Obsessive-compulsive disorder refers to an anxiety behavior portrayed by invasive thoughts. These thoughts lead to recurring behavior that can be distinguished by uneasiness, nervousness, panic, or worry. The most common type of OCD is repetitive hand washing. People with the obsessive- compulsive disorder may try to control or stop the obsessions. This does not work out for the best as it amplifies stress and anxiety.
Obsessive-compulsive behavior has been existent for centuries. In the 17th century, compulsions and obsessions were viewed as symptoms of melancholy. In 1691, Bishop John Moore of England held a sermon regarding religious melancholy. According to him, those obsessed have mischievous and at times sacrilegious thoughts that begin in their mentality. He continues by saying that, despite their devotion to God, the more they try to repress these thoughts, the more they increase. (obsessive-compulsive and related disorders, 2012)
Before the growth of psychological treatments, the endorsed treatment was to curb the condition by doing the compulsive behavior harder and often. Traditional talk better known as therapy was good for the understanding of the patients mind. Individuals who drew too much attention, which was very common, were persecuted, imprisoned, or subjected to cruel, wrong experiments (Zelman, 2009).
Some myths associated with OCD include; OCD behavior is caused by low self-esteem and bad childhood and that it is a rare disease. People should realize that these are just myths. The causes of the disorder are not completely clear and may be linked with the functions of neurotransmitters. OCD is a common disorder that is affecting about 2.2 million American adults every year.
There are common signs and symptoms of obsessive-compulsive behavior. The individual may inhabit behaviors such as extreme double-checking of stuff; frequent checking on dear ones; doing ridiculous things to lessen anxiety such as counting; constant cleaning and washing; obsession with religious or sexual thoughts; arranging stuff or accumulating petty things. Such symptoms can be time-consuming and tend to push people away.
Neurotransmitters are chemical couriers communicating diverse tasks to the body. Research implies that a disproportion of neurotransmitters could add to anxiety disorders. The neurotransmitters associated with Obsessive-compulsive disorder are gamma-aminobutyric acid (GABA), epinephrine, serotonin, and dopamine. Deficiencies in serotonin are extremely linked to depression and anxiety. Research undertaken at the University of Utah revealed that OCD is connected to the increase or decrease of certain neurotransmitters. When a decrease in the level of serotonin occurs and an increase in the level of dopamine occurs the frail interaction flanked by these neurotransmitters amplifies the anxiety of a person with OCD (Obsessive-compulsive and related disorders, 2012).
For example, when one feels the need to clean or wash a place after it gets dirty, neurotransmitters transmit the message and the body responds by looking for washing equipment. The brain of a person who has OCD conveys the message differently due to an influx of particular neurotransmitters.
Although OCD is categorized as a disease with biological roots, its diagnosis does not include medical tests. OCD diagnosis may be hard as it is difficult to distinguish it from other psychiatric disorders. The following steps make the diagnosis of the illness easy. A clinical examination of the patients emotional past is closely done. The diagnosis could also involve the observation of current symptoms. Differential diagnosis is also used in the diagnostic process of the disease.
Differential diagnosis of OCD is inclusive of hypochondriasis, depressive disorders, and generalized anxiety disorders. Examination of the patients family history is also used in diagnosing obsessive-compulsive behavior. In the diagnosis of OCD, professionals such as psychologists, psychiatrists, and family doctors are involved. They use their experience to make the diagnosis.
Obsessive-compulsive disorder can be treated using various methods. OCD treatment involves the use of antidepressant medication, behavior therapy, and in rare cases surgical severing of the cingulum. The fact that behavioral therapy involves desensitization and relearning has both advantages and disadvantages.
A patient who is going through behavioral therapy is in an environment that is prone to his/her obsessions may not respond to treatment. On the other hand, a patient who is in an environment where those around him/her are supportive is more likely to respond positively to treatment. Antidepressant medication has serious side effects. These side effects include sexual dysfunctions and weight gain. An environment where people have issues with overweight people may detract a patient from successive treatment.
Past treatment involved therapy but in the new treatment different medications are used. Past therapy involved traditional talk, as opposed to the new therapy where psychiatrists and psychologists talk about the patients history and the present. This, unlike in the past, makes the patient feel free to share experiences. OCD patients are not imprisoned as it was done in the past. Patients are now treated with care since the illness has now become accepted in society. Antidepressants are now used in the treatment of OCD. Antidepressants medications were not present in the past. They are now used to treat OCD (Obsessive Compulsive Disorder, 2012)
In conclusion, obsessive-compulsive behavior is a condition that can be dealt with if the involved parties work together to eliminate it. People with this condition may not realize it in the early stages. However, People suffering from OCD tend to have the urge to try eliminating the disease without the help of a professional. While this may have worked for a few individuals, research has shown that many are those that fall right back into their past obsessions. Therefore, OCD, like any other illness should be reported to a professional with experience for proper treatment.
References
Obsessive compulsive and related disorders. (2012). Web.
The patient is presented to the hospital with hip pain that, according to him, was caused by a workplace injury. The pain has persisted for seven years now, and after multiple diagnostic tests and examinations, it was discovered that his right hip joint was 75% torn. When referred to a surgeon, the patient was met with rejection because he was too young to undergo complete hip replacement. Since then, the man has been suffering from a cluster of symptoms including extreme cooling and cramping, which made neurologists believe that he has complex regional pain syndrome (CRPS). According to the patient, his condition is hurting his mental health and has also ruined his relationship with his fiancee. Despite the psychological strain, the patient is alert, behaves appropriately, can communicate, and denies any hallucinations, paranoia, depression, or suicidal ideation.
The first decision that the nurse has made to relieve CRPS symptoms is to prescribe amitriptyline 25 mg po QHS and titrate upward weekly by 25 mg. Oral administration of amitriptyline reaches a bioavailability of 30-60% and is widely distributed through the human body, binding to tissue and plasma proteins (Kondratenko et al., 2019). The plasma half-life of the medication lies between 10 and 28 hours and 16 and 80 hours for its metabolite, nortriptyline (Kondratenko et al., 2019). When used for neuropathic pain, amitriptyline acts as a local anesthetic due to its ability to block voltage-gated sodium channels.
