Objective:To evaluate the efficacy and safety of levetiracetam (LEV) in the management of seizures in neonates.Methods:A prospective non-blind, single arm clinical trial conducted in the Department of Neonatology and Pediatric Intensive Care, Mohamad Kermanshahi, and Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran from May 2014 to December 2014. Fifty out of 60 newborns with gestational age ≥30 weeks with clinically diagnosed seizures were included. Levetiracetam was administered orally with an initial dose of 10 mg/kg twice a day. The patients were observed continuously by Neuro Intensive Care nurses, and visited daily by a neuropediatrician in the first 7 days and then at days 14, 30, and 90 after the start of LEV administration. Clinical examination was performed for every patient, and seizure number, antiepileptic medication, and adverse events were detailed at every visit.Results:47 infants were seizure free under LEV at the end of the first week, 47remained seizure free at 4 weeks, and 46 remained seizure free at 11 weeks. No immediate and long-term side effects were noted in our patients.Conclusion:This study investigated the efficacy and safety of LEV in neonatal seizure control but confirmation with further randomized controlled trials is required.

Background: Effective Decision Making on the resources of the ED plays a significant role in the performance of the department. Since wrong decisions can have irreparable consequences on the quality of services, the decision-makers should analyze and allocate the resources effectively. Methods: The present study aimed to investigate the effective resources in the emergency department and provide an optimal combination of these resources based on the meta-modeling optimization approach to reduce the wait time for patients in the ED. Results:The results demonstrated that the number of CHWs and beds played a significant role in the total average wait time for patients. Although the effect of other variables was not statistically significant, they were deliberately used in this study to determine the optimal combination of such variables by solving the problem. Conclusion: The findings of the present simulation-model approach provide hospital managers with valuable data in order to control and re-design the admission to discharge procedure in the emergency in order to enhance efficiency. By considering the budget, the new configuration of 2 Community Health Worker, 1 Receptionist, 1 nurses, 3 Cardiologist and 10 beds, with 142 minutes of a patient's wait time shows 49.6% wait time improvement and a reduction of 51% in the cost of resource usage.

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Safflower is originated from Iran and is tolerant against water deficit stress. However, in semi-arid Mediterranean climate terminal drought and heat stress adversely affect the safflower production. In order to investigate the influence of foliar application of proline (Pr) (10 and 20 mM) and glycinebetaine (GB) (2 and 4 mM) under well and deficit irrigation (37.23° N,46.16° E). Foliar spray of compatible organic solutes started from middle vegetative growth and continued till seed filling stage. Comparison of well irrigated and stress conditions revealed that severity of water deficit stress (SI) was 0.25. Evaluation of growth-related morphological characteristics such as plant height, leaf area, canopy spread and percent ground cover showed that they considerably reduced by water deficit stress. However, foliar application of compatible solutes could somewhat increase growth related parameters. Results showed that water deficit stress noticeably reduced the chlorophyll content, while foliar spray could alleviate the water deficit stress effects when compared with intact plant (non-sprayed plants). The beneficial effect of GB was more prominent than Pr, especially under deficit irrigation condition. Principal component analysis (PCA) indicated that the best performance under well irrigated condition was obtained by application of 4 mM GB while under deficit irrigation condition the best performance was recorded for plants treated with 2 and 4 mM GB and 20 mM Pr. Overall, results of current experiments showed that foliar spray with high concentration of GB may can significantly alleviate the adverse effects of water deficit stress.

Background: Simulation is an appropriate technique for analyzing and evaluating the dynamic behavior of complex systems. The present study aimed to develop an integrated model using a simulation approach based on designing experiments to analyze performance of the admission queue system of patients, who referred to the emergency department of the Modarres hospital. Methods: In this descriptive-analytical research, effective variables on resource efficiency empowerment were identified and analyzed using inferential statistics and one-way ANOVA. Later, effects of the effective factors were estimated. Furthermore, performance of the emergency department system was simulated using the Visual Paradigm software. Results obtained from implementation of the simulation model were used as input for designing an experiment. A fully factorial 2-level experiment design was also used with central points. The independent variables studied in the simulation model included practical nurse, emergency secretary, nurse, cardiologist, and hospital bed. The dependent variable was the patients' waiting queue in the studied emergency department. Results: According to , the acceptable effects were determined based on the results of variance analysis for the model. The value of  indicated that 82.35% of the model explains all variability of the response-level data around the mean. Therefore, it can be concluded that the design space was in accordance with the estimated model based on the results of variance analysis. Conclusion: In the present study, performance analysis of the emergency department queue system was conducted using simulation and experiment design. The nonlinear regression model was able to predict the queue length. Moreover, this model can be used to predict dependent variables considering acceptable factors. According to the results, minimum length of the queue is obtained when the number of emergency secretaries is at a high level and the number of practical nurses and nurses is at a low level.