Background: Vitamin B9, also known as folate, is a water soluble vitamin found in vegetables, fruits and animal products that plays a key role in purine and pyrimidine synthesis, nucleoprotein synthesis and erythropoiesis. Deficiency can result from malabsorption, anti-epileptic and methotrexate use, pregnancy, hemolytic anemic, and alcoholism and is implicated in neural tube defects. Signs [...]

Background: Inpatient serum folate testing was recognized as a low-value practice by the Choosing Wisely campaign in 2015. Despite this recognition, clinicians at our hospital system continue to use this test in a standard workup for conditions such as anemia, dementia and altered mental status. Shifting practice patterns away from serum folate testing remains a [...]

Case Presentation: Almost 3 yo female presented to the ED) with multiple contusions, finger fractures and abrasions. Mother sought care for evaluation of a left occipital swelling that she noticed following the patient’s stay with a respite-care. The worker denied injury. When questioned by the social worker, the mother mentioned that her daughter did not [...]