Dietary constituents are shown to play an important role in the development of diabetes. Studies have shown that the fruits of Emblica officinalis Gaertn or Phyllanthus emblica Linn, colloquially known as Indian gooseberry or amla and/or some of its important constituents (including gallic acid, gallotanin, ellagic acid and corilagin), possess anti-diabetic effects through their antioxidant and free radical scavenging properties. Amla has also been reported to prevent/reduce hyperglycemia, cardiac complications, diabetic nephropathy, neuropathy, cataractogenesis and protein wasting. However, clinical trial data with human subjects are limited and preliminary. For the first time this review summarizes the anti-diabetic affects of amla and also addresses the mechanisms mediating these properties.

To summarize the association between vegetarian versus non-vegetarian diet on mortality due to ischemic heart disease, cerebrovascular disease, or all-cause mortality. We searched PubMed, Cochrane databases, and ClinicalTrials.Gov from the inception of the databases to October 2019 with no language restriction. Randomized controlled trials or prospective observational studies comparing the association between vegetarian versus non-vegetarian diets among adults and reporting major adverse cardiovascular outcomes were selected. We used Paule-Mandel estimator for tau2 with Hartung–Knapp adjustment for random effects model to estimate risk ratio [RR] with 95% confidence interval [CI].The primary outcome of interest was all-cause mortality. The secondary outcome was ischemic heart disease mortality. Eight observational studies (n = 131,869) were included in the analysis. Over a weighted mean follow-up of 10.68 years, very low certainty of evidence concluded that a vegetarian diet compared with a non-vegetarian diet was associated with similar risk of all-cause (RR: 0.84, 95% CI: 0.65–1.07, I²: 97%) or cerebrovascular mortality (RR: 0.84, 95% CI: 0.63–1.14, I²: 90%), but was associated with a reduced risk of ischemic heart disease mortality (RR: 0.70, 95% CI: 0.55–0.89, I²: 82%). A vegetarian diet, compared with a non-vegetarian diet, was associated with a reduced risk of ischemic heart disease mortality, whereas it had no effect on all-cause and cerebrovascular mortality. However, the results are to be considered with caution considering the low certainty of evidence. Despite recent studies supporting no restriction on animal protein intake gaining wide media attention and public traction, consideration for vegetarianism amongst those with risk factors for coronary artery disease should be contemplated.

The impact of coronavirus disease, 2019 (COVID-19), has been profound. Though COVID-19 primarily affects the respiratory system, it has also been associated with a wide range of cardiovascular (CV) manifestations portending extremely poor prognosis. The principal hypothesis for CV involvement is through direct myocardial infection and systemic inflammation. We conducted a systematic review of the current literature to provide a foundation for understanding the CV manifestations and outcomes of COVID-19. PubMed and EMBASE databases were electronically searched from the inception of the databases through 27 April 2020. A second literature review was conducted to include major trials and guidelines that were published after the initial search but before submission. The inclusion criteria for studies to be eligible were case reports, case series, and observation studies reporting CV outcomes among patients with COVID-19 infection. This review of the current COVID-19 disease and CV outcomes literature revealed a myriad of CV manifestations with potential avenues for treatment and prevention. Future studies are required to understand on a more mechanistic level the effect of COVID-19 on the myocardium and thus provide avenues to improve mortality and morbidity.

Background: While the impacts of social and environmental exposure on cardiovascular risks are often reported individually, the combined effect is poorly understood. Methods and Results: Using the 2022 Environmental Justice Index, socio‐environmental justice index and environmental burden module ranks of census tracts were divided into quartiles (quartile 1, the least vulnerable census tracts; quartile 4, the most vulnerable census tracts). Age‐adjusted rate ratios (RRs) of coronary artery disease, strokes, and various health measures reported in the Prevention Population‐Level Analysis and Community Estimates data were compared between quartiles using multivariable Poisson regression. The quartile 4 Environmental Justice Index was associated with a higher rate of coronary artery disease (RR, 1.684 [95% CI, 1.660–1.708]) and stroke (RR, 2.112 [95% CI, 2.078–2.147]) compared with the quartile 1 Environmental Justice Index. Similarly, coronary artery disease 1.057 [95% CI,1.043‐1.0716] and stroke (RR, 1.118 [95% CI, 1.102–1.135]) were significantly higher in the quartile 4 than in the quartile 1 environmental burden module. Similar results were observed for chronic kidney disease, hypertension, diabetes, obesity, high cholesterol, lack of health insurance, sleep 14 days. Conclusions: The prevalence of CVD and its risk factors is highly associated with increased social and environmental adversities, and environmental exposure plays an important role independent of social factors.

