2016 the pulse revitalized magazine by AUAmed

The Pulse Revitalized Magazine Spring 2016 Edition

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CONTENTS Find out whatâ&#x20AC;&#x2122;s inside this issue The Pulse Team would like to take this opportunity to thank you for your interest. In this issue,

Event Section Airport Pick Up Club Fair Blood Drive Victory Talent Explosion

Entertainment Movie Review Island attractions

The PulseRevitalized seeks to capture the old and new experiences of AUA students.

Science Corner Natural Medicine Research Wahab Gbadamosi

Community Outreach PAWS Sharing and Caring Animal Neglect and Cruelty

Culture Holi Displacement and Genetic Recombination

Student Life Whoâ&#x20AC;&#x2122;s Who AFMS IFMSA Adding Light to the Shadows Interpersonal Violence Escape through movies Resilience AMSA Army Medicine Phi Delta Epsilon AMSA: Project Cure & Convention Pie Day

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Student Life

AFMSIFMSA Candidature Antigua Federation of Medical Students (AFMS) was created for medical students to push their local boundaries by connecting with other medical students around the globe. As such, this allows for the betterment of civilization by becoming health advocates and educating communities on healthcare, as well as, the larger public. In align with this vision, an application was submitted to the International Federation of Medical Students (IFMSA) by AFMS founder Tanya Kondolay in August 2015. IFMSA brings medical students together globally to exchange knowledge and collaborate on projects (International Federation of Medical Students Association , 2016).

Antigua Federation of Medical Students (AFMS) was created for medical students to push their local boundaries by connecting with other medical students around the globe. As such, this allows for the betterment of civilization by becoming health advocates and educating communities on healthcare, as well as, the larger public. In align with this vision, an application was submitted to the International Federation of Medical Students (IFMSA) by AFMS founder Tanya Kondolay in August 2015. IFMSA brings medical students together globally to exchange knowledge and collaborate on projects (International Federation of Medical Students Association , 2016).

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The Pulse Revitalized IFMSA was founded in 1951, making it the oldest and largest medical student-run organization to date. The organization is in partnership with World Health Organization (WHO), United Nations (UN), World Medical Association (WMA), and European Union. IFMSA connects 129 National Member Organizations in 119 different countries collaborating on various topics such as medical education, sexual and reproductive health, public health and human rights and peace. Approximately 13,000 clinical and research exchange programs are hosted annually through IFMSA allowing members the opportunity to gain exposure to healthcare systems and delivery in different countries (International Federation of Medical Students Association , 2016).

In a medical conference held in Malta early March 2016, a medical student from Chile presented on behalf of AFMS candidates to different medical students around the world. After the presentation, a vote was taken and the application was approved for AFMS to become a member of IFMSA. Now AFMS at AUA joins IFMSA-Grenada at St. George’s University in the privilege of holding such a membership. Essentially, this establishment has expanded the Caribbean network of medical students having an influence within IFMSA because St. George’s University is no longer the only Caribbean medical school to be apart this organization.

AFMS members now have the ability to apply to WHO internships, submit work for publications, participation in professional exchange programs and research exchange programs, attend external meetings for the United Nations and international NGO’s, and present projects/ research at general assembly and regional conferences. Exposing the medical students of AFMS to these opportunities allow members to gain skills and resources needed to become exceptional health leaders. Furthermore, increasing the breadth of knowledge for medical students, pertaining to various aspects of the medical field, with a global perspective, will have a substantial positive impact on the

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health care systems—ultimately resulting in the betterment of health.

References: (2016, March 25). Retrieved from International Federation of Medical Students Association: http://ifmsa.org/general/

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Airport Pick Up

Ambassadors Volunteers The Welcoming Party Gabrielle Buxton

Photos Provided By: The Ambassadors

Each semester, students from around the world leave their lives to realize their dreams. Envisioning the future “white coat” and “stethoscope,” the students excitedly pack their luggage and are transported to a destination that only begins their journey. After arriving in an exotic, beautiful, yet foreign country, the anxiety begins. Did I pack everything I needed in two bags? Will customs charge me for my valuable possessions? © Copyright 2016 by The Pulse Magazine

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Will this all be worth it? These internal questions stir the doubts of many and they become discouraged. However, there is one shining light waiting on the other side of baggage claim, The Ambassadors. The Ambassadors are a student organization that represent American University of Antigua College of Medicine (AUA).

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The Pulse Revitalized For many semesters, The Ambassadors have collaborated with AUAâ&#x20AC;&#x2122;s New York office to sponsor the airport pick up of incoming medical students. While the New York office handles the logistics and administrative component, The Ambassadors serve as an immediate support system for the incoming medical students.

On February 9, 2016, The Ambassadors completed another successful airport pickup event. They assisted by providing welcoming advice to the new arrivals and general assistance. After the incoming students received their housing information, they were given the opportunity to mingle with future classmates and upperclassmen

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while they awaited transport. . Each of the incoming students were also given an Ambassador goodie bag that consisted of snacks and toilet paper. Many of the new students appreciated the welcome gift and the opportunity to mingle with upperclassman. It provided a level of reassurance to many that the upperclassman were once in their shoes.

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Student Life

Adding Light to the Shadows

Gabrielle Buxton CHRIS MARTIN

Photos Provided By: Sumita Balooja “One day I asked for help. I called the police. I actually left home. I moved in with a friend. I did all the things that I should have done to remove myself from the situation. But, why? Why do I mindlessly relive the nightmare? Why can’t I just get over it like everyone wants me to? After all, they think it was my fault. The judgement is in their eyes and actions. Maybe, I deserve this endless cycle of blame and shame.” There are many statistics that describe and present how common interpersonal violence has become. Still, many people do not understand how significant interpersonal violence can impact an individual. They do not grasp how words or bruises can alter what a person fundamentally understands about themselves. The ability to alter one’s perspective is a powerful and dangerous tool that is exploited all too frequently. The question we must ask all citizens of humanity is why is such a dangerous and terrifying experiences so common but unknown. Interpersonal violence is a monster that feeds on the dark. When no one brings this monster to the light, the darkness can take over and take more victims. In an attempt to illuminate the unknown, American University of Antigua (AUA) hosted a

series of events on Interpersonal Violence. Many courageous women shared their experiences in the hope of being encouragement for others. The many events allowed for the

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expression of buried emotions to surface in a positive supportive atmosphere. Professor McKnight of AUA Behavioral Science Department and Director of Counseling Services

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was central to the execution of the Interpersonal Violence Event. She was instrumental in gathering courageous volunteers who would share their experiences and provided support to each lady. At each event, she challenged everyone to no longer allow interpersonal violence to thrive. As future physicians and citizens of humanity, we have to be conscious of the signs so that we can offer assistance when needed. Although I cannot adequately explain the emotions experienced from individuals that suffer from interpersonal violence, it was moving and humbling to realize that our colleagues have overcome. In an open seminar, four brave women shared their stories.

My Story My name is Anonymous and this my view. When I was 9 years old, my family moved to America for a different life. This was a major change from everything I knew but my parents were extremely busy building a new life for us. They hired a nanny to help take care of me and she was a lovely grandmotherly type woman. She loved children and we loved her. The nanny eventually adopted a young boy who she loved and cared for more than anything.

My story changed when he entered my life. It started out as touching. He would encourage me to “touch him” in inappropriate places. In my mind, I knew the nanny’s son was right and no one would believe my story. So, I touched him and those touches

became more. I was 9 when my story changed.

These women walk among you. They are next to you in cubicles and struggle with you on exams. We owe them respect because they are survivors. They understand something that we hope never to realize. They understand that there is evil in the world and it will attack you no matter how safe you think you are. The experiences shared below are your fellow doctors in training sharing and hoping to make an impact on your lives. © Copyright 2016 by The Pulse Magazine

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The Pulse Revitalized My name is Anonymous and I am a victim of child molestation. Today, I can look back on the experience and realize that someone in the world has been through worse than me. It’s hard to believe that a sexual child abuse can be worse. While working as a teacher, I saw the signs in children who were younger than me when I became a victim. I was able to help them in a way that was denied to me. One day, my story will be there story too. The story won’t focus on the tragedy of sexual abuse but of overcoming and realizing the signs to help another child one day.

wonder what would have happened if I wasn’t so accommodating. Would I still be the optimistic me? I will never know because I chose to be a good person and stayed behind. Eventually, I went to the restroom and left my drink unattended for a few minutes. A few minutes was all it took to change my view forever.

