An abstract is unavailable. This article is available as a PDF only.

Background: Cholecystectomy is one of the most common procedures performed across the world. With efforts to maximize good postoperative status, one such technique involves preoperative carbohydrate loading. Methods: A thorough literature search was performed across three databases to identify articles published up to August 2024. The screening was conducted to select all primary studies evaluating the role of preoperative carbohydrate loading in patients undergoing laparoscopic cholecystectomy. Statistical analysis was conducted via RevMan using a random-effects model. Results: Thirteen records were included for quantitative synthesis, encompassing 827 participants (415 in the carbohydrate arm and 412 in the fasting arm). Carbohydrate loading was associated with significantly higher insulin levels compared to the control group (standard mean deviation [SMD]: −0.60; 95% confidence interval [CI]: −0.87, −0.34; P < 0.00001). However, other parameters like blood glucose (SMD: −0.19; 95%CI: −0.52, 0.14; P = 0.26) and homeostatic model assessment for insulin resistance (HOMA-IR) levels (SMD: −0.26; 95%CI: −0.82, 0.31; P = 0.37) had non-significant differences between both groups. On the contrary, post-operative pain levels were found to be lower among the carbohydrate group (SMD: −0.76; 95% CI: −1.35, −0.16; P = 0.01). Other outcomes like quality of recovery, use of antiemetics, or blood loss during operation had no significant differences between both groups. Conclusion: Our analysis suggests that preoperative carbohydrate loading is linked with reduced postoperative pain, incidence of nausea, and superior insulin parameters. Further research is needed to strengthen these findings.

Introduction: Scabies are a highly transmittable disease of the skin. It is caused by a specific mite named Sarcoptes scabiei. Individuals who are infected with scabies have a miserable life, and their quality of life is poor. It impacts the quality of life by causing physical discomfort due to itching. Not only does it lead to the mental distress of a diseased individual, but it also leads to social isolation due to the stigma associated with this condition. This systematic review highlights the profound effect of scabies on the lives of affected individuals and the recent breakthroughs in the management of scabies. Purpose: The purpose of this article is to shed light on the impact of scabies on the quality of life. We also discussed the advancements in the management of this disease, which impacts life physically and socially. Method: We included randomized controlled trials, clinical trials, and observational studies. Studies with full-text access were included. Case reports, letters, and systematic/narrative reviews were excluded from the search. 180 records were screened up to March 2024, of which 129 articles were from PubMed and 51 from Google Scholar. 22 articles were thoroughly screened by two different reviewers independently and included in the review. Studies were carried out with no restrictions on age or sex, including the pediatric and adult populations. Conclusion: Findings indicate a significant correlation between scabies and poor quality of life. Scabies most commonly affect children of lower socioeconomic status and in resource-limited settings. Scabies can lead to severe complications such as rheumatic heart disease, kidney diseases, and a variety of secondary bacterial infections; therefore, advances in treatment strategies are needed. Currently, permethrin and ivermectin have been used for treatment. Moxidectin, a new drug, is undergoing clinical trials to replace permethrin in regions with high resistance. The interventions need to be patient-centered, and new drugs need to be developed that have anti-parasitic actions and also lead to the prevention of secondary bacterial infections.

Background: Erdheim–Chester disease (ECD) is characterized by the excessive production and accumulation of histiocytes, particularly foamy histiocytes encircled by fibrosis, in various organs. ECD can affect a person’s long bones, skin, lungs, brain, heart, and other tissues and organs. Methods: In February 2024, we conducted a thorough literature search on main databases to find studies published between 2021 and 2024. We used keywords like “ECD CNS,” “ECD Neuro,” “Erdheim Chester Disease CNS,” “histiocytosis,” and “Erdheim Chester Disease Neurology.” We first produced 461 articles and then limited the selection process to 29 articles using an English language filter and an abstract analysis. In the end 16 articles were added in the review on ECD with neurological symptoms. Results: Ataxia, cranial neuropathies, and cognitive impairment were the main clinical findings. Histopathology showed that 88% of the cases had histiocyte infiltrates with CD68 + histiocytes, 50% had a BRAF mutation, and 83.3% had an expanding mass. The most common treatment was vemurafenib, followed by steroids, surgery, and chemotherapy. Results revealed 15.78% mortality, 26.31% progression, and 31.57% improvement or stabilization. In most cases, steroid medication proved useless; however, vemurafenib and radiation therapy helped some patients’ symptoms. Conclusion: An early diagnosis of the disease is important for timely intervention, to prevent fatal outcomes. Vemurafenib was the only drug which proved its efficacy against the disease, as compared to other drugs. This study presents valuable insights for the neurology of ECD and highlights the benefits of a comprehensive management for this complex condition.