New York Chiropractic College

Tranexamic acid (TXA) is widely used in surgery to reduce perioperative bleeding, but concerns persist regarding its potential thromboembolic risks. This study evaluates the association between intraoperative intravenous (IV) TXA use and 90-day postoperative venous thromboembolism (VTE) risk in patients undergoing plastic and reconstructive surgery of the head and neck. We conducted a retrospective cohort study using the Fortuna database, a national administrative claims dataset with over 200 million patients. Adult patients undergoing plastic and reconstructive surgery between 2010 and 2024 were identified using CPT codes, and whether they received IV TXA on the index day of procedure was determined. The primary outcome was VTE diagnosis within 90 days postoperatively. Use of enoxaparin or heparin was also documented. High-dimensional propensity score matching with inverse probability of treatment weighting (IPTW) was used to adjust for baseline demographics, comorbidities, medication exposures, and healthcare utilization. Logistic regression was used to evaluate the association between treatment and the binary outcome. A total of 1,011 patients received IV TXA and 157,959 did not. After propensity score matching, the two groups were well-balanced. The incidence of VTE was 0.2% in the TXA group, and 0.28% in the non-TXA group. Weighted logistic regression demonstrated no statistically significant difference in VTE risk (OR 0.62, 95% CI: 0.13-3.04, p = 0.55). IV TXA use was not associated with increased postoperative VTE risk in plastic and reconstructive surgery of the head and neck, supporting its continued use as a safe hemostatic adjunct in this patient population.

Adolescent idiopathic scoliosis (AIS) remains a significant clinical challenge due to limited nonsurgical interventions and inconsistent treatment protocols. Current standard practices, including observation, rigid bracing, and spinal fusion surgery, often overlook patients with mild to moderate curvature, contributing to progression and decreased quality of life. This retrospective single case report evaluates a nonsurgical treatment integrating a cantilever traction system, weekly spinal mobilization, and reflexive engagement of the labyrinthine righting reflex (LRR) in an adolescent female patient. Following three months of intervention, the patient's mild Cobb angle reduced from 10.9° to 3.8°, accompanied by clinical improvements in posture, neuromuscular balance, and proprioceptive awareness. These observations suggest the potential of integrated conservative interventions addressing existing gaps in scoliosis care, particularly for mild AIS patients.

Background: Knee ultrasonography is a key diagnostic and research tool for evaluating joint effusion, synovitis, tendon, and ligament integrity. Despite its widespread use, methodological inconsistencies across studies—ranging from patient positioning to probe settings—limit reproducibility and cross-study comparability. Objective: To outline a standardized, evidence-based procedure for knee joint ultrasound suitable for research applications, aligning with international guidelines to ensure methodological rigor and reproducibility. Methods: A comprehensive research framework was developed incorporating standardized participant selection, equipment calibration, scanning parameters, patient positioning, and both static and dynamic maneuvers Results: Implementing standardized ultrasound protocols minimizes measurement variability, improves the accuracy of synovial and vascularity assessment, and enhances longitudinal monitoring of therapeutic responses. Conclusion: Methodological standardization in knee ultrasound strengthens data validity, promotes reproducibility, and facilitates integration of imaging biomarkers into clinical and translational musculoskeletal research. The outlined framework serves as a template for future multicenter and longitudinal ultrasound studies.

The undergraduate MBBS course (Bachelor of Medicine, Bachelor of Surgery) in India is designed to produce competent Indian Medical Graduates (IMGs) capable of addressing community health needs. The preparedness of these graduates for clinical practice remains a crucial area of investigation. Objective Structured Clinical Examinations (OSCEs) have emerged as a robust assessment tool for evaluating clinical competencies. This study aims to assess the feasibility and utility of the OSCE when used as an end-of-internship evaluation, describe temporal trends in OSCE performance, and analyze the correlation between OSCE scores and final-year MBBS examination results over a six-year period at a center in South India. A descriptive study was conducted at a medical college in South India, involving six batches of students (2017-2023; n = 469). OSCE stations were designed to assess cognitive, psychomotor, and affective domains. The feasibility and utility of this exercise was assessed. OSCE scores were analyzed across domains and subdomains, and correlations with final-year MBBS examination scores were explored using Pearson's correlation coefficient. Statistical significance was set at p < 0.05. The OSCE was found to be a resource-intensive evaluation, requiring 528 faculty-hours for a batch of 60 students and 843 faculty-hours for a batch of 150. The mean OSCE score was 61.3 ± 8.0%, with the highest performance in the affective domain (72.1 ± 14.2%) and the lowest in the cognitive domain (50.0 ± 15.4%). Notably, psychomotor skills were inversely correlated with cognitive skills (-0.41, p < 0.001). OSCE scores were weakly correlated with final-year MBBS examination marks (r = 0.44, p < 0.001), with stronger correlations in smaller batches (r = 0.57, p < 0.001) than larger ones (r = 0.44, p < 0.001). The COVID-19 pandemic and increased batch sizes negatively impacted clinical and technical skill performance. It is feasible to conduct OSCEs as an end of internship assessment in a medical college. OSCEs serve as a comprehensive assessment tool, underscoring the importance of multi-modal evaluation strategies. Conducting OSCEs serves as an appropriate assessment of the MBBS training programme so as to subsequently tailor the programme according to performance in various subjects, domains and subdomains.

The integration of traditional acupuncture systems with modern biomedical technologies offers promising avenues for therapeutic innovation. This study explores the efficacy of superficial galvanic stimulation applied to Master Tung acupuncture points, aiming to evaluate its potential in enhancing clinical outcomes. Master Tung’s points, renowned for their precision and systemic effects, were selected as stimulation sites to bridge classical theory with contemporary practice. Through structured patient selection, point identification, device application, and subsequent data analysis, the intervention was assessed for its impact on symptom modulation and physiological response. Findings suggest that superficial galvanic stimulation not only reinforces the therapeutic relevance of Master Tung’s system but also demonstrates measurable benefits when interpreted through modern clinical frameworks. This approach highlights the potential of bridging tradition and modernity to create innovative, evidence-based pathways in integrative medicine.

