International Journal of Medical Students 2019-11-11T13:30:56-05:00 Francisco Javier Bonilla-Escobar, MD, MSc, PhD(c) Open Journal Systems <p>The International Journal of Medical Students (IJMS) is a peer-reviewed, open-access, scientific journal (ISSN 2076-6327) created to share the scientific production and experiences of medical students worldwide.</p> Cover, Credits, & Content 2019-11-11T13:30:38-05:00 Executive Board of IJMS 2019-08-31T00:00:00-04:00 Copyright (c) 2019 Executive Board of IJMS The Weight of Schoolbags and Musculoskeletal Pain in Children of Selected Schools in Thimphu, Bhutan: A Cross-sectional Study 2019-11-11T13:30:56-05:00 Thinley Dorji Saran Tenzin Tamang Sonam Yoezer Kuenzang Wangdi <p><strong>Background:</strong> The carriage of loads on the back in children, &gt;10% of one’s body weight (BW), induces postural change and morbidity related to spinal pain. We studied the weight of schoolbags and the prevalence of musculoskeletal pain related to carrying schoolbags among children in Thimphu, Bhutan.</p> <p><strong>Methods:</strong> This was a cross-sectional study, with a multistage cluster sampling, conducted amongst grade 8 and 10 students. Data were collected using a standardized self-administered questionnaire and weights of students and schoolbags were measured. Descriptive statistics were used to present the findings. Means were compared using t test and risk factors were identified using logistic regression.</p> <p><strong>Results:</strong> There were 131 students whose schoolbags weighed &gt;10% body weight (BW). The mean weight of schoolbags was 4.6 ±1.5 kg for grade 8 students and 4.0 ±1.5 kg for grade 10 students. Musculoskeletal pain in at least one body region was reported by 411 students. Schoolbags weighing &gt;10% BW and carrying the bags over only one shoulder were significant risk factors for reporting musculoskeletal pain. There were 197 students whose schoolbags did not have any safety feature; students did not use them consistently even if they were present.</p> <p><strong>Conclusions:</strong> The weight of school bags that were more than the recommended ≤10% BW was a strong factor in reporting musculoskeletal pain. Parents and students may be educated on the use of schoolbags with safety features. Measures such as providing storage facilities in schools may reduce the weight of bags.</p> 2019-08-31T00:00:00-04:00 Copyright (c) 2019 Thinley Dorji, Saran Tenzin Tamang, Sonam Yoezer, Kuenzang Wangdi Spine ABC, A Multidimensional Case Report from A to Z: Aneurysmal Bone Cyst of the Spine 2019-11-11T13:30:39-05:00 Eliza (Eleni-Zacharoula) Georgiou Savvina Prapiadou Helen Kourea <p><strong>Background:</strong> Aneurysmal bone cysts (ABC) are uncommon entities which cause expansile and destructive bone lesions and are characterized by reactive proliferation of connective tissue. They usually grow rapidly with hypervascularity. ABC’s incidence on the spine is 1.5 in 10 million. Most cases present with pain of unexplained origin.</p> <p><strong>The Case: </strong>Presented in this paper is an ABC case in the spinous process of the L2 vertebra of a 20-year-old Greek female patient. The main symptom was persistent back pain, without neurological symptoms, of four years’ duration. Treatment consisted of surgical curettage of the lesion. In this case report, we tried to describe not only the pathology of this disease but also the subsequent psychosocial symptoms that accompany it. We managed to accomplish that by exploiting the knowledge of an experienced pathologist, the help of the physicians responsible for this case, the interest of some sensitized medical students, and of course, the experience of the patient herself since the patient is also the lead author.</p> <p><strong>Conclusion:</strong> The focal point of this article is that even though ABCs might lead to excruciating pain, this pain can be alleviated with the proper treatment, especially if the communication between physician and patient is optimal.</p> 2019-08-31T00:00:00-04:00 Copyright (c) 2019 Eliza (Eleni-Zacharoula) Georgiou, Savvina Prapiadou, Helen Kourea Recurrent Subacute Subdural Hematoma in a 67-Year-Old Female with Late Alzheimer’s Disease: A Case Report 2019-11-11T13:30:44-05:00 Paul Marcel Morgan <p><strong>Background:</strong> Chronic Subdural Hematoma (CSDH) is becoming an urgent public health issue due to an increase of incidence in aging populations like Taiwan. Though trauma still stands as the primary mechanism of CSDH, it is often overlooked in the elderly, especially those with mid-to-late stage Alzheimer’s Disease (AD). Coincidentally, the clinical presentation of mid-to-late stage AD shares significant overlap with CSDH. AD creates an immense challenge for physicians and family members to identify early signs of CSDH.