Endocrinology, Diabetes, and Metabolism Commons^™

The High Cost Of Incomplete Physical Exams: Missed Diagnosis Of Cushing Syndrome In A Patient With Recurrent Hospital Admissions, Tarah M Burton, Miranda K Hunter, Mihail Zilbermint

Journal of Community Hospital Internal Medicine Perspectives

Cushing syndrome is a rare but life-threatening endocrine disorder associated with a classic constellation of physical exam findings (e.g. “moon facies”, abdominal striae, etc.). However, thorough biochemical testing is needed to confirm this diagnosis. We present the case of a 35-year-old male with multiple hospitalizations across a variety of healthcare institutions for heart failure, cellulitis, uncontrolled hypertension, and diabetes.  While an adrenal mass was eventually identified on imaging, classic signs of Cushing syndrome – including violaceous striae, truncal obesity, and facial plethora – were missed during prior admissions.  This case illustrates the diagnostic delay that can result from incomplete physical …

Myxedema Coma With Cardiogenic Shock: Diagnostic Challenges And Risks Of Amiodarone In Acute Thyroid Failure, Jean Carlos Ramos Cardona, Gunjan Mundhra, Munachiso Egbo, Veniamin Melnychuk, Suzanne Quinn Martinez

HCA Healthcare Journal of Medicine

Background

Myxedema coma is a rare but life-threatening manifestation of severe hypothyroidism characterized by altered mental status, hypothermia, bradycardia, and multiorgan dysfunction. Delayed diagnosis is common, particularly in elderly patients with multiple comorbidities. Cardiac complications, including malignant arrhythmias, are underrecognized contributors to morbidity and mortality. Profound hypothyroidism compromises cardiac myocyte function through reduced activity of enzymes involved in calcium uptake, leading to impaired myocardial contraction and relaxation. This results in decreased heart rate, reduced cardiac output, and altered left ventricular function, which may be further exacerbated in patients with heart failure with reduced ejection fraction. Prolongation of the ventricular action …

Trends In Emergency Department Utilization After Metabolic And Bariatric Surgery In The United States, Andrew Sanders, Isabella Moncada, Sabrina Avanzato, Michelle Fakler, Michael Dombek, R. Wesley Vosburg

HCA Healthcare Journal of Medicine

Background

In this article, we sought to understand the factors associated with emergency department (ED) utilization by patients after metabolic and bariatric surgery (MBS). The hopes were that modifiable risk factors could be identified to reduce ED visits after MBS.

Methods

We analyzed data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database (MBSAQIP) which is comprised of data from all nationally accredited bariatric centers in the United States. For our study, we included a population of 681 743 patients having undergone the 2 most common MBS procedures: sleeve gastrectomy (SG) and gastric bypass (GBP). Using logistic …

Adrenal Crisis Induced-Seizures: A Case Report And Literature Review, Israel Umoh, Elizabeth Mikhail, Narjis Batool, Nosheen Hajra, Ibrahim Al-Sanouri

Journal of Community Hospital Internal Medicine Perspectives

This case report underscores the critical interplay between adrenal crisis and seizure activity, emphasizing the importance of rapid recognition and management of this life-threatening condition. Adrenal crisis, characterized by severe hypotension and electrolyte disturbances, often manifests with nonspecific symptoms such as fatigue, nausea, and altered consciousness, which can obscure diagnosis, especially in pediatric and young adult populations. The report details a 21-year-old female with a complex endocrinologic background who developed seizures precipitated by an adrenal crisis triggered by gastroenteritis and compounded by medication noncompliance. Clinical findings included profound dehydration, electrolyte abnormalities, refractory hypotension, and low cortisol levels, which responded favorably …

Examining The Benefits Of A Standardized Protocol For Hyperglycemia Screening In Adult Oncology Patients: A Pilot Study, Alexa Dashko

Pacific Journal of Health

Many individuals receiving cancer directed therapy are at risk of developing hyperglycemia and new, or worsening of, diabetes due to location of their cancer, treatment regimen, and/or prolonged use of steroids. Research shows that uncontrolled hyperglycemia can have detrimental effects on individuals’ response to cancer therapy, treatment associated toxicities, quality of life and overall mortality. Despite extensive research identifying the need for routine monitoring and management of hyperglycemia in oncology patients, medical societies have yet to establish formal screening guidelines for practitioners. The aim of this pilot study was to examine the outcomes of establishing a protocol for screening and …

