Hallucinogen-Induced Persisting Perception Disorder: A Case Report.

Hallucinogen-persisting perception disorder (HPPD), also known as acute hallucinogen-induced psychosis or informally known as "flashbacks," is an unusual condition experienced by patients due to the use of different hallucinogenic substances. Hallucinogen-persisting perception disorder causes many symptoms, predominantly persistent visual perception distortion instead of intermittent distortion. Although different hallucinogens could cause HPPD, lysergic acid diethylamide (LSD) and LSD-like properties seem to be the most common hallucinogens causing the symptoms. In our case report, the patient is a 28-year-old Caucasian male with a long psychiatric and social history of polysubstance use using LSD and cannabis. He started experiencing many of the classic symptoms of HPPD seven months after stopping LSD. The diagnosis is suspected by ruling out all other possible underlying causes with the help of several laboratory and imaging tests. Despite having an extensive psychiatric history of illnesses, the patient's symptoms failed to improve with antipsychotics, confirming that the symptoms were not only due to mental illness. Although supposedly the first-line treatment for HPPD is the use of alpha-2 adrenergic drugs such as clonidine and benzodiazepines, we started to witness improvement in patient's symptoms with the use of lamotrigine, which is the gold standard in treating perceptual disturbance in time and space.

Overt Hypothyroidism Status Post Pfizer-BioNTech Vaccination: A Case Study.

Coronavirus disease (COVID-19) is among the most contagious viral illnesses, affecting millions worldwide. Although precautions such as social distancing, hand sanitizing, and the use of masks decreased the transmission of the virus, the situation went uncontrolled until vaccination came to light. Vaccination was vital in limiting the incidence, prevalence, and severity caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Based on the mechanism, several types of vaccines, such as Pfizer-BioNTech, Moderna, AstraZeneca, Johnson & Johnson, and Covaxin, were approved by the US Food and Drug Administration (FDA). A booster dose was implemented as the vaccine's effectiveness decreased with time. Several side effects, such as fever, soreness around the injection site, fatigue, chills, muscle weakness, and headache, have been reported after vaccination with Pfizer-BioNTech, but thyroid dysfunction is relatively rare. Several case reports and even case series describing links between COVID-19 vaccination and various types of thyroid dysfunction have appeared in the literature. However, the exact reasons have yet to be explained. This report presents the case of a healthy 50-year-old woman diagnosed with overt hypothyroidism three weeks after the administration of the Pfizer-BioNTech vaccine.

A Case Report of a Benign Fibrous Histiocytoma: A Post-mosquito Bite Reaction.

Fibrous histiocytomas can be differentiated into malignant fibrous histiocytoma or benign fibrous histiocytoma (BFH) and may involve soft tissue and hard bony tissue. A BFH is a rare group of tumors involving fibrocystic and histiocytic elements. Although BFH after a mosquito bite is rare, it must be a part of the differential diagnosis in unresponsive cases of insect bite reactions. A 57-year-old woman with a history of hypertension arrived at the clinic to discuss an 18-year-old lump in her left leg. The patient described the mass as painless and immobile on the anterior part of the left leg. She stated that it had started with a mosquito bite 18 years ago. The woman visited the clinic after her cat scratched the nodule and the erythema on the anterior area of her leg intensified. Physical examination revealed a 10 × 5 × 5 cm solid, stemmed, non-tender mass with erythema on the left leg. A CT scan revealed a stemmed soft tissue mass with well-defined borders. BFH is one of the common types of histiocytoma that is differentiated based on location, which can be dermis, subcutaneous tissue, and deep soft tissues. BFH is predominantly common in young-to-middle-aged females compared to males. BFH can emerge anywhere on the body. However, the occurrence on the lower extremities is high. This case is presented for its rarity and uncommon site of involvement and the significant clinical presentation and emerging condition following a mosquito bite.

Risks and Management of Central Serous Chorioretinopathy in a Middle-Aged Female.

Central serous chorioretinopathy (CSC) is the buildup of fluid in the posterior pole distorting the vision resulting from either neurosensory or retinal pigment epithelial detachment. This is a case report of a 33-year-old female complaining of cloudiness in the left eye who was subsequently diagnosed with CSC using optical coherence tomography (OCT). Remission was observed in four months, possibly from ocular drop treatment or spontaneous. Our case report is unique as the incidence of CSC is more common in males, almost six times higher than in females. Also, the etiology of CSC in this case report is questionable because all the risks are excluded from our patient history.

Is Emergency Remote (Online) Teaching in the First Two Years of Medical School During the COVID-19 Pandemic Serving the Purpose?

Purpose: COVID-19 pandemic and closure of campuses have required a significant and rapid shift in teaching and training methods across health professions education, including remote teaching replacing face-to-face teaching. This study aims to investigate if emergency remote teaching implemented in the first two years of the medical school at Avalon University School of Medicine served the purpose during the COVID-19 pandemic. The effectiveness of emergency remote teaching and on-campus teaching were compared using course evaluations (students' feedback) and students' performance in assessments. Methods: This is a concurrent mixed research method. The quantitative data collected are course evaluations and students' performance in assessments between the two semesters September 2019 (on-campus teaching) and May 2020 (emergency remote teaching). There are three semesters in the first year and two semesters in the second year of the medical program. Each semester has around 10-20 students at any given time. Quantitative data were analyzed for p-values and statistical significance using a t-test. The qualitative data were analyzed using thematic analysis. Results: Results have shown no statistically significant difference (p<0.05) between two semesters (between on-campus teaching and emergency remote teaching) for course evaluations. Even if there is any difference, the mean values were better in May 2020 semester with emergency remote teaching. There was no statistically significant difference (p<0.05) even on students' performance in assessments between two semesters (between on-campus teaching and emergency remote teaching) except for two courses. The thematic analysis of interviews revealed the advantages and disadvantages of online teaching. Conclusion: Emergency remote teaching served the purpose in the first two years of medical school during the COVID-19 pandemic. The advantages of online teaching are flexibility and comfort, and students can save time. The disadvantages are technical challenges, students lacking motivation, lack of personal interaction, and limitations on lab and hands-on experiences.