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In-vitro-Fertilization (IVF)

Toxic hepatitis is inflammation of the liver caused by exposure to harmful substances, such as alcohol, medications, chemicals, or herbal/nutritional supplements. It may develop within hours or days after exposure, or after months of repeated contact. Symptoms often improve once the toxin is stopped, but severe cases can lead to cirrhosis or life-threatening liver failure. Symptoms Mild cases may have no symptoms and are found on blood tests. When present, symptoms include: Jaundice (yellowing of skin/eyes) Itching Pain in the upper right abdomen Fatigue Loss of appetite Nausea and vomiting Fever or rash Weight loss Dark (tea-colored) urine Emergency: Suspected acetaminophen (paracetamol) overdose requires immediate medical care—do not wait for symptoms. Causes Alcohol (long-term heavy use) Over-the-counter pain relievers (acetaminophen, aspirin, ibuprofen, naproxen), especially in high doses or with alcohol Prescription drugs (e.g., statins, certain antibiotics, antivirals, steroids) Herbs & supplements (e.g., aloe vera, black cohosh, kava, ephedra) Industrial chemicals (e.g., carbon tetrachloride, vinyl chloride, paraquat) The liver breaks down toxins, but byproducts can damage liver cells—repeated exposure increases harm. Risk Factors Existing liver disease or viral hepatitis Older age Female sex (slower toxin metabolism for some substances) Certain genetic enzyme differences Complications Cirrhosis (permanent scarring) Acute or chronic liver failure Liver transplant may be required in severe cases Prevention Use medicines only as directed; avoid unnecessary use Never mix alcohol with acetaminophen; ask about other drugs Be cautious with herbs/supplements—discuss risks with a professional Use protective measures when handling chemicals Keep medicines and chemicals out of children’s reach Bottom line: Toxic hepatitis is often preventable. Early recognition and stopping the offending substance can protect the liver and prevent serious complications.

What Is a Cerebral Arteriovenous Fistula? A cerebral arteriovenous fistula (AVF) is an abnormal direct connection between an artery and a vein in the brain. How Normal Blood Flow Works In a healthy circulatory system: Blood flows from arteries → capillaries → veins Capillaries slow blood flow so oxygen and nutrients can be delivered to brain tissue Veins then carry blood back to the heart What Happens in an AVF In a cerebral AVF: Blood bypasses the capillaries Blood flows directly from an artery into a vein This causes high-pressure arterial blood to enter veins that are not designed to handle it Over time, this abnormal circulation can: Reduce oxygen delivery to brain tissue Increase pressure inside veins Raise the risk of bleeding and neurological damage Cerebral AVFs may be congenital (present at birth) or acquired later in life. Symptoms of a Cerebral Arteriovenous Fistula Symptoms vary depending on the size, location, and blood flow of the AVF. Some people have no symptoms initially, while others develop serious complications. Common symptoms include: Hemorrhagic stroke due to bleeding in the brain Sudden severe headache Weakness or numbness Difficulty speaking or moving Seizures Pulsatile tinnitus (a rhythmic “whooshing” sound in the ear) Audible bruit (a sound caused by turbulent blood flow) Neck or back pain Neurological deficits depending on the affected brain area Symptoms can worsen suddenly if bleeding occurs, which is a medical emergency. Causes of Cerebral Arteriovenous Fistulas Cerebral AVFs can develop for several reasons: Congenital Causes Abnormal blood vessel development during fetal growth Present at birth, though symptoms may appear later Acquired Causes Trauma (e.g., head injury, gunshot or stab wounds) Surgical or medical procedures involving blood vessels Vascular conditions, such as aneurysms or other malformations Spontaneous formation, especially in older adults Note: AVFs created surgically for dialysis are intentional and occur outside the brain. Cerebral AVFs are abnormal and potentially dangerous. Complications and Related Conditions If left untreated, a cerebral AVF can lead to serious complications: Brain Bleeding (Intracranial Hemorrhage) Veins exposed to high arterial pressure may rupture Can cause stroke, brain damage, coma or death Seizures Caused by irritation of brain tissue from abnormal blood flow or bleeding Heart Strain and Heart Failure Large AVFs force the heart to pump harder Over time, this can lead to high-output heart failure Blood Clots Turbulent blood flow increases clot formation Can result in deep vein thrombosis (DVT) or pulmonary embolism