Sequential Presentation Of Diabetic Ketoacidosis, Acute Ischemic Stroke, And St-Elevation Myocardial Infarction: A Case Report, Ichlasul Mahdi Fardhani, Putu Aditya Darmawan Kuntadi, Hammam Arif Shabri, Muhammad Isra Rafidin Rayyan, Zarrah Yuniar Qolbi Harris, Tristi Lukita Wening, Azham Purwandhono

Chulalongkorn Medical Journal

Cardio-cerebral infarction (CCI), the simultaneous occurrence of acute ischemic stroke (AIS) and acute myocardial infarction (AMI), is a rare and life-threatening emergency. Management becomes even more challenging when accompanied by metabolic complications like diabetic ketoacidosis (DKA). We report a case of a 45-year-old man with hypertension and a chronic smoking history, found unresponsive with right-sided hemiparesis. He was last seen well six hours before arrival. On examination, he was hypertensive, tachypneic, had a ketotic breath odor, GCS 12, and NIHSS 15. Laboratory results confirmed DKA, with a random blood glucose of 412 mg/dL and metabolic acidosis. Non-contrast brain CT revealed …

2025 Novel Drug Approvals, Katherine Ghattas Pharmd, Amanda Rawa Pharmd

Transformative Medicine

The year 2025 marked another strong chapter in pharmaceutical innovation, with multiple novel therapies gaining approval from the U.S. Food and Drug Administration (FDA). These approvals reflect continued progress in addressing unmet medical needs across a wide range of disease states. This article reviews the FDA’s 2025 novel drug approvals, spotlighting a few therapeutic advancements and emerging trends. A comprehensive table of all approved agents is provided, along with a focused discussion of four particularly impactful therapies: donidalorsen (Dawnzera), taletrectinib (Ibtrozi), delgocitinib (Anzupgo), gepotidacin (Blujepa), etripamil (Cardamyst). Each of these agents represents a step forward in its respective field and …

Educational Intervention To Improve Awareness Of The Female Athlete Triad Among Division I Athletes, Carly J. Haring, Jonathan Olson Md

Aesculapius Journal (Health Sciences & Medicine)

Introduction: The Female Athlete Triad poses short- and long-term health risks for female athletes through the interrelated components of low energy availability, menstrual dysfunction, and impaired bone health. Despite its prevalence, awareness and education surrounding the Triad remain limited, contributing to delayed recognition and care. The objective of this project was to assess baseline knowledge and comfort discussing Female Athlete Triad–related topics among Division I female athletes and to evaluate the impact of a brief educational intervention on knowledge, attitudes, and help-seeking intentions.

Methods: A community-based educational initiative was conducted in November 2025 among Division I female athletes …

Diagnosis And Characterization Of Thyroid Dysfunction In Patients Evaluated In Primary Care In A Rural Zone Of Honduras, Javier Shafick Asfura, Travis Wesley Harris, Amanda Reeck, María Fernanda Chévez

Journal of Community Hospital Internal Medicine Perspectives

Background: Thyroid disorders are prevalent and frequently underdiagnosed in primary care, particularly in resource-limited rural areas. Their nonspecific symptoms complicate early recognition and treatment. This study aimed to determine the prevalence of thyroid dysfunction and describe the clinical reasoning, diagnostic strategies, and laboratory findings among adults evaluated with TSH testing in rural Honduras. Methods: A retrospective, descriptive, cross-sectional study was conducted at Hospital Loma de Luz in Balfate, Honduras. Adult patients aged ≥18 years who underwent diagnostic TSH testing between January 1, 2022, and January 31, 2023, were included. Patients with prior thyroid diagnoses or current pregnancy were …

Pembrolizumab-Induced Primary Adrenal Insufficiency: A Rare But Life-Threatening Endocrine Irae, Syeda Sarah Raza, Mehr A. Orakzai, Abdullah A. Orakzai

Advances in Clinical Medical Research and Healthcare Delivery

Pembrolizumab, a PD-1 checkpoint inhibitor, is widely used in the treatment of various malignancies. While it improves overall survival, it can lead to immune-related adverse events (irAEs), including rare endocrine disorders such as primary adrenal insufficiency (PAI). We present a case of PAI induced by Pembrolizumab in a 75-year-old man, emphasizing the importance of early recognition and timely management.

