Headache Characteristics Among Patients With Epilepsy and the Association With Temporal Encephaloceles

PURPOSE: Our aim was to determine if headaches characteristic of possible Idiopathic Intracranial Hypertension (IIH) and in general were more prevalent in patients with versus without temporal encephaloceles (TEs) among patients with epilepsy. METHODS: Electronic medical records were reviewed retrospectively. Among 474 patients with epilepsy, 103 patients (21.7%) had at least one TE diagnosed on initial MRI or on retrospective review by a board-certified neuroradiologist, while 371 patients had no TE present. The patients were grouped into one of four categories depending on their headache characteristics (IIH-like, peri-ictal, other, or no headaches). Analysis of the categories was performed using a Chi Square test. RESULTS: Patients with TEs were more likely to experience headaches of any type than no headaches and more likely to experience IIH-like headaches than to have other headaches or no headaches compared to patients without TEs. Interestingly, patients with TEs were also more likely to experience peri-ictal headaches compared to patients without TEs. However, patients with TEs were no more likely or unlikely to have other (non-IIH or peri-ictal) headaches vs no reported headaches and were not more or less likely to have elevated opening pressure. CONCLUSION: On retrospective review, patients with TEs and epilepsy were more likely to exhibit headache features characteristic of IIH or to have peri-ictal headaches compared to epilepsy patients without TEs. These findings underscore the need for careful and thorough history of associated headaches in patients with epilepsy so that those patients at risk for TEs can undergo careful inspection of MRI to evaluate for their presence, which may represent a focus for seizures

Tree-Based Method for Classifying Websites Using Extended Hidden Markov Models

Abstract. One important problem proposed recently in the field of web mining is website classification problem. The complexity together with the necessity to have accurate and fast algorithms yield to many attempts in this field, but there is a long way to solve these problems efficiently, yet. The importance of the problem encouraged us to work on a new approach as a solution. We use the content of web pages together with the link structure between them to improve the accuracy of results. In this work we use Naïve-bayes models for each predefined webpage class and an extended version of Hidden Markov Model is used as website class models. A few sample websites are adopted as seeds to calculate models' parameters. For classifying the websites we represent them with tree structures and we modify the Viterbi algorithm to evaluate the probability of generating these tree structures by every website model. Because of the large amount of pages in a website, we use a sampling technique that not only reduces the running time of the algorithm but also improves the accuracy of the classification process. At the end of this paper, we provide some experimental results which show the performance of our algorithm compared to the previous ones

Patients with Mild Cognitive Impairment May be Stratified by Advanced Diffusion Metrics and Neurocognitive Testing

BACKGROUND AND PURPOSEMild cognitive impairment (MCI) is a prevalent disorder, with a subset of patients progressing to dementia each year. Although MCI may be subdivided into amnestic or vascular types as well as into single or multiple cognitive domain involvement, most prior studies using advanced diffusion imaging have not accounted for these categories. The purpose of the current study was to determine if the pattern of diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) metrics in patients with amnestic MCI (aMCI) correlate to specific cognitive domain impairments.METHODSNineteen consecutive patients with aMCI referred for brain magnetic resonance imaging (MRI) were included. All subjects underwent neurocognitive testing. A z‐score was calculated for each domain and a composite of all four domains. Brain MRI included standard structural imaging and diffusion imaging. Volumetric, DTI, and DKI metrics were calculated and statistical analysis was performed with adjustments for multiple measures and comparisons.RESULTSStatistically significant correlations between diffusion metrics and cognitive z‐scores were detected: visuospatial‐visuoconstructional z‐scores only correlated with alterations in the corpus callosum splenium, executive functioning z‐scores with the corpus callosum genu, memory testing z‐scores with the left hippocampus, and composite z‐scores with the anterior centrum semiovale.CONCLUSIONNeuroimaging studies of patients with aMCI to date have assumed a population with homogeneous cognitive impairment. Our results demonstrate selective patterns of regional diffusion metric alterations correlate to specific cognitive domain impairments. Future studies should account for this heterogeneity, and this may also be useful for prognostication.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147217/1/jon12588_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147217/2/jon12588.pd

