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While there are some recommendations about early insulin therapy in newly diagnosed Type 2 Diabetes Mellitus (T2DM) patients, there is not sufficient evidence on this strategy's cost-effectiveness. This study compared early insulin therapy versus oral anti-diabetic drugs (OADs) for managing T2DMusing a cost-effectiveness analysis approach in Iran. In this economic evaluation, a decision analytic model was designed. The target population was newly diagnosed type 2 diabetic patients, and the study was carried out from the perspective of Iran's healthcare system with a one-year time horizon. Basal insulin, Dipeptidyl peptidase-4 (DPP-4) inhibitors, and Thiazolidinediones (TZDs) were compared in this evaluation. The main outcome for assessing the effectiveness of each intervention was the reduction in the occurrence of diabetes complications. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and deterministic and probabilistic sensitivity analyses were carried out. The DPP-4 inhibitors strategy was the dominant strategy with the highest effectiveness and the lowest cost. Early insulin therapy was dominated (ICER: $-53,703.18), meaning that it was not cost-effective. The sensitivity analyses consistently affirmed the robustness of the base case findings. The probabilistic sensitivity analysis indicated probabilities of 77%, 22%, and 1% for DPP-4 inhibitors, TZDs strategies, and early insulin therapy, respectively, in terms of being cost-effective. In terms of cost-effectiveness, early insulin therapy was not cost-effective compared to OADs for managing newly diagnosed T2DM patients. Future studies in this regard, utilizing more comprehensive evidence, can yield more accurate results. [ABSTRACT FROM AUTHOR]

The advantage of tenecteplase (TNK) over alteplase (ALT) in managing acute ischemic stroke (AIS) has been reported, but the cost-effectiveness of these two strategies has not received as much attention. The objective of this study was to compare TNK and ALT for the management of AIS patients in Iran in terms of cost-effectiveness. This study was carried out from the payer's perspective in Iran, with a lifetime horizon. A full economic evaluation model was designed as a decision tree and a Markov model. After defining different Markov states, each health state was assigned a utility value, and quality-adjusted life year (QALY) was estimated using that value. The incremental cost-effectiveness ratio (ICER) was ultimately used for evaluating the comparative cost-effectiveness. Both deterministic and probabilistic sensitivity analyses were carried out. Compared to ALT, TNK can save approximately 4333.81 USD, and is able to increase one unit of QALY while saving approximately 17,450.29 USD. So, Base-case results showed that TNK strongly dominates ALT. Moreover, the base case results were strongly confirmed by deterministic and probabilistic sensitivity analysis. Base-case and sensitivity analysis showed that TNK is the dominant strategy compared to ALT for the management of AIS patients. [ABSTRACT FROM AUTHOR]

Both pulsed dye laser (PDL) and fractional CO2 laser (FCO2L) are used commonly for the treatment of hypertrophic scars. To compare the efficacy of PDL and FCO2L on hypertrophic scars. One part of each scar, or one of the two similar scars in 35 patients was treated with PDL and the other parts, or scars were treated with FCO2L. The parameters used for FCO2L were: power = 30 W, pulse energy = 50 mJ, density = 200 spots/cm2. The parameters used for 585 nm PDL were 9 J/cm2 with 5 mm spot size. The FCO2L side was treated for three passes to debulk the scar. The coagulated tissue was wiped out before the next pass. The PDL side was treated with two superimposed passes. The procedures were repeated every month for 4 months. After four sessions of laser therapy, both sides showed remarkable improvement but no meaningful difference was detected between two areas that were treated with PDL and FCO2Ls (p >.05). The mean Vancouver Scar Scale was 7.31 ± 1.93 in the beginning and 4.26 ± 1.48 for FCO2L and 4.33 ± 1.70 for PDL one months after the final session. Both PDL and FCO2Ls were equally effective on hypertrophic scars. [ABSTRACT FROM AUTHOR]

No topical and systemic treatment is proven to be effective on Cutaneous Macular Amyloidosis (CMA). The physical removal of the deposited protein by lasers may be a better choice. To compare the efficacy of different lasers including Pulsed dye laser (PDL), 1064 mode of Q-Switched Nd-YAG, CO2, and combined CO2 and Q-Switched Nd:YAG lasers for the treatment of CMA. 17 adult female patients with clinical CMA and histopathological confirmation were included in this study. Four close 1 by 1 cm2 areas were treated simultaneously with PDL, Q-Switched Nd-YAG, CO2 and combined CO2 and Nd-YAG Lasers. The energy used for 585 nm PDL were 9 J/cm2 with the spot size of 5 mm. The energy used for 1064 nm mode of Nd-YAG laser was 5 Joules/cm2, with the spot size of 4 mm, and the frequency of 10 hertz. The energies used for CO2 laser were 4 and 3.5 Micro Joules for the first and second Passes. No desirable result obtained after PDL therapy. The Q-Switched Nd-YAG was effective in only 3 patients. All areas treated with CO2 laser were cleared. The CO2 laser is seems to be the most effective laser treatment of CMA. [ABSTRACT FROM AUTHOR]

A model is presented for the gasification of beech wood particles in a bubbling fluidized bed gasifier (BFBG). The model encompasses the hydrodynamics of the solid and gas phases as well as the different reaction kinetics. It also accounts for the freeboard where additional homogeneous reactions take place. The influential impact of the pyrolysis step on the final composition of produced fuel gas was demonstrated by applying two different kinetic models for pyrolysis. Model results are compared with the experimental work of this study and other published results on wood gasification in BFBG. Effects of equivalence ratio (ER), steam to biomass ratio (SB), bed temperature, feed location, and mass transfer between the countercurrent regions (Kw) on the gas composition of product fuel gas are studied. The model shows good agreement with the experimental results. [ABSTRACT FROM AUTHOR]