The present meta-analysis was conducted to determine the efficacy of hydroxyurea in patients with transfusion dependent major β-thalassemia. The present meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines. A systematic search was carried out to evaluate the efficacy of hydroxyurea in patients with transfusion-dependent B-thalassaemia using electronic databases, including MEDLINE, Cochrane Central Register of Controlled Trials, and EMBASE. The keywords used to search for relevant studies included "hydroxyurea", "thalassemia", "transfusion-dependent", and "efficacy". Outcomes assessed in the present meta-analysis included transfusion in one year and intervals between transfusions (in days). Other outcomes assessed in the present meta-analysis were fetal hemoglobin (%), hemoglobin (%), and ferritin levels (ng/dl). Total of five studies were included in the analysis enrolling 294 patients with major B-thalassemia. The pooled analysis reported that the mean interval between transfusions was significantly higher in patients receiving hydroxyurea compared to those not receiving hydroxyurea (mean deviation {MD}: 10.07, 95% CI: 2.16, 17.99). Hemoglobin was significantly higher in patients receiving hydroxyurea compared to its counterparts (MD: 1.71, 95% CI: 0.84, 2.57). Patients receiving hydroxyurea had significantly lower ferritin levels compared to those not receiving hydroxyurea ). These findings suggest that hydroxyurea may be a promising and cost-effective alternative to blood transfusions and iron chelation therapies for betathalassemia patients. However, the authors noted that further randomized controlled trials are needed to validate these findings and to determine the optimal dosages and treatment regimens for hydroxyurea in this patient population.

The purpose of this study was to evaluate the effectiveness and safety of bempedoic acid in preventing cardiovascular events among high-risk patients. We conducted a meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent researchers carried out online database searches on Medline, the Cochrane Library of Clinical Trials, and EMBASE until April 15, 2023, using search terms such as "bempedoic acid," "cardiovascular outcomes," and "randomized controlled trial." We also utilized medical subject heading (MeSH) terms and Boolean algebra operators to refine our search. We included articles that compared cardiovascular outcomes between patients receiving bempedoic acid and those receiving a placebo. The primary outcome assessed was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, myocardial infarction, nonfatal stroke, hospitalization for unstable angina, and coronary revascularization. The meta-analysis included three randomized controlled trials with a total of 16,978 patients. The use of bempedoic acid was associated with a significant reduction in major adverse cardiovascular events. Individual analyses reported a low risk of myocardial infarction, coronary revascularization, and hospitalization due to unstable angina in patients receiving bempedoic acid. Furthermore, our meta-analysis found that bempedoic acid is a safe treatment option, as there was no significant difference between the bempedoic acid and placebo groups in terms of adverse events and serious adverse events. Our findings support the use of bempedoic acid as a promising treatment option for high-risk cardiovascular patients. However, since our meta-analysis included a limited number of studies with short follow-up periods, larger studies are necessary to provide more definitive evidence.

The dislocation of the metatarsophalangeal joint of lesser toes is a rare entity. There is a dearth of literature on the same. Also, there is no case described for neglected fifth metatarsophalangeal dislocation in the literature. We present a case of neglected lesser toe dislocation, its natural course, and its outcome after surgical management. Our patient is an eight-year-old child with a neglected dislocation of the fifth metatarsophalangeal joint two years back. The patient did not seek treatment because he has no problem walking. Gradually, there is an abnormal growth of the metatarsal which causes pressure soreness and difficulty walking. The patient was managed surgically with open reduction and K-wire fixation with good long-term results.The dislocation of fifth metatarsophalangeal dislocation is rare and may not cause difficulty in walking due to less weight-bearing. But prompt treatment is necessary, especially in children as the bones have remaining growth potential and may lead to abnormal bone growth.

This meta-analysis has been conducted to compare ustekinumab and adalimumab as induction or maintenance therapy in patients with moderate to severe Crohn's disease (CD). The current meta-analysis was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two investigators independently searched online databases including PubMed, Cumulated Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Library for relevant articles published up to April 2023. The initial search terms were “ustekinumab,” “adalimumab,” and “Crohn’s disease". Three studies (with a total of 612 patients) were included in the present meta-analysis. We did not find any significant difference in clinical remission (OR: 1.31, 95% CI: 0.68-2.52), clinical response (OR: 1.39, 95% CI: 0.39-4.91), endoscopic remission (OR: 1.56, 95% CI: 0.66-3.64), and steroid-free remission (OR: 0.98, 95% CI: 0.67-1.42) between patients who received ustekinumab and patients who received adalimumab. In conclusion, this meta-analysis provides valuable insights into the efficacy and safety of ustekinumab and adalimumab in the treatment of moderate to severe CD. Our findings indicate that both drugs have similar effectiveness in achieving clinical remission, clinical response, radiological remission and steroid-free remission.