Clinical Profile of Patients Presenting With Eclampsia at a Semi-urban Tertiary Care Center.

Introduction Pregnancies complicated by hypertensive disorders contribute to enormous burden on economy and health-care facilities. Eclampsia is one of the clinical markers of near-miss mortality. To achieve optimal outcomes, efforts should be directed at both periphery and tertiary care levels.

Late Identification of Perinatal Transmission of HIV in an Infant at High Risk.

The focus of this case study is the delayed diagnosis of a perinatal HIV transmission, which was identified when the infant reached 4 months of age, and the social conditions and structural determinants that contributed to the increased transmission risk. Despite adhering to the diagnostic testing protocols and neonatal antiretroviral (ARV) guidelines of the New York State Department of Health, this transmission still occurred. This transmission event prompted strategies to address criminalization of substance use during pregnancy and a reevaluation of the HIV testing and treatment protocols, including the timing of testing.

Bullous Pemphigoid Complicated by Sepsis.

Patients with bullous pemphigoid face many challenges when managing their disorder, one of which is balancing medication with their ailments. Because the patient population with bullous pemphigoid are primarily elderly, the current first-line treatment of corticosteroids tends to increase their rates of morbidity and mortality. During the acute process of the disease, providers must also consider the increased chance of infections caused by the opening in the skin.

COVID-19 Vaccine Hesitancy Among Healthcare Providers.

Objective: Vaccine hesitancy among healthcare providers can compromise public confidence in vaccination during the ongoing COVID-19 global epidemic and increase susceptibility to life-threatening disease. We sought to investigate predictors of openness to vaccination among healthcare workers who choose not to be vaccinated against COVID-19 in order to explore potential solutions.

Methods: Physicians, physician assistants, and nurses who chose not to be vaccinated were surveyed to decipher reasons for vaccine refusal and personal loss due to the virus along with demographic variables.

Ultrasound determination of the dural sac to sacrococcygeal membrane distance in premature neonates.

Background: Caudal epidural analgesia is the most common regional anesthetic performed in infants. Dural puncture, the most common serious complication, is inversely proportional to age. Measuring the distance from the sacrococcygeal membrane to the dural sac may prevent dural puncture.

Postpartum Mother-To-Child Transmission of HIV in a Breastfeeding Infant.

This article is an examination of MTCT of HIV through breastfeeding in a mother who seroconverted postnatally.

Abnormal Bedside Ultrasound Findings in a Complex Patient With Kawasaki Disease.

We herein report a case of an 18-year-old female with Kawasaki disease who presented to the emergency department with epigastric abdominal pain and was subsequently found to have free fluid present in her abdomen visualized on bedside Focused Assessment with Sonography for Trauma (FAST) exam. Kawasaki disease is an acute vasculitis syndrome that primarily affects children and can have serious complications such as coronary artery aneurysms. The use of ultrasound in emergency departments is rapidly increasing, with the FAST being one of the most commonly performed bedside ultrasound examinations.

An Ominous Cause of Headache in a Teenager.

We present the case of an adolescent male who presented to the emergency department with headache and vomiting. We discuss the differential diagnosis and the need to maintain a high index of suspicion to avoid missing ominous causes of headache. In this case, the patient had a pineoblastoma, detected on a noncontrast CT scan.

An Uncommon Rash in the Emergency Department: Sporothrix schenckii.

The authors present a case of diagnosed in the emergency department, based on a thorough history. The patient presented with skin nodules that had spread proximally up the arm in various stages of healing. He reported minimal pain for the unhealed ulcer and no pain for the healing ulcers, and no other concerning symptoms.

Anatomic and radiological correlation of injectate spread from first thoracic costotransverse junction in cervical erector spinae plane.

Introduction: Cervical erector spinae plane block (ESPB) provides postoperative pain relief when administered at the level of first thoracic costotransverse junction (CTJ) for surgeries on the proximal shoulder and cervical spine. We propose to describe the spread of 20 ml radiocontrast - dye solution administered at this level from caudad to cephalad direction in a fresh frozen cadaveric model through imaging and cross-sections.

Methods: An observational study with four thoracic to cervical ESP blocks at the level of first thoracic CTJ level on two fresh cadavers (total 4 specimens) was conducted using 20 ml of radiocontrast- methylene blue combination (10 ml through the needle and 10 ml through the catheter).

Epidemiology of Reported HIV and Other Sexually Transmitted Infections During the COVID-19 Pandemic, New York City.

Early in the coronavirus disease 2019 (COVID-19) crisis, a statewide executive order (PAUSE) severely restricted the movement of New Yorkers from 23 March to 7 June 2020. We used New York City surveillance data for human immunodeficiency virus (HIV), chlamydia, gonorrhea, and syphilis to describe trends in diagnosis and reporting surrounding PAUSE. During PAUSE, the volume of positive HIV/sexually transmitted infection tests, and diagnoses of HIV, chlamydia, gonorrhea, and syphilis declined substantially, reaching a nadir in April before rebounding.

Circumpsoas block ... an anterior myofascial plane block for lumbar plexus elements: case report.