A Comparison Of Biological Therapies Vs Traditional Immunosuppressant In The Management Of Inflammatory Bowel Diseases: A Narrative Review, Umme Farwah Tahir Dr, Sadaf Noureen, Fnu Partab, Muhammad Waqas Afzal, Maham Afzal, Asad Mehmood, Fatima Afzal, Kaynat Hasan, Fnu Sameeha, Seerat Riaz, Sumyya Tariq, Abida Perveen

Journal of Community Hospital Internal Medicine Perspectives

Inflammatory bowel disease (IBD), encompassing Crohn’s disease and ulcerative colitis, is a chronic immune-mediated condition requiring long-term management. Traditional immunosuppressants, such as corticosteroids, thiopurines, and methotrexate, have been widely used but are associated with broad immunosuppressive effects and significant adverse events. The advent of biological therapies, including tumor necrosis factor (TNF) inhibitors, integrin inhibitors, and interleukin (IL)-12/23 inhibitors, has revolutionized IBD treatment by offering targeted immune modulation. Biologics have demonstrated superior efficacy in achieving and maintaining remission compared to traditional immunosuppressants, particularly in moderate to severe IBD. They provide targeted immune suppression, reducing systemic side effects, but are associated with …

Fda Approval Of The Eversense 365 Continuous Glucose Monitoring System: A New Era In Long-Term Glucose Monitoring, Kiley Devoll, Alexander Defranco, Kennedy Kosikowski, Anna Spalvieri, Macy Davis, Connor Dains, Brenna Hissong, Emily Eddy

Pharmacy and Wellness Review

Eversense 365 is an implantable continuous glucose monitoring (CGM) system designed to provide accurate glucose measurements for up to 365 days. Current clinical guidelines recommend CGM use for patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), with evidence demonstrating benefit in patients with T2DM regardless of concurrent insulin use. Healthcare providers play a key role in patient education and are well-positioned to support the adoption of long-term CGM technologies, including Eversense 365. The safety and efficacy of the 365-day CGM have been evaluated across a series of clinical trials, which demonstrate clinically meaningful improvements in …

Weight-Loss Efficacy Of Glp-1 Receptor Agonists Relative To Lifestyle-Based Interventions, Amy Betterton

Lynchburg Journal of Medical Science

ABSTRACT

This clinical review compares the effectiveness of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) with traditional lifestyle modifications in managing obesity. This article also examines barriers to accessing the medications in both civilian and veteran populations. This clinical review was conducted through a wide-ranging review of the published literature, including clinical trials, observational studies, and review articles on lifestyle modifications, GLP-1 receptor agonists, and barriers to obesity treatment. While lifestyle modifications are generally considered a first-line approach and are cost-effective, they tend to yield only modest weight loss. In contrast, GLP-1 RAs offer significantly greater reductions in body weight as …

Triglyceride Glucose Index As A Predictor Of Insulin Resistance In Patients With Hypothyroidism, Nadeen El-Nakeeb, Mohammed A. Helaly, Ahmad S. Hasan, Rania Bahriz

Mansoura Medical Journal

Background: Thyroid hormones play a key role in glucose metabolism, and hypothyroidism is frequently associated with impaired insulin secretion, altered glucose disposal, and insulin resistance (IR).

Aim: This study aimed to assess insulin resistance in patients with hypothyroidism using the triglyceride–glucose (TyG) index in comparison with the homeostasis model assessment of insulin resistance (HOMA-IR).

Methods: This case-control study was conducted on 100 participants (50 hypothyroid patients and 50 euthyroid controls), aged 18–60 years. All subjects underwent detailed clinical evaluation, anthropometric measurements, and fasting laboratory investigations including glucose, lipid profile, insulin, TSH, and free T4. Insulin resistance was assessed using TyG …

Stones, Bones, And Hormones: A Multisystem Presentation Of Primary Hyperparathyroidism Due To Parathyroid Adenoma, Gadgesh B, Varsha Tandure, Nandini K, Chandana Srinath

Digital Journal of Clinical Medicine

Primary hyperparathyroidism is an endocrine disorder characterized by excessive secretion of parathyroid hormone, most commonly due to a solitary parathyroid adenoma, resulting in hypercalcemia and multisystem involvement [1]. Although many patients are diagnosed incidentally, delayed recognition may lead to severe renal, skeletal, gastrointestinal, and cardiovascular complications.

We report the case of a 44-year-old male who presented with sepsis and acute kidney injury, later found to have hypercalcemia with nephrocalcinosis, chronic calcific pancreatitis, skeletal deformities, and markedly elevated parathyroid hormone levels. Imaging localized a parathyroid adenoma, and the patient underwent successful parathyroidectomy with significant biochemical and clinical improvement.

