Background: Growing antibiotic resistance and the limited availability of key components in standard Helicobacter pylori treatments have driven the search for effective alternatives. Minocycline, with its broad-spectrum activity and favorable pharmacokinetics, has emerged as a promising substitute. This meta-analysis compares the safety and efficacy of minocycline-containing bismuth quadruple therapy (MBQT) to conventional first-line BQT regimens, incorporating data from the recent study by Lin et al. Methods: The inclusion criteria were randomized controlled trials (RCTs) with a target population of both treatment-naïve and previously treated patients diagnosed with Helicobacter pylori (H. pylori) infection. The intervention received by eligible patients was a minocycline–bismuth quadruple therapy (MBQT) regimen containing bismuth, minocycline, proton pump inhibitors (PPI), and any additional antibiotic with a minimum period of 2 weeks of administration. We excluded study designs other than RCT and clinical trials that include patients without confirmed H. pylori infection, animal populations, in vitro experiments, and reports of other outcomes that did not include a minimum intervention duration of 2 weeks. A comprehensive literature search was conducted on PubMed, EMBASE, Cochrane Library, and ScienceDirect from inception to 20 May 2025. After screening via Rayyan, data were extracted on an Excel spreadsheet. Quality was assessed using the Cochrane RoB 2.0 tool. Eligible randomized controlled trials (RCTs) were included and analyzed using RevMan 5.4. Outcomes assessed were intention-to-treat and per-protocol eradication rates. Adverse effects were compared among therapies. A random-effects model was used; an I² < 50% and p-value < 0.05 indicated homogeneity and significant results respectively. Results: Five RCTs with 7 interventions involving 2812 patients were included. The pooled odds ratio (OR) for MBQT in intention-to-treat (ITT) analysis was 1.25 (95% CI: 0.96–1.61), showing a non-significant trend. No heterogeneity was detected (I² = 0.0%). In the modified ITT (mITT) analysis (2 studies), MBQT showed higher eradication (OR: 1.70, 95% CI: 0.00–1042.90), but wide CI and high heterogeneity (I² = 70.7%) limited interpretation. All studies were included in the per-protocol (PP) analysis, which showed a statistically significant improvement with MBQT (OR: 1.67, 95% CI: 1.14–2.45) and low heterogeneity (I² = 5.2%), suggesting consistent results. Although not statistically significant, MBQT was associated with a slightly lower rate of adverse events compared to standard therapy (OR: 0.81, 95% CI: 0.59–1.12). I² = 50.6% showed moderate heterogeneity in safety outcomes. Discussion: the number of included RCTs was modest, with only five studies meeting eligibility criteria, and only two contributing to the modified intention-to-treat analysis. The risk-of-bias assessment showed variation in methodological quality across the included studies. Several studies exhibited high risk judgments in critical domains. particularly randomization, deviations from intervention, and selective reporting. Patients who completed the treatment benefited more from MBQT, which also had a comparable safety profile to conventional BQT regimens. In the treatment of H. pylori infection, MBQT may be considered a safe alternative for first-line treatment.

Spinal arteriovenous malformations (SAVMs) are rare vascular lesions .They are basically anomalous connections between arteries and veins within the spinal canal and often result in progressive neurological deficits. Cervical intramedullary arteriovenous malformations (AVMs) are uncommon, and their presentation with scapular winging is extremely rare. A 16-year-old right-handed male presented to us with a 3-month history of right shoulder pain, weakness, and limited overhead movements that initially started after lifting a heavy object. On examination, right scapular winging and serratus anterior atrophy were noted along with a positive Hoffmann's sign. The neurological deficits were predominantly confined to the right upper limb, whereas the lower limbs were spared. Electrodiagnostic studies showed chronic neurogenic changes in the serratus anterior, and MRI revealed an intramedullary cervical spinal lesion extending from C3 to C5 with cord expansion, a hypointense rim suggestive of hemosiderin, and patchy post-contrast enhancement. The patient underwent C3 to C5 laminectomy with excision biopsy. Histopathology confirmed a benign vascular malformation consistent with spinal AVM. Sensory function improved postoperatively, though the right upper limb weakness persisted. Physiotherapy was advised with regular neurosurgical follow-up at the time of discharge. This case illustrates a rare presentation of cervical arteriovenous malformation presenting as scapular winging because of long thoracic and phrenic nerve damage. It emphasizes a detailed neurological examination, identification of upper motor neuron signs, and early use of advanced imaging in atypical presentations. Early detection and surgical intervention are critical to prevent irreversible neurological deficits and thereby improve outcomes in young patients with such rare spinal vascular lesions.

