Khalid Ahmad Qidwai

Lung cancer is the leading cause of cancer-related mortality in the United States. Lung cancer screening (LCS) uptake remains low nationally, with dispropo

Brain tumors, both malignant and non-malignant, represent a persistent global health challenge. Differences in diagnosis, treatment, and outcomes are influenced by race, ethnicity, socioeconomic status (SES), and geographical location. Brain and central nervous system (CNS) tumors rank 19th in global cancer incidence and 12th in cancer-related mortality. U.S. Incidence is higher in females and individuals with greater socioeconomic means, contrasting with global patterns where males are more affected. Glioblastoma has a wide variation in incidence and survival by state, with rural regions showing higher mortality despite lower incidence, often due to reduced access to specialized care. Non-Hispanic Black children with CNS tumors experience higher mortality than their White peers, even after adjusting for SES. Outcomes are generally poorer in low- and middle-income countries, where healthcare infrastructure remains limited. Biological and genetic differences may also influence treatment response and tumor behavior across population groups. This review outlines key variations in brain tumor care, with a key focus on the United States, and emphasizes the need for patient-centered strategies to ensure timely diagnosis, consistent treatment, and improved outcomes.

Background/Objectives: Brain metastases (BM) are common in small cell lung cancer (SCLC) and portend poor outcomes. Contemporary determinants of survival in the modern treatment era remain incompletely defined. We evaluated factors associated with overall survival (OS) among patients with SCLC and BM using a recent, nationally representative dataset. Methods: We identified adults diagnosed with SCLC and brain metastases between 2018 and 2020 in the National Cancer Database (NCDB). Demographic, clinical, treatment, and survival data were extracted for analysis. Unadjusted OS was estimated using Kaplan–Meier methods. Multivariable Cox proportional hazards models identified factors associated with mortality, with proportional hazards (PH) assessed using scaled Schoenfeld residuals. Complementary Accelerated Failure Time (AFT) modeling was performed to confirm robustness. Results: Of 62,671 SCLC cases, 11,074 (17.7%) had BM, including 32.6% with brain-only disease. Median overall survival (mOS) was 6.6 months (95% CI, 6.47–6.87); patients with brain-only disease had an mOS of 8.8 months (8.38–9.26), compared with 5.95 months (5.75–6.18) for those with concurrent extracranial metastases. In multivariable analysis, age ≥ 65 years (HR 1.13, p < 0.001) was associated with higher mortality, whereas female sex (HR 0.87, p < 0.001), Black (HR 0.88, p = 0.001), Asian (HR 0.80, p = 0.022), and Hispanic (HR 0.87, p = 0.008) patients had lower hazards. Worse outcomes were associated with public or no insurance, lower income, non-academic facilities, and extracranial metastases; educational attainment was not significant. Proportional hazards assumptions were largely met with minor deviations, and AFT modeling confirmed consistent results. Treatment modality remained independently associated with survival in both models. Conclusions: In this contemporary national cohort, survival among patients with SCLC and brain metastases was influenced by multiple clinical, sociodemographic, and treatment factors, including age, sex, insurance status, facility type, and extent of metastatic disease. Treatment modality remained an independent predictor of survival. These results provide updated real-world benchmarks and highlight the need for prospective studies to define optimal management strategies in this high-risk population.

This systematic review and meta-analysis evaluated the efficacy and safety of Imeglimin in managing type-2 diabetes mellitus (T2DM). A systematic search of PubMed, Embase, and Cochrane Central was conducted up to March 26, 2025. Randomized controlled trials (RCTs) in T2DM subjects with at least two treatment arms were included in the qualitative analysis. Imeglimin, as monotherapy or in combination with other anti-diabetic agents, was compared to placebo or other treatments. Data were independently extracted by three authors, with discrepancies resolved by two other authors. Outcomes were pooled using random-effects or fixed-effects models based on heterogeneity. Thirteen RCTs and nine observational studies were included in the quantitative and qualitative analyses, respectively. Imeglimin significantly reduced glycated haemoglobin/haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG), with greater efficacy at higher doses and in combination therapy. It improved β-cell function (HOMA-β) without significant effects on insulin resistance (HOMA-IR). No major adverse events were reported. However, the studies were limited to Japanese (Asian) and Caucasian populations, affecting generalizability. Significant heterogeneity amongst studies for some outcomes further indicates the need for comprehensive clinical trials with greater sample sizes and uniform dose ranges and follow-up periods. Imeglimin is an effective and safe option for T2DM, particularly for improving glycemic control and β-cell function. Further studies in diverse populations are needed to confirm these findings. Trial Registration: PROSPERO (CRD42024564036).

