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Case Report of Glanzmann Thrombasthenia

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Unexplained Bleeding: Case Report of Glanzmann Thrombasthenia

Author: Ahmed Al Wahab1 , Alaa Nugud, M.D.2 , Shomous Nugud M.D.3, Zahran Alras1

Author Affiliations:

1College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
2Department of Pediatrics, Dubai Health Authority, Dubai, United Arab Emirates
3Department of Research, Sharjah Institute for Medical Research, Sharjah, United Arab Emirates

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Corresponding Author: Ahmed Al Wahab, a7md13@gmail.com

Key Words: Glanzmann Thrombasthenia, inherited platelet disorder, the disorder of hemostasis

Abstract:

Background

Glanzmann Thrombasthenia (GT) is a rare inherited genetic platelet disorder characterized by a qualitative, or quantitative mutation in GPIIb/IIIa receptor; which results in defective platelet aggregation and diminished clot retraction.

Case

A 19-year-old Arab descent female presented to emergency department with severe menorrhagia. On examination an ill looking pale patient in addition to generalized fatigue of one-week duration.

Conclusion

Acquired platelet disorders are more frequently encountered in practice than inherited ones, usually due to medical therapy or an underlying medical condition. GT, was previously known as hereditary hemorrhagic thrombasthenia, is an autosomal recessive disorder that is often disregarded as it has many clinical and laboratory findings similar to some acquired platelet disorders.

Published on date: September, 2017

DOI: 10.15404/msrj/09.2017.0127

Citation: Al Wahab, A., Nugud, A., Nugud, S., & Alras, Z. Unexplained Bleeding: Case Report of Glanzmann Thrombasthenia, Medical Student Research Journal (2017). doi:10.15404/msrj/09.2017.0127

References:

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Three Wishes Survey

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Are medical students becoming less altruistic and more money-oriented? A three wishes survey

Author: Anna I. Perera MSc1, Anna Serlachius PhD1, Roger J. Booth PhD2 & Keith J. Petrie PhD1

Author Affiliations:

1Department of Psychological Medicine, University of Auckland, NZ

2Department of Molecular Medicine and Pathology, University of Auckland, NZ

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Corresponding Author: Anna I. Perera, anna.perera@auckland.ac.nz

Key Words: undergraduate, motivations, altruism, money, specialization

Abstract:

Purpose

In this study we assessed the underlying values and goals of current medical students by examining personal wishes. The authors also aimed to determine the impact of the increased financial burden of medical training on students‟ motivations by comparing current wishes to those of students from 1999. We also examined the relationships between types of wishes, choice of future medical specialty, and demographic characteristics.

Methods

An anonymous survey with the question: “If you had three wishes, what would you wish for?”, and items pertaining to specialization choice and demographics was completed by 418 medical students. Wishes were coded into seventeen categories. Results were compared to a previous survey conducted in 1999.

Results

The largest category of wishes was altruism (40% of students) followed by achievement (36%), and money (34%). Significantly more medical students in 2015 had altruistic and achievement wishes compared to 1999. However, there was no significant increase in money-related wishes in the 2015 cohort compared to students from 1999. Final year students were more likely to report power-related wishes and male medical students had significantly more wishes related to power, money, and self-esteem. Students who aspired to be surgeons had more affiliation wishes and fewer knowledge-related aspirations. Conversely, medical students planning to enter internal medicine training were more likely to have wishes related to power and self-esteem. Achievement wishes were more common among individuals wanting to enter family medicine.

Conclusion

There was no evidence that medical students are becoming less altruistic and more money-orientated. Further, individuals did not appear to become less altruistic or increasingly financially driven as they progressed through the medical course.

Published on date: September, 2017

DOI: 10.15404/msrj/09.2017.0145

Citation: Perera, A., Serlachius, A., Booth, R., & Petrie K. Are Medical Students becoming Less Altruistic and More Money-Oriented? A Three Wishes Study, Medical Student Research Journal (2015). doi:10.15404/msrj/09.2017.0145

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Aerococcus Viridans

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Aerococcus Viridans Infectious Endocarditis Complicated by Splenic Infarction

Author: Joshua Budhu M.S, Dorian Wood B.S, Marvin Crawford M.D, Khuram Ashraf M.D, Frederick Doamekpor M.D, Olufunke Akinbobuyi M.D

Author Affiliations: Morehouse School of Medicine, GA, USA

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Corresponding Author: Joshua Budhu, jbudhu@gmail.com

Key Words: splenic infarct, infectious endocarditis, aercoccus viridans, HIV, immunocompromised, hemodialysis

Abstract:

In this case report we discuss splenic infarction as a presentation for infectious endocarditis. While not unheard of, splenic infarctions are usually incidental findings and are not usually used to diagnose infectious endocarditis. Since our patient was on hemodialysis, had AIDS and blood cultures tested positive for Aerococcus viridans and Streptococcus parasanguis, we propose that atypical presentations of IE should be considered in immunocompromised patients.

