Risk of cardiovascular outcomes with bempedoic acid in high-risk statin intolerant patients: a systematic review and meta analysis.

Aim: Statin intolerance and myopathy is a major issue with prolonged use of statins myopathy. Bempedoic acid can be a good alternative for those intolerant to statins. This systematic review aims to observe incidence of major adverse cardiovascular events (MACE) and other adverse events, in high-risk statin intolerant patients receiving bempedoic acid.Methods: Literature search was conducted via Google Scholar, Science Direct and PubMed, after which screening, selection and data extraction of articles was done. Meta-analysis was performed on RevMan 5.4. Subgroup analysis was also conducted and heterogeneity was evaluated. Risk of bias was performed using ROB2 assessment scale. (CRD42024536827).Results: Only six randomized controlled trials were used in final analysis consisting of 17,844 patients. Treatment with bempedoic acid was associated with a reduced risk of MACE compared with placebo (RR 0.86; 95% CI [0.79, 0.94] p = 0.0005), with myocardial infarction significantly reduced. Incidence of adverse effects was increased with bempedoic acid (RR: 1.02; 95% [1.00, 1.03] p = 0.01) but no significant difference was observed. Incidence of myalgia was reduced in bempedoic group as well.Conclusion: Bempedoic acid is a safe and effective alternative to statins in high-risk patients intolerant to statins, decreasing the risk of MACE.

What is this summary about? Low density lipoprotein (LDL-C) also known as 'bad cholesterol', is the culprit behind many heart diseases. Statins are first-line treatment to reduce LDL-C. Despite being extremely effective, some people are intolerant and experience side effects such as sleep disorders, intestinal diseases and most commonly, effects on muscles ranging from muscle pain to breakdown of muscles leading to kidney damage. Bempedoic acid is a once-a-day medication, increasing LDL-C clearance from blood, reducing the risk of heart attack and diabetes and is effective for patients intolerant to statins. This article provides insights into incidences of major heart-related, and other adverse events in patients receiving bempedoic acid.What were the results? Muscle pain and major heart-related events were reduced (especially heart attack) in patients receiving bempedoic acid as compared with those receiving placebos. Muscle weakness and other adverse events were seen in patients receiving bempedoic acid, but serious adverse events were not significantly different from those receiving placebos.What do the results mean? Bempedoic acid is a safe and effective treatment that can be given to patients who cannot tolerate statins or develop side effects to it, as it reduces the risk of heart-related adverse events.

Evaluation of NAVA-PAP in premature neonates with apnea of prematurity: minimal backup ventilation and clinically significant events.

Background: Neonates with apnea of prematurity (AOP) clinically deteriorate because continuous positive airway pressure (CPAP) provides inadequate support during apnea. Neurally adjusted ventilatory assist (NAVA) provides proportional ventilator support from the electrical activity of the diaphragm. When the NAVA level is 0 cmH2O/mcV (NAVA-PAP), patients receive CPAP when breathing and backup ventilation when apneic. This study evaluates NAVA-PAP and time spent in backup ventilation. Methods: This was a prospective, two-center, observational study of preterm neonates on NAVA-PAP for AOP. Ventilator data were downloaded after 24 h. The number of clinically significant events (CSEs) was collected. A paired t-test was used to perform statistical analysis. Results: The study was conducted on 28 patients with a gestational age of 25 ± 1.8 weeks and a study age of 28 ± 23 days. The number of CSEs was 4 ± 4.39/24 h. The patients were on NAVA-PAP for approximately 90%/min, switched to backup mode 2.5 ± 1.1 times/min, and spent 10.6 ± 7.2% in backup. Conclusion: Preterm neonates on NAVA-PAP had few CSEs with minimal time in backup ventilation.

Consumers' purchase decision in the context of western imported food products: Empirical evidence from Pakistan.

It is essential to identify consumer purchase behavior to establish and implement effective marketing strategies by Western food chains in Pakistan. By identifying motives, firms can offer extra-value products to their current and potential clients. Thus, this study seeks to understand what drives Pakistani consumers to buy imported Western food. This quantitative study uses A standardized structured questionnaire to collect data from 375 Karachi residents. The researchers use a convenient sampling strategy and analyze the data using PLS-SEM modeling through Smart-PLS 4.0. The findings of this research demonstrate that subjective norms, religiosity, product attributes, brand trust, customer satisfaction, and lifestyle significantly and positively influence consumer purchase intention. The findings also show that consumer purchase intention, lifestyle, and subjective norms significantly and positively correlate with purchase behavior. Finally, the study concludes that purchase intention significantly and positively mediates between exogenous and endogenous variables (purchase behavior). This research has significant theoretical and managerial implications. Local and international marketing professionals who wish to investigate the expanding consumer market in Pakistan can find the study's findings extremely useful. In addition, the outcomes of this research enrich the existing body of consumer behavior literature, which is helpful for future researchers.

(Acetato-κO)(acetato-κO,O')bis-(1,3-diazinane-2-thione-κS)cadmium(II).

In the title complex, [Cd(CH(3)COO)(2)(C(4)H(8)N(2)S)(2)], the Cd(II) cation is coordinated by three acetate O atoms and two S atoms of Diaz [Diaz = 1,3-diazinane-2-thione = 3,4,5,6-tetra-hydro-pyrimidine-2(1H)-thione]. The Cd(II) coordination is augmented by one considerably longer Cd-O bond of 2.782 (3) Što a carboxyl-ate O atom. The resulting coordination polyhedron around the Cd(II) cations can be described as a highly distorted octa-hedron. The Diaz ligand and the acetate anions are linked by N-H⋯O hydrogen-bonding inter-actions.