This case emphasizes …

Assessing Access To Orthopaedic Care For Patients With Osteogenesis Imperfecta, Annemarie K. Leonard, Kara Ayers, Lauren Faokunla, Kaeli Samson, Erika Carter, Tracy Hart, Maegen Wallace

Graduate Medical Education Research Journal

Background. Osteogenesis Imperfecta (OI) is a rare disorder caused by variations in collagen. Clinical manifestations include multiple fractures, short stature, scoliosis, blue sclera, hearing loss, and opalescent teeth. Patients often need many different medical providers frequently, which may place financial burdens on families. This study sought to identify and understand barriers to care for children with OI.

Methods. We utilized an Institutional Review Board (IRB)-approved survey for primary caregivers of children with OI. Questions included demographic data, type of health insurance, history of and reasons for insurance denials, access to multidisciplinary OI care, and travel to receive OI care. The …

Korelasi Kadar Serum Vegf-A Dengan Rasio Albumin-Kreatinin Urin Pada Pasien Penyakit Ginjal Diabetik, Hannie Q. Syaiful, Drajad Priyono, Harnavi Harun, Arina W. Murni, Akmal M. Hanif, Eifel Faheri, Arnelis Arnelis, Vesri Yoga

Jurnal Penyakit Dalam Indonesia

Introduction. Diabetic kidney disease (DKD) is a major microvascular complication of diabetes mellitus, characterized by persistent albuminuria and a progressive decline in glomerular filtration rate (GFR), making it a leading cause of chronic kidney disease (CKD) and end-stage renal disease. Vascular endothelial growth factor-A (VEGF-A) is implicated in the pathogenesis of DKD, being overexpressed in the kidneys and contributing to increased vascular permeability, inflammation, and fibrosis. Albuminuria, an early indicator of renal damage in DKD, is a strong predictor of CKD progression and cardiovascular events. The urine albumin-to-creatinine ratio (UACR) is the recommended test for detecting and monitoring albuminuria. …

Rare Case Of Visual Hallucinations In A 60-Year-Old Female With A Recurring Pituitary Macroadenoma, Angelica Alday, Farah Qureshi, Kayvan Mirhadi

Advances in Clinical Medical Research and Healthcare Delivery

Pituitary adenomas are the third most frequently occurring primary intracranial tumor and are benign neoplasms that can have profound clinical implications. While most of these masses cause hormone hypersecretion, they may also be clinically silent until they elicit symptoms of mass effect, including severe headaches and visual field defects such as bitemporal hemianopia. This report highlights an atypical presentation of a pituitary adenoma that could be valuable for internists to consider when forming a differential diagnosis for patients with hallucinations. We discuss a case of a 60-year-old woman with a recent history of multiple emergency department visits for ongoing urinary …

Characteristics Contributing To The Risk Of Diabulimia In Adults Living In The United States, Danielle Van Hout, Nicole Stendell-Hollis, Tafere Gebreegziabher Belay, Kelly Pritchett

Journal of the Symposium of University Research and Creative Expression

Project Mentor(s): Nicole Stendell-Hollis, PhD, RDN; Tafere G Belay, PhD; Kelly Pritchett, PhD, RDN, CSSD

The purpose of this study was to determine the prevalence and factors that contribute to the risk of diabulimia by using the validated Diabetes Eating Problem Survey-Revised (DEPS-R)¹ screening tool in adults living in the U.S., as well as to examine differences in individuals at-risk and not-at-risk for diabulimia. This observational study included a 30-question Qualtrics survey containing the DEPS-R distributed via various social media outlets and flyers on the CWU Ellensburg campus. Participants were required to be 18 years or older, diagnosed with …

Prevalence Of Diabetes Related To Acculturation, Dietary Quality, And Sedentary Lifestyle In Mexican Americans: National Health And Nutrition Examination Survey 2011 To 2018, Kivima Acevedo

Journal of the Symposium of University Research and Creative Expression

Project Mentor(s): David Gee, PhD; Kathaleen Briggs Early, PhD, RDN, CDCES; Katy Williams, MS, RDN

Objective: This study examined the prevalence of diabetes in Mexican American adults (MA-adults) and how risk factors like acculturation, dietary quality, and sedentary lifestyle contribute to the rising rates of diabetes, using the National Health and Nutrition Survey (NHANES) 2011 to 2018 data. Methods: We analyzed the NHANES data of MA-adults and Non-Hispanic White adults (NHW-adults) (n= 10670) for the association of diabetes and its risk factors (dietary habits and sedentary lifestyle) by acculturation levels. Diet quality was assessed using the Healthy Eating Index (HEI). …

