A Primer on COVID-19 for Clinicians: Clinical Manifestation and Natural Course

Context: COVID-19 is a new pandemic in the world and data in the various aspect of this disease are evolving. In this review, the authors try to cover different aspects of clinical manifestations and the natural course of the disease. Evidence acquisition: For data gathering, the authors searched through MEDLINE, Cochrane library, google scholar and Scopus. The key phrases for search were "clinical presentation of COVID-19", "clinical features of COVID-19", "natural course of COVID-19", "neurologic manifestation of COVID-19", "cardiovascular manifestation of COVID-19" and "gastrointestinal manifestation of COVID-19". Results: After screening of titles and abstracts, the authors finally enrolled 55 articles. Then the full texts of the selected articles were read carefully to determine eligibility and extracting relevant information. Conclusion: The most common presentations of COVID-19 patients were fever, non-producing cough and dyspnea but a considerable amount of patients may seek heath care without these complaints. Asymptomatic patients and patients with only gastrointestinal and neurologic symptoms remain a significant challenge for medical practitioners

A Primer on COVID-19 for Clinicians: Clinical Manifestation and Natural Course

Context: COVID-19 is a new pandemic in the world and data in the various aspect of this disease are evolving. In this review, the authors try to cover different aspects of clinical manifestations and the natural course of the disease. Evidence acquisition: For data gathering, the authors searched through MEDLINE, Cochrane library, google scholar and Scopus. The key phrases for search were "clinical presentation of COVID-19", "clinical features of COVID-19", "natural course of COVID-19", "neurologic manifestation of COVID-19", "cardiovascular manifestation of COVID-19" and "gastrointestinal manifestation of COVID-19". Results: After screening of titles and abstracts, the authors finally enrolled 55 articles. Then the full texts of the selected articles were read carefully to determine eligibility and extracting relevant information. Conclusion: The most common presentations of COVID-19 patients were fever, non-producing cough and dyspnea but a considerable amount of patients may seek heath care without these complaints. Asymptomatic patients and patients with only gastrointestinal and neurologic symptoms remain a significant challenge for medical practitioners

Depth-Optimized Reversible Circuit Synthesis

In this paper, simultaneous reduction of circuit depth and synthesis cost of reversible circuits in quantum technologies with limited interaction is addressed. We developed a cycle-based synthesis algorithm which uses negative controls and limited distance between gate lines. To improve circuit depth, a new parallel structure is introduced in which before synthesis a set of disjoint cycles are extracted from the input specification and distributed into some subsets. The cycles of each subset are synthesized independently on different sets of ancillae. Accordingly, each disjoint set can be synthesized by different synthesis methods. Our analysis shows that the best worst-case synthesis cost of reversible circuits in the linear nearest neighbor architecture is improved by the proposed approach. Our experimental results reveal the effectiveness of the proposed approach to reduce cost and circuit depth for several benchmarks.Comment: 13 pages, 6 figures, 5 tables; Quantum Information Processing (QINP) journal, 201

Hypertonic Saline in the Treatment of Hemorrhagic Shock

Context: The present review discusses different studies about the treatment of hemorrhagic shock (HS) with hypertonic saline (HTS). Evidence acquisition: We have searched the title in the most popular databases containing recent meta-analysis or randomized clinical trials (RCTs). Results: We introduce the hemodynamic effects and mechanisms of action of HTS in HS. Evidence in this field shows controversial results. There are some data supporting the potential benefits of HTS infusion in HS. The goal of research in this field is to identify the best therapy in HS with the least mortality. Conclusion: Our conclusion shows that although HTS can decrease inflammatory response during HS, it can attenuate hypercoagulability and cause complications. There are no data supporting less mortality while treatment with HTS versus other fluids in HS

Antioxidant activity of the methanolic extracts of some species of Phlomis and Stachys on sunflower oil

Antioxidant effects of the methanolic extract of Phlomis bruguieri, P. herba-venti, P. olivieri, Stachys byzantina, S. inflata, S. lavandulifolia and S. laxa were tested in sunflower oil stored at 70ºC, by measuring peroxide values after regular intervals and compared with rosemary-, green tea- and BHAcontaining samples. The methanolic extracts of P. bruguieri and S. laxa were found to be most effective in stabilizing sunflower oil

Algebraic Characterization of CNOT-Based Quantum Circuits with its Applications on Logic Synthesis

The exponential speed up of quantum algorithms and the fundamental limits of current CMOS process for future design technology have directed attentions toward quantum circuits. In this paper, the matrix specification of a broad category of quantum circuits, i.e. CNOT-based circuits, are investigated. We prove that the matrix elements of CNOT-based circuits can only be zeros or ones. In addition, the columns or rows of such a matrix have exactly one element with the value of 1. Furthermore, we show that these specifications can be used to synthesize CNOT-based quantum circuits. In other words, a new scheme is introduced to convert the matrix representation into its SOP equivalent using a novel quantum-based Karnaugh map extension. We then apply a search-based method to transform the obtained SOP into a CNOT-based circuit. Experimental results prove the correctness of the proposed concept.Comment: 8 pages, 13 figures, 10Th EUROMICRO Conference on Digital System Design, Architectures, Methods and Tools, Germany, 200

