Introduction: The aim of the study was to determine the prevalence of cardio‐metabolic risk factors in men under 30 in the United Arab Emirates.Methods: This cross‐sectional observational study included 33 327 Emirati men aged 18‐29 attending an obligatory standardized medical examination between May 2015 and February 2017. Body mass index, fasting blood glucose, total cholesterol, triglycerides and blood pressure were assessed.Results: Overall, 7720 subjects (24.4%) were overweight and 8835 (28.0%) obese. The age‐adjusted prevalence was 4.7% [95% CI: 4.4‐5.0] for diabetes, 41.3% [40.6‐41.9] for impaired fasting glucose, 5.5% [5.2‐5.8] for hypercholesterolaemia (total cholesterol ≥ 240 mg/dL), 11.5% [11.1%‐12.0%] for hypertriglyceridaemia (≥150 mg/dL) and 10.4% [10.0%‐10.8%] for hypertension (diastolic or systolic blood pressure—or both—above upper limit of normal). These conditions were already present in the youngest age groups and rise progressively and rapidly with age. Of the 26 648 subjects with valid data for all cardio‐metabolic risk factors, 16 563 subjects (62.2%) presented ≥ 1 factor, 6392 subjects presented ≥2 factors (24.0%) and 63 (0.2%) presented all five. Patients who were obese were more likely to present multiple cardio‐metabolic risk factors and to have hypertension (P < 0.0001). All cardio‐metabolic risk factors were highly correlated with each other.Conclusions: This national cohort study in the UAE revealed that obesity, diabetes, impaired fasting glucose, hypercholesterolaemia, triglyceridaemia and hypertension are already highly prevalent in young adulthood. Public health initiatives are required to address these and to anticipate the future burden of diabetes and major cardiovascular disease for which these men are at high risk.

Introduction Healthcare systems are looking to reduce their carbon impact. Short-acting β₂-agonist (SABA) overuse (≥ 3 canisters/year) is common in asthma and linked to poor outcomes; however, its environmental impact remains unknown. As part of the CARBON programme, this study retrospectively quantified the carbon footprint of SABA and controller inhalers across all respiratory indications and SABA overuse in asthma in lower-middle-income countries (LMICs), upper-middle-income countries and high-income countries across Africa, Asia Pacific, Latin America and the Middle East. Methods Two data sources were utilised to evaluate the carbon contribution of inhalers to respiratory care. To quantify greenhouse gas (GHG) emissions associated with total inhaler use across all respiratory indications, inhaler sales data were obtained from IQVIA MIDAS^® (Q4/2018–Q3/2019) and compared by dose to prevent confounding from differences in canister actuation counts. GHG emissions associated with SABA overuse in asthma were evaluated using prescription and self-reported over-the-counter purchase data from the SABA use IN Asthma (SABINA) III study (2019–2020). Inhaler-related GHG emissions were quantified using published data and product life cycle assessments. Results SABA accounted for > 50% of total inhaler use and inhaler-related emissions in most countries analysed. The total SABA-related emissions were estimated at 2.7 million tonnes carbon dioxide equivalents, accounting for 70% of total inhaler-related emissions. Among the countries, regions and economies analysed, per capita SABA use and associated emissions were higher in Australia, the Middle East and high-income countries. Most SABA prescriptions for asthma (> 90%) were given to patients already overusing SABA. Conclusions Globally, SABA use/overuse is widespread and is the greatest contributor to the carbon footprint of respiratory treatment, regardless of the economic status of countries. Implementing evidence-based treatment recommendations, personalising treatment and reducing healthcare inequities, especially in LMICs, may improve disease control and patient outcomes, thereby reducing SABA overuse and associated carbon emissions beyond SABA use alone.

Spirometry is commonly accepted as the gold standard for the diagnosis of COPD, but the reality remains that quality assured spirometry is not or cannot be provided universally around the globe. Adding PEF measurement to a screening questionnaire may rule out airflow limitation compatible with COPD rationalizing spirometry testing.

Objectives: To quantify SARS-CoV2 IgG antibody titers over time and assess the longevity of the immune response in a multi-ethnic population setting.Setting: This prospective study was conducted in a tertiary hospital in Abu Dhabi city, UAE, among COVID-19 confirmed patients. The virus-specific IgG were measured quantitatively in serum samples from the patients during three visits over a period of 6 months. Serum IgG levels ≥15 AU/ml was used to define a positive response.Participants: 113 patients were analyzed at first visit, with a mean (SD) age of participants of 45.9 (11.8) years 87.5% of the patients were men. 63 and 27 participants had data available for visits 2 and 3, respectively.Primary outcome: Change in SARS-CoV2 IgG antibody titers over the visits.Results: No mortality or re-infection were reported. 69% of the patients developed positive IgG response within the first month after the onset of symptoms. The levels of IgG showed a consistent increase during the first three months with a peak level during the third month. Increasing trend in the levels of IgG were observed in 82.5%, 55.6% and 70.4% of patients between visit 1 to visit 2, visit 2 to visit 3, and from visit 1 to visit 3, respectively. Furthermore, about 64.3% of the patients showed sustained increase in IgG response for more than 120 days.Conclusions: Our study indicates a sustained and prolonged positive immune response in COVID-19 recovered patients. The consistent rise in antibody and positive levels of IgG titers within the first 5 months suggest that immunization is possible, and the chances of reinfection minimal.

Background: The overuse of short-acting β₂-agonists (SABA) is associated with poor asthma control. However, data on SABA use in the Gulf region are limited. Herein, we describe SABA prescription practices and clinical outcomes in patients with asthma from the Gulf cohort of the SABA use IN Asthma (SABINA) III study. Methods: In this cross-sectional study conducted at 16 sites across Kuwait, Oman, and the United Arab Emirates, eligible patients (aged ≥ 12 years) with asthma were classified based on investigator-defined disease severity guided by the 2017 Global Initiative for Asthma report and by practice type, i.e., respiratory specialist or primary care physician. Data on demographics, disease characteristics, and prescribed asthma treatments, including SABA, in the 12 months prior to a single, prospective, study visit were transcribed onto electronic case report forms (eCRFs). All analyses were descriptive in nature. Continuous variables were summarized by the number of non-missing values, given as mean (standard deviation [SD]) and median (range). Categorical variables were summarized by frequency counts and percentages. Results: This study analyzed data from 301 patients with asthma, 54.5% of whom were treated by respiratory specialists. Most patients were female (61.8%), with a mean age of 43.9 years, and 84.4% were classified with moderate-to-severe disease, with a mean (SD) asthma duration of 14.8 (10.8) years. Asthma was partly controlled or uncontrolled in 51.2% of patients, with 41.9% experiencing ≥ 1 severe exacerbation in the 12 months preceding their study visit. Overall, 58.5% of patients were prescribed ≥ 3 SABA canisters, 19.3% were prescribed ≥ 10 canisters, and 13.3% purchased SABA over-the-counter (OTC) in the 12 months before the study visit. Most patients who purchased OTC SABA (92.5%) also received SABA prescriptions. Inhaled corticosteroid/long-acting β₂-agonist combinations and oral corticosteroid bursts were prescribed to 87.7% and 22.6% of patients, respectively. Conclusions: SABA over-prescription was highly prevalent in the Gulf region, compounded by purchases of nonprescription SABA and suboptimal asthma-related outcomes. Increased awareness among policymakers and healthcare practitioners is needed to ensure implementation of current, evidence-based, treatment recommendations to optimize asthma management in this region. Trial registration: NCT03857178 (ClinicalTrials.gov).