Case Presentation: A 15-year-old male with HIV and inconsistent antiretroviral therapy adherence presented to an HIV clinic in Lilongwe, Malawi with weight loss, night sweats, lower extremity rash, and diarrhea. The rash on his legs had been present for 4 months and then spread to his arms. On exam, his vital signs were unremarkable. He [...]

Background: Worldwide, the number of refugees continues to increase. By the end of 2017, there were an estimated 68.5 million individuals forcibly displaced worldwide due to persecution, conflict, or generalized violence. Refugees have unique and complex health care conditions and needs. Most physicians receive limited, if any, training on providing medical care to refugees. The aim [...]

Background: Kidney dysfunction is a risk factor for several health problems, such as ischemic heart disease, stroke, peripheral artery disease, chronic kidney disease, and gout. This study aims to analyze the global disease burden caused by kidney dysfunction at the national, regional, and territorial levels. Methods: As part of our ecological investigation, we used the [...]

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: The Lean-Kaizen approach of implementing patient-centered systems change by reducing waste and adding value has been widely used in health systems in the US to provide incremental process improvement. This approach to streamlining health care processes has been under-utilized in resource-poor regions of the world, even though the Lean-Kaizen approach was developed in under-resourced [...]

Background: Hospital medicine is the fastest growing specialty in the United States. An interesting aspect of the rapid expansion of hospital medicine is the current expansion of the field beyond North America. While the health care systems, regulations and cultural norms in these nations differ, some of the reasons for the development of hospital medicine [...]

Background: This presentation will describe a novel study started during a sabbatical year in Colombia. It will briefly cover logistics of taking a sabbatical year and then discuss the ongoing project and preliminary results. Dengue, a neglected tropical viral disease transmitted by the Aedes egypti mosquito, is endemic in Colombia and serves as an ideal [...]

Case Presentation: A 44-year-old African woman presented to the ED complaining of productive cough, headache, fever, chills and nausea for 5 days. PMH was significant for HIV (CD4 557 cells/ mm3, HIV RNA 20 copies/mL) and non-Hodgkin lymphoma (in remission since 2009). Medications included darunavir, ritonavir, abacavir/lamivudine and valacyclovir. She denied travel, drug and alcohol [...]

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 [...]

Case Presentation: A 35 year-old female with a past medical history significant for type 2 diabetes mellitus, polycystic ovarian syndrome and migraine headache presented with alteration of mental status for 2 weeks. Patient endorsed progressive, generalized fatigue with intermittent episodes of confusion, behavioral disturbance, hypersomnia and short-term memory loss. Vital signs on admission were significant [...]