This is a case of a 93 year old patient who presented with a syncopal episode due to infra-nodal atrio-ventricular block (AVB) which required placement of a permanent pacemaker (PPM). The initial pre-procedure chest x-ray (CXR) showed an elevated left hemidiaphragm with shifting of the heart to the right making PPM implant challenging.

Hyponatremia, defined as a serum sodium level less than 135 mg/mL, can be euvolemic, hypovolemic, or hypervolemic. Its presentation can be subtle or severe depending on whether the hyponatremia is acute or chronic. This case investigates a geriatric patient who suffered diarrhea and hyponatremia following a course of ferrous sulfate pills for anemia treatment. Given that ferrous sulfate pills usually result in constipation, this presentation was abnormal. Literature review and comparison to prior atypical situations resulted in the conclusion that the patient’s diarrhea was likely a result of her Crohn’s diagnosis. The subsequent resulting hyponatremia was likely due to this diarrhea coupled with her prescription thiazide diuretic which can cause hyponatremia as a common side effect. This report allows for physicians to understand potential causes behind atypical electrolyte abnormalities in their patients and hence, find an effective treatment plan.

During Fall Semester, 2019, and Spring Semester, 2020, we had 287 students participate in a blood pressure measuring exercise. Subjects included both male (n=90) and female (n=197) students from multinational backgrounds and ethnicities. Pressures were measured traditionally and nontraditionally at 8:40 a.m., 1:40 p.m., and 6:40 p.m. Data were collected after the students had been instrumented and were lying quietly on a cot for 15-20 minutes (time for baseline data to reach steady state conditions). Both systolic and diastolic blood pressures were significantly greater in males than in females (P<0.05). Blood pressures were also significantly greater in the 6:40 p.m. group vs either 1:40 p.m. or 8:40 a.m. There was also a quadratic trend for blood pressures to be elevated in the morning group compared with the 1:40 p.m. group. Correlations between both systolic and diastolic blood pressures and BMI were also significant. BMI was a much stronger predictor of systolic (P<0.001) than of diastolic pressure (P<0.05). For every unit increase in BMI, systolic pressure increased 1.1 mmHg, and for each unit increase in BMI, diastolic pressure rose 0.4 mmHg. Results suggest that otherwise healthy young adult university students should be more aware of their blood pressure and the influences of obesity and overweight on it. They should try harder to achieve and maintain healthier lifestyles. This should include, but not be limited to, being more careful with their diets and being physically more active. Students should also avoid/limit unhealthy habits such as smoking, vaping, drinking (alcohol) and consuming caffeinated beverages.

A patient diagnosed with dengue fever was recently treated at a hospital in California. This rare case raises the concern that dengue fever may become a larger threat in the future for the contiguous United States, which is not currently considered endemic for the disease. Over the past decade, there has been an increase in the number of cases; therefore, dengue fever must be given greater consideration in the differential diagnosis, especially with a patient travel history to endemic parts of the world. This case report examines the management of a patient presenting with dengue fever and demonstrates that continued vigilance, prompt testing, and patient education can improve patient care and decrease disease prevalence in the future.

This paper seeks to give a better understanding of the influence of age, creatinine level, duration of diabetes, glucose level and pulse rate on diabetic-induced sexual dysfunction among people. The study employed two-way MANOVA with balanced samples of 115 each. Prior to the analysis, univariate and multivariate normality, linearity, equality of error and covariance matrices, and multicollinearity assumptions were satisfied. Significance was attained for both sex and marital status (P < 0.05), though their interaction effect was not significant (P > 0.05). Wald’s test for individual groups confirmed the hypothetical decision of MANOVA, though independent T2 failed to report significance for marital status. Under the parameter estimation, it was ascertained that the difference between the groups was in terms of age and creatinine levels of people. The model is also considered credible since bootstrap estimates converged to the empirical estimates. Even though this paper did not exhaust all metabolic and comorbid factors relating to diabetes, it is hoped that it provides an insight into some circumstances in the evolution of diabetes.