Safety and discontinuation rate of dimethyl fumarate (Zadiva®) in patients with multiple sclerosis: an observational retrospective study

BACKGROUND: This study evaluates the real-world safety and discontinuation rate of Zadiva® (generic product of dimethyl fumarate (DMF)) in Iranian patients with relapsing-remitting multiple sclerosis (RRMS), supplementing existing clinical evidence from randomized controlled trials. METHODS: This retrospective observational study evaluated the real-world safety and discontinuation rate of DMF in RRMS patients from Amir A'lam referral hospital's neurology clinic. Data on safety, discontinuation rate, and clinical disease activity were collected retrospectively. The study aimed to assess the discontinuation rate, safety, and reasons for discontinuation, as well as the number of patients experiencing a relapse, MRI activity, and EDSS scores. RESULTS: In total, 142 RRMS patients receiving DMF were included in the study, with 15 discontinuing treatment due to adverse events, lack of efficacy, or pregnancy. Notably, a significant reduction in relapse rates was observed, with 90.8% of patients remaining relapse-free throughout the study period. After 1 year of treatment with Zadiva®, only 17.6% of patients experienced MRI activity, whereas the EDSS score remained stable. CONCLUSIONS: This study provides important real-world data on the safety and tolerability of Zadiva® in RRMS patients. The results indicate that Zadiva® is generally well tolerated and safe, with a low discontinuation rate due to adverse events or lack of efficacy. These findings suggest that Zadiva® is an effective and safe treatment option for RRMS patients in real-world practice

Safety and Efficacy of MLC601 in Iranian Patients after Stroke: A Double-Blind, Placebo-Controlled Clinical Trial

Objective. To investigate the safety and efficacy of MLC601 (NeuroAid) as a traditional Chinese medicine on motor recovery after ischemic stroke. Methods. This study was a double-blind, placebo-controlled clinical trial on 150 patients with a recent (less than 3 month) ischemic stroke. All patients were given either MLC601 (100 patients) or placebo (50 patients), 4 capsules 3 times a day, as an add-on to standard stroke treatment for 3 months. Results. Sex, age, elapsed time from stroke onset, and risk factors in the treatment group were not significantly different from placebo group at baseline (P > .05). Repeated measures analysis showed that Fugl-Meyer assessment was significantly higher in the treatment group during 12 weeks after stroke (P < .001). Good tolerability to treatment was shown, and adverse events were mild and transient. Conclusion. MLC601 showed better motor recovery than placebo and was safe on top of standard ischemic stroke medications especially in the severe and moderate cases

Energy-Efficient Service-Oriented Architecture for Mobile Cloud Handover

Mobile cloud computing uses features to deliver outsourcing data to remotely available mobile devices. However, the flexible nature of the mobile device is a critical challenge for the mobile cloud computing environment. The mobile phone significantly degrades the data transfer performance when initiating the handover process. Thus, an energy-efficient handover process could improve the quality of service (QoS). Here, we introduce a secure energy-efficient and quality-of-service architecture (EEQoSA) for the handover process in the mobile cloud computing environment. The proposed architecture involves four layers: application, the Internet protocol multimedia subsystem (IPMS), communication, and media with connectivity layers. These four layers collectively handle the energy-efficiency, security and QoS parameters. Existing service-oriented architectures designed for mobile cloud computing are based on the symmetric encryption cryptography to support different media services. However, this approach easily allows an adversary to expose the symmetric key and gain access to private data. Thus, our proposed architecture uses the secure and strong authentication (SSA) process at the IPMS layer by protecting the media services from unauthorized users, as the IPMS is the central layer that could be the entry point for an adversary. Furthermore, to extend the mobile lifetime during the handover process, an energy detection (ED) model is deployed at the communication layer to detect the energy level of the mobile device prior to the handover initialization process. The media with the connectivity layer supports the secure handover process using a priority enforcement module that allows only legitimate users to complete the re-registration process after initiating the handover. Finally, the architecture is tested using the CloudSim simulation environment and validated by a comparison with other known service-oriented architectures.https://doi.org/10.1186/s13677-017-0079-

CGMP: cloud-assisted green multimedia processing

With continued advancements of mobile computing and communications, emerging novel multimedia services and applications have attracted lots of attention and been developed for mobile users, such as mobile social network, mobile cloud medical treatment, mobile cloud game. However, because of limited resources on mobile terminals, it is of great challenge to improve the energy efficiency of multimedia services. In this paper, we propose a cloud-assisted green multimedia processing architecture (CGMP) based on mobile cloud computing. Specifically, the tasks of multimedia processing with energy-extensive consumption can be offloaded to the cloud, and the face recognition algorithm with improved principal component analysis and nearest neighbor classifier is realized on CGMP based cloud platform. Experimental results show that the proposed scheme can effectively save the energy consumption of the equipment

Towards Efficient and Scalable Data-Intensive Content Delivery: State-of-the-Art, Issues and Challenges

