Journal of Medical Sciences at NEOMED
type: channel
description: The Journal of Medical Sciences at Northeast Ohio Medical University (NEOMED) is a student-led, peer-reviewed scholarly journal created to provide a platform for NEOMED students, faculty, consortium hospital trainees and affiliates to publish original research, opinion pieces, editorials, reviews, abstracts and other works.
language: en
publication name: Journal of Medical Sciences at NEOMED
issn: 3070-6386
items: Giving Tuesday: Alternative Fundraising in the Era of COVID-19
items: The Law and Ethics of Non-beneficial Treatment Policies
items: Comparison of the Wellness of a Medical School to General Student Population
items: Prescription Drug Donation and the Private Sector—Why Ohio’s Medical Students Should Care
items: A Review of the Predisposition to Child Abuse
items: Lumateperone in the Treatment of Schizophrenia: A Review
items: Enhancement of Early-Stage Cancer Detection by Liquid Biopsy using Nanoparticle Platforms
items: TURMERIC - The Golden Herb!
items: Human Connection Through Wi-Fi: Is it possible?
items: Cardiac Metabolism in the Diseaase of Acute Myocardial Infarction
items: Enhancing Diversity in Medical Education Representation of Cutaneous Disease: VisualDx Skin-of-Color Atlas
items: Improving Community Health by Encouraging Remote Office Visits
items: Robotic Assisted Laparoscopic Prostatectomy Post-Prostatic Urethral Lift Implants
items: Efficacy of the Glasgow Coma Scale in Determining the Severity of Traumatic Brain Injury
items: Chemical and Histopathologic Effects of COVID-19 on Virchow’s Triad
items: Using Ancient Spices to Treat Chronic Diseases: Turmeric’s Potential to Modulate Disease Pathogenesis in Rheumatoid Arthritis and Inflammatory Bowel Disease
items: Burnout and Wellness in the College of Medicine at Northeast Ohio Medical University
items: Telehealth Access of Geriatric Patients During COVID-19: A Provider Team Survey
items: A Histological and Qualitative Analysis of Muscle Spindle Density in the Distal Head of M. Extensor Longus Digiti Majoris
items: Organizing a Student Led Virtual Research Conference Focused on Addressing Disparities in a Rural Community
items: An Updated Review of Bone Mineral Density and Osteoporosis Prevalence in Postmenopausal Hispanic Women
items: Qualitative Analysis of Anterior Cruciate Ligament Reconstruction Surgery in the Hispanic Population
items: YAP Signaling is Involved in Keratinocyte Proliferation and Tumorigenesis Mediated by RIPK4 Knockdown
items: The Current State of the Mitochondrial Diseases LHON, MELAS and Leigh Syndrome and Their Treatments: A Review
items: Key Practice Indicators for Hypothermia Management for Neonates in Rural Nepal
items: ICUS to ICU: A Case of Germline DDX41 Mutation in a Patient with Idiopathic Cytopenia of Undetermined Significance (ICUS)
items: Meningitis Following Otologic Surgeries: A Review
items: Erythrodermic Psoriasis: A Case Report
items: Establishment of a New Level 4 Hospital Facility in Machakos County, Kenya

Giving Tuesday: Alternative Fundraising in the Era of COVID-19
type: item
description: This abstract discusses a virtual alternative to Casino Night: Giving Tuesday. Non-profit community health services, including free clinics, provide many aspects of care to community individuals. These individual needs are amplified as community health services are strained both financially and physically by the COVID-19 pandemic. Community health workers have been shown to provide vital services to communities, including advocating on behalf of patients, transferring and interpreting information, and ensuring patients are connected to care.1 In-person fundraising events for these programs are restricted, leaving free clinics and other services across the country in need of alternatives to fundraising due to restrictions placed by COVID-19. The Student-Run Free Clinic (SRFC) at Northeast Ohio Medical University (NEOMED) has responded to this challenge by establishing a virtual fundraising initiative, which has profited close to double of in-person events. In the past, the SRFC at NEOMED has hosted a one-night in-person fundraising event, Casino Night, which annually generated a profit of over $10,000. Casino Night was attended by 250 community members with earnings coming from both ticket sales and donations. However, due to COVID-19, a large gathering was not possible, rendering the SRFC at NEOMED’s main fundraiser obsolete. In this abstract, we discussed a virtual alternative to Casino Night: Giving Tuesday. This world-wide initiative used social media to reach audiences traditional fundraising methods may neglect.2 We compared the processes of planning and organizing our 2019 in-person fundraiser to the 2020 virtual fundraiser. Costs to host the fundraisers and overall proceeds were also compared. Giving Tuesday was the most successful fundraiser in clinic history with a profit of $21,330.90 and an operating expense of $0 to the SRFC. The NEOMED Foundation provided the SRFC free access to the online donation portal, GiveCampus, a service the university previously…
subject: Articles
  topic: section
subject: fundraising
  topic: keywords
subject: free clinic
  topic: keywords
subject: Giving Tuesday
  topic: keywords
creator: Lacey Madison, MBA, MEd, LSSBB
creator: Sanjay K.A. Jinka, BS
creator: Sneha Gundavarpu, BS
creator: Whitney Stolnicki, MD
rights: Copyright (c) 2025
date: 2025-04-22
publication date: 2025-04-22

