Wah Medical College

Edaravone dexborneol (ED), a combination of edaravone and ( +)-borneol, offers antioxidant and anti-inflammatory neuroprotection in acute ischemic stroke (AIS). Prior meta-analyses were limited by small sample sizes, inclusion of observational studies, and lack of subgroup evaluations. To assess the efficacy and safety of ED in AIS, including patients undergoing endovascular thrombectomy (EVT). We systematically reviewed randomized controlled trials (RCTs) up to February 2026 using PubMed, Embase, Scopus, Cochrane Library, and ClinicalTrials.gov. The primary outcome was excellent functional recovery (mRS 0–1 at 90 days). Secondary outcomes included mRS 0–2 and 3–6, NIHSS changes, mortality, hemorrhagic complications, cognitive and functional measures, and adverse events. Risk of bias and certainty of evidence were evaluated using RoB 2 and GRADE. Eight RCTs (n = 4,197) were included. ED significantly improved mRS 0–1 (RR = 1.14; 95

Menkes disease (MD) is a rare, X-linked recessive disorder of copper metabolism, characterized by progressive neurodegeneration, connective tissue abnormalities, and the distinctive phenotype of pili torti. The disease is caused by pathogenic variants in the ATP7A gene, which encodes a copper-transporting P-type ATPase essential for cellular copper efflux and delivery of copper to secreted cuproenzymes. Severe forms of MD typically present in early infancy and are associated with rapid neurological decline and death within the first 3 years of life. Currently, therapeutic options are limited, and outcomes are highly dependent on the timing of intervention. Copper-histidine represents a biologically rational intervention designed to bypass defective intestinal copper transport and restore systemic copper availability. Experimental and clinical observations suggest that early administration may partially correct copper deficiency, improve biochemical parameters, and, in selected cases, alter neurological outcomes and survival. This letter summarizes the pathophysiological basis of MD, the rationale for copper-histidine therapy, and the existing evidence supporting its potential role as a disease-modifying intervention when initiated early in life.

BackgroundThe optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) remains debated. While DAPT with aspirin and a P2Y12 inhibitor prevents ischemic events, it increases bleeding risk. This meta-analysis evaluates whether early aspirin discontinuation with P2Y12 inhibitor monotherapy offers comparable efficacy and improved safety versus standard long-term DAPT.MethodsThis review, conducted according to PRISMA guidelines, searched PubMed, Cochrane Central and Clinicaltrials.gov up to September 2025 for RCTs comparing short-term DAPT (≤3 months) followed by P2Y12 inhibitor monotherapy with standard-duration DAPT (≥6-12 months). Outcomes included NACE, MACE, all-cause and cardiovascular mortality, myocardial infarction, stroke, stent thrombosis, and BARC 3 or 5 bleeding. Random-effects models were applied to estimate pooled risk ratios and 95% CIs.ResultsTen RCTs involving 35,277 patients were included. Compared with standard DAPT, short-term DAPT followed by P2Y12 inhibitor monotherapy significantly reduced NACE (RR = 0.80, 95% CI 0.71-0.90; p = 0.0002; I2 = 38%), and BARC type 3 or 5 bleeding (RR = 0.48, 95% CI 0.40-0.58; p < 0.001; I2 = 0%), without significant differences in MACE (RR: 1.01 [0.86, 1.19]; p = 0.87; I2 =  41%) or all-cause mortality (RR: 0.96 [0.80, 1.16]; p = 0.69; I2 = 4%).ConclusionEarly transition to P2Y12 inhibitor monotherapy after 1-3 months of DAPT in ACS patients undergoing PCI significantly reduces bleeding without increasing ischemic events. Ticagrelor- or prasugrel-based monotherapy represents a safe and effective alternative to conventional 12-month DAPT.

BACKGROUND:Cutaneous warts are exophytic, benign proliferative lesions caused by human papillomavirus infection of basal keratinocytes. Many intralesional immunomodulatory agents are used by dermatologists these days including Bacillus Calmette-Guerin vaccine, measles-mumps-rubella vaccine, purified protein derivative (PPD), Candida extract, vitamin D3, interferon alpha, zinc sulphate, and hepatitis B vaccine. Intralesional acyclovir is considered a novel intralesional therapy for warts as it directly destroys the viral cells. The objectives of this study are to provide the latest comparison among different intralesional therapies and to specifically compare acyclovir with PPD. METHODS:A comprehensive search strategy was implemented to identify relevant randomized controlled trials, and those with single-arm studies were excluded. After this, 5 studies were finally included in the review. Statistical analysis was done using a frequentist random-effects model. Dichotomous outcomes were analyzed using odds ratio and 95% confidence interval with statistical significance set as P-value < .05. All analyses were performed using R version 4.4.1.The study involved a total of 295 patients with sample size ranging from 30 being the least number of participants and 97 being the highest number of participants in a single study. RESULTS:Use of saline had the highest probability of being the best treatment for achieving a complete response (probability to be the best 96%, P-score = .96) and partial response (98% probability, P-score = .98) when compared with other modalities. The forest plot shows no statistically significant differences among the treatment arms except for saline (P < .01) for no response as compared with PPD. Blister formation was found to be higher on the use of cryotherapy (P = .03) and Mycobacterium w vaccine (P = .02). CONCLUSION:This network's meta-analysis concludes the superiority of intralesional saline in achieving response to treatment when compared with other modalities such as cryotherapy and vaccines. A higher risk of adverse events was noted on use of vaccines. Future research is needed to strengthen these findings.