Effect of Self-care on Quality of Life of Multiple Sclerosis Patients.

مولتیپل اسکلروزیس به عنوان یک بیماری غیرقابل درمان و دارای معلولیتهای فراوان، تا حدود زیادی زندگی طبیعی مبتلایان را تحت تأثیر قرار می دهد. با آموزش مراقبت از خود می توان از بروز یا پیشرفت بسیاری از عوارض کاست، زندگی مطلوب را افزایش داد و در تحمل بسیاری از مشکلات بوسیله سازگاری با شرایط به وجود آمده، خانواده را یاری داد؛ لذا این پژوهش با هدف بررسی تاثیر خودمراقبتی بر کیفیت زندگی مبتلایان به مولتیپل اسکلروزیس صورت گرفته است. این پژوهش به صورت نیمه تجربی، یک گروهی و دو مرحله ای انجام شده است. تعداد کل نمونه ها 28 بیمارمبتلا به مولتیپل اسکلروزیس مراجعه کننده به یکی ازدرمانگاه های خصوصی ونیز درمـانگاه بیمارستان الزهرا بوده اند که با روش نمونه گیری آسان انتخاب شده اند. اطلاعات مورد نیاز با استفاده از پرسشنامه خود ساخته کیفیت زندگی جمع آوری گردیده است. نتایج حاصل با استفاده از آمار توصیفی و استنباطی با نتایج قبلی مورد مقایسه قرار گرفت. یافته های پژوهش نشان داد که افزایش چشمگیری در میانگین امتیازات کیفیت زندگی در حیطه های عملکردجسمانی، روانشناختی ،حیطه عملکرد اجتماعی و سلامت عمومی بعد از اقدام به خودمراقبتی ایجاد شده است. همچنین یافته های پژوهش نشان داد که میانگین امتیازات کلی کیفیت زندگی بعد از خودمراقبتی افزایش بارزی نسبت به قبل از خودمراقبتی داشته است. نتایج حاصل از پژوهش نشان می دهد که انجام خودمراقبتی تاثیر مثبتی بر روی اجزای کیفیت زندگی دارد. امید است با ایجاد و تقویت انجمن های آموزشی و حمایتی، امکان انجام اقدامات خود مراقبتی برای بیماران مبتلا به مولیتپل اسکلروز فراهم گردد

Effect of Self-care on Quality of Life of Multiple Sclerosis Patients.

Long term diseases and their psycho-cognitive physiologic defects or signs affect life quality of the patients in different life stages and threaten their health resulting in their disabilities. Multiple sclerosis (MS) as a long-term life threatening disease can make acute disabilities affecting patients’ life trend. Unknown manner of disease, poor prognosis and treatment on one hand and hard prevention on the other hand have all limited the treatment to a supportive one although patients can have almost a normal length of life with appropriate self-care. Self care can well diminish the disease extension and complications provides the patient with a better life quality and his family with a better coping ability against new conditions. So this study was carried out with the above title. This study was quasi-experimental and the method of data gathering was questionnaires which included two sections as follows 26 MS patients referring to private and clinic of Isfahan Alzahra hospital were selected by convenient sampling. After that, the subjects started self-care programs for three weeks and then life quality questionnaire was filled either with the patients or the researcher. The findings were analyzed and compared with former findings through descriptive and inferential statistics. Findings showed a noticeable increase in life quality mean score in domain of physical function (P<0.001), psycho cognitive domain (p<0.001), social function (P<0.001) and general health (p<0.001) after self care program. There was also a sharp increase in total life quality score after self-care program compared with before that. The findings showed that self-care could positively affect life quality items. It is hoped that by formation of educational supportive associations or at least a well equipped rehabilitation center for the patients, the patients can be provided with facilities of self-care as well as a condition in which the patients themselves carry out their self care

Thrombocytopenia as a marker of outcome in patients with acute exacerbation of chronic obstructive pulmonary disease