</p> <p><strong>The Case</strong><strong>:</strong> We report a peculiar case of a 67-year-old female with a history of AD who presents to the Emergency room in Belmopan City, Belize, with recurrent CSDH. On admission her consciousness was disturbed and late stage dementia presented an enormous challenge for logical and meaningful history taking. Axial non-contrast computed tomography showed a crescent-shaped isodense subdural hematoma in the left hemisphere of the parietal lobe. She was stabilized and treated conservatively with corticosteroids, beta blockers, angiotensin-converting enzyme (ACE) inhibitors and diuretics.</p> <p><strong>Conclusion:</strong> It is important for physicians to recognize and develop protocols to identify early signs of CSDH in patients with late stage AD. Early management is a key factor in minimizing more serious complications like recurrence, seizures, and tension pneumocephalus.</p> 2019-08-31T00:00:00-04:00 Copyright (c) 2019 Paul Marcel Morgan Pulmonary Embolism Secondary to Silicone Injection 2019-11-11T13:30:45-05:00 Carolyn Frances Molina Zachary Paul Retalis <p><strong>Background:</strong> The use of silicone for synthetic enhancement in cosmetic procedures has been established for decades but is questionable in safety as it is associated with a range of possible complications. Incidental injection of this polymer into the venous system is not uncommon and can result in the formation of microemboli, which can travel to the lungs. This occurrence can result in a rapid decline of respiratory function and send a patient into severe acute distress.</p> <p><strong>The Case:</strong> This report details a female patient presenting with hemoptysis, presumed to have severe pneumonia until her history of cosmetic treatment was revealed and correlated. Her rapid respiratory decline is followed in inflammatory response markers and radiograph imaging.</p> <p><strong>Conclusion:</strong> A unique treatment approach with prone positioning was used and may play a key role in decreasing mortality in these patients. This report draws attention to the dangers of cosmetic enhancement and raises clinical awareness for associated complications.</p> 2019-08-31T00:00:00-04:00 Copyright (c) 2019 Carolyn Frances Molina, Zachary Paul Retalis Aneurysmal Subarachnoid Hemorrhage in a 68-Year-old Hyperglycemic Female Patient: Case Report and Literature Review 2019-11-11T13:30:42-05:00 Paul Marcel Morgan <p><strong>Background: </strong>While hyperglycemia is intimately associated with uncontrolled diabetes mellitus (DM), recent clinical studies have demonstrated that hyperglycemia is also present in the early acute phase of stroke and is associated with poor prognosis and increased long-term mortality. About half of patients with acute hemorrhagic stroke also present with hyperglycemia upon admission. But more than 50% of patients with acute hemorrhagic stroke develop hyperglycemia even without a previous history of DM. This sheds new light on the relationship between DM, hyperglycemia, and hemorrhagic stroke, with a pathophysiology that is perhaps more profound than is conventionally understood.</p> <p><strong>The Case: </strong>We report a case of a 68-year-old female, with a history of DM Type 2 and stage 3 hypertension who presents to the emergency room (ER) at the Western Regional Hospital in Belmopan City, Belize, with hemorrhagic stroke and hyperglycemia. Diffuse subarachnoid hemorrhage was found in the frontal, temporal, and parietal regions. Mild intraventricular hemorrhage was also observed in the frontal horns and basal cisterns. And small areas of intraparenchymal hemorrhage were present in the frontal lobes. The patient was stabilized and treated conservatively with calcium channel blockers, and diuretics.</p> <p><strong>Conclusion:</strong> Despite a unifying consensus that is still pending, maintaining glucose levels between 110-120 mg/dl by using continuous insulin infusions after traumatic brain injury or aneurysmal subarachnoid hemorrhage may carry some clinical benefit with slightly improved outcome.</p> 2019-08-31T00:00:00-04:00 Copyright (c) 2019 Paul Marcel Morgan What Was the Name of That Drug? How Medical Students can Make the Most Out of Their Education 2019-11-11T13:30:41-05:00 Aryan Riahi David Jung <p>Consolidating all of the knowledge that medical students are expected to learn in their first two years of education can be challenging. Strategies for committing concepts to memory are explored. The importance of making the most out of case-based learning is emphasized. In contrast with passive-styled learning in lectures, CBL takes an active approach requiring students to apply critical thinking. The power of active recall in committing information to memory is also delved into. In particular, one effective and popular form of active recall known as the testing effect is highly recommended. Applying these strategies will help medical students develop a strong foundation for clerkship.</p> 2019-08-31T00:00:00-04:00 Copyright (c) 2019 Aryan Riahi, David Jung