The Law and Ethics of Non-beneficial Treatment Policies
type: item
description: A non-beneficial treatment is defined as when a physician decides that the patient’s prognosis of a medical illness or injury, cannot be altered by a certain form of treatment.1 No medical therapy can improve the patient’s prognosis or condition. The ethics regarding non-beneficial treatment policies are of great debate due to their lack of consistency between healthcare systems. This paper compares the non-beneficial treatment policies between a hospital that operates under religious values and one that bases their values on community and population health with no religious ties. These policies will be compared to the guidelines put forth by the American Medical Association (AMA) Code of Medical Ethics, American Thoracic Society (ATS), American Association for Critical Care Nurses (ACCN), American College of Chest Physicians (ACCP), European Society for Intensive Care Medicine (ESICM), and Society of Critical Care (SCCM). The purpose of this paper is to highlight how subjective these policies can be and how their inconsistencies between hospital systems can lead to harmful patient outcomes.
subject: Articles
  topic: section
subject: medical ethics
  topic: keywords
subject: non-beneficial treatment
  topic: keywords
subject: health care systems
  topic: keywords
subject: health care law
  topic: keywords
creator: Emily Marsico, BS
creator: Julie Aultman
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Comparison of the Wellness of a Medical School to General Student Population
type: item
description: When compared to the general population, healthcare students have been shown to have significantly higher rates of burnout, depression, anxiety, and suicidal ideation. However, there is limited data regarding mental health, access to mental health resources, and utilization of mental health resources by healthcare students in comparison to other student populations. This study aims to evaluate a medical university’s mental health and access/utilization of resources when compared to the general student population. Survey results from The Healthy Minds Study (HMS) of Northeast Ohio Medical University (NEOMED) students were compared to a national sampling of graduate and post-graduate student populations. Categories that were assessed included mental health status (previous diagnosis, depression/ anxiety related symptoms experienced recently or within the past 12 months) and access/utilization of resources (support system, use of psychotropic medications). Analysis was completed through individual Chi-squared tests. Compared to the national sample NEOMED students were less likely to talk to a professional clinician (p=0.017), friend (p=0.001), significant other (p=0.009), or family member (p=0.001) about distress and were less likely to be on anti-anxiety medications (p=0.018). NEOMED students were less likely to be unsure of where to go for help (p=0.009) while preferring to deal with issues on their own (p=0.001); NEOMED students were less likely to report a history of depression (p=0.044) or anxiety (p=0.028). NEOMED students were more likely to have no days of the week be impacted by mental difficulties (p=0.005), and NEOMED students were more likely to strongly disagree that they were in need of help for their mental state (p=0.047). Despite the intensity of healthcare training, this survey showed that students at NEOMED were no worse than the general student population in terms of access and utilization of mental health resources and mental functioning. The data …
subject: Articles
  topic: section
subject: mental health
  topic: keywords
subject: students
  topic: keywords
creator: Amy Adik, BS
creator: Sanjay K.A. Jinka, BS
creator: Christian Seif, BS
creator: Theodore Weber, BS
creator: Anika A. Jinka
creator: Randon S. Welton, MD
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Prescription Drug Donation and the Private Sector—Why Ohio’s Medical Students Should Care
type: item
description: This perspective piece discusses the important role donation of prescription medication from the private sector plays in the financial health of Ohio’s free clinics and the patients they serve. It also discusses recent changes in Ohio’s nursing home industry that have altered this vital pipeline, why medical students should care about them, and a personal anecdote from the author about the impact these changes can have on patients.
subject: Articles
  topic: section
subject: prescriptions
  topic: keywords
subject: prescription donation
  topic: keywords
subject: drug depository
  topic: keywords
subject: free clinics
  topic: keywords
creator: Jonathan Markle
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

A Review of the Predisposition to Child Abuse
type: item
description: This present review focuses on evaluating works investigating potential risk factors for child abuse. Child abuse is a complex issue, which has many contributing risk factors. Child abuse encompasses physical abuse, sexual abuse, emotional abuse, and child neglect. Each component has its own consequence to a child's health and wellbeing. Theories have been developed to explain the causes of and the predisposition to child abuse. Several studies exist which investigate the relationship between child abuse and a variety of risk factors. Risk factors that have been shown to correlate with child abuse include parental problems and difficulties, prior sexual abuse victimization of a child or siblings, social isolation of a child and family, child drug use, poor social skills, parental substance abuse, and neighborhood risk factors. Focusing on these theories and risk factors can lead to a better understanding of the predisposition to child abuse.
subject: Articles
  topic: section
subject: child abuse
  topic: keywords
subject: risk factors
  topic: keywords
subject: predisposition
  topic: keywords
creator: Sonia Kshatri, BS
creator: Hannah Girgis, BS
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Lumateperone in the Treatment of Schizophrenia: A Review
type: item
description: Schizophrenia is a devastating mental illness that afflicts about 1% of the world’s population. This illness distorts a person’s perception of reality and consists of positive symptoms such as hallucinations and delusions, negative symptoms such as inattention and withdrawal, and cognitive deficits. Antipsychotic drugs are primarily used for the pharmacotherapy of schizophrenia. In this article, we provide a succinct review of a recently approved novel antipsychotic, lumateperone. We present an overview and history of schizophrenia, its symptoms, epidemiology, etiology, and pathophysiology. The classification of antipsychotic agents as first and second-generation based on their receptor affinity is discussed. The review focuses on describing the background, development, receptor pharmacology, mechanism of action, pharmacokinetics, clinical trials, adverse effects, therapeutic uses, and future prospects of lumateperone.
subject: Articles
  topic: section
subject: antipsychotic
  topic: keywords
subject: atypical
  topic: keywords
subject: lumateperone
  topic: keywords
subject: schizophrenia
  topic: keywords
subject: 5-HT2A serotonin receptor
  topic: keywords
creator: Gabrielle T. Robinson, BS
creator: Altaf S. Darvesh, MPharm, PhD
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Enhancement of Early-Stage Cancer Detection by Liquid Biopsy using Nanoparticle Platforms
type: item
description: Cancer has consistently been a public health burden for many decades, responsible for high mortality and morbidity rates worldwide. Effective cancer diagnostic methods are crucial to improving patients' survival and timely implementation of therapeutic and surgical interventions. Current diagnostic technologies are much more efficient in detecting cancer at late stages (stages 3 and 4) than early stages (stages 1 and 2), typically in solid tumor-based cancers. Meanwhile, cancer metastasis is a prominent feature of late stages, which poses a significant barrier to the effectiveness of therapeutic and surgical interventions. Thus, detecting early-stage cancer is crucial when the disease remains within the primary site. Though liquid biopsy has gained attention for noninvasive and low-cost diagnosis, cancer biomarkers present at early stages are at concentrations too low for conventional methods to detect with specificity. The low concentrations of early-stage cancer biomarkers pose a significant barrier in diagnosing patients with high sensitivity and specificity. This drawback can be addressed through an innovative combination of diagnostic nanoparticle platforms with liquid biopsy procedures. The strategy has been demonstrated to remarkably improve the efficiency of detecting early-stage biomarkers at the lowest concentration possible, i.e., decreasing the limit of detection (LOD). This review will assess the utility of various nanoparticle platforms in developing novel diagnostic techniques for early-stage cancer detection.
subject: Articles
  topic: section
subject: early-stage cancer
  topic: keywords
subject: gold nanoparticles
  topic: keywords
subject: quantum dots
  topic: keywords
subject: magnetic nanoparticles
  topic: keywords
creator: Pratyusha Ghanta, MPharm
creator: Timothy Winschel, BS
creator: Moses O. Oyewumi, BPharm, PhD
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

