Cardiovascular involvement is one of the end-organ complications commonly reported in coronavirus disease 2019 (COVID-19). It has also been postulated to be an independent risk factor for increased mortality in COVID-19-infected patients. With such a significant effect of COVID-19 on the cardiovascular system and vice versa, it is pivotal for physicians to observe this association closely for improving management and understanding prognosis in these patients. Here, we present three patients and describe their baseline cardiac risk factors, the cardiac complications they developed in association with COVID-19 infection, and their varying outcomes.Disorder of sex development (DSD) is the term ascribed to a wide group of disorders presenting with congenital discord between chromosomal sex and phenotypic manifestation. Its incidence is 1 in 4500 births. 46 XX testicular DSD is a rare disorder characterized by the discordance between female karyotype and male phenotype. Its incidence is 120,000 to 25,000 male infants. It is further classified into SRY positive and SRY negative individuals, depending on the presence or absence of sex-determining region Y gene (SRY) on the X chromosome as a result of translocation. We are hereby reporting a rare case of de la Chapelle syndrome (SRY negative). A 30-year-old phenotypical male presented to us with complaints of primary infertility. He had had hypospadias during his childhood and underwent corrective surgery at the age of 18 years. For the previous 1.5 years, he had been complaining of decreased libido, difficulty in micturition, and presence of watery ejaculate. On examination, he had bilateral palpable testis with the testicular volume of 7 mL each, curved micropenis with chordee, and eccentric meatus with fistula. Semen analysis revealed azoospermia and hormonal profile was consistent with hypergonadotropic hypogonadism. His karyotyping turned out to be 46 XX chromosome without the SRY gene on polymerase chain reaction (PCR) array. He was medically treated with testosterone and underwent surgical correction of chordee. The SRY negative testicular 46 XX disorder is a rare expression and can be diagnosed at the time of birth with the presence of severe hypospadias, cryptorchidism, or ambiguous genitalia. All new-borns with these findings should undergo evaluation for the disorder of sexual development. Such individuals can never father a child and genetic counseling should be offered. Infertility is the main concern for such individuals which can be addressed by in vitro fertilization (IVF) with a sperm donor or adoption.Multiple myeloma is a malignancy of plasma cells which are commonly found in the bone marrow. Known for causing a wide range of symptoms and affecting various organ systems, multiple myeloma is a rare malignancy with the entire pathophysiological process yet to be elucidated. We present a case of a 51-year-old male with a history of previously treated multiple myeloma in remission, initially presenting with chest pain with an unremarkable work-up. His hospital course was complicated by hyperammonemia causing encephalopathy requiring mechanical ventilation. After an extensive work-up to find an underlying cause, he was diagnosed with relapsing multiple myeloma. Due to a prolonged and complicated hospital course, the family pursued comfort measures and the patient passed away peacefully. Multiple myeloma induced hyperammonemic encephalopathy is a rare phenomenon carrying a high morbidity and mortality rate. Being still poorly understood, this manifestation of an already lethal diagnosis should be considered as a differential diagnosis of hyperammonemia. While early and aggressive treatment has shown some benefit and improved patient outcomes, further studies and understanding is needed to help diminish the mortality associated with hyperammonemic encephalopathy due to multiple myeloma.Dietary consumption of arsenic is considered the largest source of toxicosis for nonoccupationally exposed individuals as it can be ingested through contaminated underground water, seafood, animal products, and crops irrigated with polluted water. We present a case of a 45-year-old Caucasian male who had headaches and peripheral neuropathy for more than two months. He suspected arsenic poisoning as he has a regular heavy consumption of seafood and canned sardines. Analysis of urinary arsenic concentration confirmed his intoxication with arsenic. Yet, since it was of an inorganic form, he was prescribed with symptomatic treatments only. A symmetrical sensory or motor polyneuropathy featuring more distal impairment is among the most common neurological findings induced by arsenic toxicosis. Hence, a presenting history of heavy seafood diet should raise the differential diagnosis of arsenic or heavy metal poisoning and to investigate accordingly. This case illustrates the importance of taking the dietary regime of any patient presenting with neuropathy. In addition, the authorities must impose further rigorous surveillance and strict safety measures on food products and staples to minimize any sources of contamination of any sorts.Objective In this study, we aimed to demonstrate the effectiveness of plasmapheresis therapy in patients with acute exacerbation of chronic Hepatitis B (CHB) infection. Methods We selected 48 patients with acute exacerbation of CHB infection who were treated by plasmapheresis in our intensive care unit between 2009 and 2016. The patients' demographic characteristics and biochemical and hematological parameters, which were recorded before and after plasmapheresis, were assessed, and the effect of plasmapheresis on the course of patients' treatment was examined. https://www.selleckchem.com/products/yum70.html The patients were also divided into three groups according to their clinical course (discharged 24; transplanted six; exitus eight). The patients were further divided into four groups and compared based on the underlying causes that led to the exacerbation (spontaneous exacerbation 25; caused by immunosuppressive drugs nine; hepatotoxic drugs six; other agents eight). Results We observed significant improvements in terms of international normalized ratio (INR), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), lactate dehydrogenase (LDH), total bilirubin, direct bilirubin, blood urea nitrogen (BUN), ammonia, and the Model for End-Stage Liver Disease (MELD) score after plasmapheresis therapy.