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

Compliance of Healthcare Workers with Hand Hygiene Practices in the Northeast of Iran: an Overt Observation

Hand hygiene (HH) is one of the most effective methods to prevent transmission and spread of microorganisms from one patient to another, also, it used to reduce the spread of pathogens in clinical settings and to help control outbreaks but compliance is usually poor. The purpose of this study was to analyze the compliance of hand hygiene and affecting factors among healthcare workers (HCWs) of northeast hospitals in Iran. This study was conducted based on observation method for the compliance of hand hygiene according to the World Health Organization (WHO) guidelines. HCWs were observed during routine patient care in different shifts, also the technique of hand hygiene was assessed through hand washing with alcohol-based disinfectant. Data were collected during 1 year, from June 2014 to July 2015 by the infection control teams in the northeast hospital of Iran. By direct observation, we evaluated a total of 92518 hand hygiene opportunities from 29 hospitals in the northeast of Iran during 1 year, with overall compliance rates in these hospitals were 43.42%. Compliance rates differed by role: nurses43%, doctors 19 % and other health workers 29%. In this observational study, we identified that adherence to hand hygiene practice and use of alcohol-based disinfectant was very low in this hospitals, so effective intervention programs to promote adherence to hand hygiene and use of disinfectants could be effective to increase compliance

High prevalence of extended-spectrum β-lactamase (blaCTX-M-15) and New Delhi metallo-β-lactamase-1 (NDM-1) genes among high-level carbapenem resistance Klebsiella pneumonia: an alarm for our health system

Background: The extended-spectrum β-lactamase (ESBL) carbapenems-resistant Klebsiella isolates are considered one of the most significant challenging in the treatment of patients in hospitals. The aim of this study was to determine the prevalence of important carbapenem resistance genes ESBL subtypes and between K. pneumoniae from patients at hospital in Tehran, Iran.Methods: Fifty-four isolates of K. pneumoniae were isolated from Shariatee Hospital in Tehran from February 2013 to July 2016. Antibiotic testing was done by using the standard disk diffusion method and E-test MIC. The confirmation of carbapenemase activity was performed using an MHT and a new method called the carbapenem inactivation method test (CIM). Finally, a polymerase chain reaction (PCR) and sequencing of related genes was performed.Results: Our PCR data demonstrate that blaCTX-M group’s 40 (81.4%) genes were the most prevalent in our hospital followed by group genes blaCTX-M-3 (18.51%) and blaCTX-M-2 (20.38%). The distribution of the CTX-M group revealed that blaCTX-M-15 23 (42.6%) was the dominant subtype. The coexistence of multiple genes included blaTEM, CTX-M and blaSHV, and CTX-M The presence of blaNDM1, blaOXA-48, and blaKPC were identified in the carbapenem-resistant isolates, 22 (40.7%), 10 (18.5%), and 7 (12.9%) respectively.Conclusion: Our research showed that a CIM test for the first time in Iran is possible and has a high facility for the fast identification of carbapenem-resistant Klebsiella (CRK). We are encountered with the emergence of CTX-M, OXA-48, KPC, and NDM1 harboring CRK strains in our hospitals. Therefore, the treatment of patients infected with these isolates will be an important future concern in our clinical settings.Running Head: Resistance genes among carbapenem-resistant Klebsiella pneumoniaKeywords: New Delhi metallo-beta-lactamase-1, Klebsiella pneumoniae, Carbapenem, Extended-spectrum ß-lactamas

Cost-effectiveness of rotavirus vaccination for under-five children in Iran

Background: Rotavirus diarrhea is one of the most important causes of death among under-five children. Anti-rotavirus vaccination of these children may have a reducing effect on the disease. Objectives: this study is intended to contribute to health policy-makers of the country about the optimal decision and policy development in this area, by performing cost-effectiveness and cost-utility analysis on anti-rotavirus vaccination for under-5 children. Patients and Methods: A cost-effectiveness analysis was performed using a decision tree model to analyze rotavirus vaccination, which was compared with no vaccination with Iran�s ministry of health perspective in a 5-year time horizon. Epidemiological data were collected from published and unpublished sources. Four different assumptions were considered to the extent of the disease episode. To analyze costs, the costs of implementing the vaccination program were calculated with 98 coverage and the cost of USD 7 per dose. Medical and social costs of the disease were evaluated by sampling patients with rotavirus diarrhea, and sensitivity analysis was also performed for different episode rates and vaccine price per dose. Results: For the most optimistic assumption for the episode of illness (10.2 per year), the cost per DALY averted is 12,760 and 7,404 for RotaTeq and Rotarix vaccines, respectively, while assuming the episode of illness is 300, they will be equal to 2,395 and 354, respectively, which will be highly cost-effective. Number of life-years gained is equal to 3,533 years. Conclusions: Assuming that the illness episodes are 100 and 300 for Rotarix and 300 for Rota Teq, the ratio of cost per DALY averted is highly cost-effective, based on the threshold of the world health organization (< 1 GDP per capita = 4526 USD). The implementation of a national rotavirus vaccination program is suggested. © 2015, Growth & Development Research Center

