Chronic obstructive pulmonary disease (COPD) significantly impacts global health due to persistent airflow limitation and inflammation. Despite standard therapies, symptoms persist. Ensifentrine, targeting both bronchoconstriction and inflammation as a dual phosphodiesterase 3 and 4 inhibitor, offers a promising therapeutic advancement for COPD management. This meta-analysis evaluates the safety and efficacy of ensifentrine in improving lung function, dyspnea, and quality of life in COPD patients. We searched PubMed, Embase, and Web of Science through August 2024 for randomized controlled trials evaluating ensifentrine in COPD patients over a minimum of four weeks. Data extraction and screening utilized Knowledge software, and meta-analyses were performed using R v4.4 with a random-effects model. From 206 studies identified, four met our inclusion criteria. Ensifentrine improved FEV1 significantly at a dose of 3 mg (LS mean difference: 40.90 mL; 95 % CI: 19.65-62.15). It also improved dyspnea as measured by the Transition Dyspnea Index (TDI) (LS mean difference: 0.91; 95 % CI: 0.61-1.21) and quality of life according to the St. George's Respiratory Questionnaire-C (SGRQ-C) scores (LS mean difference: -1.92; 95 % CI: -3.28 to -0.55). Safety profiles were comparable between the ensifentrine and placebo groups, with no significant increase in treatment-emergent adverse events (TEAEs) (RR: 1.02; 95 % CI: 0.94-1.10). Ensifentrine significantly enhances lung function, reduces dyspnea, and improves quality of life in COPD patients, especially at a 3 mg dose. These benefits, coupled with a stable safety profile, support its use as an adjunctive therapy in COPD management.

Obstructive Sleep Apnea (OSA) is a significant health concern characterized by recurrent upper airway blockages during sleep, causing various health issues. There's growing evidence of a link between air pollution and OSA, though research results have been inconsistent. This systematic review and meta-analysis aims to consolidate and examine data on the relationship between air pollution and OSA's risk and severity. A literature search across PubMed, EMBASE, and Web of Science was conducted until January 10, 2024. The selection criteria targeted studies involving OSA participants or those at risk, with quantitative air pollution assessments. The Nested Knowledge software facilitated screening and data extraction, while the Newcastle-Ottawa Scale was used for quality assessment. Meta-analyses, utilizing random-effects models, computed pooled odds ratios (ORs) for the OSA risk associated with PM2.5 and NO2 exposure, analyzed using R software version 4.3. The systematic review included twelve studies, four of which were analyzed in the meta-analysis. The meta-analysis revealed diverse results on the association of PM2.5 and NO2 with OSA risk. PM2.5 exposure showed a pooled OR of 0.987 (95% CI: 0.836 to 1.138), indicating no substantial overall impact on OSA risk. Conversely, NO2 exposure was linked to a pooled OR of 1.095 (95% CI: 0.920 to 1.270), a non-significant increase in risk. Many studies found a relationship between air pollution exposure and elevated Apnea-Hypopnea Index (AHI) levels, indicating a relationship between air pollution and OSA severity. The findings suggest air pollutants, especially NO2, might play a role in worsening OSA risk and severity, but the evidence isn't definitive. This highlights the variability of different pollutants' effects and the necessity for more research. Understanding these links is vital for shaping public health policies and clinical approaches to address OSA amidst high air pollution.

