Background Secretory carcinoma (SC) is a well‐established salivary gland malignancy that has earned its popularity for its unique clinicopathological behavior. Although it is an indolent malignancy, few of them have been reported with high grade transformation making it mandatory to differentiate it from its prime histological mimicker, acinic cell carcinoma (AciCC). Recently, many studies have been directed toward validating the sensitivity and specificity of pan‐TRK IHC for confirming ETV6::NTRK3 gene fusion in SCs involving salivary gland. Aim The aim of the present systematic review was to establish the diagnostic utility of pan‐TRK immunostaining in histological differentiation of SC from AciCC. Material and methods An electronic search was carried out using MEDLINE by PubMed, Scopus, Google scholar, Trip, Cochrane library and EMBASE databases. Articles in which SC assessed with pan‐TRK immunohistochemical expressions were included for systematic review and their staining pattern (cytoplasmic, nuclear and/or combined), sensitivity, specificity, positive as well as negative predictive were gathered. Risk of bias was analyzed for each study using QUADAS‐2 tool. Results Thirteen eligible articles were included for the quantitative analysis, which revealed positive immunostaining of pan‐TRK by nearly all the ETV6::NTRK3 fusion prevalent SCs alongside negative expression in almost all the cases of AciCC with 100% of sensitivity as well as specificity. Conclusion The evidence from the included studies supports that pan‐TRK immunostaining could be used as a reliable preliminary screening tool for discerning SC from AciCC. PROSPERO No: CRD42022308913.

Funding Acknowledgements Type of funding sources: None. Background Sodium glucose co-transporter 2 (SGLT2) inhibitors have been recommended in the practice guidelines for the treatment of patients with heart failure with reduced ejection fraction, however their effects among patients with preserved ejection fraction has been debatable. Objective We aim to evaluate the SGLT2 inhibitor effect among patients with HFpEF including DELIVER and EMPEROR-Preserved trials. Methods We performed a systematic literature search using the PubMed, Embase, Scopus, and Cochrane libraries for relevant articles from inception until August 30th, 2022. Statistical analysis was performed by calculating hazard ratio (HR) using the random effect model with 95% confidence interval (CI) and probability value (P). Statistical significance was met if 95% CI doesn’t cross numeric "1" and p <0.05. Results A total of 4 studies with 30418 patients (15390 SGLT2 inhibitor vs 15028 placebo) were included in our analysis. The average age and percentage of females were comparable between groups, with a mean age of 68.3 years and 39.7% of females in the SGLT2 inhibitor group, whereas 67.7 years and 40.5% of females in the placebo group. Most common comorbidities among the SGLT2 inhibitor group included diabetes mellitus (78.8% vs 78.4%). Mean follow-up duration was 2.92 years. SGLT2 inhibitors reduced composite cardiovascular death or first hospitalisation for heart failure (HR, 0.82(95%CI: 0.75-0.89), P<0.001, heart failure hospitalisation (HR, 0.74(95%CI: 0.67-0.82), P<0.001) compared with placebo. However, all-cause mortality (HR, 0.97(95%CI: 0.89-1.06), P=0.54), and cardiovascular mortality (HR, 0.96(95%CI: 0.82-1.13), P=0.66) were comparable between the both groups on SGLT2 inhibitor and placebo. Conclusion SGLT2 inhibitors reduced the risk of cardiovascular death and hospitalisation for heart failure. The results suggest patients with HFpEF have almost similar outcomes compared with previous studies on HFrEF. Hence SGLT2 inhibitors can be used among patients with reduced and preserved ejection fraction.

Funding Acknowledgements Type of funding sources: None. Background The association between non-alcoholic fatty liver disease (NAFLD) with cardiovascular and cerebrovascular outcomes, as well as their clinical impact, has yet to be established in the literature. Objective We aim to evaluate the association between NAFLD patients and the risk of atrial fibrillation (AF), heart failure (HF),stroke, cardiovascular mortality (CVM), and peripheral revascularization. Method We performed a systematic literature search using the PubMed, Embase, Scopus, and Cochrane libraries for relevant articles from inception until July 20th, 2022. Odds ratios (OR) were pooled using a random-effect model, and a p-value of <0.05 was considered statistically significant. Results A total of 10 studies with 17886340 patients (2887214 NAFLD vs 14999126 non-NAFLD) were included in our analysis. The average age and percentage of males were comparable between groups, with a mean age of 55 years and 72.5% of males in the NAFLD group, whereas 52 years and 47.4% of males in the non-NAFLD group. The most common comorbidities among the NAFLD group included: hypertension (38% vs 24%), diabetes mellitus (14% vs 8%). The mean follow-up duration was 6.26 years. The likelihood of atrial fibrillation [OR, 1.42(95%CI: 1.18-1.70), P<0.001], heart failure [OR, 1.48(95%CI: 1.27-1.73), P<0.001], stroke (OR, 1.26(95%CI: 1.17-1.36), P<0.001], and peripheral revascularization (OR, 3.95(95%CI: 1.60-9.73), P=0.003] was significantly higher in NAFLD patients when compared with non-NAFLD patients. In contrast, cardiovascular mortality was comparable between both the groups of patients [OR, 3.11(95%CI: 0.32-30.03), P=0.33] respectively. Conclusion Patients with NAFLD demonstrated increased incidence of cardiovascular and/or cerebrovascular outcomes; heart failure, stroke, and arrhythmia. Patients with associated comorbidities were at higher risk of cardiovascular disease, implying a greater need for screening and adoption of cardio-protective measures amongst NAFLD patients.

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Rhabdomyosarcoma with TFCP2 rearrangement is a newly introduced spindle cell neoplasm showing predilection for craniofacial bones exhibiting highly aggressive nature and poor prognosis. Therefore, an attempt was made to delineate the entity for improved understanding and treatment outcomes through comprehensive analysis of the clinicopathological and molecular characteristics. An electronic search was carried out using MEDLINE by PubMed, Scopus, Google scholar, Cochrane library, and EMBASE databases. Original articles and case reports involving intraosseous rhabdomyosarcoma arising in head and neck region with TFCP2 fusion were included. Data were compiled and risk of bias was analyzed using JBI tool. Thirteen eligible articles were included for the quantitative analysis, which revealed 33 cases with TFCP2 fusion. Majority of the affected individuals were females (58%) with mandible being the common site. Most of the patients died within few months after diagnosis demonstrating a low mean survival rate (30 months). Odds ratio, overall survival and disease-free survival were calculated and analyzed statistically concluding that intraosseous rhabdomyosarcomas harboring TFCP2 fusion are found to be novel and dreadful neoplasms. The predilection for young age with poor prognosis exhibited by these lesions demand early diagnosis and specific treatment planning to curtail mortality.