After the administration of amitriptyline, the patient reported that his pain level dropped from nine out of ten to six out of ten. Among other positive results is a reduction in toe cramping that used to cause a lot of discomfort for the patient. These outcomes are consistent with existing research: for instance, Brown et al. (2016) show that when used for six weeks, amitriptyline led to an improvement in pain symptoms. As reported by van den Driest et al. (2017) sleepiness is a common side effect of amitriptyline, which is something that the patient is experiencing. In summation, the first decision led to satisfactory results, though the pain levels are manageable but not exactly low.
Because the pain levels are far from ideal and the patient complaints about morning grogginess, the nurse decides to work toward 200mg of amitriptyline daily. The patient is advised to take the medication one hour early every night to avoid the side effects. As a result, he reports reduced pain levels, improved mobility, and even a return to dating life. Moore et al. (2015) reveal that adverse events associated with the use of amitriptyline wane after two or three weeks while the benefits become more prominent.
However, alongside positive changes, the patient is frustrated with weight gain. For this reason, the third decision includes not only Elavil but also a referral to a nutrition coach who could help him with dietary habits. Existing research suggests that diet plays a crucial role in preserving and improving mental health. Disordered eating may lead to an onset of mental disorders or the deterioration of those with which a person is already diagnosed. For instance, Firth et al. (2019) confirm that dietary interventions are beneficial for treating both depression and anxiety. Therefore, eating healthy will help the patient to make sure that he keeps his psychological state in check and acts proactively toward his goals.
References
Brown, S., Johnston, B., Amaria, K., Watkins, J., Campbell, F., Pehora, C., & McGrath, P. (2016). A randomized controlled trial of amitriptyline versus gabapentin for complex regional pain syndrome type I and neuropathic pain in children. Scandinavian Journal of Pain, 13, 156-163.
Kondratenko, S. N., Savelyeva, M. I., Kukes, V. G., Shikh, E. V., & Gneushev, E. T. (2019). Experimental and Clinical Pharmacokinetics of Fluoxetine and Amitriptyline: Comparative Analysis and Possible Methods of Extrapolation. Bulletin of experimental biology and medicine, 167(3), 356-362.
Moore, R. A., Derry, S., Aldington, D., Cole, P., & Wiffen, P. J. (2015). Amitriptyline for neuropathic pain in adults. The Cochrane database of systematic reviews, 2015(7), CD008242. Web.
van den Driest, J. J., Bierma-Zeinstra, S. M., Bindels, P. J., & Schiphof, D. (2017). Amitriptyline for musculoskeletal complaints: a systematic review. Family Practice, 34(2), 138-146.
Biological Theories Applied to the Etiology of Bipolar And Related Disorders
Precise biological causes of bipolar and related disorders are still not known, but there are several biological theories applied to their etiology. The neural circuitry theory suggests that bipolar disorder (BD) is caused by structural and functional abnormalities in brain areas, such as grey matter reduction or overactivation of the thalamus and amygdala (Sigitova et al., 2017). Another theory suggests that BD is caused by genetic polymorphism of some candidate genes, such as 5-HTT, DAT, BDNF, TPH, and others, which makes some individuals be more susceptible to BD than others (Sigitova et al., 2017). According to the monoamine hypothesis, BD is associated with a lack of monoamine neurotransmitters, such as serotonin, dopamine, and norepinephrine (Sigitova et al., 2017). The inflammatory theory posits that in patients with BD, the immune system is constantly activated, which leads to producing inflammatory cytokines, changing the brain function, and causing mood disorders (Sigitova et al., 2017). These are some of the theories that try to explain the etiology of BD and related disorders.
Summary of the Assigned Medications
Lithium carbonate and carbamazepine are two medications used for treating patients with bipolar and related disorders. Lithium is used for treating BD during the maintenance phase; in the acute phase, lithium is more effective when combined with an antipsychotic or sodium valproate (Sani et al., 2017). Carbamazepine is prescribed for treating epilepsy but is also used as a second-line treatment for BD (Ayano, 2016). Both medications are used for the long-term treatment of BD.
The Mechanism of Action
The mechanism of action of lithium carbonate is based on its influence on transmitter receptors. Lithium affects adrenoceptors and serotonin, the phosphoinositide cycle, and the calcium-calmodulin systems, which has an impact on neurotransmission (Sani et al., 2017). As a result, it decreases apoptosis, i.e., the death of cells, thus increasing the cell viability (Sani et al., 2017). Carbamazepine also influences neurotransmission, namely, GABA neurotransmission, glutamate neurotransmission, and dopaminergic transmission (Ayano, 2016). As a consequence, it has antimanic and mood-stabilizing effects on patients with BD.
Possible Side Effects and Their Presence in Behavioral Symptoms
Both medications have such common side effects as nausea, diarrhea, and weight gain. The intake of lithium may lead patients to have subjective feelings of tremor, weight gain, or cognitive impairment (Sani et al., 2017). As a result, they can stop adhering to this medication. As for carbamazepine, patients have a good response to it, especially in the cases with various manias, history of alcoholism, and substance issues (Ayano, 2016). The presence of side effects of carbamazepine in behavioral symptoms is not reported in the literature.
Possible Interactions and Contraindications
Both medications should be administrated with caution to patients taking other drugs because interactions with some drugs may increase their toxicity. Lithium should not be used in patients with renal and cardiovascular diseases, while carbamazepine is contraindicated to patients with previous bone marrow problems.
The human body highly depends on food for survival because various nutrients play different roles in maintaining ones wellbeing. Metabolism is the process by which the food ingested is processed into energy. An element everyone needs to engage in various activities. Meals mainly comprise fats, carbohydrates, and proteins, which are broken down in the digestive system with the aid of enzymes into acids and sugars that act as fuel to the body. Additionally, the body can make use of the produced energy immediately or store it in the body tissues. However, individuals with metabolic disorders can neither convert food into energy correctly nor store it for later use.
Carbohydrate is the main source of body energy and are therefore responsible for the majority of metabolism disorders. Ordinarily, the body enzymes are supposed to break down carbohydrates into sugars. However, people with metabolism-related illnesses often lack the amount of enzymes required to successfully disintegrate carbohydrates, which can lead to other health complications, including death. Most carbohydrate metabolism disorders are hereditary, and it is always appropriate that are screened through blood tests.