Tuberculosis (TB) remains a significant global health concern. Although the Gulf Cooperation Council (GCC) countries have relatively lower TB incidence rates, they face unique challenges, particularly with a large migrant workforce from TB-endemic regions. Understanding trends in TB burden in these countries is essential for guiding public health strategies. We analyzed TB trends in GCC countries from 1990 to 2021 using data from the Global Burden of Disease (GBD) study. Joinpoint regression assessed temporal trends, and ARIMA modeling was used to forecast future TB incidence, mortality, and DALYs. The metrics considered age-standardized mortality rates (ASMR), DALYs rate (ASDR), and incidence rates (ASIR). Data visualizations, including choropleth maps and trend graphs, were also created using R and MS Excel. From 1990-2021, TB incidence, mortality, and DALYs showed a steady decline across the GCC countries. The age-standardized mortality rate (ASMR) decreased by an average annual percentage change (AAPC) of -5.39 %, while the age-standardized DALYs rate (ASDR) decreased at a slightly higher rate of -5.50 %. Forecasting through 2031 predicts a continued decline: the age-standardized incidence rate (ASIR) will fall from 28.4 per 100,000 in 2022-5.4 by 2031, and mortality is expected to decline from 3.87 per 100,000 to 2.39 over the same period. DALYs are projected to decrease from 103.5 in 2022-62 by 2031. Countries like Qatar and Saudi Arabia showed significant improvements, with Qatar achieving a 95.56 % reduction in mortality. However, the UAE with a 61.18 % reduction in incidence and DALYs, showed a 26.71 % increase in mortality. TB control in GCC countries shows positive trends, reflecting successful public health interventions. However, challenges remain, particularly the high prevalence of TB among migrant populations. Continued efforts and tailored interventions are essential to sustain progress toward TB elimination.

Stroke remains a leading cause of morbidity and mortality worldwide, contributing significantly to public health burdens. Cardiovascular and metabolic risk factors such as diabetes, hypertension, obesity, and dyslipidaemia are strongly associated with an increased risk of stroke. The cardio-metabolic index (CMI), which integrates these factors into a single measure, has emerged as a potential predictor of stroke. This systematic review and meta-analysis intended to examine the link between CMI and risk of stroke, offering an in-depth evaluation of its predictive value METHODS: A systematic search was conducted in PubMed, Embase, and Web of Science until 10 December 2024. The inclusion criteria focused on observational studies (cohort, cross-sectional, and case-control) that reported original data on the association of CMI and stroke risk. Data extraction was standardized, and quality was assessed using the Newcastle-Ottawa Scale. Meta-analysis was performed using a random effects model in R software version 4.4 RESULTS: From 545 articles initially retrieved, with 5 studies met inclusion criteria, encompassing over 100,000 participants. Meta-analysis showed a significant association between elevated CMI and stroke risk with a pooled RR of 1.66 (95 % CI: 1.25 to 2.20). A subgroup analysis of cohort studies yielded a pooled HR of 1.63 (95 % CI: 1.21 to 2.21). There was no significant heterogeneity across studies (I² = 0 %). Our findings demonstrated a strong association between elevated CMI and an increased risk of stroke. CMI, by integrating multiple cardiovascular and metabolic factors, serves as a comprehensive predictor of stroke risk. Incorporating CMI into routine health screenings could enhance early identification and prevention efforts, ultimately aiding in the reduction of stroke incidence.

Atrial fibrillation (AF) is the most prevalent form of sustained cardiac arrhythmia, with vascular endothelial growth factor (VEGF) increasingly recognized for its potential role in the pathogenesis of AF through mechanisms involving atrial remodeling, inflammation, and fibrosis. This systematic review aims to synthesize available evidence on the association between VEGF and AF, exploring the implications of VEGF as a biomarker and therapeutic target. We conducted a comprehensive search across PubMed, Embase, and Web of Science until November 10 2024, selecting studies based on pre-defined criteria that involve adults with AF and measurements of VEGF levels. The selected studies included observational and experimental designs, excluding non-English and methodologically insufficient publications. Narrative synthesis was used for summarising the results. Eight studies met the inclusion criteria. The studies show a general trend of elevated VEGF levels in AF patients compared to controls, with significant heterogeneity in findings across studies. VEGF subtypes such as VEGF-A and VEGF-D demonstrated stronger associations with AF risk compared to VEGF-C. These variations point to the complex role of VEGF in AF, influencing factors like angiogenesis, endothelial function, and inflammatory responses. VEGF is potentially a significant contributor to AF pathophysiology, with its levels reflecting disease activity. The variability observed across studies suggests a need for standardized measurement approaches and further investigation into VEGF subtypes. Future research should focus on longitudinal studies to better understand the causal relationships and the potential of VEGF as a therapeutic target and biomarker in AF management. Not applicable.