Disease-a-month : DM
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Disease-a-month : DM · Jul 2023
ReviewCurrent Limitations and Recent Advances in the Management of Asthma.
Asthma is a significant worldwide health issue affecting kids and adults. Asthma management is mainly straightforward, but considering the associated co-morbidities, it is essential to diagnose the disease accurately. Steroid resistance and dependence, along with inhaler abuse, are the other challenges in clinical practice. Despite being treated with the recommended guidelines, a good portion of the population has persistent symptoms. Emerging biological treatments can alter the global landscape of managing severe asthma. With these new therapeutic possibilities, phenotype- and endotype-specific therapies can be used to individualize treatment plans. ⋯ Clinical practice should consider an integrative approach to the care and prevention of asthma. We advocate for a large-scale cohort of observation studies and RCTs that further look into the underlying immunological mechanisms, the function of hereditary and environmental variables, and the novel molecular targets of asthma in light of the rising incidence and prevalence of the disease. Even with rising steroid resistance and dependence, the standard therapy will be the mainstream of asthma management. Biologics have promiscuous results and the potential for changing the treatment of uncontrolled asthma. Optimizing the standard therapy with biologics is needed to decrease asthma-related morbidity.
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Disease-a-month : DM · Jul 2023
ReviewPulmonary Hypertension in Scleroderma- Evaluation and Management.
Pulmonary Arterial Hypertension (PAH) is a clinical syndrome consisting of physiologic/hemodynamic criteria that are a consequence of several etiologies. Systemic Sclerosis (SSc), one of the most common causes of PAH, is an autoimmune disorder of the connective tissue leading to fibrosis that involves the skin, gastrointestinal tract, lungs, heart, kidney etc. SSc has an annual prevalence of one to five cases for every 1000 individuals and nearly 15 percent of all cases develop PAH. ⋯ A diagnosis of PAH in SSc is virtually a death sentence, with studies reporting a mortality rate of 50 per cent in the 3 years of diagnosis. Therefore, developing and implementing a robust screening and diagnosis protocol is crucial in the fight against this pervasive disease. This review aims to summarize the current literature of PAH in SSc, with a special focus on the screening and diagnosis protocols, newer treatment options and prognostic indicators for the same.
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Disease-a-month : DM · Jun 2023
Kratom: History, pharmacology, current user trends, adverse health effects and potential benefits.
Kratom (Mitragyna speciosa Korth.) is a tree native to Southeast Asia with dose-dependent stimulant and opioid-like effects. Dried, powdered leaf material is among the kratom products most commonly consumed in the US and Europe, but other formulations also exist including enriched extracts, resins, tinctures, and edibles. Its prevalence in the US remains debated and the use pattern includes self-treatment of mood disorders, pain, and substance use disorders. ⋯ Kratom may also present with drug-drug interactions primarily through CYP 3A4 and 2D6 inhibition, although the clinical significance remains unknown to date. The variability in composition of commercially available kratom products complicates generalization of findings and requires further investigation by employing clinical trials. Healthcare professionals should remain cautious in counseling patients on the use of kratom in a therapeutic setting.
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Disease-a-month : DM · May 2023
ReviewFrontotemporal dementia: Addressing the scattered harbingers of genetics and its relationship with glucose metabolism, bipolar disorder, and amyotrophic lateral sclerosis.
Frontotemporal Dementia, also known by the name Pick's disease, is a rare form of dementia that can run for several generations. The two key characteristics are argyrophilic, spherical intraneuronal inclusions, which most frequently impact the frontal and temporal poles, and localized cortical atrophy (Pick bodies). Although personality decline and memory loss are frequently more severe than the visuospatial and apraxia disorders that are common in Alzheimer's disease, clinical overlap with other non-Alzheimer degenerative disorders is being increasingly recognized. ⋯ Leukoencephalopathy and inflated cortical neurons are less specific symptoms (Pick cells). In this paper, we review the factors leading to Picks disease along with its pathophysiology, clinical manifestations, diagnosis, imaging, treatment, prognosis, and a comprehensive discussion on the same. We have also discussed the relationship of frontotemporal dementia with glucose metabolism, bipolar disorder, and amyotrophic lateral sclerosis, all of which are emerging fields of interest and need more studies.