The emergence of genetically-modified human proteins and glucagon-like peptide-1 (GLP-1) receptor agonists have presented a promising strategy for effectively managing diabetes. Due to the scarcity of clinical trials focusing on the safety and efficacy of semaglutide as an adjunctive treatment for patients with type 2 diabetes who had inadequate glycemic control with metformin, we conducted a systematic review and meta-analysis. This was necessary to fill the gap and provide a comprehensive assessment of semaglutide compared to sitagliptin, a commonly prescribed DPP-4 inhibitor, in this patient population. A comprehensive and systematic search was carried out on reputable databases including PubMed, the Cochrane Library, and Elsevier’s ScienceDirect to identify relevant studies that compared the efficacy of once-weekly Semaglutide with once-daily Sitagliptin in individuals diagnosed with type 2 diabetes mellitus. The analysis of the gathered data was performed utilizing the random-effects model, which considers both within-study and between-study variations. The meta-analysis incorporated three randomized controlled trials (RCTs), encompassing 2401 participants, with a balanced distribution across the treatment groups. The primary focus of the study revolved around evaluating changes in HbA1C, blood pressure, pulse rate, body weight, waist circumference, and BMI. The findings revealed that once-weekly Semaglutide showed substantially improved HbA1C (WMD: −0.98; 95% CI: −1.28, −0.69, p-value: < 0.0001; I2: 100%), systolic (WMD: −3.73; 95% CI: −5.42, −2.04, p-value: <0.0001; I2: 100%) and diastolic blood pressures (WMD: −0.66; 95% CI: −1.02, −0.29, p-value: 0.0005; I2: 100%), and body weight (WMD: −3.17; 95% CI: −3.84, −2.49, p-value: <0.00001; I2: 100%) compared to once-daily Sitagliptin. However, there was an observed increase in pulse rate (WMD: 3.33; 95% CI: 1.61, 5.06, p-value: <0.00001; I2: 100%) associated with Semaglutide treatment. Regarding secondary outcomes, there was an elevated risk of total adverse events and premature treatment discontinuation with Semaglutide. The risk of serious, severe, moderate, and mild adverse events did not significantly differ between the two treatments. In conclusion, the administration of once-weekly Semaglutide exhibited a substantial reduction in HbA1c, average systolic blood pressure (SBP), mean diastolic blood pressure (DBP), body weight, waist circumference, body mass index (BMI), and a rise in pulse rate, as opposed to the once-daily administration of Sitagliptin.

Heart failure remains a major global health challenge, and despite therapeutic advances, chronic disease self-management continues to show significant gaps at patient, provider, and system levels. This narrative review synthesizes evidence published between 2000 and 2025 across randomized trials, systematic reviews, guideline statements, and qualitative studies to examine the effectiveness of education, lifestyle modification, medication adherence strategies, digital health tools, and psychosocial support in improving self-management outcomes. The literature consistently demonstrates that patient education, structured exercise, and dietary modification enhance clinical and quality-of-life outcomes, while digital health interventions offer promising but variable long-term benefits. Persistent disparities rooted in socioeconomic status, cultural beliefs, health literacy, and access to technology influence the uptake and effectiveness of self-management strategies. Implementation science underscores challenges related to cost, scalability, and sustainability, whereas patient perspectives emphasize the need for simplified treatment regimens, caregiver involvement, and culturally tailored education. Overall, optimizing chronic disease self-management in heart failure requires a holistic, patient-centered approach that integrates evidence-based strategies with real-world implementation considerations and equity-focused adaptations. Future research should prioritize digital health innovations, caregiver-patient dyadic models, and culturally adapted interventions to reduce disparities and improve long-term outcomes.

The Entrapped Temporal Horn (ETH) is characterized by localized enlargement of the temporal horn of the lateral ventricle of the brain. This study aimed to investigate the factors, development, prognosis, and effective treatment. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic search was conducted in major research databases. The inclusion criteria included patients of all ages with TTH diagnosis in cohort studies, case series, and case reports. Our study included 160 patients and 49 studies. The major causes of TTH were neoplastic lesions (42.3%), infections (22.3%), and cystic disease (13.08%). Of these cases, 71 were unrelated to cranial surgery, while 89 were unrelated to prior surgeries. Headache was the most common symptom (41.91%), followed by seizures (13.20%), drowsiness (12.50%) and memory loss (11.00%). Surgery was not required in 17 patients. Fenestration of the trapped temporal horn was performed in 24 patients, while VP/VA shunt surgeries were performed in the majority (57 patients) owing to favorable outcomes, lower revision rates, and extensive experience. However, TTH recurred in six of the 21 patients who underwent endoscopic ventriculocisternostomy. Tumors were the main cause, and isolated headache was the most frequent symptom. Ventriculoperitoneal shunts (VPS) are preferred because of their positive outcomes, lower revision rates, and wider expertise. Tumors near the trigonal area pose a higher risk. Although TTH remains a rare condition, VPS continues to be the most widely preferred procedure among surgeons.