My View My name is Anonymous and this my view. I considered myself a small town girl with big dreams. Those dreams could only be fulfilled outside of my rural area in a very industrious city. Small town girl moves to a big city to find love, peace, and happiness. To say the least, I was extremely optimistic about the world. Arriving in my new college in a new city with high expectations, I believed in the positivity of humanity. There are moments in our lives that have the ability to change how we view life. On September 23, 2011, my view of life was rocked. This night, I will remember as when I become someone else. I became “that girl.” It was at a party among strangers that my roommate asked me to stay behind.

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That was code for I want to have the room to share with my boyfriend. Even though I didn’t know anyone else at the party, I stayed behind to be accommodating. The old me was always accommodating and willing to help my fellow neighbor. . I guess it was my small-town upbringing. Sometimes, I

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My name is Anonymous and I am a victim of drug induced rape. I remember every moment he took from me. I remember screaming but no sound emerged. Taking from my body was assault but taking from mind was like murder. He killed the girl I use to be. He killed the happiness and joy that I felt in the world. My innocence and belief that people are good were stolen with no remorse. He drugged my body for brief compliance, but my mind was trapped in the state of compliance. The next day I tried to tell my roommate what happened, but she didn’t believe my view of the past night’s events. I didn’t try to tell anyone else what I was going through and why I had changed. The initial rejections shaped how I viewed the world. No one would believe me. It took years before I could admit this to my parents. Today,

I am still affected by what happened to me years ago, but the acceptance and support I received from my parents have removed my jaded view of rejection.

My Rescue My name is Anonymous and this is my rescue. I had a happy childhood. My parents were both physicians in training so they often left my brother and me to the care of my grandmother. My parents were so busy they didn’t truly see me. As I grew up and started maturing into a woman, my parents realized that their daughter was not the traditional Pakistani woman. To them, I didn’t envision what culture and religion said I should be. They started to notice more often that I wasn’t what they wanted in a daughter. Then, it started.

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The same parents who spent my childhood becoming physicians that are trained to care for people were verbally abusing their child. In my parent’s mind, they believed that they were reeducating me to become the perfect daughter. In my frail teenage mind, I didn’t understand what was so terrible about me that I deserved humiliation and mistreatment. I ran away several times hoping to escape, but I always returned.

My name is Anonymous and I am the victim of verbal abuse. People believe that scars are physical. However, the scars that people don’t see are the scars that are hardest to heal. It took me years to rescue myself from being manipulated by my parents. This rescue did not involve me leaving my parents. I love them despite of who they are and how they treated me. Today, I have a retrained my parents and took back my power.

At some point, I believed that my parents were right. I changed and tried to be who they wanted me to be. When you are young and have nothing, it’s easier to follow what you are being told. People always ask abuse victims why they don’t leave. Leaving permanently is not easy for anyone. For children, it becomes more difficult to leave. I didn’t need another escape. I desperately needed someone to rescue me. I needed one person to take an interest in helping me. Fall July 2016 ....... 10

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The Pulse Revitalized My Voice My name is Anonymous and I have found my voice. We sat around a table in the public library and opened our acceptance letters together. I couldn’t believe that we were accepted into the same school because he was always so much smarter than me. I was filled with joy as I anticipated our upcoming academic journey. It was the night before movein day and as usual, I still hadn’t finished packing. He stayed up and talked with me on the phone until I was finished. Both of us still were too excited to sleep. Our lives as undergraduate students would officially start the next day. I was already thinking of what medical school I would attend and if he would go to the same one.

The first month of undergrad was a dream come true. We had the most incredible study groups with all of us excelling at the top of the class. With my new-found freedom and academic success, I was finally able to lift my nose out of the books and flourish socially. A group of new and old friends went to concerts and keggers. Still, we were back to the library for study the next morning. After one party, he offered to walk me home to make sure I got back “safe.” The world grew darker that night. I shut my eyes so tight thinking if I didn’t see it then maybe it wasn’t happening. After he left, I couldn’t move. It wasn’t until my RA opened my door because someone had pulled the fire alarm. Over and over I think of who I would be if they had pulled the fire alarm half an hour earlier.

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I stood outside in the October cold surrounded by other students from my apartment and I felt alone. Friends asked why I stopped going to class and why I didn’t want to be in their study group. Why did I stop smiling when I’d see him coming my way from a distance? I saw him everywhere I looked: in class, in the grocery store, in my faded eyes when I looked in a mirror. I still fight every single day, to climb my way out of that darkness. I will fight against the shame and selfhatred. I will not blame myself or allow others to blame me for what he chose to do. My name is Anonymous and I am a survivor of rape. You pass by me every day in the hallways not knowing that I have been to hell and back. Love and faith have bandaged my wounds but the scars will forever be a

reminder. Some days, they are a reminder of my pain. However more often, they remind me of my strength and resilience. I have a voice and I am telling you what I wish someone had told me all those years ago. You will survive this. You will claw your way through your demons and break through that darkness. The light within you is not lost. You will experience joy, love, and friendship once more. Heal how you want to heal. Reach out for support and do not be afraid. I believe you. I will speak for you until you are ready to speak for yourself. Our voices will be heard.

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Student Life

AUA Students introduce American Medical Student Association Gabrielle Buxton Photos Provided By:

Samuel Lee

AUA was fortunate to introduce several new student clubs during the Spring 2016 semester. American Medical Student Association (AMSA) was one of the most active new student groups during the semester. This semester AMSA created and Project Cure. This was a campus wide effort to raise money for medical supplies for our sister island Barbuda.

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The Pulse Revitalized AUA AMSA chapter was also invited to attend the annual AMSA convention in Washington, DC. Several AUA AMSA members attended this event and participated in the many seminars and hands on activities.

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Escaping through Movies:

A medical student’s perspective Alexander Kilpatrick Photos Provided By: Internet Source There are moments when I have been studying for a long period of time and I want an escape. My eyes are so tired and I don’t have any desire to read more words on a page. What is someone to do to try to relax and get re-energized enough to study again?

Movies and television offer a great way to escape to another place and/or time, real or imagined. Our own AUA Professor Dr. Wedding has written a book titled Positive Psychology at the Movies, which explores how movies can improve our lives and shape our personality. He has also written a book called Movies and Mental Illness. Although we may not have a mental illness (I am sure many people believe medical students have mental impairment for enduring our academic journey.), some of the lessons mentioned in the book can apply to our lives.

we see personality traits in them that we want to replicate or change in ourselves. The discussion with Dr. Wedding prompted me to consider the television show House which I began watching at the start of my medical journey at AUA. Mostly, I dislike the main character, but I admire some of the personality traits he exhibits. In my opinion the main character is self-centered and slightly sadistic; however he is redeemed by his an unquenchable thirst for knowledge and uncanny problem solving ability. His curiosity is a characteristic that I can relate to and want to build within me.

Movies allow basic escapism for minds to wander and be free. Movies create an opportunity to connect beyond our normal circles and engage in meaningful conversations about various topics while learning through situational observation. For me, a study break is also a time to connect with my wife. Technology allows us to see one another and sync movies so that we can experience and react to it together. In my opinion, this is the mental aspect of movies, I can escape the medical world when I need to and be taken away to another place. I am sure there are many other students that use this strategy to escape the pressures that we all encounter as a method to maintain our sanity. After meeting with Dr. Wedding I came to realize that the “positive psychology” he describes in his book has been something that I was unconsciously practicing and benefiting from. By watching characters that we love or loathe, © Copyright 2016 by The Pulse Magazine

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The Pulse Revitalized Movies offer the audience a different perspective on handling different situations. A great example that Dr. Wedding mentions for the medical field is the ethical dilemma that faced Atticus Finch in To Kill a Mockingbird. The scenario allows the viewer to reflect on how they might react in a similar situation and how they might realistically approach it. We will face many ethical dilemmas in our careers. This movie, along with many others, provides perspective about how we would hope to react when an ethical dilemma arises. Although I donâ&#x20AC;&#x2122;t want to ruin the ending for the audience, I will however highly recommend watching To Kill a Mockingbird. We all find strategies to survive this crazy ride, that we call medical school. Survival may take the form of mental releases or opportunities to connect with someone else, or to escape the daily grind. When choosing your next coping mechanism, consider a movie that will provide an opportunity to reflect who you are and who you want to become.

