The psychiatric and neurological symptoms of systemic lupus erythematosus (SLE) are referred to as lupus cerebritis. The wide range of symptoms associated with SLE can pose a diagnostic challenge. We present a case of lupus cerebritis in a 31-year-old female presenting with psychosis. We present this case to increase awareness of the psychiatric manifestations of SLE that can be mistaken for more common etiologies of psychosis.Background The aim of this study was to determine the frequency of hypoalbuminemia and in-hospital mortality in acute ischemic stroke patients at a tertiary care hospital in Hyderabad. Methodology This was a prospective observational study conducted at the Department of Medicine, Isra University Hospital, Hyderabad, from February 17, 2017 to August 18, 2017. A total of 196 consecutive cases of acute ischemic stroke were included. Hypoalbuminemia was defined as serum albumin of less then 3.5 mg/dL. In-hospital outcome in terms of survival or death within seven days of admission was assessed and recorded. Data were analyzed using SPSS, version 20.0. (IBM Corp., Armonk, NY, US). Chi-square test was applied, and p-value of ≤0.05 was considered significant. Results Out of the 196 acute ischemic stroke cases, 146 (74.5%) were males and 50 (25.5%) were females. The mean age was 49.31 ± 10.46 years. A total of 90 (45.9%) cases had hypoalbuminemia. Out of these 196 cases, 22 (11.2%) expired within seven days of presentation of acute ischemic stroke, and out of these 22 expired cases, 18 (81.8%) had hypoalbuminemia. In-hospital mortality was found to be strongly associated with hypoalbuminemia (p less then 0.001). Conclusions Frequency of hypoalbuminemia was significantly higher in ischemic stroke patients and was found to be associated with in-hospital mortality, warranting monitoring at regular intervals, as well as recognizing and treating it early for risk stratification.Background In the absence of frank craniocervical dissociation, there is a lack of consensus regarding what patterns of craniocervical junction ligamentous injuries require occipital-cervical fusion. This study was undertaken to examine the integrity of the craniocervical junction ligaments and analyze clinical outcomes in patients who underwent occipital-cervical fusion for craniocervical junction injury. Methods Adult patients requiring occipital-cervical fusion were identified retrospectively utilizing keyword searches in cervical computed tomography and magnetic resonance imaging reports between 2012 and 2020 using Nuance mPower software (Nuance, Burlington, MA). The cervical magnetic resonance imaging examinations for these patients were reviewed for craniocervical ligamentous injury by two neuroradiologists. Descriptions of craniocervical junction injuries, demographic information, clinical history, surgical management, and global outcomes were recorded. Results Nine adult patients were identified with cervical fusion.Tracheobronchial injuries are either traumatic or iatrogenic but can be lethal in a high dependency setting if not managed promptly. There are few reported cases of cocaine-induced airway damage and barotrauma due to thermal or ischemic injury and increased intra-alveolar pressure. We present a sui generis case of cocaine-induced bronchial laceration with pneumomediastinum which was challenging to diagnose based on the patient’s recent history of hospitalization, as well as the patient’s reluctance to share the history of cocaine use. The patient was successfully managed conservatively. Here, we discuss the mechanism involved and the various treatment options available, along with the role of early involvement of the multidisciplinary team to deliver the best possible outcome.We report the successful management of a 31-year-old female, treated by cornual wedge resection. ARV471 manufacturer The patient suffered from vaginal spotting and lower abdominal pain. Transvaginal ultrasonography revealed a 4-5 cm right cornual pregnancy and beta-human chorionic gonadotropin was measured to be 614.7 IU/L. This ectopic pregnancy was removed via a laparotomy with cornual wedge resection and right salpingectomy.Longitudinal melanonychia striata, presenting as a black linear vertical band of the nail plate, can be caused by pigmented lesions and non-pigmented etiologies. A fungal infection of the nail plate, also referred to as onychomycosis or tinea unguim, can result from dermatophytes, non-dermatophyte molds, and Candida. Albeit rare, Candida-associated fungal melanonychia can present as a longitudinal black nail plate streak. The case of a 79-year-old man who developed a solitary linear black streak on his right fourth fingernail after a prior history of recent trauma to the digit’s nail folds is described; the fungal culture grew Candida parapsilosis. Including our patient, Candida-associated longitudinal melanonychia striata has been described in four women and two men ranging in age from 40 to 79 years (median, 70 years) at diagnosis. The black streak, present from one month to one year (median, seven months), affected either a hand digit (five patients) or the great toe (one patient). Fungal organisms were vied longitudinal melanonychia striata and exclude the diagnosis of a pigmented melanocytic tumor.Gall bladder perforation (GBP) is a rare and life-threatening complication of acute cholecystitis that requires immediate intervention. The diagnosis itself poses a diagnostic challenge, if the patient presents after the perforation of the gall bladder, especially if the initial imaging techniques such as ultrasonogram (US), computed tomography (CT) scan, hepatobiliary iminodiacetic acid (HIDA) scan and magnetic resonance cholangiopancreatography (MRCP) are inconclusive. Subtle clues such as free fluid around gall bladder and contracted gall bladder should warrant the clinician as these might be the only clues suggestive of gall bladder perforation. Here we describe a case of GBP successfully diagnosed by peritoneal drainage and analysis and subsequently managed by endoscopic retrograde cholangiopancreatography (ERCP) and open cholecystectomy.Background This study aimed to evaluate the role of disturbed circadian rhythm in potentiating intensive care unit (ICU)-acquired delirium.Previous studies have demonstrated bright light therapy (BLT) as an effective modality to improve sleeping patterns and cognitive function in non-critically ill patients. However, its benefit in the ICU has not been clearly established. In this study, we aimed to evaluate the application of daily high-intensity phototherapy at the bedside to deter ICU delirium incidence and duration. Methodology This was a single center, prospective study conducted in ICUs at the Carilion Roanoke Memorial Hospital in Roanoke, VA. Adults patients admitted to the ICU from July 9, 2018 to March 20, 2020 were included in the study. The patients were subjected to 30-minute BLT session (10,000 lux) at the bedside starting at 0700 while in the ICU. Patients were randomized into either the control group (standard hospital lighting) or phototherapy group. Data were analyzed using Wilcoxon rank sum test for continuous variables, Pearson chi-square test for categorical variables, and logistic regression for multivariable analysis that examined significant risk factors for ICU delirium.