 

Published on date: September, 2017

DOI: 10.15404/msrj/07.2017.0002

Citation: : Budhu, J., Wood, D., Crawford, M., Ashraf, K., Doamekpor, F., & Akinbobuyi, O. Aerococcus Viridans Infectious Endocarditis Complicated by Splenic Infarction, Medical Student Research Journal (2017). doi:10.15404/msrj/07.2017.0002

References:

  1. Baddour M., Wilson  W.R., Bayer  A.S.; Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. Circulation. 111 2005:e394-e434.
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MRI vs. CT in Diagnosing Acute Appendicitis in Children

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Systematic review of the accuracy of magnetic resonance imaging in the diagnosis of acute appendicitis in children: comparison with computed tomography

Author: Benjamin Whitt

Author Affiliations: Saba University School of Medicine, MA, USA

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Corresponding Author: Benjamin Whitt, btwhitt22@gmail.com

Key Words: Appendicitis; Diagnostic Imaging; Sensitivity; Specificity; Children

Abstract:

Purpose

Computed tomography (CT) has emerged as the gold standard test for the evaluation of suspected appendicitis in pediatric patients. It has been shown to have excellent accuracy and to decrease negative appendectomy rates. However, CT scans expose patients to ionizing radiation, which is of especially high concern in children. Magnetic resonance imaging (MRI) is a potential alternative that could be used to evaluate children while eliminating exposure to radiation. This systematic review tests the hypothesis that the sensitivity and specificity of MRI are not inferior to that of CT in the evaluation of suspected appendicitis in children.

Methods

A search of the Medline database was conducted to identify articles that used MRI to evaluate children with suspected appendicitis. Articles that focused on pediatric subjects and reported sensitivity and specificity of MRI in these subjects were included. Data for the calculation of sensitivity, specificity, and 95% confidence intervals for each were extracted from each study included. Pooled data for sensitivity and specificity of MRI were calculated and tested for significance compared to sensitivity and specificity of CT using Fisher’s exact test.

Results

Nine studies were found to be relevant to the question posed by this systematic review and met the inclusion criteria. The pooled sensitivity and specificity of MRI for the diagnosis of appendicitis were 0.96 (95% CI: 0.94-0.98) and 0.97 (95% CI: 0.96-0.98) as opposed to values of 0.94 (95% CI: 0.92-0.97) and 0.95 (95% CI: 0.94-0.97) for CT. The difference between MRI and CT was not statistically significant for sensitivity (p=0.11) or specificity (p=0.06) in the evaluation of suspected appendicitis in children.

Conclusion

In children with suspected appendicitis, the sensitivity and specificity of MRI are comparable to those of CT in terms of sensitivity and specificity. MRI is a viable choice for imaging in these patients and limits exposure to radiation.

 

Published on date: September, 2017

DOI: 10.15404/msrj/07.2017.0001

Citation: Whitt, Benjamin. Systematic review of the accuracy of magnetic resonance imaging in the diagnosis of acute appendicitis in children: comparison with computed tomography, Medical Student Research Journal (2015), 4(3), 54-58. doi:10.15404/msrj/07.2017.0001

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  34. Leeuwenburgh, M.M., Wiarda, B.M., & Jensch, S. et al. (2014). Accuracy and interobserver agreement between MR-non-expert radiologists and MR-experts in reading MRI for suspected appendicitis. European Journal of Radiology, 83(1), 103-10. http://dx.doi.org/10.1016/j.ejrad.2013.09.022

Editorial Staff 2017-2018

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Introducing the new 2017 – 2018 editorial staff for the MSRJ! We are thrilled to welcome many new junior editors to our experienced MSRJ team. The journal has been making exciting new changes with the start of e-publication and we look forward to another productive year of publishing, editing, and supporting medical student research efforts around the world!

