A randomized open-label clinical trial on the effect of Amantadine on post Covid 19 fatigue

Many COVID-19 survivors experience lingering post-COVID-19 symptoms, notably chronic fatigue persisting for months after the acute phase. Despite its prevalence, limited research has explored effective treatments for post-COVID-19 fatigue. This randomized controlled clinical trial assessed the impact of Amantadine on patients with post-COVID-19 fatigue. The intervention group received Amantadine for two weeks, while the control group received no treatment. Fatigue levels were assessed using the Visual Analog Fatigue Scale (VAFS) and Fatigue Severity Scale (FSS) questionnaires before and after the trial. At the study's onset, VAFS mean scores were 7.90 ± 0.60 in the intervention group and 7.34 ± 0.58 in the control group (P-value = 0.087). After two weeks, intervention group scores dropped to 3.37 ± 0.44, significantly lower than the control group's 5.97 ± 0.29 (P-value < 0.001). Similarly, FSS mean scores at the trial's commencement were 53.10 ± 5.96 in the intervention group and 50.38 ± 4.88 in the control group (P-value = 0.053). At the trial's end, intervention group scores decreased to 28.40 ± 2.42, markedly lower than the control group's 42.59 ± 1.50 (P-value < 0.001). In this study, we report the safety, tolerability, and substantial fatigue-relieving effects of Amantadine in post-COVID-19 fatigue. The intervention demonstrates a statistically significant reduction in fatigue levels, suggesting Amantadine's potential as an effective treatment for this persistent condition.

Formalin and ferric chloride inactivated Pasteurella multocida type a adjuvanted with bacterial DNA and alum as a new vaccine candidate in sheep pasteurellosis

The aim of the present study was to investigate humoral and cellular immune responses in sheep inoculated with inactivated P. multocida antigen with alum and bacterial DNA adjuvant by identifying IgG and cytokines from serum and cell culture. Sheep were immunized with iron and formalin-inactivated antigens at an interval of 2 weeks. These immunogens were mixed with alum adjuvant and P. multocida type A DNA (AbDNA). After injection and blood sampling, the serum antibody titer and cellular immune responses (IL-4, IFN-γ, and TNF-α) on serum samples and lymphocyte cell were tested by ELISA. The ELISA results showed a higher antibody titer in the bDNA adjuvant group compared to the alum adjuvant group and the control group. In general, the level of IgG in the serum of immunized animals was significantly increased compared to the control group. The peak antibody titer (1.794) was observed on the 28th day of injection in the IIV-AbDNA group. After immunization, inactivation with iron and bDNA adjuvant increased cytokine production compared to other experimental and control groups. High levels of lymphocyte and serum titers of IL-4, IFN-γ, and TNF-α were also obtained in the IIV-AbDNA group. The findings showed that killed P. multocida type A antigens formulated with bacterial DNA as an adjuvant are candidates for new immunogens against P. multocida infections in sheep. The inactivation of bacteria with iron also enhanced proper immune responses.

Cerebral hemodynamic response to generalized anxiety disorder

BACKGROUND

Generalized anxiety disorder (GAD) is the least studied among anxiety disorders. Therefore, we aimed to compare the cervical blood flow velocities using doppler ultrasonography in untreated chronic GAD patients and healthy individuals.

MATERIAL AND METHODS

In this study, thirty-eight GAD patients were enrolled. And thirty-eight healthy volunteers were recruited as control participants. The common carotid artery (CCA), internal carotid artery (ICA), and vertebral artery (VA) of both sides were explored. Also, we trained machine learning models based on cervical arteries characteristics to diagnose GAD patients.

RESULTS

Patients with chronic untreated GAD showed a significant increase in peak systolic velocity (PSV) bilaterally in the CCA and the ICA (P value < 0.05). In GAD patients, the end-diastolic velocity (EDV) of bilateral CCA, VA, and left ICA was significantly decreased. The Resistive Index (RI) showed a significant increase in all patients with GAD. Moreover, the Support Vector Machine (SVM) model showed the best accuracy in identifying anxiety disorder.

CONCLUSION

GAD is associated with hemodynamic alterations of extracranial cervical arteries. With a larger sample size and more generalized data, it is possible to make a robust machine learning-based model for GAD diagnosis.

MLC901 in hypoxic-ischemic brain injury patients: A double-blind, randomized placebo-controlled pilot study

BACKGROUND

Hypoxic-ischemic brain injury (HIBI) is a disabling consequence of cardiopulmonary resuscitation, which has no direct treatment except supportive care. Many studies have used pharmacological agents to reduce or stop this disability. MLC901 is a traditional Chinese medicine showing neuroprotective and regenerative effects on focal and global ischemia in previous animal and human studies. We designed an experimental, randomized, double-blind, placebo-controlled study to analyze MLC901 efficacy in HIBI patients.

