Congenital Torticollis in a Child With Cervical Spine Deformity: A Case Report and Literature Review

Congenital torticollis is an abnormal tilt of the neck in a newborn especially on the side of the pathology with the chin pointing toward the contralateral side. The most frequent cause is termed congenital muscular torticollis (CMT) which is a structural abnormality in the muscle of the neck called sternocleidomastoid muscle. There are also other causes of congenital torticollis that may arise such as anomalies of the cervical vertebrae, syndromic causes, and ocular defects. Diagnosing these other causes of congenital torticollis requires careful examination, cervical X-ray, CT scan, and MRI. The objective of this review is to create an awareness of the different types and causes of cervical spinal deformity. It also confirms that it is easy to misdiagnose these rarer causes of congenital torticollis as seen in a clinical vignette of a newborn who was managed for CMT for about one year with physical therapy and later turned out to have an associated hemivertebrae and fusion of the second and third cervical vertebrae. It is rare but it has the burden of huge financial and psychosocial impact.

Programmed Cell Death Protein 1 (PD-1) and Programmed Cell Death Ligand 1 (PD-L1) Immunotherapy: A Promising Breakthrough in Cancer Therapeutics

The advent of immune checkpoint inhibitors has revolutionized cancer therapy by leveraging the body's immune system to combat malignancies effectively. Among these groundbreaking agents, programmed cell death protein 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors have emerged as pivotal therapeutic approaches. PD-L1, a key protein expressed on the surface of various cells, including cancer cells, plays a central role in immune regulation by interacting with the programmed cell death protein 1 (PD-1) receptor on T-cells leading to immune suppression. The substantial increase in PD-L1 expression on cancer cell surfaces has driven the exploration of PD-1/PD-L1 inhibitors as potential immunotherapeutic agents. These inhibitors are monoclonal antibodies designed to impede the PD-L1 and PD-1 interaction and disrupt the immunosuppressive signal, thereby reinvigorating the anti-tumor immune response mediated by activated T-cells. Clinical trials investigating PD-1/PD-L1 inhibitors have demonstrated remarkable efficacy in the treatment of diverse advanced or metastatic cancers, including leukemia, non-small cell lung (NSCLC), hepatocellular, melanoma, gastric, colorectal, and breast cancers, among others. Regulatory approvals have been granted for both monotherapy and combination therapy with other cancer treatments, encompassing chemotherapy and additional immune checkpoint inhibitors. While PD-1/PD-L1 inhibitors have exhibited significant success, they are not devoid of challenges. The emergence of intrinsic or acquired resistance, as well as immune-related adverse events, warrants thorough investigation and management. Consequently, researchers have embarked on combination trials to augment the therapeutic potential of PD-1/PD-L1 inhibitors and surmount resistance mechanisms.

Efficacy and Safety of Anti-calcitonin Gene-Related Peptide (CGRP) Monoclonal Antibodies in Preventing Migraines: A Systematic Review

The neuropeptide calcitonin gene-related peptide (CGRP) is an essential pathophysiological treatment for migraines. A unique class of medications called CGRP monoclonal antibodies target CGRP and its receptor and have demonstrated promising benefits in the treatment and prevention of migraines. This study sought to identify and assess the quality of existing systematic reviews about the effectiveness of CGRP antibodies for preventing migraines, as well as systematically review and synthesize the evidence on these topics. This included the four Food and Drug Administration (FDA)-approved medications erenumab, galcanezumab, fremanezumab, and eptinezumab. The effectiveness and safety of these monoclonal antibodies in preventing migraines should also be examined in light of patient characteristics, and any gaps in the body of knowledge should be noted in order to suggest new lines of investigation. Data gathering included a thorough search of internet databases (PubMed, Cochrane Library, Web of Science, and Scopus) for relevant research released between 2018 and 2023. The findings imply that CGRP monoclonal antibodies are efficient and secure for preventing migraines and may be considered a first-line alternative for treating migraines and drug misuse. The results further imply that combination treatment with CGRP antibodies and onabotulinumtoxinA may enhance the prevention of migraine in adults. With suggestions for more studies to find and address these variables, the significance of genetic and epigenetic factors in the progression of pediatric patients' acute postoperative pain to chronic postsurgical pain is underlined. All four anti-CGRP monoclonal antibodies, erenumab, fremanezumab, galcanezumab, and eptinezumab, were shown to be safe and effective for the prevention of migraine when the research additionally looked at their individual effectiveness and safety. Additionally, the study discovered considerable variances in effectiveness amongst various groups. However, further investigation is required to establish the best time and dosage and the effect of patient characteristics on the effectiveness and safety of these medications.

Maternal Diet and Infant Risk of Eczema and Food Allergy: A Systematic Review

A significant portion of the pediatric population is affected by allergy diseases, which have become a worldwide public health concern. Could maternal diet during pregnancy or breastfeeding influence allergy outcomes in offspring? If this cause-and-effect relationship exists, it will be simpler to design prevention strategies to reduce the incidence of allergic disorders in children, reduce costs to the public health system and to parents, and improve the quality of life of allergic children and their parents. In this systematic review, we will visit the literature from January 2019 to December 2022 to see if any relationship was found between maternal nutrition and its consequences on children's allergy occurrence. We will focus only on food allergy and eczema outcomes in the offspring. Also, we will summarize what was found to be protective or nonprotective to better control the outcomes if applied in the future.

