The effect of NeuroAiD™ (MLC601) on cerebral blood flow velocity in subjects' post brain infarct in the middle cerebral artery territory

Background

Stroke is the third common cause of mortality and the most common cause of morbidity in adults. MLC601 (NeuroAiD™) is a treatment indicated for post stroke recovery. An increase of impaired cerebral blood flow may be an important parameter for recovery processes. The aim of this study was to investigate the effect of MLC601 on cerebral blood flow velocity as an indirect evidence of cerebral blood flow increase in post stroke subjects.

Methods

This is a double-blinded, placebo controlled, randomized study of 80 subjects included within a week of stroke onset. All subjects were given either MLC601 or placebo, 4 capsules, 3 times a day for 3 months. Cerebral blood flow within the middle cerebral artery, with blood flow velocity measured by transcranial Doppler (TCD), and Barthel index was assessed at baseline and at 3 months.

Results

The mean change in cerebral blood flow velocity in the MLC601 treatment group (15.9) was significantly increased (p = 0.009) compared to the placebo group (9.6). Subjects in the treatment group also showed a significant difference in the mean rank of modified ranking scale (p < 0.001) and mean change of the Barthel Index: 36 vs. 29 in the placebo group (p < 0.001).

Conclusion

This is the first study suggesting that treatment with MLC601 may increase cerebral blood flow in stroke subjects. This may be mediated by an effect on stimulating microcirculation, an important process contributing to neuroplasticity in the central nervous system. This effect on cerebral blood flow may be associated with improvement in measures of functional recovery.     

Acute renal failure due to leptospirosis in a renal transplant recipient: a brief review of the literature

We present the case of a 43-year-old renal transplant patient who presented with fever, malaise, pruritus, headache, and severe jaundice of 3-week duration following work in a rice field. He was found to have acute renal failure and severe hyperbilirubinemia with a positive serum leptospira antibody titer, making the diagnosis of Weil's disease. The patient responded to reduction in immunosuppressive medications and intravenous penicillin therapy with no need for dialysis. This is the second case of leptospirosis in a kidney transplant patient reported in the English literature.     

Right Sensory Alien Hand Phenomenon from a Left Pontine Hemorrhage

Background

Acute onset of a sensory alien hand phenomenon has been observed only from a supratentorial lesion involving the non-dominant hand, mostly from a right posterior cerebral artery infarction. A single acute vascular lesion resulting in a dominant hand sensory alien hand syndrome has not been previously documented.

Case Report

A 78-year old right-handed woman exhibited right sensory alien hand phenomenon from a left pontine hemorrhage. Disturbance of proprioceptive input and visuospatial perception are likely to play a role in manifesting the sign.

Conclusions

Dominant-hand sensory alien hand phenomenon may occur in an acute setting from a left pontine hemorrhage.     

The NLRP3 inflammasome: a therapeutic target for inflammation-associated cancers

ABSTRACT

Introduction: Inflammasomes are large multimeric intracellular complexes that are capable of maturation and secretion of pro-inflammatory cytokines, IL-1β and IL-18, in response to danger signal molecules. As a member of the inflammasome family, the NLRP3 inflammasome has recently been under intense investigation revealing its possible role in several human diseases especially cancers.

Areas covered: In this review, we will discuss the biology and mechanism of NLRP3 inflammasome activation, its role in specific types of tumors and the novel therapeutic modalities targeting this complex.

Expert opinion: The NLRP3 inflammasome and its components including the adapter apoptosis-associated speck-like (ASC) protein and caspase-1 impose different and sometimes contrasting effects in tumorigenesis depending on various contexts. Considering the novel role of this complex in the initiation and progression of neoplasia, the NLRP3 inflammasome and its pathways provide desirable therapeutic targets for prevention, treatment, and prognosis of certain types of cancer. To date, several agents have been introduced for this purpose, some of which have shown promising results in the clinic.     

The effect of the magical hour on post-traumatic stress disorder (PTSD) in traumatic childbirth: a clinical trial

Objective: This study aimed to investigate the influence of the magical first hour after birth on post-traumatic stress in traumatic childbirths. Background: Traumatic childbirth with disturbing memories can have negative impacts on the mental health of postpartum mothers. Due to the growing trend of post-traumatic stress, the emphasis of recent research is on the identification and prevention of this kind of stress and the enhancement of maternal mental health. Methods: In this randomised clinical trial, which was carried out with 84 newly delivered mothers who were diagnosed with traumatic childbirth, participants were first randomly assigned into intervention (magical first hour) and control groups. Then, the nine instinctive stages were implemented to the intervention group while the control group received routine after-birth procedures. Then, using the Impact of Event Scale-Revised (IES-R), stress was measured at three intervals of 2 weeks, 4–6 weeks and 3 months after childbirth. The collected data were analysed using a mixed analysis of variance. Results: The mean total score of post-traumatic stress in the intervention group was 16.83 ± 1.1 and in the control group 21.04 ± 1.1, which showed a statistically significant difference between the two groups (P < 0.01). With the passage of time, the average scores of post-traumatic stress in both groups decreased and no interaction was observed between time and intervention. Conclusion: Implementation of the magical hour stages is recommended as a preventive and therapeutic guideline for relieving post-traumatic stress in women with traumatic childbirth experiences.     

A comparison study between the direct agglutination test and conventional methods in the diagnosis of vulvovaginal candidiasis

We compared the current diagnostic methods (clinical examination, microscopy and mycological culture) with a direct agglutination (DA) test in the diagnosis of vulvovaginal candidiasis (VVC). One hundred fifty women with suspected VVC were examined by microscopy and culture methods. The patients' sera were tested for the presence of anti-Candida antibody and iron and zinc concentration. Of the 150 patients studied, 120 (80%) were found to be Candida positive using both microscopy and culture methods whilst 30 cases (20%) were infected with non-Candida agents. Forty nine (32.7%) and 71 (47.3%) were positive in microscopy and culture, respectively. VVC was mostly observed in patients ranging from 20 and 29 years of age (42.5%). Candida albicans (65.3%) was found in significantly higher proportion of patients compared to other isolated yeasts (P < 0.05). The iron and zinc concentrations were similar in the two patient groups. The DA test was positive in 114 (76%) of patients, indicating the incidence of a positive value increasing in direct proportion to the amount of yeast isolated. A titre of 1:16 was the most frequent value in both groups with positive and negative cultures. This study offers the DA test as a useful alternative to conventional methods for the diagnosis of VVC.     

Association between plasminogen activator inhibitor 1 gene mutation and different subgroups of recurrent miscarriage and implantation failure

Purpose

To compare plasminogen activator inhibitor type1 (PAI-1) mutation rates in different groups of patients with the record of recurrent miscarriage (RM) or implantation failure (IF) with special emphasis on the number of missed pregnancies and/or implantation failures (RM ≥ 2, IF ≥ 2, RM + IF ≥ 2, RM ≥ 3, IF ≥ 3 and RM + IF ≥ 3).

Method

Case-control study from PCR products and RFLP data of DNA from blood of patients who referred to the infertility clinic including 595 patients (421 RM ≥ 2, 119 IF ≥ 2 and 55 RM + IF ≥ 2) as the case groups and 100 healthy women as the control group.

Results

All six different subgroups of patients showed increased frequencies of the mutant allele (4G) in comparison to the control group (p < 0.001) suggesting a role for PAI-1 mutation in RM and IF.

Conclusions

The different patient subgroups suffer similar rates of risk in developing RM and IF when compared to controls.