A Deontic Logic Analysis of Autonomous Systems' Safety

We consider the pressing question of how to model, verify, and ensure that autonomous systems meet certain \textit{obligations} (like the obligation to respect traffic laws), and refrain from impermissible behavior (like recklessly changing lanes). Temporal logics are heavily used in autonomous system design; however, as we illustrate here, temporal (alethic) logics alone are inappropriate for reasoning about obligations of autonomous systems. This paper proposes the use of Dominance Act Utilitarianism (DAU), a deontic logic of agency, to encode and reason about obligations of autonomous systems. We use DAU to analyze Intel's Responsibility-Sensitive Safety (RSS) proposal as a real-world case study. We demonstrate that DAU can express well-posed RSS rules, formally derive undesirable consequences of these rules, illustrate how DAU could help design systems that have specific obligations, and how to model-check DAU obligations.Comment: 11 pages, 4 figures, In 23rd ACM International Conference on Hybrid Systems: Computation and Contro

Utilising novel green binders in ground improvement applications

Special attention is being paid currently to geopolymers as novel binders in ground improvement applications. The use of industrial by-products such as fly ash (FA) and slag (S) in the synthesis of geopolymers makes these alternatives to traditional binders, such as Portland cement, sustainable binders with low-carbon footprint. Geopolymers have been studied and used in a variety of applications, such as concrete or ceramic manufacturing, with controllable conditions of production environment. There are however limited knowledge on the use of geopolymers, as stabilising binders, in ground improvement projects and lack of certainties as to how these new binders would behave in the field where varying factors such as water table or temperature could affect the strength development. This study evaluates the reliability of using a FA and S based geopolymer to stabilise a soft marine clay. The strength development and the mineralogy of the mixtures were studied. The combined FA+S contents were 10, 20 and 30%, and mixtures were prepared at water contents of 0.75, 1.0 and 1.25 liquid limit (LL). Samples were cured for 28 days at temperatures of 10, 25 and 40°C. Strength development was significantly increased by adding the FA+S content, particularly at 20% and higher. Moreover, when the water content was increased from 0.75 to 1.0 LL, strength development was enhanced, followed by a decrease at water content of 1.25 LL. Furthermore, by increasing the curing temperature, higher strengths were achieved and the strength development was accelerated. The results indicated that green geopolymeric binders could be used as reliable binders in ground improvement applications

Comparison of the effectiveness and safety of formoterol versus salmeterol in the treatment of patients with asthma: A systematic review and meta-analysis

Background: Formoterol and salmeterol are two long-acting β2-agonists given by inhalation, with bronchodilating eff ects lasting for at least 12 h after a single administration. Formoterol has a faster onset of action compared with salmeterol. Th e aim of this study was to perform a systematic review and meta-analysis on the data published from previous review in order to calculate pooled estimates of eff ectiveness and safety assessment of formoterol and salmeterol in treatment of patients with asthma. Materials and Methods: In this study, we conducted an electronic search for medical citation databases including Cochrane, PubMed, Scopus, PsycInfo, and IranMedex. Besides manual search of the databases that record randomized clinical trials, conference proceedings, and journals related to asthma were included. Studies were evaluated by two independent people based on inclusion and exclusion criteria, and the common outcomes of studies were entered into the RevMan 5.0.1 software, after evaluation of studies and extraction of data from them; and in cases where there were homogeneous studies, meta-analysis was performed, and for heterogeneous studies, the results were reported qualitatively. Results: Of the 1539 studies initially found, 13 were included in the study. According to the meta-analysis conducted, no signifi cant diff erence was found between the inhalation of formoterol 12 μg and salmeterol 50 μg in the two outcomes of mean forced expiratory volume 1 s (FEV1), 12 h after inhalation of medication and Borg score (A frequently used scale for quantifying breathlessness) after inhalation of medication. In addition, salmeterol was more eff ective than formoterol in the two outcomes of percent decrease in FEV1 after inhalation of methacholine and the number of days without an attack. Since the two outcomes of FEV1 30-60 min after inhalation of medication and morning peak expiratory fl ow after inhalation of medication were heterogeneous, they had no meta-analysis capabilities, and its results were reported qualitatively. Conclusion: Th e data from included studies shows that, more effi cacy has been achieved with Salmeterol, especially in some outcomes such as the percent decrease in FEV1 after inhalation of Methacholine, and the number of days without an attack; and therefore, the administration of Salmeterol seems to be benefi cial for patients, compared with Formoterol. © 2015 Journal of Research in Medical Sciences

Parameterization of a linear vibronic coupling model with multiconfigurational electronic structure methods to study the quantum dynamics of photoexcited pyrene

With this work, we present a protocol for the parameterization of a Linear Vibronic Coupling (LVC) Hamiltonian for quantum dynamics using highly accurate multiconfigurational electronic structure methods such as RASPT2/RASSCF, combined with a maximum-overlap diabatization technique. Our approach is fully portable and can be applied to many medium-size rigid molecules whose excited state dynamics requires a quantum description. We present our model and discuss the details of the electronic structure calculations needed for the parameterization, analyzing critical situations that could arise in the case of strongly interacting excited states. The protocol was applied to the simulation of the excited state dynamics of the pyrene molecule, starting from either the first or the second bright state (S2 or S5). The LVC model was benchmarked against state-of-the-art quantum mechanical calculations with optimizations and energy scans and turned out to be very accurate. The dynamics simulations, performed including all active normal coordinates with the multilayer multiconfigurational time-dependent Hartree method, show good agreement with the available experimental data, endorsing prediction of the excited state mechanism, especially for S5, whose ultrafast deactivation mechanism was not yet clearly understood