J Natl Med Assoc
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Review Case Reports
Risperidone induced hypotension: A case report and literature review.
Risperidone is a second-generation antipsychotic agent used in psychiatric management, acutely and chronically. A rare adverse effect has been described with its use in the form of orthostatic hypotension especially in pharmaceutical clinical trials. However, there remains a lack of literature on the replication or prevalence of this adverse effect among patients in clinical settings. Hence, we present an incidental case of orthostatic hypotension following Risperidone therapy.
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The SARS-COV-2 (COVID-19) pandemic has shed a bright light on the long-standing health inequities experienced by Blacks across the United States. The need to promote the health and well-being for the Black population has been highlighted. ⋯ This concept resulted from empathetic and non-judgmental conversations over a 10-year period with over one thousand patients. This article will provide simple solutions through the practical application of patient engagement and cultural sensitivity using the common thread of the human experience.
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Case Reports
Cataract surgery and Hydrus stent implantation in juvenile open-angle glaucoma: A case report.
To report a case of a patient with juvenile-onset open-angle glaucoma (JOAG) who was successfully treated with combination cataract extraction and Hydrus stent implantation. ⋯ Cataract surgery in combination with the Hydrus stent implant effectively lowers intraocular pressures and can be used to surgically manage patients with JOAG. This intervention is a probable adjunct or substitute to first line treatments such as trabeculotomy.
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There are disparate findings in the literature on the impact of race and insurance status on gonadal loss in testicular torsion. We sought to determine if race or levels of social vulnerability influence the rate of torsion or gonadal loss. ⋯ Black/African American children have an increased risk of testicular torsion. Despite these patients having higher levels of social vulnerability, it was not associated.
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Case Reports
Systemic thrombolysis for acute central retinal artery occlusion in sickle cell disease: Case report.
In sickle cell disease (SCD), blood oxygen content is decreased due to anemia and the Hb-SS phenotype, in particular leads to an increased blood viscosity, which limits tissue oxygen delivery. Nonetheless, vasculopathy, correlating with daytime oxygen saturation,1 thrombophilia and hyper coagulability are all underappreciated etiologies of stroke in SCD.2 As a result, there is less known about the role of systemic thrombolysis for the management of acute stroke in SCD. Given the lack of studies and cases reviewed in literature, we describe a patient with SCD found to have an acute stroke treated with both intravenous (IV) alteplase and exchange transfusion. ⋯ In reviewing this case, we recommend that current clinical trials for management of acute stroke including an acute CRAO carefully consider including patients with sickle cell disease to receive simultaneous IV thrombolysis and RBC exchange. The benefits outweigh the risk of a permanent disabling deficit with significant functional impairment. And while considering care plans tailored to the projected needs of acute care management for this patient population, we also recommend implementing healthcare models that improve access to preventative care in settings where the majority of children and adults with SCD live.