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Events

AUA Students Host Blood Drive to Meet the Urgent Needs of the Antiguan Community Gabrielle Buxton Photos Provided By: Sumita Balooja

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On Thursday, March 24, 2016, American University of Antigua (AUA) sponsored its 2nd Blood Drive Event from 1pm to 6pm that day. Visionary, Armin Edalatpour 3rd Semester Medical Student at AUA, created this event in hopes of inspiring other AUA students to give back to the community and save a life by donating blood. Armin Edalatpour, current President of the AUA Emergency Response Team (ERT) and a Paramedic from the US, is in the unique position to introduce life changing events to the Antiguan community. He is passionate about having access to proper resources in the event of emergencies. Mr. Edalatpour noticed the increased demand and scarce supply of blood in the local community. Understanding the gravity of the situation, he was successful in creating an event that has become a tradition.

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The Pulse Revitalized She was critical in the recruitment of other key members of the leadership team including Htet San and Monica Sheinin. This team of AUA medical students gathered the necessary experienced personnel and supplies to ensure the success and efficiency of this event. The team partnered with local Red Cross agents and members of the AUA faculty to gain specialized equipment such as medical chairs and qualified phlebotomists. The 2nd Blood Drive Event was a success for all who participated. In preparation for this event, Mr. Edalatpour recruited the aid of fellow classmate, Leah Grossman. Ms. Grossman has ample experience in the execution of large scale participation events. The execution of this event required the collaboration of many individuals to successfully complete the mission. Ms. Grossman reported that there were many successful collections and many willing student participant.

After 39 successful collection, the team closed the event and securely transferred the blood to local hospital, Mount Saint John’s Memorial Center (MSJMC). Ms. Grossman closing thoughts were, “We are grateful for the support and turnout of the AUA community for the blood drive benefitting MSJMC. It truly could not have been more successful as we had more donors than allocated supplies. The partnership between MSJMC and AUA allows students, staff, and faculty the opportunity to donate blood in a hospital-like setting, right here on campus, without the constraints of transportation and time. Our hopes for the future include continuing the blood drive on campus each semester, as well as organizing blood drives on short-notice, when there is a dire need for donors at MSJMC.”

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Holi

AUAâ&#x20AC;&#x2122;s Indian Student Association

Making a Difference Swapna Sista, AUA ISA Vice President AUA's Indian Student Association (ISA) was recently talked about for their service in the local Antiguan community. For those unfamiliar with ISA, we are an Indian studentrun organization that was established to promote unity and understanding of the various cultures of the South Asian subcontinent among our students by hosting social events and community service projects. Our main event for this Spring 2016 semester was Holi Hungama, the Festival of Colors. Holi is a very popular festival in India,

usually celebrated in March. It is typically celebrated at the beginning of the spring to bring in the season and abundant colors, as well to say farewell to the winter season. Many religious stories and prayers symbolize the Holi festival all over India, however, traditionally, Holi is well known for its colors. On Holi, people will normally wear white clothing and smear dry colored powder on each other's faces. People will also celebrate with water guns and water balloons, painting everyone like a canvas.

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On Saturday, March 26th, we held the first Holi event AUA had in four years, and it was such a success! All had great fun as we celebrated with color, water balloons, music, and delicious samosas. On April 9th, the ISA Executive Board donated all of the money we raised from Holi ticket sales ($400) to Care Project, a local orphanage for children with disabilities. Their disabilities included being unable to walk and/ or talk. owever, that didn't stop them from smiling at us, giving us hugs, Hor holding our hands! After speaking with Juliet De Labastide, one of the staff

members who runs the facilities, we were told that Care Project is privately funded by the government and receives a monthly budget for the children. Anything else that the facility may need that exceeds the budget needs to come from other outside sources. Due to the students' efforts with running Holi, the money we raised will help to purchase medicines for the children. Thank you AUA, for participating in our event and donating to this incredible facility. Thank you to my ISA Executive Board for helping me put on this event for the school and our local community. And

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thank you to the children for your beautiful spirit and inspiration!

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Events

Spring 2016 AUA Club Fair

Urvi Bhavsar

Photos Provided By: Urvi Bhavsar and Sumita Balooja

On Friday February 12, 2016, the Student Government Association hosted the biannual Student Club Fair at the American University of Antigua (AUA). This event is one most anticipated by current AUA students. It is the introduction of incoming Med 1 students to the AUA culture and an opportunity to taste the delicious local island food. The club fair provides an opportunity to meet students and explore personal interests. This year’s club fair was charged with a sense of excitement from the many games, raffles and candy giveaways. Myra Haq, a current Med 2 student stated, “The club fair was very welcoming, especially for the Med 1 students who are looking for ways to fit in on campus. The clubs were very organized and the banners were colorful. It was a great representation of AUA’s diversity.” Becoming involved in student organizations is a great way to meet people, contribute to society, explore the island, and learn about various aspects of medicine. For example, the AUA Glaucoma Awareness Group, Emergency © Copyright 2016 by The Pulse Magazine

Medicine Interest Group (EMIG), and Emergency Response Team (ERT) are very active in the AUA Community. Other clubs are active in the surrounding community such as AUA Oncology Interest Group. The club works closely with The Cancer Center Eastern Caribbean by coordinating events that feature world renowned speakers and providing its members clinical opportunities for shadowing. Attending the club fair was motivation to many of the incoming students. Jaspreet Dabb, incoming Med 1 student, shared his experience from the club fair, “I wanted to be part of the Emergency Medicine Interest Group because I am an EMT. I wanted to share my expertise and knowledge with my peers. Working with Jaffer Ahmed, the EMIG president, I was able to help with the training process. I also joined Phi Delta Epsilon because they provide opportunities to give back to the Antiguan community through programs such as PAWS and Care Home.” Fall July 2016 ....... 20

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With the club fair as inspiration, Jaspreet Dabb created his own group, an Improv Comedy Club called Hypeman. “There are academic benefits for Introduction to Clinical Medicine and in clinical practice where you have rubrics and scripts to follow when interviewing a patient. In reality, there is no such thing as a script when it comes to a patient. Learning how to communicate with a flow, being personable, gaining confidence and being quick on your feet are all favorable qualities in a physician. This is how Improv Comedy is beneficial academically as well as a means to improve help.”

Overall, the Student Government Association organized a successful event. The success of the event proves that there is something for everyone at AUA. In the event that your interest are not featured, then

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all that is needed is a bit of inspiration and dedication. Anyone can take advantage of the opportunities offered by the AUA community or allow your creativity to surface and pave the way for a new organization on campus. Fall July 2016 ....... 21

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Entertainment

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Movie Review The Road Within Stephanie Ferrigan The Road Within is a film about three adolescents, each with different behavioral disorders including Tourette’s (with coprolalia), OCD, and anorexia nervosa. They find one another at an inpatient treatment facility trying to navigate through their respective rehabilitation programs. While I have not yet interacted with people who have rip-roaring cases of Tourette’s, OCD, or anorexia nervosa, I have researched each and imagine much of this film as accurate.

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Realizing this film is attempting to destigmatize mental disorders in general, and that it is not intended to entirely depress its audience, I felt the actors did a splendid job portraying mental disorders. The film adds a bit of romance demonstrating struggles of the

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heart and unlikely friendships. It highlights how families may handle the illness of loved ones, and how caretakers handle both patient and family members. It reminds us that we all need a little help sometimes, and you shouldn’t be ashamed of this. Fall July 2016 ....... 23

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The film uses comedy to lighten each characters’ grueling situation. While many critics thought this was distasteful, I felt it was probably entirely necessary. Yes, these disorders are serious and yes they deserve respect and attentive therapy. However, who are we if we can’t laugh off our insecurities and try to rise above what holds us back? I think as future physicians we should always find the bright side of the bleak positions we will all find ourselves in. We should try to smile and make sure they smile. We should never forget that we are all human, and that each and every one of us has a struggle regardless of our status as ‘omnipotent’ physician or ‘vulnerable’ patient. I suggest we all take a step back and reflect on who we want to be, and what we need to be to maneuver through this world. As I am writing this review,

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The movie continually emphasizes people who have behavioral disorders don’t have them on purpose, and many would rather not have problems. It shows that although we root for the underdog, it can be extremely difficult to heal problems of the mind and it often requires harder work than other diseases.

