Phoenix dactylifera L. seeds (PDS) are traditionally used to treat gastric ailments. This study evaluated the gastroprotective effects of PDS (Sewy variety) extracts polar (70
Abstract Background Stent retriever (SR), contact aspiration (CA), and combined treatment are vital mechanical thrombectomy (MT) techniques for acute ischemic stroke (AIS) patients. Aim This study aimed to compare and rank these three MT strategies for AIS caused by large vessel occlusion using a Frequentist network meta-analysis (NMA). Methods A systematic review and Frequentist NMA following PRISMA guidelines were conducted. Relevant randomized controlled trials (RCTs) and observational studies were identified from electronic databases from inception to March 2025. Random effect models were used to estimate odds ratios (ORs) and mean differences with 95% confidence interval (CI). Results A total of 55 studies was included in the current NMA study. CA showed significantly higher modified thrombolysis in cerebral infarction (mTICI) 2c/3 scores at the end of the procedure (OR = 1.99, 95% CI [1.04, 3.81]), higher favorable modified Rankin Scale (mRS 0–2) at 3 months (OR = 1.28, 95% CI [1.03, 1.58]), and fewer adverse events (OR = 0.70, 95% CI [0.50, 0.98]) compared to combined approach. No significant differences among groups regarding National Institute of Health Stroke Scale, symptomatic intracerebral hemorrhage, and all-cause mortality. Conclusions The CA group demonstrated superior outcomes in mTICI 2c/3 scores, mRS 0–2 and adverse event rates. However, no significant differences were found between CA, SR, or combined approaches for other outcomes. These findings can guide clinicians in selecting appropriate thrombectomy strategies for AIS patients.
To assess the effectiveness and safety of intravenous efgartigimod in patients with myasthenia gravis (MG) and to compare treatment responses between anti-acetylcholine receptor antibody (AChR-Ab)-positive and -negative subtypes. A comprehensive search was conducted in the PubMed, Scopus, Web of Science, and Cochrane CENTRAL databases up to 15 October 2025. Clinical trials and cohort studies evaluating the effectiveness and safety of efgartigimod in patients with MG were included. A random-effects model was used to pool mean differences (MDs) for continuous outcomes and proportions for categorical outcomes, with corresponding 95
Migraine is a common, disabling neurological disorder affecting over one billion people worldwide, characterized by recurrent unilateral, pulsating headaches lasting 4–72 h. Caffeine, a widely consumed psychoactive alkaloid found in coffee, tea, and other beverages, is frequently implicated as both a trigger and a treatment for attacks. We aim to comprehensively evaluate the association between caffeine exposure and migraine by integrating observational evidence with Mendelian Randomization (MR) studies. A comprehensive search was conducted through PubMed, Scopus, Web of Science, and the Cochrane Library till August 2025. We included primary studies assessing the impact of caffeine exposure on migraine risk. 19 studies (nine cross-sectional, seven MR, and three cohort) were included in our review. MR studies included over one million participants, while cross-sectional studies involved over 43,000 participants, and the cohort studies included 421 migraine cases. MR reflected lifelong genetic liability (population-level, chronic exposure) and associated with a reduced risk with overall odds ratio (OR) ranging from 0.53 to 0.71, with stronger associations reported in migraine with aura (ORs as low as 0.37–0.39). Observational studies captured short-term, acute effects and showed that abrupt withdrawal or acute excessive intake (≥ 3 drinks/day) can trigger attacks in some people (P = 0.024). While habitual moderate use was generally not linked to higher average migraine burden. Lifelong genetic liability to higher coffee/caffeine intake is associated with a reduced risk of migraine especially for migraines with aura. However, acute excessive intake or sudden changes in caffeine habits can trigger attacks in some people. More future large, well prospective cohorts and carefully designed MR studies are needed to confirm our results and clarify the precise impact of caffeine on migraine risk.
Abstract Background Many studies discovered that psychiatric comorbidities such as depression, anxiety and cognitive impairment (CI) are common in MS (multiple sclerosis) and have a deleterious effect on MS outcome, in comparison to general population. Aim of our study is to determine the frequency of anxiety, depression and cognitive impairment (CI) in RRMS (relapsing –remitting multiple sclerosis) patients in Upper Egypt as a part of Middle East and North Africa (MENA) region and predictors of these comorbidities. Results A cross sectional study was conducted on 100 RRMS patients. Demographic and clinical data were collected prospectively. Hamilton Anxiety scale (HAM-A), Hamilton Depression scale (HAM-D) and Brief International Cognitive Assessment for MS (BICAMS) scales were applied to determine frequency of anxiety, depression and CI, respectively. Binary logistic regression was applied to determine the predictors of these comorbidities. Roc curve analysis was performed to determine the cutoff values. Sixty-two patients (62%) were female with a mean age 33.52 ± 9.75 and range age 18–58 years. Frequency of anxiety, depression and CI were 19%, 44%, 66%, respectively. EDSS (Expanded Disability Status Scale) was the only predictor of anxiety and depression with cutoff value 3.5 on EDSS scale. EDSS and number of MS attacks were the predictors of CI, with cutoff value 3 on EDSS scale and three attacks, respectively. Conclusion Psychiatric and cognitive comorbidities with MS are more prevalent when EDSS ≥ 3.5 and ≥ three MS attacks, respectively. Combined screening with psychosocial assessments may improve the accuracy of detection. Future studies should validate these cutoff values in diverse MENA cohorts and assess whether early psychiatric intervention alters disability trajectories and improve the quality of life in these chronic patients.
