Kota Medan

Researchers are evaluating whether the medicine tenecteplase helps adults recover from an acute ischemic stroke when given more than 4.5 hours after they were last seen well. This study focuses on people who had a stroke caused by a clot blocking blood flow in the brain and who have imaging showing brain tissue that can still be saved. Participants should not be planning to receive a procedure to remove the clot and must have a pre-stroke disability level of 0 or 1 on the modified Rankin Scale. Participants are randomly placed into two groups. One group receives a single injection of tenecteplase into a vein, while the other group receives standard medical care. The study includes adults aged 18 and over who had an acute stroke or woke up with stroke symptoms more than 4.5 hours ago. Imaging with MRI or CT is used to confirm eligibility. The study lasts about three months, starting with a hospital stay of about one week. During the study, participants have seven clinical examinations or visits to monitor their recovery and health. The last two visits may be done from home to allow remote assessments. Researchers use the modified Rankin Scale to measure disability or dependence in daily activities at 90 days after treatment. They also monitor for any side effects or health changes to compare the effects of tenecteplase against standard care.

Researchers are evaluating whether adding doxycycline to the standard treatment for central nervous system tuberculosis (CNS-TB) can improve outcomes such as reducing death or severe neurological problems. CNS-TB remains a serious condition with high mortality rates of 30-50% despite current treatments that include anti-tuberculous drugs and corticosteroids. The study focuses on the role of enzymes called matrix metalloproteinases (MMPs) that contribute to tissue damage in CNS-TB and tests if doxycycline, known to inhibit MMPs, can reduce this damage and improve patient recovery. This is a Phase 2 randomized controlled trial comparing doxycycline plus standard care against placebo plus standard care over 8 weeks. Participants will receive standard anti-tuberculous therapy and corticosteroids, with the doxycycline group receiving adjunctive doxycycline, and the control group receiving a placebo. Corticosteroids will be given starting at 0.4 mg/kg/day of dexamethasone or equivalent, tapered over 8 weeks. The interventions are administered during an 8-week treatment period, and the safety and effects of doxycycline alongside standard therapy are closely monitored. The study also measures biological markers in blood and cerebrospinal fluid to assess inflammation and MMP activity. During the 8-week study, participants will undergo lumbar puncture and brain imaging at baseline. Researchers will monitor mortality and neurological function using the modified Rankin scale to assess disability. Additional tests include measuring MMPs and inflammatory gene activity in blood and cerebrospinal fluid. Safety assessments include liver function tests and monitoring for serious side effects. The primary outcome is death or severe neurological disability at 8 weeks. Findings from this trial aim to inform larger studies and improve treatment guidelines for CNS-TB.