In an attempt to improvise the analgesia in patients with femoral fractures, we aimed at depositing local anesthetic deep to anterior psoas fascia (APf) under ultrasound (US) guidance to block lumbar plexus elements which emerge lateral, anterior, and medial to the psoas major muscle. We termed this as circumpsoas block (CPB). Clinical and computed tomography contrast studies revealed that a continuous CPB infusion with a catheter provided a reliable block of the lumbar plexus elements.

Neural Tube Defects in Pregnancies Among Women With Diagnosed HIV Infection - 15 Jurisdictions, 2013-2017.

In May 2018, a study of birth defects in infants born to women with diagnosed human immunodeficiency virus (HIV) infection in Botswana reported an eightfold increased risk for neural tube defects (NTDs) among births with periconceptional exposure to antiretroviral therapy (ART) that included the integrase inhibitor dolutegravir (DTG) compared with other ART regimens (1). The World Health Organization* (WHO) and the U.S.

Transition from paediatric to adult care among persons with perinatal HIV infection in New York City, 2006-2015.

Objective: The aim of this study was to evaluate the transition process from paediatric to adult care among persons with perinatal HIV infection in New York City (NYC).

Design: A retrospective prepost study and a matched exposed/unexposed nested cohort study.

Methods: Using data from the NYC HIV registry, a retrospective prepost study was performed among persons who transitioned from paediatric to adult care to assess pre and posttransition retention in care (≥1 CD4 cell count/viral load in a 12-month period), CD4 cell count and viral suppression (≤200 copies/ml).

Role of ultrasound guided epidural anesthesia for lower limb surgery in children with previously repaired meningomyelocele.

Background: Children that have had a meningomyelocele repair often present for hip and bilateral lower limb surgeries. Due to vertebral, epidural, and nerve root abnormalities, placement of epidural catheter is difficult.

Aims: We aim to describe the potential role of ultrasound in delineating the most appropriate intervertebral space for central neuroaxial blocks in these patients.

Repetitive Transcranial Magnetic Stimulation in Chronic Pain: A Meta-analysis.

Background: In this meta-analysis, we explore the role of repetitive transcranial magnetic stimulation (rTMS), a noninvasive neuromodulation technique in the treatment of chronic pain.

Methods: Studies comparing rTMS and conventional treatment for chronic pain were searched. The comparison was made for decrease in the pain scores with and without (sham) the use of rTMS after a follow-up interval of 4-8 weeks.

Continuum of Care Among People Living with Perinatally Acquired HIV Infection in New York City, 2014.

Objective: The HIV care continuum outlines the steps from HIV infection to diagnosis, linkage to care, and viral suppression among people living with HIV. We examined data for steps along the HIV care continuum among people living with perinatally acquired infection in New York City using surveillance data.

Methods: This study included data for people who acquired HIV infection perinatally and lived in New York City as of December 31, 2014.

Optimizing Prophylactic CPAP in Patients Without Obstructive Sleep Apnoea for High-Risk Abdominal Surgeries: A Meta-regression Analysis.

Introduction: Prophylactic continuous positive airway pressure (CPAP) can prevent pulmonary adverse events following upper abdominal surgeries. The present meta-regression evaluates and quantifies the effect of degree/duration of (CPAP) on the incidence of postoperative pulmonary events.

Methods: Medical databases were searched for randomized controlled trials involving adult patients, comparing the outcome in those receiving prophylactic postoperative CPAP versus no CPAP, undergoing high-risk abdominal surgeries.

Comparison of dexamethasone and clonidine as an adjuvant to 1.5% lignocaine with adrenaline in infraclavicular brachial plexus block for upper limb surgeries.

Background And Aims: The role of clonidine as an adjuvant to regional blocks to hasten the onset of the local anesthetics or prolong their duration of action is proven. The efficacy of dexamethasone compared to clonidine as an adjuvant is not known. We aimed to compare the efficacy of dexamethasone versus clonidine as an adjuvant to 1.

Health outcomes for HIV-infected persons released from the New York City jail system with a transitional care-coordination plan.

Objectives: We sought to assess 6-month outcomes for HIV-infected people released from New York City jails with a transitional care plan.

Methods: Jail detainees in New York City living with HIV who accepted a transitional care plan during incarceration were asked to participate in a multi-site evaluation aimed at improving linkages to community-based care. The evaluation included a 6-month follow-up; HIV surveillance data were used to assess outcomes for those considered lost to follow-up.

Confirmation of local anesthetic distribution by radio-opaque contrast spread after ultrasound guided infraclavicular catheters placed along the posterior cord in children: a prospective analysis.

Background: The needle tip placed at the level of posterior cord under ultrasound guidance is described as the most effective way to obtain single shot successful block in adults, for forearm and hand surgeries.

Objective: The aim of this research was to study the spread of dye (depicting the local anesthetic) through catheters placed along the posterior cord. This was performed with continuous infraclavicular blocks placed under ultrasound guidance in children.

Improving outcomes for patients with proximal femoral fractures.

A peri-operative bay was created to treat all patients with proximal femoral fractures admitted to one trauma ward at the Queen's Medical Centre, Nottingham. All patients had urinary catheterisation and their fluid intake and output was recorded; patients had daily blood tests and were cared for on pressure-relieving mattresses. In addition, a study day was provided for all nursing staff on the management of patients with proximal femoral fractures.