Old Remedies for Epilepsy: Avicenna\u27s Medicine.

BACKGROUND: The history of epilepsy and its treatments dates back to at least 4 millennia. Avicenna, c. 980 AD in Bukhara, Khorasan-1037 in Hamedan was a Persian-speaking Iranian physician, who has many recommendations and suggested various therapies for epilepsy in his book, The Canon of Medicine. METHODS: We first reviewed the most important ancient treatments for epilepsy mentioned by Avicenna and considered those as the key words for our next step. Then, we made a literature search (medline and scopus) with those key words to find out new scientific findings in modern medicine about the Avicenna\u27s suggestions. RESULTS: Among the Avicenna\u27s recommended therapies for epilepsy, only Rue has been tested for anticonvulsant activities in modern medicine. Interestingly, it had a dose dependent anticonvulsant effect. CONCLUSION: It is worthwhile to consider the Avicenna\u27s recommended therapies for epilepsy and to design future scientific studies based on his suggestions

MIMO Underwater Visible Light Communications: Comprehensive Channel Study, Performance Analysis, and Multiple-Symbol Detection

In this paper, we analytically study the bit error rate (BER) performance of underwater visible light communication (UVLC) systems with binary pulse position modulation (BPPM). We simulate the channel fading-free impulse response (FFIR) based on Monte Carlo numerical method to take into account the absorption and scattering effects. Additionally, to characterize turbulence effects, we multiply the aforementioned FFIR by a fading coefficient which for weak oceanic turbulence can be modeled as a lognormal random variable (RV). Moreover, to mitigate turbulence effects, we employ multiple transmitters and/or receivers, i.e., spatial diversity technique over UVLC links. Closed-form expressions for the system BER are provided, when equal gain combiner (EGC) is employed at the receiver side, thanks to Gauss-Hermite quadrature formula and approximation to the sum of lognormal RVs. We further apply saddle-point approximation, an accurate photon-counting-based method, to evaluate the system BER in the presence of shot noise. Both laser-based collimated and light emitting diode (LED)-based diffusive links are investigated. Since multiple-scattering effect of UVLC channels on the propagating photons causes considerable inter-symbol interference (ISI), especially for diffusive channels, we also obtain the optimum multiple-symbol detection (MSD) algorithm to significantly alleviate ISI effects and improve the system performance. Our numerical analysis indicates good matches between the analytical and photon-counting results implying the negligibility of signal-dependent shot noise, and also between analytical results and numerical simulations confirming the accuracy of our derived closed-form expressions for the system BER. Besides, our results show that spatial diversity significantly mitigates fading impairments while MSD considerably alleviates ISI deteriorations

Cardiac manifestations of PRKAG2 mutation.

BACKGROUND:The Protein Kinase AMP-Activated Non-Catalytic Subunit Gamma 2 (PRKAG2) cardiac syndrome is characterized by glycogen accumulation in the cardiac tissue. The disease presents clinically with hypertrophic cardiomyopathy (HCM), and it is often associated with conduction abnormalities. CASE PRESENTATION:A 23 year-old female with history of Wolff-Parkinson-White (WPW) and HCM presented for evaluation after an episode of Non-ST Elevation Myocardial Infarction (NSTEMI). The patient was found to have severe coronary bridging on angiography and underwent an unroofing of the left anterior descending artery (LAD). Due to the constellation of symptoms, the patient underwent genetic testing and a cardiac muscle biopsy. Genetic testing was significant for an Arg302Gln mutation in the PRKAG2 gene. Cardiac tissue biopsy revealed significant myocyte hypertrophy and large vacuoles with glycogen stores. CONCLUSION:The pathologic and genetics findings of our patient are consistent with PRKAG2 syndrome. Patients presenting with conduction abnormalities and suspected HCM should be considered for genetic testing to identify possible underlying genetic etiologies

Depression and Anxiety in Patients with Epilepsy, With or Without Other Chronic Disorders

