Effects of the Family Status of Osteopathic Medical Students on Their Perceived Level of Stress.

Osteopathic medical students face an exceptional stress-inducing 4-year period of their lives while in medical school. Students who might have an interest in entering marriage during medical school may hesitate to commit, perceiving marriage as a possible additional stressor to the already complex and vast medical curriculum. This investigation aimed to understand the effects of marital status on osteopathic medical student stress levels. An online survey was conducted, and 100 responses were recorded and analyzed. To measure stress levels, the Perceived Stress Scale was utilized. Raw stress scores were compared utilizing t2 analysis while stress level categories, such as low stress, moderate stress, and high stress, were compared using χ2 analysis. The findings show that there is no significant difference between osteopathic medical students who are married and those who are not when comparing for both, raw stress score (P=0.092), and stress score level (P=0.186). These results conclude that marriage does not act as an exacerbator or alleviator for osteopathic medical student stress levels.

Post-surgical Median Arcuate Ligament Syndrome (MALS) Symptom Exacerbation Treated With Osteopathic Manipulative Treatment (OMT): A Case Report.

Median arcuate ligament syndrome (MALS, also known as celiac artery compression syndrome, celiac axis syndrome, celiac trunk compression syndrome, Dunbar syndrome, or Harjola-Marable syndrome) is a rare condition characterized by abdominal pain attributed to the compression of the celiac artery and celiac ganglia by the median arcuate ligament. Pain can occur post-prandially and may be accompanied by weight loss, nausea, or vomiting. Following angiographic diagnosis, current definitive treatment may include open or laparoscopic decompression surgery with celiac ganglion removal (if affected), which has been found to provide relief. In this case report, we outline a young female patient with a MALS diagnosis and subsequent surgery, but whose pain recurred in various stress-related instances even after surgical intervention. After a particular pain episode, osteopathic manipulative treatment (OMT) was applied, with a focus on restoring autonomic balance through the use of various gentle osteopathic treatment techniques. A significant reduction in pain was reported post-treatment, followed by complete pain resolution, indicating a great benefit to the incorporation of OMT into the treatment plan of MALS patients in future osteopathic practice.

Use of Osteopathic Manipulative Treatment for the Management of Pectus Excavatum: A Single Case Study.

Pectus excavatum (PE) is a congenital defect that presents with an anterior depression of the chest wall, which can impact cardiopulmonary function. A 25-year-old hypermobile male presented with a history of PE and chronic dyspnea on exertion, chronic cough, and intermittent chest wall pain. This study explores osteopathic manipulative treatment (OMT) as a possible alternative to improve symptoms associated with PE. Osteopathic structural exam (OSE), volumetric measurements of the thoracic cavity, vitals, and pulmonary function tests were evaluated at baseline and after OMT. The patient was treated with 14 weeks of weekly OMT for his exertional dyspnea, cough, and chest wall pain. Somatic dysfunctions were addressed through OMT, which all improved by the end of the 14-week treatment. Notably, the excursion at the sternal angle increased by threefold after complete treatment. The patient reported subjective improvement in all symptoms, with durable improvement in chest wall pain at 10 months after cessation of treatment. The application of OMT can help alleviate symptoms of pectus excavatum and aid in the management of patients who have not received surgical interventions.

Reduction and Resolution of a Hiatal Hernia Using Osteopathic Manipulative Treatment: A Case Report.

Hiatal hernia is a condition where components of the abdominal cavity, most often a part of the stomach, penetrate through the diaphragm and into the chest cavity. The symptoms of hiatal hernias may differ secondary to their type and severity. The two main types of hiatal hernias are sliding and paraesophageal. Sliding hernias, which are more common and less of a cause for concern, are when the upper portion of the stomach and junction between the stomach and esophagus slides up into the thoracic cavity through a weakened diaphragm. These hernias account for the majority of all hiatal hernias, and their symptoms mimic those of gastroesophageal reflux disorder (GERD) due to laxity in the lower esophageal sphincter. Paraesophageal hernias occur when parts of the stomach and other abdominal organs protrude through the hiatus adjacent to an intact and in-place esophagus and stomach. Obesity and old age are risk factors for hiatal hernias, but they can occur in patients of any age and gender. Although some hiatal hernias may be asymptomatic, patients with positive symptoms may complain of heartburn, regurgitation of liquids and food back into their mouths, dysphagia, or discomfort and pain in the stomach or esophagus. Hiatal hernias are preferentially diagnosed with proper imaging, mainly with an upper gastrointestinal barium study, or by upper gastrointestinal endoscopy. The treatment for hiatal hernias depends on their severity and surgical repairs, if needed, are mostly done laparoscopically. In this case of a patient with a 3 cm hiatal hernia diagnosed with the help of esophagogastroduodenoscopy (EGD), the treatment did not require surgery. Instead, osteopathic manipulative treatment (OMT) was used to restore the functionality of the gastrointestinal tract and the placement of the gastroesophageal junction. The patient's symptoms were found to have improved after the application of OMT alone, with no symptoms of hiatal hernia and resolution of her somatic dysfunctions. The results of this case study suggest that OMT can be effectively utilized to treat the symptoms of hiatal hernias and may also be effective as a curative method as well.

