Leptin: Mechanisms Involved In Signaling and Resistance

Leptin is secreted mainly by white adipocyte tissue, and it circulates at levels positively correlated with fat mass, thus reflecting primarily the amount of energy stored in adipose tissue. Leptin levels also change with acute changes in energy intake and thus, secondarily reflect acute energy availability. Several potential mechanisms behind leptin resistance have been identified including: Inflammatory signaling, elevated free fatty acids, high leptin and genetic mutation in OB and DBU genes. This review summaries all the physiological, biological aspects of leptin hormone including increases energy expenditure, thermogenesis, heart rate, blood pressure but decreases glycaemia. This review summarizes the pharmacological and nonpharmacological treatment of leptin hormone imbalances.

Migraine in children and adolescents: modern principles of diagnostics and treatment

Migraine is a nervous system disorder that affects 7.7% of children and can debut before the age of 3 years. As they get older, the incidence of migraine increases, and among adolescents, its prevalence reaches 15%. The disease can significantly reduce the child's daily activity, school performance. Migraine is the most common cause of headache in children and adolescents, but it is not always diagnosed; it is not uncommon for patients with migraine to be misdiagnosed and given ineffective treatment. An effective approach to the diagnosis of migraine in children is presented, diagnostic criteria for migraine according to the 3rd edition of International Classification of Headache Disorders are described. Special disorders in childhood are described – episodic syndromes in children associated with migraine. Migraine treatment in children includes four main approaches: 1) lifestyle recommendations; 2) migraine attack treatment; 3) nonpharmacological treatment; 4) migraine preventive pharmacotherapy. All of the listed approaches for the treatment of migraine in childhood are discussed in detail.

Implications for Early Diagnosis and Treatment in Schizophrenia Due to Correlation between Auditory Perceptual Deficits and Cognitive Impairment

It is indicated that auditory perception deficits are present in schizophrenia and related to formal thought disorder. The purpose of the present study was to investigate the association of auditory deficits with cognitive impairment in schizophrenia. An experimental group of 50 schizophrenia patients completed a battery of auditory processing evaluation and a neuropsychological battery of tests. Correlations between neuropsychological battery scores and auditory processing scores were examined. Cognitive impairment was correlated with auditory processing deficits in schizophrenia patients. All neuropsychological test scores were significantly correlated with at least one auditory processing test score. Our findings support the coexistence of auditory processing disorder, severe cognitive impairment, and formal thought disorder in a subgroup of schizophrenia patients. This may have important implications in schizophrenia research, as well as in early diagnosis and nonpharmacological treatment of the disorder.

Application of Foot Massage Therapy Procedures Using Lavender Essential Oil on Clients With Hypertension in RT 001 RW 01 Baru Village, Pasar Rebo District, East Jakarta

Background: Hypertension is one of the main problems in the world of health in Indonesia and the world. According to WHO (2011) there are 1 billion people in the world suffer from hypertension and 2/3 of them are in developing countries. This condition requires pharmacological and nonpharmacological treatment. One of them, giving foot massage therapy using lavender essential oil. Objective: This study aims to determine the effectiveness of applying foot massage procedures using lavender essential oil on hypertensive clients. Methods: This study uses a qualitative design to describe in-depth information about the application of foot massage therapy procedures using lavender essential oil on clients who have hypertension. Result: Foot massage is done using lavender essential oil for 15-20 minutes 2 x 1 day. Although the nursing problems are the same, the end result is different. After 3 days of intervention, there was a decrease in blood pressure in Mr D from 150/90 mmHg to 120/80 mmHg with a scale of pain from 4 to 0. While in Mr. S from 170/100 mmHg to 150/90 mmHg with a scale of pain from 5 to 1. Mr. D has decreased blood pressure more optimally than Mr. S because you do therapy regularly. Conclusion: of the study is that foot massage therapy using lavender essential oil can reduce the value of blood pressure and the scale of pain. This therapy is effective if done routinely and client can take advantage of health facilities.

