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Thrombotic thrombocytopenic purpura (TTP) is a rare life-threatening hematologic disorder. It is mainly characterized by thrombocytopenia, microangiopathic hemolytic anemia (MAHA), fever, renal impairment and neurological abnormality. Plasmapheresis and steroids are the standard of care. MAHA/TTP can be the initial presentation of solid organ malignancies especially gastrointestinal tumors. We report a 56-year-old female patient who presented with progressive back pain, tiredness, easy bruising, fever and weight loss. Laboratory results showed anemia, thrombocytopenia, and schistocytes in the peripheral smear. An initial diagnosis of thrombotic thrombocytopenic purpura (TTP) was made on the basis of clinical presentation and lab findings. She was treated with corticosteroids and plasma exchange but with no major response. CT abdomen and PET CT were suggestive of pancreatic carcinoma with extensive lymph nodal, organs and bone metastases. Supraclavicular lymph node biopsy was compatible with metastatic adenocarcinoma. As a result, the diagnosis of pancreatic cancer was established and the decision was for palliative treatment. This case highlights the need to consider malignancy in patients with MAHA/TTP especially if it does not respond to plasmapheresis. Hence, the treatment of MAHA/TTP could be directed to the underlying malignancy if available.

India being the largest smokeless tobacco (SLT) producer and consumer in the South East Asia Region (SEAR) entitled with a range of products. SLT consumption is very common because it is associated with socio-economic and cultural perspectives in the India. After the implementation of the first treaty of the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC), public health standards were reaffirmed and improvised through successful implementation of articles since 2007 as reported in the global progress factsheet. Many measures have been implemented for achieving the success of WHO-FCTC in India and to control the huge disease burden induced by tobacco use. The objective of the present study was to understand and explore the factors involved in the SLT demand reduction by revealing the dependence and cessation implementation in India in the context of strategies and policies. For this study, we searched for SLT dependence and SLT cessation literature survey in PubMed and obtained 102 literatures consisting of studies and reviews, which were further scrutinized by excluding the reviews, studies conducted abroad and studies conducted within the last 5 years (after 2015). No statistical significance was observed in comparison of National to International SLT dependence and an attempt to quit SLT following the tenure of a year. This is in-line with GATS-2 and international data. We have also discussed a diverse approach in the control of SLT at different levels-such as SLT users, healthcare professional, policy advocates supplier, labeling, legal policies, and educating at various platforms. Effective strategies for the cessation of SLT is mandatory with proper guidance for the manufacturer, users and sellers in controlling SLT products.

World records that two out of six individuals will bite the dust from coronary illness and six out of ten men over age 30 may have indications of coronary illness. The redeeming quality, be that as it may, is heart issues are sensible; furthermore, they can be forestalled, or even switched, with ideal, proficient clinical treatment. A huge number of hazard factors assumes a job in the improvement of coronary illness cigarette, smoking, physical idleness, stress, weight, high blood cholesterol, (hypertension) and diabetes. These components are controllable and not controllable. The most ideal way one can decrease the danger of coronary illness is by limiting, or dodging, the hazard factors-quitting any pretense of smoking, keeping away from liquor, confining salt use, constraining calorie consumption, practicing normally, diminishing enthusiastic pressure, getting observed and researched for hypertension, raised fat, cholesterol and different elements. The initial step, obviously, ought to be meant to bring down one’s hypertension the higher the circulatory strain, the more noteworthy is the danger of coronary episode, stroke and kidney illness. All the more significantly, if any of one’s nearby family members have had hypertension, at an early age, such people ought to be encouraged to have their circulatory strain checked all the time. However it can be miraculously treated by homeopathy

The resettlement projects in Ethiopia have been carried out mainly as a response to extreme problems of drought, food insecurity, population growth and land degradation during the imperial and Derg regime in the 1960’s and 1980’s. The disastrous famine of 1984-85 brought equally disastrous response of Derg government which relocated peasants from famine affected north to the sparsely populated and unoccupied southwest of the country. One of the targeted areas to perform was the Metekel area called Pawie or Beles resettlement site along North Western Ethiopia, originally inhabited by the Gumuz shifting cultivators. The inadequately planned of the Pawie or Beles resettlement site from the 1984-85 was affected the relocated people and the indigenous Gumuz communities. This program resulted Gumuz communities clashed with state sponsored settlers. After a long time tension, the settlers and the host communities formed a bond of relationship known as Wadaj.