We need to be truthful to our patients about the road they will have to travel, but we should never let them feel like they walk alone. I would also suggest watching the film. It might be enlightening for you to try and strip away the ‘disorders’ these characters have and find that, well….there is a bit of ‘crazy’ in all of us.

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Community Outreach

Sharing and Caring Gabrielle Buxton Photos Provided By: Eric Trevizo In the Spring of 2016, The Ambassadors, Phi Delta Epsilon, and The Student Government Association (SGA) presidents formed a committee to allow students to give back to the community. Bimonthly, students are able to donate lightly used items to people in need within the surrounding area. All proceeds are collected on campus and given to local charities and group homes of the Antiguan community. Visionary Ayman Karaman of the SGA created this committee with the goal of helping students help the community. He gathered Jean Nezivar and Swati Vasireddy and combined the group made his vision a reality. Every other Wednesday volunteers from The Ambassadors, Phi Delta Epsilon and SGA are responsible for the collection from the student body. This event has built ties among students and the community.

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Student Life

American Medical Student Association AUA Chapter Presents US Army Medicine in Action Gabrielle Buxton Photos Provided By: Samuel Lee American University of Antigua (AUA) is undergoing a season of change. From the continuous construction projects to the newly implemented US Federal Loan Title IV participation, many new doors are opening for AUA. On Tuesday, March 29th at 6pm, the American Medical Student Association (AMSA) introduced a new concept to the AUA community. AMSA, a student-governed international organization, invited US Army Personnel to provide information regarding the benefits and incentives of becoming US Army Physician. This event was the first of its kind at AUA to emphasize the military career opportunities available to the IMG/FMG students. Sergeant First Class Ryan Covington AMEDD Recruiter of the US Army Medical Recruiting Command in Lexington, KY attended the event via skype.

American University of Antigua (AUA) is undergoing a season of change. From the continuous construction projects to the newly implemented US Federal Loan Title IV participation, many new doors are opening for AUA. On Tuesday, March 29th at 6pm, the American Medical Student Association (AMSA) introduced a new concept to the AUA community. AMSA, a student-governed international organization, invited US Army Personnel to provide information regarding the benefits and incentives of becoming US Army Physician. This event was the first of its kind at AUA to emphasize the military career opportunities available to the IMG/FMG students. Sergeant First Class Ryan Covington AMEDD Recruiter of the US Army Medical Recruiting Command in Lexington, KY attended the event via skype.

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He inspired many students with an impressive list of the benefits, incentives, and factual information on specialty shortages. He also educated students who are not US citizens on the many opportunities available to them upon graduation from AUACOM.

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Students were particularly interested in the loan repayment program. This type of loan repayment program is a financial incentive open to IMG/FMG students whereas US medical students have the option to sign up for the Health Professional Scholarship Program (HPSP). The HPSP is a program that funds the four years of medical school in exchange for four to eight years of their military service in uniform. Another exciting speaker, Captain Rosciae Savior, Medical Intelligence Officer from San Antonio, TX introduced our students to ongoing global health concerns that impact world healthcare and policy, strategic allocation and logistics, and public health to both civilians and military service members. The closing thoughts of Spring 2016 AMSA AUA Chapter President and Semester 4 Medical Student, Samuel Lee, expressed delight with the active participation of the US Army Department and the substantial interest displayed by the AUA student body.

AMSA executive board leadership created this event in hopes of informing the AUA students and faculty members about the many options that are available to future medical doctors as US Army Medical Corps commissioned officers. AMSA President issued this statement on behalf of the chapter. “We are excited about the success of the overall event. This event aided those who have already served in the US military services and those who have not yet experienced the benefits and lifetime camaraderie the US Army Medical Corps offers. Over 40 students participated in learning about US Army Medicine benefits and incentives. Participants also received vital information about specialty shortages in the Army, such as trauma surgery, anesthesiology, and neurology. The speakers informed participants of military residency opportunities as a paid Soldier, research opportunities at CDC, and services provided to major VA hospitals and clinics in times of war and peacetime.”

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AMSA received support from many students and faculty of AUA. On behalf of AMSA, Sam, extends his sincere appreciation for making this occasion a success. He also extends his gratitude to Subway Antigua for sponsoring the event with sandwiches and generously offering two 25EC gift cards as prizes in a raffle drawing. As a small token from the AMSA E-Board, two presenters and the Subway Country Manager, Mr. Linely Doray, were awarded with an official AMSA t-shirts and Certificate of Appreciation for their generous support and care of the AUA student body.

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Science Corner

Spring 2016

The Natural Medicine Corner

> JeanNezivar > PhotosProvidedBy:InternetSource Medicine is described as measures taken to maintain and to restore health. Medicine has existed since the earliest signs of life and has undergone many changes and advances. This section of the magazine will explore the holistic aspect of medicine. In this section of the magazine, you will learn about easy natural remedies which do not require advance medical knowledge and can be safely used right away.

Natural Remedies for Wound Care Humans are often described by many words such as dynamic, superior, and intelligent. However, in basic level science classes, you’ll inevitably come to the conclusion that we are masses of particles living in a world of particles. These particles assemble by interacting with each other to take on new properties. They are transformative. Like many medical students, I am fascinated by the particles and their interactions that contribute to the human body and determine how it functions. Even more fascinating is how we can manipulate the heath of the human body using elements readily available in nature.

Natural Remedies for Wound Care In today’s article, we will explore the world of bleeding. From our science, we understand clotting factors and bleeding times. What does this mean in real life? This article provides applicable knowledge on minor cuts which I believe is an important concern for medical students living abroad. Minor cuts often happen in the kitchen, especially when inexperienced famished medical students decide to prepare their own meals. While this is a dramatic example, minor cuts can happen everywhere from paper cuts to shaving cuts. How would handle these small annoyances? Let’s think about this critically as a physician would. A surgeon, who often deals with cuts and bleeding, would first inquire about vital factors. These factors include the size of the wound, location and the severity of the bleeding, and then recommend hemostatic agents which can only be found at the pharmacy. Our solution for this problem is much simpler and definitely doesn’t require a trip to the pharmacy. First, you start by cleaning the affected area with some running water. Then, you sprinkle some cayenne paper over the cut skin and apply pressure.

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I can already imagine the terrified look from the idea of sprinkling cayenne pepper on an open wound. Believe me it will work and the bleeding will stop! Also don’t worry about the pain because individuals who’ve used this method confirm that it does not burn. Again, let’s think critically about the application of cayenne pepper. Cayenne pepper is a great seasoning to many dishes but it also has styptic property. There’s lots of ongoing research on ways to stop bleeding and there are currently many styptic preparations available on the market. It’s good to know that you already have one in your kitchen cabinet.

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Bibliography Anthony, S. (2014, May 26). Cayenne Pepper for kitchen cuts. Retrieved from West Seattle Herald: http:// www.westseattleherald.com/2014/05/26/features/ cayenne-pepper-kitchen-cuts Donghong Li, P. L. (2012). Enhanced Hemostatic Performance of Tranexamic AcidLoaded Chitosan/Alginate Composite Microparticles. Journal of Biochemistry and Technology . Howe N, C. B. (2013). Obtaining rapid and effective hemostasis: Part I. Update and review of topical hemostatic agents. Journal of the American Academy of Dermatology . Schreiber MA, N. D. (2011). Achieving hemostasis with topical hemostats: making clinically and economically appropriate decisions in the surgical and trauma settings. AORN Journal . Suhr, H. (2015). Cayenne pepper can stop bleeding in 10 seconds! Retrieved from The raw food world: http://news.therawfoodworld.com/ cayenne-pepper-can-stop-bleeding-10-seconds/

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Entertainment

Island AttractionWhat to do on a long school weekend- JA Arpitha Jammula Photos Provided By: Arpitha Jammula I can answer that for you in a few points: 1. Study 2. Study more 3. Study even more so you can finally get honors on block! Duh. Talk about using that time wisely 4. What the heck, be a little adventurous and go exploring?

