Despite the currently available treatment, one-third of epilepsy patients continue to experience seizures. Transcranial direct current stimulation (tDCS) has emerged as a potential neuromodulation approach for the non-invasive treatment of refractory epilepsy. This study aims to provide a comprehensive investigation of the efficacy and safety of tDCS in patients with drug-resistant epilepsy. The following databases were searched from inception until June 2023; PubMed, Scopus, Embase, WOS, EBSCO, Cochrane Central, and Ovid MEDLINE. Pooled mean difference was calculated for change in seizure frequency (SF), and number of Interictal epileptiform discharges (IEDs) at different follow-up intervals. We included nine parallel randomized sham-controlled trials with a total of 267 patients. Active tDCS patients had a significantly lower SF per month at 4 and 8 weeks (MD = -4.06, 95% CI [-6.01 to -2.12], p < 0.0001), and (MD = -2.66, 95% CI [-5.09 to -0.23], p = 0.03), respectively. However, weekly SF showed no statistically significant results at 4 weeks of follow-up. The IEDs were observed to significantly decline at 2, 4, and 8 weeks of follow-up. The reported adverse events were mild including mild itching and erythematous rash that resolved spontaneously. In conclusion, tDCS significantly reduced monthly SF and the number of IEDs. Future large RCTs with standard clear informed parameters are still required.

Introduction: Language barriers in medicine can hinder effective communication, comprehension, and patient care. While English has emerged as the dominant language in global medicine, the importance of native languages should not be overlooked. This article aims to examine the extent of publishing in native languages by analyzing the PubMed database literature to gain further insights into the usage of native languages in medicine and medical research. Methods: In December 2023, a comprehensive examination of the PubMed literature was conducted for each of the 55 registered languages. We searched for records published in each language (e.g., German[lang]) by applying language filters. Ethnologue provided data on the number of worldwide native speakers for each language, facilitating a comparative analysis. Results: By December 2023, PubMed contained over 36 million publications, with 86.5% of them published in English. German, French, and Russian came after English, with over 700 thousand publications each. Among the languages analyzed, fourteen had fewer than 50 publications, nineteen had fewer than 100, twenty-two had fewer than 500, and twenty-five had fewer than one thousand publications. European languages were well-represented with thousands of publications each, while widely spoken languages such as Hindi and Arabic had limited representation. Conclusion: The production of medical research in native languages reflects the attention given to native languages in medicine and medical education within each country. It is crucial to provide due attention to these language-related issues and explore strategies for including native languages in medicine to bridge the gaps in language and medicine.

The current research efforts in the Middle East do not sufficiently capture the full extent of the burden posed by brain tumors in the region. Our study aimed to investigate the present state and future prospects of neuro-oncological research in the Middle East, with a focus on addressing existing research gaps. We conducted a comprehensive literature search on brain tumors in the Middle East, utilizing PubMed, Scopus, and Web of Science databases. Data extraction was performed by a team of four authors using Microsoft Excel. We categorized studies based on research type, study design, subject matter, and author collaboration. Statistical analysis was conducted using RStudio 4.2.3 for categorical variables, and charts and figures were generated using RStudio 4.2.3 and Microsoft Excel version 16. Our scoping review analyzed 1,451 research articles related to Central Nervous System (CNS) tumors. Primary research accounted for 65.3 % of the studies, secondary research for 11.4 %, and other research types for 23.3 %. Turkish and Iranian authors played a significant role in primary research. Case reports (23.7 %) and retrospective studies (15.9 %) were the most common study designs. Clinical studies constituted the majority (89.5 %), with public health (2.75 %) and experimental studies (7.75 %) forming the rest. Gliomas were the most prevalent CNS tumor type (20.7 %), followed by astrocytomas (6.8 %) and meningiomas (6.2 %). To meet the increasing demands of researchers, improved access to high-quality neurosurgical programs and centers in the Middle East is essential. Inadequate institutional planning may contribute to the current research accessibility deficits.