Case Presentation: A 43-year-old woman with cryptogenic cirrhosis complicated by a previous episode of spontaneous bacterial peritonitis, recurrent bilateral hepatic hydrothorax, hepatic encephalopathy, and esophageal variceal bleeding presented with a three-day history of dyspnea. Her oxygen saturation was 90% on room air, but the remainder of her vital signs were within normal limits. A chest [...]

Case Presentation: A 72-year-old Caucasian woman without a known history of Myasthenia Gravis (MG) presented to the emergency department (ED) with profound fatigue and shortness of breath for 1 week. The patient had received her second Moderna COVID-19 vaccine dose 1.5 weeks prior to presentation.The patient reported that she was in her normal state of [...]

Case Presentation: FC is a 67-year-old female with prior history of diabetes, hypertension, and hyperlipidemia. She was initially admitted for three days of watery diarrhea. During her hospitalization, she suddenly suffered PEA arrest, and received CPR and ACLS algorithm for 26minutes before achieving ROSC. Patient was subsequently intubated. Her post-arrest neurologic exam was notable for [...]

Case Presentation: A 78 year old female with history of chronic kidney disease (CKD) stage 4, diet-controlled diabetes, and bilateral idiopathic ureteral obstruction s/p percutaneous nephrostomies presented with 5 days of changes in urine color. Initially, the patent reported a darker and thicker appearance to her urine that transitioned to a purple color. She denied [...]

Case Presentation: A healthy 22-year-old presented with four days of acute onset emesis, jaundice, and fever. Four days prior to presentation, the patient ate fried chicken and rice for lunch. Four hours later he had twelve episodes of non-bilious non-bloody vomiting, without associated diarrhea or abdominal pain. Over the next three days, he developed progressive [...]

Background: Alcohol withdrawal syndrome is a clinical syndrome with clinical manifestations of anxiety, insomnia, irritability, disorientation, hallucinations, seizures, and autonomic hyperactivity. Delirium tremens is the most severe manifestation of alcohol withdrawal. Although benzodiazepines are currently the first line for treatment of alcohol withdrawal, barbiturates are increasingly used for treatment as an alternative[1–3]. We need strong [...]

Background: Guillain barre syndrome(GBS) has been recently associated with COVID-19 disease. Usually, GBS cases are associated with immune stimulation and reported after taking different vaccines, however, there is no confirmed evidence that this is a causal association. In this systematic review, we are investigating cases of GBS that have been reported following the COVID-19 vaccination. [...]

Background: Neonatal abstinence syndrome (NAS) occurs when a neonate is exposed to licit or illicit chemical substances in utero and manifests withdrawal symptoms postnatally. Appropriate identification, documentation, and communication of NAS diagnosis is needed to qualify for federally funded therapies aimed at supporting development through early intervention (EI) programs. Our objective was to assess characteristics [...]

Background: Hospitalists are at the forefront of the opioid epidemic. Over half of hospitalized patients are exposed to opioids during their admission, most of whom are opioid naïve.1 Patients discharged on opioids have a 15% chance of long-term use after one year.2 There is significant variation in provider opioid prescribing practices, even within the same [...]

Background: United States Preventive Services Task Force recommends clinicians provide smoking cessation counseling and interventions to all smokers and lung cancer screening with low dose CT scan for high-risk individuals. We aimed to determine the prevalence of smoking cessation counseling and lung cancer screening rate at the residents’ clinic and implement a multimodal plan to [...]