The COVID-19 Outbreak in Iran; The First Patient with a Definite Diagnosis.

The novel coronavirus, formerly named as 2019 novel coronavirus (2019-nCov) caused a rapidly spreading epidemic of severe acute respiratory syndrome (SARS) in Wuhan, China and thereafter, progressed globally to form a pandemic of coronavirus disease 2019 (COVID-19) in numerous countries; and now confirmed cases are reported from several provinces of Iran. Now various medical centers, clinicians and researchers around the world share their data and experiences about COVID-19 in order to participate in the global attempt of controlling the pandemic. The current report investigates the clinical presentations and paraclinical findings of the first confirmed cases and mortalities in the initiation of the outbreak of COVID-19 in Iran.

Manifestation of hemispheric laterality in chewing side preference and handedness.

Introduction: Humans manifest a behavioral inclination towards more utility of one side of the body, in relation with the dominant hemisphere of the brain. The current investigation assessed handedness together with chewing preference which have not been evaluated in various food textures before. Methods: Nineteen young and healthy volunteers chewed hard (walnut) and soft (cake) foods, during surface electromyography recording from masseter muscles. The side of the first and all chews in the two food types were determined and compared with the side of the dominant hand. Results: Results indicated the two lateralities in the same side considerably (60%-70%), implying the solidarity in the control of the dominant hemisphere of the brain. The unilaterality was more prominent in the assessment of all chews in hard food, with higher statistical agreement and correlation. Conclusion: Thereupon masticatory preference is found with probable origins in the dominant hemisphere of the brain.

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

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

What does the research say about androgen use and cerebrovascular events?

Many studies have investigated the benefits of androgen therapy and neurosteroids in aging men, while concerns remain about the potential associations of exogenous steroids and incidents of cerebrovascular events and ischemic stroke (IS). Testosterone is neuroprotective, neurotrophic and a potent stimulator of neuroplasticity. These benefits are mediated primarily through conversion of a small amount of testosterone to estradiol by the catalytic activity of estrogen synthetase (aromatase cytochrome P450 enzyme). New studies suggest that abnormal serum levels of the nonaromatized potent metabolite of testosterone, either high or low dihydrotestosterone (DHT), is a risk factor for stroke. Associations between pharmacologic androgen use and the incidence of IS are questionable, because a significant portion of testosterone is converted to DHT. There is also insufficient evidence to reject a causal relationship between the pro-testosterone adrenal androgens and incidence of IS. Moreover, vascular intima-media thickness, which is a predictor of stroke and myocardial symptoms, has correlations with sex hormones. Current diagnostic and treatment criteria for androgen therapy for cerebrovascular complications are unclear. Confounding variables, including genetic and metabolic alterations of the key enzymes of steroidogenesis, ought to be considered. Information extracted from pharmacogenetic testing may aid in expounding the protective-destructive properties of neurosteroids, as well as the prognosis of androgen therapy, in particular their cerebrovascular outcomes. This investigative review article addresses relevant findings of the clinical and experimental investigations of androgen therapy, emphasizes the significance of genetic testing of androgen responsiveness towards individualized therapy in post-IS injuries as well as identifying pertinent questions.

Spectrophotometric analysis of thrombolytic activity: SATA assay.

Introduction: Measurement of thrombolytic activity is crucial for research and development of novel thrombolytics. It is a key factor in the assessment of the effectiveness of conventionally used thrombolytic therapies in the clinic. Previous methods used for the assessment of thrombolytic activity are often associated with some drawbacks such as being costly, time-consuming, complex with 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=405nm) 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 the 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=405nm. 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). Conclusion: 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).

Recent advances in targeted delivery of tissue plasminogen activator for enhanced thrombolysis in ischaemic stroke.

Tissue plasminogen activator (tPA) is the only FDA approved medical treatment for the ischaemic stroke. However, it associates with some inevitable limitations, including: short therapeutic window, extremely short half-life and low penetration in large clots. Systemic administration may lead to complications such as haemorrhagic conversion in the brain and relapse in the form of re-occlusion. Furthermore, ultrasound has been utilised in combination with contrast agents, echogenic liposome, microspheres or nanoparticles (NPs) carrying tPA for improving thrombolysis - an approach that has resulted in slight improvement of tPA delivery and facilitated thrombolysis. Most of these delivery systems are able to extend the circulating half-life and clot penetration of tPA. Various technologies employed for ameliorated thrombolytic therapy are in different phases, some are in final steps for clinical applications while some others are under investigations for their safety and efficacy in human cases. Here, recent progresses on the thrombolytic therapy using novel nano- and micro-systems incorporating tPA are articulated. Of these, liposomes and microspheres, polymeric NPs and magnetic nanoparticles (MNPs) are discussed. Key technologies implemented for efficient delivery of tPA and advanced thrombolytic therapy and their advantages/disadvantages are further expressed.

Voluntary drinking versus imposed drinking in the methodology of investigations about the drinking-induced thermoregulatory sweating.