Introduction: Thrombocytopenia (TP) is associated with poor outcome in patients who are critically ill with pneumonia, burns, and H1N1 influenza. To our knowledge, no similar study in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has been conducted to date. The aim of this study was to determine the impact of platelet count on the outcome of patients with AECOPD. Material and methods: Patients admitted to our teaching hospital for AECOPD were divided into two cohorts, those with and without TP. The outcome of all patients was followed. Results: Of the 200 patients with AECOPD, 55 (27.5%) had TP. Of these, 14 (25.5%) died in the hospital, whereas of the 145 non-TP patents, 11 (7.5%) died (p-value = 0.001). There was a significantly higher transfer rate to the ICU and mechanical ventilation in TP patients. The mean platelet count was significantly lower in patients who died than those who were discharged (161,672 vs. 203,005 cell/μL; p-value = 0.017). There was negative correlation between duration of hospitalization and platelet count. Conclusion: TP was associated with poor outcome in AECOPD. TP could be considered as a marker for the assessment of inflammation and prognosis in AECOPD patients based on its cost-effective features

Your Out-of-Distribution Detection Method is Not Robust!

Out-of-distribution (OOD) detection has recently gained substantial attention due to the importance of identifying out-of-domain samples in reliability and safety. Although OOD detection methods have advanced by a great deal, they are still susceptible to adversarial examples, which is a violation of their purpose. To mitigate this issue, several defenses have recently been proposed. Nevertheless, these efforts remained ineffective, as their evaluations are based on either small perturbation sizes, or weak attacks. In this work, we re-examine these defenses against an end-to-end PGD attack on in/out data with larger perturbation sizes, e.g. up to commonly used $\epsilon=8/255$ for the CIFAR-10 dataset. Surprisingly, almost all of these defenses perform worse than a random detection under the adversarial setting. Next, we aim to provide a robust OOD detection method. In an ideal defense, the training should expose the model to almost all possible adversarial perturbations, which can be achieved through adversarial training. That is, such training perturbations should based on both in- and out-of-distribution samples. Therefore, unlike OOD detection in the standard setting, access to OOD, as well as in-distribution, samples sounds necessary in the adversarial training setup. These tips lead us to adopt generative OOD detection methods, such as OpenGAN, as a baseline. We subsequently propose the Adversarially Trained Discriminator (ATD), which utilizes a pre-trained robust model to extract robust features, and a generator model to create OOD samples. Using ATD with CIFAR-10 and CIFAR-100 as the in-distribution data, we could significantly outperform all previous methods in the robust AUROC while maintaining high standard AUROC and classification accuracy. The code repository is available at https://github.com/rohban-lab/ATD .Comment: Accepted to NeurIPS 202

The possibility of access to the kidneys from posterior axillary line in supine position for percutaneous nephrolithotomy

Please cite this article as: Tabibi A, Kashi AH, Mirjalili SAM, Mahmoudnejad N, Kashani P, Salavatipour B, Soltani MH. The possibility of access to the kidneys from posterior axillary line in supine position for percutaneous nephrolithotomy. Novel Biomed 2013;1(2):43-47.Objectives: To evaluate the possibility of access to the kidneys from posterior axillary line (PAL) in supine position for percutaneous nephrolithotomy.Materials and Methods: 102 consecutive patients who were candidated for abdominal CT scan, enrolled in this study. In cases of impossible access, the point on the posterior surface of body which permitted safe access was determined and the percent of movement toward body midline (relative to PAL) was calculated (M.PER).Results: Percutaneous access was simulated from upper and middle calyces of the kidney in 13% and 75% of cases, respectively. Access to the lower region was possible in 90% of right and 79% of left lower calyces, respectively (p=0.03). In cases with impossible access from PAL, the M.PER for a safe access was 46-47% for upper region and 34- 38% for middle and lower calyces of the kidney (P = 0.0001).Conclusions: Access to upper calyces from PAL was limited in some cases regarding to the presence of solid organs. Presence of colon made access impossible in the lower right and left calyces in about 10% and 20% of cases, respectively. In upper region, more deviation toward midline was necessary to establish a safe access compared with middle and lower calyces

