Brugada Syndrome and Kawasaki Disease in a Two-Year-Old: A Case of Double Jeopardy.

Brugada syndrome (BrS) is a genetic channelopathy that may predispose to ventricular arrhythmia. It is inherited as an autosomal dominant pattern with incomplete penetrance. Fever can unmask Brugada syndrome in children who have a genetic predisposition.

Predictors of Post-ERCP Pancreatitis: A Comprehensive Systematic Review and Meta-Analysis.

Background And Aims: Pancreatitis is the most common serious adverse event associated with endoscopic retrograde cholangiopancreatography (ERCP). This meta-analysis aimed to precisely assess the risk factors for post-ERCP pancreatitis (PEP).

Methods: We searched electronic databases for studies that assessed risk factors for PEP after adjusting for ≥3 risk factors, including at least one pre-specified patient-related and one procedure-related risk factor, and reported the data as adjusted odds ratios (OR) with 95% confidence intervals.

The Effect of Epidural Analgesia on In-Hospital Outcomes in Patients with Acute Pancreatitis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Objectives: Acute pancreatitis (AP) can lead to severe complications and high mortality. Previous studies suggest that epidural analgesia (EA) may reduce AP severity and improve outcomes. This systematic review and meta-analysis aimed to evaluate the efficacy of EA on in-hospital outcomes in AP patients.

Pregnancy Management and Outcomes in a Small Bowel, Pancreas, and Liver Transplant Recipient: A Case Report and Literature Review.

BACKGROUND Small bowel transplantation (SBT) is a rare but life-saving surgery. However, successful full-term pregnancies in individuals with SBT are exceedingly rare due to the nutritional and immunosuppression challenges this transplant poses for pregnancy. Therefore, clear guidelines for treating pregnant SBT recipients are unavailable.

Malignant Peripheral Nerve Sheath Tumour Presenting as Sciatica in a Patient with Neurofibromatosis Type 1: Is Magnetic Resonance Imaging an Effective Screening Tool?

Unlabelled: Peripheral malignant nerve sheath tumours (MPNST) are rare and aggressive soft tissue sarcomas often associated with neurofibromatosis type I (NF-1). We describe a case of 26-year-old female with NF-1, initially misdiagnosed as sciatica, who was later found to have a malignant spindle cell peripheral nerve sheath tumour of the right sciatic nerve. Magnetic resonance imaging (MRI) proved to be a valuable tool for diagnosis.

Opioid use disorder's impact on asthma hospitalizations: A propensity-matched nationwide study.

Background: Patients with asthma and opioid use disorder (OUD) experience higher rates of acute exacerbation, but the effects of OUD on asthma hospitalizations have been poorly described.

Objective: To explore how concurrent OUD may affect the clinical outcomes of adult patients hospitalized for asthma.

Methods: Using the National Inpatient Sample, adult patients admitted for asthma with concomitant OUD were identified and compared with those without OUD.

Comparison of Machine Learning Models to a Novel Score in the Identification of Patients at Low Risk for Diabetic Retinopathy.

Purpose: To develop an easily applicable predictor of patients at low risk for diabetic retinopathy (DR).

Design: An experimental study on the development and validation of machine learning models (MLMs) and a novel retinopathy risk score (RRS) to detect patients at low risk for DR.

Subjects: All individuals aged ≥18 years of age who participated in the telemedicine retinal screening initiative through Temple University Health Systems from October 1, 2016 through December 31, 2020.

Hyponatremia Prevalence in Decompensated Chronic Liver Disease: Insights from a Tertiary Care Hospital.

Background: Liver cirrhosis is a prominent global contributor to mortality, and hyponatremia is a common complication in patients with decompensated chronic liver disease (DCLD). Hyponatremia is characterized by kidney impairment when eliminating solute-free water. The presence of contradictory findings in existing literature prompted this study.

Statin-associated muscle symptoms: A comprehensive exploration of epidemiology, pathophysiology, diagnosis, and clinical management strategies.

Statins are the first line of treatment for both primary and secondary prevention of atherosclerotic cardiovascular disease. Despite the positive effects of statins on cardiovascular events, not all patients can use them at an optimized dose. The reason for this is the skeletal muscle side effects, termed statin-associated muscle symptoms (SAMS).

Immobile to Ambulation: Complex Multijoint Pathologies in a Patient with Advanced HIV Disease: A Case Report.

Case: A 30-year-old man with a history of advanced HIV disease (AHD) presented with bilateral equinocavus, leg, and foot muscle paresis, Brooker grade 4 heterotopic ossification of hips and knee stiffness, and was unable to sit upright, stand independently, or walk. Electromyography showed demyelinating sensorimotor and axonal polyneuropathy of lower extremities. Multiple surgeries of bilateral hips, ankles, and feet enabled joint mobility, plantigrade feet, and independent ambulation.

Risk of Aspiration Pneumonitis After Elective Esophagogastroduodenoscopy in Patients on Glucagon-Like Peptide-1 Receptor Agonists.

Background Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are gaining popularity in the management of diabetes mellitus and obesity. It has been suggested that this class of medications causes delayed gastric emptying which raised concerns about the potential for aspiration of gastric contents in patients undergoing sedation. This led to a statement by the American Society of Anesthesiologists about their preoperative use.

Small Bowel Ischemia and Ischemic Colitis Secondary to Thrombotic Thrombocytopenic Purpura in a Patient With Systemic Lupus Erythematous: A Rare Clinical Entity.

