In December 2019, several patients from Wuhan, China were admitted to hospitals with symptoms of pneumonia. As the number of patients presenting with similar symptoms started to rise, the causative agent was eventually isolated from samples. It was initially called the 2019 novel coronavirus (2019-nCoV) and has been recently relabelled as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2);
Kawasaki disease is an acute systemic vasculitis that was first reported in 1961. Over the last 5 decades multiple papers have been published to further understand this disease. The diagnosis of Kawasaki disease is made based on the clinical findings. Atypical Kawasaki disease includes patients who do not meet all the criteria for diagnosis. The main complication of Kawasaki disease is coronary aneurysm, and the treatment is intravenous immunoglobulin and aspirin. A second dose of immunoglobulin is given if the patient does not improve, and several other treatment options have been proposed over the last few years as second and third line options.
A recent study by Desai et al. (1) showed that the incidence and economic burden of hospitalizations due to diabetic ketoacidosis (DKA) in the U.S. increased between 2003 and 2014 (1). We sought to understand the most recent impact of the disease in the U.S. using the 2017 National Inpatient Sample (NIS) (www.hcup-us.ahrq .gov/nisoverview.jsp). A total of 220,340 patients were identified with a primary diagnosis of DKA (61.6 cases of DKA per 10,000 admissions) (Table 1). The incidence of DKA per 10,000 admissions was higher in males (71.2) than females (54.1), and the majority of DKA patients were covered by Medicaid (79,175 patients [36.0%], P , 0.01). Of all DKA patients, 53.3% were of ages 18-44 years. However, a higher incidence per 10,000 admissions was noted in patients of ages 1-17 years. The mean age of patients with DKA was 38.4 years. The total charges among DKA patients in 2017 were $6,757,748,178, with a mean of $30,836.19. The mean length of stay was 3.22 days. A total of 835 deaths were found among DKA patients, with a mortality rate of 0.38%. The overall mortality rate was higher among males admitted with DKA (40.5 deaths per 10,000 cases of DKA) than females (35.3 deaths per 10,000 cases of DKA). While most cases and deaths were recorded among whites (120,330 cases [56.5%], 435 deaths [53.7%]), the
It was observed that in early 2018, several newspapers raised a concern about the negative effects of social media applications, such as Snapchat and Instagram, on users related to the choice of plastic surgeries. Several plastic surgeons have shared their experiences whereby they encountered requests sounding similar to what a "filtered" Snapchat picture would look like, with one plastic surgeon even having a patient who actually produced a "filtered" image. There are several red flags to look out for in such patients, and proper management in those cases should include counseling and not plastic surgery.
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