Parents with a history of the conditions are also encouraged to conduct genetic tests to ascertain whether they have the genes. When identified in good time, patients can receive treatments in the form of supplements, special diets, and prescribed medicines. It is also important to note that there is no cure for some of these disorders, but therapies are crucial in managing the symptoms. Understanding the various carbohydrate metabolism disorders and their features is necessary for medical researchers and also educating the public about the same.
Research Objectives
One of the most neglected areas in the subject of carbohydrate metabolism is the study of related diseases. Consequently, the research aims at investigating all pathways involved in carbohydrate metabolism and chances of illnesses from involved reactions. Secondly the paper will evaluate all the possible disorders associated with carbohydrate metabolism throughout the digestion process. Additionally, the paper attempts to identify the damages these illnesses cause to the general body function. However, the research will be restricted to disorders that relate to digestion, absorption, synthesis, and breakdown of carbohydrates. The main research question is, what are the metabolic disorders associated with carbohydrate metabolism?
Methodology
Since this is a scientific research, the selected methodologies are systematic review and meta-analysis. The former technique will help in the identification, selection, evaluation, and synthesis of all relevant studies that answer the research question. Consequently, the paper will use the search phrase carbohydrate metabolism disorders , and the identified materials will be limited to articles published within the past five years. Meta-analysis will be instrumental in the statistical evaluation of the pooled data. The collected data information regarding carbohydrate information will be summarized and scrutinized in the results and analysis section.
Results and Discussion
The study used a total of seven scholarly and peer-reviewed articles that all researched carbohydrate metabolism and related disorders. The collected data, as is narrated in this section, entails information relating to the process of carbohydrate metabolism, digestion, and synthesis disorders. Before obtaining materials on the disorders, it is important to gather data on the steps involved in carbohydrate metabolism (Malicka, 2016). The components of carbohydrates include starch, fructose, galactose, and glucose. Once these elements are synthesized, they are passed into the bloodstream through the metabolism process, which comprises anabolism and catabolism, as represented below.
The process through which glucose is oxidized to pyruvate is termed glycolysis, and this occurs in all tissues. During digestion, polysaccharides are broken down into monosaccharides including glucose which are then transferred across the small intestines walls into the bodys circulatory system. Blood then transports these sugars to the liver, which can then be released immediately as a source of energy or stored as glycogen (Vijaya, 2016). Body cells obtain the glucose in the circulatory system through glycolysis, and some of the energy is transferred to adenosine diphosphate (ADP) to form adenosine triphosphate (ATP). Glycolysis is the most important process in carbohydrate metabolism and can be summarized in a chemical equation.
Glucose + 2ADP + 2Pi 2L (+) Lactate +2ATP + 2H2O
Consequently, carbohydrate metabolism disorders can occur when the reactions in a glycolytic pathway are interrupted. Glycolysis involves a 10 step reaction with every phase of the process crucial in metabolism. In summary, nicotinamide adenine dinucleotide (NAD+) is converted into nicotinamide adenine dinucleotide hydrogen NADH. Additionally, the glyceraldehyde 3-phosphate undergoes oxidation to form 1, 3-biphosphoglycerate within the same duration. Nonetheless, NADH is oxidized again to ensure the coenzyme NAD+ is not used, and this is all done during the conversion of pyruvic acid into lactic acid and in the presence of anaerobic conditions (Vijaya, 2016). Any slight interference with the ten stages involved in glycolysis can induce different metabolic disorders. The pathway is represented diagrammatically in the figure below.
Anaerobic Phase
Oxygen is important in carbohydrate metabolism because its absence hinders the conservation of NAD+ since the NADH cannot be oxidized in the glyceraldehyde 3-phosphate phase. However, since the cells still have little coenzymes, the re-oxidation of NADH can be achieved by allowing pyruvate to lactate without manufacturing ATP (Lutsenko, 2018). It is important to note that it is the presence of glyceraldehyde 3-phosphate as a catalyst that hinders the production of ATP. Without oxygen, it is impossible to produce energy in the entire metabolism process. The anaerobic phase is represented in the figure below.
Tricarboxylic Acid (TCA) Cycle
The other process, as realized in the analyzed literature, which can be a source of carbohydrate-related disorders is the tricarboxylic acid (TCA) cycle. This stage is referred to as the aerobic phase, which imitates the anaerobic pathway in the pyruvate stage and is also known as the citric acid cycle. In this phase, pyruvate is converted into Acetyl coenzyme A through oxidation and decarboxylation before proceeding into the citric acid cycle. The process occurs in the mitochondrion organelle and results in a connection between the TCA cycle and glycolysis (Mendrick et al., 2017). All the processes of carbohydrate metabolism are interconnected, and it is important to note that disorders can occur at any phase and in any body part or cell, including mitochondria. Additionally, the pyruvate dehydrogenase complex is the enzyme responsible for the reaction in the TCA cycle. The chemical reaction can be represented in the form of a summary equation and a schematic diagram.
Citric Acid Cycle
There are eight steps involved in the citric acid cycle, as demonstrated in the diagram, and they are all aimed at producing energy to the body through metabolism. When a single molecule of the TCA cycles substrate is oxidized in the presence of NADH, three ATP molecules will be produced. An addition of two other ATP molecules will be formed through flavin adenine dinucleotide (FADH2) (Pankiv, 2017). Consequently, when two molecules of pyruvate are generated from a single glucose molecule through glycolysis, the same process also results in the production of two other molecules in the TCA cycle.
Hexose Monophosphate (HMP) Shunt Pathway
The main metabolic pathways, as deduced in the findings, are the citric acid cycle and glycolysis since they provide the right enzymes and environment for glucose oxidation in animal tissues to produce ATP energy and CO2 and H2O. However, the research results also indicate alternative pathways which are equally effective in carbohydrate metabolism. One that has been proven to be essential is the Hexose monophosphate (HMP) shunt pathway that takes place in the additional mitochondrial soluble components of the cells. In this pathway, nicotinamide adenine dinucleotide phosphate (NADPH) in preparation for steroids and fatty acids synthesis (Rochlani et al., 2017). The process is also instrumental in the fusion of ribose to produce nucleic acid and nucleotide. Since glucose is among the primary hexoses obtained from the digestive system, the HMP shunt pathway facilitates the conversion of fructose and galactose into glucose, and this occurs in the liver. Any damages in the liver and mitochondria hinder the successful transformation of the two sugars into glucose, over ally interfering with the metabolism process. The hexose monophosphate (HMP) shunt pathway can be represented in a chemical equation below.