The study clarifies the relations of Nile Basin countries after independence. Nile Basin countries are Burundi, Kenya, Rwanda, Tanzania, Uganda, Ethiopia, Eritrea, Egypt, North and newly independent South Sudan. Members of the region are independent in history; politics, economy and geography but tie by the Nile River. Economy determined by the agriculture supported by Pastoralism and agro-Pastoralism among the member countries. Their political development of the region was biased by the colonization and the cold war. From the time when the end of colonization and the cold war, the Nile basin countries can be attained relations in history, politics, economy and geography through the use of Nile Basin Initiative which played a role to the possibilities for cooperation and smooth relations among Nile basin countries.

Gestational Diabetes Mellitus (GDM) is a common complication in which hyperglycemia goes by physiological state, beneficial to the embryo, to metabolic condition that causes damage to both mother and child. Placental hormones, insulin resistance, visceral fat tissue, dyslipidemia, and other biochemical agentes, subscribe the physiopathological mechanisms that lead to GDM. Nowadays, there are mRNAs, proteins, and even vitamins being associated with GDM risk and its pathophysiology. These new pathways usher a new horizon to discover and describe other important parts of metabolism that play a key role to GDM. With a larger picture of pregnant women metabolism prior and after GDM, better predictors and efficient treatment can be managed.

Gestational diabetes mellitus (GDM) is characterized by the WHO as a condition of hyperglycemia detected for the first time during pregnancy, with blood glucose levels that do not meet the diagnostic criteria for DM. There are some hormones produced by the placenta and increased by pregnancy, such as placental lactogen, cortisol, and prolactin. In which, they can reduce the performance of insulin at its receptors and, consequently, increase insulin production in healthy pregnant women. Prenatal care is essential to prevent complications for women and children. Thus, an individualized diet should be indicated, exercise during pregnancy, and delivery should be monitored. If the recommendations do not normalize the condition of GDM, spontaneous abortions, the formation of excess amniotic fluid, congenital malformations, restricted fetal growth, and even the death of the mother and fetus may occur.

Although there is medical care focused on obstetric and neonatal care, Gestational Diabetes Mellitus (MDG) is still considered one of the main gestational complications, due to numerous metabolic, hematological and anatomical risks for pregnant women, fetuses and newborns. In this chapter, the symptoms and clinical manifestations of pregnant women diagnosed with MDG and their offspring during and after pregnancy will be addressed, presenting the probable sequelae, in addition to the pathogenesis of the main clinical complications.

Treatment for Gestational Diabetes Mellitus comprises a series of Clinical-therapeutic protocols, which are necessary for proper attention to the patient with this pathology. In this sense, this chapter will address treatment care and postpartum care for Gestational Diabetes Mellitus, taking into account pharmacotherapeutic protocols and adverse effects of non-recommended treatments.

Anxiety and Depression Throughout history, humans have created various “instruments” for the survival of their species, including a need for socialization. These social relationships do not always occur successfully and when they do, there are behavioral changes, such as anxiety disorder, depression and even risk of suicide (SAVALLI; ADES, 2016; SOUSA; OLIVEIRA; CALOUI, 2018). Social Anxiety Disorder (SAD) presents as main resources exacerbated fear or anxiety in social situations. Also called Social Phobia, SAD usually manifests itself before or during moments of interaction, as well as in situations where the individual feels observed or exposed to the approval of others (APA, 2013). This disorder is a consequence of one or several factors, whether psychological, biological or arising from lived situations (GOMES, 2014). Those who suffer from SAD tend to exhibit more reclusive habits, reducing their social circle to only their family members and to avoid situations in which they need to speak or even eat in the public. Physically, anxiety disorder usually manifests as hand tremors, flushing, nausea, frequent urination and/or panic attacks, signs that negatively influence the behavior of the affected individual and may cause a more intense degree of social isolation. Social Phobia physiologically impairs the functionality of the hypothalamus, pituitary gland, and adrenal glands, producing changes in production and releasing of several important hormones, such as adrenaline and cortisol. This physiological change implies the maintenance of alertness, increases heart rate, alter body blood flow, and digestive processes and pupil dilation, these signals being the preparation of the body for situations of fight or escape. From the biological point of view, these characteristics are important for the survival of individuals. However, in the anxiety scenario, these effects are constantly manifesting, leading to the predominance arc of deleterious effects on the individual’s life. Early aging and cognitive signs, such…