The efficacy and safety of gene therapy approaches in Parkinson's disease: A systematic review.

BACKGROUND: Parkinson's disease (PD) is a neurodegenerative disorder characterized by the progressive loss of dopaminergic neurons in the brain. Despite existing treatments, there remains an unmet need for therapies that can halt or reverse disease progression. Gene therapy has been tried and tested for a variety of illnesses, including PD. The goal of this systematic review is to assess gene therapy techniques' safety and effectiveness in PD clinical trials. METHODS: Online databases PubMed/Medline, and Cochrane were used to screen the studies for this systematic review. The risk of bias of the included studies was assessed using standard tools. RESULTS: Gene therapy can repair damaged dopaminergic neurons from the illness or deal with circuit anomalies in the basal ganglia connected to Parkinson's disease symptoms. Rather than only treating symptoms, this neuroprotective approach alters the illness itself. Medication for gene therapy is currently administered at the patient's bedside. It can hyperactivate specific brain circuits associated with motor dysfunction. PD therapies are developing quickly, and there aren't enough head-to-head trials evaluating the safety and effectiveness of available treatments. When choosing an advanced therapy, patient-specific factors should be considered in addition to the effectiveness and safety of each treatment option. CONCLUSION: In comparison to conventional therapies, gene therapy may be advantageous for PD. It may minimize side effects, relieve symptoms, and offer dependable dopamine replacement.

Worsening of migraine headache with fasting Ramadan.

BACKGROUND: Fasting is known as a trigger for migraines. Muslims fast 1 month every luminal year. We aimed to study the impact of The Holy month of Ramadan on migraine headaches. METHODS: This retrospective study included patients diagnosed with migraines according to The International Classification of Headache Disorders, 3rd edition (ICDH-3). Both genders, aged between 18 and 65 years were included. The impact of Ramadan fasting and changing habits during the month of Ramadan was studied. The frequency and the severity of migraine attacks, and the number of analgesic days during Ramadan were compared to those during Shaban, the immediately preceding month to Ramadan. The number of breaking fasting due to migraines was reported. RESULTS: This study identified 293 with migraine with mean age and mean disease duration 37.09 ± 9.36, 12.34 ± 9.27 years respectively. Most of them were females (89.1%). Most of our cohort had changed sleep and food habits during Ramadan (93.2%). The majority of them were dehydrated (89.8%). Most of the patients completed fasting the whole month of Ramadan. A minority (1.7) could not tolerate fasting the whole Ramadan due to intolerable migraine headaches and 36.5% broke their fasting for some days during Ramadan. Most of our cohort (82.3%) continue on the same management plan for migraines during Ramadan. During the month of Ramadan, the patients had a significant increase in migraine days of 10.42 ± 7.98 compared with 6.90 ± 6.55 migraine days during the previous month (p < 0.001). Also, days of analgesic use (11.32 ± 10.46 versus 6.11 ± 6.69; P < 0.001) and migraine severity (7.46 ± 2.39 versus 6.84 ± 2.25; P < 0.001) were significantly increased during Ramadan compared with Shaban. In multivariate analysis, change in sleep and feeding habits together with non-modification of the treatment plan before Ramadan significantly predict breaking fasting due to worsening of migraine headache (p value = 0.041, p value = 0.025; respectively). The majority of our cohort (75.4%) reported that migraines interfered with their daily activities due to fasting during Ramadan. CONCLUSION: Change in sleep and food habits along with dehydration make Migraine frequency and severity worse during Ramadan fasting. Physicians should educate migraine patients who fast to manage their headaches and habits before starting fasting.