Kota Medan

This trial is for adults who have had an acute ischemic stroke caused by a blood clot blocking a brain vessel. It focuses on people whose stroke occurred or was discovered more than 4.5 hours ago, including those who woke up with stroke symptoms. The study aims to find out if the medicine tenecteplase helps recovery when given after this 4.5-hour window, compared to standard medical care. Tenecteplase is already used within 4.5 hours after stroke onset, but this study tests its effect when given later. Participants are randomly assigned to one of two groups one receives a single injection of tenecteplase into a vein, and the other receives the usual standard treatment. Both groups have an equal chance of receiving either treatment. The study lasts about three months, starting with approximately one week of hospital stay. During the study, participants have seven clinical examinations or visits, with the final two visits conducted remotely from home to allow for easier participation. Throughout the study, doctors regularly assess participants recovery using a scale that measures disability and dependence in daily activities. They also monitor overall health and record any side effects. The main outcome measured is the level of recovery 90 days after treatment, comparing the two groups. This includes neurological improvement, bleeding events, and survival over the study period.

Tuberculosis affecting the central nervous system CNS-TB remains a serious condition with high death rates and severe neurological problems despite current standard treatments. Researchers are studying whether adding doxycycline, a drug that may reduce harmful enzymes contributing to tissue damage, to standard anti-tuberculous therapy and corticosteroids can improve survival and reduce brain injury in CNS-TB patients. This is a Phase 2 randomized controlled trial focusing on outcomes at 8 weeks. Participants receive either doxycycline twice daily or a placebo, along with daily standard anti-tuberculosis drugs and corticosteroids tapered over 8 weeks. The anti-tuberculosis regimen includes multiple agents like rifampicin, isoniazid, ethambutol, and possibly others, adjusted for kidney function if needed. After 8 weeks, doxycycline or placebo is stopped, and patients continue their usual TB treatment under their physicians guidance. During the study, participants will have brain imaging and lumbar puncture at baseline and 8 weeks, with lab tests to measure specific enzymes and gene activity related to inflammation. Safety is monitored through liver tests and adverse event tracking. The main outcome is death or severe neurological disability measured by a standardized scale at 8 weeks. The study duration per participant is 8 weeks with close monitoring throughout.

Patients with schizophrenia who are on long-term antipsychotic therapy often face chronic low-grade inflammation and metabolic issues, leading to worse physical health and higher cardiovascular risks. This trial is designed to study how Structured Medical Nutrition Therapy MNT affects the Systemic Inflammation Index SII, an inflammatory marker based on blood cell counts, in this population. The goal is to see if individualized nutrition support can better reduce inflammation compared to standard nutritional care. The trial compares two groups one receiving standard hospital diet according to institutional protocols and another receiving a modified diet tailored to each patients nutritional needs to improve dietary quality. The intervention period lasts 4 to 6 weeks, during which dietary changes and nutrition education are provided with regular monitoring. This approach aims to integrate nutritional therapy into the overall management of schizophrenia to address inflammation and metabolic health. Participants will be hospitalized adults aged 18 to 60 with schizophrenia, stable on antipsychotic medication for at least 4 weeks. Throughout the study, their Systemic Inflammation Index is measured at baseline and at the end of the intervention to evaluate changes. Other evaluations include monitoring dietary intake, health status, and laboratory tests. Safety and adherence are tracked during the hospital stay, and the total participation time covers the intervention period plus follow-up until the study ends.