Health-related quality of life and medication adherence in elderly patients with epilepsy

Objective. Considering the high prevalence of epilepsy in the elderly and the importance of maximising their quality of life (QoL), this study aimed to investigate the relationship between medication adherence and QoL, and the mediating effects of medication adherence on the association between serum antiepileptic drug (AED) level and seizure severity with QoL in elderly epileptics. Methods. In a longitudinal study, 766 elderly patients with epilepsy who were prescribed a minimum of one antiepileptic drug were selected by convenience sampling method. A Medication Adherence Report Scale (MARS-5) questionnaire was completed at the baseline. Seizure severity and QoL were assessed after six months using the Liverpool Seizure Severity Scale (LSSS) and the QoL in Epilepsy (QOLIE-31) questionnaires respectively. Serum level of AED was also measured at six-month follow-up. Results. Medication adherence was significantly correlated with both seizure severity (β = –0.33, p < 0.0001) and serum AED level (β = 0.29, p < 0.0001) after adjusting for demographic and clinical characteristics. Neither QoL nor its sub-classes were correlated with seizure severity. In addition, a significant correlation was not observed between serum AED level and QoL. However, medication adherence was significantly correlated with QoL (β = 0.30, p < 0.0001). The mediating effects of medication adherence on the association between serum AED level (Z = 3.39, p < 0.001) and seizure severity (Z = –3.47, p < 0.001) with QoL were supported by the Sobel test. Conclusion. This study demonstrates that medication adherence has a beneficial impact on QoL in elderly epileptics. Therefore, adherence to treatment should be monitored to improve their QoL

Histologic evaluation of pulpal response to MTA and capsaicin in cats

Introduction: In direct pup capping, the exposed pulp is directly capped with a capping material to provoke a dentinal bridge formation to seal the exposed area.The aim of this study was to evaluate the pulpal response to MTA and capsaicin in cats. Methods: The sample for this experimental study consisted of 24 canines of cats, weighed approximately 3-4kg. After sedation, the teeth were cut and exposed at 3mm above cementoenamel junction, then divided into two groups: 1) direct pulp capping with MTA 2) direct pulp capping with Capsaicin. The cavities were filled with glass ionomer cement (Fuji IX). The cats were sacrificed in the first, second, and fourth weeks 4 canine teeth were extracted for the purpose of histologic analysis. 6Serial sections were cut parallel to the longitudinal axis of the canines. The sections were stained with hematoxylin & eosin, and were observed and analyzed using a light microscope. Results: In both groups treated with MTA and capsaicin, the inflammation decreased during weeks1, 2, and 4. Less inflammation was seen in MTA group but there was no statistical difference between the two groups (p=0.22). In the group treated with capsaicin, necrosis was observed in every 12 samples, but in the other group treated with MTA, only 1 pulp necrosis was seen in the first week (p=0.000). There was no significant difference in dentinal barrier formation, inflammatory response, and soft tissue changes between the two groups. Conclusions: The results of this study showed that capsaicin can decrease the severity of inflammation, but it is ineffective in dentinal barrier formation

Investigating effect of Helicobacter pylori treatment on improvement of non-alcoholic fatty liver parameters: a randomized trial

Background and objective: The correlation between the eradication of Helicobacter pylori (HP) and non-alcoholic fatty liver disease (NAFLD) is a controversial one. The aim of this study is to investigate the effect of Helicobacter pylori treatment on liver function tests and lipid profiles and to compare its effects with exercise therapy and diet alone. Method: This was a double-blind randomized clinical trial conducted at Qazvin University of Medical Sciences. One hundred patients with NAFLD having a positive test for urea breath testing were randomly assigned into one of the intervention and comparison groups. The diet and physical activity program were given to two groups of patients for 8 weeks, three sessions per week. In addition to the above therapy, the patients in the intervention group also received HP treatment for 2weeks. The data corresponding to anthropometric and clinical features before and after the intervention were collected in both groups and compared using appropriate statistical methods. Results: After the treatment interventions, the variables of weight, BMI, blood glucose, triglyceride, AST, ALT, total cholesterol, and LDL-C were significantly decreased in both groups (p < .05). In the between-group comparisons, only ALT was significantly lower in the intervention group (HP) (p < .05). Conclusion: Findings of this study showed that the eradication of Helicobacter pylori could significantly improve the ALT index, but it had no additional effect on changes in metabolic indicators. Trial registration: Registration number: IRCT2015042020951N2 Name of trial registry: The study of treatment of Helicobacter pylori in improvement of non-alcoholic fatty liver disease The date of registration: 2015-05-12 Where the full trial protocol can be accessed: https://fa.irct.ir/trial/18489 Keywords: Non-alcoholic fatty liver disease, Helicobacter pylori, Alanine transaminase, Aspartate aminotransferase

Comparison ability of algae and nanoparticles on nitrate and phosphate removal from aquaculture wastewater

