Mohtarma Benazir Bhutto Shaheed Medical College

Obesity is a global health challenge associated with substantial cardiometabolic morbidity. Cagrilintide, a long-acting amylin analogue, alone or in combination with semaglutide (CagriSema), has emerged as a novel pharmacologic strategy for weight management. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of cagrilintide-based therapies in adults with overweight or obesity. A systematic review and meta-analysis of randomized controlled trials was conducted according to PRISMA 2020 and AMSTAR 2. Eligible studies enrolled adults with overweight or obesity randomized to cagrilintide or CagriSema versus placebo and reported at least one efficacy or safety outcome. The primary outcome was percent change in body weight. Secondary outcomes included absolute weight change, waist circumference, blood pressure, glycated hemoglobin (HbA1c), and safety outcomes. Random-effects meta-analyses were conducted, and risk of bias was assessed using the Cochrane RoB 2 tool. Four trials including 5,023 participants were pooled. Cagrilintide significantly reduced percent body weight versus placebo (mean difference − 6.08

Prediabetes is a high-risk metabolic state associated with progression to type 2 diabetes and increased cardiometabolic burden. Magnesium plays an essential role in insulin signaling and glucose metabolism, with deficiency linked to insulin resistance. However, evidence on oral magnesium supplementation in prediabetes remains limited. To evaluate the impact of oral magnesium supplementation on glycemic regulation, insulin sensitivity, and cardiometabolic outcomes in adults with prediabetes. A systematic review and meta-analysis following PRISMA guidelines included randomized controlled trials comparing oral magnesium supplementation to placebo in prediabetic adults. The primary outcome was fasting plasma glucose (FPG). Secondary outcomes included 2-hour OGTT glucose, HbA1c, fasting insulin, HOMA-IR, blood pressure, BMI, waist circumference, lipid parameters, high-sensitivity C-reactive protein, and serum magnesium. Random-effects models were used with subgroup analyses for magnesium chloride (MgCl₂) and magnesium oxide (MgO). Five trials (n = 384) were included. Magnesium supplementation showed a non-significant reduction in FPG (MD − 4.13 mg/dL). Significant improvements were observed in 2-hour OGTT glucose (MD − 0.99 mmol/L; p < 0.00001), HOMA-IR (MD − 1.10; p = 0.03), triglycerides (MD − 14.57 mg/dL; p = 0.04), HDL-C (MD + 3.87 mg/dL; p = 0.04), and serum magnesium (MD + 0.18 mmol/L; p < 0.00001). Blood pressure, adiposity measures, LDL-C, and hs-CRP showed no significant changes. MgCl₂ demonstrated stronger HDL-C improvement in subgroup analysis. Oral magnesium supplementation modestly improved insulin sensitivity, post-load glucose, and lipid profiles in prediabetic adults with excellent safety and tolerability. Magnesium may serve as a cost-effective adjunct to lifestyle interventions for diabetes prevention, though larger standardized trials are needed.

Left atrial (LA) strain parameters predict mortality in patients with ischaemic/non-ischaemic dilated cardiomyopathy (DCM). Left bundle branch block (LBBB) is a common conduction abnormality in those patients. To date, the impact of LBBB on LA strain parameters assessed by cardiovascular magnetic resonance imaging (cMRI) has not been studied systematically. In this retrospective single-centre study, we included 20 (10 female) controls without DCM or LBBB, 21 (11 female) patients with LBBB without DCM, 20 (7 female) patients with DCM without LBBB, and 20 (9 female) patients with DCM and LBBB. LA volumes and strain were assessed semi-automatically using the cvi42® and Segment® software. LA reservoir/conduit strain and corresponding strain rates were significantly impaired in patients with DCM (p = 0.003/0.022 respectively < 0.001/0.004) in comparison to controls. The presence of LBBB did not lead to significant changes of LA reservoir/conduit strain in controls (p = 0.919/0.391) nor in patients with DCM (p = 0.862/0.999), same was true for LA reservoir/conduit strain rate in patients with DCM (p = 0.999/0.812). LA conduit strain rate of patients with LBBB was significantly impaired in comparison to controls (p = 0.005). Left ventricular dilatation was associated with significantly impaired LA reservoir/conduit strain/strain rates. The presence of LBBB was not associated with additional impairment in LA strain/strain rate parameters in patients with ischaemic/non-ischaemic DCM, supporting the robustness of LA functional parameters in the presence of this common conduction abnormality. However, in patients with LBBB without dilatation LA conduit strain rate was significantly impaired in comparison to controls and further studies are needed to evaluate the impact of this finding.

Endoscopic radial artery harvesting (ERAH) is a minimally invasive alternative to open radial artery harvesting (ORAH) for coronary artery bypass grafting (CABG), though concerns persist regarding graft patency and neurological outcomes. PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched through February 21, 2026. Randomized controlled trials and propensity-matched observational studies were included. Risk of bias was assessed using ROB 2 and the Newcastle-Ottawa Scale; certainty of evidence was evaluated using GRADE. Pooled risk ratios and mean differences with 95

South Asia still bears a disproportionate percentage of the world's tuberculosis (TB) burden despite significant advancements in TB diagnosis, treatment, and case detection. Although treatment outcomes have been enhanced by current control techniques, the incidence decreases necessary to satisfy End TB targets have not been attained. This article looks at undernutrition as a significant but unaddressed factor contributing to the region's ongoing TB spread. Undernutrition appears to play a significant role in the occurrence of tuberculosis, especially in high-burden nations like Bangladesh, India, and Pakistan, where low body weight and food poverty are still common. Undernutrition directly reduces host immunity through changes in cellular immunological responses, adipokine signaling, and micronutrient status, which increases susceptibility to active disease and recurrence beyond its socioeconomic correlations. We examine the implications of the RATIONS experiment, which showed a significant decrease in TB incidence among household contacts receiving nutritional support, and we review current epidemiological and mechanistic findings. These results cast doubt on the conventional understanding of nutrition as only supportive care and instead present it as a possible preventive measure. We contend that incorporating nutritional evaluation and assistance into TB initiatives could hasten South Asia's efforts to eradicate TB. One of the most practical and scalable approaches to lowering the region's persistent TB burden may be to address undernutrition in conjunction with biological therapies.