COMPARATIVE EFFECTS OF NITRAZEPAM AND ACTH ON THE TREATMENT OF INFANTILE SPASM

ObjectiveInfantile spasms (IS) or West syndrome is a convulsive disease characterized by brief, symmetric axial muscle contractions (neck, trunk, and/or extremities).The therapy universally recognized as most effective in the treatment of IS, is treatment with the adrenocorticotropic hormone (ACTH) or oral corticosteroids. This therapy however has important side effects. Many studies have sought to find alternative therapies with fewer side effects. Nitrazepam, it has been proven, can be as effective as ACTH in controlling infantile spasms. The aim of this study was to evaluate and compare the efficacy of Nitrazepam and ACTH on the treatment of infantile spasms. Materials & MethodsThis randomized controlled clinical trial, enrolled sixty patients with newly diagnosed and previously untreated IS; diagnosis was made based on the criteria of The International Classification of Epilepsies of the International League Against Epilepsy (ILAE). Prior to treatment, all patients underwent Electro encephalo graphs (EEGs) and CT scans. Patients were randomized to receive 0.5-1 mg/kg Nitrazpam (NZP) in three daily doses or 40 IU Depot ACTH in a single morning dose. Complete cessation of spasms was considered to be as optimal response.ResultsOf the sixty patients studied, 24 (40%) were girls and 36(60%) were boys. All patients in the both groups were matched for age and sex.There were no differences between the both groups regarding age and sex (non-significant). Following treatments, at the end of the 6-week duration therapy, optimal response (Cessation of spasms) was obtained in 19 (63%) patients of NZP group and 9 (30%) patients of ACTH group, (

Supremasi Hukum dan Demokrasi

The government administration laid upon the principle of people's sovereignty is absolutely in need of the enforcement of law supremacy as well as the clear democracy mechanism. The enforcement of law supremacy itself depends on the visibility and the accuracy of the regulation of law and legislation for government, representative, and judicial institutions, and the assurance of law protection for individuals (citizens) against the behavior of authorityandsocialaction which contradict with the norms of law as well. In undertaking the enforcement of law supremacy dan democracy, the cultural aspect must be put in line with the quality of substance one. This effort is greatly needed in arranging conflicts so that the maturation of democracy through law enforcement can be consistent and fair

Dynamic sampling schemes for optimal noise learning under multiple nonsmooth constraints

We consider the bilevel optimisation approach proposed by De Los Reyes, Sch\"onlieb (2013) for learning the optimal parameters in a Total Variation (TV) denoising model featuring for multiple noise distributions. In applications, the use of databases (dictionaries) allows an accurate estimation of the parameters, but reflects in high computational costs due to the size of the databases and to the nonsmooth nature of the PDE constraints. To overcome this computational barrier we propose an optimisation algorithm that by sampling dynamically from the set of constraints and using a quasi-Newton method, solves the problem accurately and in an efficient way

Estimating Blood Pressure from Photoplethysmogram Signal and Demographic Features using Machine Learning Techniques

Hypertension is a potentially unsafe health ailment, which can be indicated directly from the Blood pressure (BP). Hypertension always leads to other health complications. Continuous monitoring of BP is very important; however, cuff-based BP measurements are discrete and uncomfortable to the user. To address this need, a cuff-less, continuous and a non-invasive BP measurement system is proposed using Photoplethysmogram (PPG) signal and demographic features using machine learning (ML) algorithms. PPG signals were acquired from 219 subjects, which undergo pre-processing and feature extraction steps. Time, frequency and time-frequency domain features were extracted from the PPG and their derivative signals. Feature selection techniques were used to reduce the computational complexity and to decrease the chance of over-fitting the ML algorithms. The features were then used to train and evaluate ML algorithms. The best regression models were selected for Systolic BP (SBP) and Diastolic BP (DBP) estimation individually. Gaussian Process Regression (GPR) along with ReliefF feature selection algorithm outperforms other algorithms in estimating SBP and DBP with a root-mean-square error (RMSE) of 6.74 and 3.59 respectively. This ML model can be implemented in hardware systems to continuously monitor BP and avoid any critical health conditions due to sudden changes.Comment: Accepted for publication in Sensor, 14 Figures, 14 Table

Redesigning Primary Care Processes to Improve the Offering of Mammography. The use of Clinic Protocols by Nonphysicians.