Complexity of Computing the Anti-Ramsey Numbers for Paths

The anti-Ramsey numbers are a fundamental notion in graph theory, introduced in 1978, by Erd\" os, Simonovits and S\' os. For given graphs $G$ and $H$ the \emph{anti-Ramsey number} $\textrm{ar}(G,H)$ is defined to be the maximum number $k$ such that there exists an assignment of $k$ colors to the edges of $G$ in which every copy of $H$ in $G$ has at least two edges with the same color. There are works on the computational complexity of the problem when $H$ is a star. Along this line of research, we study the complexity of computing the anti-Ramsey number $\textrm{ar}(G,P_k)$, where $P_k$ is a path of length $k$. First, we observe that when $k = \Omega(n)$, the problem is hard; hence, the challenging part is the computational complexity of the problem when $k$ is a fixed constant. We provide a characterization of the problem for paths of constant length. Our first main contribution is to prove that computing $\textrm{ar}(G,P_k)$ for every integer $k>2$ is NP-hard. We obtain this by providing several structural properties of such coloring in graphs. We investigate further and show that approximating $\textrm{ar}(G,P_3)$ to a factor of $n^{-1/2 - \epsilon}$ is hard already in $3$-partite graphs, unless P=NP. We also study the exact complexity of the precolored version and show that there is no subexponential algorithm for the problem unless ETH fails for any fixed constant $k$. Given the hardness of approximation and parametrization of the problem, it is natural to study the problem on restricted graph families. We introduce the notion of color connected coloring and employing this structural property. We obtain a linear time algorithm to compute $\textrm{ar}(G,P_k)$, for every integer $k$, when the host graph, $G$, is a tree

A Study of Sojourn Time for Indoor LiFi Cellular Networks

Sojourn time is an important parameter in the analysis and design of mobile cellular networks. It shows the expected time that a user equipment (UE) remains connected to the serving access point (AP) while moving in the network, i.e. stays within one cell. Therefore, an accurate estimation of the sojourn time is an essential element for mobility management. In this study, an analysis of the sojourn time for indoor light-fidelity (LiFi) cellular networks is presented based on the random waypoint (RWP) mobility model. It is initially assumed that the UE is oriented vertically upward and closed-form analytical expressions are derived. Monte-Carlo simulations are also provided to validate the analytical derivations and to gain more insight into the performance with different orientations. It is shown that the sojourn time mainly varies depending on the speed of the user. However, other factors such as the device orientation and the coverage area of cells also play a role in determining the sojourn time. The results offer several insights and design guidelines in consideration of this parameter for indoor LiFi networks

Early Effects of Percutaneous Nephrolithotomy on Glomerular Filtration Rate and Determining the Potential Risk Factors Responsible for Acute Postoperative Renal Function Impairment

Background: In this study, the early effects of percutaneous nephrolithotomy (PCNL) on glomerular filtration rate (GFR) was assessed in different postoperative times and likewise, we determined the correlation of different variables with significant postoperative GFR drop  after PCNL.Materials and Methods: Patient records of 486 cases that had undergone PCNL from January 2010 to October 2011 were reviewed retrospectively. GFR in six hours, one, two and three days after PCNL and in the discharge day were calculated and then compared with preoperative level. Correlation between different variables (Perioperative hemorrhage, co-morbidities, previous stone surgery, renal anomaly, number of access, stone burden and location) and risk of acute postoperative renal function impairment (GFR drop greater than 25%) were assessed.Results: Mean preoperative GFR was 87.85±29.41ml/min/1.73m² which decreased to 86.18±28.77, 78.45±28.74, 78.79±26.94, 84.24±29.71 and 86.18±28.77 in 6, 24, 48 and 72 hours after surgery and discharge day post PCNL, respectively. GFR significantly decreased in one and two days after surgery (p value&lt;0.0001 and p value &lt;0.05) but returned to near preoperative values in 3th post PCNL day. Among different variables, only perioperative bleeding (Cut-off point for serum hemoglobin drop was 2.8 mg/dL) was concomitant with significant postoperative renal function impairment.Conclusion: Our findings revealed that co-morbidities, large or multiple stones, multiple punctures and previous history of stone surgery have no significant impact on surgical outcomes. Postoperative GFR returned to near preoperative values in a few days after operation. Avoidance of significant perioperative bleeding is an important point to prevent post PCNL renal insufficiency