Gluconeogenesis
Gluconeogenesis is the other carbohydrate metabolism process that can be a source of disorders in case of any alterations in the involved reactions. It is defined as the production of glucose with the help of non-carbohydrate chemicals and processes. The reaction which normally occurs in the liver is often triggered by insufficient carbohydrate in the diet which fails to meet the bodys need of the nutrient (MedlinePlus, n.d.). Consequently, the protein tissues in the body are broken down during starvation into amino acids used to produce glucose. However, for gluconeogenesis to take place, reactions in glycolysis and the citric acid cycle must have taken place to give the molecules that will act as substrates. These precursors include lactate, glycerol, and amino acids, which are crucial in the synthesis of glucose in the liver.
However, the results of the study indicate that gluconeogenesis and glycolysis are contradicting metabolic pathways but use similar enzymes in their reactions. For instance, glucose is transformed into pyruvate during glycolysis, and on the other hand, pyruvate is converted back to glucose in gluconeogenesis. Nonetheless, it is important to note that neither of the pathways is a reverse of the other (Vijaya, 2016). Consequently, there are three irreversible stages in glycolysis represented in the form of chemical equations below that have to be bypassed or replaced for gluconeogenesis to occur. Gluconeogenesis has to occur on the three precursors for the body to have energy in the absence of carbohydrates.
A diagrammatical representation of Gluconeogenesis
Galactose and Fructose Disorders
Galactosemia: Galactose disorder is also known as galactosemia, which results from issues in the second phase of metabolism when breaking down galactose. When this type of sugar is taken into the body, mainly in the form of milk, an accumulation of galactose-1-phosphate takes place. Consequently, the signs and symptoms of galactosemia begin to manifest as soon as milk feeding is initiated. When realized, it is advised that the feeding is stopped immediately. Otherwise, the child will develop kidney-related complications, jaundice, weight loss, and lethargy (Malicka et al., 2016). Moreover, infants with the disorder are also prone to numerous bacterial infections. Delayed and lack of treatment leads to intellectual disability and the development of cataracts in the patients. Removal of galactose from the infants diet is one of the major therapy approaches which helps in reversing the symptoms.
Hereditary Fructose Intolerance (HFI): Fructose 1-phosphate is crucial in the general metabolism, and its absence, which is often due to problems in the liver, leads to hereditary fructose intolerance (HFI). The symptoms of this disorder are visible after taking in fructose and therefore can only be discovered at a later age compared to galactosemia. The common sources of fructose are fruits, infant meals that mainly contain sucrose, and table sugar. Some signs and symptoms of HFI include defects in the kidney, deficiencies in the liver, weight loss, hypoglycemia, and vomiting (Malicka et al., 2016). Furthermore, children with this condition prefer not to use extremely sugary foods such as candy with minimal caries in their teeth. The best intervention for hereditary fructose intolerance is avoiding meals with sucrose and fructose sugars.
Fructose 1, 6-Diphosphatase Disorder: The disorder is caused by the lack of the enzyme fructose 1, 6-diphosphatase disorder, crucial in gluconeogenesis, a process that converts glucose into other substrates crucial in metabolism. Symptoms of the condition include liver enlargement, inability to fast, and extreme hypoglycemia. The treatment of the disorder includes the use of intravenous fluids with the right glucose content, and patients are advised to avoid fasting in all its forms (MedlinePlus, n.d.). In severe fructose 1, 6-diphosphatase disorder cases, affected individuals are given bedtime doses and continuous drips throughout the night to help minimize the development of hypoglycemia.
Glycogen Storage Disorders (GSD)
Aside from galactose and fructose-related metabolism conditions, some result from the bodys inability to store glycogen in the body tissues. Glucose is very important to the body because it is necessary for the metabolic processes that take place in the brain, adrenal medulla, and red blood cells (Rochlani et al., 2017). The availability and distribution of glucose commence at the small intestine, where transport proteins facilitate the movement of glucose into the cells. The glucose is then transported via the blood to the liver and then stored in the form of glycogen which is later broken down again to give out energy to the body, particularly during fasting and starvation. Furthermore, glycogen can also be stored in body tissues and used during rigorous body activities such as exercises.
Consequently, when enzymes meant to aid in the breaking down the glycogen in the body tissues and liver into energy fail to do so, glycogen storage disorders (GSD) emerge. These conditions can either affect the liver and muscles, depending on the affected enzyme. GSD type 1 is an example of the disorders which takes place due to a faulty liver and often leads to hypoglycemia. Treatments in infants include a constant supply of glucose using drips into the digestive system. The continuous process helps the child do away with some of the symptoms as they grow older (Rochlani et al., 2017). The other effective GSD therapy is a liver transplant, but this step is reserved for extreme cases where the patients are unable to respond to the ordinary treatment process or are victims of liver cancer. Individuals who have muscle-related GSDs are to avoid different forms of demanding exercises to manage their conditions.
Glycosylation Congenital Disorders
Metabolism disorders not only affect the liver and muscles, as in the case of GSD but other vital body organs such as the brain. Congenital disorders of glycosylation (CDG) is a condition that damages various parts of the body, and its manifestation is in the endoplasmic reticulum and cytoplasm, crucial to the fusion of lipids and proteins. CDG type 1 is a common type of this illness, which is brought about by a defective phosphomannomutase 2, one of the enzymes responsible for glycosylation (Mendrick et al., 2017). Some of the symptoms of the disorder include abnormalities in the brain, poor muscle development during infancy, and extreme developmental delay. Additionally, children with CDG type 1 may have seizures, retinal damage, hypoglycemia, vomiting, and diarrhea. Unfortunately, there are no effective treatment approaches to this group of disorders. Affected patients can only find means of managing the symptoms as curing the condition is not possible at the moment.
