The Journal of Health Sciences

Volume 1, Issue 2

Resident Education in a Time of Health Care Reform- Editorial

All one hears in the news today is the ongoing unified cry for health care reform:

A)    to remove waste and duplication

B)     improve access to health care

C)    improve the quality of health care

All these perpetual discussions and heated debates speak to everything but the one critical factor that will directly impact all aspects of health care delivery and that is the ongoing continued process of approved resident medical education in the United States.

It seems obvious that no health care delivery system can exist without physicians, Read full text

Disparities in Colon Cancer among an African American Population at a Community Hospital in Brooklyn.

  Introduction: Each year approximately 148,810 new cases of colorectal cancer are diagnosed and nearly 50,000 people die from the disease.[1] Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States and accounts for 15% of all cancers diagnosed annually.  Early diagnosis is closely related to survival.  Five-year survival exceeds 90% for patients diagnosed with disease localized to the colon or rectum compared with only 60% for patients with regional lymph node involvement.  Survival for persons with distant metastasis (spread to organs such as the liver and lungs) is dismal, Read full text

TWIN PREGNANCY COMPLICATED BY MOYAMOYA DISEASE

 SYNOPSIS

We report a 22 year old twin gestation female successfully delivered preterm with postpartum complications which turned out to be secondary to Moyamoya disease.

Keywords: Moya moya disease, Cerebro vascular disease

 ABSTRACT

Background: There are only 53 reported cases of Moya Moya disease (MMD) associated with pregnancy in the literature1. 

Case: Our report highlights the difficulty in diagnosing and treating newly diagnosed pregnant patients with MMD. Read full text

Eclampsia in HIV Cocaine Abuser at 25 weeks old gestational age

Abstract

       A 43 year old African American female presented to our facility with high-grade fever, seizures, elevated blood pressure and altered mental status. Our laboratory investigations revealed HIV positive serum, Read full text

A New Technique for Utilizing a Powered Periotome for Preserving Bone During Odotectomy

Implant driven restorative dentistry has superseded traditional crown and bridge and heroic endodontics as the preferred treatment planning modality of many dentists for treatment of the pulpally involved tooth. As the discipline progresses and the surgical and restorative materials reach new heights of perfection, Read full text

Why Am I Here? A Survey of Patent Knowledge on their Care in the E.D.

Objective: We observed that admitted patients in the ED were often inadequately informed about the care they were receiving and their admission diagnosis. Our search of the medical literature revealed no study evaluating patients' knowledge of their admission diagnosis. Read full text

Pregnancy Outcome in Patients with “Corrected” Mid-Trimester Placenta Previa

Background:

Placenta Previa, defined as placental implantation over the internal cervical os, occurs in 1 in 300 live births.

 Figure 1. Depiction of Normal Gestation (left) versus uncorrected Placenta previa ( right). Read full text

Evaluating the Management of Diabetes Mellitus Type-2 in HIV-Infected Patients

BACKGROUND

Diabetes mellitus (DM) and impaired glucose tolerance in HIV-infected patients are common Insulin resistance is an important cardiovascular disease risk factor in HIV-infected patients Hemoglobin A1c (HbA1c) used to monitor glucose control  Literature suggests HbA1c overestimates glucose control Fructosamine measures glycosylated proteins in the serum or plasma over previous 2-3 weeks Fructosamine may be more reliable marker of glucose control in HIV patients If treatment is necessary, Read full text

Clinical Outcome of Nursing Home and Non-Nursing home patients admitted to Intensive Care Unit

Introduction:

Catastrophically ill nursing home (NH) residents with high Acute Physiology and Chronic Health Evaluation (APACHE score) are admitted to Medical Intensive Care Unit (MICU) for life prolonging therapy. Read full text

VEXING ISSUES IN COLORECTAL CANCER SCREENING

Background

Colonoscopy is the gold standard test for prevention and early detection of Colorectal Cancer (CRC).  The United States Preventive Services Task Force (USPSTF) recommends against routine screening for colorectal cancer (CRC) in adults over 75 years of age. Read full text

Percutaneous Endoscopic Suturing:An effective treatment for Gastrocutaneous fistula.

