Ali Hasan

Despite advances in human immunodeficiency virus (HIV) treatment, disparities in HIV-related mortality persist across demographic groups in the United States. The COVID-19 pandemic disrupted healthcare systems and may have influenced established mortality trends. This study evaluates HIV-related mortality in the U.S. from 1999 to 2023, with emphasis on changes following the onset of COVID-19. Data were obtained from the CDC WONDER database, identifying HIV-related deaths (ICD-10: B20–B24) among adults aged 25 to 85+. Age-adjusted mortality rates (AAMR) per 100 000 were calculated. Trends were analyzed using Joinpoint regression to estimate annual percent changes (APCs) and average annual percent changes (AAPCs). From 1999 to 2023, there were 271 932 HIV-related deaths in the U.S. The overall AAMR declined by an AAPC of −4.34%, with a slower post-COVID decline of −4.19% ( P < 0.05) from 2020 to 2023. Gender-stratified analysis showed greater post-COVID declines in women (APC: − .58%) than in men (APC: −3.90%). Older adults (85+) experienced a post-COVID increase in mortality (APC: +12.37%). Urban centers showed an APC increase (+2.33%), while rural areas continued to decline. Racial disparities narrowed modestly. Black and Hispanic populations saw sharper post-COVID declines (APCs: −6.21% and −6.26%, respectively) compared to White populations (−1.33%). The Southern U.S. remained the highest-burdened region across both timeframes. Observed mortality trends were temporally associated with demographic characteristics and urbanization patterns during the COVID-19 period. While HIV mortality continues to decline, the COVID-19 pandemic has disrupted progress, especially among elderly and urban populations. Persistent disparities demand targeted, equitable public health interventions.

Background: The optimal strategy for blood pressure management following mechanical thrombectomy for acute ischemic stroke due to large vessel occlusion remains a subject of ongoing research. Methods: We comprehensively searched PubMed, Embase, and the Cochrane Library from inception to June 20, 2025. Randomized controlled trials comparing intensive versus standard blood pressure control following mechanical thrombectomy for acute ischemic stroke were included. The primary outcomes were excellent functional outcome (modified Rankin Scale score 0–1 at 90 days) and good functional outcome (modified Rankin Scale score 0–2 at 90 days). Pooled odds ratios (ORs) with 95% CIs were calculated using a random‐effects model. Results: A total of 6 randomized controlled trials were included. The pooled estimates indicated that intensive blood pressure control was associated with lower rates of good functional outcome (OR, 0.70 [95% CI, 0.54–0.91]), an increased likelihood of all‐cause mortality (OR, 1.21 [95% CI, 1.05–1.40]), and a higher incidence of hypotensive episodes (OR, 2.49 [95% CI, 1.56–3.96]). No significant differences were found in excellent functional outcome (OR, 0.91 [95% CI, 0.67–1.23]) or symptomatic intracranial hemorrhage (OR, 1.19 [95% CI, 0.89–1.61]). The overall strength of evidence was high for functional outcomes and hypotensive episodes, whereas it was moderate for all‐cause mortality and symptomatic intracranial hemorrhage. Conclusions: This meta‐analysis demonstrates that intensive blood pressure control following mechanical thrombectomy does not improve functional outcomes and may be associated with harm, including reduced rates of good functional outcome, increased all‐cause mortality, and a higher incidence of hypotensive episodes.

Background: Psoriasis is a chronic inflammatory skin disorder affecting 2% to 3% of the global population and is increasingly linked to systemic complications, including cardiovascular events like stroke. This meta-analysis aimed to clarify the relationship between psoriasis and stroke risk. Methods: We systematically searched PubMed, Google Scholar, and Cochrane databases for observational studies published through December 2024 that evaluated stroke risk in psoriasis patients. Studies were selected according to PRISMA guidelines, and data were extracted on patient characteristics, study design, and adjusted risk estimates. Results: A total of 18 studies involving 705,602 psoriasis patients and 17,971,569 controls were included. Using a random-effects model, the overall pooled hazard ratio (HR) for stroke in psoriasis patients was 1.24 (95% confidence intervals [CI]: 1.15–1.35, P <.05). When stratified by disease severity, mild psoriasis had an HR of 1.09 (95% CI: 1.02–1.16), whereas severe psoriasis showed a higher risk with an HR of 1.36 (95% CI: 1.21–1.53). Regional analyses indicated increased stroke risk in Asia (HR = 1.08), Europe (HR = 1.26), and North America (HR = 1.49). Age subgroup analysis further supported a consistent association across different age groups. Conclusion: Our meta-analysis indicates that psoriasis is associated with a significantly increased risk of stroke, particularly among patients with severe disease and older age. These findings highlights the importance of comprehensive cardiovascular risk management in individuals with psoriasis. Further research needed to explore the underlying mechanism in this high-risk population.

