Obesity and dementia are both associated with an increased risk of Alzheimer's disease (AD), and underlying neurodegenerative changes. Review articles provide evidential support that obesity and dementia result in an early old-age memory crisis. Obesity triggering vascular dementia decreases not only blood supply to the brain, but also increases fat cells that damage the brain white matter leading to loss of cognitive and intellectual behaviour. Adipocyte-secreted proteins and inflammatory cytokines explain the association between obesity and increased risk of dementia. Late-life elevated body mass index (BMI) confers a lower risk of having dementia. The hormone leptin explained the mechanism for the reverse association. Future studies need to reveal the linkage between adiposity and excess risk of dementia and AD.

Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous disorder of the autonomic nervous system that is defined by symptoms of orthostatic intolerance. According to the current criteria for adults, currently, POTS is defined as a heart rate increment of 30 beats/minute or more after 10 minutes of standing in the absence of orthostatic hypotension. There is a vast majority that remains misdiagnosed due to the heterogeneity of the disorder. Due to a lack of Food and Drug Administration (FDA) approved therapy, alternative therapies and over the counter medications are used to alleviate the symptoms. This is an uncommon presentation observed primarily in women, as it is more prevalent in females.

Background: Thalassemia is one of the most common genetic blood disorders in Asia. Consanguineous marriages and avoiding pre-marital and antenatal screening are common in Pakistan due to psychosocial, cultural, and religious factors. Few studies have investigated the beliefs regarding thalassemia, especially in a developing country. The aim of this study was to assess the knowledge, beliefs, and practices regarding thalassemia in an urban population.Method: A cross-sectional descriptive study was conducted in the urban areas of Karachi, Pakistan over a period of six months during March 2016 through August 2016. Participants selected by representative sampling were interviewed face-to-face using a pre-designed, pre-tested questionnaire. The questionnaire was divided into four parts. The first part inquired about general demographic variables, while the second part assessed knowledge of the participant regarding thalassemia. The third and fourth parts were concerning the beliefs and practices regarding thalassemia. Data were entered and analyzed using the Statistical Package for Social Sciences (SPSS) Statistics, v. 24.0 (IBM SPSS Statistics, Armonk, NY).Results: Only 53% (n = 720) of the respondents had heard about thalassemia. The mean knowledge score was 5.8. The total possible score ranged between 0 - 12 with the higher scores indicating better knowledge. About three-quarters (70%) of the sample did not know that an individual can be a carrier of thalassemia. Less than half (38%) of the participants viewed premarital screening for thalassemia as necessary, with only 10% agreeing that thalassemia carriers should not marry. There was no pre-marriage counseling done in 98% of the families. Conclusion: Our study highlights the prevalence of numerous myths and a low level of knowledge regarding thalassemia in an urban population of Pakistan.

Ischemic stroke is defined as a sudden loss of blood to the brain which results in deprivation of oxygen and other nutrients. It can be either a transient episode called as “transient ischemic attack” (TIA), or it could last longer than 24 hours giving rise to “infarction of tissues” in the central nervous system. Anti-platelet agents are widely used for the secondary prophylaxis of ischemic stroke, and amongst them, aspirin remains the drug of choice. In this literature review, we summarized the existing data regarding the ischemic type of strokes with particular attention to the use of antiplatelet agents for this purpose. The following review highlights the significance of the use of dual antiplatelet (aspirin and clopidogrel) regimen for the stroke prevention. The role of dual antiplatelet (aspirin and clopidogrel) in patients with a recent TIA (within 30 days) or severe stenosis (70%–99%) of a major intracranial artery, for 90 days, might be a beneficial approach.

Meningiomas are classified into three types according to the World Health Organization classification system which is based on morphologic criteria. Type 1 is the benign variant, in which meningothelial is the most common subtype. Angiomatous also belongs to the same subtype but comprises only 2.1% of all meningiomas. Although most meningiomas are asymptomatic, some may present with varying symptoms ranging from seizures to focal deficits. Often, large meningiomas can also manifest as neuropsychiatric symptoms ranging from depression to overt psychosis. Here, in this case, we have further elaborated the importance of the organic cause of psychiatric symptoms as our patient initially presented with symptoms of depression. Regarding the diagnosis of meningiomas, nowadays excellent neuro-imaging methods are available, however, histological examination and immunohistochemistry remain the gold standard tools for a definite diagnosis. In our patient, the histological examination showed well-formed sinusoids and vascular channels which were consistent with the diagnosis of an angiomatous variant. Gross total resection of the lesion remains the treatment of choice with radiation therapy being used for residual tumors postoperatively. Being a type 1 variant, these meningiomas have a very small risk of recurrence. Here, we have presented a rare variant of meningioma initially presenting with prominent psychiatric symptoms of depression advancing to focal deficits.