Glucagon-like peptide-1 (GLP-1) overpowers glucagon secretion, endorses satiety, postpones gastric draining, and arouses peripheral glucose consumption. This systematic review was carried out including PubMed, Google Scholar, and EBSCO that examined randomized controlled trials, observational, and experimental studies that had studied the role of GLP-1 (liraglutide) in controlling juvenile diabetes. The study included 7 studies and concluded that the introduction of liraglutide to insulin treatment juvenile diabetic patients results in a considerable and fast decrease in glycemic excursions and a consequent reduction in insulin dose. Body weight decreases substantially as reported in many studies.
Encephalitis is a major cause of morbidity, mortality, and permanent neurological disability in both adults and children. The term "encephalitis" literally means inflammation of part or all of the "brain" or the brain parenchyma. Encephalitis affects people of all ages; however, the incidence is higher in the pediatric population. Although both genders are affected, most studies showed slight dominance in men. There are two main types with different causes: primary or infectious encephalitis can develop when a fungus, virus, or bacteria infects the brain and accounts for approximately 70% of confirmed cases of encephalitis, and secondary or post-infectious encephalitis when the immune system is active and reacts. to a previous infection and mistakenly attacks the brain. The clinical manifestations depend on whether the brain parenchyma or the meninges are predominantly involved and cause an encephalitic or meningitis syndrome. Diagnostic tests should include a lumbar puncture, an MRI of the brain, and an EEG for suspected encephalitis. In encephalitis, a broad differential diagnosis, both infectious and non-infectious, should be considered. These alternatives include malignancy, autoimmune or paraneoplastic diseases (eg, anti-NMDA receptor encephalitis), brain abscess, drug-induced tuberculosis or delirium, neurosyphilis, or bacterial, fungal, protozoal, or helminthic encephalitis. Antiviral medications, such as intravenous acyclovir, are often given at the initial diagnosis of encephalitis before the cause is known. Acyclovir is the best treatment for herpes simplex encephalitis. If medication can be started soon after symptoms appear, the chance of a full recovery is much higher.
Prolactinomas usually lead to infertility and medical treatment restores fertility. Prolactinoma size might increase during pregnancy (2.1% for microprolactinomas and 21% for macroprolactinomas). In this review article, multiple aspects of prolactinomas care during and before pregnancy were discussed. Dopamine agonists are the treatment of choice, if indicated during pregnancy (cabergoline and bromocriptine, while quinagolide is not recommended). It is recommended to stop dopamine agonists in patients with microprolactinoma during pregnancy and follow the patients for mass effect symptoms and visual disturbances every trimester. Dopamine agonists could be stopped as well in patient with intra-seller macroprolactinomas with more frequent clinical follow ups during pregnancy. Magnetic resonance imaging (MRI) without contrast is indicated for patients suspected to have tumor enlargement. Dopamine agonists (cabergoline or bromocriptine) are the treatment of choice for invasive/metastatic macroprolactinomas during pregnancy, and neurosurgery is rarely indicated.
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