Background: Emotional intelligence (EI) is a key determinant of professional competence, interpersonal communication, and psychological well‐being in the medical field. Among medical students, EI supports empathy, effective communication, and stress management. However, researchers have found limited data on EI levels among medical students in Khyber Pakhtunkhwa (KP), Pakistan. Objectives: To assess the level of EI among MBBS students in KP, Pakistan, and to examine its association with selected demographic variables. Participants from all academic years were recruited using convenience sampling. EI was assessed using the Schutte Self‐Report Emotional Intelligence Test (SSEIT). Demographic variables included age, gender, year of study, and history of psychiatric illness. Data were analyzed using IBM SPSS Statistics version 26.0, and associations between EI and demographic variables were tested. A p ‐value < 0.05 was considered statistically significant. Results: A total of 376 students participated; 234 (62.2%) were female, and 142 (37.8%) were male. Of these, 303 (80.6%) were from 11 public and 73 (19.4%) from 10 private medical colleges. The mean EI score was 123.14 ± 13.12. Female students had significantly higher overall EI scores than males (123.63 ± 13.32 vs. 120.66 ± 15.28; p = 0.048) and scored higher in empathy/social skills ( p = 0.003) and self‐motivation/adaptability ( p = 0.003). The majority of participants had moderate (44.2%) and high (54.5%) levels of EI, and 1.3% had low EI; there were no significant differences by type of institution and year of study. Conclusion: Medical students in KP demonstrated moderate to high levels of EI. Female students had significantly higher EI scores, particularly in empathy and adaptability. No significant differences were observed based on institution type or year of study. These findings support integrating EI training into medical curricula.

Background: Cold therapy, or cryotherapy, is the application of low temperature to reduce pain and swelling, and it is used widely in routine practice to ease the pain and anxiety of venipuncture. This systematic review and meta‐analysis evaluated its effect on venipuncture pain and anxiety, together with postprocedure heart rate. Methods: This systematic review and meta‐analysis was registered on PROSPERO and included randomized controlled trials (RCTs) of cryotherapy during venipuncture, with no geographical restrictions. We searched PubMed, the Cochrane Library, Embase, Scopus, Web of Science, and ClinicalTrials.gov, which returned 502 records, and screened them in Rayyan. Sixteen RCTs met the eligibility criteria, and 14 provided data suitable for pooling. Pain was the primary outcome, and anxiety was the secondary outcome, with postprocedure heart rate as an additional outcome. Risk of bias was assessed with the Cochrane ROB2 tool. Analyses were carried out in R using the meta and metafor packages with a random‐effects model and the Hartung–Knapp adjustment. Because the trials used several pain scales, the standardized mean difference (Hedges g) was the primary effect measure. Subgroup analyses and random‐effects meta‐regression (age, application duration, and needle gauge) were used to explore heterogeneity, and small‐study effects were examined with the funnel plot, Egger’s test, and trim and fill. Results: The quantitative synthesis pooled data across 14 RCTs. Cryotherapy significantly reduced venipuncture pain (primary effect measure: SMD [Hedges’ g] = −1.23; 95% CI: −2.03 to −0.44; p = 0.005; expressed on a common 0–10 pain scale for interpretability: MD = −1.97 points, 95% CI: −2.98 to −0.96) although substantial heterogeneity was observed (I ² = 93%). Subgroup analysis revealed that clinical condition significantly modified treatment response ( p = 0.038), with maintenance hemodialysis patients experiencing the largest benefit (SMD = −1.87). Meta‐regression identified needle gauge as a notable variance modifier (coefficient = −0.16 per gauge unit; p = 0.070), suggesting enhanced relative relief with finer needles. Cryotherapy yielded no statistically significant effect on anxiety (SMD = −0.19; 95% CI: −1.49 to 1.10; p = 0.59; I ² = 75%), but was associated with a small reduction in postprocedure heart rate (MD = −2.58 bpm; 95% CI: −4.20 to −0.96; p = 0.015; I ² = 0%). According to GRADE criteria, certainty of evidence was rated low for pain and heart rate, and very low for anxiety. Conclusion: Cryotherapy may reduce venipuncture pain, with the largest possible effects in hemodialysis patients, but it does not appear to reduce procedural anxiety. High heterogeneity, the impossibility of blinding, and low certainty of evidence mean that the findings should be read with caution, and the pooled pain effect may vary in practice. Larger, standardized trials are needed to define its clinical role.