TURMERIC - The Golden Herb!
type: item
description: The curry spice, turmeric, is used to provide color and flavor to food, as well as for its health benefits. Turmeric contains many polyphenolic compounds known as curcuminoids, with curcumin being the most prominent curcuminoid. In this perspective, the health benefits of turmeric curcuminoids are highlighted. Specifically, this perspective summarizes the source, history, and the general use of turmeric. The pharmacology, especially the antioxidative and anti-inflammatory properties, safety, and the pharmacokinetic profile, as well as the therapeutic potential of curcuminoids in several disease conditions is discussed. The development of semi-synthetic forms and novel formulations for delivery of curcuminoids is mentioned. This article reflects upon the current status of turmeric use and the potential challenges, as well as future steps needed for development of curcuminoids as therapeutic agents in the clinic.
subject: Articles
  topic: section
creator: Altaf Darvish
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Human Connection Through Wi-Fi: Is it possible?
type: item
description: Due to the COVID-19 pandemic, all medical student assessments at Northeast Ohio Medical University (NEOMED) were redesigned to be performed virtually. This included my final standardized patient encounter. As nerve-wracking as it may feel to perform any aspect of the physical examination, it serves as a rite of passage for medical students transitioning into clinical rotations all around the country. My biggest concern was that my practice sessions and other standardized patient encounters had always occurred in person over the course of my first two years of medical school. Would I be able to successfully examine a patient virtually? Would I be able to connect with my patient to gather the sometimes personal, yet pertinent, details of medical history through a virtual platform? Knowing specific questions to review each organ system was not enough, and I knew I needed to identify more strategies to connect with patients. Empathizing and connecting with my patient through a virtual platform proved to be much harder than I expected. I no longer had the privilege or security of directly facing my patients. Human connection and empathy were the original foundation of my history-taking and physical examination skills. Staring at my laptop screen, I practiced. I practiced using my eyes to gaze with compassion. I practiced keeping my lips sealed to motivate my patient to overcome their hesitations. I practiced using my hands to encourage my patient to open up and trust me with their problems. I practiced nodding my head to aﬃrm my patient’s feelings. Every part of my physical nature served to complement my purpose. This was not so that my encounter would feel scripted. Rather, I did not want my screen to numb my non-verbal communication skills just because I could hide behind it. On test day, I was able to virtually empathize with my patients by making eye contact, listening to their problems, and trying to absorb each part of the conversation and guide it in the direction…
subject: Articles
  topic: section
creator: Sanaa Mansoor, MS, MD
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Cardiac Metabolism in the Diseaase of Acute Myocardial Infarction
type: item
description: Overproduced reactive oxygen species (ROS) with decreased oxidative phosphorylation is a hallmark of the post-ischemic heart, which results in reperfusion-induced oxidative injury of the citric acid cycle (CAC). During ischemia, hypoxic conditions slow down the CAC resulting in succinate accumulation. Succinate is then rapidly oxidized during reperfusion, fueling ROS overproduction and contributing to ischemia- reperfusion (I/R) injury. We test the hypotheses that 1) reperfusion re-accelerates the CAC to correct succinate accumulation and 2) a vicious cycle caused by excess ROS can impair and downregulate the CAC plus other metabolic pathways in the post-ischemic heart. Nine–ten-week-old Sprague-Dawley rats (n=15) were subject to coronary ligation for 30-min followed by 24-h reperfusion. This process allowed us to closely mimic acute myocardial infarction (MI) and I/R injury. The non-ischemic and risk-regions of myocardium were excised, and the mitochondria were isolated. Dimethyl labeling was used to illuminate key metabolic pathways. Previous studies showed data that I/R impairs ADP-dependent O2 consumption rate and ATP generation via downregulating CAC and fatty acid β-oxidation. However, a major finding in our study was that I/R dramatically upregulated the Phosphocreatine (PCr)/Creatine (Cr) shuttle (p<0.05) via upregulation of mitochondrial S-type creatine kinase (Ckmt2). The increased PCr formed in the mitochondria is transferred to the cytosol for ATP regeneration in-situ, which therefore increases the bioenergetic support of the post- ischemic myocardium. Therefore, we conclude that upregulating the PCr/Cr shuttle via increased Ckmt2 serves as feedback regulation of I/R, which can be useful for therapeutic intervention by increasing oxygenation and bioenergetics of the ischemic heart.
subject: Articles
  topic: section
creator: Nikhil Datla, MD
creator: Chwen-Lih Chen, PhD
creator: Patrick Kang, PhD
creator: Yeong-Renn Chen, PhD
creator: Takhar Kasumov, PhD
creator: Serguei Ilchenko, PhD
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Enhancing Diversity in Medical Education Representation of Cutaneous Disease: VisualDx Skin-of-Color Atlas
type: item
description: The COVID-19 pandemic has recently brought to light the gross underrepresentation of cutaneous pathology in SoC. In early 2020, dermatologists created an international registry to compile cases of dermatological manifestaions of COVID-19, to gather clues to the disease and aid diagnosis. Out of the 700 submissions to the registry, there were only 34 Hispanic patients and 13 black patients represented (5). Despite the pandemic starting in March, it took until July of 2020 for the first pictures of "Covid toes" in nonwhite patients to be published in the Journal of the American Academy of Dermatology. This prompted Adelekun et al. to launch an investigation on how severely underrepresented SoC truly is. According to their study published in April 2020, only 4.5% of images in general medicine textbooks illustrate dermatologic diseases in dark skin (6). It is clear that the underrepresentation of SoC in medicine is not a new issue, and physicians worldwide are starting to notice the injustice.
subject: Articles
  topic: section
subject: Perspective
  topic: keywords
subject: Bias
  topic: keywords
subject: Dermatology
  topic: keywords
subject: Medical Education
  topic: keywords
creator: Arjun Pandya, MD, MBA
creator: Jay Patel, MD
creator: Sarah Eley, BS
creator: Rachel Krevh, BS
creator: Kishan Pandya, BS
creator: Rahul Mal, MD
creator: Kelly Kimball, BS
creator: Eliot Mostow, MD, MPH
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Improving Community Health by Encouraging Remote Office Visits
type: item
description: The COVID-19 pandemic has affected patient access to healthcare in the field of dermatology. Due to efforts to minimize in-person healthcare visits, wait times for dermatology visits have increased, negatively affecting patients’ finances and furthering concerns about their skin conditions. This commentary highlights how the pandemic will potentially change the future of dermatology by promoting the use of telemedicine to reduce office wait times during the pandemic and beyond.
subject: Articles
  topic: section
subject: Telemedicine
  topic: keywords
subject: Teledermatology
  topic: keywords
subject: COVID-19
  topic: keywords
subject: Dermatology
  topic: keywords
subject: Remote
  topic: keywords
subject: Wait Times
  topic: keywords
creator: Rachel Krevh, BS
creator: Eliot Mostow, MD, MPH
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Robotic Assisted Laparoscopic Prostatectomy Post-Prostatic Urethral Lift Implants
type: item
description: Prostate cancer is the second most commonly diagnosed form of cancer in men. While there are several treatment options for prostate cancer, robotic assisted laparoscopic prostatectomy is a customary option in the treatment of clinically localized disease. It entails prostate removal using the Intuitive da Vinci surgical system. Another very prominent urologic condition affecting older males is benign prostatic hyperplasia (BPH); BPH has an increased lifetime prevalence reaching 80% of men by the 9th decade of life. It is characterized by lower urinary tract symptoms due to prostatic enlargement. These conditions often develop concomitantly in males given the high prevalence of each. Surgical advancements such as the prostatic urethral lift (PUL) system are becoming more commonly utilized. However, patients with benign prostatic hyperplasia who independently develop clinically significant prostate cancer may necessitate definitive management, namely prostatectomy. In this case report, we discuss a 67-year-old male presenting with Gleason group 2 (3+4=7) prostate cancer with previous PUL implants, who then underwent robotic assisted laparoscopic radical prostatectomy. Prostatectomy following prior PUL implantation has never been fully discussed in the literature, and there are no intraoperative or postoperative complications from prostatectomy to report thus far.
subject: Articles
  topic: section
subject: Prostatectomy
  topic: keywords
subject: Prostate Cancer
  topic: keywords
subject: Benign Prostatic Hyperplasia
  topic: keywords
subject: Prostatic Urethral Lift
  topic: keywords
creator: Matthew R. DeSanto, MD
creator: Daniel J. Ricchiuti, MD
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Efficacy of the Glasgow Coma Scale in Determining the Severity of Traumatic Brain Injury
type: item
description: Mr. D, a 52-year-old male, was in an un-helmeted motorcycle collision with a concrete barrier resulting in polytrauma and traumatic brain injury. Mr. D was assessed by emergency services to be unresponsive with a Glasgow Coma Scale (GCS) of 13. He sustained an open skull injury, subdural hematoma, multiple facial fractures, and traumatic vitreous humor hemorrhage with unresponsive, dilated pupils. He received CT and X-ray imaging before undergoing multiple surgeries for repair and debridement of injuries. After being weaned off sedation, he entered a state of post-traumatic amnesia lasting two months. Fifteen days post- accident, he began a regimen of amantadine to stimulate interaction and participation in physical therapy. Mr. D remained for two months until he progressed with physical therapy and was independent with his mobility. He was admitted to an inpatient traumatic brain injury facility because he was mentally unable to care for himself.
subject: Articles
  topic: section
subject: Traumatic Brain Injury
  topic: keywords
subject: Glasgow Coma Scale
  topic: keywords
subject: Physical Medicine & Rehabilitation
  topic: keywords
creator: Vihanga Perera, MD
creator: Harris Imam, MD
creator: Percival Pangilinan, MD
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Chemical and Histopathologic Effects of COVID-19 on Virchow’s Triad
type: item
description: Although COVID-19 is known primarily as a respiratory disease, infected patients have been known to experience COVID-19-associated coagulopathy from overactivation of immune response resulting in cytokine storm. As a fundamental principle of venous thromboembolism, Virchow’s triad – consisting of stasis, hypercoagulability, and endothelial injury – remains the foundation for increased clotting risk which can often precipitate life-threatening complications, such as pulmonary embolism, if left untreated. We conducted a literature search using PubMed for evidence to explain the increased coagulopathy in COVID- 19 positive patients in relation to the three pillars of Virchow’s triad. Hypercoagulability in COVID-19 patients is increased due to cytokine-induced fibrin clot formation. Infected patients also have decreased ADAMTS13, which leads to endothelial injury. Lastly, the increased blood viscosity combined with patient immobility promotes vascular stasis. These factors put COVID-19 patients at an increased risk of acquiring blood clots. In conclusion, we have defined a plausible mechanism by which COVID-19 may induce venous thrombosis using the three components of Virchow’s triad. Due to the fatal nature of vascular complications, it is important to consider prophylactically treating these patients with a low molecular weight heparin regimen in order to mitigate the effects of hypercoagulability.
subject: Articles
  topic: section
subject: COVID-19
  topic: keywords
subject: Virchow’s triad
  topic: keywords
subject: venous thromboembolism
  topic: keywords
subject: hypercoagulability
  topic: keywords
subject: endothelial injury
  topic: keywords
subject: venous stasis
  topic: keywords
subject: anticoagulation
  topic: keywords
creator: Jay P. Natarajan, BS
creator: Ashorne K. Mahenthiran, BA
creator: Gary W. Lemmon, MD, FACS
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Using Ancient Spices to Treat Chronic Diseases: Turmeric’s Potential to Modulate Disease Pathogenesis in Rheumatoid Arthritis and Inflammatory Bowel Disease
type: item
description: This review aims to highlight two major health conditions that could benefit from regular supplementation of turmeric, as well as to discuss the importance of more widespread uses of this natural therapeutic in commonly used multivitamins and multi-drug regimens. There is a wide range of potential benefits patients could gain from this supplement, but we will be focusing only on the effects on inflammation in two of the most prevalent chronic inflammatory diseases, rheumatoid arthritis (RA) and inflammatory bowel disease (IBD). We propose that turmeric supplementation could be more commonly used in a healthcare setting as an adjuvant treatment in these inflammatory conditions. Future studies investigating turmeric’s role for treatment in RA and IBD must aim to further evaluate the effects of curcumin on the human microbiota and how its bioavailability can be increased to provide therapeutic results.
subject: Articles
  topic: section
subject: Tumeric
  topic: keywords
subject: Anti-Inflammatory
  topic: keywords
subject: Irritable Bowel Disease
  topic: keywords
subject: Rheumatoid Arthritis
  topic: keywords
creator: Kelly Kimball
creator: Giovanna Leone
creator: Bina Mehta
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Burnout and Wellness in the College of Medicine at Northeast Ohio Medical University
type: item
description: Burnout is a syndrome of professional distress defined by symptoms of emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment. Previous surveys (Wellness Surveys) at Northeast Ohio Medical University (NEOMED) seemed to have demonstrated low scores in the wellness categories. As such, we sought to investigate further the frequency and factors of medical student burnout symptoms, the quality of medical student wellness, and contributing stressors at NEOMED. Over three weeks, an anonymous 8-question survey was sent out via e-mail to all NEOMED College of Medicine students. This survey included a novel scale created by the authors to measure burnout, wellness, and contributing stressors. The survey was done on Qualtrics SM Survey software and was statistically analyzed by class using Microsoft Excel. The survey was completed by 166 students (participation = 28%). Results demonstrated statistically significant differences in burnout and multiple components of wellness when stratified by class. Burnout and suboptimal wellness were most severe in preclinical (M1-M2) years. Groups rating higher frequencies of burnout also rated lower qualities of wellness. Nearly 50% of all respondents feel the challenge of medical school was more difficult than expected. At NEOMED, peak burnout frequencies and suboptimal wellness ratings are in the preclinical years. Groups that scored higher frequencies of burnout also scored poorer on wellness ratings. A systematic approach dedicated to promoting wellness at NEOMED may lead to lower frequencies of burnout.
subject: Articles
  topic: section
subject: Burnout
  topic: keywords
subject: Wellness
  topic: keywords
subject: Education
  topic: keywords
subject: Mental Health
  topic: keywords
creator: Arjun Pandya
creator: Akanksha Dadlani
creator: Alexander E. Isla
creator: Amy Adik
creator: Randon Welton
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Telehealth Access of Geriatric Patients During COVID-19: A Provider Team Survey
type: item
description: The COVID-19 pandemic has prompted the rise in the use of virtual healthcare through Telehealth. The importance of Telehealth is multi-fold, from communicating with patients virtually to providing care when in-person services are unavailable. Although this virtual platform has significant benefits, the geriatric population is underutilizing this resource. Our initial objective was to understand the perceptions of healthcare providers and their assessment of the comfort level and the utility of telehealth software for geriatric patients. We surveyed Geriatric specialists, Social Workers, Registered Nurses, and healthcare management team members regarding their perceptions of the rise and utility of telehealth before and after the pandemic. The survey was conducted in Northeast Ohio, specifically from Summa Health Akron City Hospital and the Direction Home Akron Canton Area Agency on Aging and Disabilities. 72.7% of those invited completed the survey, specifically five (33.3%) were physicians. Additionally, we surveyed participants regarding patient capability and understanding of telehealth software. A large subset of participants using telehealth (69.2%) stated that their patients fell between “somewhat uncomfortable” to “completely uncomfortable” in utilizing telehealth. Regarding their use of blood pressure and glucose monitors, 76.9% felt their patients had a “medium comfort” level. Finally, 92.3% would find a volunteer service to help train patients and caregivers in the use of telehealth software and medical devices “extremely helpful.” These data demonstrate a perception among geriatric providers that patients have difficulties using telehealth. Our goal is to develop a student-led virtual program to better assist patients and providers in the use of telehealth modalities.
subject: Articles
  topic: section
subject: Telehealth
  topic: keywords
subject: COVID-19
  topic: keywords
subject: Geriatrics
  topic: keywords
subject: Telemedicine
  topic: keywords
creator: Sohi Mistry
creator: Siddhartha Singh
creator: Alisha Gupta
creator: Sanjay Jinka
creator: Maahi Mistry, BS
creator: Mariquita Belen
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