This chapter presents the authors’ work for the Case Study entitled “Delivering Social Media with Scalability” within the framework of High-Performance Modelling and Simulation for Big Data Applications (cHiPSet) COST Action 1406. We identify some core research areas and give an outline of the publications we came up within the framework of the aforementioned action. The ease of user content generation within social media platforms, e.g. check-in information, multimedia data, etc., along with the proliferation of Global Positioning System (GPS)-enabled, always-connected capture devices lead to data streams of unprecedented amount and a radical change in information sharing. Social data streams raise a variety of practical challenges: derivation of real-time meaningful insights from effectively gathered social information, a paradigm shift for content distribution with the leverage of contextual data associated with user preferences, geographical characteristics and devices in general, etc. In this article we present the methodology we followed, the results of our work and the outline of a comprehensive survey, that depicts the state-of-the-art situation and organizes challenges concerning social media streams and the infrastructure of the data centers supporting the efficient access to data streams in terms of content distribution, data diffusion, data replication, energy efficiency and network infrastructure. The challenges of enabling better provisioning of social media data have been identified and they were based on the context of users accessing these resources. The existing literature has been systematized and the main research points and industrial efforts in the area were identified and analyzed. In our works, in the framework of the Action, we came up with potential solutions addressing the problems of the area and described how these fit in the general ecosystem

EFFECTS OF 6-MONTHS TREATMENT WITH DONEPEZIL AND RIVASTIGMIN ON RESULTS OF NEUROPSYCHOLOGICAL TESTS OF MMSE, NPI, CLOCK AND BENDER IN PATIENTS WITH ALZHEIMER&apos;S DISEASE

Alzheimer&apos;s disease is the most common degenerative disease of brain. Nowadays, the most common treatment being used to slow down disease progression, include Donepezil , Rivastigmine and Galantamine, which all of them act as inhibitors of acetyl cholinesterase. General purpose of our study was to show effects of treatment with Donepezil and Rivastigmine, as two drugs that commonly used for treatment of AD in Iran and to compare these effects between two drugs. Samples selected from patients who had Alzheimer` disease with DSM IV criteria and were candidate of receiving Donepezil or Rivastigmine, as treatment of AD, for the first time. We used four neuropsychological tests including MMSE, NPI, Clock and Bender to assess patient&apos;s cognitive and behavioral changes during treatment with two drugs. Patients divided to two groups (each group 35 cases); Patients with plan of taking Donepezil entered into one of the groups and patients with plan of taking Rivastigmine entered into another. The four tests were completed once before starting treatment and then, 1 month, 3 months and 6 months after treatment with Donepezil and Rivastigmine. MMSE, 6 months after treatment with Donepezil, improved from 20.63 before treatment to 21.83, which is statistically significant (P = 0.04). Also, MMSE, 6 months after treatment with Rivastigmine, improved from 20.03 before treatment to 22.71, which was statistically significant (P = 0.007). About Clock test, there was a significant improvement from 5.74 before treatment to 6.4 after 6 months of treatment with Rivastigmine; while this significant improvement was not seen in patients receiving Donepezil. In two other tests, no significant differences were seen before and after treatment. Also, No significant difference was detected between two groups and so no different effects on these tests between Donepezil and Rivastigmine in 6 months period of treatment

"THE EFFECTS OF ANODAL IONTOPHORESIS OF EPINEPHRINE ON NEUROMUSCULAR RESPONSES IN HEALTHY MEN AND PATIENTS WITH MYASTHENIA GRAVIS "

Iontophoresis of epinephrine for assessment of neuromuscular junction response is a new technique that can improve diagnose of neuromuscular dysfunction. The purpose of this study was to investigate the effects of iontophoresis of epinephrine on neuromuscular junction response. Iontophoresis of epinephrine solution (1mg/ml), sodium chloride, calcium gluconate, epinephrine with sodium chloride and distilled water was applied in five groups of healthy men and 7 patients with myasthenia gravis (MG). Amplitude, depolarization, repolarization and recovery times and slops of compound muscle action potential (CMAP) were measured. Also low repetition stimulus tests were applied before and after iontophoresis of epinephrine. Following results were obtained: 1) iontophoresis of sodium ion increased depolarization time, and iontophoresis of sodium and calcium ions increased recovery and duration times of CMAP, 2) slope of depolarization and recovery were reduced by iontophoresis of active ions, 3) iontophoresis of epinephrine increased slope of recovery or Na-K transport at 10 and 15 minutes after iontophoresis, 4) iontophoresis of epinephrine in patients with MG reduced amplitudes of all CMAPs and percentage of decrement between first and fifth signal increased at low frequency stimulus test, and 5) iontophoresis of epinephrine in normal group increased percentage of amplitude increment between first and fifth signal in low frequency stimulation test. Neuromuscular responses in patients with MG in comparison to normal men are sensitive to iontophoresis of epinephrine and demonstrate significant decrement findings to low repetition stimulus tests. Iontophoresis of epinephrine with RNS tests can be useful in assessments of these patients