Introduction and importance: Yellow nail syndrome (YNS) is a rare disorder diagnosed by a triad of yellowish-green discoloration of the nails, respiratory manifestations, and lymphedema. Kartagener’s syndrome (KS) is an autosomal recessive syndrome characterized by chronic sinusitis, bronchiectasis, infertility, and situs inversus. In this case we report the rare coexistence of these solitary occurring disorders. Case presentation: This report details an interesting case wherein the clinical manifestation of YNS in a 54-year-old male patient not only led to its diagnosis but also revealed the coexistence of another distinctive underlying genetic disorder – KS. Clinical discussion: KS is an autosomal recessive syndrome characterized by chronic sinusitis, bronchiectasis, infertility, and situs inversus. While KS and YNS are two discernibly unique syndromes, the simultaneous clinical manifestation of their pathologies within a single patient, as presented in our patient, is notably infrequent and rare. Conclusion: While there is significant documented evidence of YNS co-occurring with only bronchiectasis, we present this case due to the rarity of the amalgamation of YNS with the complete spectrum of pathologies associated with KS. This may help in early diagnosis of either disorder via investigation on the basis of their coexistence as presented in this case and may result in better health outcomes in clinical practice.

Background: Hypoplastic left heart syndrome (HLHS) is a severe congenital heart defect requiring complex surgical interventions, including the Norwood, Glenn, and Fontan procedures. This narrative review aims to explore the long-term neurodevelopmental outcomes of children with HLHS following surgical palliation with potential risk factors. Objectives: This review synthesizes current evidence on long-term ND outcomes in children with HLHS after surgical palliation and identifies key risk factors, assessment tools, and emerging neuroprotective strategies. Methods: A comprehensive literature review was conducted, focusing on the interplay of altered fetal circulation, impaired cerebral oxygenation, and extensive medical interventions on neurodevelopment. We conducted literature search of full-text, peer-reviewed English articles published between 2000 and 2024 using PubMed, Scopus, and Google Scholar with the terms “hypoplastic left heart syndrome,” “surgical palliation,” “neurodevelopmental outcomes,” and “children.” Results: Evidence indicates that children with HLHS face significant risks for cognitive, motor, behavioral, and adaptive impairments. Assessment tools such as the Bayley Scales of Infant and Toddler Development, MRI, and EEG are essential for early detection and ongoing monitoring. Discussion: A multidisciplinary approach involving pediatric cardiology, neurology, and developmental therapy is crucial for managing HLHS and addressing neurodevelopmental issues. Early intervention can improve outcomes, guided by diagnostic tools like MRI, EEG, and the Bayley Scales. There is a need for more research on neuroprotective strategies and perioperative management to reduce brain injury and enhance long-term developmental outcomes in children with HLHS. Conclusion: Children with HLHS face significant ND challenges due to a complex interplay of physiological and medical factors. A multidisciplinary approach with early intervention is critical. Emerging strategies, such as maternal hyperoxygenation, merit further investigation regarding their feasibility, cost, and ethical considerations.

Ozempic (semaglutide) was first authorized to treat type 2 diabetes, but because of its appetite-suppressing properties, it has become popular off-label for weight loss. According to clinical investigations, GLP-1 significantly decreases blood sugar and helps people lose weight. Approximately 15 million persons in the United States are currently taking GLP-1 drugs. Off-label use is becoming more common, which raises worries about potential health hazards and significant side effects such as non-arteritic anterior ischemic optic neuropathy (NAION). According to a study, 6.7% of people who were overweight and 8.9% of those with diabetes who took semaglutide had NAION. The FDA issued a warning regarding counterfeit and compounded products while approving semaglutide for weight loss under the Wegovy ^® brand. Unsupervised usage and problems with diabetes accessibility raise ethical questions.

Background: Worldwide, the awareness about childhood obesity as a public health concern is increasing, particularly in developing countries like Pakistan. Obesity during early childhood may persist into later ages, increasing the risk of chronic illnesses such as diabetes and hypertension. Objective: The aim of this study was to examine the relationship of different types of food groups with obesity among children with normal and stunted growth trajectories in Pakistan. Methods: This cross-sectional study conducted a secondary analysis of Pakistan Demographic and Health Surveys (PDHSs) conducted in the years 2012–2013 and 2017–2018. Data of 1230 healthy and obese children with either normal or stunted growth were analysed after excluding those who were aged below six months, wasted, underweight, or had missing anthropometric or dietary data. The relationship of different food groups with obesity among the children with normal and stunted growth was analysed by bivariate logistic regression. Results: The prevalence of paediatric obesity dropped from 7.3% in 2012–2013 to 2.4% in 2017–2018. However, the coexistence of stunting with obesity—termed the nutritional paradox—slightly increased from 2.8% in 2012–2013 to 3% in 2017–2018. Among the different food groups, the continuation of breastmilk was associated with lowering the odds of obesity by 69% (25% to 88%) among children with normal growth. Conversely, among children with stunted growth, the continuation of breastmilk was associated with an increase in the odds of obesity by 3.71 (1.08 to 12.62) times. Conclusion: Despite the 4.9% reduction in paediatric obesity, cases of the nutritional paradox are still escalating in Pakistan. This reflects an urgent need for targeted nutritional interventions to mitigate the impact of obesogenic diets and reduce the prevalence of childhood obesity in Pakistan.

Background and objective: The global rise in the incidence of diabetes mellitus necessitates innovative management strategies to mitigate the severity of the disease. The mainstay of diabetes treatment is still insulin therapy, although there are drawbacks, such as the need to maintain ideal glycemic control while lowering the risk of hypoglycemia and user fatigue. The development, clinical usefulness, and constraints of insulin delivery systems are examined in this narrative review, with particular attention to sensor-augmented and closed-loop technologies. Methods: A thorough electronic database search was conducted to obtain pertinent data on major insulin delivery devices, including sensor-augmented and closed-loop systems. We studied advancements in insulin delivery systems over time and their impact on the management of diabetes mellitus. We thoroughly examined both qualitative and quantitative data to summarize our conclusions. Key content and findings: Closed-loop insulin delivery systems, which combine insulin pumps, advanced control algorithms, and continuous glucose monitoring, are the next step forward in the treatment of diabetes. These systems autonomously regulate blood glucose levels, reducing the need for user intervention. Closed-loop devices outperform sensor-augmented pump (SAP) treatment in reducing hypoglycemia, extending the time-in-range, and lowering self-management responsibilities. In order to provide real-time control, closed-loop systems dynamically modify insulin delivery in response to glucose variations by using algorithms powered by artificial intelligence. Because SAP therapy depends more on user input and may not be as successful in providing consistent glycemic control, this capability helps overcome its drawbacks. Further improving overall safety and efficacy, the closed-loop technique decreases blood glucose variability. Conclusion: The two primary developments in diabetes care are sensor-augmented and closed-loop insulin devices, which offer better glucose control and lower hypoglycemia rates compared to traditional therapies. Closed-loop insulin delivery systems seem to be a more clinically successful option for controlling diabetes mellitus than SAP therapy.