A Histological and Qualitative Analysis of Muscle Spindle Density in the Distal Head of M. Extensor Longus Digiti Majoris
type: item
description: Inconspicuous muscles in avian taxa have been previously discussed as vestigial remnants, however, evidence has shown that such muscles may hold a function in flight. Further investigations into inconspicuous muscles, such as M. coracotriceps, have demonstrated a muscle spindle density much greater than surrounding muscles. A higher density of muscle spindles suggests a proprioceptive function during flight. We investigated another diminutive muscle that may bear a similar function, the distal head of M. extensor longus digiti majoris (ED). Studies included a qualitative histological analysis comparing the density of muscle spindles in the ED to the adjacent proximal head of the M. extensor longus digiti majoris (EP) in 15 total samples excised from Columba livia (rock pigeon) and Gallus gallus (jungle fowl). EP is a functional muscle that serves as an osteo-pulley for the major digit, which we analyzed the ED against. Based on our qualitative histological analysis of ED, this muscle does not demonstrate a greater muscle spindle density compared to the EP. Although further research of this muscle in other Avian species may be necessary to discern its function, our research demonstrates no evidence of a proprioceptive function.
subject: Articles
  topic: section
subject: Avian Species
  topic: keywords
subject: Histology
  topic: keywords
subject: Muscle Spindles
  topic: keywords
subject: Flight
  topic: keywords
creator: Arjun Pandya
creator: Tobin Hieronymus
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-04-22
publication date: 2025-04-22