I think I’ll go with #4. As much as studies are the center of your attention at AUA, GIVE YOUSELF A BREAK! You deserve it. While time is a huge issue on campus with multiple lectures every day and demanding labs, especially for Med 3’s, shuffling through busy schedules to make sure you get that very much needed study time in, it is essential and in your best interest to give that ATP consuming brain of yours a break. Embrace the clean, crisp, ocean kissed air and other attractions Antigua has to offer by going on a mini adventure. A few of my friends and I took the opportunity to go visit the “Pillars of Hercules” located on the South East coast of Antigua. We did this on one of the days in a four-day weekend. © Copyright 2016 by The Pulse Magazine

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This attraction is a couple of miles away from English Harbor that hosts yearly Sailing Week competitions held in the last week of April and attracts hundreds of tourists from all over the world. As fun as Sailing Week sounds, and it is, our block exams are held in that same week of April and so a lot of students aren’t able to witness those adrenaline driven races. So, to make up for that take a visit to Galleon Bay, walk across the resort located right behind it, climb a few rocks and come across one of the nature’s beautiful handiworks, carved none other by one of its own reliable architects: the ocean, that Antiguan shores boast of. Take a few pics, Fall July 2016 ....... 31

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post them on Instagram for your friends and family back home to see and then, wait you’re not done yet, go for a hike up the hill to Shirley’s Heights and witness some magnificent views. This hike is a bit intense as the slope is quite steep but it isn’t as difficult as it seems. We didn’t get to go all the way up to Shirley’s this time, but we still got some nice views. Get those heart rates up, that blood flowing and that wonderful adrenaline rush we all crave; oh yea and get that work out you’ve been wanting to get all semester but had no time to get ‘cause you kept making excuses.

food and all the other good things that come with fun adventures. Obviously, if this activity is going to put you behind on your study schedule, go another time because your studies come first. But if you have some time to spare, I highly recommend this as a “to do” while on the island. If you have a Polaroid camera, the pictures you take will be ones you never forget and the memories you make will stay with you forever in those good ol’ neurons of yours. This is just one of many things you can do. If you need other ideas of affordable activities to do in Antigua, I’ve included a list here:

Personally, I’m a very happy person when I hike or go exploring and this is a fun way to exercise that beats working out at the gym. Make sure to take loads of water and good food for afterwards ‘cause you’ll get really hungry. I love any kind of adventure, especially ones accompanied with great company, laughter,

1. Beach/D-boat 2. Day passes at any resort e.g. Jolly Beach, Pineapple Beach, Verandah 3. Sheer rocks restaurant 4. Sting Ray City 5. Dickenson Bay (you can rent Jet Skis for however long you’d like. Just depends on how much money you want to spend)

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The Pulse Revitalized 6. Boat trips depending on the company (a simple google search should answer your questions about this) 7. English Harbor (Shirley’s Heights, Galleon, etc.) There are probably more things to do but these are some of the main things. Until next time folks,

Arpitha

Here are a few pictures from the hike:

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Student Life

Who’s Who among AUA Students Gabrielle Buxton We enter American University of Antigua (AUA) with one goal in mind, becoming a physician. Many of us leave behind successful and fruitful careers for “the chance” to fulfill that goal. Until recently fulfilling that goal came at great financial cost to most students. However, AUA has acquired many different financial options such as Title IV. We owe these prestigious opportunities to the many hard working faculty and staff of AUA. With so many new opportunities presenting themselves, we forget how valuable our time at AUA is. We forget the unique student experiences that have molded us into aspiring physicians. This section of the magazine is dedicated to appreciating the students of AUA AUA is privileged to attract young talented minds from around the world. Each student is a representation of our future health care delivery system. Many students enter AUA with a wealth of experience in their respective health care fields. Some students begin their journey anew at AICASA and migrate to the AUA campus. Their arrival at AUA is not important and barely registers in AUA history.

It is difficult to select a student from the incoming Med 1 class at AUA for many reasons. Most of the students are trying to find their footing and learning to adapt to island life. It is a difficult time for many to build friendships. Cindy Davis is 32 year old native of South Carolina. She was a Med 1 student in Spring 2016 semester. Many people see Cindy as a positive role model and a caring individual. However, people are unaware of the long journey that she has endured on her path to become a physician. During the Spring 2016 semester, Cindy was repeating Med 1and managed to successfully develop academically and mentally. Instead of becoming despondent and losing hope, Cindy returned to AUA in the Spring of 2016 with a mission and a determined attitude to see it through. For these and many more reason, Cindy Davis is featured in Who’s Who at AUA.

Their actions and deeds while at AUA are what makes them special. This Who’s Who Series seeks to capture the many bold and intelligent faces at AUA. Although we are unable to capture every unique experience, we welcome feedback and suggestions of candidates in our next edition. © Copyright 2016 by The Pulse Magazine

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Meet Cindy Davis

■ Q. Who/what was your support system that assisted with the island adjustment? A. My roommate and I really "meshed" well from day one. I believe that the selection process was divine because we have been able to encourage each other along the way especially through the most difficult and stressful times of medical school. I also found that the staff and faculty are all very helpful. I will never forget the countless hours Dr. Sanii, Ms. Brianne Swartz, and Mrs. Cox literally pushed and encouraged me along the way just to say, "Regardless of your current situation, you are going to make it and you will become a doctor." I continue to cling to those words and are forever grateful for them being a part of my support system during my journey through medical school.

■ Q. Why did AUA appeal to you vs any other medical school? A. I was attracted by AUA's success rate as a Caribbean medical school, the cost of attendance for such a high quality education, and how efficient their representatives were through the entire application/approval process. I knew that I would be attending a Caribbean medical school and to be honest, Ross was my first choice because a representative came to our school for an event. However, I began to do more research on Caribbean medical schools and AUA would always appear; either on the sidebar of my e-mail or just through-out my searching. I researched AUA for about 2 years prior to making a decision to apply. Once I applied, I was immediately contacted by Ms. Katherine McDonald. I liked how it was stressed to me that at AUA it was not just about the "numbers" but about me as a person on a journey to become a great physician. I got accepted in August 2014 but could not attend because of the loan requirements at that time. Internally, I felt this was the true test for Ms. McDonald to prove to me that I was not just a number. Ms. McDonald along with Mr. Stanley Jean the loan officer did just that. For about a year, they demonstrated their commitment to me as they helped me every step of the way until my loan was approved. They never failed to give me a call or email me just to check on the progress for the loan or to see how I was doing personally. I knew from those experiences, that AUA was beyond appealing but proved to me that if I committed to attending AUA, it would be the right medical school for me. Although, I do not know any previous AUA graduates, I felt that the school had a huge network of people who care about my future.

■ Q. How did you feel when you first arrived on the island? A. When I first arrived on the island, I was excited and I appreciated how small the island was. It was more rewarding to me when I saw that the school was located in a remote location on the island. I am from a very small town and that was really what I liked about being in Antigua. It feels like a touch of home because everyone is able to get to know you on a personal level and it is easy to build longlasting relationships.

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The Pulse Revitalized ■ Q. How do you combine school, extracurricular activities, and social outings? Please provide the names of any clubs/organization you have participated or are currently involved in? A. First, I am a student. Then, if there is any "extra" time in my schedule for extracurricular activities, I engage in them. I was involved in Doctor's for Christ and was selected to serve on Campus Ambassador's. However, I had to relinquish from those extracurricular activities once I saw my grades suffering. So, till this day, I believe in working hard and playing later especially after block exams. I will take the day off after the exam and go have dinner on the beach with some friends before preparing for the next block exam.

■ Q. Do you partake in any other academic studies such as research or dual Master’s programs? Please provide details.

■ Q. What are your study strategies or tips? Do you have a time management schedule or daily goals? A. My study strategies and tips are sticking to my time management schedule. Within that time management schedule, I make sure that I pre-read before each class, attend class, and then lecture capture after each class all lectures on the same day. Also, I have found it helpful to extensively read difficult topics as well as talk to the professors about those subjects. The best tips I can share with any medical student is to listen to the advice from EED, talk to the professor before trying to go to any TA session or even asking a colleague about a concept that is unclear. Most importantly, make sure that whatever is on the time management schedule is completed within that day in order to prevent from getting behind on the workload. I remember Dr. Barbara Francois saying, "Make sure you eat all your pancakes on the first day because the next day you will get all new ones." That is a powerful statement in which I try to follow in order to achieve my daily goals.

