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Background and aim: Hypertension is an unparalleled risk factor among cardiovascular diseases (CVD) and has been reported to target over 1.4 billion people globally. The Omega-3 polyunsaturated fatty acids (PUFAs), especially the eicosapentaenoic acid (EPA) and the docosahexaenoic acid (DHA) have been put forward as possible non-pharmacological interventions to control blood pressure because they are known to be vasoactive. The purpose of the systematic review was to summarize available evidence on the vasoactive properties of omega-3 PUFAs, and how these properties apply in managing hypertension and reduction of cardiovascular risk.

Methods: Systematic review was done in compliance with the PRISMA guidelines. The search in PubMed, Scopus, and Web of Science was conducted to identify the publications published between 2010 and 2025. Inclusion criteria were randomized controlled trials, cohort studies, and other related meta-analyses on the effect of EPA and/or DHA on blood pressure, and endothelial function, inflammation, lipid metabolism, and cardiovascular outcomes. Synthesis of data was done in the form of systematic narrative without quantitative pooling.

Results: Randomized controlled trial evidence has shown that omega-3 PUFA supplementation is linked with slight systolic and diastolic blood pressure decreases especially in hypertensive or those with high cardiometabolic risk persons. These effects have been shown to mediate via enhancement of endothelial nitric oxide bioavailability, reduction of vascular inflammation and positive remodeling of lipid profiles. Diversity of the outcomes of the studies was noticed and probably it is the difference in dosage, ratios of EPA:DHA, duration of the intervention, and the population specifics at the baseline.

Conclusion: Omega-3 PUFAs have shown promise as supplemental agents in the process of controlling hypertension and prevention of cardiovascular disease by a variety of complementary vasoactive pathways. Nonetheless, the heterogeneity of the studies does not allow conclusive findings on the best dosing strategies. Standardized hypertension-oriented large-scale randomized controlled trials conducted in the future are justified to improve clinical practice.

Introduction: Atherosclerotic cardiovascular diseases remain the leading cause of mortality worldwide, with chronic inflammation driving progression despite traditional lipid-lowering and antiplatelet therapy, leaving substantial residual cardiovascular risk. This study aimed to systematically analyze immunomodulator efficacy and safety in treating atherosclerosis and chronic cardiac diseases, determining therapeutic potential and associated risks.

Methods: A systematic search of Scopus, Web of Science, PubMed, Embase, and the Cochrane Library identified 264 records. After removing 134 duplicates and screening 130 unique records, 74 studies (20 randomized controlled trials, 16 systematic reviews/meta-analyses, 22 prospective cohort studies, 9 retrospective analyses, and 7 experimental studies) were selected that met the inclusion criteria and were included in the qualitative synthesis according to PRISMA 2020.

Results: Three main immunomodulator categories demonstrated cardiovascular efficacy: interleukin-1β inhibitors (canakinumab reduced events by 15%), small anti-inflammatory molecules (colchicine achieved 23-31% risk reduction), and interleukin-6 receptor antagonists (tocilizumab reduced infarct size by 12.4%). However, biological agents showed increased infectious complications, with canakinumab demonstrating statistically significant fatal infection increase. Immunomodulatory therapy represents transformative advancement targeting inflammatory mechanisms beyond lipid reduction. Colchicine emerged as priority drug for clinical implementation given optimal efficacy-cost ratio and favorable safety profile, while biologics face economic barriers exceeding $70,000 annually.

Conclusions: Long-term monitoring of immunosuppressive therapy safety profiles, particularly regarding infectious complications and oncological risks, remains critically important for future large-scale studies requiring decade-long surveillance in diverse populations.

Background: Osteoporosis is a serious public health problem worldwide, especially among the aging population. It is characterized by low bone mineral density (BMD), which leads to an increased risk of fractures. Despite the growing burden, data on the prevalence of osteoporosis and related risk factors in Kazakhstan are limited. The purpose of this study was to assess the state of BMD and identify key risk factors associated with osteoporosis among adults aged 45 years and older in the Abay region of Kazakhstan.

Methods: The cross-sectional study was conducted from July 2023 to March 2024 with 367 women. Data collection included measurement of BMD using dual-energy X-ray absorptiometry (DXA), a standardized questionnaire adapted by the International Osteoporosis Foundation, and laboratory tests (vitamin D, calcium, and alkaline phosphatase levels). The participants were grouped by age and BMD status. Statistical analysis included the chi-square criterion or Fisher's exact criterion for categorical variables and the Mann-Whitney U-test or Kruskal-Wallis criterion for continuous variables. Logistic regression was used to study the relationship between low BMD and demographic factors, lifestyle, and nutrition.