Organizing a Student Led Virtual Research Conference Focused on Addressing Disparities in a Rural Community
type: item
description: The purpose of his study was to describe the implementation of a virtual student-led research conference at a medical school in a rural area that focused on addressing disparities in medical education opportunities and ways to address disparities in an underserved medical community. The ability to host virtual conferences in light of an evolving digital presence in medical education is both cost-effective and allows a greater dissemination of research to those that may not have been able to attend an in-person conference. Two virtual research symposiums were hosted on Zoom in 2020 and 2021 with the help of faculty and students. Submissions were allowed from any student and could have any mentor affiliation involved. Abstracts were organized into sessions based on common themes, such as orthopaedics, cardiology, and translational sciences, then analyzed according to various categories such as social determinants of health, mental health, and healthcare for marginalized groups. Those who attended the conferences were asked to complete a digital evaluation form in weeks following the conference and the average ratings of the responses were analyzed. In total, 425 individuals attended both events with the majority being students (64%) from the College of Medicine, Pharmacy, and Graduate Studies. Eighty-four percent of the 211 presenters were from the College of Medicine. Forty three percent of research presentations addressed rural disparities with a 12% rise in presentations focused on these areas (36% to 48%) from 2020 to 2021. Eighty eight percent of all participants who completed an evaluation form were agreeable to attending a virtual event again. Based on these results, the implementation of virtual conferences led by medical students presents an effective solution to increase research opportunities for students located in rural settings. Increased opportunities to present their research at their school encouraged students to identify and address disparities in th…
subject: Articles
  topic: section
subject: Medical education
  topic: keywords
subject: virtual conference
  topic: keywords
subject: disparities
  topic: keywords
subject: healthcare
  topic: keywords
subject: rural
  topic: keywords
creator: Manasa Melachuri
creator: Andrew Alejo
creator: Raman Bhambra
creator: Gordon Hong
creator: Jay Natarajan
creator: Giovanna Leone
creator: Stacey Gardner-Buckshaw
creator: Fady Abdlrasul
creator: Alexander Galazyuk
creator: Steven Schmidt
creator: Julie Aultman
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-06-11
publication date: 2025-06-11