OBJECTIVE: To develop, within the framework of continuous quality improvement, new processes for offering mammography and determine whether protocols executed completely by nonphysicians would increase mammography utilization. DESIGN: A prospective follow-up study with patients from an intervention clinic and two control clinics. SETTING: Three general internal medicine clinics in a large, urban teaching hospital in Detroit, Michigan. PATIENTS/PARTICIPANTS: A total of 5,934 women, aged 40 through 75 years, making 16,546 visits to one of the clinics during the study period (September 1, 1992, through November 31, 1993). INTERVENTION: Medical assistants and licensed practical nurses in the intervention clinic were trained to identify women due for screening mammography, and to directly offer and order a mammogram if patients agreed. MEASUREMENTS AND MAIN RESULTS: Patients were considered up-to-date with screening if they had a mammogram within 1 year (if age 50-75) or 2 years (if age 40-49) prior to the visit or a mammogram within 60 days after the visit. The proportion of visits each month in which a woman was up-to-date with mammography was calculated using computerized billing records. Prior to the intervention, the proportion of visits in which women were up-to-date was 68% (95% confidence interval [CI] 63%, 73%) in the intervention clinic and 66% (95% CI 61%, 71%) in each of the control clinics. At the end of the evaluation, there was an absolute increase of 9% (95% CI 2%, 16%) in the intervention clinic, and a difference of 1% (95% CI -5%, 7%) in one of the control clinics and -2% (95% CI -3%, 5%) in the other. In the intervention clinic, the proportion of visits in which women were up-to-date with mammography increased over time and was consistent with a linear trend (p = .004). CONCLUSIONS: Redesigning clinic processes to make offering of mammography by medical assistants and licensed practical nurses a routine part of the clinic encounter can lead to mammography rates that are superior to those seen in physicians\u27 usual practice, even when screening levels are already fairly high. Physicians need not be considered the sole, or even the primary, member of the health care team who can effectively deliver some preventive health measures

Research Notes : India : Mutation breeding research in soybean in India

Systematic mutation breeding research in India was started at Ranchi Agricultural College, Kanke, Bihar, India, around 1971 by Haque and his co-workers. Choudhary (1972) studied induced polygenic variability in the R-II generation in the variety of \u27Sepaya Black\u27 of soybean. Choudhary (1972) reported that 10 Kr radiation treatment of gamma rays was effective in shifting the mean values in positive direction for various quantitative characters including seed yield

Cholera and household water treatment why communities do not treat water after a cholera outbreak: a case study in Limpopo Province

Background: Cholera is one of the common diseases in developing countries caused by consumption of contaminated and untreated drinking water. A study was conducted 7 months after a cholera outbreak in Vhembe district, Limpopo, South Africa. The aim of the study was to assess if the communities were still conforming to safe water practices after an outbreak of cholera. Methodology: One hundred and fifty-two (152) participants from 11 villages were recruited to form 21 focus groups, with a mean of 7. The interview transcripts were coded and arranged based on the study themes. Results: Of the 21 groups in 11 villages, three villages were using water from boreholes, six were using river water and three were using mixed sources which included river, canal and spring water, three depended on municipal tanks and only six were using tap water. Only 19% of the respondents treated their water, even though the majority of communities reported treatment of water as a priority. Four villages claimed they never received environmental health education at all, while most of the villages confirmed they received education during a cholera outbreak. Conclusion: Regardless of the outbreak and health education efforts done, communities continued using unprotected water sources without any form of treatment, as they perceived it to be unimportant. Sustainable water supplies and environmental health education should be continued after an outbreak as it is important for public health gains

Quantum teleportation between light and matter

Quantum teleportation is an important ingredient in distributed quantum networks, and can also serve as an elementary operation in quantum computers. Teleportation was first demonstrated as a transfer of a quantum state of light onto another light beam; later developments used optical relays and demonstrated entanglement swapping for continuous variables. The teleportation of a quantum state between two single material particles (trapped ions) has now also been achieved. Here we demonstrate teleportation between objects of a different nature - light and matter, which respectively represent 'flying' and 'stationary' media. A quantum state encoded in a light pulse is teleported onto a macroscopic object (an atomic ensemble containing 10^12 caesium atoms). Deterministic teleportation is achieved for sets of coherent states with mean photon number (n) up to a few hundred. The fidelities are 0.58+-0.02 for n=20 and 0.60+-0.02 for n=5 - higher than any classical state transfer can possibly achieve. Besides being of fundamental interest, teleportation using a macroscopic atomic ensemble is relevant for the practical implementation of a quantum repeater. An important factor for the implementation of quantum networks is the teleportation distance between transmitter and receiver; this is 0.5 metres in the present experiment. As our experiment uses propagating light to achieve the entanglement of light and atoms required for teleportation, the present approach should be scalable to longer distances.Comment: 23 pages, 8 figures, incl. supplementary informatio