Local hemodynamics play an essential role in the initiation and progression of coronary artery disease. While vascular geometry alters local hemodynamics, relationship between structure is poorly understood. Previous computational fluid dynamics (CFD) studies have explored how anatomy influences plaque-promoting hemodynamics. For example, areas exposed to low wall shear stress (ALWSS) can indicate regions plaque growth. However, small sample sizes, idealized geometries, simplified boundary...

Peritonitis is a very serious complication encountered in patients undergoing peritoneal dialysis and healthcare providers involved the management should be vigilant. Gram-positive organisms are frequent cause of peritonitis compared to gram-negative organisms. There has been recognition caused by uncommon because improved microbiological detection techniques. We report case Moraxella osloensis (M. osloensis), which an unusual infections humans. A 68-year-old male, who on for 2 years,...

Venous thromboembolism is a rarely described complication of diabetic ketoacidosis (DKA). We describe 21-year-old male patient with poorly controlled type 1 diabetes mellitus who was admitted DKA, presumably secondary to noncompliance, whose clinical picture complicated by generalized thrombosis involving multiple venous locations including renal vein, pulmonary vasculature, external iliac and common veins. The had no family history any coagulation disorders hypercoagulabilty work-up...

Acute interstitial nephritis (AIN) classically presents as acute kidney injury most often induced by offending drugs. Less frequently it is secondary to infections, autoimmune disorders, or idiopathic conditions. Development of drug-related AIN not dose dependent and a recurrence can occur with re-exposure the drug. We present 50-year-old male treatment resistant schizoaffective disorder who developed clozapine-induced AIN, confirmed biopsy within 2 months taking this medication. His...

Peritonitis can be a lethal outcome of peritoneal dialysis (PD), often leading to significant morbidity and mortality. It is caused mostly by gram-positive organisms. Neisseria cinerea gram-negative nasal oropharyngeal commensal, rarely reported as an etiology peritonitis in PD patients. Our patient was 37-year-old female on continuous ambulatory for the last seven years, who developed found from cinerea. She didn't respond broad-spectrum antibiotics well had switched intermittent...

We present a case of hypercalcemia in 79-year-old female likely secondary to uterine leiomyoma. To the best our knowledge, due benign tumor has only been described five cases. Of these above cases, leiomyoma was thought be cause three

Hyponatremia is a very common electrolyte disorder and significant independent predictor of medical prognosis costs. Tolvaptan vasopressin receptor antagonist developed for the treatment hyponatremia. It has its principal application in euvolemic hypervolemic Its major role heart failure (HF), cirrhosis syndrome inappropriate antidiuretic hormone secretion (SIADH). While at present tolvaptan not demonstrated long term survival benefit with use, it clearly proven short efficacy management...

Candida parapsilosis can cause invasive fungal infection which is associated with significant morbidity and mortality. Timely management of this uncommon pathogen essential to prevent peritoneal dialysis patients from succumbing the infectious complications peritonitis related it. We present a 75-year-old Caucasian female end-stage renal disease, on at home, who presented features found be rare species. She was treated four weeks course oral fluconazole switched incenter hemodialysis....

Roseomonas species, a rare Gram-negative microorganism, has seldom been reported to cause peritonitis in end-stage renal disease patients on peritoneal dialysis. Only seven cases of by this microorganism have worldwide. Treatment options can be challenging if not detected early and lead significant morbidity mortality along with the switching dialysis modality hemodialysis which is highly undesirable. Our patient 65-year-old Caucasian female who needed changed emergency due inability perform...

Yersinia enterocolitica is primarily a gastrointestinal tract pathogen known to cause gastroenteritis, although it may produce extra-intestinal infections like sepsis and its sequelae. However, primary cutaneous are extremely rare. We present case of Y. thigh abscess in an immunocompetent adult. The portal entry unclear this case. He did many outdoor activities that involved skin injuries exposure soil contaminated water. Hence, direct inoculation as result water postulated the absence...

Intravenous immunoglobulin (IVIG), initially developed for immunodeficiency disorders, has now been used multiple autoimmune diseases and infections. These are generally well tolerated, with few adverse effects. Acute kidney injury described in very rare instances. We report an interesting case of a 59-year-old African American male pertinent history diabetes mellitus, hypertension, endocarditis, peripheral vascular disease, who was diagnosed post-transfusion purpura. He then treated IVIG...

A 45-year-old Nepalese refugee was admitted with complaints of abdominal pain one day duration, associated radiating from loin to groin.The patient's medical history significant for diabetes mellitus, hypertension, hyperlipidemia and a recent diagnostic cardiac catheterization 4 months previously.Initial imaging revealed wedgeshaped hypodensity (Picture 1) in the right kidney compatible an infarct multiple low density lesions spleen suggestive embolic lesions.CT angiography 2) confirmed...

Mechanical valve thrombosis is a rare condition in an adequately anticoagulated patient the absence of underlying thrombophilia. We report case 76-year-old male with mechanical prosthetic mitral as presenting feature polycythemia vera. The was treated thrombolysis at time acute presentation and subsequently maintained on low molecular weight heparin, low-dose aspirin, phlebotomy hydroxyurea. Hemoglobin, leucocytosis platelet count were controlled for almost 4 years after which suffered...

Brevibacterium casei is an extremely rare organism that can lead to peritonitis in End stage renal disease patients of peritoneal dialysis. Out only five overall species reported worldwide, two them had subspecies detected, with both needing dialysis catheter removal and change modality hemodialysis. Our patient, elderly 63-year-old Hispanic male, was on at home presented features suggestive peritonitis. He diagnosed subsequently started broad spectrum intraperitoneal antibiotics. However,...