Iranian Stroke Model-How to Involve Health Policymakers

Stroke in Iran, with more than 83 million population, is a leading cause of disability and mortality in adults. Stroke has higher incidence in Iran comparing the global situation and unfortunately the onset age of first ever stroke is dropping about 10 years.1 Intravenous thrombolysis, as an approved treatment in ischemic stroke, has been used only in some university or private hospitals in Iran since 2008.2 The main limit for this therapy in Iran was the lack of coverage by health insurance companies for tPA. A project for situation analysis of stroke cases entering to Imam Reza Hospital, a tertiary university hospital in North-West of Iran, was performed in 2010 by Neurosciences Research Center. The percentage of cases referring on time and eligible for thrombolysis, barriers, pitfalls and delay gaps in the hospital were detected.3 After analyzing and involving all the related authorities & departments of the Tabriz University of Medical Sciences and performing a maneuver, thrombolysis in all eligible stroke cases was systematically started as pilot in the hospital since 2010. Other centers such as Firoozgar Hospital in Tehran, Ghaem Hospital in Mashhad, Namazi Hospital in Shiraz, and Alzahra Hospital in Isfahan were active in thrombolysis but non-systematically

Spectrophotometric analysis of thrombolytic activity: SATA assay

Introduction: Measurement of thrombolytic activity i.e. clot lysis is crucial for research and development of novel thrombolytics. It is also a key factor in assessment of the effectiveness of conventionally used thrombolytic agents in the clinic, which are the choice effective therapies for myocardial infarction and ischemic stroke. Previous methods used for the assessment of thrombolytic activity are often associated with some drawbacks such as being costly, time-consuming, complication and low accuracy. Here, we introduce a simple, economic, relatively accurate and fast method of spectrophotometric analysis of thrombolytic activity (SATA) assay, standardized by tissue plasminogen activator (tPA), which can quantitatively measure in vitro thrombolytic activity. Methods: Blood clots were formed, uniformly, by mixing citrated whole blood with partial thromboplastin time (PTT) reagent, together with calcium chloride. Then, designated concentrations of tPA were added to the samples, and the released red blood cells from each clot were quantified using spectrophotometry (λmax= 405 nm) as an indicator of thrombolytic activity. The accuracy of the method was tested by assessment of dose-responsibility against R2 value obtained by linear equation and measurement of limit of detection (LOD) and limit of quantification (LOQ). The SATA assay was validated in comparison with some currently used techniques. Results: A linear relationship was obtained between different concentrations of tPA versus the spectrophotometric absorbance of the related dilutions of lysed clots, at λmax = 405 nm. Calculated R2 values were greater than 0.9; with LOD of 0.90 μg/mL of tPA (436.50IU) and LOQ of 2.99 μg/mL of tPA (1450.15IU). Conclusions: Conclusively, the SATA assay is a very simple quantitative method with repeatable and reproducible results for estimating the potency of an unknown thrombolytic agent, and calculating the activity as delicate as 1 μg/mL of tPA (485 IU/mL of thrombolytic dose). © 2018 The Author(s)

The Efficacy of Low-Level Laser Therapy in the Treatment of Bell’s Palsy in Diabetic Patients

Introduction: The most common causes of the abrupt onset of unilateral facial weakness are stroke and Bell’s palsy. The drug regimen plus electrical stimulation was more effective in treating Bell’s palsy than conventional drug treatment alone. We aimed to evaluate more effective and safe for the treatment of Bell’s palsy.Methods: This clinical interventional study was conducted on 30 diabetic patients with Bell’s palsy who presented to pain clinic over one year and were treated by low-level laser. The system of House- Brackmann was used for the severity of damage and patients were evaluated by electromyography and nerve conduction velocity before and after treatment of low-level laser. These patients did consume any other medication for facial nerve palsy.Results: In the present study, 30 cases with poor control diabetes mellitus (18females, 12 males) were studied. After 12 sessions of low-level laser therapy, we could observe complete recovery in 18 patients and partial recovery in 6 patients after 3months.Conclusion: Recovery rate showed us that LLLT is a safe, reliable, and proper alternative approach to the treatment of facial nerve palsy especially in the presence of underlying conditions such as diabetes mellitus

