METHODS: This randomized controlled clinical trial enrolled patients with symptomatic knee chondral lesions smaller than 3 cm2. They were randomized to either the BiCRI (n = 11) or microfracture (n = 10) treatment groups. BiCRI or microfracture surgical procedures were performed on the patients, who were subsequently followed for a period of five years. Primary outcome measures included the International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Visual Analog Scale (VAS) score, Magnetic Resonance Imaging (MRI) measured cartilage thickness, and the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score.
RESULTS: 21 patients were enrolled, who were subsequently followed for a period of five years. Both BiCRI and microfracture treatments demonstrated significant improvements in IKDC, KOOS and VAS scores, with no significant differences between the two. MRI analysis indicated a significant increase in minimum cartilage thickness with BiCRI treatment (median of difference: 1 mm, P = 0.026)), in contrast to the nonsignificant change in the microfracture group (median of difference: 1 mm, P = 0.102). The MOCART scores revealed a significant increase percentage of isointense signal intensity identical to the adjacent articular cartilage (P = 0.03) in the BiCRI group from the 2-year to the 5-year mark, while the scores remained stable in the microfracture group. Moreover, the BiCRI technique displayed superior performance in graft infill at 5 years (P = 0.008), border integration at 5 years (P = 0.04), surface contour at 2 years (P = 0.04) compared to microfracture.
CONCLUSIONS: Both BiCRI and microfracture treatments showed significant effectiveness in improving clinical outcomes in patients with small symptomatic articular cartilage defects of the knee, with the BiCRI group demonstrating a superior radiological outcome than microfracture, over a five-year period. However, the sample size of our study is relatively small to reach a definite conclusion, and further studies with larger sample size and longer follow up are recommended. Trial registration The trial was registered on ClinicalTrials.gov under the identifier NCT01477008.
METHODS: In this cross-sectional study, adults with epilepsy were assessed using the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), Generalised Anxiety Disorder-7 (GAD-7), Epilepsy Self-Stigma Scale (ESSS), Rosenberg Self-Esteem Scale (RSES), Work Extrinsic and Intrinsic Motivation Scale (WEIMS), and Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Participants screening positive for depression and/or severe anxiety symptoms were offered psychiatric referral. Group comparisons and Pearson correlation analyses were performed.
RESULTS: Of 207 patients, 34 (16.4%) screened positive for depression and/or severe anxiety symptoms. Compared with those screened negative, they had poorer seizure control (76.5% vs. 56.1%,p = 0.027), higher self-stigma (22.24 ± 4.09 vs. 18.49 ± 4.08,p
METHOD: Children were supplemented with L-carnosine (10-15 mg/kg) along with standard care therapies for 2 months. Before and after supplementation, scores on the ATEC, CARS2-ST, BEARS sleep screening tool, 6-item Gastrointestinal Severity Index, and Parental Stress Scale were evaluated, and L-carnosine was measured at the end of the trial.
RESULTS: The calibration curve was linear in the range of 100-600 ng/mL (R2 = 0.998). The level of L-carnosine quantified was 33.7 ± 0.2 ng/mL. There was no significant difference found in any of the outcome measures (p > 0.05).
CONCLUSIONS: Despite the fact that L-carnosine is detectable in the blood, it was found to be ineffective in the management of ASD in children.
CLINICAL TRIAL REGISTRATION: The study was registered in the Clinical Trial Registry-India, registration number: CTRI/2019/07/020102.
STUDY DESIGN AND SETTING: We searched bibliographic databases, dissertations, and trial registries from inception to September 10, 2025, for routine-care studies reporting adherence or persistence to secondary prevention medications after ischemic stroke or transient ischemic attack. Cutoff-based proportions were extracted. We used 3-level hierarchical Bayesian models to characterize heterogeneity and multivariable meta-regression to evaluate associations with measurement specifications, follow-up window, medication class, region, and study-level characteristics. From the fitted model, we derived estimates standardized to a prespecified reference specification: pharmacy or administrative data, moderate definition stringency, and a 9- to 15-month follow-up window.
RESULTS: The review included 141 studies; 101 (432 estimates; 976,020 participants) contributed to the quantitative synthesis. Unstandardized pooled estimates suggested that 74.1% of patients were adherent and 76.8% were persistent. Heterogeneity was substantial, with explained variation concentrated more in the measurement-related Assessment and Administration domains than in reported Patient characteristics. Under the common reference specification, the model-based estimates were lower, at 53.7% for adherence and 48.2% for persistence. Standardized persistence declined from 63.3% at 1 to 4 months to 28.1% beyond 30 months. Adjusted estimates were generally lower in Asia; persistence was numerically lowest for anticoagulants, although credible intervals were wide and overlapping.
CONCLUSION: A large proportion of the heterogeneity reported in medication adherence and persistence after ischemic stroke or transient ischemic attack appears to be attributable to methodological non-equivalence in how these outcomes are defined and measured. When evaluated within a standardized framework, suboptimal medication continuation appears more common than conventional pooled estimates indicate. Meaningful surveillance and benchmarking require longitudinal, standardized, and transparent measures of medication continuation rather than reliance on discharge prescribing alone.
METHODS: We conducted a double-blinded, randomised controlled trial involving 651 rural primary schoolchildren (8-12 years) with VAD in Malaysia. The schoolchildren were randomised to receive either RPO-enriched biscuits (experimental group, n = 334) or palm olein-enriched biscuits (control group, n = 317) for 6-month duration.
RESULTS: Significant improvements in retinol and retinol-binding protein 4 levels were observed in both groups after supplementation (P
METHODS: The mathematical model for the adjusted LSB LIV tilt angle (α) measured preoperatively, was expressed as the sum of preoperative LSB LIV tilt angle (x) and LIV displacement angle (y) (α = x + y). This model was validated through inter-rater and intra-rater analysis in Part I of the study. The α angle derived was applied to estimate the intraoperative LIV tilt angle. In part II of the study, clinical and radiological outcomes of 50 Lenke type 1 and 2 (non-AR curves) AIS patients operated using the α angle were reviewed. The difference between the intraoperative LIV tilt angle achieved (β) and the preoperative α angle was determined (∆LIV tilt angle = β-α).
RESULTS: The α angle had excellent inter-rater and intra-rater intraclass correlation coefficients (0.982; 0.907). 42 patients had positive ∆LIV tilt angles whereas 8 patients had negative ∆LIV tilt angles. The overall incidence of distal adding-on (AO) was 10.0% (n = 5/50). Patients with negative ∆LIV tilt angles had a higher incidence of distal AO (n = 4/8, 50.0%) than patients with positive ∆LIV tilt angles (n = 1/42, 2.4%) (p = 0.001).
CONCLUSION: Achieving an intraoperative LIV tilt angle (β) greater than or equal to the preoperative α angle derived (β ≥ α) may help avoid the distal AO phenomenon.