An Updated Review of Bone Mineral Density and Osteoporosis Prevalence in Postmenopausal Hispanic Women
type: item
description: Background: Osteoporosis is characterized by a loss of bone mineral density (BMD) and bone mass, causing an increased risk of fractures associated with greater morbidity and mortality.1-4 Aged women are at an increased risk of osteoporosis due to loss of ovarian estrogen following menopause.5 Older studies suggest that Hispanic women (HW) have a higher BMD on average than non-Hispanic White (NHW) women and are at less risk for osteoporotic fractures.7-10 The purpose of this literature review is to summarize recent studies on BMD in postmenopausal HW in the United States and to promote bone health education and osteoporosis prevention in this understudied population. Methods: PubMed and CINAHL searches were conducted using the search terms “bone mineral density”, “osteoporosis”, “Hispanic”, and “women.” Inclusion criteria for articles were peer-reviewed, published within the last 20 years, evaluated HW at least 40 years-old in the United States, and measured BMD using dual x-ray absorptiometry (DXA). Studies were excluded that did not fit these criteria, included patients with serious health conditions, involved a specific intervention, or did not include BMD or osteoporosis prevalence as the primary outcome. Results: Of the 1,216 total articles found, 13 were included in this review based on our criteria. There is a gap in the literature regarding BMD and risk factors for osteoporosis in postmenopausal HW. Nonetheless, there were minimal differences in total body BMD between HW and NHW women, with some evidence of greater prevalence of osteoporosis and osteopenia among HW than NHW women.11,17,21-23 When assessing BMD with DXA and high-resolution peripheral quantitative CT (HRpQCT), Caribbean HW had significantly lower BMD and poorer microstructural properties at the lumbar spine than NHW women.12,13 Data from the 2005-2010 and 2013-2014 National Health and Nutrition Examination Survey (NHANES) demonstrated that osteoporosis prevalence is highest amongst individuals …
subject: Articles
  topic: section
subject: Hispanic
  topic: keywords
subject: Women
  topic: keywords
subject: Aging
  topic: keywords
subject: Health Education
  topic: keywords
subject: Prevention
  topic: keywords
subject: Bone Mineral Density
  topic: keywords
subject: Osteoporosis
  topic: keywords
creator: Emily R. Arellano
creator: Arnold Diaz
creator: Sofia V. Perez
creator: Sophie Tayade
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-06-11
publication date: 2025-06-11

