Safety and Efficacy of an Implantable Cardioverter Defibrillator (ICD) in the Detection and Prevention of Cardiac Arrhythmia - A Systematic Review.

Implantable cardioverter defibrillators (ICD) have been recommended as an effective therapy in treating sudden cardiac deaths. This study evaluates the safety and efficacies of ICDs in detecting arrhythmias. Different ICDs, such as the transvenous cardioverter defibrillator (TV-ICD) and the subcutaneous implantable cardioverter defibrillator (S-ICD), are used. This systematic review identified Embase, PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), and Web of Science as the primary electronic databases for research. Supplementation of the available articles for the review was done using Google Scholar. The population, exposure, control, outcome, and studies (PECOS) criteria were used in this study. The quality of the included studies was assessed using the Critical Appraisal Skills Program (CASP) standard checklist. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used in this systematic review. Two researchers conducted the extraction of data. A pre-designed Excel worksheet (Microsoft, Redmond, Washington) was used in the recording of extracted data. Eight studies were identified for use in this systematic review. Safety of the ICDs was observed with the minimum number of reported inappropriate shocks. Studies conducted identified that women had a lower number of incidences when a long detection setting by sex was conducted. Strategic programming of ICDs was noted as effective in lowering the levels of mortality. Studies claimed that the reduction of inappropriate shocks were important in the reduction of myocardial damage, which resulted in the mortality rate among the patients decreasing. Having high cutoff rates and long intervals for detection in ICD programming was noted to help in reducing ICD therapy intervention among patients. Differences among the male and female populations were inconsequential in the efficacy and safety of ICDs. Their effectiveness in sensitivity, pacing success, and defibrillation success were high and very significant. ICDs were safe in their use in the detection of arrhythmias.

The Key Role of Glutathione Compared to Curcumin in the Management of Systemic Lupus Erythematosus: A Systematic Review.

In recent years, many documented cases of systemic lupus erythematosus (SLE) have been on the rise. The complicated pathophysiology of the disease makes it challenging to manage. Two databases, PubMed and Google Scholar, have a detailed screening using keywords and Medical Subject Heading (MeSH) combinations. The words are "Systemic Lupus Erythematosus OR SLE OR Lupus," "Glutathione," and "Curcumin." Articles had a detailed process of screening and quality appraisal. Using the English language as a primary filtering parameter, papers over the last 20 years, dating from 2002 to 2022, are the basis of this review. We reviewed all possible human studies documenting the use of curcumin and glutathione for treating SLE. A total of 15 articles are part of this systematic review. Curcumin and glutathione can act as potent drugs for treating lupus. Curcumin can be a more promising alternative since it operates on various pathways and is a more easily accessible source.

Case report: A case of undiagnosed cannabinoid hyperemesis syndrome in rural part of Nepal.

Introduction: and importance: Cannabinoid, a widely used recreational drug worldwide. In Nepal, it is found easily and has multiple used as well as misused as a psychoactive substance. Despite having anti emetic property of Marijuana, chronic use of the substance can lead to cyclic vomiting syndrome due to effect in central nervous system and gastrointestinal system. Case: we present a case of 28 year old man presented frequently with severe vomiting and abdominal pain which improved with hot showers and stopping use of cannabinoid. Clinical findings and investigation: Patient abdomen was tender but all other physical examinations were within normal limits. His lab investigations were within normal limit except of Total leukocyte count and urine analysis. Intervention and outcome: The patient was hospitalized and treated for dehydration, nausea and vomiting, and abdominal pain. The patient was diagnosed with cannabinoid hyperemesis syndrome and was discharged from the hospital two days later with the advice to stop using cannabis completely.

Efficacy and Safety of Medical Marijuana in Migraine Headache: A Systematic Review.

Medical marijuana treatment for migraine is becoming more common, although the legality and societal acceptance of marijuana for medical purposes in the United States have been challenged by the stigma attached to it as a recreational drug. These substances function to reduce nociception and decrease the frequency of migraine by having an impact on the endocannabinoid system. Our study reviewed the clinical response, dosing, and side effects of marijuana in migraine management. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a literature search in PubMed, Google Scholar, and Science Direct, and nine studies were included in the systematic review. The studies demonstrated that medical marijuana has a significant clinical response by reducing the length and frequency of migraines. No severe adverse effects were noted. Due to its effectiveness and convenience, medical marijuana therapy may be helpful for patients suffering from migraines. However, additional clinical trials and observational studies with longer follow-ups are required to study the efficacy and safety of the drug.

Efficacy of Cognitive Behavioral Therapy and Methylphenidate in the Treatment of Attention Deficit Hyperactivity Disorder in Children and Adolescents: A Systematic Review.

The treatment of attention deficit hyperactivity disorder (ADHD) in children and adolescents can be challenging and involve a combination of pharmacologic and non-pharmacological approaches. Using recent literature, we aim to identify the effectiveness of cognitive behavioral therapy (CBT) and methylphenidate (MPH) in reducing the symptoms and improving the quality of life. The investigators conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Investigators independently conducted a routine search on PubMed and Google Scholar for articles published within the last five years through July 30, 2022. Fourteen studies were identified as generally good quality but with some limitations. The final analysis included 2098 patients with an age range of three to eighteen. Nine studies reporting the efficacy of MPH in children, adolescents, or both had different formulations and doses. Six studies documenting the effectiveness of CBT had varying sessions, duration per therapy, modality of administration, and participants. The diagnostic assessment measures showed that the parent symptom rating was the highest and appeared in 11 studies, reflecting the burden on the family. In addition, a structured-self-rated questionnaire rating appeared in eight studies, and two diagnostic assessment measures, teacher symptom rating and investigators, appeared in six. The studies demonstrated significant reductions in the primary symptoms of ADHD at assessment, which led to improved behavioral and functional status with a reduced impact on family and society. Further trials are needed to understand the benefits of CBT and MPH when combined to reduce psychiatry co-morbidities and improve learning and overall quality of life in the long term.