A. I am currently working on my MBA Healthcare degree that was suggested by Ms. Katherine McDonald. I have been able to maintain a 4.0 GPA while in the program. The way that I manage the MBA and medical school workload is by completing the MBA course before going back to AUA. For example, if my class starts in January, I will complete the entire course before February when medical school starts. This works well for me because when I get to medical school I can just focus on medical school workload and not have too many tasks to complete from the MBA course.

■ Q. Do you have any words of wisdom that you would like to share with your peers or perspective AUA students? A. My words of wisdom to my peers will be to always stay positive about any circumstance or situation that is presented. Whether it is facing repeating a semester or financial difficulties, stay positive regardless of the situation. Also, regardless of what changes that may occur at AUA, see them as changes that will better you as a physician and be grateful that AUA has accepted you into their program to achieve your goal of becoming a physician. Just stay positive! © Copyright 2016 by The Pulse Magazine

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Meet Priya Vora.

■ Q. What attracted you to AUA as opposed to other schools? A. AUA’s tuition prices was more attractive than other schools. I was researching American medical schools, but the tuition prices per semester were out of my price range. My decision was evident after realizing I would need to apply for an international loan. AUA seemed to be the most financially sound option for me in the Caribbean.

■ Q. How did you feel when you first arrived at AUA? Did you have any fears about coming to an island school? What type of support system did you have to conquer adverse feelings?

Priya Vora is currently off island after successfully completing Med 5. She is a 24 year old Canadian resident who entered AUA in Fall 2013. While in attendance at AUA, she become close friends with Errisha Richardson. The two ladies would build a friendship that transcends geographical boundaries. Priya was involved in many organizations while attending AUA and was a part of the leadership team for many of these organizations. However, many people remember Priya as the enthused President of The Ambassadors. She was a credit to the organization and developed many ideas that has shaped the capacity of The Ambassadors. While this is remarkable, Priya has led a humble and grateful life. For this reason, we have featured her as one of our Med 5 Who’s Who. In an interview, Priya shared her thoughts about her time at AUA and plans for the future. © Copyright 2016 by The Pulse Magazine

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I was worried when I first arrived in Antigua because I didn’t know many people. Getting accepted into medical school made me feel anxious even before coming to AUA. It was a bittersweet feeling. On the one hand, I was achieving my dream by coming to AUA, but it was far from my family and friends. I felt excited and worried at the same time. However, one of my high school friends was already on the island and she was a semester ahead of me. She helped me a lot in terms of getting to know the campus and the different professors. She gave me ideas on how to study for the tougher courses at AUA. Having her as a support system helped me to reduce my anxiety about coming to AUA and conquering the medical school curriculum.

■ Q. How do you manage being a successful medical student and extracurricular activities? A. Early on in Med 1, I realized that prioritizing was the best way to manage my extracurricular activities and academics. I wanted to join different clubs and groups but I also wanted to focus on academics. In Med 1, I used to write out what I wanted to accomplish after the lectures were over. I would also come to the library early in the morning before the afternoon classes to finish what I didn’t cover the night before. Using this method, I was able to keep up with the courses. At the same time, I could also make time to go to meetings for various clubs and groups that I joined. In my first semester, I limited the amount of groups I joined because I wanted to see how much work I would finish. More importantly, I wanted to monitor my exam results to make sure I was spending adequate time studying. onfidence to start adding more extracurricular activities in the following Fall July 2016 ....... 37

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■ Q. What is the single greatest accomplishment that you achieved at AUA?

■ Q. What was your game plan when you first arrived at AUA? How has it changed since you completed Basic Sciences?

A. One of the greatest accomplishments that I have achieved at AUA was being chosen to be a part of the Medical Scholars team on campus. I have worked as a peer mentor and a Tutor for all of the Basic Science Curriculum. This was an amazing

A. My game plan when I came to AUA was to simply focus on the courses and the lectures. I tried to review the concepts after class. This strategy worked very well in the first year at AUA for Med 1 and Med 2. Eventually, the strategy changed. In the second year at AUA, we were introduced to new courses such as Pathology, Microbiology and Pharmacology. I was never exposed to these courses before I came to AUA. Also, they seemed more based on factual than concepts based so I had to memorize specific details. After class, I began to memorize facts and answer practice questions for application. This was a continuous cycle. Despite the change in study habits, I still believe that the amount of repetition that I did before the exams was what made me successful. I made it a point to finish all my notes and memorizing the week before the exam. Then I did questions and verbally and mentally repeated the information as much as possible. This strategy has really helped me through the Basic Sciences Curriculum and I hope that it will help me through all my medical examinations.

opportunity to help my fellow students through courses and concepts that are tough. I was able to share my thoughts and motivate these students so that they would also be successful through this journey.

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I knew the journey that other students were going through because I have journeyed it. Being an upperclassmen, I was able to help them and share in their struggles of studying and being away from family and friends. I was able to motivate many to keep the determination of becoming a doctor and eventually living the dream.

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The Pulse Revitalized Meet Errisha Richardson

■ Q. What attracted you to AUA as opposed to other schools? A. There are many reasons that I was attracted to AUA including cheaper tuition, accreditation in all US states, and a high school friend was attending and recommended it. After beginning the application process, I came appreciate the willingness and helpfulness of the advisors.

■ Q. How did you feel when you first arrived at AUA? Did you have any fears about coming to an island school? What type of support system did you have to conquer adverse feelings?

Errisha Richardson is from Oakland CA. She is a 27 year old successful Med 5 student. Currently, she is off island and preparing for Step 1. During her time at AUA, she befriended Ms. Priya Vora. The two have shared many amazing and dire experiences. Over the course of five semesters, they have built the foundation for a lifelong friendship. Many people on campus have seen Errisha at AUA sponsored events. She is a diligent servant to the AUA student body. What many people have not seen is that Errisha truly cares for her fellow students. She is a member of the Medical Scholars program at AUA serving in the capacity of tutor and peer mentor. Although her position as a Medical Scholar allows her a source of income, she never withholds a helping academic hand to her struggling incoming and current classmates. Errisha is a unique individual at AUA and she has earned a place in our edition of Who’s Who. © Copyright 2016 by The Pulse Magazine

A. When I first arrived at AUA, I experienced a mixture of feelings. I was happy and feeling extremely blessed but scared of the journey before me. I never believed that I would get into medical school with my past academic record but when I was accepted, I was filled happy feelings. After I reached the island, I began to feel fearful and doubtful but still happy. Those mixed feelings lasted for a month before I started to settle into things. I had a lot of fears about coming to an island school and surviving medical school in general. I still remember the many questions that plagued me my first semester. ‘Could I actually make it through? Would I even make a great doctor? Was I making the right decision or should I have just gone with my "safe" choice?’ Those fears were intensified because I was on an island that was so far from home. Luckily, I had my entire family and my closest friends supporting me. They were all cheering for me to take the chance and come to AUA. Even now after completing Basic Sciences, they still ask how things are going, and they reassure me that they are so proud of me. I think that was a huge factor in me becoming academically successful. It kept me motivated even when I was unsure of myself. I will be the first doctor in my family. The thought of it can be a bit overwhelming but also, it serves as a source of major motivation and strength.

■ Q. How do you manage being a successful medical student and extracurricular activities? A. I try to set a study schedule for each week. I have to study a set number of hours each day despite my many extracurricular activities. For example, if I miss an hour one day, then I have to make it up by the end of the week. For the most part, I stuck to it. However, there were times when it did not. Fall July 2016 ....... 39

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The Pulse Revitalized I knew when I had meetings so I worked my time around that. Even being on several e-boards, I learned how to balance my time. I wrote out my academic schedule and added meetings and made compromises. If I had a lot of meetings in one week, then I was at school all day on the weekends and/or I stayed late a couple days. As hard as it can be to make a schedule and stick to it, it can help in the long run. I also put in time for the gym and questions. I forced myself to stick with it which really comes in handy for the 2nd year of basic sciences.