Hypertension is the biggest and most prevalent risk factor for cardiovascular diseases. Depression is the most common psychiatric illness worldwide. Many studies have linked the development of new depression to the use of antihypertensive drugs. This meta-analysis was done to ascertain the relationship. Using standard reporting techniques a literature search was undertaken in Pubmed from inception till 10 May 2024. The risk bias assessment was done using the ROBINS-I tool. Data for the odds ratio were combined using Revman 5.4 using a random or fixed effects model. Our analysis found a significant association between beta blockers and calcium channel blockers use and the risk of developing new depression. Results for other classes of antihypertensives were not significant. The findings highlight the importance of taking into account the potential psychiatric side effects of antihypertensive drugs in people with hypertension. Physicians should stay vigilant and screen their patients for these conditions regularly.

Retatrutide is a novel triple hormone receptor agonist which has shown great promise in tackling obesity in preliminary trials. We did this systematic review and meta-analysis to pool the results of all available trials and ascertain its safety and efficacy in the treatment of obesity. A literature search was conducted in PubMed, Cochrane Central and Embase using appropriate search terms and randomized control trials (RCTs) were identified which reported the safety and efficacy of retatrutide. Data was pooled using mean differences for continuous variables and risk ratios for the safety profile in RStudio. After the initial search four RCTs were included in the analysis which compared the safety and efficacy of retatrutide versus placebo. Retatrutide showed a dose dependent relationship with the 12 mg dose causing the maximum reductions across all the outcomes considered. The safety profile of retatrutide was found to be comparable to the control group. In conclusion our analysis found retatrutide to be clinically and statistically better than placebo in the various studies outcomes. We eagerly await the conduction of further trials for more robust and substantial results. www.crd.york.ac.uk/prospero identifier is CRD42024566153.

Background: Hypertension is a leading cause of premature mortality and morbidity. Recent guidelines advocate for out-of-office blood pressure monitoring, including ambulatory and home BP monitoring, to better identify hypertension phenotypes like masked hypertension, white coat hypertension, and sustained hypertension. However, clinical inertia persists due to a lack of robust evidence on the effectiveness of screening these phenotypes and their association with cardiovascular and all-cause mortality. This systematic review and meta-analysis aims to evaluate the relationship between various hypertension phenotypes and future cardiovascular events and all-cause mortality to support the broader implementation of out-of-office BP monitoring. Main body: Following PRISMA, Cochrane, and MOOSE guidelines, we conducted a comprehensive search in Pubmed, OvidSP, and Cochrane Central databases up to October 17, 2023. Eligible studies reported associations between hypertension phenotypes and cardiovascular or all-cause mortality, with normotension as the reference group. Hazard ratios with 95% confidence intervals (CIs) were pooled using random-effects models. Eight studies with 15,327 participants were included. Masked hypertension was associated with increased cardiovascular mortality (pooled HR 2.05, 95% CI 1.69–2.48). Sustained hypertension also showed a higher risk (pooled HR 2.42, 95% CI 2.12–2.76). WCH did not significantly increase cardiovascular mortality risk (pooled HR 1.18, 95% CI 0.98–1.42). For all-cause mortality, neither masked hypertension (pooled HR 2.10, 95% CI 0.91–4.88) nor white coat hypertension (pooled HR 1.96, 95% CI 0.71–5.42) showed significant increases. Conclusion: Masked hypertension and sustained hypertension are linked to higher cardiovascular mortality compared to normotension, highlighting the importance of out-of-office BP monitoring to identify and manage high-risk phenotypes effectively. Further high-quality studies are needed to generalize these findings and support policy changes.

Remogliflozin is a novel SGLT-2 inhibitor used for the management of Type 2 Diabetes Mellitus (T2DM). Since its introduction medical literature is scarce on its quantitative effects. We performed this meta-analysis to ascertain its safety and efficacy in the treatment of T2DM. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook, six studies involving 1,605 participants were analyzed. Our analysis found comparable reductions in glycated hemoglobin (HbA1c) by remogliflozin in comparison to the comparators. It was found to be inferior to other anti-diabetic drugs in decreasing fasting plasma glucose and post-prandial glucose. A significant reduction was obtained in body weight and a significant increase was also found in high-density lipoprotein cholesterol (HDL-C) levels. Remogliflozin did not significantly increase the risk for total adverse events, severe adverse events, or hypoglycemic episodes. The results were accompanied by high heterogeneity, which necessitates conducting high-quality randomized control trials for more robust evidence synthesis. Overall Remogliflozin can be considered a safe drug with beneficial effects on body weight and HDL-C levels for the treatment of people with T2DM.