Increased cannabis use in pregnant women during COVID-19 pandemic.

Almost one in every 20 pregnant women self-reports marijuana use during pregnancy. During the COVID-19 pandemic, this number has risen to 1 in 6 pregnant women. Some of the main factors associated with cannabis use during pregnancy and lactation are management of chronic conditions, sensation-seeking, dealing with stress, and other conditions related to pregnancy. The action of cannabis on endocannabinoid receptors might cause poor blastocyst implantation, inhibition of decidualization, compromised placentation, miscarriage and poor embryo development.The children born to mothers who used cannabis during pregnancy manifested higher aggression, anxiety, hyperactivity, and higher levels of the hormone cortisol, compared to children of non-cannabis users. In this review we summarize the effects of cannabis use on fetal development during the COVID-19 pandemic based on the existing published peer-reviewed scientific literature. The COVID-19 pandemic has served as an additional stimulus that has increased cannabis use among pregnant women. Prenatal cannabis use is associated with health risks for the mother and child. Cannabis use in pregnant mothers is associated with low infant birth weight and potential negative neurodevelopmental effects in the offspring. It remains unclear how long these changes will persist in the affected children. It is essential that clinicians educate pregnant women about the harm of prenatal cannabis use, improve strategies to support women at risk, and create new intervention strategies to help them stop using cannabis.

COVID-19 and Pregnancy.

It is of greatest concern how COVID-19 is affecting pregnancy, mothers, and babies. Scientists are studying the impact of COVID-19 on pregnant women and babies and are understanding a little more every day. Reports show that there is an increased risk in pregnant women compared to nonpregnant women to get more serious illness due to COVID-19. Researchers are also investigating COVID-19 and its potential impact on a fetus. There are exceedingly rare cases of COVID-19 transmission to the fetus, and newborns can pick up COVID-19 when exposed. Vaccines are proved to be safe for pregnant women and help prevent both mother and the fetus from getting COVID-19 and are also highly effective to prevent COVID-19 infection, critical sickness, and fatalities in general. There are specific guidelines for labor and delivery during the COVID-19 pandemic which are to be imposed and followed to achieve safer and healthier childbirth. In this article, the overall influence of COVID-19 in pregnancy, its pathophysiology, effects on placenta and neonates, maternal and perinatal features and outcomes, the role of vaccination, available treatment options, and the guidelines to be followed during the pandemic are discussed based on the available scientific evidence.

A Multidisciplinary Approach and Current Perspective of Nonalcoholic Fatty Liver Disease: A Systematic Review.

In recent times, nonalcoholic fatty liver disease (NAFLD) has been considered one of the major causes of liver disease across the world. NAFLD is defined as the deposition of triglycerides in the liver and is associated with obesity and metabolic syndrome. Hyperinsulinemia, insulin resistance (IR), fatty liver, hepatocyte injury, unbalanced proinflammatory cytokines, mitochondrial dysfunction, oxidative stress, liver inflammation, and fibrosis are the main pathogenesis in NAFLD. Recent studies suggest that the action of intestinal microbiota through chronic inflammation, increased intestinal permeability, and energy uptake plays a vital role in NAFLD. Moreover, polycystic ovarian syndrome also causes NAFLD development through IR. Age, gender, race, ethnicity, sleep, diet, sedentary lifestyle, and genetic and epigenetic pathways are some contributing factors of NAFLD that can exacerbate the risk of liver cirrhosis and hepatocellular carcinoma (HCC) and eventually lead to death. NAFLD has various presentations, including fatigue, unexplained weight loss, bloating, upper abdominal pain, decreased appetite, headache, anxiety, poor sleep, increased thirst, palpitation, and a feeling of warmth. Some studies have shown that NAFLD with severe coronavirus disease 2019 (COVID-19) has poor outcomes. The gold standard for NAFLD diagnosis is liver biopsy. Other diagnostic tools are imaging tests, serum biomarkers, microbiota markers, and tests for extrahepatic complications. There are no specific treatments for NAFLD. Therefore, the main concern for NAFLD is treating the comorbid conditions such as anti-diabetic agents for type 2 diabetes mellitus, statins to reduce HCC progression, antioxidants to prevent hepatocellular damage, and bariatric surgery for patients with a BMI of >40 kg/m2 and >35 kg/m2 with comorbidities. Lifestyle and dietary changes are considered preventive strategies against NAFLD advancement. Inadequate treatment of NAFLD further leads to cardiac consequences, sleep apnea, chronic kidney disease, and inflammatory bowel disease. In this systematic review, we have briefly discussed the risk factors, pathogenesis, clinical features, and numerous consequences of NAFLD. We have also reviewed various guidelines for NAFLD diagnosis along with existing therapeutic strategies for the management and prevention of the disease.

Omicron variant of SARS-CoV-2 infection elicits cross-protective immunity in people who received boosters or infected with variant strains.

INTRODUCTION: The B.1.1.529 (Omicron) variant of SARS-CoV-2 is the most antigenically unique SARS-CoV-2 variant of concern to date, which is currently widespread across the world. Omicron variant and its sublineages contain a plethora of mutations than other variants of concern, which increases their transmissibility and virulence. Concerns regarding potential immunological evasion have been reignited by emerging subvariants of the Omicron variant. Determining the effectiveness of Omicron-induced immunity and whether it is cross-protective against other variants is a crucial aspect of the research. METHOD: A systematic search of relevant articles until September 25, 2022, from databases such as PubMed, Scopus, Google Scholar, and ScienceDirect was done independently by two authors. A total of 11 articles discussing about immunological evasion of different Omicron subvariants were included in the study. RESULTS: Numerous studies have demonstrated that Omicron variant causes a restricted immune response after infection. Omicron infection boosts preexisting vaccine-induced immunity, but it may not be enough to establish widespread, cross-neutralizing humoral immunity in unvaccinated people. CONCLUSION: Due to co-circulation and the emergence of novel SARS-CoV-2 variants, findings highlight the importance of booster vaccinations for immune protection. More studies should focus on the efficacy of Omicron-induced immunity, its cross-protective properties against other variants, and development of a universal vaccine.

Recent Advances and Future Prospects of Treatment of Pulmonary Hypertension.

Pulmonary hypertension is one of the difficult situations to treat. Complex pathophysiology, association of the multiple comorbidities make clinical scenario challenging. Recently it is being shown that patients who had recovered from coronavirus disease infection, are at risk of developing pulmonary hypertension. Studies on animals have been going on to find out newer treatment options. There are recent advancements in the treatment of pulmonary hypertension. Role of anticoagulation, recombinant fusion proteins, stem cell therapy are emerging as therapeutic options for affected patients. SGLT2 inhibitors have potential to have beneficial effects on pulmonary hypertension. Apart from the medical managements, advanced interventions are also getting popular. In this review article, the authors have discussed pathophysiology, recent advancement of treatments including coronavirus disease patients, and future aspect of managing pulmonary hypertension. We have highlighted treatment options for patients with sleep apnea, interstitial lung disease to discuss the challenges and possible options to manage those patients.