■ Q. What was your game plan when you first arrived at AUA? How has it changed since you completed Basic Sciences? A. My game plan when I first arrived to AUA was unknown even to me. I think I planned on using the same approach that I used for the BTMD program. It worked for half of the courses and the others I honestly just kind of winged it. My game plan has drastically changed since then. I now handwrite all of my notes consisting of teacher's thoughts from what was said in class and extra notes from textbook if need be. I rewrite all of my notes so that everything is combined and organized. I highlight and underline the most important concepts from my notes. In some courses like pharm and genetics, I make flashcards. For me to really grasp the material, I have to write it out review several times. Then I test my knowledge by doing questions and reviewing it with someone. All of those things really enforce the material and help me to identify what I know and don’t know. When I do questions, I try not to look at notes to gage where I am and what I still have to review.

Words or wisdom that I would give to my fellow students is start early. Have a schedule or game plan at least in the works when you arrive on the island. It will make things easier and you will already be one step ahead. Also, do questions. It really does help to show you what you are strong and weak in. It feels stupid to do them before you have all the material down, but it will tell you if you are even studying the material correctly. It gives you a chance to see how questions may be presented on important exams. Besides most of us never feel 100% prepared anyway, trust me. I never feel completely ready even with all the exams I have taken, and I am completed basic sciences.

Priya and Errisha at Med 5 Social

Q. What is the single greatest accomplishment that you achieved at AUA? A. My single greatest accomplishment while at AUA is growing as a person and as a woman. This growth will help me to be the best doctor that I can be. I experienced many different cultures which helped me to understand the diversity of people better. One day soon, I will be working with a variety of cultures. AUA was like practice for when that day comes. I always learned how to trust my instincts more as well as believing in myself. This helped when it came to exams and meeting new people. Most of my closest friends are of different religions and cultures than me. We all get along and understand each other. I am thankful for all of them because we helped each other through one of the most difficult times of our lives. A big part of what I achieved is also thanks to them. © Copyright 2016 by The Pulse Magazine

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Events

AUA Host Talent Explosion for Victory Center Photos Provided By: Sumita Balooja

On Thursday, May 26, 2016, AUA hosted a talent show for local group home, Victory Center. This event was a highly involved effort among AUA student groups and the staff of Victory Center. The local organizer of the event was Kelly Hedges of the Victory Center. Victory Center is a nonprofit school that assist students with special needs. The center was created by parents of children with special needs. It was the hope of all involved that this event would allow the children a creative outlet. Ms. Hedges requested the assistance of AUA in executing this event. Forming a strong partnership, AUA and Victory Center were able to plan a successful talent show.

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Roshan & Student Volunteer Team

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Roshan & Kelly of Victory Center

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Victory Center Talent Show Participants

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Community Outreach

Animal Neglect and Cruelty

The Great Antiguan Paradox Stephanie Ferri • Photos Provided By: Stephanie Ferri

When new AUA students arrive in Antigua, they are invariably faced with a paradoxical presentation. At first, you see a stunningly beautiful island. Upon closer inspection, you notice that it is littered with scared, hungry dogs and cats scavenging for food. It is perhaps one of the most difficult adjustments for students to make regarding ‘life on the island.’ Luckily, there is a local movement spearheaded by caring people who want to make a difference. PAAWS Antigua and Dog and Cats of Antigua, are two organizations working tirelessly to care for these unfortunate animals and rehome them. PAAWS recently said goodbye to its founder, Nora Nedden, and Jo has taken the helm. I recently sat down with Jo to talk about her vision for future of PAAWS Antigua. Jo is from Sussex, England and first became involved with PAAWS while she was here on holiday 12 years ago. She found an abandoned dog on the side of the road and gave him much needed medical attention and perhaps more importantly, human contact and love. As her holiday came to an end, she was forced to grapple with finding caring for her new friend. She took the dog to PAAWS which found him a loving “forever” home. Upon her return to England, she never forgot PAAWS and sponsored fundraisers for PAAWS. © Copyright 2016 by The Pulse Magazine

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The Pulse Revitalized Over the years, she frequently returned to Antigua to donate her time to PAAWS as a volunteer. When Jo recently moved to the island and opportunity allowed her to become the new leader of PAAWS, she did not hesitate to take on the challenge. One of Jo’s priorities is rehoming the animals. PAAWS boards’ dogs and cats in need of care of care and rehoming. Unfortunately, many of the dogs and cats at PAAWS have been there for years and are permanent residents as opposed to dogs waiting for their “forever” homes. Liza, for example, has been at the shelter for 12 years. While her sweet face and kind demeanor demonstrate the level of care she receives at the shelter, Jo would like to see her find a permanent home. Jo worked tirelessly to see that Liza found a permanent home. While Liza”s eventual placement was a success, many more dogs and cats are still looking for permanent loving homes. Jo, a passionate and enthusiastic new leader, headed a massive rehoming effort recently at PAAWS. This effort included reaching out to rescue organizations in the US. Jo’s efforts paid off by providing space to take in 12 abandoned puppies from four different litters and two horribly neglected pit bulls. She also expanded the cat houses with “catios” – lovely outdoor additions that allow the cats to enjoy the outdoors. This occurred just in time to accommodate a plastic bag full of kittens that were thrown over the PAAWS fence last week.

When asked about the future of PAAWS, Jo states that it will include more fundraising, more social media networking, and a closer working relationship with Dogs and Cats of Antigua (DCA). Joy Farrell of DCA has taken on the task of getting Antiguan law enforcement to address issues of animal cruelty and neglect including the alarmingly common island practice of poisoning dogs. To increase awareness of animal cruelty, DCA erected their first billboard. It featured a picture of a starving dog with a plea to report animal abuse and neglect to the authorities. Unfortunately, the Antiguan authorities recently forced them to remove it, stating that it did not depict Antigua in a good light. One can only wonder about this statement because it is a fact that starving dogs roam the streets everywhere in plain sight. In spite of this negative turn, DCA continues their efforts to help Antiguan animals in need.

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Despite the animal cruelty, Jo, her volunteers, and DCA are an example of how a few driven people really can make a difference. Fall July 2016 ....... 45

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The Pulse Revitalized If you would like to be part of this movement, please consider volunteering at PAAWS or fostering an animal at your home. Many students at AUA are involved in this initiative. Members of AUA's student organization Phi Delta Epsilon volunteer at PAAWS in a variety of ways such as walking the dogs and helping socialize the puppies and kittens. If you feel that you cannot spare the time, consider donating dog food, cat food, old towels, collars and leads. With the limited time we have on this beautiful island, why not make a difference in the lives of the Antiguan cats and dogs who desperately need our help.

If you want to get involved, visit the following links for more information. http://www.paaws-antigua.com/aboutus.html https://www.facebook.com/paaws.antigua/ https://www.facebook.com/Dogs-and-Cats-of-Antigua-1623970834498348/info/?tab=page_info

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Science Corner

Wahab Gbadamosi EXPLORE XA: Betrixaban compared with Warfarin in patients with atrial fibrillation: The result of Phase II randomized dose-ranging study.

Background • Atrial Fibrillation (AF) is estimated to affect an estimate of 7 million people in the United States and Europe. One of the major risks associated with AF is stroke. Medical guideline recommends Warfarin to be used for this condition based on the randomized controlled trials (RCT), but it is a challenging medication that requires frequent monitoring. Therefore, other options like factor Xa inhibitors continue to be compared with warfarin effectiveness.

Introduction • The EXPLORE XA study was a Phase II randomized dose-ranging study to evaluate the safety and tolerability of Betrixaban compared to warfarin in patients with AF. • The lead author was Stuart Connolly. It was printed by Oxford University on behalf of the European Society of Cardiology on March 13th, 2013. • Primary Objective: To evaluate the time to occurrence of major or clinically relevant non-major bleeding (CRNM). • Secondary Objective: To evaluate any kind of bleeding (Major, CRNM, any other reported bleeding, MI, embolism, stroke of any type, and death).

Methods •

Design

o This was 11 months randomized double blinded dose ranging study. Patients were allocated to different Betrixaban doses of 40mg, 60mg, 80mg ( double blinded) and Warfarin (not blinded). It was conducted in USA, Canada, and Germany.