Background: Epilepsy poses significant challenges globally, with varied clinical, social, and economic impacts. Despite advances in treatment, epilepsy-related mortality remains a concern. This study aimed to analyze the demographic and regional distributions of epilepsy-related mortality in the United States (U.S.) from 1999 to 2020, identifying high-risk populations for targeted interventions. Methods: Data on death certificates were obtained from the 1999 to 2020 Centers for Disease Control and Prevention Wide-Ranging Online Study Epidemiologic Research (CDC-WONDER) database. We gathered data on demographics, place of death, and urban/rural classification. Mortality rates per 100,000 people were computed and classified according to state, year, sex, race/ethnicity, and urban/rural status. Trends were examined using Joinpoint regression. Results: A total of 12,573 deaths (age <35), 22,947 (35–64), and 21,782 (65+) were attributed to epilepsy. Mortality rates varied by age group, sex, race/ethnicity, and region. Trends showed significant increases, notably in middle-aged and older adults, with higher rates in males and nonHispani, African American populations. Conclusion: Epilepsy-related mortality exhibits demographic and regional disparities in the U.S. Understanding these patterns can guide targeted interventions to mitigate mortality risk.

Background: Lung cancer, a significant global health challenge, notably the non-small-cell lung cancer (NSCLC) subtype, is a topic of utmost importance. The continuous advancements in NSCLC treatment, especially in the context of anaplastic lymphoma kinase (ALK)-positive NSCLC, are of great interest. A thorough review of alectinib’s comparative efficacy and safety with other treatment modalities is a crucial step, and the role of clinicians and surgeons is integral in optimizing patient care. This review can also inform neoadjuvant therapies and enhance surgical education, facilitating more informed decision-making processes between surgeons and patients. Methods: This comprehensive systematic review results from rigorous screening. Following a rigorous screening process of the PubMed, PubMed Central, and Medline databases by quality assessment and application of inclusion/exclusion criteria filters, 9 relevant articles were identified that directly addressed the research question and provided a holistic understanding of it. The analysis included a total of 1403 patients from 9 different studies. Alectinib was given to 836 patients, while 567 patients received other chemotherapeutic drugs. The primary objective of this study was to evaluate and compare the efficacy of alectinib with other treatment modalities. Results: The analysis revealed that alectinib is promising for ALK-positive NSCLC cases, with significantly better efficacy and a positive impact on limiting central nervous system metastases. Alectinib’s favorable safety profile, with medically manageable adverse events, provides reassurance about its safety compared with other treatment modalities. Conclusions: Alectinib has emerged as a viable, significantly superior treatment option for patients with ALK-positive NSCLC. The superior efficacy and manageable safety profile are significant; it remains a novel therapy with much potential, such as neoadjuvant therapy, which will make significant strides in patient care of ALK-positive NSCLC. Therefore, it is crucial for healthcare professionals, including surgeons, to be well-versed in alectinib and its potential. This knowledge will empower them and instill confidence in their ability to provide the best care for their patients.

Background: Children with congenital heart defects (CHD) commonly experience decreased exercise capacity due to structural heart abnormalities, surgical interventions, and parental-and physician-imposed activity restrictions. This reduced activity can lead to physical deconditioning, impaired quality of life, and increased cardiovascular risk later in life. While exercise-based rehabilitation is highly recommended, significant knowledge gaps persist regarding the long-term impact of structured exercise on diverse CHD subtypes, optimal modalities, and standardized protocols for implementation. This meta-analysis assesses the effect of structured exercise rehabilitation programs on functional and health-related outcomes in children with CHD. Methods: A comprehensive search was done using PubMed/MEDLINE, Embase, and Web of Science until April 23, 2025, for randomized controlled trials (RCTs) and observational studies which compares exercise or cardiac rehabilitation with standard of care or no rehabilitation intervention in pediatric CHD patients. Key outcomes included changes in exercise duration, peak oxygen uptake (peak VO2), peak workload, heart rate, and other cardiopulmonary parameters. Data were analyzed and pooled using random-effects models, with heterogeneity evaluated via I ² statistics. Risk of bias (RoB) was assessed using RoB 2 for RCTs and ROBINS-I for observational studies, and evidence certainty was assessed using the GRADE approach. Results: Ten studies (5 RCTs, 5 observational) comprising of 378 patients were included. Exercise rehabilitation significantly elevated exercise duration [MD = 0.55, 95% CI: (0.01, 1.09); p = 0.04; I ² = 0%]. No significant advancement was seen in peak VO2 [MD = 1.14, 95% CI: (−1.07, 3.34); p = 0.31; I ² = 69%], peak workload, heart rate, or other cardiopulmonary parameters. Heterogeneity was high for several outcomes, especially peak workload and VO2, which was settled in sensitivity analyses for specific subgroups. Evidence certainty was moderate due to heterogeneity and study limitations. Conclusion: Exercise rehabilitation moderately enhances exercise duration in pediatric CHD patients but does not notably enhance most cardiopulmonary parameters. High heterogeneity reflects outcomes variability by CHD subtype and intervention protocol. Standardized, multicenter trials are required to improve and optimise exercise prescriptions and evaluate long-term benefits.