Mitochondrial Disorders
As noted in previous carbohydrate metabolism disorders, the mitochondrion is crucial in the oxidation process. Therefore any defects in this element can lead to more metabolism issues within the human body. In a mitochondrial respiratory chain, there are five protein networks responsible for producing the energy required to complete chemical reactions in the cells (Malicka et al., 2016). Consequently, any abnormality affecting the respiratory chain triggers toxic oxygen reactive substances due to low energy production. Moreover, defects in the mitochondria lead to the production of apoptotic elements, which prompt cell death.
The signs and symptoms of the disorders are linked to deficiencies in the mitochondrion by the level of mutation, considering they can be inherited, the energy required by the affected tissues, and the segments of the mitochondria that have been damaged. Patients with the disorder experience defects in the muscular and nervous systems because the tissues of these two cannot function without mitochondrial metabolism. Furthermore, there is a connection between the disorder and neurodegenerative conditions such as amyotrophic lateral sclerosis (ALS), Parkinsons disease, and Alzheimers disease (Malicka et al., 2016). It is important to note that there is no proven cure for mitochondrial disorders. However, there are existing supplements prescribed by medical professionals and other experiments meant to aid in gene therapy.
Lysosomal Storage Disorders
Lysosome is another group of organelles with multiple enzymes with the capability of breaking down carbohydrates. This means that it is an integral component metabolic processes in the body. Each lysosome has a corresponding lysosomal enzyme with specific nuclear DNA markers (Lutsenko, 2018). Consequently, when a lysosomal enzyme goes missing, becomes insufficient, or mismatches a lysosome, the broken down macromolecules accumulate and lead to irregular storage of compounds, including glycogen. Most lysosomal storage defects are considered autosomal recessive, other than the Hunter syndrome and Fabry disease, which are X-linked.
The signs and symptoms of lysosomal storage disorders are determined by the storage location of the degraded molecules. For instance, the gauche disease causes anomalies in the peripheral tissues such as bones, spleen, and the liver. On the other hand, Tay-Sachs disease affects the nervous system, while Niemann-Pick disease damages both systemic organs including the brain. Consequently, the symptoms of the lysosomal storage related conditions include enlarged spleen and liver, eye deformities, bone diseases, and coarse facial features (Lutsenko, 2018). Generally, this group of diseases often cause acute neurological damages as early as infancy. There are no scientific interventions to lysosomal storage disorders other than supportive care. Previously, there have been attempts of bone marrow transplant but the few cases have not been successful.
Conclusion
Carbohydrate metabolism is one of the most significant activities in the body because it is necessary for the production of the energy required to perform even the simplest of human tasks. Whenever people eat, the food can be broken down immediately through glycolysis to provide energy to the body, or excess of the energy can be stored in the form of glycogen in tissues which can be used later. However, the interference of these chemical processes leads to carbohydrate metabolism disorders. The bodies of people with these conditions struggle to disintegrate the ingested carbohydrates into sugar because they lack enough enzymes required to do so. Additionally, during starvation, the body is forced to obtain glucose of cell proteins through gluconeogenesis. Consequently, in studying carbohydrate metabolism disorders, it was imperative to understand glycogen-related disorders and those that affect different enzymes and organelles that participate in energy production and storage. Since a majority of these disorders are genetic, few therapies can be used to treat the illnesses effectively. However, their symptoms can be managed by simple adjustments in the diets of the affected individuals.
References
Agana, M., Frueh, J., Kamboj, M., Patel, D., & Kanungo, S. (2018). Common metabolic disorder (inborn errors of metabolism) concerns in primary care practice. Annals of Translational Medicine, 6(24), 469-469. Web.
Lutsenko, L. (2018). Glycemic screening and recurrent carbohydrate metabolism disorders with endocrine pathology. International Journal of Endocrinology, 14(2), 205-210. Web.
Malicka, J., Kurowska, M., DudziDska, M., SmoleD, A., Oszywa-Chabros, A., & Tarach, J. (2016). Disorders of carbohydrate metabolism and their relationship with the prevalence of cancer in patients with acromegaly authors own observations. Family Medicine & Primary Care Review, 3, 291-293. Web.
Mendrick, D., Diehl, A., Topor, L., Dietert, R., Will, Y., & La Merrill, M. et al. (2017). Metabolic syndrome and associated diseases: From the bench to the clinic. Toxicological Sciences, 162(1), 36-42. Web.
Pankiv, V. (2017). Disorders of carbohydrate metabolism in clinical practice. International Journal of Endocrinology, 13(1), 39-44. Web.
Rochlani, Y., Pothineni, N., Kovelamudi, S., & Mehta, J. (2017). Metabolic syndrome: pathophysiology, management, and modulation by natural compounds. Therapeutic Advances in Cardiovascular Disease, 11(8), 215-225. Web.
Vijaya, J. (2016). Salacia Chinensis Extract (SCE) Modulates Carbohydrates and Lipid Metabolism: in vitro and in vivo Models. Endocrinology & Metabolism International Journal, 3(6), 45-69. Web.
The case focuses on an older adult, and at 69 years old, he presented some memory and speech problems. The wife had noticed that her husband has been having difficulties remembering the names of his family members and close friends. The man has been experiencing these memory losses for the past few months. He was lost while driving in his own neighborhood and had missed several appointments. Upon neurological examination, the patient seems to forget two objects of three in only three minutes.
The patients symptoms are consistent with those of an individual suffering from a vascular neurocognitive disorder. The possible disease is Alzheimers disease (AD), whose most distinct feature is memory impairment.
According to Ulep et al. (2018), ADs progression takes several months, and the initial symptoms include amnesia, where the language, visual-spatial, or executive dysfunction are affected.
With time, the disease affects episodic memory, including the inability to store new information and forgetting appointments, names, or medications. These signs were consistent with the ones displayed by the patient.
As people grow older, it is possible to become forgetful of essential things. Therefore, a conclusive test should be conducted to ascertain the patients condition. Arvanitakis et al. (2019) proposed using the Montreal Cognitive Assessment, which is helpful in the early detection of cognitive impairment.
Once the disease is identified, the patient can be started with non-pharmacologic approaches such as cognitive training, reminiscence, art therapy, and appropriate physical exercises.
These exercises might not be enough, requiring the need for medications. Some of the most reliable drugs for cognitive symptoms include acetylcholinesterase inhibitors, which help increase acetylcholine abundance (Arvanitakis et al., 2019). They come in different forms, and they help slow down cognitive decline.