Beta-amyloid exhibits antagonistic effects on alpha 7 nicotinic acetylcholine receptors in orchestrated manner

AbstractAlthough beta-amyloid (Aβ) has been regarded as the principal toxic factor in the pathogenesis of Alzheimer’s disease (AD), it plays important physiological roles in phenomena such as neuron survival, synaptic plasticity, and memory formation. There are numerous plausible reasons to assume that all of the mentioned pathological and physiological functions of Aβ may be partially mediated via alpha 7 nicotinic acetylcholine receptor (nAChR). Agonistic and antagonistic aspects of Aβ on nAChRs may explain this paradox in peptide–receptor function. It seems that Aβ shows antagonistic effects on α7 nAChR in a dose-dependent manner, and its pathologic function may partially correlate with antagonization of the receptor.If this hypothesis is supported, the related mechanisms of neurotoxicity, neuroprotection, memory formation, and AD pathogenesis might be identified. In addition, such knowledge helps make a more valid interpretation of neuron signaling and a better design of AD animal models. In addition, it may provide new insights into AD therapy development via reducing the amount of Aβ and inhibiting peptide aggregation

Thymol decreases apoptosis and carotid inflammation induced by hypercholesterolemia through a discount in oxidative stress

Objective: Atherosclerosis sclerosis is a chronic inflammatory disease that can lead to cardiovascular and cerebrovascular disorders that are generally along with hypercholesterolemia and oxidative stress. Various surveys have shown that thymol is a polyphenolic compound with anti-inflammatory and antioxidant properties. This study aimed to investigate the anti-inflammatory and antiapoptotic effects of thymol on carotid tissue of hypercholesterolemic rats. Materials and Methods: Forty male Wistar rats were randomly divided into 4 groups with 10 members each (n = 10): a control group with a normal diet (ND), a group with a high-cholesterol (2%) diet (HD), a group with a high-cholesterol diet combined with thymol (24 mg/kg HD + T), and a group with a thymol diet (T). After preparing serum from peripheral blood of rats, lipid measurements were obtained, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), by using a colorimetric method; the levels of oxidized LDL (OxLDL) were obtained through enzyme-linked immunosorbent assay (ELISA). The activities of superoxide dismutase (SOD) and glutathione peroxidase (GPx) antioxidant enzymes, as well as the concentrations of malondialdehyde (MDA) and serum total antioxidant capacity (TAC), were determined with the use of colorimetric methods. The protein expressions of Bcl2 and cleaved caspase 3 and the phosphorylation of p38 mitogen-activated protein kinase (MAPK) in rat carotid tissue were determined by an immunoblotting method. Results: The rats fed with a high-cholesterol diet for 8 weeks increased TC and OxLDL in HD group compared with the ND group (P < 0.01; OxLDL HD vs ND (214.42 ± 17.46 vs 69.13 ± 9.92; P < 0.01); (229.39 ± 13.26 vs 67.89 ± 5-14 (215.58 ± 12.46 vs 229.35 ± 13.26; P < 0.05, OxLDL HD vs HD + T 105.53 ± 10.44; P < 0.01). Both of them were decreased with the intervention of thymol in the HD + T group compared with the HD group. The amount of phosphorylation of p38 (p-p38) and the protein expression of cleaved caspase 3 showed a significant increase in the HD group compared with the ND group (P < 0.01). In contrast, the expression of Bcl-2 in the high-cholesterol diet group decreased compared with the control group (P < 0.01). A comparison of the p-p38 and the protein expression of cleaved caspase 3 between the T + HD and the HD groups showed that in both cases, thymol caused a decrease (p<0.01), whereas Bcl-2 effected an increase (P < 0.05). Regarding the oxidant and antioxidant indices, thymol significantly decreased the MDA level and increased the total antioxidant content (P < 0.01). Conclusion: The results of this study indicate that thymol significantly decreases the expression of inflammatory and apoptotic proteins in carotid tissue. However, this decrease is probably not mediated by an effect on lipid metabolism because thymol decreases the total level of cholesterol but has no significant effect on the LDL-C level as the atherogenic index. In addition, thymol possibly exerts an antioxidant effect without the direct involvement of antioxidant enzymes