Assessing the Knowledge of the Osteopathic Profession in New York City's Eastern European Communities.

Background According to the decennial Osteopathic Survey of Healthcare in America, the osteopathic profession has been steadily gaining recognition in the United States, particularly among the White/Caucasian demographic. This, however, does not take into account immigrant European communities that, while racially classified as White/Caucasian, may be unexposed to osteopathic physicians (DOs) in their home country and may be reticent to osteopathic manipulative medicine. Data on non-English-speaking communities are limited and can mask the need for further outreach. This study aimed to identify literature in osteopathic outreach to minority communities and assess osteopathic awareness in New York City's Eastern European communities. Secondary objectives include characterization of potential barriers in hindering access to osteopathic medicine, and, by extension, other minority groups. Methodology An anonymous survey prepared in Russian and English was used to gather demographics, education level, healthcare habits, and knowledge of the osteopathic profession. To provide a clinical scenario, a health habit question regarding low back pain (LBP) was provided to participants. Participants over the age of 18 were randomly selected from high density Eastern European areas at two separate time points. Statistical analysis was performed using R to evaluate independence between questions using chi-square tests. Results A total of 150 surveys met the inclusion criteria, with 71 males and 79 females, an age range of 18-92, and a median age of 62. On comparing demographics, education level, and healthcare habits, only English proficiency showed statistical significance (p = 0.039) in determining recognition of the osteopathic profession. Overall, 60% (n = 94) stated that they have heard of osteopathic medicine and knew what a DO physician does. However, only 35% (n = 53) would see a DO for LBP, with 50% (n = 77) seeing a physical therapist. Conclusions Compared to research examining osteopathic awareness in ethnic minority communities, the Russian community in New York appears to have greater recognition of the osteopathic profession. This, however, does not translate into a clinical scenario as more participants were more likely to see a physical therapist. While this difference can be attributed to numerous factors, it stands without doubt that greater osteopathic outreach and data collection needs to be performed in minority communities.

Osteopathic Manipulative Treatment of Herpes Zoster Ophthalmicus/Postherpetic Neuralgia.

Herpes zoster (HZ) and herpes zoster ophthalmicus (HZO) are the result of reactivation of varicella-zoster virus (VZV) from a dormant condition. Although HZ symptoms typically subside after a few weeks, HZO and postherpetic neuralgia (PHN) can persist at least 90 days after the appearance of the HZ rash. Presently, there is no gold standard for a disease-modifying therapy for postherpetic neuralgia and the current treatment is focused on early intervention and management of symptoms and dermatological complications. In the present case, a 74-year-old Caucasian male initially developed severe right-sided eye pain and headache. He was diagnosed with HZO and treated with acyclovir, but later developed swelling over the right eye and skin rash over the right side of the forehead and face. He presented to the office after the acute manifestation of the infection disappeared, but the headache and scalp hypersensitivity persisted and increased. Osteopathic manipulative treatment (OMT) included correction of cranial strains, inhibition, myofascial release, balanced ligamentous tension, and facilitated positional release. In one week, the patient reported a reduction in pain from 10/10 to 2/10. Two weeks later, he reported complete resolution of his initial symptoms. There are a limited number of cases that illustrate the benefit of OMT in diminishing pain and associated symptoms in different types of neuralgias. OMT ensures the restoration of normal anatomical structure and associated function through correcting somatic dysfunction, normalization of blood supply, muscle tone, and lymphatic drainage, therefore, providing pain relief. Better documentation of case reports and more research in this area would greatly benefit the medical community. The present case demonstrates the successful treatment of PHN with OMT. OMT can be successfully used as an adjunct therapy in cases of HZ and PHN.

Treating Bell's Palsy With Osteopathic Manipulative Medicine: A Case Report.