Background: Noncommunicable diseases (NCDs), once primarily considered a concern of older adults, have shown shifting mortality patterns in recent decades. This study assesses national trends in NCD‐specific mortality among U.S. adults aged ≥ 25 years between 1999 and 2023, with particular attention to divergent trends observed between younger adults (25–44 years) and older age groups (≥ 45 years). Methods: This observational analysis employed de‐identified CDC WONDER database mortality data, examining death certificates with ICD‐10‐coded classifications for large NCD categories. Age‐adjusted mortality rates (AAMRs) and annual percent changes (APCs) were estimated by demographics such as gender, race/ethnicity, region, urbanization, and age group. Joinpoint regression was used to determine statistically significant temporal trends, and results were standardized to the 2000 U.S. population. Results: A total of 58,554,916 NCD‐related deaths were reported in 1999–2023. AAMRs decreased from 1197.02 in 1999 to 1002.4 in 2023, with a general AAPC of −0.80%. Age‐specific analyses revealed divergent patterns. Adults aged 25–34 years demonstrated a sustained increase in mortality (AAPC: +2.21% [95% CI, 1.50%–2.93%]). Adults aged 35–44 years also experienced an overall increase (AAPC: +0.68% [95% CI, −0.26%–1.64%]), whereas mortality declined across all age groups ≥ 45 years over the study period. Conclusion: While total NCD mortality declined among adults aged ≥ 45 years, a concerning rise was observed among adults aged 25–44 years. These divergent age‐specific trends highlight the need for targeted public health strategies addressing early adulthood risk accumulation and healthcare access.

Background and objective Targeting the interleukin-23 (IL-23) pathway is an emerging therapeutic strategy for moderate to severe ulcerative colitis (UC). This systematic review and meta-analysis evaluated the efficacy and safety of IL-23 inhibitors for induction and maintenance therapy in UC. Methods A systematic search of PubMed, Cochrane, and Google Scholar was conducted up to May 2025 to identify randomized controlled trials (RCTs) of IL-23 inhibitors (mirikizumab, risankizumab, guselkumab) in UC. Data were analyzed using Review Manager (RevMan 5.4) with a random-effects model. Results Seven RCTs (four induction, three maintenance) including 4203 patients were analyzed. IL-23 inhibitors significantly increased clinical remission during both induction (RR 1.52) and maintenance (RR 1.62). Rates of histo-endoscopic healing were also higher with IL-23 blockade in both induction (RR 2.53) and maintenance (RR 1.81). Importantly, IL-23 inhibitors were associated with a reduced risk of serious adverse events during induction (RR 0.39), with no significant difference observed during maintenance (RR 0.68). Other outcomes, including clinical response and corticosteroid-free remission, also consistently favored IL-23 blockade. Conclusion IL-23 inhibitors provide significant improvements in clinical remission and mucosal healing, with a favorable safety profile, particularly during induction therapy in moderate to severe UC.

Introduction: Cardiac amyloidosis (CA) is a restrictive cardiomyopathy characterized by amylin deposits in the heart muscle. While the prevalence of atrial arrhythmias in CA is high, the data regarding the outcomes of catheter ablation in these patients are limited. This study aimed to elucidate the safety and efficacy of catheter ablation for treating atrial arrhythmias in patients with CA.Methods: We conducted a comprehensive literature search across PubMed, Embase and Cochrane from inception till January 2024 for randomized control trials and observational studies reporting catheter ablation (cryoablation or radiofrequency ablation) for the treatment of atrial arrhythmias (AAs) (atrial flutter, atrial fibrillation, atrial tachycardia) in patients with cardiac amyloidosis. The primary outcome of interest was pooled recurrence rate. The secondary outcomes were re-ablation rate and all-cause mortality. All data were analyzed using the Hedges-Olkin random-effects model and presented as percentage proportions.Results: A total of 9 cohort studies (n = 283) were included. The median age ranged from 67.6 years to 76.5 years, with a median follow-up of 13 to 60 months. The pooled incidence of recurrence rate was 45% (95% CI = 23.4% to 66.5%). The pooled proportion of re-ablation rate was 20% (95% CI = 3.3% to 36.7%) and of all-cause mortality was 30.7% (95% CI = 15.5% to 46%).Conclusions: The high rates of recurrence, need for re-ablation, and associated mortality highlight the need for better patient selection. Prospective and randomized controlled data are needed to further study the outcomes of catheter ablation in these patients.

