The Effect of SGLT-2i and GLP-1RA on Major Cardiovascular Conditions: A Meta-Analysis

Purpose: Sodium-glucose co-transporter 2 inhibitors (SGLT-2i) and Glucagon-like Peptide-1 Receptor Agonists (GLP-1RA) are two common anti-hyperglycemic agents prescribed by clinicians. The effects on cardiovascular conditions such as Heart Failure (HF) hospitalization, stroke, Myocardial Infarctions (MI), and other cardiovascular conditions are not well studied. The purpose of this study is to analyze existing data on the effect of SGLT-2i and GLP-1RA on preventing these cardiovascular conditions. Methods: A retrospective meta-analysis of all existing literature on the effect of SGLT-2i and GLP-1RA on the rates of the following categories were researched: primary cardiovascular outcomes, HF hospitalizations, Atrial Fibrillation (AF), stroke, MI, and HF symptoms. Hazard ratios for each category were obtained, and the overall Hazard Ratio (HR) to determine overall statistical significance was computed. Result: Both medication classes provided a statistically significant reduction in preventing major cardiovascular events. Only SGLT-2i provided a statistically significant reduction in heart failure hospitalizations. Only GLP-1RA provided a statistically significant reduction in preventing stroke. Neither medication class provided a statistically significant benefit in preventing myocardial infarctions. More studies are needed on the effects of either SGLT-2i or GLP-1RA agonists on preventing HF symptoms or AF. Conclusion: This study demonstrates that SGLT-2i and GLP-1RA are important for improving both diabetic and cardiovascular health. In patients at risk for a major cardiovascular event, SGLT-2i or GLP-1RA may be prescribed by clinicians. More studies must be performed to draw more conclusions.&nbsp

Autoimmune Diseases Associated with Iron Deficiency Anemia; Coexistence of Demyelinating Disease and Inflammatory Bowel Disease

In a young patient with iron deficiency anemia and low hemoglobin levels, we identified a very rare association: Demyelinating disease with Inflammatory Bowel Disease (IBD)

Pediatric Dysgerminoma: Unveiling a Rare Ovarian Tumor

Background: Dysgerminomas, account for only 1% - 2% of all malignant ovarian neoplasms.Objective: This case report aims to present a rare occurrence of dysgerminoma in a pediatric patient, highlighting the clinical characteristics, diagnosis, and management.Case presentation: We present a case of dysgerminoma in a 12-year-old girl who presented with a three-week history of pelvic pain and progressive abdominal swelling. Physical examination revealed a distended abdomen with evident suprapubic fullness, and a palpable abdominopelvic mass measuring approximately 20 weeks in size. Imaging studies confirmed the presence of a solid heterogeneous mass originating from the pelvis. The patient underwent a right salpingo-oophorectomy without complications. Histological examination coupled with an immunohistochemical study confirmed the diagnosis of dysgerminoma. The patient had an uneventful postoperative course and was discharged without adjuvant treatment. Regular follow-up visits, physical examinations, ultrasound scans, and lactate dehydrogenase assays were initiated for monitoring. Conclusion: Prompt recognition and appropriate surgical intervention, followed by regular monitoring, are crucial for optimal outcomes in pediatric dysgerminoma cases

Myeloid Neoplasms: Better Understanding of their Molecular Pathogenesis with Improvised Genomic Testing: A Ray of Hope for Better Clinical Outcomes

With the increase in incidence and prevalence of myeloid neoplasms in India, it has become a necessity to understand its molecular mechanisms, acquisition of genomic alterations, and understand its primary and secondary resistance pathways which ultimately impact the decision of therapeutics. The objective of this review is to investigate the molecular aspects of this disease type and identify the biomarkers that help with diagnosis, risk assessment, prognosis, and selecting the best line of treatment for a specific myeloid neoplasm. Advancements and innovations in molecular technologies from simplest Real-Time PCR to high throughput next-generation sequencing have played a vital role in screening the most common mutations and fusions to the novel and rare. Molecular technologies have helped to enumerate the genomic landscape of myeloid malignancies. The understanding of both- the mechanisms and the technology is a strong combination as it has helped revolutionize precision oncology and helped in giving better therapeutic choices with better clinical outcomes. The importance of cellular morphology, clinical symptoms, and molecular pathology in assessing the risk of myeloid malignancies is emphasized and summarized in the review. The review concludes that understanding molecular pathogenesis can be improved by using clinical-pathological-molecular strategies for diagnosis and therapy decision-making

Optimizing Milk Safety: Applying Nuclear Techniques in X-ray Fluorescence Spectroscopy for Heavy Metal Quantification in Powdered Milk Consumed in Senegal