Topical gel of Metformin solid lipid nanoparticles: a hopeful promise as a dermal delivery system

The aim of the present study was to enhance the skin delivery of metformin by making solid lipid nanoparticles containing metformin using the ultra-sonication method. To achieve the optimum skin delivery for metformin, the effects of the ratio of two surfactants (Tween:Span) on nanoparticles properties and their performance were investigated. Photon correlation spectroscopy, scanning electron microscopy (SEM), Powder X-ray Diffractometer (PXRD), Fourier transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC) were used to characterize the solid state of metformin in solid lipid nanoparticles. Generally, the particle size of nanoparticles decreased by the addition of co-emulsifier (Span®60). Results showed that all formulations made by binary mixtures of surfactants had low particle size, low Polydispersity index and high zeta potential. It was interesting to note that the smallest nanoparticles (203.8 ± 15.356) was obtained when the HLB of the binary surfactants (HLB of 11.67) was closer to the HLB of beeswax (HLB of 12) used in the preparation of SLN. It was also found that by decreasing the HLB of the system from 14.9 to 10.06 the zeta potential of SLNs increased from −0.651 ± 0.315 to −6.18 ± 0.438 mV. But, a further reduction in the HLB from 10.06 to 8.45 caused a reduction in the zeta potential from −6.18 to −3.596 ± 0.255. Results showed that the highest entrapment efficiency of 45.98 ± 9.20% was obtained for formulation with larger particle size and with the highest HLB value (HLB 14.9). DSC study showed that metformin in SLN is in an amorphous form. FT-IR spectra of Met-SLN showed that the prominent functional groups existed in the formulations which could be an indication of good entrapment of metformin in a lipid matrix. FT-IR results also ruled out any chemical interaction between the drug and the excipients. The amounts of metformin detected in the skin layers and the receptor chamber at all sampling times were higher for nanogel compared to metformin gel. This is an indication of a better performance of Metformin nanogel ex-vivo and could be developed further for clinical studies

Emergency Overcrowding Impact on the Quality of Care of Patients Presenting with Acute Stroke

Introduction: Emergency overcrowding is defined as when the amount of care required for patients overcomes the available amount. This can cause delays in delivering critical care in situations like stroke. Objective: The aim of this study was to assess the possible impact of emergency department (ED) crowding on the quality of care for acute stroke patients. Methods: In this cross-sectional prospective study, all patients with symptoms of acute stroke presenting to the ED of educational hospitals were enrolled. All patients were assessed and examined by the emergency medicine (EM) residents on shift and a questionnaire was filled out for them. The amount of time that passed from the first triage to performing the required interventions and delivering health services were recorded by the triage nurse. ED crowding was measured by the occupancy rate. Then, the correlation between all of the variables and ED crowding level were calculated. Results: The average daily bed occupancy rate was 184.9 ± 54.3%. The median time passed from the first triage to performing the interventions were as follows: the first EM resident visit after 34 min, the first neurologic visit after 138 min, head CT after 134 min, ECG after 104 min and ASA administration after 210 min. There was no statistically significant relationship between the ED occupancy rate and the time elapsed before different required health services in the management of stroke patients either throughout an entire day or during each 8-hour interval (p > 0.05). Conclusion: In the current study, the ED occupancy rate was not significantly correlated with the time frame associated with management of admitted acute stroke patients

Nebulized Budesonide vs. Placebo in Adults with Asthma Attack; a Double Blind Randomized Placebo-Controlled Clinical Trial

Introduction: Asthma is one of acute respiratory diseases leading to emergency department (ED) referral. Management of acute attack plays an important role in its outcome. Objective: This trial was designed to evaluate the effectiveness of nebulized budesonide versus placebo in moderate to severe acute asthma attack in adults in the ED. Method: In this clinical trial, we enrolled patients with acute exacerbation of asthma and standard treatment of acute asthma attack was administered to all of them. 41 patients in our study were randomly entered into 2 groups. In one group, we prescribed nebulized budesonide and in the other group nebulized placebo (normal saline) was administered. Patients’ demographic data, vital signs, symptoms’ acuity and the time of symptom relief, patient and physician satisfaction were all recorded and compared between the 2 groups. All cases were followed and disease outcome, readmission, mortality and morbidity rates were documented. Results: In this study, 20 patients were entered the budesonide group and 19 patients were enrolled in the placebo group. The mean age ranges were 55.70±15.30 and 60.32±18.41 years old respectively. Heart rate, respiratory rate and O2 saturation in the first group were improved significantly after the treatment in comparison to the second group (p<0.05). The mean time of recovery and length of hospital stay were better in the first group than the second group but this difference was not significant (p>0.05). Conclusion: The addition of nebulized budesonide to standard asthma treatment might result in more improvement in O2 saturation and less patient’s distress