Examples include donepezil, which should be administered 5mg daily for the first six weeks, and past that, increase the dosage to 10mg daily (Arvanitakis et al., 2019).
Rivastigmine capsule starts with 1.5mg before increasing it to 3mg, then progresses to 4.5mg, and finally 6mg when the patient builds tolerance (Arvanitakis et al., 2019). In each phase, the drug should be administered twice daily for two weeks apart from the last stage, where the patient can take it for as long as needed.
The following study attempts to investigate sex differences among individuals with opioid use disorders who are treated by either buprenorphine maintenance or some other form of treatment (Ling et al., 2019). It does so by posing a focused question on whether buprenorphine is effective for female individuals with opioid use disorders, the numbers of which have been increasing in the past few years.
The studys use of papers
This article implements randomized controlled trials throughout a number of databases, including PsycINFO, PubMed/Medline, CINAHL, Embase, and Cochrane Central. The aforementioned databases are some of the most widely used and trusted in the sphere of medical research. As such, the authors of the article were able to utilize appropriate studies from good sources.
The studys inclusion of relevant studies
While the study used a randomized controlled trial for their inclusion of papers, there was also a particular focus on including studies that account for sex differences among tested individuals. References depict studies that also acknowledge several other variables, such as differences based on age, geographic location, and socioeconomic elements.
Assessment of quality of the included studies
The study uses a customized template of the software Covidence. This program is able to navigate components of the papers used in the study by factors such as eligibility criteria, participant demographics, opioid use prior to the study participants, and the duration of the intervention. Collectively with the Cochrane Risk of Bias assessment, these factors were able to ascertain the validity of the used studies.
The Combination of the Results of the Review
The following paper presents the results of the studies separately. The sample sizes of the studies vary, but not by degrees that are highly disproportionate. Similarly, the gender ratios have variations throughout the studies but usually depict the same pattern of fewer female participants. Not combining the results was beneficial to this study in order to observe differences among age groups and locations.
What Are the Results?
The Overall Results of the Review
Initially, the study found that only 52% of the examined studies noted any differences among sex as a variable. Throughout the studies, only 26% of participants were female, with studies focusing on treatment retention, substance use, and sexual risk behaviors. Due to the minimal sample size, the paper concluded that no definitive conclusion could be drawn.
The Precision of the Results
While no confidence intervals are given in the paper, due to the issue faced by the research team with few studies assessing sex differences and the much smaller sample sizes of female participants, no precise result could be deducted. As such, the overall conclusion of the paper states that obstacles such as inconsistent findings and the inability to conduct meta-analyses hindered a precise result.
Will the Results Help Locally?
Application of the Results to the Local Population
A number of studies that occurred in countries in North America were utilized within this review. As such, the study has the potential to implement its findings within countries like the U.S. or Canada. However, the use of the studys findings elsewhere may not be cohesive with opioid misuse, treatment, and sex differences elsewhere.
Consideration of the Outcomes
The study notes that further research is necessary for the direction of how female and male patients react differently to buprenorphine as a treatment for opioid use disorder. Additionally, further investigation into socioeconomic and cultural backgrounds as a factor is also necessary.
The Benefits, Harms, and Costs
Opioid misuse and use disorders are still especially prevalent in North American countries. The study illustrates that gender disparity may become an issue with the current treatment of opioid use disorder. As such, the benefits would include acknowledging the extent of the issue and formulating strategies to combat this disparity.
The Level of Evidence for the Study
The following review is likely a Level II in terms of the levels of evidence as it uses randomized controlled trials but was unable to conduct a meta-analysis.
The patient is showing some issues with concentration and attention.
HPI
S. H. is showing some issues with concentration and attention. At the request of her mother and teacher, she was checked by a psychiatrist for mental issues. ADHD was suspected.
Objective
Diagnostic results
S. H. has attention-deficit/hyperactivity disorder, according to the case study and transcript data (ADHD). According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), it is one of the most prevalent disorders among school-age children. A persistent pattern of inattention, hyperactivity, and more extreme impulsivity than in children usually developing are the key characteristics of ADHD (AgnewBlais et al., 2022). These characteristics are linked to behavioral and intellectual challenges, which may make establishing and sustaining relationships difficult. In other words, having an ADHD diagnosis increases the number of academic and social risk factors in a students interactions at school.
Additionally, S. H.s academic success and her instructors perceptions of her are impacted by ADHD. Numerous studies have been done on the value of solid bonds between instructors and pupils. A healthy student-teacher relationship (STR) is essential for learning since it establishes the basis for the students success (or failure). Nevertheless, despite the extensive studies, generally developed pupils have received most of the attention. High-quality connections can be especially crucial for persons who lack the skills to establish and sustain relationships independently, which may make this seem out of the ordinary.
S. H. ability to adjust to the school environment depends on her interaction with the instructors. Teachers and peers of students with ADHD must know ADHD symptoms and their possible effects on students academic and social functioning to prevent stigmatization, alienation, and decreased self-perception in such individuals. However, research indicates that most instructors are unaware of ADHD and how it could affect their pupils academic and social success. The ability of teachers to make interactional attributions to explain ADHD symptoms and to accommodate the unique characteristics of each student in interactions, with proportionate expectations within the classroom environment and in their interpersonal relationships, depends on their knowledge of ADHD.
The context of the school is more crucial in S. H. situation. When kids are expected to sit still, be quiet, and focus, ADHD symptoms are frequently brought on in these environments (Ewe, 2019). When kids attempt to accomplish this, their symptoms may worsen, harming their sense of themselves, self-esteem, and interactions with classmates and instructors. Low-structured settings like lunch and recess can also cause impulsivity and inattentiveness. These situations make it difficult for ADHD children to maintain self-control, especially as they frequently involve much physical activity, which fuels the students hyperactivity and inattentiveness. Behavior management techniques are generally unsuccessful, including harsh words, criticism, negative behavioral consequences, and lengthy verbal instructions. Negative interactions with the pupils so frequently operate as a trigger for solid emotions in interpersonal connections and those with ADHD, counteracting their intended effects. Instead, pupils tend to live up to greater expectations when professors interact sensitively and responsively with such students to support their achievement.
