBs) at home. In the TX Sprouts cluster-randomized trial, 16 schools were randomized to TX Sprouts (

View-Sharing For 4d Magnetic Resonance Imaging With Randomized Projection-Encoding Enables Improvements Of Respiratory Motion Imaging For Treatment Planning In Abdominothoracic Radiotherapy, Ergys Subashi, Li Feng, Yilin Liu, Scott Robertson, Paul Segars, Bastiaan Driehuys, Christopher R Kelsey, Fang-Fang Yin, Ricardo Otazo, Jing Cai

Faculty, Staff and Student Publications

BACKGROUND AND PURPOSE: The accuracy and precision of radiation therapy are dependent on the characterization of organ-at-risk and target motion. This work aims to demonstrate a 4D magnetic resonance imaging (MRI) method for improving spatial and temporal resolution in respiratory motion imaging for treatment planning in abdominothoracic radiotherapy.

MATERIALS AND METHODS: The spatial and temporal resolution of phase-resolved respiratory imaging is improved by considering a novel sampling function based on quasi-random projection-encoding and peripheral k-space view-sharing. The respiratory signal is determined directly from k-space, obviating the need for an external surrogate marker. The average breathing curve is used to optimize …

Coronary Heart Disease And Ischemic Stroke Polygenic Risk Scores And Atherosclerotic Cardiovascular Disease In A Diverse, Population-Based Cohort Study, Allison Bebo, Jamie A Jarmul, Mark J Pletcher, Natalie R Hasbani, David Couper, Vijay Nambi, Christie M Ballantyne, Myriam Fornage, Alanna C Morrison, Christy L Avery, Paul S De Vries

Faculty, Staff and Student Publications

The predictive ability of coronary heart disease (CHD) and ischemic stroke (IS) polygenic risk scores (PRS) have been evaluated individually, but whether they predict the combined outcome of atherosclerotic cardiovascular disease (ASCVD) remains insufficiently researched. It is also unclear whether associations of the CHD and IS PRS with ASCVD are independent of subclinical atherosclerosis measures. 7,286 White and 2,016 Black participants from the population-based Atherosclerosis Risk in Communities study who were free of cardiovascular disease and type 2 diabetes at baseline were included. We computed previously validated CHD and IS PRS consisting of 1,745,179 and 3,225,583 genetic variants, respectively. Cox …

Awareness Of The Role Of Nutrition In Cancer Causation And Prevention Among Rural Adult Population: A Cross-Sectional Study, Sayana Basheer, Kavya G. Upadhya, Sana Khader M

Digital Journal of Clinical Medicine

Background

In recent years, nutrition has received an increasingly important role in the aetiology of cancer. Thus, public education about dietary factors associated with cancer risk or prevention could be an important intervention for cancer prevention, particularly in low- and middle-income countries where the burden of cancer is increasing rapidly and access to care is limited. This study aimed to assess the awareness among rural adults about the role of nutrition in cancer development and its prevention.

Methods

A cross-sectional study was conducted among 300 individuals in the adult population (> 18 years) in rural field practice area of a …

Exploring The Evolution Of Trypanosoma Cruzi And The Emergence Of Chagas Disease In The Context Of Environmental Change: Applying The Stockholm Paradigm To Archaeoparasitology, Part I, Aida Romera Barbera, Daniel R. Brooks, T. Michael Fink, Karl J. Reinhard

Karl Reinhard Publications

The Stockholm Paradigm is an evolutionary synthesis that explains the emergence of novel pathogens in the context of environmental disturbances. Considering the urgent climate change situation, anticipation stands as key to prevent and mitigate the effects that climate change can have in the emergence of pathogens. However, the success of preventive measures is hindered by a limited knowledge of the interplaying dynamics between biology, environment, and culture leading to emerging infectious diseases. For many decades, bioarchaeologists have been gathering data on past human-environment interactions, therefore contributing to the conversation. Archaeoparasitology, at the intersection between pathology, bioarchaeology, and biology, is uniquely …

Documenting The Presence Of Chagas Disease In Prehistoric North America: Applying The Stockholm Paradigm To Archaeoparasitology, Part Ii, Karl J. Reinhard, Daniel R. Brooks, Aida Romera Barbera, T. Michael Fink

Karl Reinhard Publications

The DAMA protocol (Document, Assess, Monitor, Act) is the applied aspect of the Stockholm Paradigm. Evidence from archaeology and history of medicine has a demonstrated value in documenting infection risk for specific study areas. Bioarchaeological remains and historical documents show vivid examples of pathology related to the Chagas disease life cycle. The science of archaeology defines the lifestyles that created risk of triatomine kissing bug infestations and trypanosome protozoa infections. Paleogenetics, in the form of molecular analyses of Trypanosoma cruzi, elucidate the temporal origins of genetic variants and adaptation to human environments. We illustrate how these fields reveal the risk …

The Effect Of An Educational Handout On Knowledge, Awareness And Attitudes Of Pre-Exposure Prophylaxis (Prep) Among Participants At A Needle And Syringe Exchange Site, Mckenzie Buckel

DNP Projects

Background: In 2018, the total number of HIV cases in the United States was 1.2 million. Almost 186,500 of these cases were attributed to intravenous drug use. With the adherence to pre-exposure prophylaxis (PrEP) there is approximately a 49% decrease in the rates of HIV among people who inject drugs and the most significant barrier to PrEP among this population is a lack of awareness and knowledge.

