Context With the surge of the novel coronavirus (SARS-CoV-2 [COVID-19]), the modality of teaching anatomy has shifted from in-person cadaveric dissection to virtual lessons for incoming first-year medical students. As a result, we aim to assess the impact that this curriculum change has on student perspectives. Objectives This study aims to understand the relative effect of a virtual anatomy course implemented during the pandemic (2019–2020) on the confidence, skills, and perspectives of first-year medical students compared to medical students who had traditional in-person anatomy at Rowan University School of Osteopathic Medicine (Rowan SOM) in Stratford, New Jersey. Methods The authors developed a 14-question survey to target gross anatomy students of the Classes of 2023 and 2024 at Rowan SOM. The Class of 2024 had a virtual anatomy lab compared to the Class of 2023, who had an in-person anatomy lab in their first year of medical school. The responses were analyzed to understand the difference between a hands-on cadaver lab and a virtual anatomy lab utilizing SPSS. Results The survey was administered to approximately 400 people, from which we received 149 responses (37.3%). Among all responses, 36.2% (n=54) belonged to the Class of 2023 who encountered hands-on cadaver experience, whereas 63.8% (n=95) belonged to the Class of 2024 who gained virtual anatomy lab experience. An independent t-test statistical analysis was utilized. Under the confidence domain, when students were asked about the understanding of trauma after their respective anatomy labs, 64.0% of the Class of 2023 (n=50) showed significantly higher confidence with p<0.001, compared to 15.4% for the Class of 2024 (n=78). Under the skills domain, the Class of 2023 (n=50) felt more comfortable with ultrasound (64.0%), identifying all of the pertinent anatomical structures and their respective locations on imaging (72.0%), and identifying the pathology (90.0%) with respective p values of <0.001, <0.001, and 0.004. Only 36.9% of Class of 2024 respondents shared similar comfort with ultrasound (n=84), 30.9% identifying pertinent anatomical structures (n=84) and 65.4% in identifying pathology (n=84). Under the attitude domain, the Class of 2023 (n=50) had more respect toward the human body with their hands-on cadaver experience (88.0%) than the Class of 2024 (n=89, 33.3%). Conclusions Based on current results, it can be established that medical students who had in-person cadaveric dissection had a favorable attitude toward their anatomy course compared to students who had virtual anatomy during the COVID-19 pandemic.
During an ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel virus, new discoveries about its complications and treatment are made every day. Bowel perforation is another rarely reported complication due to the virus itself leading to ischemia or can be due to the treatment with antiviral drugs that reduces the integrity of epithelial barriers. This makes the bowel more prone to perforation even in patients with no prior history of bowel disease. We report a case of bowel perforation in a 72-year-old male patient with severe COVID-19 infection.
Granulomatosis with polyangiitis (GPA), earlier known as Wegener's granulomatosis, is an autoimmune inflammatory disorder that causes necrotizing vasculitis of small-and medium-sized blood vessels. It primarily affects the upper respiratory tract, lungs, and kidneys. Most of the cardiac involvement tends to be subclinical and is often not clinically apparent with involvement of the conduction pathway; myocarditis, pericarditis, or coronary artery involvement are associated with increased morbidity and mortality. These present with the symptoms of shortness of breath, cough, bilateral pedal edema, orthopnea, syncope, and features of heart failure such as elevated jugular venous pressure. We report a rare case of heart involvement with profound valvular deformity involving all four cardiac valves along with renal impairment in a 76-year-old female with recently diagnosed granulomatosis with polyangiitis.
Pancreatic adenocarcinoma is the second most common gastrointestinal cancer after colon cancer. There is a delay in the detection of pancreatic adenocarcinoma as it remains asymptomatic in many individuals until it has metastasized to different parts of the body. We present a case of pancreatic cancer causing a large bowel obstruction in a 78-year-old female, detected during an exploratory laparotomy. Despite the increased incidence of pancreatic cancer, there are no screening guidelines that have been enacted for early detection and cure. Practicing clinicians should keep pancreatic cancer in the differential in high-risk individuals.
Essential thrombocythemia (ET) is a myeloproliferative neoplasm involving the clonal proliferation of platelets. It is Philadelphia negative and is associated with Janus kinase 2 (JAK2), calreticulin (CALR), or myeloproliferative leukemia virus oncogene (MPL) mutations. The resultant platelets have quantitative and qualitative defects, making them more sticky and prone to thromboembolism. However, ET does not only affect platelet survival, it also has a low leukemogenic potential. It's more common in the elderly, 60 years or more, but can be seen in all age groups, including children. Patients with ET have an increased risk of vascular events like hemorrhage and thromboses like cerebrovascular events, myocardial infarction, superficial thrombophlebitis, deep vein thrombosis, and pulmonary embolism. Cardiovascular risk factors like hypertension, diabetes, and smoking can lead to increased thromboembolism and atherosclerosis. The management of ET focuses primarily on the prevention of thrombosis and hemorrhage. It involves cardiovascular risk management and antiplatelet and cytoreductive therapy according to the risk stratification. Low-risk ET patients are treated with low-dose aspirin, and high-risk ET patients are treated with cytoreductive therapy with hydroxyurea. Interferon (IFN) and anagrelide are reserved for young patients or pregnant women. This case report discusses a 40-year-old male, a known smoker presenting with myocardial infarction and left anterior descending artery (LAD) blockage without any prior history. His high platelets and the relative absence of cardiovascular risk factors helped reach the diagnosis, and bone marrow analysis and mutation analysis confirmed the diagnosis. The patient was started on hydroxyurea, which decreased the total platelet count.
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