Background: Hypertension remains a major contributor to global cardiovascular morbidity and mortality. Aldosterone, a key hormone in blood pressure regulation, plays a significant role in hypertension pathophysiology. This has led to growing interest in aldosterone synthase inhibitors (ASIs) as a potential treatment. This meta‐analysis aims to evaluate the efficacy and safety of ASIs in managing hypertension. Methods: A systematic search of PubMed, Google Scholar and Cochrane Central was conducted up to 13 July 2025, to identify randomised controlled trials (RCTs) evaluating ASIs in hypertensive adults. Data were analysed using RevMan version 5.4, employing random‐effects models with significance set at p < 0.05. Results: A total of 8 RCTs were included, with a total of 2003 participants in the ASI group and 650 participants in the placebo group. ASIs significantly reduced systolic blood pressure (SBP) compared to placebo (MD: −6.01 mmHg; 95% confidence interval [CI]: −9.31 to −2.71; I ² = 85%; p = 0.0004); diastolic blood pressure (DBP) was found to be comparable between the two groups (MD: −2.20 mmHg; 95% CI: −4.46 to 0.06; I ² = 69%; p = 0.06). There was a significant reduction in serum aldosterone levels favouring ASI use (MD: −1.46; 95% CI: −2.76 to −0.16; I ² = 99%; p < 0.00001). The risk of serious (RD: 0.00; 95% CI: −0.01 to 0.02; I ² = 30%; p = 0.75) and non‐serious adverse events (RD: 0.05; 95% CI: −0.02 to 0.12; I ² = 64%; p = 0.20) did not differ significantly between ASI and placebo groups. However, ASI use was associated with a significantly higher risk of hyperkalemia (RD: 0.04; 95% CI: 0.02 to 0.06; I ² = 70%; p = 0.002). Conclusion: ASIs effectively lower SBP and serum aldosterone in adults with hypertension. They appear safe overall but may increase the risk of hyperkalemia.

Background: The safety and efficacy of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) in acute ischemic stroke remain uncertain. Methods: We comprehensively searched PubMed, Embase, and the Cochrane Library from inception to May 30, 2025. Randomized controlled trials comparing IVT before MT versus MT alone in acute ischemic stroke were included. The primary outcome was excellent functional outcome (modified Rankin Scale score 0–1 at 90 days) and good functional outcome (modified Rankin Scale score 0–2). Secondary outcomes included successful recanalization, all-cause death, symptomatic, and any intracranial hemorrhage. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Results: Seven randomized controlled trials encompassing 2884 patients (MT + IVT: 1448; MT–IVT: 1436) met the inclusion criteria. The pooled analysis demonstrated comparable results for excellent functional outcome (31.3% vs. 29.5%; OR, 1.08 [95% CI, 0.92–1.28]), good functional outcome (51.2% vs. 48.0%; OR, 1.13 [95% CI, 0.96–1.34]) between the MT + IVT and MT alone groups, respectively. Rates of successful recanalization (OR, 1.24 [95% CI, 0.95–1.62]), all-cause death (OR, 0.98 [95% CI, 0.80–1.19]), symptomatic intracranial hemorrhage (OR, 1.21 [95% CI, 0.87–1.68]), and any intracranial hemorrhage (OR, 1.17 [95% CI, 0.97–1.41]) were also comparable between the two groups. Trial sequential analysis demonstrated insufficient evidence to confirm a 20% relative benefit of bridging therapy compared to MT alone. Conclusion: In this study-level meta-analysis, IVT followed by endovascular treatment showed comparable safety and efficacy to endovascular treatment alone, with similar outcomes in functional recovery, successful recanalization, all-cause mortality, symptomatic intracranial hemorrhage, and any intracranial hemorrhage.