Clinical Documents

To edit the draft, click on the text box below.

×

Draft a comprehensive differential diagnosis for acute substernal chest pain in a 45-year-old male with hypertension and hyperlipidemia, diaphoresis, exertional onset, and normal initial ECG/troponin; include life-threatening causes first, key distinguishing features, and immediate diagnostic next steps.

Draft a detailed differential diagnosis for new-onset unilateral throbbing headache with visual aura and brief monocular vision loss in a 32-year-old female on oral contraceptives; include red-flag symptoms, stroke/TIA considerations, and recommended initial workup.

Draft an assessment and plan for stage-2 hypertension (BP 162/98) in an obese 52-year-old with suspected obstructive sleep apnea; include ASCVD risk estimate, lifestyle prescriptions, first-line pharmacotherapy with drug/dose/targets, baseline labs/monitoring, and 4–6 week follow-up.

Draft an assessment and plan for type 2 diabetes follow-up with A1c 9.2% on metformin 1,000 mg BID and eGFR 65; compare adding a GLP-1 receptor agonist vs an SGLT2 inhibitor, address weight loss goals, hypoglycemia education, vaccinations, and micro/macrovascular screening.

Draft a history and physical for a patient presenting with chest pain, including HPI using OLDCARTS, pertinent ROS, PMH/meds/allergies, FH/SH, focused cardiac/pulmonary exam, initial labs and imaging orders, prioritized differential, HEART score risk stratification, and early management.

Draft a history and physical for a new patient with progressive exertional dyspnea, orthopnea, and bilateral leg edema; include differential (heart failure, COPD, PE, anemia, renal disease), targeted exam maneuvers, and first-line diagnostics and management.

Draft a progress note for COPD follow-up two weeks after an acute exacerbation treated with prednisone and antibiotics; include symptom trajectory, CAT score (if available), inhaler technique/adherence, oxygen needs, spirometry plan, smoking cessation counseling, and return precautions.

Draft a progress note for post-operative day 2 after total knee arthroplasty; include pain control strategy, DVT prophylaxis, PT/OT milestones, wound status, bowel/urinary function, labs/vitals review, complications screening, and discharge readiness.

Draft a discharge summary for community-acquired pneumonia admission; include admission/discharge dates, presenting symptoms, radiology/labs, pathogen if identified, inpatient therapies and response, discharge medications with durations, pending tests, follow-up appointments, and return precautions.

Draft a discharge summary for myocardial infarction managed with PCI and drug-eluting stent placement; include cath findings, complications, inpatient course, discharge medications (DAPT, statin, beta-blocker, ACEi/ARB), cardiac rehab referral, and follow-up plan.

Draft discharge instructions for a patient hospitalized with acute decompensated heart failure; include daily weights, sodium and fluid restriction amounts, medication list with dosing, signs of worsening heart failure, follow-up appointments, and lab monitoring plan.

Draft discharge instructions for an asthma exacerbation; include controller and reliever regimen, steroid taper schedule, spacer technique, trigger avoidance, a written asthma action plan, return precautions, and follow-up timing.

Draft a patient handout on managing high blood pressure in plain language; explain what BP numbers mean, key lifestyle steps (DASH diet, sodium limits, alcohol moderation), home BP monitoring instructions, medication adherence tips, and when to call the doctor.

Draft a patient handout for type 2 diabetes education in plain language; cover A1c goals, the plate method, physical activity targets, self-monitoring of blood glucose, hypoglycemia signs and the 15-15 rule, foot care basics, and a vaccination checklist.

Draft a summary of the latest CDC and WHO guidelines for managing community-acquired pneumonia in adults, including empiric antibiotic choices, duration of therapy, and follow-up recommendations.

Draft a plain-language overview of the ADA and AACE guidelines for diabetes management, focusing on A1c goals, weight management, and the use of GLP-1 receptor agonists and SGLT2 inhibitors.

Draft a summary of the 2024 USPSTF breast cancer screening recommendations, including updated screening intervals, risk-based approaches, and the role of MRI for high-risk patients.

Draft a concise summary of NCCN guidelines for melanoma management, including staging, surgical margins, adjuvant therapy, and checkpoint inhibitor recommendations.

Draft treatment alternatives for community-acquired MRSA skin infections in patients allergic to sulfa drugs; include oral and IV options, dosing, and duration.

Draft treatment alternatives for patients with type 2 diabetes who are unable to tolerate GLP-1 receptor agonists due to nausea; include medication substitutions and lifestyle recommendations.

Draft a summary of options for treating refractory depression, comparing ketamine infusions, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT).

Draft treatment options for advanced prostate cancer, including hormonal therapy, radiopharmaceuticals, and novel androgen receptor pathway inhibitors.

Draft a summary of recent research on mRNA vaccine technology beyond COVID-19, including applications in oncology and autoimmune disease prevention.