Social determinants of health (SDoH) significantly impacts health outcomes and disparities. While the Centers for Medicare and Medicaid Services has mandated hospitals to collect standardized SDoH data, existing tools lack key elements. This systematic review identified 78 studies and 20 screening tools addressing various SDoH domains. However, most tools were missing several key domains and lacked standardization. We propose a comprehensive tool meeting essential criteria: validated questions, brevity, actionability, cultural appropriateness, workflow integration, and community linkage. Our tool addresses gaps in available tools and incorporates standardized and validated questions to enable patient-centered screening for diverse social and environmental determinants of health. It uniquely includes detailed race/ethnicity data collection, housing characteristics, physical activity assessment, access to healthy food measures, and environmental exposure evaluation. The tool aims to provide actionable data for immediate interventions while informing broader population health strategies and policy initiatives. By offering a holistic assessment of SDoH across multiple domains, our tool enables standardized data collection, risk stratification, and focused initiatives to address health inequities at both individual and population levels. Further research is needed to develop evidence-based pathways for integrating SDoH data into real-world patient care workflows, improve risk prediction algorithms, address health-related social needs, and reduce disparities.

The role of systemic corticosteroid as a therapeutic agent for patients with COVID-19 pneumonia is controversial. The purpose of this study was to evaluate the effect of corticosteroids in non-intensive care unit (ICU) patients with COVID-19 pneumonia complicated by acute hypoxemic respiratory failure (AHRF). This was a single-center retrospective cohort study, from 16^th March, 2020 to 30^th April, 2020; final follow-up on 10^th May, 2020. 265 patients consecutively admitted to the non-ICU wards with laboratory-confirmed COVID-19 pneumonia were screened for inclusion. 205 patients who developed AHRF (SpO₂/FiO₂ ≤ 440 or PaO₂/FiO₂ ≤ 300) were only included in the final study. Direct admission to the Intensive care unit (ICU), patients developing composite primary outcome within 24 hours of admission, and patients who never became hypoxic during their stay in the hospital were excluded. Patients were divided into two cohorts based on corticosteroid. The primary outcome was a composite of ICU transfer, intubation, or in-hospital mortality. Secondary outcomes were ICU transfer, intubation, in-hospital mortality, discharge, length of stay, and daily trend of SpO₂/FiO₂ (SF) ratio from the index date. Cox-proportional hazard regression was implemented to analyze the time to event outcomes. Among 205 patients, 60 (29.27%) were treated with corticosteroid. The mean age was ~57 years, and ~75% were men. Thirteen patients (22.41%) developed a primary composite outcome in the corticosteroid cohort vs. 54 (37.5%) patients in the non-corticosteroid cohort (P = 0.039). The adjusted hazard ratio (HR) for the development of the composite primary outcome was 0.15 (95% CI, 0.07–0.33; P <0.001). The adjusted hazard ratio for ICU transfer was 0.16 (95% CI, 0.07 to 0.34; P < 0.001), intubation was 0.31 (95% CI, 0.14 to 0.70; P– 0.005), death was 0.53 (95% CI, 0.22 to 1.31; P– 0.172), composite of death or intubation was 0.31 (95% CI, 0.15 to 0.66; P– 0.002) and discharge was 3.65 (95% CI, 2.20 to 6.06; P<0.001). The corticosteroid cohort had increasing SpO₂/FiO₂ over time compared to the non-corticosteroid cohort who experience decreasing SpO₂/FiO₂ over time. Among non-ICU patients hospitalized with COVID-19 pneumonia complicated by AHRF, treatment with corticosteroid was associated with a significantly lower risk of the primary composite outcome of ICU transfer, intubation, or in-hospital death, composite of intubation or death and individual components of the primary outcome.