BACKGROUND: Most people with epilepsy lead a normal emotional and cognitive life, however neurobehavioral problems can be found in a large number of patients. This study evaluates the prevalence of depression and anxiety among patients with epilepsy and determines whether having other chronic somatic illnesses increases the prevalence. METHODS: Adults with epilepsy were recruited in either the inpatient epilepsy monitoring unit or the Outpatient Epilepsy Clinic at Thomas Jefferson University in 2006. Patients anonymously filled out a questionnaire, included data about age, sex, education, having other chronic illnesses, and degree of seizure control. The Hospital Anxiety and Depression scale was used to define the presence or absence of anxiety and depression. RESULTS: Two hundreds patients participated, with a mean age of 40.3±16 years. Nineteen (9.5%) patients had depression and 49 (24.5%) had anxiety. Age, seizure control, and having other chronic illnesses did not have a significant relationship with either depression or anxiety. Gender was significantly related to anxiety, with females displaying greater frequency of anxiety than males. Depression was inversely related to education. CONCLUSIONS: It is probable that people with higher education use more effective ways to psychologically and physically adapt to their illness

Psychogenic non-epileptic seizures in Iran

AbstractPurposeWe investigated the demographic and clinical characteristics of psychogenic non-epileptic seizures (PNES) in patients in Iran.MethodsIn this prospective study, all patients with a clinical diagnosis of PNES (based on ictal recordings) were recruited at the outpatient epilepsy clinic at Shiraz University of Medical Sciences, from 2008 through 2013. The epileptologist interviewed all the patients. We investigated the demographic and clinical characteristics of PNES.ResultsTwo hundred and forty-nine patients were diagnosed as having PNES. Two hundred and eleven patients had video-EEG recordings available and included in the study. One hundred and forty-one (66.8%) were female and 70 (33.2%) were male. There were no significant differences between our patients and previous reports regarding the clinical and semiological characteristics of PNES.ConclusionPsychogenic non-epileptic seizures are relatively common at epilepsy clinics. It appears that an Islamic lifestyle (in Iran) has little influence on the clinical characteristics and manifestations of PNES, as we observed similar results as in most previous studies from other cultures

Comparison of temporal lobe epilepsy with hippocampal sclerosis and temporal lobe epilepsies due to other etiologies.

BACKGROUND: This study compares the clinical characteristics of patients with mesial temporal lobe epilepsy with hippocampal sclerosis (mTLE-HS) with those who have temporal lobe epilepsy (TLE) due to other etiologies. METHODS: In this retrospective study all patients with a clinical diagnosis of TLE were recruited in a referral outpatient epilepsy clinic at Shiraz University of Medical Sciences from September 2008 to May 2013. We classified the patients with TLE as having mesial temporal sclerosis if they had clear signs of mesial temporal sclerosis and/or atrophy in their MRI and others who had any other MRI abnormality. RESULTS: A total of 174 patients were studied (including 105 patients with mTLE-HS and 69 patients with TLE due to other etiologies). Frequency of seizure types was not significantly different between these two groups. Earlier age at epilepsy onset (p= 0.005), a past history of febrile seizures (p= 0.010) and presence of affective auras (p= 0.008) were commonly seen in patients with mTLEHS, while auditory auras (p= 0.020) were more frequent in those with TLE due to other etiologies. CONCLUSION: The mainstay for making a correct diagnosis, when evaluating a patient with seizure, is having a standardized approach, particularly with regard to taking a detailed clinical history. One may find important clues in the clinical history (e.g., age at disease onset, detailed seizure description and past history) to make a correct diagnosis

Efficacy and tolerability of adjunctive brivaracetam in patients with prior antiepileptic drug exposure: A post-hoc study.

