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It is possible that she may develop more signs and symptoms of SLE with time and will need close follow up. Timely diagnosis and prompt treatment are vital to decrease morbidity and mortality, as done in our case. The patient was started on high-dose steroids with significant improvement in her symptoms. These patients may need early treatment with plasmapheresis and long-term follow-up with immunotherapy to prevent relapse. There are few case reports in the literature, and more information is needed to understand and better diagnose NMO with coexisting SLE.Kwashiorkor syndrome is a form of severe protein-energy malnutrition characterized by protein deficiency and bilateral extremity swelling. Worldwide, most affected regions include Southeast Asia, South Africa and Central America; it is rare in developed countries such as the USA. We report a case of profound kwashiorkor in a 38-year-old male with an underlying psychiatric disorder and restricted diet who presented with extensive abdominal distention and systemic findings indicative of protein malnutrition.The clinical features of cardiac myxoma vary significantly from asymptomatic to severe cardiovascular complications like atrioventricular valve obstruction and thromboembolism depending on the location, size, and mobility of the tumor. Echocardiography is the diagnostic study of choice, and surgical resection is the method of choice to prevent complications. We report a case of a 47-year-old female who presented with exertional dyspnea, malaise, and weight loss. Physical examination was significant for jugular venous distension, basal crackles in lungs, 2+ pedal edema, and rumbling diastolic murmur at apex. CT of the chest revealed a hypodense filling defect in the left atrium. Transthoracic echocardiogram showed a 5.5 × 4.5 cm mobile density, likely myxoma, attached to the interatrial septum and prolapsing into the left ventricle during the diastolic phase, causing functional mitral stenosis. She underwent a resection of cardiac myxoma. The histopathology report confirmed the diagnosis of myxoma, and post-operative recovery was uneventful.The literature review aimed to see the safety and efficacy of bronchial thermoplasty in patients with severe asthma. We searched the online database, PUBMED, using bronchial thermoplasty and asthma as the key words and including trials from 2007 to 2021. Our review found that bronchial thermoplasty reduces asthma-related hospitalizations, emergency room visits and asthma exacerbations with sustained benefits for 5-10 years. This came at the expense of increased asthma-related adverse events, most commonly during the 7 days immediately after the procedure. Adverse events from 6 weeks after procedure to up to 5 years were similar between the bronchial thermoplasty group and the medication-only group. Bronchial thermoplasty is a safe and efficacious treatment modality for patients with severe asthma.Spontaneous pneumomediastinum (SPM), a rare occurrence, is defined by the presence of extraluminal gas in the mediastinum in the absence of trauma or underlying parenchymal disease. It is usually benign and has been associated with the inhalation of marijuana, cocaine, and amphetamines. The breathing maneuvers along with cyclical vomiting have been postulated as the underlying etiology. We present a case of a 27-year-old previously healthy male who presented with sudden onset chest pain and was found to have marijuana-induced pneumomediastinum.Background Vasospastic angina (VA), or Prinzmetal's angina, is characterized by symptoms of coronary angina caused by coronary vasospasm, usually in the absence of atherosclerotic changes. It typically presents with chest pain, which can be accompanied by transient electrocardiographic changes, if visualized during the attack. It can also rarely present with severe manifestations of acute myocardial angina, ventricular fibrillation, or cardiac arrest. Case presentation We present a case of a 50-year-old Caucasian male who initially presented to the hospital with chest pain and was diagnosed with VA. Later, he was brought to the hospital by emergency medical services later with ventricular fibrillation, despite normal coronary anatomy on angiogram. He was managed with placement of an intra-cardiac defibrillator (ICD) for secondary prevention. The patient continued to have recurrent episodes of ventricular fibrillation with associated ICD shocks, and had multiple admissions to the hospital with similar presentations. Symptoms and arrhythmia improved after optimizing antianginal therapy. Conclusions Ventricular fibrillation can be an uncommon but severe manifestation during VA crises. In cases with normal coronary vasculature, it is important to recognize VA as a cause of recurrent ventricular fibrillation in order to optimize medical management for prevention of fatal arrhythmias.Hyponatremia is a common finding in patients admitted to hospitals in the USA. There is a plethora of causes ranging from excessive diuretic use to volume overload from underlying heart failure or liver cirrhosis. The consequences of missing or mistreating the aforementioned diagnosis can lead to catastrophic outcomes. Here, we focus on a rare yet overlooked cause of hyponatremia obstructive nephropathy. The causes of obstructive nephropathy in elderly patients are broad with neurogenic bladder being one of the common ones. Our patient is an elderly male who presented with hyponatremia in setting of urine retention post an orthopedic surgery.Background There is no 'gold standard' method of rounding for hospitalists. IKE modulator This study investigates hospitalist rounding preferences to improve efficiency based on resources categorized under work assignment and communication. Methods An anonymous survey containing demographics and questions on preferences for rounding efficiently by hospitalists were widely distributed online. Res6ponses were presented using descriptive statistics and SPSS v26. Results There were 143 respondents, majority male (60%) with (40%) female. Most (80%) expect higher patient volumes when working with an advanced practitioner (AP). Half (50%) preferred rounding independently, (34%) with an AP, and majority (62%) with a resident. Geographic rounding was most efficient at 85%. Text messaging for paging was preferred (70.1%) to pagers (23.4%). Respondents preferred calling a consultant (52%) or text messaging (40%). Majority have not used a WOW yet (74%) believe WOWs could improve efficiency. Majority prefer dictation via Dragon (47%) to the phone application (23%).