Hubungan Visceral Adiposity Index Dengan Neuropati Diabetik Perifer Pada Pasien Diabetes Melitus Tipe 2, Muhammad Arif Sanusi, Dian Anindita Lubis, Santi Syafril

Jurnal Penyakit Dalam Indonesia

Introduction. Type 2 diabetes mellitus (T2DM) is the leading metabolic disease in Indonesia. Diabetic peripheral neuropathy (DPN), a major complication of T2DM, was associated with insulin resistance and adipose dysfunction. Visceral adiposity index (VAI) is a tool to measure visceral fat as the indicator of adipose dysfunction and insulin sensitivity. The association between VAI and DPN has not been widely researched, especially in Indonesia. This study aims to assess the association between them.

Methods. This was a cross-sectional study conducted on adult patients (aged ≥18 years) with T2DM at H. Adam Malik General Hospital, Medan, from December 2024 …

Thyrotoxicosis In Pregnancy Cured By Total Thyroidectomy, Owen G. Alvine, Daniel Thum Md

Aesculapius Journal (Health Sciences & Medicine)

Thyrotoxicosis during pregnancy is a rare but potentially life-threatening condition that requires prompt recognition and management. This case report describes a 23-year-old pregnant woman with a history of Graves’ disease who presented with symptoms of thyrotoxicosis, including tachycardia, weight loss, and dyspnea. Initial treatment with propylthiouracil and propranolol was insufficient, and her condition progressed to include pericardial effusion with early tamponade physiology and systemic inflammatory response syndrome (SIRS). Despite medical therapy, her symptoms persisted, necessitating a total thyroidectomy during the second trimester. Postoperatively, the patient experienced significant clinical improvement and delivered a healthy infant at term. This case highlights the …

A Rare Case Of Familial Hypocalciuric Hypercalcemia In Patient With Pancreatitis, Muhammad Ijaz Khan, Tanvi Jain, Muhammad Mohsin Abid, Samra Israr, Muhammad Haris Khan

Journal of Community Hospital Internal Medicine Perspectives

Familial hypocalciuric hypercalcemia (FHH) is a rare autosomal dominant condition caused by mutations in the calcium-sensing receptor gene (CASR), leading to asymptomatic hypercalcemia. Here, we report a case of hypercalcemia in a patient with acute pancreatitis, subsequently diagnosed with FHH. A 41-year-old male presented with abdominal pain and elevated pancreatic enzymes. Imaging revealed changes consistent with acute pancreatitis. Surprisingly, serum calcium was elevated, which is uncommon in acute pancreatitis. Further work-up demonstrated normal parathyroid hormone (PTH), PTH-related peptide (PTHrp), and vitamin D levels. A 24- hour urinary calcium excretion of 24 mg/24 hr and a calcium-to-creatinine clearance ratio (CCCR) of …

Artificial Intelligence For Detecting Non-Alcoholic Steatohepatitis (Nash), Muhammad Wildan Gifari, Yogi Ramadhani, Dhadhang Wahyu Kurniawan

Pharmaceutical Sciences and Research

Non-alcoholic steatohepatitis (NASH), an inflammatory disease of the liver, has recently raised concern among healthcare professionals worldwide due to its asymptomatic features, making early diagnosis challenging. If left unnoticed, NASH often progresses to lethal diseases such as liver fibrosis or hepatocellular carcinoma. Recent developments in the field of artificial intelligence (AI) might facilitate the early diagnosis of NASH in a more efficient manner, forming a promising strategy to diagnose patients. In simple terms, AI is any machine that is capable of human-level intelligence, including visual perception, speech recognition, or decision making. A subclass of AI, which particularly deals with knowledge-based …

Clinical Outcomes After Hospitalization For Acute Coronary Syndrome In Patients Treated With Semaglutide Versus Bariatric Surgery: A Retrospective Multicenter Analysis, Nameer Ascandar, Charles Boadu, Gauthier Stepman, George Skaf, Olugbenga Oyesanmi, Sabry Omar, Rias Ali, Michael Schandorf-Lartey

HCA Healthcare Journal of Medicine

Background

Obesity is a chronic medical condition with a rising prevalence in the United States. A wide range of morbidity and mortality is associated with obesity, with coronary artery disease being among the most common. Ischemic heart disease continues to be the primary cause of death in the United States. Taken together, interventions to minimize the detrimental effects of obesity on patients at risk of heart disease will not only benefit the patient, but the health care system as well.

