Is a Glucocorticoid Antagonist a Potential Treatment Alternative for Antipsychotic-Induced Weight Gain?

Objective: To evaluate the efficacy and safety of mifepristone as a new treatment modality for antipsychotic-induced weight gain. Methods: We searched databases up to March 2021, for the published English-language literature including a Medical Subject Heading “Mifepristone,”“Receptors, Glucocorticoid,” “Weight gain,” “Overweight,” “Obesity,” “Body Weight Change,” “Antipsychotics Agents,” “Glucocorticoid Receptor Blocker,” “Glucocorticoid Receptor antagonist.” We identified two clinical and four preclinical studies utilizing mifepristone as a treatment modality. Results: The results of the olanzapine clinical trial showed that mean increase in weight from baseline to day 14 was greater in the olanzapine with the placebo group (3.2 ± 0.9 kg) than the olanzapine with mifepristone group (2.0 ± 1.2 kg) and the mifepristone with placebo (2.0 ± 0.7 kg), and a similar effect was observed in the risperidone with mifepristone clinical trial. Conclusions: Mifepristone shows potential in the management of AIWG. Glucocorticoid antagonists can be a viable alternative to curb this side effect. Large-scale clinical studies are warranted to determine the medication’s safety and efficacy based on this mechanism of action.

Case Reports of Neuroinvasive Manifestation of Viral Encephalitis.

West Nile virus (WNV) infection is a mosquito-borne viral disease, which can cause an inflammation of the brain and meningitis. WNV is commonly found in Africa, West Asia, the Middle East and Europe. For the first time in North America, WNV was confirmed in the New York metropolitan area during the summer and fall of 1999. Since then, WNV over-wintered in the northeastern United States and has been described in humans, horses, birds, and mosquitoes. It is estimated that more than 80% of infected persons remain asymptomatic. Of those who develop symptoms, 80–90% develop an uncomplicated, self-limited febrile illness (‘West Nile fever’; WNF) while the remaining persons develop severe diseases including West Nile meningitis (WNM), West Nile encephalitis (WNE), or an acute poliomyelitis- like syndrome. In fact, less than 1% patients will develop neuroinvasive disease, which typically manifests as meningitis, encephalitis, or acute flaccid paralysis [1]. We are presenting two cases admitted at our tertiary medical center-Vidant Medical Center in Eastern North Carolina with neuroinvasive WNV manifestation. Both patients presented with fever, altered mental status, and proceeded to develop respiratory failure. One patient died thirty days after admission and the other survived with residual isolated right lower extremity weakness that required prolonged rehabilitation.

Garlic: Review of literature.

Garlic is one of the components, which have effects on reducing the risk of cancer. Including garlic in the diet helps for the betterment of the health. Medicinal effects of the garlic were known since 5,000 years. Recently, studies were carried out to known its effect on the cancer cell lines. Many studies have shown its effects not only on carcinomas, but also on the cardiovascular system and immune system. Functions of the each component of the garlic were studied to know exactly, which component has got beneficial effect. So this review has been carried out to know about the component, functions of each component, mode of action, and beneficial effects of the garlic.

Traumatic brain injury: A case-based review / 世界急诊医学杂志（英文）

@#BACKGROUND: Traumatic brain injuries are common and costly to hospital systems. Most of the guidelines on management of traumatic brain injuries are taken from the Brain Trauma Foundation Guidelines. This is a review of the current literature discussing the evolving practice of traumatic brain injury. DATA SOURCES: A literature search using multiple databases was performed for articles published through September 2012 with concentration on meta-analyses, systematic reviews, and randomized controlled trials. URESULTS: The focus of care should be to minimize secondary brain injury by surgically decompressing certain hematomas, maintain systolic blood pressure above 90 mmHg, oxygen saturations above 93%, euthermia, intracranial pressures below 20 mmHg, and cerebral perfusion pressure between 60–80 mmHg. CONCLUSION: Much is still unknown about the management of traumatic brain injury. The current practice guidelines have not yet been sufficiently validated, however equipoise is a major issue when conducting randomized control trials among patients with traumatic brain injury.