This study conducted an elemental analysis and assessed heavy metal concentrations in five powdered milk samples (V1, L1, H1, G1, and D1) from Senegal, utilizing X-ray Fluorescence (XRF). The analysis focused on aluminum (Al), calcium (Ca), potassium (K), phosphorus (P), and chlorine (Cl). Aluminum was either undetected or found at negligible levels in all samples. Calcium levels consistently surpassed the Acceptable Maximum Level (AML) in all samples, with H1 exceeding the AML by approximately 11.1 times (27,745.06 ± 310.16 ppm). Potassium concentrations varied, with G1 exhibiting the highest levels, significantly exceeding the AML (51,058.15 ± 456.13 ppm), while V1 remained within acceptable limits. Chlorine concentrations generally complied with the AML, except for G1, which slightly exceeded the limit (3631.04 ± 31.23 ppm). Phosphorus concentrations in H1 were notably higher than the AML (13,750.94 ± 275.35 ppm). The non-uniformity in heavy metal concentrations among samples emphasizes the need for ongoing research and regulatory scrutiny to address potential risks and ensure the safety of powdered milk

Most Comparative Study of Cerebral Volumetric Variations in Patients with Schizophrenia with their Unaffected First-degree Relatives, using Magnetic Resonance Imaging Technique, a Case-control Study

Background and purpose: Schizophrenia (SZH) is a chronic mental disorder affecting the individuals` thoughts, perceptions, emotions, and behaviors. People with SZH may experience a wide range of positive, negative, and cognitive symptoms. Since there are no laboratory assays for definite SZH diagnosis, the authors aimed to identify the cerebral volumetric variations in SZH patients with the most prevalent positive symptoms as a diagnostic tool. This study selected 15 SZH patients displaying the most prevalent positive symptoms based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. Assessment tools included the Mini-Mental State Examination (MMSE) for cognitive impairment, the Positive and Negative Syndrome Scale (PANSS) for symptom evaluation, and the Wechsler Intelligence Scale (WIS) for intelligence assessment. Additionally, 15 Healthy Controls (HC) without cerebral pathologies were recruited. T1w MRI images underwent analysis using Freesurfer software. Data analysis employed Mann-Whitney U and χ² tests, considering p < 0.05 as significant.Results: SZH and HC groups showed no significant differences in age and gender. However, significant (p < 0.05) alterations in Gray Matter (GM) volume were observed in SZH patients compared to HC. In the right hemisphere, several regions exhibited volume reduction, including the Fusiform sulcus, Rostral middle frontal gyrus, isthmus cingulate, Frontal pole, Middle temporal gyrus, Lateral occipital gyrus, and Inferior Parietal gyrus. Notably, the Precentral sulcus and Postcentral gyrus demonstrated volume acceleration. Similarly, in the left hemisphere, various regions showed volume reduction while the Paracentral gyrus indicated volume acceleration, all significant (p < 0.05).Conclusion: SZH patients display significant volumetric brain changes, indicating potential for future diagnostic procedures in SZH

Treatment Outcome in Patients with Myofascial Orofacial Pain: A Randomized Clinical Trial

Background: Temporomandibular Disorder (TMD) pain attributed to myalgia is a common condition and patients should get advice on the best treatment option. Objectives: The aim was to evaluate the effect of two different exercise programs, or bite splint therapy, respectively, in patients with chronic frequent primary myofascial orofacial pain. Methods: The study was a randomized clinical trial including patients fulfilling criteria of chronic frequent primary myofascial orofacial pain with a reported pain intensity of ≥ 4 on a numerical rating scale (0-10). Ninety subjects were randomized to either bite splint, home exercises, or a supervised exercise program. Two examiners blinded to the treatment modality examined the same subject at baseline and a 3-month follow-up. Non-parametric statistical methods were applied for the outcome of treatment in intended-to-treat analyses. A P-value <0.05 was considered statistically significant. Results: The pain severity index was significantly reduced (p < 0.001) in all treatment groups. Jaw opening capacity improved significantly (p < 0.05) for those randomized to bite splint and for those in the home exercise program. About 70% of the participants reported improvement in their TMD pain severity with no significant difference between treatments. Both exercise groups improved in jaw function at the 3-month follow-up compared to baseline. Those who had a bite splint reported significantly more improvement in their headaches compared to those in the exercise programs. Conclusion: Jaw exercise programs and bite splint treatments had similar positive effects on TMD pain severity attributed to myalgia after 3 months

Persistent Bilateral Vocal Cord Paralysis Following Unilateral Basal Ganglia Hemorrhage

Post-stroke vocal cord paralysis is a condition much less recognized compared to dysphagia. We describe bilateral vocal cord palsy in a thirty-six-year-old man following a stroke.&nbsp

