Nortriptyline-Induced Room Tilt Illusion.

Room tilt illusion (RTI) is a rare and transient perceptual disturbance in which an individual perceives their surroundings as having been rotated or tilted, usually at 90 or 180 degrees. Primarily linked with vestibular disorders and neurological lesions, this report details the only reported occurrence of the RTI phenomena in nortriptyline use for treatment-refractory depression. The patient developed RTI six days after starting the medication and the disturbance resolved after medication cessation. Although the mechanism behind such a phenomenon with medication use has not been elucidated, its etiology may rest on the effect of tricyclic antidepressants on the vestibulo-thalamo-cortical system and visual-vestibular integration. Clinicians should be aware of the potential for such a medication-induced perceptual disturbance, especially in the workup for more serious etiologies in elderly patients with co-morbidities.

Herba Epimedii and Increased Opioid Cravings While on Buprenorphine: A Case Report.

Herba Epimedii, commonly known as yin yang huo, inyokaku, and horny goat weed, is a traditional Chinese herbal medicine utilized for treating osteoporosis and enhancing libido. Studies conducted in vitro have demonstrated that Herba Epimedii interacts with the enzyme cytochrome P450 3A4 (CYP3A4). This interaction poses a potential risk for drug-drug interactions, particularly with medications metabolized by CYP3A4, such as buprenorphine. This paper presents a case of a patient experiencing exacerbated opioid cravings following the initiation of Herba Epimedii. This is the first reported case supporting this interaction, emphasizing the necessity of screening for alternative medicines in patients undergoing medication-assisted treatments for opioid use disorder.

Inguinal Polyorchidism Found Incidentally During Orchiopexy in 9-Year-Old Male: A Case Report and Review of Orchiopexy of Nonscrotal Supernumerary Testes.

Polyorchidism, the presence of more than two testes, usually presents as a painless scrotal mass or is diagnosed incidentally during the management of another condition.1 It is a rare congenital abnormality with approximately 200 reported cases in the literature. Most cases are found on the left side within the scrotum. We report a case of right-sided polyorchidism in a 9-year-old patient found incidentally during inguinal orchiopexy. As there is debate on the management of polyorchidism, a careful approach is required as the surgeon must decide between either scrotal fixation or the removal of the supernumerary testis. This case report will discuss the anatomical and clinical considerations when making this decision.

Migration of an Interactive Global Health Conference to a Virtual Platform: Engaging Learners During the Pandemic.

The COVID-19 pandemic has halted many large gatherings, and research conferences are no exception. Large conferences, once attended in-person, have primarily switched to a virtual format, utilizing online platforms. Every January, Medical Students Providing Across Continents (MedPACt), the University of Central Florida College of Medicine's global health interest group, hosts a student-run Global Health Conference that features a keynote speaker, discussion panel, and research presentations, and workshops for participants to engage in. Though planning this event is always challenging, organizing the 2021 conference was particularly strenuous as accommodations had to be made to optimize the conference to fit a never-attempted virtual format.  This drastic shift warrants further investigation into the efficacy and audience engagement of the virtual format. Using a post-conference survey with specific questions geared towards each component of the conference along with registration data, the virtual conference in 2021 was compared to the in-person conference in 2020. This study found that the virtual format was comparably efficacious in creating relevant and global health-oriented programming for the 2020 in-person conference. Additionally, the 2021 virtual conference received more registrants and cost less to plan, meaning the virtual model is a cost-effective way to deliver quality conference content.