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Types of spina bifida 1 Spina bifida occulta (mildest) Vertebral defect only Skin intact Often asymptomatic Signs: Tuft of hair Dimple Lipoma over spine 2 Meningocele Herniation of meninges only CSF-filled sac Usually no neural tissue damage 3 Myelomeningocele (most severe) Herniation of meninges + spinal cord Major neurological deficits Most common clinically significant type Common sites Lumbosacral region (most common) Cervical and thoracic are rare Risk factors Folic acid deficiency Maternal diabetes Valproate or carbamazepine use Obesity Family history Poor antenatal care Clinical features (myelomeningocele) Lower limb weakness or paralysis Sensory loss Bowel and bladder incontinence Orthopedic deformities (club foot, scoliosis) Hydrocephalus (ArnoldChiari II malformation) Diagnosis Antenatal Maternal serum AFP Ultrasound (1820 weeks) Postnatal Clinical examination MRI spine/brain Management Prevention is key Folic acid 400 g/day (5 mg/day if high risk) Surgical closure of defect Management of complications: Hydrocephalus (VP shunt) Physiotherapy Urologic care Prognosis Depends on level and severity Early intervention improves outcomes Most common neural tube defect affecting the spine = spina bifida

Supplement with Oral L-Glutathione High-quality oral L-Glutathione supplements remain one of the most popular ways to support healthy glutathione levels

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Conclusion Both Semaglutide and Phentermine offer effective options for weight loss, but they are suited for different needs and health profiles

While cyanocobalamin addresses nausea and vitamin status, glycine targets muscle preservation