International Journal of Medical Students <p>The International Journal of Medical Students (IJMS) is a peer-reviewed open-access journal (ISSN 2076-6327) created to share the scientific production and experiences of medical students worldwide. Our objective is to be the primary diffusion platform for medical students, using standards that follow the process of scientific publication.</p> <p>The Journal receives contributions and unpublished manuscripts of Original Articles, Short Communications, Reviews, Case Reports, Interviews, Experiences, and Letters, which are reviewed by experts (Peer-Reviewers). This supports the quality and validity of the publications.</p> <p>The International Journal of Medical Students is published online triannually on behalf of the Executive Committee of the International Journal of Medical Students which main office is located in the United States of America (USA). Any publication, dissemination or distribution of the information included in the Journal is permitted if the source is cited (Int J Med Students).</p> <p>This journal provides immediate <em>open access</em> to its content. There are no article processing charges, submissions fees, or any other costs required of authors to submit, review or publish articles in the International Journal of Medical Students.</p> International Journal of Medical Students Publisher en-US International Journal of Medical Students 2076-6327 <p>Authors who publish with this journal agree to the following terms:</p> <ul> <li class="show">Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="" rel="license">Creative Commons Attribution 4.0 International License</a>&nbsp;that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal.</li> <li class="show">Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li class="show">Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</li> </ul> <p><em>Enforcement of copyright</em></p> <p>The IJMS takes the protection of copyright very seriously.</p> <p>If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.</p> <p>If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to <a href=""></a></p> <p>&nbsp;</p> <p><em>Infringing material</em></p> <p>If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to&nbsp;<a href=""></a></p> Cover, Credits, & Content Executive Board of IJMS Copyright (c) 2019 Executive Committee of IJMS 2019-12-17 2019-12-17 7 3 52 57 10.5195/ijms.2019.455 Characterization of Patients with Guillain-Barré Syndrome in the General Hospital of Mexicali <p><strong>Background: </strong>Guillain-Barré Syndrome is a progressive autoimmune polyradiculoneuropathy characterized by symmetrical flaccid paralysis accompanied by areflexia, hyporeflexia or hyperreflexia on rare occasions. Worldwide, it remains the first cause of flaccid paralysis. It is usually associated with infectious disease history; however, there are various clinical variants, each with a different outcome. Prognosis is usually good, although 20% of patients could suffer a severe clinical variant of Guillain-Barré Syndrome and 5% will die despite treatment.</p> <p><strong>Methods: </strong>This is a cross-sectional study, including the records of hospitalized patients with Guillain- Barré Syndrome at Mexicali’s General Hospital within a five-year period.</p> <p><strong>Results: I</strong>n a five-year span there were 64 patients with Guillain-Barré Syndrome, most of the patients were men (70.3%), with age ranging 1 to 76 years. A total of 8 (12.5%) patients died, from which 7 (87.5%) required mechanical ventilation during hospitalization. Immunoglobulin therapy was provided to 56 (87.5%) patients, and 6 (10.7%) of them perished due to acute kidney injury.</p> <p><strong>Conclusion: </strong>Guillain-Barré Syndrome is a common disease among male population, with no dominating onset age, however, leaning for the young and elder. Most of the patients that were hospitalized at the General Hospital of Mexicali had a history of previous infection (gastrointestinal, respiratory, or other infectious diseases). The need for mechanical ventilation represents a higher severity index, nonetheless, this does not mean that assisted ventilation is directly associated with mortality. As for treatment, immunoglobulin is the most common choice for therapy, though some of the patients died from acute kidney injury.