Continue reading →

Hardware Repair

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Re-fracture of Distal Radius and Hardware Repair in the Setting of Trauma

Authors: Brandon P. Lucke-Wold, PhD1*, Patrick C. Bonasso, MD2, and Glen Jacob, MD3

Author Affiliations:

1 Department of Surgery, West Virginia University School of Medicine.  Medical student author.

2 Dept. of Surgery, West Virginia University School of Medicine. Co-author, pbonass3@hsc.wvu.edu.

3 Dept. of Surgery, West Virginia University School of Medicine. Faculty author, gjacob@hsc.wvu.edu

[button link=”http://msrj.chm.msu.edu/wp-content/uploads/2016/12/HardwareRepairEpub.pdf” type=”big” color=”green” newwindow=”yes”] Full Text Article PDF[/button]

Corresponding Author: Brandon Lucke-Wold, PhD, Bwold@mix.wvu.edu

Key Words: Volar locking plate-distal radius fracture-open reduction-internal fixation

 

Abstract:

Distal radius fractures are one of the most common fractures in the elderly. Falls and motor vehicle collisions lead to increased risk for this type of fracture. A seventy-three year-old female had a previous history of distal radius fracture with repair by open reduction and internal fixation. She was involved in a motor vehicle collision that re- fractured the distal radius. The plate was bent and required removal, which is a very rare but potentially serious complication. Surgery was done to fix the open reduction and internal fixation with volar locking plates while removing damaged hardware. Only a select few cases have reported hardware failure as a cause of complications. Among those cases, high-energy activities and maintained stress on the hardware were likely causes. Distal radius fractures are the most common upper extremity fracture in the elderly. We highlight a unique case of re-fracture in the setting of trauma with prior hardware failure and describe the strategy for hardware repair.

 

Published on date: December, 2016

 

DOI: 10.15404/msrj/11.2016.0009

Citation: Lucke-Wold B, Bonasso P, Jacob G. Re-fracture of Distal Radius and Hardware Repair in the Setting of Trauma. Medical Student Research Journal (2016). doi:10.15404/msrj/11.2016.0009

References:

  1. Sebastin SJ, Chung KC. An Asian perspective on the management of distal radius fractures. Hand Clin. 2012;28(2):151-156.
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  1. Berglund LM, Messer TM. Complications of volar plate fixation for managing distal radius fractures. The Journal of the American Academy of Orthopaedic Surgeons. 2009;17(6):369-377.
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  1. Dasari CR, Sandhu M, Wisner DH, Wong MS. Approaches to Distal Upper-Extremity Trauma: A Comparison of Plastic, Orthopedic, and Hand Surgeons in Academic Practice. Ann Plast Surg. 2016;76 Suppl 3:S162-164.
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  1. Naito K, Zemirline A, Sugiyama Y, Obata H, Liverneaux P, Kaneko K. Possibility of Fixation of a Distal Radius Fracture With a Volar Locking Plate Through a 10 mm Approach. Tech Hand Up Extrem Surg. 2016;20(2):71-76.
  2. Diaz-Garcia RJ, Oda T, Shauver MJ, Chung KC. A systematic review of outcomes and complications of treating unstable distal radius fractures in the elderly. The Journal of hand surgery. 2011;36(5):824-835 e822.
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  1. Chung KC, Squitieri L, Kim HM. Comparative outcomes study using the volar locking plating system for distal radius fractures in both young adults and adults older than 60 years. The Journal of hand surgery. 2008;33(6):809-819.
  1. Sugun TS, Gurbuz Y, Ozaksar K, Toros T, Bal E, Kayalar M. A new complication in volar locking plating of the distal radius: longitudinal fractures of the near cortex. Acta Orthop Traumatol Turc. 2016;50(2):147-152.
  1. Yu YR, Makhni MC, Tabrizi S, Rozental TD, Mundanthanam G, Day CS. Complications of low-profile dorsal versus volar locking plates in the distal radius: a comparative study. The Journal of hand surgery. 2011;36(7):1135-1141.

Scrotal Rupture

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Scrotal Rupture in a Premature Neonate with Cystic Fibrosis as a Consequence of Meconium Periorchitis

Authors: Michael Bedgood1* BS, Christine Cortelyou1 MD, Cynthia Blanco1, MD, MSc, Rafael Fonseca2, MD, Alvaro Moreira1, MD

Author Affiliations:

1University of Texas Health Science Center (UTHSC), San Antonio, TX;

2University of Texas Medial Branch (UTMB), Galveston, TX

[button link=”http://msrj.chm.msu.edu/wp-content/uploads/2016/12/ScrotalRuptureEpub.pdf” type=”big” color=”green” newwindow=”yes”] Full Text Article PDF[/button]

Corresponding Author: Michael Bedgood BS, bedgood@uthscsa.edu

Key Words: neonate, meconium peritonitis, meconium periorchitis

 

Abstract:

Neonatal meconium periorchitis is a rare condition, with less than 60 cases described in the literature. Of the reported cases, only one describes the complication of a congenital rupture of the scrotum. We present a case of a Hispanic preterm neonate who was diagnosed with cystic fibrosis after scrotal rupture secondary to meconium periorchitis. The neonate was taken to the operating room for exploratory laparotomy and scrotal exploration. No calcification was noted and the patient’s left scrotum was surgically packed as well as creating a colostomy. The surgery proved successful and the patient was discharged home on day of life 79. This case of a neonate presenting with meconium periorchitis and scrotal rupture notes the varying degree of initial presentations for cystic fibrosis in a neonate. Successful outcomes for neonates presenting with a ruptured scrotum depend on early clinical assessment.