Objective: The purpose of this study was to determine participants’ of a needle and syringe exchange site knowledge, awareness and attitudes of PrEP after reviewing an educational handout about PrEP.

Methods: A quasi …

Prostate Cancer Aggressiveness And Financial Toxicity Among Prostate Cancer Patients, Madhav Kc, Evrim Oral, Ariane L. Rung, Edward Trapido, Laura S. Rozek, Elizabeth T.H. Fontham, Jeannette T. Bensen, Laura Farnan, Susan E. Steck, Lixin Song, James L. Mohler, Saira Khan, Sanah Vohra, Edward S. Peters

School of Public Health Faculty Publications

Introduction: Financial toxicity (FT) is a growing concern among cancer survivors that adversely affects the quality of life and survival. Individuals diagnosed with aggressive cancers are often at a greater risk of experiencing FT. The objectives of this study were to estimate FT among prostate cancer (PCa) survivors after 10−15 years of diagnosis, assess the relationship between PCa aggressiveness at diagnosis and FT, and examine whether current cancer treatment status mediates the relationship between PCa aggressiveness and FT. Methods: PCa patients enrolled in the North Carolina-Louisiana Prostate Cancer Project (PCaP) were recontacted for long-term follow-up. The prevalence of FT in …

Recent Advances On The Molecular Mechanism And Clinical Trials Of Venous Thromboembolism, Shao-Li Huang, Hong-Yi Xin, Xiao-Yan Wang, Guang-Gui Feng, Fu-Qing Wu, Zhi-Peng Feng, Zhou Xing, Xi-He Zhang, Hong-Wu Xin, Wen-Ying Luo

Faculty, Staff and Student Publications

Venous thromboembolism is a condition that includes deep vein thrombosis and pulmonary embolism. It is the third most common cardiovascular disease behind acute coronary heart disease and stroke. Over the past few years, growing research suggests that venous thrombosis is also related to the immune system and inflammatory factors have been confirmed to be involved in venous thrombosis. The role of inflammation and inflammation-related biomarkers in cerebrovascular thrombotic disease is the subject of ongoing debate. P-selectin leads to platelet-monocyte aggregation and stimulates vascular inflammation and thrombosis. The dysregulation of miRNAs has also been reported in venous thrombosis, suggesting the involvement …

Age And Sex-Specific Stroke Epidemiology In Covid-19, Youngran Kim, Maria A Parekh, Xiaojin Li, Yan Huang, Guo-Qiang Zhang, Bharti Manwani

Faculty, Staff and Student Publications

BACKGROUND: COVID-19 has emerged as an independent risk factor for stroke. We aimed to determine age and sex-specific stroke incidence and risk factors with COVID-19 in the US using a large electronic health record (EHR) that included both inpatients and outpatients.

METHODS: A retrospective cohort study was conducted using individual-level data from Optum

RESULTS: Of 387,330 COVID-19 patients, 2,752 patients (0.71%, 95% CI 0.68-0.74) developed stroke during the 180-day follow-up, AIS in 0.65% (95% CI 0.62-0.67), and ICH in 0.11% (95% CI 0.10-0.12). Of strokes among COVID-19 patients, 57% occurred within 3 days. Advanced age was associated with a substantially …

Effect Of "Maccog" Tcm Tea On Improving Glucolipid Metabolism And Gut Microbiota In Patients With Type 2 Diabetes In Community, Biyue Hu, Tongtong Yin, Jiajia Zhang, Minjing Liu, Hang Yun, Jian Wang, Renmei Guo, Jie Huang, Yixia Zhou, Hongyan Meng, Li Wang

Faculty, Staff and Student Publications

OBJECTIVES: This work aimed to observe the effect of consuming Chinese herb tea on glucolipid metabolism and gut microbiota in patients with type 2 diabetes mellitus (T2DM).

METHODS: Ninety patients with T2DM were recruited from a community and randomly divided into the control group (CG) and intervention group (IG). CG maintained conventional treatment and lifestyle, and IG accepted additional "maccog" traditional Chinese medicine (TCM) tea (mulberry leaf, radix astragali, corn stigma, cortex lycii, radix ophiopogonis, and gynostemma) for 12 weeks. Glucolipid metabolism, hepatorenal function, and gut microbiota were then measured.

