There are a minimum of five distinct sub-types of ovarian cancer based on histology, each of which has distinct factors of risk, types of cells, molecular makeups, clinical characteristics, and therapeutic approaches. Ovarian cancer is detected usually at later stages, and there is no reliable screening method. Cytoreductive surgery and chemotherapy which use platinum-containing drugs are the standard treatments used for freshly detected cancer. Chemotherapy, drugs that are anti-angiogenic, poly ADP-ribose polymerase inhibitors, and immunological treatments are all used to treat recurrent cancer. The most frequent type of ovarian cancer to be diagnosed is high-grade serous carcinoma (HGSC), which often responds well to platinum-based chemotherapy when discovered. However, HGSCs commonly relapse and develop increased treatment resistance in addition to the other histologies. As a result, ovarian cancer research is actively focused on understanding the processes causing platinum resistance and developing strategies to combat it. Serous tubal intraepithelial carcinoma is an HGSC precursor lesion. It is one of the early complications seen in ovarian carcinoma. It has been very useful in identifying the people who have a greater chance of developing ovarian cancer and development of strategies to prevent it. This has led to a significant progress for identification of the genes which are found in people with greater chances of development of ovarian carcinoma (for example, the BRCA1 and BRCA2).
Propofol-related infusion syndrome (PRIS) is a lethal condition characterized by multiple organ system failures. It can occur due to prolonged administration of propofol (an anesthetic) in mechanically intubated patients. The main presenting features of this condition include cardiovascular dysfunction with particular emphasis on impairment of cardiovascular contractility, metabolic acidosis, lactic acidosis, rhabdomyolysis, hyperkalaemia, lipidaemia, hepatomegaly, acute renal failure, and eventually mortality in most cases. The significant risk factors that predispose one to PRIS are: critical illnesses, increased serum catecholamines, steroid therapy, obesity, young age (significantly below three years), depleted carbohydrate stores in the body, increased serum lipids, and most importantly, heavy or extended dosage of propofol. The primary pathophysiology behind PRIS is the disruption of the mitochondrial respiratory chain that causes inhibition of adenosine triphosphate (ATP) synthesis and cellular hypoxia. Further, excess lipolysis of adipose tissue occurs, especially in critically ill patients where the energy source is lipid breakdown instead of carbohydrates. This process generates excess free fatty acids (FFAs) that cannot undergo adequate betaoxidation. These FFAs contribute to the clinical pathology of PRIS. It requires prompt management as it is a fatal condition. The clinicians must observe the patient's electrocardiogram (ECG), serum creatine kinase, lipase, amylase, lactate, liver enzymes, and myoglobin levels in urine, under propofol sedation. Doctors should immediately stop propofol infusion upon noticing any abnormality in these parameters. The other essentials of management of various manifestations of PRIS will be discussed in this article, along with a detailed explanation of the condition, its risk factors, diagnosis, pathophysiology, and presenting features. This article aims to make clinicians more aware of the occurrence of this syndrome so that better ways to manage and treat this condition can be formulated in the future.
Gastroesophageal reflux disorder (GERD) or chronic acid reflux disorder is a condition in which acidcontaining contents continuously leak from the stomach and return to the esophagus. Acid reflux disease occurs in nearly every person at some unspecified time. In reality, it is considered as a reoccurrence of acid reflux disease disorder and heartburn, every day. However, when you have acid reflux disorder/heartburn greater than two times every week over numerous weeks, constantly take heartburn medicinal tablets and antacids. However, if your signs and symptoms and symptoms keep returning, you can have superior GERD. Your GERD needs to be handled with the aid of your healthcare employer. Now not simply to alleviate your symptoms, but because of the reality, GERD can result in extra intense issues. Dental erosion (DE) is the shortage of the ground of your tooth because of acids you eat or drink or acids arising from your stomach. Those acids can wash away the tough substance that makes up your enamel, number one to tooth floor loss. Acid also can melt the teeth floor, making it much less complicated to wear away with the beneficial aid of erosion. This is called acid put on or erosive enamel wear. The belly contains many sturdy acids that are used to digest food. Vomiting and reflux can reason those belly acids to enter your mouth. Gastric acids are very sturdy and might purpose considerable harm to the tooth. DE is the lack of the enamel's hard tissues due to the interplay of gastric juice, pepsin, and acid.
Psychedelics are hallucinogenic drugs that alter the state of consciousness substantially. They bring about psychological, auditory, and visual changes. The psychedelics act on the brain, implying that they have a powerful psychological impact. One of the main factors contributing to disability worldwide is pain. The majority of people deal with pain on a daily basis. Living with chronic pain affects daily life and has social implications. Chronic pain can be associated with any disease that may be genetic, idiopathic, or traumatic. The standard management of pain is done with pharmacological intervention and physical therapy. However, with time, patients may become resistant to a particular class of drugs. As these drugs do not help in treating the cause of pain, they act by blocking receptors and suppressing nervous systems, as this pharmacological intervention is not a permanent solution for pain management. Long-term use of the pharmacological intervention, which acts by suppressing the nervous system, may develop other side effects on the body. These standard therapies are not as effective in managing pain. The opioid class of drugs has good pain-relieving properties but causes addiction; it needs therapeutic drug monitoring to monitor that it is not abused. Since the first synthetic psychedelic was developed, until today, we have had a fair chance to understand its effects and side effects.These drugs are very potent and effective. They have shown promising developments in the field of clinical psychology. There is upcoming research on psychedelics' use in treating pain disorders. In this article, let us understand the effect of psychedelic drugs on the brain and body and how they modulate pain. Even today, the precise mechanism of chronic pain is still not understood completely. Psychedelics' application and uses in future medicine and pain management are being studied. Understanding psychedelics' effects on the brain and how they function allows us to link how they might be used to treat chronic pain.
Somatization refers to the condition in which psychological distress is shown in the form of somatic symptoms such as persistent headache, nausea, gastrointestinal discomfort, etc. Various predisposing factors, including familial such as high expressed emotion, poor parental care, genetic, biological, and demographic which includes age and gender, cognitive such as learning disabilities, psychiatric such as depression, anxiety, post-traumatic stress disorder, social, etc., play an essential role in saturation of the disease. During the time of the COVID-19 pandemic, psychological distress increased in the patients infected with the coronavirus due to some the factors such as social distancing from loved ones, lack of physical exercise, loss of income, loneliness due to quarantine, etc. Therefore, management and treatment of the disorder became essential, especially in coronavirus-infected patients, as it may lead to an increase in complications of the disease. Many studies have been conducted to identify the proper way to manage the condition. Treatments include pharmacological therapy and psychosocial interventions. Pharmacological therapy includes using various antidepressants, hypnotics, and sedatives such as benzodiazepines. For the treatment, mirtazapine is a secure and reliable antidepressant. Another drug, trizolobenzodiazepine adinazolam, was also very useful in treating patients. In some randomized experiments, alprazolam significantly outperformed amitryptiline in reducing the symptoms. Psychosocial interventions include sessions such as cognitive behavioral therapy (CBT), mindfulness-based cognitive therapy, relaxation training, meditation, and psychological interventions such as enhancing multidimensional social help, modifying cognitive assessment, directing positive coping, and inspiring positive emotions.
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