Efficacy and Safety of Sodium-Glucose Cotransporter 2 Inhibitors to Decrease the Risk of Cardiovascular Diseases: A Systematic Review

Cardiovascular disorders are one of the most frequent causes of death in people throughout the world. These disorders can account for the deaths of 31% of people worldwide. This systematic review examines the effectiveness of sodium-glucose cotransporter 2 (SGLT2) inhibitors in lowering the likelihood of cardiovascular diseases. The study aimed to evaluate various types of research, including randomized controlled trials and observational studies, to analyze how SGLT2 inhibitors impact cardiovascular disorders and establish evidence-based recommendations for clinical practice. The data in this research study were collected from 19 relevant published research articles. The key findings emphasized the potential advantages of SGLT2 inhibitors in reducing major cardiovascular disorders, such as myocardial infarction and stroke. Nonetheless, the study had certain limitations, including reliance on existing literature, exclusion of articles published prior to 2018, and restriction to English-language studies. Despite these limitations, this study contributed significantly to understanding the role of SGLT2 inhibitors in decreasing cardiovascular risk.

Effect of short term immobilization on mechanical characteristics of skeletal muscle in uromastix

Gastrocnemius muscles of Uromastix were used to observe the effects of short term (7 days) immobilization in flexed position. Results demonstrated significantly (P < 0.01) lesser magnitude as well as rate of rise in isometric twitch and tetanic tensions with insignificantly different twitch/tetanus ratio in the immobilized muscles. Both the twitch and tetanus also demonstrated significantly (P<0.01) higher twitch half relaxation and twitch/tetanus half relaxation time ratio. While, immobilized muscles showed insignificantly higher twitch contraction, tetanus half relaxation and duration of active state as well as peak twitch duration, than control ones. These changes in the mechanical contraction parameters were not found to be associated with changes in weight, resting, stretched and shortened length of the immobilized muscles. A comparison of present results with previous work performed on skeletal muscles of Uromastix at longer period (20 days) of immobilization has suggested that Uromastix muscles are no prone to a significant immobilization atrophy. However, decreased mechanical response after immobilization irrespective of the period of immobilization in Uromastix muscles is probably due to a depletion in various substrates involved in muscle mechanics.

Effect of temperature on the maximum rate of rise of tension in denervated rat diaphragm muscle

Effects of chronic denervation and temperature were studied on the maximum rate of rise of tension in isometric twitch and tetanus of rat diaphragm muscles. The muscles were denervated for 15-20 days and the maximum rate of rise of tension was measured according to Hill (1951). The results showed that the maximum rate of rise of tension in twitch and tetanus was temperature dependent, exponentially increasing with increasing temperatures in both the normal and denervated muscles. A further observation was that the maximum rate of rise of tension in denervated muscle was always smaller than normal controls. It is suggested that probable changes in the series elasticity and duration of active state in the denervated muscle are responsible for the observed changes.

Effect of triturated dilutions of ethanol on the peristaltic contractions of isolated rabbit intestine

Effect of triturated dilutions of ethanol from to 10(-3) to 10(-24) were studied on the peristaltic contractions of isolated rabbit intestinal pieces. Triturated dilutions of ethanol were applied in two doses. It was generally observed that the addition of first dose was followed by a small increase of 1.1 gms. in the resting tension which occurred at a slower rate in about 36.5 sec. The second doses however, increased the resting tension by 24 gms, in about 21 sec. In addition, the active tensions showed large variations on the application of first doses of triturated ethanol, while the second doses always decreased this parameter below the first dose levels. The rate of contractions was however, unaltered by both the first and second doses of ethanol, although an increase in the contraction times was found to be balanced by a simultaneous decrease either in the peak duration or relaxation times. The results are discussed in terms of electrophysiological, active state and free ionic Ca++ release phenomena.

A comparative study of the effects of ethanol, acetylcholine and adrenaline on various parameters of intestinal contractions of rabbit

A comparative study was carried out to observe the effects of ethanol, acetylcholine and adrenaline on various parameters of the contraction cycle of rabbit intestine. Acetylcholine and adrenaline were used in concentrations of 10(-3), either alone or in combination with absolute ethanol. The results showed that ethanol and acetylcholine had no effect on the rate of intestinal contractions while adrenaline increased it significantly. However, all these drugs decreased the active tension of the contracting intestine, the decrease being minimum for ethanol, moderate for acetylcholine and maximum for adrenaline. On the contrary, a small transient decrease in resting tension was produced by ethanol and this occurred at a very fast rate while adrenaline produced a marked decrease in this parameter, its rate being 6-10 times slower. Ethanol and acetylcholine were also found to increase the resting tension, it being 2 times greater and occurring at a faster rate with acetylcholine. It is suggested that these drugs produce their effect by altering resting membrane potential, Ca++ and other ion fluxes.

Effect of Mukteswar and Komarov strains of newcastle disease vaccines on egg production

Effect of live mesogenic strains of Mukteswar and Komarov ND vaccines was studied on the egg production of laying birds. The results showed that pullets vaccinated with Mukteswar ND vaccine produced more eggs than the Komarov vaccinated or non vaccinated birds. The peak egg production was noted at the age of 29 weeks in these birds and this latter decreased. When birds were re-vaccinated with the same vaccine and route, at the age of 32 weeks, the egg production again increased to 81%. Intra muscular vaccination with Komarov ND vaccine demonstrated 11% less egg production than the birds vaccinated with Mukteswar ND vaccine. In all the experiments, birds were found to be severely affected by the hot weather resulting in a drop of egg production.

Effect of hypothermia on the twitch and tetanic contractions of denervated rat diaphragm muscle under isotonic conditions

Effect of hypothermia was studied on the twitch and tetanic contractions of the chronically denervated rat diaphragm muscles under isotonic conditions. The muscles were denervated for 15-20 days and the temperature was lowered from 35 degrees C to 15 degrees C. The results showed that hypothermia and chronic denervation had very little effect on the isotonic contraction parameters since these were found to be unaltered at all temperatures except at 15 degrees C. It is suggested that denervation has no significant effect on the contractile component of our experimental muscles.