Introduction: Angina is one of the ischemic heart diseases (IHD) that contributes to major cardiovascular complications up to death. We aim to assess angina-related mortality among adults aged ≥65 years in the U.S. Methods: Nationwide mortality records were obtained from the CDC-WONDER database from 1999 to 2023 among U.S. adults aged ≥65 with angina. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 population. Joinpoint regression analysis was utilized to evaluate average annual percent changes (AAPCs). Results: From 1999 to 2023, a total of 36,544 deaths occurred among the elderly with angina in the U.S. The overall AAMR per 100,000 decreased from 7.52 in 1999 to 3.73 in 2023 (AAPC of -3.18; 95%CI: -3.79 to -2.75; p < 0.001). The AAMR for men decreased from 8.22 in 1999 to 4.75 in 2023 (AAPC of -2.53%; 95%CI: -3.02 to -2.09), and for women decreased from 6.95 in 1999 to 3.02 in 2023 (AAPC: -3.55%; 95%CI: -4.12 to -3.09). Across racial/ethnic groups, the highest overall rates were observed among NH-White individuals, 3.56. Overall, AAMRs were highest in the West, 4.00. The majority of deaths occurred in medical facilities (40.19%). Between 1999 and 2020, rural areas had a higher overall AAMR of 4.37 compared to urban areas, which had a rate of 3.02. Conclusion: Trends in angina-related mortality declined from 1999 to 2023. Higher mortality rates were observed in men, rural areas, the West region, and among NH White individuals. Our findings indicated that these categories require targeted interventions to reduce mortality.

Background: Aortic Dissection (AD) is a life-threatening condition and one of the major causes of death in the U.S. Despite its clinical significance, trends in AD related mortality remain understudied. We aim to analyze nationwide mortality trends in AD in the U.S. Methods: Data from CDC WONDER (1999–2024) identified U.S mortality rates in adults aged ≥ 25 years with AD (ICD-10: I71.0). Crude mortality rates (CMRs) and age-adjusted mortality rates (AAMRs) per 100,000 were calculated. Trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Results: From 1999 to 2024, a total of 115,449 deaths from AD were recorded. The AAMR increased from 2.1 in 1999 to 2.4 in 2024 (AAPC of 0.46; 95% CI: 0.31 to 0.61; p < 0.001). Men had higher mortality than women (Overall AAMR: 2.62; p < 0.001 vs. 1.45; p < 0.001) (AAPC: 0.22; 95% CI: 0.05 to 0.39 vs. 0.61; 95% CI: 0.42 to 0.83) respectively. Racially, non-Hispanic (NH) Blacks demonstrated the greatest overall AAMR of 3.11. Regionally, AAMRs were highest in the Midwest (2.17) followed by the West (2.14). The urban areas had higher overall AAMRs than the rural areas (1.95, p = 0.27 vs. 1.90, p = 0.074). The majority of deaths occurred in medical facilities (88,976 deaths, 77.06%) and in older adults with CMR (5.8). Conclusion: Mortality trends in AD increased from 1999 to 2024. Higher trends occurred in men, urban areas, Midwest region, NH Black population and medical facilities.

Background and Aim: Carnitine deficiency contributes to various comorbidities in maintenance hemodialysis (MHD) patients. This study aims to assess the impact of levocarnitine supplementation on hematological and serum iron profile parameters, comparing the efficacy of oral versus intravenous (IV) administration in these patients. Materials and Methods: This was a multicenter, randomized controlled trial was conducted on patients undergoing MHD at the hemodialysis unit of our study center in Karachi, Pakistan. Eligible patients were randomly assigned to either the oral or IV groups. Patients in the oral group received levocarnitine tablets of 500 mg three times daily, while patients in the IV group received an IV bolus of levocarnitine at a dose of 20 mg/kg body weight, infused over 2–3 min directly into the IV line after each hemodialysis session. Both groups received intervention for a total of 24 weeks, and the final analysis included 49 patients from the oral group and 34 patients from the IV group. Results: The study involved 83 patients with a mean age of 44.72 ± 8.77 years, with a balanced distribution of 41 males and 42 females. The IV group showed a significant improvement in hemoglobin levels (mean increase: 0.57 g/dL, p < 0.001) and hematocrit (mean increase: 3.83%, p = 0.001), while the oral group showed only slight, nonsignificant changes in hemoglobin (mean increase: 0.07 g/dL, p = 0.22). Serum iron profile parameters improved significantly in both groups, though the IV group demonstrated greater enhancements across all parameters. Hematological parameter analysis revealed significant post‐intervention differences in hemoglobin, MCH, and MCHC, favoring the IV group. Conclusion: levocarnitine improves the hematological and iron profile in MHD patients. However, IV levocarnitine significantly more effective than oral administration. It notably improves hemoglobin, and enhances iron profile parameters. Trial Registration: ClinicalTrials.gov : NCT05817799.

To assess the effects of excessive screen time on the health of medical and dental students due to online teaching during the Covid-19 pandemic. It was a descriptive cross-sectional study, conducted in Bahria University of Health Sciences from June 2022 to September 2022 after getting ethical approval. A total of 200 students who attended online teaching modules for at least one year through online teaching Apps, were included. A structured questionnaire was distributed using google forms. The results revealed that factors including strain on the eyes, restlessness, declined academic performance and exercise during lockdown, along with feeling connected as a group had a significant association with increased screen time. Excessive screen time has various adverse effects on the physical and mental health of medical and dental students. For improving students’ physical and mental health during online teaching we need to change teaching strategies and support the introduction of flipped classroom.