Prevelance of symptoms during menstruation and its management among adolescent girls

Background: Menstruation is a natural phenomena of the female reproductive cycle in which discharge of blood from the uterus exits through the vagina every month, it is the spontaneous onset of puberty. 75% of girls confront some problems associated with menstruation including delayed, irregular, painful and heavy menstrual bleeding. Menstruation can be accompanied with premenstrual and postmenstrual symptoms which include both physiological symptoms and psychological symptoms. It is important to treat both physiological and psychological symptoms with pharmacological and nonpharmacological treatment approaches.Methods: The study was a prospective observational study done with a sample size of 650 subjects of 9 to 18 age group in whom menstruation already occurred were recruited from five different schools in regions of Pathanamthitta and Alappuzha. The study was conducted in 3 phases, where initially a predesigned well-structured questionnaire was provided to assess the attitude, awareness and practices.Results: Subjects experienced some or other type of symptoms and had better knowledge regarding menstrual symptoms and its importance of management when compared to subjects from other regions of India which was imparted from a developed and supporting society but still, they lacked some adequate and updated information on symptoms and management of symptoms during menstruation.Conclusions: So, this study laid the groundwork for discussion on menstrual symptoms, various approaches of treatment to the adolescent girls, providing them the information they lacked and better guidance.

A Review on Nonpharmacological Treatment of Diabetic Mellitus: Myth V/S Reality

There are many reasons for medical myths occur. Most often they are passed from one generation to another by word of mouth. The origins of some myths are difficult to find out. Understanding those myths and misconceptions in patients with diabetes is important in providing better care to those.1 Diabetes mellitus (DM) is a lifestyle related painless morbidity that produces complex behavior of an individual 'living with disease'. There is a strong influence in the life of those individuals during the treatment of illness. Understanding those myths and misconceptions, and providing education to those individuals and their caregivers are necessary. In the more recent effect of this lifelong disease many factors affect prognosis including education, occupation, attitudes, values, beliefs, and perceptions of need for optimum management, which are shaped over time by cultural and social exposures.2 Myths existing about diabetes in the public have become a major hurdle for its proper treatment and control.3 Keywords: myths, diabetes and lifestyle.

Fever as a Side Effect after Electroconvulsive Therapy

<b><i>Background:</i></b> Electroconvulsive therapy (ECT) is the most important and safe nonpharmacological treatment for psychiatric disorders. Some patients experience unexplained fever after ECT, but only a few studies have reported on this. <b><i>Method:</i></b> We investigated fever after ECT by retrospectively reviewing the medical records of patients. Patients treated at the ECT unit of the Department of Psychiatry at Asan Medical Center, Seoul, South Korea, between 30 June 2004 and 30 June 2019, were included. Differences in variables were compared between groups with or without fever after ECT sessions. <b><i>Result:</i></b> There were 28 patients (8.8%) in the fever group. Forty-three ECT sessions (1.5%) resulted in fever after treatment. The female-to-male ratio was higher in the fever group than in the control group, and the mean number of total ECT sessions was also higher in the fever group than in the control group, but there were no other differences between the 2 groups. <b><i>Conclusion:</i></b> Comparing fever and control sessions, fever sessions relatively preceded control sessions and had a longer seizure duration. Postictal delirium occurred more often in the fever sessions than in control sessions. Fever sessions had a higher white blood cell count and lower concomitant quetiapine dosage than control sessions. Because 8.8% of patients who received ECT experienced fever after treatment more than once, fever after ECT is considered to be a common side effect.

Racial and Ethnic Disparities in Peripheral Artery Disease

Peripheral artery disease is an obstructive, atherosclerotic disease of the lower extremities causing significant morbidity and mortality. Black Americans are disproportionately affected by this disease while they are also less likely to be diagnosed and promptly treated. The consequences of this disparity can be grim as Black Americans bear the burden of lower extremity amputation resulting from severe peripheral artery disease. The risk factors of peripheral artery disease and how they differentially affect certain groups are discussed in addition to a review of pharmacological and nonpharmacological treatment modalities. The purpose of this review is to highlight health care inequities and provide a review and resource of available recommendations for clinical management of all patients with peripheral artery disease.