Fibroids are a common benign tumor located in the female reproductive tract and affect up to 10 percent of women, leading to challenges during cesarean section. Few cases of myomectomy at the time of cesarean section have been described and most describe uteri with only a few fibroids present. Our case describes a 39 year old G1P0101female with extensive fibroids including large fibroids located at the lower uterine segment. This patient underwent cesarean section and myomectomy at 27 weeks and five days gestation with a fundal, vertical hysterotomy, extending from the anterior to posterior wall of uterus. This is the first case described in the literature of a cesarean section performed on a uterus with innumerable intramural fibroids and first case documented of a fundal, anterior to posterior hysterotomy.

Introduction: There have been over 87 million cases of Coronavirus Disease 2019 (COVID-19) in the United States (US). Objective: The objective of this study was to develop a novel questionnaire to assess risk perception of COVID-19 and xenophobic attitudes among adults in the US at the beginning of the pandemic. Methods: An anonymous self-report questionnaire was developed for this study in February 2020, and was distributed using convenience sampling from March 10 to March 25, 2020. The questionnaire assessed knowledge and risk perceptions of COVID-19, as well as attitudes toward individuals of various races and ethnicities. Results: 662 US adults completed the questionnaire. On a scale from 1 (low) to 5 (high), the mean risk perception was 3.44. Those with knowledge of COVID-19 and higher education levels reported higher risk perception and higher feelings of warmth towards Asian people. Forty percent of the sample had recently witnessed or experienced anti-Asian attitudes at the time of the survey. The majority of participants reported having heard about COVID-19 from news media, social media, and family or friends. Conclusions: Our sample had a moderate level of risk perception, potentially due to the time period of data collection (i.e., early in the pandemic course). The results suggest that knowledge about COVID-19 informed perceived risk and affected willingness to engage in healthy protective behaviors. Our study provides historic context of how people perceived the virus at the beginning of the pandemic, and gives insight into the aftermaths regarding quarantine and attitudes towards Asian Americans.

Methods: This study included adult, English speaking patients of the high-risk prenatal clinic at Cooper University Hospital that missed at least one appointment. We completed three, one hour focus groups with seven participants. Constant comparison analysis was used to determine common themes discussed by participants. Axial coding and basic unit descriptors were defined by both facilitators to determine common themes discussed during the focus group sessions. Results: We identified two main themes in regards to patient visit non-adherence in our population: logistic issues and perceived relationship issues between the patient and the care team. Logistic issues included issues with rescheduling, seeing different providers, parking, wait time and office hours. In regards to patient-care team relationships, subjects frequently brought up issues with respect, feeling heard by providers, communication and professionalism. All seven patients identified at least one of the five domains of logistic barriers as a concern. Five of the seven participants identified an issue across the four domains of relationship issues. Discussion: The focus group analysis illustrated recurrent themes of logistic barriers and deficiencies in patient-care team relationships that contributed to high-risk prenatal visit non-adherence. A follow-up survey study is necessary to quantitatively assess the most prominent reasons for visit non-adherence based on the themes identified in our study.

This report aims to review a case of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) by comparing the patient's course with the current literature. BIA-ALCL is a specific type of T-cell lymphoma that can develop after breast implantation, but has only recently been recognized within the last decade. Although overall rare, certain types of breast implants have increased association with developing subsequent lymphoma. This case occurred after mastectomy with breast reconstruction for unilateral invasive ductal carcinoma with a textured, saline Allergan breast implant. BIA-ALCL manifested and was symptomatic nine years after implantation.

Lyme disease is a zoonotic illness caused by Borrelia burgdorferi, which present with skin, joint, heart, and central nervous system complications. Central nervous system manifestations of this disease are common, and typically include meningitis, facial nerve palsies, and radiculoneuritis. In this case report, we present a patient who presented with acute right sided hemiplegia and ataxia with negative neuroimaging findings of stroke, inflammation, or mass. Further investigation with cerebrospinal fluid studies and infectious panels revealed the patient had active Lyme disease. The patient improved his motor function, coordination and sensation with ceftriaxone treatment over a few weeks. Acute hemiplegia and ataxia are rare manifestations of Lyme Disease.

Thyrotoxic Periodic Paralysis (TPP) is a rare manifestation of thyrotoxicosis, resulting in periodic episodes of acute onset muscle weakness in the setting of hypokalemia. The thyrotoxic form of Hypokalemic Periodic Paralysis (HPP) is less studied than the more well-known familial form due to fewer reported cases and smaller prevalence. This case study presents a 30-year-old African American male with multiple episodes of acute lower extremity muscle weakness, tachycardia, and a history of heat intolerance. Abnormal findings on thyroid ultrasound coupled with increased thyroid related immunoglobulins led to a diagnosis of TPP related to exacerbation of newly-found Graves’ disease. The case study will further discuss the importance of imaging in assessing the etiology of TPP with review of relevant literature.

Securing a residency position has become increasingly competitive, thereby making the interview crucial in matching successfully. In this commentary, what I consider “Ten Commandments” of a successful interview are elaborated. Although this is geared to those applying in dermatology, the principles are applicable for any medical student applying for a residency program.