Case Presentation: A young man presented to the ED with four days of severe, sharp midsternal chest pain, fevers, diffuse arthralgias, bilateral conjunctivitis, diarrhea, and fatigue. He reported sexual intercourse with an HIV positive male partner four months prior to presentation and a history of multiple STI’s diagnosed in the past 6 years. Vitals: 101.5F, [...]

Case Presentation: A 56 year old female patient with past medical history of hypertension and diabetes mellitus type 2 presents to the emergency department with a 1 day history of fever and confusion. Vitals showed a temperature of 101.4 F, heart rate at 112 beats per minute, blood pressure at 136/73. Initial lab work was [...]

Case Presentation: A 28-year-old man from Central America with a history of newly diagnosed human immunodeficiency virus (CD4 119 cells/mm^3, CD4 8%, viral load 61,000 copies/mL) presented with two months of progressive shortness of breath. Physical exam was remarkable for anasarca, diffuse cutaneous purpuric plaques as well as bilateral respiratory crackles. Chest x-ray revealed bilateral [...]

Case Presentation: A 49-year-old man with known history of class III obesity (body mass index 43), hypertension, hyperlipidemia, and insulin dependent diabetes presented to the emergency department with bilateral lower extremity swelling and dyspnea on exertion of two weeks duration. Pertinent vitals included blood pressure 161/74 mmHg, heart rate 99 beats per minute, and saturation [...]

Background: Blood transfusion practices is an important topic that may significantlyreduce maternal mortality and morbidity. This study assessed the incidence, demographics,obstetric profile, and indications of transfusion of blood products among women admitted forobstetric care, in a tertiary care hospital. Methods: This Cross-sectional study at Southern Railway Head Quarters hospital, Perambur, Chennai was conducted with women [...]

Case Presentation: A 70-year-old man presented with 3-months of profuse watery diarrhea and 40 lb. weight loss. Two months prior, he was seen at an outside facility where he underwent extensive non-diagnostic work-up of his symptoms with lab testing, imaging, esophagogastroduodenoscopy (EGD), and colonoscopy. At that time, his serum pancreatic elastase-1 level was low, prompting [...]

Case Presentation: A 63-year-old gentleman with a history of unprovoked left lower leg deep vein thrombosis (DVT) on rivaroxaban and seizure disorder on phenytoin, presented with acute onset abdominal pain, hematochezia, vomiting for two days. On presentation patient was tachycardic with a heart rate of 130/min, a physical exam revealed a distended and tender abdomen. [...]

Background: While the electronic health record (EHR) provides many benefits, its use can easily allow for incomplete documentation of relevant historical information. The EHR is designed to store documentation of a patient’s past medical history (PMH), surgical history (PSH), family history (FH), and active hospital problems in the History tab. When the information is in [...]

Background: Residents receive little feedback on their clinical reasoning (CR) documentation due to time constraints of supervisors and lack of a shared mental model. We developed an innovative workplace-based assessment tool using machine learning (ML) to provide feedback on CR documentation. Here, we describe the impact of feedback using this assessment tool. Methods: In earlier [...]

Case Presentation: A 62-year-old male with hypertension, CAD s/p CABG, atrial fibrillation on oral anticoagulation, type 1 diabetes s/p pancreatic and renal transplant in 1999 on maintenance Tacrolimus and Mycophenolate presented to the ED complaining of severe headache and confusion. He was very agitated and unable to follow commands. At one point, he was sitting [...]