Qualitative Analysis of Anterior Cruciate Ligament Reconstruction Surgery in the Hispanic Population
type: item
description: Background: The anterior cruciate ligament (ACL) is a supportive structure in the knee that provides resistance to internal tibial rotation and anterior tibial translation.1 ACL injuries are commonly seen in athletics and can lead to joint instability.1,2 The severity of injury determines the most suitable treatment option for patients. Sprains are typically healed through rest and rehabilitation, while tears may require surgical reconstruction to properly recover.2 The purpose of our study is to evaluate the quality of current literature that investigates ACL reconstruction surgery outcomes in Hispanic patients. Methods: We completed a review of literature that includes post-operative statistics on Hispanic patients who have undergone ACL reconstruction surgery through the PubMed database. Twenty-one of the studies found through PubMed fit the inclusion criteria and were included for review (10 systematic reviews, 7 cohorts, 2 narrative reviews, 1 cross-sectional, and 1 meta analysis).3-23 The data gathered focused on the incidence of multiple postoperative complications. Results: Qualitative measures were used to provide a comparison between Hispanic patients and other ethnicities. The most common variables measured were concurrent meniscal injuries (5), revision procedures (5), physical therapy follow-up (4), delay to surgery (3), sports clearance (2), physical strength (2), and range of motion (1). Hispanic patients from all of the studies reporting saw an increased risk for concurrent meniscus injuries, experienced a greater delay to surgery, and attended fewer physical therapy sessions which contributed to decreased strength during post-surgery recovery. The literature showed conflicting evidence about whether ethnic minorities are at an increased risk for revision surgery or failing sports clearance criteria. There was not a significant difference between ethnic groups for range of motion. Conclusion: Hispanic patients are less likely to have a successful rec…
subject: Articles
  topic: section
subject: literature review
  topic: keywords
subject: orthopedic
  topic: keywords
subject: surgery
  topic: keywords
subject: anterior cruciate ligament
  topic: keywords
subject: latino
  topic: keywords
subject: hispanic
  topic: keywords
creator: Maximilian Dawson
creator: Jeffrey William Toman
creator: Amanda Iset
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-06-11
publication date: 2025-06-11

YAP Signaling is Involved in Keratinocyte Proliferation and Tumorigenesis Mediated by RIPK4 Knockdown
type: item
description: Cutaneous squamous cell carcinoma (cSCC) is the second most common cancer of the skin, with approximately 800,000 new cases diagnosed yearly in the US, and its incidence is continuing to increase. Although local cSCC is curable with conventional treatments, cSCC exhibits a significant risk of metastasis and no effective treatment is currently available for patients with the metastatic disease, leading to a survival rate of less than 20% over 10 years. Thus, a better understanding of the molecular mechanisms of cSCC pathogenesis is urgently needed for developing novel effective therapies to combat this disease. Recently, we have found that RIPK4 mRNA levels are significantly lower in human cSCC samples than in normal human keratinocytes. Interestingly, newly genomic studies identified the protein kinase RIPK4 (also known as PKK) as a recurrently mutated gene in aggressive and metastatic cSCCs. We previously demonstrated that knockdown of RIPK4 expression increased the proliferation of human cSCC cells in vitro as well as tumor growth of human cSCC in a mouse xenograft model. In addition, we showed that conditional knockout of RIPK4 in mouse epidermis greatly enhanced the development of mouse cSCC induced by chemical carcinogen treatment, suggesting RIPK4 functions as a tumor suppressor. Although we showed that the NFkB and p63 pathways are involved in the RIPK4-mediated cSCC development, the link of RIPK4 with the Hippo pathway has not been reported. In our current study, we investigated whether YAP1, a transcription regulator downstream of the Hippo pathway, is involved in RIPK4-mediated tumor formation. By using small-hairpin RNA (shRNA) targeting the RIPK4 gene and small interfering RNA targeting the YAP1 gene, we demonstrated that suppression of RIPK4 led to tumor development in keratinocytes via upregulating YAP signaling. More strikingly, silencing YAP1 expression led to a dramatic decrease in the size of colonies formed due to RIPK4 depletion. Our results may …
subject: Articles
  topic: section
subject: YAP
  topic: keywords
subject: RIPK4
  topic: keywords
subject: Cutaneous squamous cell carcinoma
  topic: keywords
subject: Human Cancer
  topic: keywords
creator: Tony Zhao
creator: Kaitlyn Malek
creator: Luojing Chen
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-06-11
publication date: 2025-06-11

The Current State of the Mitochondrial Diseases LHON, MELAS and Leigh Syndrome and Their Treatments: A Review
type: item
description: Metabolic disorders like Leber Hereditary Optic Neuropathy (LHON), Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS), and Leigh Syndrome (LS) are severe, rare mitochondrial diseases causing perturbed mitochondrial function. These disorders present a broad spectrum of clinical manifestations, complicating diagnosis and treatment. Management of LHON, MELAS, and LS remains largely supportive, with no FDA-approved treatments available. However, therapies like Idebenone for LHON, L-arginine for MELAS, and EPI-743 for LS are showing significant therapeutic promise and are presently being evaluated in clinical trials for their efficacy and safety. This review delves into the defining characteristics of LHON, MELAS, and LS, highlights the current state of therapeutic developments, and discusses established disease models.
subject: Articles
  topic: section
subject: LHON
  topic: keywords
subject: MELAS
  topic: keywords
subject: Leigh's Syndrome
  topic: keywords
subject: Mitochondrial disease
  topic: keywords
creator: Catherine Hord
creator: Amber Dinchman
creator: Patrick Kang
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-06-11
publication date: 2025-06-11

Key Practice Indicators for Hypothermia Management for Neonates in Rural Nepal
type: item
description: In rural Nepal, neonatal hypothermia is a common complication due to lack of proper infrastructure and resources at birthing centers. The purpose of this research study is to examine the common medical practices incorporated in Nepal for prevention of hypothermia during the neonatal period. The study took place in Nuwakot, Nepal from June 2022 to June 2023, with surveys conducted on auxiliary nurse midwives from various birthing clinics in 5 different communities. Within these 5 communities surveyed, each birthing center (hospital, health post, home) gave a priority ranking of 1 (most important) to 14 (least important) for newborn temperature management procedures. Findings revealed that hospitals and health posts prioritized the same procedures except for procedures ranked 8 and 9, where less than 50% of health posts agreed with the hospitals. Home births presented significant variation in the ranking of each procedure, with exception to procedures ranked 1-3 and 12-13, which were similar in ranking to the hospitals and health posts. All home birth surveys explained the reason for their ranking variation as due to geographical remoteness. Among all birthing centers, procedures ranked 1-7 and 10-14 were prioritized the same for greater than 50% of surveys. However, for procedures ranked 8 and 9, less than 50% agreement was observed overall. When neonates were found to be cold, all clinics utilized kangaroo mother care as treatment. Overall, neonatal temperature management practices in rural Nepal were consistent across hospitals and health posts, with notable variation in home births. Table 1. Summary rank of newborn temperature management procedures at each birthing center. Parentheses denote how many of the 5 surveys agreed on the rank of that procedure. No parentheses mean the majority of surveys at that birthing location agreed on the ranking for that procedure. Birthing centers surveyed within each of the 5 communities Hospital Health Post Homebirth Warm delive…
subject: Articles
  topic: section
creator: Nicholas Ventigan
creator: Bernhard Fassl
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-06-11
publication date: 2025-06-11