Bulbar-onset amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease characterized by early decline in speech, swallowing, and respiratory function, and is associated with a poor prognosis. We report the case of a woman whose treating neurologist determined, eight months after symptom onset, that her presentation was most consistent with bulbar-onset ALS. At 16 months, she began receiving intermittent pelvis-stabilized axial spinal traction (PSAST) as a supportive intervention. Remarkably, over the subsequent 21 months, she maintained oral intake and preserved respiratory function, an outcome atypical of the expected trajectory of bulbar-onset ALS. While this single case relies on provider reports for diagnostic confirmation, it raises the hypothesis that axial spinal traction may help sustain bulbar and respiratory function in ALS. Given the lack of effective treatment options, we present this case to raise awareness of a potential supportive approach that warrants further investigation.

We present the case of an 18-year-old Asian male patient with extreme adolescent idiopathic scoliosis (AIS) exceeding 180 degrees, who remained untreated for eight years following his initial diagnosis due to socioeconomic barriers and limited access to healthcare. At presentation, the patient measured 165 cm in height and weighed only 40 kg (BMI14.7). He exhibited severe spinal deformity, compromised pulmonary function (forced vital capacity (FVC) at 65% of the predicted value), chronic pain (rated 5-7/10), and progressive functional declinethat had led to withdrawal from traditional schooling. A multidisciplinary team implemented a presurgical optimization protocol incorporating halo-gravity traction, spinal manipulation, therapeutic exercises, respiratory rehabilitation, and nutritional intervention, all tailored through patient-specific 3D-printed spinal modeling. After eight weeks, the patient demonstrated remarkable improvements: a 2-cm height increase, 4-kg weight gain, improved pulmonary function (FVC 78% of the predicted value), and reduced pain reduction (2-3/10). Thesegains enabled successful posterior spinal fusion from T2 to L4. Postoperatively, pulmonary function normalized to 82% of thepredicted value, and the patient continues withrehabilitation focused on functional restoration and pain management. This case uniquely contributesto the literature by documenting quantifiable improvements achieved through multidisciplinary presurgical optimization in extreme deformity. It demonstrates effective integration of multidisciplinary spine care, provides rare insight into the natural history of untreated severe AIS, and offers a comprehensive model for transitional care from conservative management to surgical intervention. The successful outcome, despite significant barriers, underscores the importance of adaptive, multidisciplinary strategies in managing complex spinal deformities, particularly in resource-limited settings.

The aim of this case report is to provideclinicians with an option for the treatment of spine pain, spine disorders caused or complicated by abnormal spine alignment,and failed prior interventions for pain and suffering with a conservative protocol. Multi-decade chronic widespread pain (CWSP), low back pain (LBP) headache (HA), and neck pain (NP) cause significant disability and reduced quality of life across all socio-economic and societal categories.Treatment options for decades-old long-term pain with good outcomes are uncommon with non-surgical and surgical interventions. Herein is a single case of positive outcomes with Chiropractic BioPhysics® (CBP®)protocol and long-term follow-up. A 60-year-old male with a lifting injury working on a farmat age 12 suffered for decades with LBP, mid-back pain (MBP), NP,HAs, radiculopathy, and poor health-related quality of life (HRQoL). Prior over-the-counter (OTC) medications with diminishing results over 48 years were reported.The patient had multiple abnormal patient-reported outcomes (PROs) as well as measured postural and spine structural abnormalities at the initial assessment. Following 12 treatments, PROs and other measures improved dramatically.Continued brief treatment showed continued progress followed by no treatment beyond continued home exercises and home postural orthoses.All subjective and objective outcome measures improved at one-year follow-up and remained long-term. Improvements in sagittal and coronal postural balance with improved spine alignment, better PROs, and measurably improved HRQoLs were found at one- and three-year follow-ups from the initial evaluation. Chronic NP, LBP, MBP, and extremity pain with altered sensation, loss of function, and failed drug therapy are common across the globe and combined represent the greatest contributors to disability and the global burden of disease (GBD). Economic, efficacious, repeatable, and reliable methods for treating pain will reduce GBD and improve PROs.Larger studies of CBP® methods for multi-decade chronic pain are challenging; however, continued case reports and RCTs for similar conditions are warranted.

Chiropractors are primary healthcare providers who diagnose and manage various health conditions, including rare cases like desmoid tumors. Desmoid tumors are locally aggressive soft-tissue tumors originating from fibroblasts. This report presents the case of a 30-year-old woman who initially sought chiropractic care for persistent neck pain that was later discovered to be a symptom of a sporadic desmoid tumor. The patient presented with severe right upper neck pain, which was diagnosed as myofascial pain syndrome and yielded no significant improvement after various treatments. Physical examination by a chiropractor revealed a soft-tissue mass in the right upper trapezius and rhomboid region. In addition, magnetic resonance imaging revealed an intramuscular lesion measuring 8 × 4 cm in the right rhomboids, and subsequent biopsy confirmed the diagnosis of a sporadic desmoid tumor. The patient underwent successful surgical excision of the tumor. Postoperatively, the chiropractor initiated a comprehensive 12-week rehabilitation program that significantly improved the patient's range of motion and muscular strength and alleviated pain. The remarkable aspect of this case was the location of the tumor in the right rhomboid muscle, a less common site for desmoid tumors. This case underscores the crucial role of chiropractors as primary healthcare providers in the early detection of oncological cases and management of post-surgical rehabilitation.