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Patients

o Inclusion Criteria: Male and Female ≥ 18 years in AF or Atrial flutter at the time of documentation or documented within the previous year with ≥ one risk factor for stroke, indicated for anticoagulation with vitamin K antagonist, and an INR of ≤ 2.2 at randomization. o Exclusion criteria: Body weight < 40kg, dialysis, AF due to reversible causes, history of congenital or acquired bleeding disorder, intracranial, retroperitoneal or intraocular bleeding within six month, high risk of bleeding for other reasons, and patient on verapamil. There were 127 patients from Canada, 369 from the USA, and 12 from Germany to o make a total of 508 patients that were screened for eligibility and randomized into four groups. o A total of 466 patients completed the study, and 42 patients were withdrawn. o The baseline characteristics of patients had a mean age of 73 years, 33.5% was female, and 97.8% were Caucasian. The average weight and CHADS2 were 90.9kg and 2.2. Glomerulus Filtration Rate (GFR) was > 70ml/min in 53.5% and < 40ml/min in 8.1%

Treatment Regimens o Eligible patients were randomized into four different group of Betrixaban 40, 60, 80mg, and warfarin (target INR 2-3). Concurrent use of antiplatelet deemed necessary by the investigator was allowed during the study. o Subjects were assessed at screening, and week 0, 1, 2, 4, 8, 12, then every two months after that a maximum of 1 year

Outcomes Measures o The primary outcome was the time of occurrence of major or clinical relevant non- major bleeding (CRNM). o The Secondary endpoint was any kind of bleeding (including major, CRNM), MI, systemic embolism, stroke, and death. o Major Bleeding was defined as the reduction in hemoglobin of ≥ 20g/L or transfusion of ≥ two units of blood. CRNM was defined as overt bleeding not meeting criteria for major bleeding but medical intervention was done. o Death was classified as vascular or non-vascular.

Data Handling o The primary efficacy analyses were completed on an intent-to-treat population. o Measured laboratory included plasma concentration of Betrixaban, D- dimer, and thrombin generation. o In Betrixaban group, 34 patients were withdrawn and eight patients were withdrawn in the warfarin group.

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The Pulse Revitalized Statistics o The study plan was to enroll 500 patients to provide a power of 80% to detect a hazard ratio of 2.27 in the primary endpoint at 0.05% confidence interval. o Continuous parameters were summarized using standard deviations and categorical data were summarized by percent. o Kaplan- Meier was used to detect the survival analysis o Adverse event rates were compared using Fisher’s exact tests.

Results

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The Pulse Revitalized • Figure II shows the level of thrombin generation associated with increasing concentration of Betrixaban. Doses of Warfarin INR 2-3 was similar to Betrixaban doses at 12-30ng/ml.

Adverse events: Higher rates of diarrhea in Betrixaban (6%) group compared to warfarin (0.8%) Limitations o o

The major limitation was that it was a small study size. The result from the outcome events was not statistically significant.

Conclusion o The primary outcome was lowered in all three doses of Betrixaban compare to warfarin. Betrixaban 40mg had a statically lower rate compare to warfarin. This finding suggests that there may be dose –response relationship for bleeding with Betrixaban. Therefore Betrixaban at doses between 40-80mg was well tolerated in AF patient at risk for major bleeding or stroke.

References Stuart J. Connolly, et al. Betrixaban compared with warfarin in patients with atrial fibrillation results of phase two, randomized dose-ranging study. European Society of Cardiologist. European Heart Journal (2013):34:1498-1505.

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Culture

Displacement breeds genetic recombination A closer look at the prevalence of hypertension between African blacks and AfroCaribbean and African American blacks

Tiffany Benjamin

Cardiovascular disease is considered to be one of the leading causes of death in the Americas (PAHO, 2008). Specifically, hypertension is one of the primary causes for early mortality. A number of studies have proven that persons who are of African descent are at a greater risk of developing high blood pressure compared to other ethnicities. To delve even further, persons who are AfroCaribbean may be more likely to develop hypertension than those individuals who are born and raised in Africa according to a study done by (Cooper et. al, 1997). It has become a cultural issue that persons who are of African descent consume

a high sodium diet, where a significant proportion is from the seasonings used.

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While it has been well established that a lack of exercise and a high sodium diet are the predominant culprits a closer look at the genetic component could reveal some answers. A number of hypotheses have been presented to explain the reason for the genetic predisposition persons of African descent who reside in the Caribbean and America have on developing hypertension. This article will briefly discuss the “Slavery hypertension hypothesis’ and its implications. The Transatlantic slave trade can be dubbed as ‘one of the greatest tragedies in humanity in both scale and duration’. It spanned from the 15th to the 19th centuries, where it was estimated that 15-20 million African men, women and children were trafficked to the Americas and the

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Caribbean. The triangular trade was orchestrated by the major European powers where ships would sail from Europe bearing ammunition, weapons and other manufactured goods in exchange for slaves. Slaves would be tightly packed into the holding vessels of slave ships chained to each other in the planking position and transported to the Americas and the Caribbean. The voyage would last a couple of months where many of the African captives were unable to survive the inhumane conditions. This portion of the triangular trade was known as the middle passage and is believed to have contributed to the genetic changes that led to the higher prevalence of hypertension among Afro- Caribbean and African American people.

The final leg of the journey involved the production of cotton, sugar and tobacco from the slave labor which would be sold in Europe.

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Studies have shown that American blacks are able to retain sodium longer than Caucasians (Wilson et. al, 1991). It is the belief of some researchers that American blacks may have inherited a ‘renal defect in handling sodium’ caused by inherited variations in the renin gene. Another theory proposed by (Armelagos, 2005) suggested that the people of Sub-Saharan Africa were prone to excessive sweating and thus became genetically adapted to the environment. In order to retain the water lost by sweating the kidneys

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would have to retain water by increasing the amount of angiotensin produced. The ‘slavery hypertension hypothesis’ has been debated since the early1980’s in an attempt to explain the sodium sensitivity that is prevalent amongst African Americans. During the middle passage the captives were underfed and suffered from a number of saltdepletive diseases such as diarrhea and vomiting. Due to high mortality and low fertility natural selection allowed for the ‘favourable’

would have to retain water by increasing the amount of angiotensin produced. The ‘slavery hypertension hypothesis’ has been debated since the early1980’s in an attempt to explain the sodium sensitivity that is trait to be passed on to subsequent generations (Wilson et.. al, 1991). While working on the plantations the slaves lost an excessive amount of salt due to

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It is at this point that researchers who are against the ‘slavery hypertension hypothesis’ find fault. If the hot climate in the Caribbean played a significant role in naturally selecting for an increase in sodium retention then Africans who live in the same or a similar tropical climate should also have similar risk in developing hypertension (Armelagos, 2005).

It must be noted at this junction that the social and economic conditions between persons of African descent living in Africa versus those living in the western hemisphere is vastly different which requires consideration. Current research geared specifically to comparing hypertensive risk patterns between Afro-Caribbean individuals and Africans is limited. Although a study

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conducted by (Cooper et. al, 1997) examined the prevalence of hypertension amongst individuals from West Africa (Cameroon and Nigeria), the Caribbean (Jamaica, St Lucia, Barbados) and the United States (metropolitan, Chicago Illinois). It was confirmed that the frequencies of the reninangiotensin genes in US and Jamaican blacks were derived from 75% of their Nigerian ancestry. Results showed that persons

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The Pulse Revitalized living in Nigeria and rural Cameroon had the lowest prevalence of hypertension while in the urban area of the Cameroons it was similar to those persons living in the Caribbean (Cooper et. al, 1997). Unfortunately, the genetic or environmental hypotheses were not further explored in the study and the results were inconclusive. However, the shared alleles still present in the two populations which migrated from Africa centuries before is significant and suggests that environmental factors plays a major role which has already been identified. In the future, a more conclusive study should be undertaken where more West Indian islands are included and their genes are compared to those persons living in African countries that are known to have exported slaves to the West Indies. A number of factors would have to be adjusted for due to a noticeable shift from subsistence farming to a more Westernized lifestyle.

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Student Life

Pie Day

Gabrielle Buxton

Photos Provided By: Sumita Balooja

The Phi Delta Epsilon Pledge Class of Spring 2016 hosted its first pie-throwing fundraiser event. With the assistance of the faculty, student body, and members of PHI D, we were able to execute a successful event. After the stress of Block Exams, students were given the opportunity to “pie” the faculty. This was an amazing event showing the AUA faculty working together to help students achieve a goal.

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