Results: Osteopenia and osteoporosis were detected in 25.3% and 21.0% of participants, respectively, and their prevalence was significantly higher among people aged 56-65 years (p<0.004). Regression analysis showed that low BMD was significantly associated with older age (AOR 1.034; p=0.025), weight (AOR 0.975; p=0.071), lower BMI (AOR 0.989; p=0.764).

Conclusions: This study highlights the high prevalence of low BMD among middle-aged and older adults in the Abay region and underscores key modifiable risk factors, including older age, lower BMI, fracture history, and rheumatoid arthritis. These findings are essential for strengthening clinical diagnostic practices and guiding preventive strategies to reduce osteoporosis-related complications in the Kazakh population.

Background: Type 2 diabetes mellitus is associated with increased cardiovascular risk, with physical inactivity contributing significantly to metabolic dysfunction. This study aimed to investigate the association between physical activity status and cardiometabolic markers in patients with type 2 diabetes mellitus in the United Arab Emirates.

Methods: This cross-sectional study was conducted at Thumbay Labs, UAE, between January and October 2025. A total of 185 participants with type 2 diabetes were stratified into active (at least 150 minutes per week for more than 3 months) (n=99) and sedentary (n=86) groups based on physical activity levels. The active group was further subclassified by exercise type: aerobic (n=70), combined (n=17), and resistance training (n=11). Anthropometric measurements and biochemical parameters including fasting glucose, HbA1c, Fructosamine, fasting insulin, HOMA-IR, and lipid profile were assessed. Mann-Whitney U test, Kruskal-Wallis test, and Spearman's correlation were used for statistical analysis.

Results: The active group demonstrated significantly lower BMI (26.4 vs 28.6 kg/m², p<0.001), fasting glucose (127 vs 149 mg/dl, p<0.001), HbA1c (6.84% vs 8.07%, p<0.001), Fructosamine (303 vs 362 μmol/L, p<0.001), fasting insulin (9.03 vs 10.99 μU/mL, p=0.011), and HOMA-IR (3.0 vs 4.1, p<0.001) compared to the sedentary group. No significant differences were observed in lipid parameters. Among exercise subgroups, resistance training exhibited the most favorable metabolic profile with the lowest HbA1c (6.41%), BMI (23.01 kg/m²), and HOMA-IR (1.9). Correlation analysis revealed significant positive associations between BMI and glycemic markers as well as insulin resistance indices.

Conclusion: Physical activity is associated with significantly better glycemic control, insulin sensitivity, and body composition in patients with type 2 diabetes. Resistance training demonstrated particularly favorable metabolic outcomes; however, limited sample size restrict generalizability. These findings support the integration of regular physical activity into comprehensive diabetes care strategies.

Background and aim: The relationship between calcium, 1,25-dihydroxyvitamin D and serum uric acid levels in thyroid patients involves complex physiological mechanisms. This study aimed to evaluate the association of serum calcium and 25-hydroxyvitamin D with serum uric acid concentrations in individuals with hypothyroidism.

Methodology: A Cross-sectional study conducted in Thumbay Hospital in Ajman UAE on 180 male and female with hypothyroidism and normal individuals, the study subjects divided into five age categories: 21-30, 31-40, 41-50, 51-60 and >60 years. The concentrations of calcium and uric acid in the samples measured by Beckman Coulter and DxI Analyzer, for the thyroid hormones and 25-hydroxyvitamin D (25-OH Vitamin D) tests used DxI Analyzer. The results analyzed by SPSS version 26, the mean and SD obtained, and "t" test independent, one-way ANOVA and Linear regression used for correlation and P value obtained to assess the significance of the results (p value of <0.05 was significant).

Results: Among 180 participants, no significant difference age was seen between hypothyroid patients and controls (p=0.959). Hypothyroid patients showed markedly elevated TSH (p<0.001) and reduced FT4 (p = 0.001), calcium (p < 0.001), and vitamin D (p=0.012) levels, while uric acid increased significantly (p=0.015). Correlation analysis showed a weak negative association between uric acid and TSH (r=-0.082). Uric acid was higher in males (p=0.016), while calcium revealed significant differences across age groups (p=0.011), showed age-related alterations in calcium metabolism.

Conclusion: This study showed significant associations between calcium, 25-hydroxyvitamin D and serum uric acid levels in individuals with hypothyroidism. The negative correlations between uric acid and both calcium and 25-hydroxyvitamin D underscore the complex metabolic interactions characteristic of hypothyroidism.

