Background: In the pre-operative setting, hospitalized patients are often made “NPO” after midnight prior to their procedure. This practice stems from concerns about aspiration of stomach contents intra-operatively, though many studies have established that fluid intake preoperatively does not increase aspiration or other adverse outcomes (1-10). Preoperative fasting has, however, been associated with adverse outcomes [...]

Background: Ultrasound-guided thoracentesis and paracentesis are frequently performed for both diagnostic and therapeutic indications. While the risk of aspiration is low, our institution has historically required patients to be fasting for 4 hours prior to the procedure. In the hospital setting, unnecessary fasting requirements could contribute to missed patient meals and procedure delays. Here, we [...]

Background: Patients are frequently ordered to fast while hospitalized. Though these “nil per os” (NPO) orders are often placed for sound clinical reasons (e.g. small bowel obstruction), they are also frequently placed in preparation for imaging studies or procedures to reduce the theoretical risk of aspiration. There is often a great deal of confusion among [...]

Background: Imaging diagnostics such as CT and MRI are practically inaccessible to many of this developing nation’s 42 million citizens. Ultrasound, however, is more readily available but primarily limited to use in obstetrics. With proper training, the diagnostic utility of ultrasonography may be expanded to non-obstetric point-of-care examinations. In this study, we aimed to evaluate [...]

Background: Islam is the second-largest religious tradition in the world, with approximately 3.45 million members in the United States. New York State has the third largest Muslim population and recent data estimates 20,000 to 25,000 Muslims reside in the greater Rochester area. During the month of Ramadan, all Muslims who are physically capable are obligated [...]

Case Presentation: A 61-year-old African American male with history of recent atopic dermatitis treated with topical corticosteroids presented with 4 days of fevers, night sweats and worsening exertional dyspnea. On admission, he was febrile with decreased left lower lobe breath sounds. CT showed a moderate left-sided pleural effusion and left upper lobe cavitary lesion. The differential included both infectious and malignant etiology [...]

Case Presentation: A 49 year-old woman with end stage renal disease on peritoneal dialysis (PD) for the past year, presented with progressively worsening abdominal pain, fevers, and nausea. This was her second presentation as she had been treated with antibiotics for presumed culture-negative PD-catheter-associated bacterial peritonitis three weeks earlier without improvement. Admission vital signs and [...]

Case Presentation: A 76-year-old Hispanic man with poorly-controlled diabetes mellitus complicated by nephropathy presented to a hospital with 2 weeks of nausea, vomiting, and progressive lethargy. During the initial evaluation, he developed a focal right-sided seizure advancing to a generalized tonic-clonic seizure lasting 30 seconds. He was afebrile, hypertensive, and non-tachycardic with normal saturation on [...]

Case Presentation: A 52 year-old man with PMH of HIV presented with inguinal lymphadenopathy, intermittent abdominal pain, suprapubic fullness, fever and poor urine production for several days. Bladder catheterization yielded a large volume of bloody urine. The patient had not experienced hematuria previously and had no history of urinary retention, urgency, perineal or GU trauma. [...]

Case Presentation: We detail the hospital course of a 44-year-old man with HIV, inconsistent treatment adherence, and suspected pulmonary tuberculosis (TB). Referred due to miliary lesions on CT scan post-positive QuantiFERON test, weight loss prompted further investigation. The patient, with a CD4 count of 290 cells/μL, had a history of HAART non-adherence, yet no prior [...]