Draft an easy-to-understand overview of long COVID research, summarizing major symptoms, hypothesized mechanisms, and emerging treatment approaches.

Draft a summary of current research on Alzheimer’s disease biomarkers, including amyloid and tau imaging, and discuss how they influence diagnosis and trial design.

Draft an explanation of the interaction between warfarin and antibiotics such as ciprofloxacin or TMP-SMX, including INR effects and management recommendations.

Draft a summary evaluating drug interactions for patients taking Paxlovid and common cardiovascular drugs; include mechanism and recommended dose adjustments.

Draft a summary of the common and serious side effects of semaglutide, including GI intolerance, gallbladder disease, and thyroid-related warnings.

Draft an overview of potential side effects associated with long-term corticosteroid use, including osteoporosis, glucose intolerance, and adrenal suppression.

Draft a summary of essential lab tests to order in suspected acute pancreatitis, including amylase, lipase, liver enzymes, and metabolic panels, with interpretation guidance.

Draft laboratory workup recommendations for suspected hypothyroidism, including TSH, free T4, thyroid antibodies, and when to consider secondary causes.

Draft an explanation of which labs should be monitored in patients receiving methotrexate therapy, including CBC, LFTs, renal function, and frequency of monitoring.

why choose us

Edit Geo

×

300×250 Ad Slot

Research Article: Two-injection start regimen of long-acting aripiprazole for bipolar disorder: tips and tricks for better efficacy and tolerability

Date Published: 2026-01-23

Abstract:
To comparatively evaluate the efficacy and safety of the two aripiprazole long-acting injectable (LAI) initiation regimens, including one-injection start (OIS) regimen and two-injection start (TIS) regimen, in patients with bipolar disorder (BD). A total of 46 BD patients experiencing acute manic episodes with psychotic or mixed features were included in this observational study. Patients were divided into two groups based on the aripiprazole LAI initiation regimen including OIS group (n=23; patients received a single 400 mg LAI injection on Day 1, followed by oral aripiprazole (15–20 mg/day) for 14 days) and TIS group (n=23; patients received two 400 mg doses of aripiprazole LAI administered on the same day together with a single 20 mg oral dose of aripiprazole). Data on patient demographics, clinical characteristics and previous hospitalization were retrieved from hospital records. The effectiveness of the treatment was evaluated based on the Young Mania Rating Scale (YMRS) and Hamilton Depression Scale (HAM-D) scores recorded on Day 1 and Day 15 of the injection. The safety and tolerability of the OIS and TIS regimens were assessed via Udvalg for Kliniske Undersøgelser Side Effect Rating Scale (UKU-SERS) scores recorded on Day 15 of the injection. At baseline, the rate of previous hospitalization was higher in the OIS group than in the TIS group (60.9% vs. 26.1%, p=0.037). YMRS scores on Day 15 (11.0 ± 5.7 vs. 16.6 ± 6.2, p=0.003) and UKU-SERS Psychiatric adverse effects score on Day 15 (4.4 ± 1.8 vs. 7.5 ± 3.2, p<0.001) were significantly lower in the TIS group than in the OIS group. YMRS scores and HAM-D scores were significantly decreased from Day 1 to Day 15 of injection in both TIS (p= 0.002 and p=0.025, respectively) and OIS (p= 0.002 and p=0.025, respectively) groups, while the change was significantly higher in the TIS group. Linear regression analysis revealed that OIS regimen was a significant risk factor for increase in YMRS Day 15 scores (B: 0.434, p=0.003) and increase in UKU-SERS psychiatric scores (B: 0.526, p<0.001). Logistic regression analysis revealed that OIS regimen was an independent determinant of previous hospitalization history (OR: 4.407, p=0.020), increasing the likelihood of previous hospitalization by 4.407 times compared to TIS regimen. Both regimens had tolerable side effects, with no life-threatening issues. This study highlights the efficacy and reliability of the TIS regimen in treating BD episodes, potentially facilitating faster clinical recovery by reducing the need for prolonged oral supplementation.

Introduction:
Bipolar disorder (BD) is a chronic mental illness characterized by intense mood shifts with alternating episodes of mania (or hypomania) and depression, leading to significant impairment in vocational, social and occupational functioning of affected individuals ( 1 , 2 ). More than 1% of the world’s population is at risk of developing BD throughout their lifetime, while the disorder typically begins in young adulthood with significant impacts on workforce and societal costs ( 2 ). Minimizing problems that may…

Read more

300×250 Ad Slot

×
Chat & Ask Questions Career Openings Medical Doctors Check on Drug
Interactions Latest Health News
by WebHealthNetwork Get CME Credits Latest Clinical Trials Latest Research Articles Clinical Documents Update Profile

News

Chat

HCP Tools

Careers

Update Profile