Widespread antibiotic resistance represents an increasingly significant burden for healthcare systems worldwide. One of the primary contributors to this pressing issue is Klebsiella pneumoniae, a pathogen of major clinical concern. Here we describe five distinct phages that infect antibiotic-resistant K. pneumoniae strains. A total of 100 clinical bacterial strains were systematically assessed for their antibiotic- and phage susceptibility profiles. Notably, 94 of these strains demonstrated high levels of antibiotic resistance across multiple drug classes. The five described phages, which target nearly all studied strains, were comprehensively characterized regarding their virion morphology, their lytic spectra, their intracellular growth parameters, and their potential to trigger development of phage-resistant bacterial forms. Two Siphoviridae phages exhibited remarkably low rates of phage-resistant form development during the study period. While such rates were comparatively higher for the three Myoviruses tested, bacterial forms that acquired resistance to these particular phages subsequently became sensitive to other phages in the collection. In conclusion, the studied phages effectively targeted 93 out of 100 bacterial strains tested. Such broad coverage of diverse clinical strains by these phages strongly underscores their considerable potential in therapeutic settings, particularly for treating multidrug-resistant infections.

Aplastic anemia (AA) and paroxysmal nocturnal hemoglobinuria (PNH) are rare clonal bone marrow disorders. AA is characterized by autoimmune destruction of bone marrow stem cells and pancytopenia. In PNH, acquired genetic mutation and impaired glycoprotein synthesis leads to hemolysis and thrombus formation. The combination of both diseases represents a diagnostic and therapeutic dilemma, since increasing evidence suggests the connection between autoimmunity in AA clonal expansion of PNH. The purpose of this publication is to illustrate the pathogenetic relationship between AA and PNH by review of available literature regarding the mechanisms of immune-mediated destruction of bone marrow and clonal expansion in combination of these hematological pathologies. A clinical case is presented as an example of this phenomenon.

Background: Patients in intensive care units are more susceptible to catheter-associated urinary tract infections (CAUTIs) caused by drug resistant bacteria.

Methods: This retrospective study was done to determine the antibiogram of Urinary Catheter-associated Bacterial Pathogens in the Intensive Care Unit, at King Khalid General Hospital, Saudi Arabia, using full automated MicroScan walkaway 96 plus Beckman Coulter.

Results: Among the identified bacteria, Escherichia coli and Klebsiella pneumoniae were the most prevalent, accounting for 33.7% (29/86) and 23.3% (20/86), respectively. High resistance was documented against ciprofloxacin 75.6% (65/86), cefuroxime 69.8% (60/86), levofloxacin 68.6% (59/86) and amoxicillin/clavulinic acid 65.1% (56/86), but Colistin showed high activity against the isolated bacteria with low resistance rate 5.81 % (5/86). Frequency of multi-drug-resistant bacteria revealed a rate of 65.1% (56/86). Resistance to piperacillin/tazobactam and cefuroxime was significantly associated with length of stay in the intensive care unit, duration of antimicrobial use, and catheterization duration with a p<0.05. Also, the results strongly indicated that resistance to all cephalosporins examined was significantly associated with long stay in ICU.

Conclusion: The identified bacteria among CAUTIs displayed resistance to at least one agent in three or more antimicrobial groups, indicating high resistance of common prescribed antibacterial agent in the study area.

Objective: Hip fractures are serious injuries of elderly associated with 6.2% mortality in first 30-days and 22% mortality in first year. We aim to identify the key risk factors affecting mortality and to produce a score to predict 30 and 365-day mortality risk in patients with hip fracture.

Methods: 689 hip fractures managed at our hospital between 2016 and 2019 were analysed. Mortality at 30 and 365-days was obtained for factors like age, gender, American Society of Anaesthesiologists physical status classification (ASA grade), residence, pre-fracture ambulatory status, Abbreviated Mental Test Score (AMTS), fracture classification, treatment method, time to surgery and anaesthesia used. This data was analysed using univariate and then multivariate regression analysis and a 7-point (5 Factor) score was devised to predict mortality in the first month and first year following hip fracture.

Results: 6.7% and 25.3% of the 689 patients died within 30 and 365-days of suffering a hip fracture. Older age, Male sex, ASA Class IV/V, Non-operative management, and housebound/bedbound status, were all found to be associated with increased mortality at 30 and 365-days post-fracture.

Conclusions: This study identified Age, Sex, ambulation, ASA grade and non-operative management as key factors influencing 30 and 365-day mortality. Patients with the non-operative management and ASA grade 4/5 had the worst mortality risk. We devised a scoring system to predicts the 30-day and 365-day mortality which shows an almost linear relationship between the score and mortality rates.