We have reviewed the article “Investigation of Vitamin D Levels in Men with Suspected Infertility” by Fırat Aşır

Chemotherapy-induced cardiotoxicity, particularly from anthracyclines, limits treatment in oncology patients. Carvedilol, a third-generation β-blocker

Background: Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by isolated thrombocytopenia and increased bleeding risk. Although first-line therapies such as corticosteroids and intravenous immunoglobulin provide initial benefit, many patients relapse or develop refractory disease. Romiplostim, a thrombopoietin receptor agonist, has emerged as an effective second-line therapy; however, evidence comparing its efficacy and safety with placebo across both pediatric and adult populations remains limited. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines (PROSPERO: CRD420261357179). PubMed, Scopus, Cochrane Library, and Google Scholar were searched up to March 2026. RCTs comparing romiplostim with placebo in ITP patients were included. A random-effects model was used to calculate mean differences (MD) and risk ratios (RR) with 95% confidence intervals (CI). Risk of bias was assessed using the Cochrane RoB 2 tool. Certainty of evidence was evaluated using the GRADE approach. Results: Nine RCTs (n=748) were included. Romiplostim significantly increased platelet counts at week 2 (MD 25.71; 95% CI 9.41–42.02), week 4 (MD 42.74; 95% CI 26.82–58.66), week 6 (MD 50.42; 95% CI 33.87–66.97), and week 8 (MD 49.14; 95% CI 20.45–77.83), with larger effects in adults. Platelet response rates were significantly higher with romiplostim (RR 6.10). The proportion achieving ≥20×10 ⁹ /L increase improved (RR 3.23), and the need for rescue therapy decreased (RR 0.49). Adverse events were comparable between groups, with slight increases in myalgia and rash. Conclusion: Romiplostim is an effective and well-tolerated therapy for ITP, significantly improving platelet outcomes and reducing rescue therapy requirements without major safety concerns.

Background: The optimal management of medial epicondyle fractures remains controversial, particularly in displaced fracture without incarceration. Traditionally, non-surgical treatment remains the treatment of choice for the management of medial epicondyle fracture; however recent evidence suggesting favorable outcomes with surgical fixation has increased interest in operative management. This systematic review and meta-analysis aimed to compare surgical versus non-surgical treatment for the management of medial epicondyle fracture in pediatric population to determine the optimal management therapy. Methods: A systematic search of PubMed, Cochrane Library, and Google Scholar and Clinical trial govt. was conducted from inception to April 2026 according to PRISMA guidelines (PROSPERO: CRD420261393871 ) . Randomized controlled trials and observational studies were included. Statistical analyses were performed using a random-effects model in RevMan 5.4. Risk of bias was evaluated using the Cochrane RoB 2 tool and Newcastle–Ottawa Scale, while certainty of evidence was assessed using GRADE. Results: Six comparative studies involving 564 pediatric patients were included, comprising two randomized controlled trials and four cohort studies. Surgical fixation significantly reduced the risk of non-union (RR = 0.09, 95% CI: 0.02–0.39; p = 0.001) and worse cosmetic VAS scores (MD = − 8.56, 95% CI: −12.66 to − 4.46; p < 0.0001), favoring non-surgical management. However, surgery was associated with a significantly greater likelihood of requiring additional surgery (RR = 13.37, 95% CI: 5.20–34.35; p < 0.00001). No significant differences were observed between groups for DASH scores, elbow flexion or extension deficits, PedsQL scores, or valgus instability tests. Conclusion: Surgical treatment reduces nonunion but is associated with worse cosmetic outcomes in pediatric medial epicondyle fracture. However, its effect on functional outcomes remains uncertain compared with non-surgical treatment. Treatment decisions should therefore be individualized based on clinical and patient-specific factors.