RESULTS: After the intervention, the decreases in fasting plasma glucose …

Application Of Implementation Mapping To Develop Strategies For Integrating The National Diabetes Prevention Program Into Primary Care Clinics, William B Perkison, Serena A Rodriguez, Fernanda Velasco-Huerta, Patenne D Mathews, Catherine Pulicken, Sidra S Beg, Natalia I Heredia, Pierre Fwelo, Grace E White, Belinda M Reininger, John W Mcwhorter, Roshanda Chenier, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Diabetes is considered one of the most prevalent and preventable chronic health conditions in the United States. Research has shown that evidence-based prevention measures and lifestyle changes can help lower the risk of developing diabetes. The National Diabetes Prevention Program (National DPP) is an evidence-based program recognized by the Centers for Disease Control and Prevention; it is designed to reduce diabetes risk through intensive group counseling in nutrition, physical activity, and behavioral management. Factors known to influence this program's implementation, especially in primary care settings, have included limited awareness of the program, lack of standard clinical processes to facilitate …

Association Of The Gut Microbiome With Kidney Function And Damage In The Hispanic Community Health Study/Study Of Latinos (Hchs/Sol), Brandilyn A Peters, Qibin Qi, Mykhaylo Usyk, Martha L Daviglus, Jianwen Cai, Nora Franceschini, James P Lash, Marc D Gellman, Bing Yu, Eric Boerwinkle, Rob Knight, Robert D Burk, Robert C Kaplan

Faculty, Staff and Student Publications

BACKGROUND: The gut microbiome is altered in chronic kidney disease (CKD), potentially contributing to CKD progression and co-morbidities, but population-based studies of the gut microbiome across a wide range of kidney function and damage are lacking.

METHODS: In the Hispanic Community Health Study/Study of Latinos, gut microbiome was assessed by shotgun sequencing of stool (

RESULTS: Higher eGFR was associated with overall gut microbiome composition, greater abundance of species from Prevotella, Faecalibacterium, Roseburia, and Eubacterium, and microbial functions related to synthesis of long-chain fatty acids and carbamoyl-phosphate. Higher UAC ratio and CKD were related to lower gut microbiome diversity and …

Beyond Breathless: Unravelling The Enigma Of Pulmonary Arteriovenous Malformations, Sri Mounya Jampala, Jagadish Kumar K Dr., Manjunath V G, Nandish H R

Digital Journal of Clinical Medicine

Pulmonary Arteriovenous Malformations (AVMs) are abnormal connections between the pulmonary arteries and veins, leading to a direct shunting of blood without passing through the normal capillary bed. These AVMs can be associated with a rare genetic disorder called Hereditary Hemorrhagic Telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome. HHT is an autosomal dominant disorder characterized by the development of fragile telangiectasias in various organs, including the skin and mucous membranes. These telangiectasias are prone to bleeding, leading to recurrent nosebleeds and mucocutaneous bleeding. In patients with HHT, the most common site of AVMs is in the lungs. Pulmonary AVMs can cause …

Stroke: A Neurological Complication In Covid-19., Abhigna M, Vikram Patil

Digital Journal of Clinical Medicine

No abstract provided.

A Study On The Prevalence Of Vitamin B12 Deficiency In Eastern Indian Type 2 Diabetes Mellitus Patients With Peripheral Neuropathy On Metformin Presenting To A Tertiary Care Hospital, Ajay Hanumanthu, Soumik Goswami, Kavya Bhadrapura Thimmegowda, Nilanjan Sengupta, Arjun Baidya, Pranab Kumar Sahana

Digital Journal of Clinical Medicine

Introduction:

The association between long-term metformin use in type 2 diabetes mellitus (T2DM) and low vitamin B12 levels has been proven and screening for the same is recommended by American Diabetes Association (ADA) guidelines. The potential of the deficiency to cause or worsen diabetic peripheral neuropathy (DPN) in T2DM patients has been investigated in previous studies. However, the prevalence estimates of vitamin B12 deficiency in T2DM patients treated with long term metformin and having established DPN is lacking in our country. The aim of our study was to estimate the prevalence of vitamin B12 deficiency in T2DM patients with DPN …

The Trichobezoar Enigma: Untangling The Intricacies Of Rapunzel Syndrome, Debabrata Sahu, Dr Rajkishor Sahu

Digital Journal of Clinical Medicine

Rapunzel Syndrome is a rare manifestation of trichobezoar, characterized by the presence of hair strands extending beyond the stomach and into the duodenum. Trichobezoars typically develop in individuals with a history of trichotillomania, a compulsive behavioral disorder involving hair-pulling, combined with trichophagia, the ingestion of hair. While trichobezoars predominantly form within the stomach, their occurrence in the jejunum is infrequent. This condition is more commonly observed in adolescent females.

The formation of bezoars within the gastrointestinal tract is typically attributed to anatomical changes. However, in cases where no such anatomical abnormalities are present, psychiatric disorders like trichotillomania can lead to …

Modified Electroconvulsive Therapy As Maintenance Treatment, Jatin Kumar, Kishor M, Murali M R

Digital Journal of Clinical Medicine

Depression is the most common psychiatric condition that significantly affects the quality of life of individual affected with it and it can present with various signs and symptoms. It usually presents with persistent and pervasive sadness of mood, anhedonia, sleep disturbance, reduced appetite, reduced concentration, multiple somatic symptoms, and suicidal thoughts. In this case report a 61-year-old gentleman presented with sadness of mood, loss of interest, sleep disturbance, multiple body aches, and abdominal pain which varied from 2 to 6 weeks. He had failed to respond to multiple classes of antidepressants, mood stabilizers, and antipsychotics. However, he would respond well …