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It was felt to represent high mortality with severe liver conditions like portal cirrhosis, metastatic liver disease, infective hepatitis, etc. Ertugliflozin solubility dmso At that time, EEG was used to diagnose early stages of hepatic encephalopathy and as a tool to guide treatment with medications like neomycin. The term triphasic waves was first coined in 1955 by Bickford and Butt, given the three-phase morphology.The brachiocephalic artery, brachiocephalic trunk, or more commonly referred to clinically as the innominate artery, is one of the three great vessels of the aortic arch that supplies blood to the head, neck and upper extremities. Specifically, the artery goes on to form the right subclavian artery, which provides blood to the right upper extremity, and the right common carotid artery, which is one of the main arteries supplying blood to the head and neck. The innominate artery is of particular clinical significance not only due to its vital role in providing much of the blood to the superior aspect of the body but also due to anatomic variations that are numerous and not at all uncommon. These variations can often lead to malformations that may require surgical correction early on, primarily due to tracheal and/or esophageal compression. One of the more significant clinical circumstances involving the innominate artery is the formation of trachea-innominate artery fistulas in patients who have undergone tracheostomy, and are a leading cause of mortality after such procedures.Perioperative acute kidney injury (AKI) is a serious yet under-recognized problem in patients who have recently undergone surgery. Due to increasing age and number of comorbidities, perioperative AKI is increasing in incidence and has significant morbidity and mortality. Postoperative AKI is of particular concern because when compared to patients without postoperative AKI, the risk of short- and long-term mortality is increased, and both costs of hospitalization and utilization of resources are significantly increased. Early recognition of AKI and implementation of early goal-directed therapy is critical to reducing the incidence of progression to chronic kidney disease, renal replacement therapies (RRT), and death.Chronic fatigue syndrome is a chronic disease that potentially affects about two million Americans. The United States Public Health Services initially described it during an epidemiological study of Los Angeles County during the summer of 1934. Chronic fatigue syndrome, also called myalgic encephalomyelitis, is a complex multisystem disease commonly characterized by severe fatigue, cognitive dysfunction, sleep problems, autonomic dysfunction as well as post-exertional malaise, severely impairing activities of daily living. Things get worsened due to the condition remaining undiagnosed for years secondary to inadequate medical teaching on the subject, provider bias, as well as confusion regarding diagnoses and treatment of the disease.Marcus Gunn pupil (MGP) is the term given to an abnormal pupil showing aberrant pupillary response in certain ocular disorders. In literature, the term is often used synonymously with Marcus Gunn phenomenon or relative afferent pupillary defect (RAPD). After exposure to bright light, a normal pupil constricts.A Marcus Gunn pupil, on the other hand, has a relative weakness of the afferent limb of the pupillary light reflex compared to the other eye because of which when light is rapidly transferred from the normal eye to the eye with MGP, the MGP dilates instead of constricting. It is named after Scottish Ophthalmologist Robert Marcus Gunn. Hirschberg first noted this phenomenon in the case of unilateral retrobulbar optic neuritis. The presence of a relative afferent pupil defect (RAPD) is the hallmark of a unilateral afferent sensory abnormality or bilateral asymmetric visual loss. An afferent pupillary response is characterized by 2. Dilatation of pupils of both eyes when the light stimulus is rapidly transferred from the normal eye (after brief light exposure to the normal eye) to the affected eye.Plantar fibromatosis is a benign fibroblastic, connective tissue proliferative disorder of the superficial plantar aponeurosis of the foot. It belongs to a family of similar diseases (Peyronies and Dupytrens) that were first described in 1610 by Plater. George Ledderhose, a German physician, initially described the disease in 1897 following his observation of fifty cases. Ledderhose disease is diagnosed by identifying nodules within the central or medial bands of the plantar fascia of the foot. Onset is slow and patients usually present after the disease becomes locally aggressive causing pain and swelling in the medial non-weight bearing plantar surface of the feet.Patients commonly present to emergency departments, primary care offices, or specialty clinics with musculoskeletal injuries. The initial management of an acute traumatic limb injury involves a thorough history and physical evaluation of the injury, which includes a motor, sensory, and neurovascular examination. Injuries that result in instability require immobilization, decreasing the likelihood of further damage, protecting soft tissues, alleviating pain, and accelerating healing. Instability may result from direct injury to the bones (fracture), joints (dislocation), or the soft tissues such as the muscles (strain) or ligaments (sprain). Following the diagnosis of an unstable injury, a splint may be the best treatment option and is loosely defined as an external device used to immobilize an injury or joint and is most often made out of plaster. A splint must be differentiated from a cast, to determine the best form of immobilization based on the clinical scenario. Contrary to a splint, a cast is a circumfes. As such, a thorough understanding of the indications, contraindications, and approach to proper splint placement is essential for practitioners that treat patients with acute musculoskeletal injuries.Angina, or chest pain, is the most common symptom of ischemic heart disease, which is a major cause of morbidity and mortality worldwide. Chest pain can be due to non-cardiac and cardiac causes, and thorough history and physical is critical in differentiating these causes and identifying patients experiencing acute coronary syndrome. Angina is one of the signs of acute coronary syndrome (ACS) and can further subdivide into stable and unstable angina. Stable angina defines as the occurrence of symptoms with exertion only. Unstable angina or symptoms occurring at rest requires more prompt evaluation and management. Approximately 9 million patients in the United States have symptoms of angina, and recognizing these symptoms is imperative in improving patient outcomes.