ICUS to ICU: A Case of Germline DDX41 Mutation in a Patient with Idiopathic Cytopenia of Undetermined Significance (ICUS)
type: item
description: Genetic testing for both somatic and germline mutations is a crucial component of the modern work up of cytopenia, myeloid neoplasms, and bone marrow failure syndromes. However, the specific genes tested in each clinical scenario are continually evolving, making standards for genetic testing a moving target. Germline mutation of the DDX41 gene is associated with familial acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), but its role in idiopathic cytopenia of undetermined significance (ICUS) is less clear. We present the case of a 65-year-old male with a history of rheumatoid arthritis (RA) found to have ICUS with a germline DDX41 mutation. The patient’s cytopenia was long standing, present at least 3 years prior to initiation of immunosuppression for his RA. Two months after his initial hematologic evaluation, the patient was admitted to the ICU for neutropenic enterocolitis. The patient was severely neutropenic and required a right hemicolectomy. Subsequent work-up revealed a pathogenic germline DDX41 mutation. Repeat bone marrow biopsy 8 months later was consistent with MDS/AML as defined by 2022 International Consensus Classification Guidelines. This patient, asymptomatic for years, went through an ICU admission and emergent surgery before his germline DDX41 mutation was discovered. Expanded guidelines regarding somatic and germline genetic testing will likely prove helpful in delineating the etiology of ICUS and initiating early management in the future.
subject: Articles
  topic: section
subject: DDX41
  topic: keywords
subject: idiopathic cytopenia of undetermined significance
  topic: keywords
subject: genetic testing
  topic: keywords
subject: germ-line mutation
  topic: keywords
subject: myelodysplastic syndrome
  topic: keywords
creator: Maximilian Brockwell
creator: Jordan Hatch
creator: John Jakob
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-06-11
publication date: 2025-06-11

Meningitis Following Otologic Surgeries: A Review
type: item
description: Objective The review aimed to examine the incidence, etiology, and time course of meningitis as a postoperative sequela of otologic surgeries. Data Sources PubMed, Cochrane, and Web of Science databases. Review Methods The date range was 1960-2022. MESH terms “meningitis”, “postoperative complications”, and subcategories of otologic surgical procedures identified through PubMed’s MESH terms “auditory brain stem implantation”, “cochlear implantation”, “endolymphatic shunt”, “labyrinth fenestration”, “mastoidectomy”, “middle ear ventilation”, “myringoplasty”, “ossicular replacement”, “stapes surgery”, and “tympanoplasty” were used with “AND”. Additional studies were identified from reference lists. Non-English and non-human studies were excluded. Studies were included if they specified the presence/absence of meningitis irrespective of the primary goal of the study and provided the number of patients. Results 140 studies were reviewed for a total of 57,108 patients. 49.0% were male, and 57.5% were pediatric patients. There were 215 patients with meningitis, most commonly following cochlear implantation at 72.1% of the total cases. Inner ear malformations were noted in 38.3% of patients with meningitis. Streptococcus pneumoniae was the most common causative agent, followed by Pseudomonas aeruginosa, aseptic, and Haemophilus influenzae. The timing of meningitis ranged from 0-180 months post-otologic surgery. Vaccination status was reported in 14.3 to 34.7% of studies. The overall incidence of meningitis following otologic surgeries was 0.38%, from 1951-1999 was 0.35%, and from 2000-2020 was 0.39%. Conclusion Meningitis post-otologic surgery continues to have an impact on pediatric and adult patients. Meningitis can occur immediately or after many years following otologic surgery, necessitating continual vigilance. S. pneumoniae is the leading causative agent for postoperative meningitis. Inner ear malformations increase susceptibility to postoperative meningitis. While …
subject: Articles
  topic: section
subject: meningitis
  topic: keywords
subject: otologic surgeries
  topic: keywords
subject: postoperative complications
  topic: keywords
subject: systematic review
  topic: keywords
creator: Quan Lu
creator: Anita Jeyakumar
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-06-11
publication date: 2025-06-11

Erythrodermic Psoriasis: A Case Report
type: item
description: Erythrodermic psoriasis is a rare, but serious subtype of psoriasis characterized by widespread erythema affecting over 75% of the total body surface area. It is a condition that may be mistaken for pathologies with similar clinical presentation, including seborrheic dermatitis or atopic dermatitis. A missed diagnosis of erythrodermic psoriasis may lead to life-threatening systemic complications including hypothermia, sepsis, and high-output heart failure. In this report, we introduce a case of erythrodermic psoriasis with acute progression after an initial diagnosis of new onset atopic dermatitis.
subject: Articles
  topic: section
subject: case report
  topic: keywords
subject: erythrodermic psoriasis
  topic: keywords
subject: atopic dermatitis
  topic: keywords
creator: Nathan Ryan
creator: Maximilian Dawson
creator: Vissy Elad
creator: Vincent Hensperger
creator: Kelly Kimball
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-06-11
publication date: 2025-06-11

Establishment of a New Level 4 Hospital Facility in Machakos County, Kenya
type: item
description: No abstract
subject: Articles
  topic: section
subject: kenya
  topic: keywords
subject: establishment of a new hospital
  topic: keywords
subject: rural Africa
  topic: keywords
subject: community needs assessment
  topic: keywords
subject: healthcare disparities
  topic: keywords
subject: standardized questionnaire
  topic: keywords
creator: Cynthia Uzoukwu
creator: Palvir Baadh
rights: Copyright (c) 2025 Journal of Medical Sciences at NEOMED
date: 2025-06-11
publication date: 2025-06-11