Background

Development of persistent gastrocutaneous fistula and leakage after removal of a PEG tube is a well-known complication. Various treatments including medications to alter gastric pH, prokinetic agents, endoscopic clipping, Read full text

Diffuse Lung infiltrates in a smoker with HIV infection

CASE PRESENTATION

 

Acknowledgement:

We acknowledge Dr.Philip Xiao MD (Dept of Pathology, The Brooklyn Hospital Center) for providing the photographs of histopathology slides used in this presentation.

Abbreviations:

ABG-Arterial Blood Gas                                                              H&E-Hematoxylin eosin

DLCO-Diffusing capacity of the lung                                           LCH-Langerhans’ Cell Histiocytosis

 for carbon monoxide                                                              PCO2-Partial pressure of CO2

FEF25-75%-Forced expiratory flow at                                         PO2-Partial pressure of O2

25-75% of the pulmonary volume                                            PFT-Pulmonary function Test

FEV1-Forced Expiratory Volume in 1 sec                                     RV-Residual volume

FVC-Forced vital capacity                                                         TLC-Total lung capacity

Introduction:

         Opportunistic lung infections are frequently considered when patients with HIV infections present with respiratory symptoms and abnormal Chest. Read full text

Can a Man’s Shirt (collar) size serve as an indicator for an underlying sleep disorder?

Background

The importance of chronic sleep insufficiency is under-recognized as a public health problem, despite being associated with numerous physical and mental health problems, injury, loss of productivity, and mortality1.  An estimated 50-70 million persons in the United States have chronic sleep and wakefulness disorders. Read full text

New Development in Bone Regeneration Use of rhBMP-2 in Oral Maxillofacial Surgery

Background:

INFUSE Bone Graft is indicated as an alternative to autogenous bone graft .Bone Morphogenetic Proteins (BMP) are cytokines that belong to a family of TGF-beta superproteins. There are 15 BMPs identified  BMP2 is the product used).

BMP functions include: the induction of bone and cartilage maturation of osteocytes, Read full text

Assessing Risk Factors and Outcomes of interests in Hospitalized Elderly patients with Delirium

Background

Delirium is frequently found in the elderly hospitalized patient, particularly in the frail elderly.  In the acute care setting, delirium can be found in greater than 30% of elderly patients, Read full text

Anti-tussive Medication use among coughing children presenting to the PED

                                                                       

Background:

 Cough medication use is a world wide phenomenon

 with sales of 3.5 billion annually in the US.

 Every week 4 million children < 12 years old use

 antitussive medication.

 There have been several recent reports of toxicity

 and death associated with their use.

 The AAP recommends against the use of antitussive

 medication in children.

 The FDA strongly recommends against the usage of

 anti-tussive medications in children below 2 years

 And even published a black box warning.

 Major recognized adverse effects include sedation, Read full text

Gastroenterological Emergencies Part I: Acute Upper Gastrointestinal Bleeding

Introduction

Gastrointestinal (GI) bleeding is a common and costly medical condition. Approximately 1,000,000 hospitalizations occur annually for GI bleeding.1 Upper gastrointestinal (UGI) bleeding accounts for about half of these cases, and at a cost of $2.5 billion annually.1,2 The mortality rate of about 10% is unchanged despite widespread use of fiberoptic endoscopy, Read full text

The Captivating Cryptococcoma - A Mystery Lurking in the Brain

 

Cerebral cryptococcoma is a cryptococcal infection of the CNS presenting as a focal granuloma.  These intracranial lesions are uncommon in AIDS patients with cryptococcal meningitis, but when the two entities co-exist, Read full text

Chronotropic Incompetence and Dobutamine Testing in Overweight and Obese Patients

 Abstract

Background

Dobutamine stress testing is a pharmacological alternative to exercise-induced tachycardia and is commonly used as a form of cardiac testing in patients unable to exercise. With adequate heart rate response, Read full text

Scholarly Activity – A Program Director’s Observations

"Somewhere, something incredible is waiting to be known." - Carl Sagan 

Graduate medical education involves a formal period of training after medical school in order to prepare the physician for independent medical practice. Read full text