Bell's palsy (BP) occurs when the facial nerve (CN VII) is swollen, inflamed, or compressed, resulting in facial weakness or paralysis; etiology is unknown. BP patients often succumb to a decreased quality of life due to the inability to make facial expressions, increased sensitivity to auditory stimuli, and dysregulation in tear and saliva production. Despite conventional examination and therapy options, the syndrome is majorly regarded as idiopathic and left unresolved for many patients. In this case of a patient with BP, treatment with osteopathic manipulative treatment (OMT) which focused on restoring a normal structure-function relationship resolved the patient's symptoms. The osteopathic manipulative procedures utilized findings from an osteopathic structural exam and addressed those somatic dysfunctions with OMT. The authors report that the patient's symptoms improved after the application of OMT and without the use of pharmaceuticals. The results of the case study suggest that treating BP with OMT can rapidly improve symptoms and can be used without or concurrently with other treatment modalities, if applicable. Patient's consent for this case report was obtained in written and verbal form.

Perceptions of the osteopathic profession in New York City's Chinese Communities.

Objective: The purpose of this study was to assess knowledge of and barriers to osteopathic medicine in Chinese immigrant communities in New York City (NYC). Design: A cross-sectional study was designed in which a culturally appropriate survey in Chinese and English versions was administered anonymously to measure immigrant perceptions and knowledge of osteopathic medicine. Setting: Data collection occurred in the municipal delineations for the Chinatown neighbourhood within the New York, New York borough of Manhattan. Participants: Community members were selected using convenience sampling from high-density areas to participate. Information gathered from the survey included demographics, education level, healthcare habits and knowledge of the osteopathic profession. Results: 120 surveys were conducted with 68 males and 52 females, with an average age=40. Respondents in the age range of 18-29 years, those with fluent English-language proficiency, and participants with graduate-level education status demonstrated a higher proportion of knowledge of osteopathic manipulative medicine and osteopathic physicians (doctors of osteopathic medicine) among the study variables. Conclusion: Compared with research on the general US population, a general lack of knowledge of osteopathic medicine exists within NYC's Chinese immigrant community. Although this difference may be ascribed to linguistics and ethnosociological factors, greater outreach and education is needed in urban minority communities to make immigrants aware of all healthcare resources available during the current shortage of US primary care physicians.

Osteopathic Manipulative Treatment in Tension Headaches.

Tension-type headaches, associated with young age, poor health, sleep disturbances, anxiety, stress, and poor posture, account for 90% of all headaches diagnosed by healthcare professionals. Diagnosis and treatment of the various headache subtypes are often aimed at determining the underlying cause but commonly involve over-the-counter pain medication. Because recurrence is common in tension-type headaches, with a subsequent refractory response to over-the-counter medications, adjunctive and alternative treatment modalities should be further studied. Here we present a case of tension headache initially non-responsive to pain medication but resolved with osteopathic manipulative treatment and lifestyle modifications. Osteopathic considerations and literature are also reviewed in the broader context of headache management.

Osteopathic Philosophy and Manipulation Enhancement Program: Influence on Osteopathic Medical Students' Interest in Osteopathic Manipulative Medicine.

CONTEXT: Interest in osteopathic manipulative medicine (OMM) among first- and second-year osteopathic medical students typically declines toward the end of the second year of medical school. An osteopathic philosophy and manipulation enhancement (OPME) program was implemented for osteopathic medical students to gain additional exposure to OMM at the Touro College of Osteopathic Medicine in New York, New York. OBJECTIVE: To assess how additional exposure to OMM through the OPME program influenced first- and second-year students' interest in using OMM. METHODS: A survey of first- and second-year osteopathic medical students was conducted at the end of the school years to evaluate students' demographics, exposure to OMM before matriculation, reasons for participating in the OPME program, and level of interest in OMM before and after participating in the OPME program. RESULTS: Of 390 students, 204 returned the survey. Respondents reported that their exposure to OMM before enrollment was mostly from reading about OMM philosophy (112 [54.9%]). Respondents also gained exposure from learning about OMM from family members or friends who had been treated by an osteopathic physician (37 [18.1%]), shadowing an osteopathic physician before matriculation (33 [16.2%]), and being treated by an osteopathic physician themselves (22 [10.8%]). After the OPME sessions, respondents reported improved practical skills (98 of 170 [57.6%]) and increased level of confidence in applying OMM (87 of 170 [51.2%]). Nearly half of respondents reported that being treated by a faculty member (100 [49.0%]) was very likely to increase their level of interest in OMM, followed by treating other classmates (77 [37.7%]) and being treated by classmates (73 [35.8%]). CONCLUSION: The OPME program improved students' interest in OMM and can be modified and implemented in any college of osteopathic medicine.