Background: Aquaculture wastewater contains high levels of phosphate and nitrate. The reuse of this water requires standards beyond the secondary standards to eliminate more organic pollutants from aquaculture effluents. In this research, the removal of these pollutants from wastewater using Chlorella vulgaris and Fe3O4 nanoparticles in the reactor space was investigated. Methods: This study was conducted on fish farms effluent in the laboratory system. For this purpose, a 5-L semi-industrial reactor with a mixer blade, porous plate, and a compressor was designed. Chlorella vulgaris samples were collected from the natural environment and cultured in the laboratory environment. Also, Fe3O4 nanoparticles were prepared from Iranian Nano Pishgaman Company to make the desired solution. During the experiment (3 weeks), samples were taken weekly (in one phase) from the effluent. Dissolved oxygen (DO), pH, nitrate (NO3), and phosphate (PO4) factors from the influent and effluent of the farms were measured. The statistical data were analyzed using SPSS version 21 and Excel 2013. Results: The amounts of nitrate and phosphate were decreased by about 80.76 and 80.55% in the biological reactor, whereas these amounts were 70.52 and 70.48% in the nanoparticle reactor, respectively. Also, there were significant differences in the amounts of NO3 and PO4 between the control treatment and weekly treatment (P < 0.05). Conclusion: Based on the results, both reactors were able to reduce nitrate and phosphate from aquaculture wastewater, but the efficiency of the biological reactor was higher than that of the nanoparticle reactor. Keywords: Nitrate, Phosphate, Fe3O4 nanoparticle, Chlorella vulgaris, Biological refinemen

Levels of Blood Biomarkers among Patients with Myocardial Infarction in Comparison to Control Group

BACKGROUND: Myocardial infarction (MI) as a term for a heart attack happens due to reduced blood flow to heart myocardium and lack of oxygen supply caused by plaques inthe interior walls of coronary arteries. With respect to the importance of MI etiology, we aimed to study the relationship of MI and blood examination variables.METHODS: This study was conducted in Mazandaran Heart Center as a hospital-based case-control Comprising 894 participants including 465 cases and 429 controls, individually matched by sex and age. Considered blood markers were analyzed using routine laboratory methods and equipment.RESULTS: Of all participants, 64.3% of the cases and 51.0% of the controls were males with a mean age of 61.2 (±13.8) in cases and 62.4 (±14.) in controls. We could not find any differences between cases and controls for total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and alkaline-phosphatase (ALP) (P&gt;0.05). However, levels of creatine-kinase-muscle/brain (CK-MB) (P&lt;0.0001), fasting-blood-sugar (FBS) (P&lt;0.0001), aspartateaminotransferase (AST) (P&lt;0.0001), alanine-transferase (ALT) (P&lt;0.0001) and erythrocyte sedimentation rate (ESR) (P=0.001) were significantly higher in cases compared to the controls (P&lt;0.05). Multivariable analyses revealed that the risk of MI was associated with high levels of AST (adjusted OR=24.3, 95%CI=3.5±165.6, P=0.001) and LDL (adjusted OR=7.4, 95%CI=1.0±51.8, P=0.001).CONCLUSION: Our investigation indicated that the levels of CK-MB, FBS, AST, ALT and ESR were significantly higher in patients with MI. Besides, our findings showed that the risk of MI in cases with high levels of AST and LDL was about 24 and 7 times more than the control group respectively

Cyber-enabled unconventional warfare: the convergence of cyberspace, social mobilization, and special warfare

TheUnited States currently faces an environment of constrained resources and increasing threats where new foreign policy options need to be considered. An area that holds the potential for low-profile campaigns to confront enemies of theUnited States is cyber-enabled unconventional warfare (UW). Conducting military operations through cyber-enabled UW is less expensive, and inherently, it involves less physical risk than a conventional deployment of U.S. military personnel abroad. This research indicates that seven conditions exist in the cyberspace environment that can enhance the conduct of UW. Since no organization in the U.S. military with the requisite capabilities to exploit these conditions in the cyber domain exists, one should be created. Cyber-enabled UW can provide scalable military options to U.S. policymakers that are currently not available.http://archive.org/details/cyberenabledunco1094547951Major, United States ArmyApproved for public release; distribution is unlimited

Treatment Outcome in Chronic Hepatitis C Infection: A Four Years Survey Among Iranian Patients

Abstract Background: Hepatitis C virus (HCV) infection is universal. Side effects of its treatment are observed in many patients. The present study was designed to evaluate treatment outcome and side effects of the treatment in chronic HCV infection. Materials and Methods: The current study was conducted prospectively on patients with hepatitis C infection. They had been treated with the standard drug regimen, if indicated. They were followed for treatment response, side effects of therapy, and its related factors. Findings: From ninety one patients, eighty four persons finished their treatment course. They comprised 71 (84.5%) males and 13 (15.5%) females. Their mean age was 41.5± 11.90 years (20-69 years). Genotype 3 was the most common virus genotype (51.2%). Sustained virologic response (SVR) was 84.5% for genotype 3 and 47.5% for genotype 1. Decrease in hemoglobin (43%), weakness and fatigue (26%), neutropenia (13%), and thrombocytopenia (13%) were the most common side effects of the treatment. Seven patients can not finish their treatment course, because of the side effects. Conclusion: Genotype 3, viral load less than 600000, and more than 3- fold rise in AST are associated with higher SVR. Early administration of the added drugs such as erythropoietin and G-CSF to not reduce the drug doses were also influential. Keywords: chronic hepatitis C, SVR, Peg-interferon, α-2a pegaferon, ribavirin, treatmen