</p> Fátima María Martínez-González Jeremy Hernández-Ríos Arely Gutiérrez Andrés Beltrán René González Hiram Jaramillo-Ramírez Copyright (c) 2019 Fátima María Martínez-González, Jeremy Hernández-Ríos, Arely Gutiérrez, Andrés Beltrán, René González, Hiram Jaramillo-Ramírez 2019-12-17 2019-12-17 7 3 58 61 10.5195/ijms.2019.433 Dyslipidemia and Hyperglycemia in Psoriatic Inpatients <p><strong>Background:</strong> Psoriasis is a chronic cutaneous T-cell mediated disease, which has been associated with many comorbidities, especially with metabolic disorders such as dyslipidemia, diabetes mellitus, obesity, and metabolic syndrome, many of which are themselves risk factors for other diseases. The goal of this study was to evaluate the presence of dyslipidemia and hyperglycemia in patients with psoriasis.</p> <p><strong>Methods:</strong> We compared 48 inpatients with plaque psoriasis aged 29-79, hospitalized between March 2018 and February 2019, to 48 age- and gender-matched controls. We evaluated dyslipidemia and hyperglycemia using enzymatic methods as part of a standard blood test, or medication history indicative of ongoing treatment of dyslipidemia and/or hyperglycemia. Hypertension was evaluated by registering blood pressure greater than 140/90 mmHg or ongoing antihypertensive treatment. Smoking habits were also noted.</p> <p><strong>Results:</strong> There were statistically significant differences between psoriasis patients and controls for elevated total cholesterol (p=0,028), elevated LDL (p=0,015), hypertriglyceridemia (p=0,006), and hyperglycemia (p=0,021). The two groups had statistically insignificant differences for lowered HDL (p=0,084), hypertension (p=1), and smoking (p=0,836).</p> <p><strong>Conclusion:</strong> Hypertriglyceridemia, hyperglycemia, and elevated LDL cholesterol were more prevalent in the group containing psoriatic patients compared to the control group. This indicates that further investigation of metabolic abnormalities should be conducted in psoriatic patients which could greatly benefit from early treatment of the aforementioned underlying conditions.</p> Bojan Popchanovski Margareta Balabanova-Stefanova Copyright (c) 2019 Bojan Popchanovski, Margareta Balabanova-Stefanova 2019-12-17 2019-12-17 7 3 62 65 10.5195/ijms.2019.438 Breast Cancer and Lymphedema: A Narrative Review <p>Breast cancer is the second most common cancer diagnosed worldwide, and the leading cause of cancer death in women. The understanding of disease presentation by patients and health care providers is crucial for a correct diagnosis and management.&nbsp; Preventive measures emphasize risk-reducing behaviors such as a healthy diet, reduced alcohol consumption, increased physical activity, and breastfeeding children. Screening techniques such as mammography, ultrasound, and MRI aid in early detection. Following the screening, a breast biopsy is performed, and a histopathological assessment is carried out to confirm a breast cancer diagnosis<em>.</em> In addition to surgery, radiotherapy, and lifestyle modifications, treatment regimens include a range of medications such as anti-hormonal drugs and chemotherapy. Lymphedema is a severe and major long-term consequence of breast cancer treatment. The major contributors to the diminished lymph drainage are a lumpectomy/mastectomy procedure that involves the surgical removal of lymph nodes, and radiotherapy. The fluid accumulation of lymphedema poses physical limitations to the patient and impacts the overall quality of life. A sentinel lymph node biopsy is an essential method of identifying the first draining lymph nodes affected by metastasis. This procedure allows surgeons to later remove only affected lymph nodes, sparing those that are unaffected and hence reduce the risk and magnitude of lymphedema development. Patients who receive education about lymphedema demonstrate higher compliance with treatment and self-care management practices. The purpose of this review is to provide information about breast cancer, the development of lymphedema, and how to recognize and manage both.</p> Athena Michaelides Constantina Constantinou Copyright (c) 2019 Athena Michaelides, Constantina Constantinou 2019-12-17 2019-12-17 7 3 66 72 10.5195/ijms.2019.362 Outcomes of Patients Referred for Arteriovenous Fistula Construction: A Systematic Review <p>Chronic Kidney Disease (CKD) affects 10-16% of the US population and its incidence is rising due to increasing prevalence of associated risk factors. Renal replacement therapy is required to treat late stage CKD and hemodialysis is the preferred modality for many patients. Vascular access is required for hemodialysis and arteriovenous fistulas (AVF) are currently the gold standard. This review intended to collate current knowledge on AVF outcomes regarding both the patient and fistula.