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening hematologic disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ dysfunction. This report highlights a rare case of small bowel ischemia and ischemic colitis caused by TTP in a 35-year-old woman with systemic lupus erythematosus (SLE), hypertension, and end-stage renal disease on hemodialysis. She presented with severe abdominal pain, diarrhea, vomiting, and bloody bowel movements.

A Paradox Unveiled: A Case Report of Cerebral Infarctions in a Patient With Severe Thrombocytopenia.

Thrombocytopenia is a condition in which the platelet count is less than 150,000/μL, which can be congenital or acquired. The condition can be further sub-classified. Nevertheless, the causes include infection, medication-mediated, liver diseases, or heart diseases.

Preventive Antibiotic Use and Complications After Endoscopic Retrograde Cholangiopancreatography in Patients Hospitalized for Primary Sclerosing Cholangitis.

Background: The American Society for Gastrointestinal Endoscopy recommends prophylactic antibiotics before endoscopic retrograde cholangiopancreatography (ERCP) in primary sclerosing cholangitis (PSC). We assessed the impact of this approach on the incidence of post-ERCP outcomes using nationwide data.

Methods: Using 2015-2021 Nationwide Inpatient Sample data and relevant ICD-10 codes, we analyzed adult hospitalizations for PSC who underwent ERCP, with and without antibiotic prophylaxis.

Rhabdomyolysis in Acute HIV Infection.

Rhabdomyolysis is a rare but potentially life-threatening complication of acute HIV infection. We present a case report of a young adult male who presented with fever, myalgia, and elevated creatine phosphokinase levels, ultimately diagnosed with acute HIV infection-associated rhabdomyolysis. This case highlights the importance of considering HIV infection in the differential diagnosis of rhabdomyolysis, particularly in at-risk populations, even in the absence of typical HIV-related symptoms.

A Case of Legionella Pneumonia with Rhabdomyolysis, with Extremely high Creatinine Kinase without Acute Kidney Injury in an Adult.

Unlabelled: is a bacterium that usually causes pulmonary disease but can rarely present with extrapulmonary manifestations, such as rhabdomyolysis. This is a case of Legionella infection with significant rhabdomyolysis but a lack of acute kidney injury. A 38-year-old male with a history of epilepsy presented to the emergency department after a seizure episode with confusion, fever, emesis and bruises.

Group B Streptococcus Primary Pyogenic Ventriculitis in an Adult.

Pyogenic ventriculitis is a disorder characterized by inflammation of the cerebral ventricular lining secondary to infection within the ventricular system. Very few cases of primary pyogenic ventriculitis have been reported among adults. We present a case report of a 74-year-old female with a history of hypertension and diabetes mellitus who presented with Group B Streptococcus (GBS) primary pyogenic ventriculitis.

A Case Report of Challenging Diagnosis of Persistent Hypoglycemia Secondary to Methadone Dose-Dependence in a Patient With End-Stage Renal Disease (ESRD) and Liver Cirrhosis (LC).

Methadone is a widely used opioid used for the management of chronic pain, treatment for opioid use disorders (heroin addiction), as well as for acute opioid withdrawal syndrome. Even though methadone is considered a safe drug, it is not exempt from unwanted side effects, some of them can be rare and may be overlooked due to patients' comorbidities, delaying proper identification of the actual etiology. This article highlights one of those side effects, hypoglycemia, in a 64-year-old woman with a medical history of end-stage renal disease (ESRD) on hemodialysis, Acquired immune deficiency syndrome, liver cirrhosis, and a history of intravenous (IV) drug abuse disorder on a methadone maintenance program, and the importance of prompt identification and management, such as dose splitting or alternate medication to manage opioid withdrawal.

An Unusual Case of Paroxysmal Third-Degree Atrioventricular Block: Thinking Outside the Box.

During the assessment of a third-degree atrioventricular (AV) block in a patient with syncope, different etiologies should be considered and evaluated. Extrinsic vagal paroxysmal AV block, extrinsic idiopathic AV block and intrinsic paroxysmal AV block are among the types of third-degree AV block in the differential diagnoses. Extrinsic vagal paroxysmal third-degree atrioventricular block (EV-AVB) is linked to parasympathetic influence on cardiac conduction and can be observed in bladder distention and urinary retention.

The efficacy of Hemospray in managing bleeding related to gastrointestinal tumors: systematic review and meta-analysis.

Introduction: Gastrointestinal (GI) bleeding stemming from malignant tumors is increasingly recognized, due to advancements in oncology and detection methods. Traditional endoscopic hemostatic techniques have shown variable success rates in managing hemorrhagic GI neoplasms. Hemospray, an emerging endoscopic hemostatic powder, offers promise in treating upper GI bleeding, potentially extending its utility to neoplastic bleeding sites.

Unveiling Rarity: A Case Report of a Poorly Differentiated Synovial Sarcoma Mimicking a Plunging Ranula.

Synovial sarcomas are uncommon and highly aggressive sarcomas. Typically, they start in the soft tissues of the extremities, although they may develop in the head and neck region in rare cases. When they do, they usually present with localized symptoms in the affected area.

Metachronous Human Papillomavirus (HPV)-Related Eye Carcinoma in Previously Metastatic Breast Cancer: A Case Report.

Multiple primary malignancies (MPMs) occur when an individual develops two or more distinct primary cancers. These are categorized as synchronous or metachronous based on the timing of their diagnosis. Patients previously diagnosed with cancer face increased risks due to exposure to carcinogenic factors and treatments such as chemotherapy and radiotherapy.