Evaluating the therapeutic effects of isotretinoin on patients with coronavirus disease 2019 (COVID-19): A controlled open-label clinical trial.

Coronavirus disease 2019 (COVID-19) is still a global health issue with no certain treatment option. So far, various treatments have been suggested among which one can mention isotretinoin. The aim of the present study was to investigate the potential of this medication as a side treatment for COVID-19. This open-label controlled clinical trial with the approval ID of IRCT20190624043993N3 was conducted in Farabi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Considering the inclusion and exclusion criteria, 52 patients diagnosed with COVID-19 were enrolled. The control group only received standard of care (SOC) treatment while the intervention arm received 40 mg per day of isotretinoin along with the SOC. The patients were followed until discharge. The results showed no death among the groups. The hospitalization duration in the intervention and SOC groups were 5.1 ± 2.29 and 5.1 ± 3.44 days, respectively with no statistical difference (P = 0.98). Moreover, the SpO2, pulse rate, respiratory rate, and blood pressure also showed no statistical difference neither at admission nor upon discharge (P > 0.05). The laboratory investigations showed that white blood cells, absolute lymphocyte count, hemoglobin value, and platelet count did not differ between the groups at admission or upon discharge (P > 0.05). According to the results, it seems that isotretinoin didn't act as a potent side therapy in patients with COVID-19. However, due to the small sample size, we suggest further investigations.

Activation of androgen receptors alters hippocampal synaptic plasticity and memory retention through modulation of L-type calcium channels.

AIMS: It has been revealed that membrane androgen receptor activation modulates avoidance memory and synaptic plasticity. In a previous study, we showed that Calcineurin, a calcium dependent phosphatase, could be a potential mediator of these AR effects. Also, it is reported that AR activation leads to L-type calcium channel activation. The aim of the current study is to test whether L-type calcium channels are downstream of AR and whether this signal pathway mediates the impairment effect of androgenic steroids on passive avoidance memory and synaptic plasticity. MATERIALS AND METHODS: We measured the effect of Nandrolone Decanoate (AR agonist), AR antagonist (Nilutamide) plus ND or L-type calcium channel inhibitor (Nifedipine) plus ND on passive avoidance performance of adolescent male rats. For extracellular field potential recordings hippocampal slices were perfused with ND, Nilutamide-ND or Nifedipine-ND. KEY FINDINGS: Our results clarified that AR activation by ND could impair avoidance behavior as step through latency decreased in ND-treated group while application of both Nilutamide and Nifedipine reestablished normal avoidance behavior. Also, LTP induction in the CA1 area of hippocampus was diminished by ND perfusion and both AR antagonist and L-type calcium channel inhibitor application lead to normal LTP. These findings support our hypothesis that activation of L-type calcium channels are involved in ARs mechanism effects on both avoidance behavior and hippocampal synaptic plasticity. SIGNIFICANCE: Understanding the biological effects of AR agonists on cognitive processes and its cellular mechanism may be a new/supplementary way to treating fear-related disorders.

The effect of cryoprecipitate on prevention of intra cerebral hemorrhage and brain contusion expansion in traumatic patients.

BACKGROUND: Traumatic brain injury (TBI) is a general and socioeconomic complication and is one of the important causes of mortality and disability among young people in the world. Falling and violence and sports injuries are the other cause. It causes for about ten million new patients, accounting for 9% of all deaths. This interventional study aims to investigate the effects of early administration of cryoprecipitate to prevent expansion of intracranial hemorrhage. METHODS: This randomized clinical trial recruited 54 non-pregnant patients. 27 patients in the control group and 27patients in the interventional group. For all patients, common and accepted procedures in scientific centers, including anticonvulsant drugs, normal saline and the other routine management was done and only for patients in the intervention group, 4 units of cryoprecipitate were added to their routine treatments; computed tomography scan (CT) scan was performed 48 hours later in both groups and finally the contusion size was compared in both groups. RESULTS: It was observed in the intervention group that by adding 4 units of cryoprecipitate to their treatments; they had no increased size of the brain parenchymal contusion according to the criteria defined in the study compared to the control group (OR: 0.08, 95% CI: 0.0102_0.6303). CONCLUSIONS: According to a clinical trial, it seems that cryoprecipitate can prevent of cerebral parenchymal hemorrhage expansion in traumatic patients.

The Serum Level of Midkine in Patients With Multiple Sclerosis and Neuromyelitis Optica.

INTRODUCTION: Midkine (MK), a heparin-binding growth factor, is involved in neurological diseases by mediating the inflammatory responses through enhancing the leukocyte migration. The present study assesses the serum concentration of this growth factor among newly developed Multiple Sclerosis (MS) and Neuromyelitis Optica (NMO) patients. METHODS: The present research, as a cross-sectional study, was performed at Isfahan University of Medical Sciences, Isfahan City, Iran. All samples were selected from patients who visited Kashani and Alzahra hospitals for two years (2014 to 2016). The MK level was assessed in 80 new MS cases, 80 NMO patients, and 80 healthy subjects. After collecting blood sera samples, MK serum level was measured using the ELISA. The obtained data were analyzed in SPSS. RESULTS: The Mean±SD MK level was 1038.58±44.73 pg/mL in the MS group, which was significantly higher than the Mean±SD MK level in the NMO (872.62±55.42 pg/mL) and control groups (605.02±9.42 pg/mL). CONCLUSION: Overall, these results demonstrated that MK plays a prominent role in inflammatory reactions and neuroautoimmune diseases, especially in MS. So, the MK level may be used for earlier diagnosis and also prevention of disease progression by using a special inhibitor.