Brivaracetam (BRV), a selective, high-affinity ligand for synaptic vesicle protein 2A, is a new antiepileptic drug (AED) for adjunctive treatment of focal (partial-onset) seizures in adults with epilepsy. This post-hoc analysis was conducted to explore the efficacy of adjunctive BRV in patients with prior levetiracetam (LEV) exposure and whether changes in efficacy were related to the similar mechanism of action of these two drugs. Data were pooled from three Phase III studies (NCT00490035; NCT00464269; NCT01261325) of adults with focal seizures taking 1-2 AEDs who received placebo or BRV 50-200mg/day without titration over a 12-week treatment period. Patients taking concomitant LEV at enrollment were excluded from this analysis. Patients were categorized by their status of prior exposure to LEV, carbamazepine (CBZ), topiramate (TPM), or lamotrigine (LTG), to investigate any consistent trend towards reduced response in AED-exposed subgroups compared to AED-naïve subgroups, regardless of the mechanism of action. Study completion rates, percent reduction from baseline in focal seizure frequency over placebo, ≥50% responder rates, and tolerability were evaluated for each subgroup. A total of 1160 patients were investigated. Study completion rates were similar in the AED-exposed subgroups and AED-naïve subgroups. In subgroups with (531 patients) or without (629 patients) prior LEV exposure, ≥50% responder rates for each dose of BRV compared with placebo were generally higher among the LEV-naïve subgroups than the previously LEV-exposed subgroups. LEV-exposed subgroups receiving BRV doses ≥50mg/day showed greater ≥50% responder rates than those receiving placebo. Similar results were observed for CBZ, TPM, and LTG. Previous treatment failure with commonly prescribed AEDs (LEV, CBZ, TPM, or LTG) is associated with a reduced response to BRV irrespective of the mechanism of action. Hence, this post-hoc analysis indicates that previous treatment failure with LEV does not preclude the use of BRV in patients with epilepsy

Neural-Shadow Quantum State Tomography

Quantum state tomography (QST) is the art of reconstructing an unknown quantum state through measurements. It is a key primitive for developing quantum technologies. Neural network quantum state tomography (NNQST), which aims to reconstruct the quantum state via a neural network ansatz, is often implemented via a basis-dependent cross-entropy loss function. State-of-the-art implementations of NNQST are often restricted to characterizing a particular subclass of states, to avoid an exponential growth in the number of required measurement settings. To provide a more broadly applicable method for efficient state reconstruction, we present "neural-shadow quantum state tomography" (NSQST)-an alternative neural network-based QST protocol that uses infidelity as the loss function. The infidelity is estimated using the classical shadows of the target state. Infidelity is a natural choice for training loss, benefiting from the proven measurement sample efficiency of the classical shadow formalism. Furthermore, NSQST is robust against various types of noise without any error mitigation. We numerically demonstrate the advantage of NSQST over NNQST at learning the relative phases of three target quantum states of practical interest. NSQST greatly extends the practical reach of NNQST and provides a novel route to effective quantum state tomography

Statistical Studies of Fading in Underwater Wireless Optical Channels in the Presence of Air Bubble, Temperature, and Salinity Random Variations (Long Version)

Optical signal propagation through underwater channels is affected by three main degrading phenomena, namely absorption, scattering, and fading. In this paper, we experimentally study the statistical distribution of intensity fluctuations in underwater wireless optical channels with random temperature and salinity variations as well as the presence of air bubbles. In particular, we define different scenarios to produce random fluctuations on the water refractive index across the propagation path, and then examine the accuracy of various statistical distributions in terms of their goodness of fit to the experimental data. We also obtain the channel coherence time to address the average period of fading temporal variations. The scenarios under consideration cover a wide range of scintillation index from weak to strong turbulence. Moreover, the effects of beam-collimator at the transmitter side and aperture averaging lens at the receiver side are experimentally investigated. We show that the use of a transmitter beam-collimator and/or a receiver aperture averaging lens suits single-lobe distributions such that the generalized Gamma and exponential Weibull distributions can excellently match the histograms of the acquired data. Our experimental results further reveal that the channel coherence time is on the order of $10^{-3}$ seconds and larger which implies to the slow fading turbulent channels