<strong>&nbsp;</strong>Scopus and Medline were utilized to identify relevant literature. Inclusion and exclusion criteria were applied to narrow search results. Among CKD patients, 33.5-77.4% require a central venous catheter (CVC) before dialysis through a fistula. Many patients (33-51%) use a CVC regardless of AVF creation due to fistula immaturity or failure. There are large variations in AVF creation policies internationally; 16% of American hemodialysis patients use a fistula compared to 72% of German patients. Primary patency and primary AVFs' failure ranges from 60-70% and 20-26%, respectively.&nbsp;AVFs reduce morbidity and mortality in CKD. At present, too many patients are receiving hemodialysis through a CVC. Inadequate referral times for AVF creation can lead to fistula immaturity or failure in the intervention. Many countries are lagging behind recommended AVF creation rates published by the Kidney Disease Outcomes Quality Initiative. There is a paucity of literature concerning when a patient should be referred for AVF creation. It is paramount to have better predictive outcome measures and more clarity as to when patients will benefit from an AVF.</p> Andrew Stanton Kucey Anish Engineer Shawn Stefan Albers Copyright (c) 2019 Andrew Stanton Kucey, Anish Engineer, Shawn Stefan Albers 2019-12-17 2019-12-17 7 3 73 81 10.5195/ijms.2019.331 The Role of Intraindividual Carotid Artery Variation in the Development of Atherosclerotic Carotid Artery Disease: A Literature Review <p>Carotid artery disease (CAD) is associated with numerous risk factors, including hypertension, hyperlipidemia, hypercholesterolemia, diabetes mellitus, and smoking. These systemic risk factors do not affect the carotid arteries equally in most patients, resulting in asymmetrical bilateral and unilateral CAD. It is unclear if anatomic variations in the carotid arteries predispose an individual to formation of atherosclerotic CAD. We wanted to assess (1) the inter-individual or intra-individual anatomical variations in the carotid arteries and (2) whether anatomical variations predispose the development of atherosclerotic CAD. PubMed and Medline were utilized to identify relevant literature for critical appraisal, summarization and documentation. Inclusion and exclusion criteria were applied to narrow results and articles were critically appraised and analyzed. Evidence suggests that a low outflow/inflow ratio, elevated bifurcation height, and bifurcation angle are associated with increased risk for CAD. Sex and age demonstrated positive correlation with the disease. Additionally, tortuosity and kinking of the carotid arteries may affect the formation of CAD but coiling of the arteries is a natural age-dependent process and does not affect CAD development. This review suggests there are anatomic variations in the carotid arteries that increase the risk of developing carotid artery disease. The most significant risk factors include a low outflow/inflow ratio, increased internal carotid artery tortuosity, elevated bifurcation height, and bifurcation angle.</p> Shawn Stefan Albers Andrew Stanton Kucey Anish Engineer Copyright (c) 2019 Shawn Stefan Albers, Andrew Stanton Kucey, Anish Engineer 2019-12-17 2019-12-17 7 3 82 91 10.5195/ijms.2019.380 Predatory Journals: What You Need to Know About Them? <p>N/A</p> David Avelar-Rodriguez Copyright (c) 2019 David Avelar-Rodriguez 2019-12-17 2019-12-17 7 3 92 94 10.5195/ijms.2019.449 Sculpture for Surgeons Natalia Katarzyna Bober Copyright (c) 2019 Natalia Katarzyna Bober 2019-12-17 2019-12-17 7 3 95 96 10.5195/ijms.2019.435 Having Diabetes in a Middle-Income Country Diego Carrion Alvarez Nallely Alejandra Obregon Perales Copyright (c) 2019 Diego Carrion Alvarez, Nallely Alejandra Obregon Perales 2019-12-17 2019-12-17 7 3 97 99 10.5195/ijms.2019.423 Medical Students Burning Out: Why and What We Can Do About It? Abuzar Siraj Copyright (c) 2019 Abuzar Siraj 2019-12-17 2019-12-17 7 3 100 101 10.5195/ijms.2019.421 Acknowledgement of Reviewers Vol 7 (2019), IJMS Executive Committee of IJMS Copyright (c) 2019 Executive Committee of IJMS 2019-12-17 2019-12-17 7 3 102 103 10.5195/ijms.2019.456