Obesity can be regarded as the curse of this modern advanced and efficient lifestyle as it is the crux of very precarious comorbidities. The prevalence of obesity is so widespread that cases of obesity can be seen on either end of the age spectrum. With the rise of the twenty-first century and the rise of ease of living, the sedentary lifestyle also went on the rise to become the primary contributor to the rise in obesity. For the management of obesity, various dietary modifications grew in popularity, among which is intermittent fasting. Intermittent fasting grew in popularity with the rise of the internet. Intermittent calorie restriction/time-restricted feeding is a form of caloric restriction revolving around a short window for eating and a comparatively larger window for fasting. This form of feed-fast cycle promotes increased consumption of adipose tissue and glycogen stores, leading to increased fat loss and reduced satiety. Intermittent fasting is also said to have cardioprotective functions as well known to control diabetic parameters and reduce the incidence of diabetes. This narrative review article's goals are to outline the benefits of intermittent calorie restriction while accounting for any of its potential limitations and pinpoint any knowledge gaps that may exist.
Amyotrophic lateral sclerosis (ALS) is one of the most frequent motor neuron illnesses. Motor neuron illnesses are various disorders that include upper and lower motor neuron abnormalities. Amyotrophic lateral sclerosis accounts for roughly 80% of motor neuron disorders. ALS is a fatal motor neuron disease that involves the loss of motor neurons in the spinal cord and brain, resulting in gliosis and muscle weakening and wasting in the upper, lower, and respiratory muscles, reducing life expectancy to 2-5 years from the onset of symptoms. Up until now, oral riluzole, a glutamatergic neurotransmitter inhibitor, has been used to manage ALS, the only drug for the management of ALS that has been approved by the United States (US) Food and Drug Administration (FDA). In recent studies, edaravone has been used through intravenous mode to halt the progression of ALS. We conducted a systematic search on PubMed; we selected Google Scholar, PubMed, websites regarding ALS, WebMD, Researchgate, als.org, consultant360, and the relevant articles for the review. It shows us riluzole and edaravone's efficacy for managing A.L.S. and how it can increase the life span of the patients.
The cell-free fetal DNA (cffDNA) analysis for screening fetal genetic anomalies has increased dramatically since its commercialization in 2011 worldwide. In the early weeks of pregnancy, it offers a hassle-free, noninvasive procedure of antenatal screening. It guides and protects mothers from undergoing unwanted riskladen invasive prenatal testing. cffDNA testing is accurate at detecting the abnormal fetus chromosome among a large pool population. Patau syndrome, Edward syndrome, and Down syndrome are currently being accurately screened by this method. Due to their sensitivity and specificity, they now have become the screening method of choice, approaching almost 100% in various studies with a large sample pool. The latest procedures to analyze cffDNA, like the new digital droplet polymerase chain reaction (ddPCR) and sophisticated next-generation sequencing (NGS), have increased detection rates with decreased analyzing time. The latest techniques make it possible to screen large numbers of the population with faster report generation. Screening for Rh incompatibility and its timely prevention is now more accessible and more accurate with the help of cffDNA analysis. The problem arises when we deviate from the primary disease and start testing for anomalies not intended to be screened by cffDNA in the first place. Fetal sex chromosome aneuploidy screening by cffDNA is one area where the test gives mixed results either due to differences in machinery, laboratory parameters, or human error. Other rare occurrences like trisomes, such as trisomy 7, trisomy 16, trisomy 22, and a few microdeletion syndromes are also being screened but with less accuracy. Like every technology, cffDNA analysis is not entirely free of criticism. Its high testing cost, potential to accurately prognosticate the gender of the developing fetus and absence of standard testing practices will become an issue as the test becomes routine worldwide.
Uni-ventricle transposition of great arteries with ductus-dependent pulmonary circulations with hypoplastic pulmonary atresia (PA) represents rare cardiac malformations. We are presenting a unique case of a 22-year-old male who complained of dizziness since morning with numbness of the left lower and upper limbs. He also complained of palpitations on and off for two to three years with episodes of cyanosis on exertion. He gave a history of cough with frothy pink sputum at the same time. At birth, he was diagnosed to have cyanotic congenital heart disease (CCHD), for which he was prescribed a combination of ambrisentan 5 mg and tadalafil 20 mg and tablet aspirin 75mg along with some lifesaving modalities like proper hydration and phlebotomy as and when required. He was told to go for high-risk surgery like Blalock Taussig shunt or bidirectional Glenn. A Blalock Taussig shunt is a short tube only a few mm wide, which makes a path for blood to go from the arterial circulation to the lungs and bidirectional Glenn sends blood directly from the upper body to the lungs. Strict compliance with drug therapy is implied for the patient for a better outcome.
A woman came to the emergency room with swelling of the face, which included swelling around the lips and the eyes. The patient had undergone root canal treatment under lidocaine anesthesia one day prior, after which she developed swelling. Because angioneurotic edema was a possibility, the complement components C3 and C4 and C1 esterase inhibitor (C1-INH) were tested. The C4 level was found to be very low (0.08 gm/l) and the C1 level was also on the lower side (0.26 gm/l). Angioneurotic edema with acquired C1-INH deficiency was diagnosed after complete systemic and physical examinations. The patient made a complete recovery with the help of steroids, fresh frozen plasma, antibiotics, and antiallergic medications. For its rarity, this case of systemic lupus erythematosus refractory angioneurotic edema with acquired C1-INH deficiency is being reported.
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