METHODS

In a randomized, placebo-controlled trial, 35 patients with HIBI were randomly designated to receive either MLC901 or placebo capsules 3 times per day over 6 months. We assessed the 2 groups by modified Rankin Scale and Glasgow Outcome Scale at baseline, and follow-up visits in 3rd month, and 6th-month after injury.

RESULTS

Thirty-one patients completed this study. There was no significant difference in baseline characteristics between the 2 groups as regards age, gender, time of resuscitation, the interval between injury and start of the intervention, and the length of intensive care unit stay. Both the placebo and intervention groups improved during the investigation. However, the Glasgow Outcome Scale and modified Rankin Scale scales were significantly improved in the MLC901 group compared to the placebo after 6 months (P < .05) with close to no adverse effects. No major side effect was reported.

CONCLUSION

MLC901 has shown, compared to placebo, a statistically better improvement at 6 months in neurological functions of patients with HIBI.

The Role of Fluconazole Prophylaxis Regimen and the Regimes Chosen by the Patient’s Risk of Fungal Infection in Reducing the Infection Rate after Bone Marrow Transplantation

Objective: Invasive fungal infections (IFI) in bone marrow transplant (BMT) recipients are common and lethal. Fluconazole was the choice prophylaxis previously, but recent strategy utilization antifungal drugs according to the risk of IFI in patients undergoing transplantation. In this study we aim to evaluate the efficacy of fluconazole prophylaxis regimen and the regimes chosen by the patient’s risk of IFI. Materials and Methods: We evaluated 376 patients with BMT. Patients were divided into those treated before 2012 with fluconazole prophylaxis (group I, n=206) or those undergone transplantation after 2012 and received fluconazole, voriconazole and posaconazole prophylaxis according their risk of fungal infection (group II, n=170). Results: Group I was significantly younger (p=0.007), less smoker (p=0.01), received more autologus transplant (p=0.001) and mostly high risk patient for infection (p<0.001). Group I had significantly higher duration of fever (p=0.004) and increased WBC (p=0.02), longer length of stay (p=0.001), more proven and less probable fungal infections (p=0.008) and higher hepatic complications (p=0.003). There was no significant difference in fungal related and overall mortality rate between groups. Conclusion: The use of prophylaxis based on risk of fungal infection in patients undergoing BMT results in reduce fungal infections, duration of fever and accelerate the engraftment and patient discharge.

Development of a disperse dye immunoassay technique for detection of antibodies against Neospora caninum in cattle

In this study a disperse dye immunoassay method was standardized and evaluated for detection of antibodies against Neospora caninum in cattle. Sera from 150 cattle with a recent history of abortion were collected and tested by commercial ELISA kit and a standardized in-house dye immunoassay system. The positivity rate for the sera used in this study was 34.6% for the disperse dye immunoassay (DDIA) compared to 32% obtained by ELISA kit. This study showed no significant difference between DDIA and ELISA. The results indicated that the DDIA provide an economic, simple, rapid and robust test for detection of N. caninum infection in cattle.

Seroprevalence of Neospora spp. in horses in South of Iran

Neospora caninum, an apicomplexan protozoan parasite, is recognized as a major cause of abortion in cattle. However, limited information is presently available on the seroprevalence of Neospora antibodies in horses worldwide. The aim of the present study is to determine serological prevalence of Neospora infection in horses in Iran. Blood samples were obtained from 200 horses and tested for serum antibodies against Neospora spp. by the Neospora modified direct agglutination test (N-MAT). Antibodies were found in 64 (32%) horses being tested with titers of 1:80. This is the first serological survey for Neospora antibodies performed on horses in Iran.

Seroprevalence of Neospora spp. in Horses in North East of Iran

BACKGROUND

Neospora caninum, an obligate intracellular protozoan parasite, is recognized as a major cause of abortion in cattle, while limited information is presently available on the seroprevalence of Neospora antibodies in horses' worldwide. The aim of the present study was to determine serologic prevalence of Neospora infection in horses in Iran.

METHODS

Sera from 150 horses from Mashhad suburb in Razavi Khorasan Province, northeast Iran were examined for antibodies to Neospora spp. using Neospora modified direct agglutination test (N-MAT).

RESULTS

Antibodies to this parasite were detected in 45 (30%) of the examined serum samples. Thirty four percent of the samples had titer of 1:40 while then reduced to 30% when 1:80 serum dilution was applied as significant cut off titer.

CONCLUSION

This study is the first investigation carried out on the Neospora in horses in Iran and indicates that horses in Iran are exposed to this parasite.

Recombinant interleukin-1 promotes leishmaniasis in susceptible mice

Interleukin-1 exacerbates leishmanial lesions in Leishmania major-infected BALB/c mice. Indomethacin can modulate the effect of IL-1, so at least part of the IL-1 effect on disease progression is due to the induction of prostaglandin synthesis.