The effect of the STR on usually developing students social and intellectual success has been extensively studied, as was already indicated. According to this research, teachers grade students differently depending on their own and the students traits (Holland & Sayal, 2018). These ratings consequently impact the academic success and behavioral results of their kids. Students are acutely aware of their position within the school and how other students and instructors see them. This remark is supported by research, which states that all teachers should prioritize creating excellent STRs.
That view is in line with some who contend that teachers relationship skills are essential for the academic success of their pupils. Specifies this by highlighting the qualities of being warm and demanding while defining high-quality STRs. Together, these provide instructors who are interested in and active in the lives of their students access to emotional support as well as standards and expectations for academic accomplishment and proper behavior. In order to provide accessible learning, instructors comprehension of how their connections with their students impact students behavior and learning is crucialrelationships built on mutual trust, understanding, and respect encourage students accomplishments.
According to their findings, interactions between instructors and students with CP are less intimate and more contentious than those with usually developing pupils. It appears that this is particularly true for kids who have co-morbid CPs and CU. Furthermore, by the school years conclusion, students with low-quality STRs at the start of the year had greater levels of oppositional defiant disorder and more functional severe impairment (Mowlem et al., 2019). Problematic STRs frequently develop complex, which lowers academic success among students. In other words, externalizing activities among students frequently have a detrimental impact on the STR, leading to more disagreements and less closeness.
Assessment
S. has problems with concentration and memory, often loses things, and has a certain awkwardness in communication. These symptoms fit the description of attention-deficit/hyperactivity disorder.
Mental Status Examination
S. is quite polite and has no problem understanding social skills. However, she does feel a little uncomfortable. Apart from ADHD, she is a healthy child with no special problems related to her age. According to her mothers description, the syndrome manifested itself after the start of schooling. This circumstance is extremely common and is common for schoolchildren with ADHD.
Differential Diagnoses
S. expresses no mental or physical weaknesses other than problems with attention and focusing thoughts.
Reflections
Given the age of the child, it can be assumed that without further treatment, S. may face other problems. In particular, the social discomfort caused by ADHD can lead to an anxiety disorder later in school. It is recommended not to resort to drug treatment at this stage of the development of the syndrome. Children with ADHD often benefit from behavioral therapy, social skills training, parenting skills training, and counseling, which can be provided by a psychiatrist, psychologist, social worker, or other mental health professional. Some children with ADHD may also have other conditions, such as anxiety or depression. In these cases, counseling can help with both ADHD and related problems.
A mental disorder is a clinically significant disturbance in an individuals cognition, emotional regulation, or behavior. Examples of cognitive disturbances include anxiety, depression, schizophrenia, and bipolar. These psychological problems are characterized by distress or impairment in key areas of functioning, lowering ones quality of life. Therefore, psychological issues can lead to social isolation, complex relationships, and decreased sense of belonging, which are catalysts of ill-being.
Discussion
People across the globe are affected by psychiatric issues, which result in limited self-actualization. Ruggeri et al. explain that well-being is a sustainable condition that allows the individual or population to develop and thrive (1). Psychological issues interfere with life satisfaction by making an individual feel subjective in their environment and experience less pleasure (Dong 519). Well-being has been linked to success at professional, personal, and interpersonal levels, with those individuals high in well-being exhibiting greater productivity in the workplace, more effective learning, increased creativity, more pro-social behaviors, and positive relationships (Ruggeri et al. 1). Therefore, cognitive disorders can reduce an individuals quality of life, affecting all aspects of well-being such as career, relationship, and educational achievement.
Many people are affected by cognitive issues, which make these disorders among the most suppressive. According to the world health Organization, 1 in every 8 people in the world live with a mental disorder (para 1). This data reveals that many people are affected by psychiatric problems indicating an upward trend in newly reported cases of these ailments. The most common psychological disorders include anxiety and depression, considering that they are not easily detectable in the initial stages, especially among high-functioning individuals.
Anxiety is a psychological disorder that can affect the pattern of life, decreasing satisfaction. This disorder occurs when an individual experiences persistent worry and fear of every situation resulting in stress (World Health Organization para 2). In addition, anxiety may lead to social isolation due to the continuous sense of impending danger and panic. This situation may prevent an individual from experiencing good relations with people, affecting their well-being. Furthermore, this exclusion makes it hard for people to ask for help when needed due to overreliance on self-support, which results in a high level of suffering.
Another psychiatric issue is depression which affects an individual sense of belonging and psychosocial functioning. People who are depressed have signs of feeling sad and empty, resulting in less productivity in their engagements (Christensen et al. 280). These symptoms take a toll on an individual, resulting in significant setbacks in pleasure and fulfillment in their activities. That kind of life is not ideal, considering that it results in a loss of sense of belonging, especially when people cannot keep up with their peers pace (Christensen et al. 280). Depression reduces well-being by reducing happiness and increasing guilt which may make an individual feel worthless and develop intrusive thoughts of suicide.
Most mental disorders contribute to emotional factors, like guilt, anger, negative thinking, frustration, and fear which affect flexibility. A person who has not suffered a cognitive impairment maintains emotional intelligence, which helps them handle agitating and stressful situations without feeling excessive burnout. This situation is not the case for people with mental health illnesses, including schizophrenia. This disorder is a complicated, long-term psychological issue with a broad spectrum of symptoms, such as delusional thoughts, hallucinations, dissociative symptoms or behavior, and trouble with cognitive processes. As highlighted by Ganguly (166), Individuals with schizophrenia are often unable to run their daily chores. People who have schizophrenia are unable to fulfill their duties at work, home, and school, meaning they achieve less, making them more frustrated. This finding indicates that people affected with such illnesses lead a poor-quality lifestyle, considering that all the aspects of satisfaction in ones life are restricted.
Bipolar disorder is a serious cognitive illness that affects how people relate and sustain relationships. Bipolar patients endure alternating cycles of depression and manic symptoms. Such persons are pleased one minute and sad the next, making social relations complex. Individuals energy levels, thoughts, and sleep patterns fluctuate, leading to extreme thoughts of suicide (Zakowicz et al. para 1). An individual suffering from the condition may abruptly experience mood changes during a meaningful encounter, such as an interview, resulting in a ruined reputation. This personality shift may have negative consequences, such as a loss of possibilities for a job or promotion, resulting in financial burden and a lower quality of life.