Effect of music on driving performance and physiological and psychological indicators: A systematic review and meta-analysis study

Background: Many studies have assessed the effect of music on driving. However, their results are very scattered and contradictory. Therefore, this systematic review is conducted to determine the effect of music on driving performance and drivers’ physiological and psychological indicators. Methods: Scopus, PubMed, and Web of Science databases were searched until July 2023. A manual search in Google Scholar for gray literature was conducted. The Simulation Research Rubric (SRR) tool was used to assess the reporting quality of the studies. Stata software (StataCorp, version 16) was used to perform a meta-analysis. Results: A total of 2650 records were identified. The findings of 19 studies were analyzed. Most of them were carried out in high-income countries (HICs) using simulators. The most frequently used music style was classic rock. The meta-analysis results indicated that music with high and medium volume increases the average driving speed, and music with low volume decreases it. Although music in every mood reduces the average reaction time, it positively reduces response delay and increases coherence. Music with high volume decreases the heart rate, but music with medium and low volume increases it. Listening to music increases the level of arousal and mental load. Conclusion: It was concluded that, in some indicators, listening to music has adverse effects on driving. However, in many indicators, music has a positive impact on improving driving safety. It is better to choose appropriate music for different driving conditions and to train the drivers about it

Testosterone May Hold Therapeutic Promise for the Treatment ofIschemic Stroke in Aging: A Closer Look at Laboratory Findings

Male sex is more prone to cerebrovascular disorders, yet the exact role of androgens in cerebralischemia remains unclear. Here we reviewed current understanding of testosterone (TES)neuroprotective activity against ischemic stroke and mechanisms underlying these effects inaging. TES may exert a neuroprotective effect in aging through pathways including inhibition ofoxidant molecules production, enhancing the enzymatic antioxidant capacity of the brain andmodulation of apoptotic cell death. Given this, a better understanding of the neuroprotectiveroles of TES may propose an effective therapeutic strategy to improve the quality of life anddecrease androgen-related cerebrovascular problems in the aging men

Effect of erythropoietin on inflammatory response and ischemic brain damage after carotid artery clamp in rat

Introduction: Erythropoietin (EPO) is reported to have a minimizing effect on the ischemic condition, but the detailed association between EPO and the ischemic upshot is still not clearly understood. We aimed to evaluate the effect of EPO on inflammatory response and ischemic brain damage after carotid artery clamp in rats. Methods: In this experimental, animal trial study, which was conducted at the Animal Facility and laboratory at Tabriz University of Medical Sciences, 50 adult male Wistar rats with (250 to 300 g) were randomly allocated to intervention and control groups. The intervention and control groups were administered intraperitoneally with equal volumes of EPO (5000 U/kg) and normal saline, respectively. Both groups had common carotid arteries clamped for 20 minutes. Using the Nissl staining technique, the slides of brain ischemic areas were observed and the rate of ischemic injury in both groups was determined. The blood level of inflammatory cytokines was also measured. Results: The levels of inflammatory markers including creatine phosphokinase (CPK), interleukin (IL)-6, IL-1B and tumor necrosis factor alpha (TNF)-α in the intervention group were significantly lower than that of control group. Mean percentage of the ischemic area in the intervention group with an amount of 4.30±2.15%, was significantly lower than that of control group (11.20±2.35%, P=0.023). Conclusion: Findings of this study showed that the injection of EPO before carotid clamping is effective in preventing cerebral ischemic injury in rats