 

Published on date: December, 2016

 

DOI: 10.15404/msrj/11.2016.0008

Citation: Bedgood M, Cortelyou C, Blanco C, Fonseca R, & Moreira A. Scrotal Rupture in a Premature Neonate with Cystic Fibrosis as a Consequence of Meconium Periorchitis. Medical Student Research Journal (2016). doi:10.15404/msrj/11.2016.0008

References:

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  3. Regev RH, Markovich O, Arnon S, Bauer S, Dolfin T, Litmanovitz I. Meconium periorchitis: Intrauterine diagnosis and neonatal outcome: case reports and review of the literature. Journal of Perinatology. 2009: 29; 585-7
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  7. Soferman R, Ben-Sira L, Jurgenson U. Cystic fibrosis and neonatal calcified scrotal mass. Journal of Cystic Fibrosis. 2003; 2: 214-216
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Editorial Staff 2016-2017

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Introducing the new 2016 – 2017 editorial staff for the MSRJ! We are thrilled to welcome 20+ junior editors to our experienced MSRJ team. The journal has been making exciting new changes with the start of e-publication and we look forward to another productive year of publishing, editing, and supporting medical student research efforts around the world!

Continue reading →

Tonsillar Ectopia

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Determining if a Relationship Exists Between Tonsillar Ectopia and Symptom Presentation in Chiari Malformation Patients

Author: Julia R. Saling, B.S.1, Paige Marty, B.S.2, Rebecca Fischbein, Ph.D3, Michelle Chyatte, Dr.PH., MPH4

Author Affiliations:

1 Student Research Fellow, Northeast Ohio Medical University

2 Student Research Fellow, Northeast Ohio Medical University

3 Research Coordinator and Assistant Professor of Family and Community Medicine, Northeast Ohio Medical University

4 Assistant Professor of Family and Community Medicine, Northeast Ohio Medical University

[button link=”http://msrj.chm.msu.edu/wp-content/uploads/2016/08/TonsillarEctopiaepub.pdf” type=”big” color=”green” newwindow=”yes”] Full Text Article PDF[/button]

Corresponding Author: Julia R. Saling, jsaling@neomed.edu

Key Words: Chiari Malformation Type I, Tonsillar Ectopia, Symptom Presentation

 

Abstract:

Purpose

Chiari Malformation Type I (CM I) is characterized by cerebellar tonsil ectopia and has varying symptomatology . Previous research has shown a relationship between tonsillar dominance and related conditions but few examined association with symptomatology. This study attempts to elucidate a relationship between cerebellar tonsil dominance, age, and symptomatology.

Methods

Data from CM I patients were extracted from the Conquer Chiari Patient Registry. Tonsillar dominance was determined using a ratio of right-to-left herniation length. Pearson’s correlation and one-tailed Student’s T-test were used for analysis.

Results

Length of tonsillar descent appears to be negatively correlated to age of onset (r = -0.266; p < 0.001; n = 113) and diagnosis (r = -0.323; p < 0.001; n = 113). No correlation was found between tonsillar dominance and symptom location, nor between tonsillar dominance and symptom severity bilaterally (p > 0.05).  Symptom location and severity ratios appear to be correlated (r = 0.666; p < 0.001). Tonsillar descent length appears to be strongly correlated bilaterally (r = 0.972; p < 0.001; n = 50).

Conclusion
Inconsistency between tonsillar dominance as related to symptomatology suggests a multifactorial contribution to clinical presentation. The inverse relationship between tonsillar herniation length and age of symptom onset and diagnosis suggests herniation length may be an important predictor for clinical outcomes. Further research is needed to elucidate additional contributing factors and tonsillar dominance and symptomatology association.

 

Published on date: August, 2016

 

DOI: 10.15404/msrj/08.2016.0007

Citation: Saling et al. Determining if a Relationship Exists Between Tonsillar Ectopia and Symptom Presentation in Chiari Malformation Patients Medical Student Research Journal (2016). doi:10.15404/msrj/08.2016.0007

References:

  1. Siasios J, Kapsalaki EZ, Fountas KN. Surgical Management of Patients with Chiari I Malformation. Int J Pediatr. 2012;2012:1-10. doi:10.1155/2012/640127.
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