Dengue Hemorrhagic Fever (DHF) is a severe form of dengue fever (DF), which can be life threatening. The first recorded epidemic of dengue was reported in the late 18 th century and affected Asia, Africa, and North America. Female mosquitoes, predominantly of the species Aedes aegypti and less commonly, Aedes albopictus, are responsible for the transmission of the dengue virus. As the most dangerous and widespread mosquito-borne viral infection, the dengue virus affects more than 100 countries worldwide. Increasing 30-fold in the last 50 years, the social and economic effects of dengue are far reaching and of worldwide concern. The disease is widespread throughout the tropics with local variations in risk influenced by rainfall, temperature, and unplanned rapid urbanization. Upto 400 million people are infected each year. Currently, vaccines are still under development for DHF; therefore, prevention is of utmost importance in lessening the impact of dengue on a global scale. This review article summarizes the global epidemiology of Dengue Hemorrhagic fever by utilizing the most recent and available information on the topic.

Obesity is linked with the growth of white adipose tissue and associated chronic hyperleptinemia. Leptin is a hormone-like cytokine or adipokine secreted mainly from adipose tissue. High leptin state in obesity rapidly causes selective resistance, focused in the arcuate nucleus of the hypothalamus, and centered round leptin's role in food intake and satiety. This resistance lowers the body's reaction to food intake and prevents the anorexigenic effects of leptin. As this resistance builds up, the intake of food increases causing an enhancement in body adiposity and leptin levels. However, some pathways do not build resistance to leptin and continue to exhibit the stimulatory effects, which cause a persistent stimulation of sympathetic nervous system (SNS), particularly in the kidneys and skeletal muscles. The increase in SNS activity in the kidney, along with the endothelial dysfunction and oxidative stress, lead to an increase in blood pressure. Apart from leptin's effects on SNS and renal function, this adipokine influences vascular health and hypertension through several phenomena or mechanisms such as baroreflex sensitivity, release of nitric oxide and cardiac hormones. In this review, an attempt has been made to highlight different aspects of leptin biology, which are relevant to hypertension.

Morbid obesity increases the average risk of a patient developing a paraesophageal or hiatal hernia. Paraesophageal hernias (PEH) include several types, and their treatment is indubitably one of the most contentious topics in minimally invasive surgery. Though it is rare for PEH to manifest as a strangulated, volatilized intrathoracic stomach with infection, the increased risk of mortality is an indication for many to pursue surgical repair. Moreover, morbidly obese individuals represent a substantial rate of failure of PEH repairs. The modes of confirmation diagnostics are barium swallow or upper endoscopy. This case study focuses on a 64-year-old female who presented with several comorbidities, was appropriately evaluated for laparoscopic sleeve gastrectomy, and was previously identified to have a severe type III PEH with grade IV configuration. Additionally, the pathological finding from the extracted specimen was significant for helicobacter pylori gastritis.