Impact of Balanced Lifestyles on Childhood Development: A Study at Crèche

Introduction: In our fast-paced world, children’s dietary habits and behaviour are increasingly concerning, with a tendency toward indulging in sweets and snacks. Insights are derived from observations of 20 children at a crèche facility.Temptation of sweets: Children’s inherent attraction to sweet and salty snacks challenges maintaining a healthy diet. Excessive consumption can lead to health issues, recognizing the pivotal role parents and caregivers play in guiding children toward healthier choices.Significance of a balanced diet: A well-rounded and nutritious diet is crucial for a child’s physical and mental development. Providing fruits, vegetables, whole grains, and lean proteins is essential.Role of activities: Diversifying a child’s routine with engaging activities is a powerful strategy to redirect their focus from unhealthy snacks. Sports, arts, outdoor play, and educational games promote physical fitness, creativity, and cognitive development, contributing to a well-balanced lifestyle.Strategies for encouraging healthy choices:•    Lead by example: Modelling healthy habits inspires children to adopt similar behaviour.•    Educate about nutrition: Imparting knowledge about the nutritional value of foods equips children to make informed choices.•    Make healthy options accessible: Stocking the kitchen with nutritious snacks makes it convenient for children to opt for healthier alternatives.•    Limit unhealthy choices: Setting clear limits on sugary snacks helps children develop moderation and self-control.•    Create a fun and active environment: Fostering an enjoyable environment involves family outings, games, and making exercise a natural part of daily life.Results: Encouraging results were observed among the 20 children. Two children, aged around 12, demonstrated awareness of healthy habits. Excluding these two, others showed positive changes in behaviour towards sweets and snacks through activities and counselling.Conclusion: Maintaining a balance between a child’s consumption of sweets and snacks and engaging in diverse activities is crucial for overall development. A combination of nutritious choices and engaging activities guides children toward a path of health and happines

An Individual Rehabilitation and/or Habilitation Program for Children with Disabilities (IPRH)

Introduction: The individual program of rehabilitation and (or) habilitation of children with disabilities (IPRH) is mandatory for execution by the relevant state authorities, local self-government bodies, as well as organizations regardless of organizational-legal forms and forms of ownership.Objective: To conduct a pilot analysis of the implementation of the IPRH contingent of patients of children with disabilities in an urban children’s clinic.Patients and methods: There were 366 reports on the implementation of measures provided for by an IPRH for a disabled person (disabled child) of 222 disabled. The organization of the study was in the nature of a continuous sample. The criterion for the inclusion of patients in it was the passage of an IPRH in a disabled child within a specified time frame. The following techniques were used: grouping, absolute and relative values, average values, detailing, and generalization. The threshold error probability for statistically significant differences was set at a level of 0.05.Results: The structure of the results of the control of the performance of IPRH in 222 disabled children according to the classes of diseases that caused the onset of disability (ICD) was as follows 1) G00-G99 - 35.47 ± 3.13%; 2) Q00-Q99 - 23.50 ± 2.77%; 3) 11.11 ± 2.05%; 4) C00-D48 - 10.25 ± 1.98%; 5) H60-H95 - 7.26 ± 1.67%; 6) M00-M99 - 2.99 ± 1.11%; 7-8) H00-H59 and P00-P96 - 2.14 ± 0.95%; 9-10) K00-K93 and S00-T98 - 1.29 ± 0.74% each; 11-12) I00-I99 and N00-N99 - 0.85 ± 0.60% each; 13-14) J00-J99 and L00-L99 - 0.43 ± 0.42% each.Conclusion: 1. In the structure of IPRH in 222 disabled children, according to the classes of diseases that caused disability (ICD), the following prevailed: 1) VI Diseases of the nervous system G00-G99 – 35.47%; 2) XVII Congenital anomalies, chromosomal disorders Q00-Q99 - 23.50%; 3) IV Diseases of the endocrine system, nutritional disorders, and metabolic disorders E00-E90 – 11.11%; 4) II Neoplasms C00-D48 - 10.25%; 5) VIII Diseases of the ear and mastoid process H60-H95 - 7.26%; 6) XIII Diseases of the musculoskeletal system and connective tissue M00-M99 - 2.99%; 7-8) VIII Diseases of the ear and mastoid process H60-H95 and VII Diseases of the eye and its adnexa H00-H59 - 2.14% each.2. The effectiveness of medical rehabilitation of disabled children was as follows: 1) Improvement - 23.26%; 2) Stabilization - 74.88%; 3) Deterioration - 1.86%. Dynamic observation was carried out on 94.26% of disabled children, drug therapy - 77.32%, non-drug therapy - 66.93%, and other types of medical rehabilitation were received by 14.48% of patients. Reconstructive operations were performed on 11.26% of disabled children.3. Prosthetics and orthotics were performed on 38.74% of disabled children. 32.43% of disabled children in need received sanatorium treatment, and 30.18% are currently in line to receive a voucher. For various reasons, 24.32% refused this type of rehabilitation; 3.60% of patients had contraindications at the time the voucher was provided.4. The obtained research results become the initial everyday statistical tool for objectifying the process of rehabilitation of patients and determining the strength and means of a medical institution to monitor and successfully implement an individual rehabilitation/habilitation program for a disabled person