Methods

In this retrospective study, we used the HCA Healthcare enterprise data warehouse to identify all adult patients who were …

Intermittent Fasting For Metabolic Syndrome Management, Tony Laborde

Lynchburg Journal of Medical Science

This paper reviews the potential of intermittent fasting as a non-pharmacological therapeutic approach to the treatment of metabolic syndrome (MetS). MetS is a global health problem with risk factors that include obesity, hypertension, hyperglycemia, low high-density lipoprotein (HDL) cholesterol, and high triglycerides that predispose to cardiovascular disease and type 2 diabetes. Traditional treatment approaches, including pharmacological agents and lifestyle modification, are typically of short-term benefit. Intermittent fasting, with its scheduled cycles of eating and fasting, presents another strategy for improving weight control, insulin sensitivity, lipid profiles, and blood pressure. Various intermittent fasting regimens, including time-restricted feeding and alternate-day fasting, have …

Efficacy And Safety Of Olezarsen In Dyslipidemia: A Systematic Review And Dose-Response Meta-Analysis Of Randomized Controlled Trials, Christopher D. Tristan, Risalina Myrtha, Matthew A. Wijayanto, Erlangga M. Kynaya, Muhammad F. Hamka, Nathania E. Sudiono, Muhammad A. Rusyidi, Muhana F. Ilyas

Journal of the Saudi Heart Association

Olezarsen emerged as a novel promising Apo-C3 inhibitor for dyslipidemia. However, its dose-response relationship remains uncertain. This review aims to evaluate the lipid-lowering effect of olezarsen, safety measures, and dose-response effects to determine the optimal dose. A systematic search was conducted across Scopus, PubMed, ScienceDirect, and CENTRAL on January 2, 2025. Randomized controlled trial (RCT) comparing olezarsen with placebo in dyslipidemia was included. The Rob 2.0 tool was implemented to assess quality. R-studio and STATA were used to conduct statistical analysis. From a total of 194 documents at initial search, four RCTs involving 361 patients were included in the present …

Why Acromegaly Dies: A Systematic Review, Isam Noori Salman, Safaa Ehssan Atta, Baydaa Ahmed Abed, Noor Ulhuda G. Mohammed

Maaen Journal for Medical Sciences

Acromegaly is a rare endocrine clinical syndrome characterized by long-term elevated production of growth hormone (GH) due to a pituitary adenoma tumor. The main problem of acromegaly patients (AC-PTs) is prolonged elevated GH concentration, which leads to increased insulin-like growth factor 1 (IGF-1) production, causing the characteristic tissue and bone overgrowth. The appearance of diabetes in AC-PTs was linked with the high risks of cardiovascular morbidity, indicating that individuals with both conditions face heightened health challenges. Acromegaly typically has a higher cancer incidence rather than the general population. Without early diagnosis and effective treatment, excess GH can have widespread systemic …

Chorea Hyperglycemia Basal Ganglia (Chbg) Syndrome: A Case Report, Ammad Naeem, Mohamad Omar Beck, Ahsan R. Khan, Ribal Sajjad

Journal of Community Hospital Internal Medicine Perspectives

Chorea, characterized by sudden, involuntary movements of the face and limbs, arises from various causes, including neurodegenerative diseases, metabolic disorders, and structural brain changes, notably in the basal ganglia. Acute lesions in the basal ganglia due to ischemia or vascular pathology can also precipitate chorea. Hyperglycemia-induced basal ganglia changes, termed chorea hyperglycemia basal ganglia, predominantly affect elderly females with type 2 diabetes. We report a 62- year-old female with poorly managed diabetes presenting with involuntary jerking movements, initially in the right leg, progressing to the right arm, face, and lips over three days. Her history included hyperlipidemia and hypertension, and …

Endocrinology Expert Witness: Bridging Healthcare And Law To Uphold Standards, Mihail Zilbermint, Stacey B. Lee

Journal of Community Hospital Internal Medicine Perspectives

The role of a medical expert witness is vital in bridging the gap between the healthcare and legal systems, ensuring that justice is served while maintaining high standards of medical care. This perspective highlights the importance of medical professionals engaging in expert witness work, examining both the challenges and rewards of this role. Initially, community physicians may hesitate to participate due to misconceptions about legal risks or potential professional backlash. However, expert witness work provides a unique opportunity to supplement income, contribute to the integrity of the medical profession, and deepen medical knowledge.

The development of legal knowledge, such as …