Conclusion
Mental health problems significantly impact all aspects, negatively influencing academic performance, relationships with others, and how people use the opportunities available. Depression and anxiety are two of the most common psychiatric problem. The ailments make it hard for people to establish long-lasting friendships, discover their full potential, and overcome solitude. Schizophrenia and bipolar are also psychological issues that reduce the quality of life by exerting guilt and changing personality and mood, affecting social life. All these symptoms can result in challenging relationships, decreased sense of belonging, and financial problems because of missed opportunities. Such impacts affect well-being by limiting satisfaction, actualization, and contentment, which promote life fulfillment.
Bulimia is a severe eating disorder characterized by the uncontrolled consumption of large amounts of food, followed by emptying the stomach. Patients constantly overeat, after which they feel guilty and try to cleanse their bodies in various ways. These include enemas, inducing vomiting, and taking diuretics and laxatives. People with bulimia begin to torture themselves with heavy physical exertion and go on strict diets to reduce weight.
The main symptoms of bulimia include intermittent eating of enormous amounts of food to the point of stomach discomfort, abdominal pain, flatulence, constipation, and blood in the vomit due to irritation of the esophagus. According to Wade (2019), patients often hide the disease, but it can be guessed from some signs. These include persistent complaints of being overweight, a distorted perception of ones body, repeatedly eating large amounts at one meal, not wanting to eat in public places and the presence of other people, and going to the bathroom or toilet immediately after eating. Artificial cleansing of the body causes complications such as dehydration caused by vomiting, which can lead to kidney failure, as well as heart rhythm disturbances, as the body loses potassium, magnesium, and other substances along with food. Other consequences are damage to the enamel of the teeth, tooth decay, gum disease, and lack of menstruation.
Wade (2019) identifies several factors that can trigger the development of the disease. Among them are a hereditary predisposition, lack of serotonin in the body, depression, and chronic stress. In turn, Lydecker and Grilo (2019) note that most often, the disease occurs in young girls aged 15-24 years, whose weight is within the normal range or slightly higher. Moreover, at risk are people with psychological problems with low self-esteem and obsessive-compulsive states and people subject to public opinion, which is associated with forming a stereotype about the beauty of exceptionally thin people. Most patients are associated with areas that require weight control, such as gymnasts, runners, dancers, and models (Lydecker & Grilo, 2019). Thus, bulimia is a serious disease that needs mandatory treatment.
References
Lydecker, J. A., & Grilo, C. M. (2019). Food insecurity and bulimia nervosa in the United States. International Journal of Eating Disorders, 52(6), 735-739.
Wade, T. D. (2019). Recent research on bulimia nervosa. Psychiatric Clinics, 42(1), 21-32.
The Delta wave is a delayed upstroke in the Q Wave R Wave S Wave (QRS) multifaceted that is frequently linked to a brief PR interval. Wolff-Parkinson-White pre-excitation disorder is usually linked with the delta wave. The action potential from the sinoatrial node conducts through the accessory route very fast to the ventricles, and therefore, it occurs after the P wave (Ishihara et al., 2021). On examination for this patient, he has a tachycardia heart-rate of 180 beats / minute and a pulse-rate of 105/70 mm/Hg. WPW with atrial fibrillation can be fatal, mainly if AV obstructing drugs are used (remember ABCD for adenosine or intramuscular injections, beta-blockers, calcium conduit blockers, and digoxin). The sensation in the process is the conventional therapy, although electrical cardiac Cath is also a viable option, particularly in cases of hemodynamic instability.
The irregular atrial nerve impulses in individuals with WPW combined with arrhythmia can pass through a supplemental route quicker than an AV node. As a result, individuals who acquire irregular heartbeat due to WPW have more significant ventricular pulses than those who do not (Sacramento, 2020). If one takes an AV blocker, fewer atrial nerve impulses will travel via the AV nodal, but more will flow through the supplemental route (Sacramento, 2020). This, ironically, raises the cardiac rate, increasing the risk of ventricular arrhythmias, a possibly lethal and hemodynamically problematic rhythm. Therefore, a second ECG reveals sinus rhythm with a short refractory period and a broad QRS with a delayed upstroke for this patient.
Reentrant Tachycardias in this Condition
Atria and ventricles reentry beats, also known as AVRT, is a form of supraventricular that necessitates using an auxiliary route to begin and perpetuate the actual situation. The auxiliary route connects the atrial to the ventricular without going through the AV network and exhibits electrophysiological features distinct from the AV junction and the His-Purkinje loop. However, the characteristics of the supplementary route are more similar to those of nerve fibers (Talib & Shenasa, 2019). The supplementary route is one of two necessary limbs, again for reentrant circuitry; the other being the AV nodal and His-Purkinje loop. As a corollary, the auxiliary route may carry an impulse antegrade or retrogradely, culminating in orthodromic or antidromic AVRT (Talib & Shenasa, 2019). Although localized or non-reentrant processes are thought to function in rhythmogenesis, most fatal cardiac abnormalities are believed to be caused by reentry. Therefore, consistent reentrant ventricular tachycardia (VT) is primarily regarded as among the most prevalent antecedents of ventricular fibrillation (VF) and cardiovascular problems in individuals with pathological heart abnormalities.
Mechanisms that Give Rise to Tachycardia
From the above information, other underlying causes of ventricular tachycardia (VT), which are connected to premature or subsequent after prospects, include aberrant neural impulses and triggered action (TA). Torsades de Pointes is the responsibility of nascent TA. Certain verapamil-responsive VT may be caused by delayed TA, although nutrient reentry could be ruled out (Kobayashi, 2021). In affecting the level VT, impaired automatic processing or late TA could also contribute. The making of medicines tailored to the mechanism challenged by the findings of planned excitation and tracing could help researchers better know the process of VT in particular patients. This would allow for more effective and well-tolerated antiarrhythmic treatment (Vanniasegaram, 2017). If other neurons start firing on their own, abnormal automaticity ensues, leading to early heartbeats. All cardiovascular cells can fire spontaneously, but only at a very sluggish pulse rate. As a result, they will never have the opportunity to demonstrate the firing capability at a regular heartbeat.
lucose + 2ADP + 2Pi 2L (+) Lactate +2ATP + 2H2O
