Background: Glucagon-like peptide-1 (GLP-1) agonists are increasingly prescribed for obesity and type 2 diabetes, demonstrating efficacy in weight loss and glycemic control [1-3]. Beyond metabolic effects, these medications show protective effects against renal disease progression and reduce major adverse cardiovascular events [4]. GLP-1 agonists influence body composition through effects on both fat mass and fat-free [...]

Background: Glucagon-like peptide-1 (GLP-1) agonists are increasingly prescribed for obesity and type 2 diabetes, demonstrating efficacy in weight loss and glycemic control [1-3]. Beyond metabolic effects, these medications show protective effects against renal disease progression and reduce major adverse cardiovascular events [4]. GLP-1 agonists influence body composition through effects on both fat mass and fat-free [...]

Background: Obstructive sleep apnea (OSA) is closely associated with obesity, and weight reduction is a critical component of its management. Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) agonists have shown promise in promoting weight loss, potentially improving outcomes in OSA patients. We aimed to calculate the mean reduction in BMI and waist circumference after [...]

Background: Among bedside procedures, factors such as body mass index (BMI), prior spinal procedures, and complex spinal anatomy are known to affect the success of lumbar punctures (LP) [2, 3]. However, the phenomenon of a “dry tap,” where cerebrospinal fluid (CSF) cannot be obtained despite the needle tip being correctly positioned in the thecal sac, [...]

Background: Providing patient centered care is a core value of all healthcare systems in our nation. However, having a code status discussion with patients and their families continues to be a challenging endeavor due to multiple factors such as competing priorities and time constraints, especially in the hospital setting. To improve code status discussion and [...]

Case Presentation: Valproic acid (VPA) is a widely-used medication in various neurological disorders. Although generally well-tolerated, we present a rare complication of VPA therapy inducing pancreatitis. A 49-year-old male with PMH of autism, epilepsy (on VPA), HTN and HLD presented to the ED with complaints of lethargy and pallor. He denied abdominal pain, fever, diarrhea, [...]

Case Presentation: A 56-year-old female with past medical history of systemic lupus erythematosus (SLE) on hydroxychloroquine (HCQ) for 30 years, gastroesophageal reflux disease, autoimmune hepatitis on budesonide, asthma, and fibromyalgia presented to the emergency department (ED) with five days of worsening fatigue, bilateral lower extremity weakness, and pain. One week prior, she experienced nausea, heartburn, [...]

Case Presentation: We report a case of a 35-year-old pregnant female with a history of type 2 diabetes complaint with only dulaglutide but not insulin, hypertension, and hyperlipidemia who presented with a two-day history of chills, shoulder pain, and reduced range of motion. She had a history of chronic left shoulder pain managed with intra-articular [...]

Case Presentation: A 56-year-old male presented to the emergency department with acute-onset severe hypotension, light headedness, rash, nausea, and vomiting. He progressed to develop widespread urticaria and facial flushing. He was previously in his normal state of health. He reported eating “meat and potatoes for dinner”. Social history was pertinent for frequent tick exposure as [...]

Case Presentation: A 62-year-old female presented to the Emergency Department with 48 hours of persistent palpitations and a week of poor oral intake, polydipsia, and polyuria. Her past medical history included Type II Diabetes Mellitus treated long-term with metformin and dapagliflozin. Two weeks before presenting to the Emergency Department, she transitioned from dulaglutide to tirzepatide [...]