UNLABELLED: Studies have shown that dehydrated humans or animals in a warm environment begin to sweat within seconds to minutes after drinking. This phenomenon is one of the drinking-induced thermoregulatory responses; being investigated from different aspects. Our objective is to show the difference of voluntary drinking and imposed drinking in the methodology of these experiments. Six healthy subjects 23.7 ± 0.6 yr old and 80.7 ± 5.7 kg wt were dehydrated by performing mild exercise (ergometer cycling) in a hot and humid chamber (38-40°C, 20-28% relative humidity). We incorporated two protocols: after dehydration, subjects were allowed to drink water with 1) imposed volumes of 1, 3, 5 ml/kg and 2) voluntary volumes; on four separate days. The sweating rate was measured on the forehead area before and after drinking. Sweating increased markedly just a few minutes after the onset of drinking. The mean sweat rates of the imposed volumes of 1, 3, 5 ml/Kg were 0.33 ± 0.15, 0.31 ± 0.17, 0.47 ± 0.21 respectively and for the voluntary volume it was 0.54 ± 0.19. The mean intake in the voluntary trial was 6.58 ± 1.14 ml/Kg, more than the imposed volume of 5 ml/Kg. The trend of the rate of the sweating response in the imposed trials was distinct from the response in the voluntary trial. CONCLUSION: There exists a difference between voluntary drinking and imposed drinking in the sweating response that follows rehydration. So it is suggested to use the methods of voluntary drinking in the investigations of this phenomenon, to reveal the natural events that happen in the actual circumstances.

The effect of water temperature and voluntary drinking on the post rehydration sweating.

During heat stress and dehydration, thermoregulation is partly suppressed to save body fluid and circulation. Drinking induces the recovery of thermoregulatory responses including sweating. Our objective is to investigate the effect of water temperature and voluntary drinking on the extent of the drinking-induced sweating. Six healthy subjects 23.7 ± 0.6 yr old and 80.7 ± 5.7 kg wt were dehydrated by performing mild exercise (ergometer cycling) in a hot and humid chamber (38-40°C, 20-28% relative humidity). After dehydration, subjects were allowed to drink water with temperatures of 5, 16, 26, 58°C on four separate days. The sweating rate was measured on the forehead area before and after drinking. Also, blood samples were collected during the experiments and plasma osmolality was measured. Sweating increased markedly just a few minutes after the onset of drinking. The rate of this response was lower in ingested water temperature of 5°C (0.43 ± 0.03 g, p = 0.000). Different intake occurred with different water temperatures (respectively 4.2, 6.4, 3.1, 1.8 ml/kg). Water at 16°C induced higher intake (6.4 ml/kg) together with lower sweating (0.54 ± 0.03 g), which can result in optimum level of hydration. Conclusion- When dehydrated subjects drink water with different temperatures, there are different sweating responses together with different voluntary intakes. According to our results, consuming 16°C water, cool tap water, could be suggested in dehydration.

Chewing side preference in first and all mastication cycles for hard and soft morsels.

Preferred chewing side is a still controversial matter and various methods used have yielded some inconsistencies. The aim of this study is to compare the preference determined in different conditions. Nineteen healthy subjects were offered hard (walnut) and soft (cake) foods, while the electromyography was recorded from their masseter muscles, in 2009 in the Research Center of Physical Medicine and Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran. Four occurrences were determined as the side of the first chews/all chews in the two food types, and then analyzed for correlations and agreements. For hard food 73.68% and for soft food 57.89% of the subjects showed preference. The comparison of all chews showed a highly significant preference towards the right side in both food types (p=0.000 & 0.003). There was both correlation and agreement between the first chew preferences in both food types, and an agreement between the first and all chew preferences in the hard food. Therefore, there seems to exist some laterality in mastication, which is more explicit when using hard food and assessing all chews.

Water temperature, voluntary drinking and fluid balance in dehydrated taekwondo athletes.

Voluntary drinking is one of the major determiners of rehydration, especially as regards exercise or workout in the heat. The present study undertakes to search for the effect of voluntary intake of water with different temperatures on fluid balance in Taekwondo athletes. Six young healthy male Taekwondo athletes were dehydrated by moderate exercise in a chamber with ambient temperature at 38-40°C and relative humidity between 20-30%. On four separate days they were allowed to drink ad libitum plane water with the four temperatures of 5, 16, 26, and 58°C, after dehydration. The volume of voluntary drinking and weight change was measured; then the primary percentage of dehydration, sweat loss, fluid deficit and involuntary dehydration were calculated. Voluntary drinking of water proved to be statistically different in the presented temperatures. Water at 16°C involved the greatest intake, while fluid deficit and involuntary dehydration were the lowest. Intake of water in the 5°C trial significantly correlated with the subject's plasma osmolality change after dehydration, yet it showed no significant correlation with weight loss. In conclusion, by way of achieving more voluntary intake of water and better fluid state, recommending cool water (~16°C) for athletes is in order. Unlike the publicly held view, drinking cold water (~5°C) does not improve voluntary drinking and hydration status. Key pointsFor athletes dehydrated in hot environments, maximum voluntary drinking and best hydration state occurs with 16°C water.Provision of fluid needs and thermal needs could be balanced using 16°C water.Drinking 16°C water (nearly the temperature of cool tap water) could be recommended for exercise in the heat.