Comparison of analgesic effects of intravenous and intranasal ketorolac in patients with mandibular fracture-A Randomized Clinical Trial

Similarity of pharmacokinetics of intranasal ketorolac to the intravenous form and other advantages have promoted its application. This study compared the analgesic effects of intravenous and intranasal ketorolac in patients undergoing mandibular fracture surgery. In this clinical trial study, Sixty-four patients with unilateral mandibular fracture were divided randomly into two groups. In group 1, 30 mg of intravenous (IV) ketorolac was injected every 8 hours and in group 2, intranasal (IN) ketorolac spray was used as a 100-µL puff in each nostril (31.5 mg) every 6 hours. After each patient regained consciousness, pain intensity was measured based on visual analogue scale for 48 hours. Finally, the total dose of the opioid analgesic agent (pethidine) and the time for the first request for an analgesic agent were recorded for each patient, and their means were compared in each group with proper statistical tests. Mean pain intensity of patients at baseline was significantly higher than that at other intervals and then, it decreased significantly (P0.05). Application of intranasal ketorolac spray decreased pain after mandibular fracture surgery, especially at 8-hour interval after surgery, decreasing the need for opioids

Evaluation of last-year dental students’ skill at the Tabriz Faculty of Dentistry about principles of writing prescriptions

Background: Inattention to the principles of writing prescriptions might give rise to ineffective or hazardous treatment and inflict injuries to the patient. The aim of this study was to evaluate the last-year dental students’ skill in writing prescription at the Tabriz Faculty of Dentistry in 2016-2017. Methods: In this cross-sectional study, all last-year dental students (92 students) at the Tabriz Faculty of Dentistry were asked to write separate prescription for 3 patients. The level of compliance with the principles of writing prescriptions was evaluated based on the WHO checklist, which consists of the following items: patient’s name, gender and age; date of prescription; Rx symbol; the form and name of the drug; the dose of the medication; the number of the drugs to be filled; administration interval; the strength of the drug; route of administration; the signature and seal of the physician; and the refill order. Each correct item was given a positive score and each incorrect item received no score (score range: 0-45). Results: 10.9%, 43.5% and 45.6% of the students exhibited high, moderate and low skill. The mean score was 27.75 (SD 8.75) of a total possible score of 45. There were no significant differences between male and female students (P = 0.7, CI = -4.5 to 3.2, effect size = -0.035). Conclusion: Overall, final-year dental students’ skill in writing prescriptions was at a moderate level and no student fully observed all the principles for the correct method of writing prescriptions

The expression analysis of IL-6, IL-18, IL-21, IL-23, and TGF-β mRNA in the nasal mucosa of patients with Allergic rhinitis

Background: The profile of inflammatory and suppressing cytokines is important to contribute to the disruption of TH1/ TH2 balance in Allergic rhinitis (AR). Objective: This study aimed to assess the expression levels of IL-6, IL-18, IL-21, IL-23, and TGF-beta in nasal biopsies in AR patients and evaluate its correlation with the severity of AR. Material and method: The study included 30 patients with mild persistent allergic rhinitis (MPAR), patients with moder- ate-to-severe (M/S) PAR, and 30 healthy individuals. The biopsies of nasal inferior turbinate mucosa were collected from each participant. The expression of IL-6, IL-18, IL-21, IL-23, and TGF-beta was evaluated by the quantitative real-time polymerase chain reaction. The degree of eosinophil infiltration into the nasal mucosa, blood eosinophils, and total serum IgE level were also measured. Result: The expression of IL-6, IL-18, and IL-23 in patients with AR significantly increased compared to the control group. Conversely, the gene expression of the TGF-beta declined in the M/S PAR group rather than the AR-group. The data did not show a significant difference in the expression of the IL-21 gene between AR+ and AR-groups. Conclusion: We suggested that inflammatory cytokines including IL-6, IL-18, and IL-23 may be involved in the severity of AR and associated with markers of inflammation