Application of sparse linear discriminant analysis and elastic net for diagnosis of IgA nephropathy: statistical and biological viewpoints

Background: IgA nephropathy [IgAN] is the most common primary glomerulonephritis diagnosed based on renal biopsy. Mesangial IgA deposits along with the proliferation of mesangial cells are the histologic hallmark of IgAN. Non-invasive diagnostic tools may help to prompt diagnosis and therapy. The discovery of potential and reliable urinary biomarkers for diagnosis of IgAN depends on applying robust and suitable models. Applying two multivariate modeling methods on a urine proteomic dataset were obtained from IgAN patients, and comparison of the results of these methods were the purpose of this study

Methods: Two models were constructed for urinary protein profiles of 13 patients and 8 healthy individuals, based on sparse linear discriminant analysis [SLDA] and elastic net [EN] regression methods. A panel of selected biomarkers with the best coefficients were proposed and further analyzed for biological relevance using functional annotation and pathway analysis

Results: Transferrin, a1-antitrypsin, and albumin fragments were the most important up-regulated biomarkers, while fibulin-5, YIP1 family member 3, prasoposin, and osteopontin were the most important down-regulated biomarkers. Pathway analysis revealed that complement and coagulation cascades and extracellular matrix-receptor interaction pathways impaired in the pathogenesis of IgAN

Conclusion: SLDA and EN had an equal importance for diagnosis of IgAN and were useful methods for exploring and processing proteomic data. In addition, the suggested biomarkers are reliable candidates for further validation to non-invasive diagnose of IgAN based on urine examination

Effect of pre-pregnancy maternal body mass index on pregnancy outcomes in nulliparous women in the Islamic Republic of Iran

This study was conducted to evaluate the effect of pre-pregnancy BMI on pregnancy outcomes. BMI was calculated measured in 360 nulliparous women. According to BMI, pregnant women were placed into three groups: group I [lean group BMI . 19.8], group II [normal weight group BMI = 19.9.24.9], and group III [obese group BMI . 25]. Data were analyzed using SPSS 16. The mean duration of the first and the second stage of labour were significantly different between three groups [P < 0.001]. Cesarean section ratio in group I was lower than group II [OR = 0.15; P = 0.013]. Instrumental delivery in group III was more than group II [OR=4.6; P = 0.002]. Risk of nonreactive non-stress test [NST] was significantly different between groups II and III [OR = 5.7; P = 0.009]. Induction ratio in group I was lower than group II [OR=0.43; P = 0.002]. Deviation of BMI from the normal level is associated with adverse outcomes of pregnancy and delivery

[Effectiveness of stress coping skills training on the resiliency of mothers of handicapped children]

Background and Aim: Handicapped child in the family is a source of stress which can affect physical and mental health of the parents, especially mothers. Increase in resiliency increases ability to manage stressors. The aim of this study was to determine the effect of stress coping skills training on the resiliency of mothers with handicapped children

Material and Method: This semi experimental study with pre-test, post-test design and control group included 60 mothers with handicapped children who had been referring to the Kermanshah welfare center in 2013. They were selected by using convenient method and then divided randomly into two groups. In this study we used a coping skill training package and Connor and Davidson Resiliency Scale [CD-RISC]. SPSS 20 software was used for data analysis

Results: The results showed that coping skills training resulted in a significant increase in resiliency level in the mothers with disabled children [P<0/001]

Conclusion: In most of the coping skills training programs, handicapped children were the center of attention and their families that take care of them had been ignored. Therefore, training programs for parents with handicapped children is at the forefront of planning policies

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Cardio-pulmonary resuscitation is the critical skill needed by emergency medical personnel; so they must be aware of the recent changes in CPR. This study has been done to determine the awareness level of emergency medical technicians in Kermanshah of the 2010 guidelines for CPR in 2012. In this descriptive cross-sectional study, emergency medical technicians [159 ones] were studied using census sampling in Kermanshah's emergency base in 2012. By using a self-administrated questionnaire, data were collected with face, content and reliability [r=%74]; also were analyzed by STATA-11 software, tests of Kruskal-Wallis, Mann-Whitney U and Spearman [P<0.05]. According to the findings, the level of awareness in emergency medical personnel was as follows:%19.5 excellent,%78.6 good and%1.9 moderate. Also, there was no statistically significant relationship between level of awareness and gender, work experience, field of study, previous workplace, passing advanced CPR training and observing CPR. However, level of awareness was higher in emergency technicians who had experience of passing and performing CPR training independent. In some areas, level of awareness was influenced by workplace and observing CPR [P<0.001]. It is recommended to teach CPR based on the 2010 guidelines for emergency technicians with the emphasis on Laryngeal Mask Airway [LMA], combitube intubations, reasons of termination and undoing of CPR, intraosseous injections [IO] and induced-hypothermia

Comparison between the outcomes of water birth and normal vaginal delivery

Warm water immersion during labor is associated with relaxation and pain reduction for pregnant women. This method is not extensively used in Iran, given the fear of infection and other maternal/neonatal complications. Alternative methods are required to increase the safety of normal vaginal delivery. The purpose of this study was to compare maternal and neonatal outcomes, associated with water birth and normal vaginal delivery.This analytical, cross-sectional study was performed on 43 water birth cases [study group] and 62 subjects with normal vaginal delivery [control group]. Random sampling and consensus were applied for normal vaginal delivery and water birth groups, respectively. Data were collected in a data collection form, using hospital records and interviews with mothers. For data analysis, descriptive and analytical tests including t-test and Chi-square were carried out, using SPSS version 15. No significant difference was observed between the two groups in terms of labor and delivery complications; although three cases of complications during the second stage of labor and four cases of hospitalizations at birth were reported in the control group. The two groups were not significantly different in terms of hospitalization for the reason of neonatal period complications. Regarding maternal complications, there was a significant difference in the rate of episiotomy between the two groups [P=0.032]. Postpartum hemorrhage was mostly observed in the control group, although the difference was not significant. In this study, no significant difference was observed in terms of maternal or neonatal complications between the two groups. Therefore, it seems that water birth is a safe method, associated with improved pregnancy outcomes

[Prevalence of bacterial and antibiotic sensitivity in septicemia of neonates admitted to Kermanshah Imam Reza Hospital [2007-2008]]

Neonatal septicemia is an important cause of morbidity and mortality. The most common pathogens of bacterial sepsis and antibiotic sensitivity patterns may vary in different areas of the world. Understanding the etiology of bacteriological profiles is very important and helps to reduce the associated mortality. The aim of this study was to assess prevalence of bacterial and antibiotic sensitivity sepsis in neonates during 2007-2008. In this cross sectional descriptive study the information of neonates who have been admitted to Imam Reza Hospital were collected. Ninety out of 2175 admitted subjects had inclusive criteria including positive blood culture and clinical symptoms of fever, shock, hyporeflexia. Demographic data collected using questionnaires and SPSS version 15 was used for statistical analysis. The prevalence of sepsis was 4.13%. 37.7% of bacteria were gram positive and 12 types of bacteria were isolated. The most common isolated microorganisms were staphylococcus aureus [31.1%] and Klebsiella Pneumoniae [16.7%]. The mortality rate was 33.3%. The most sensitive antibiotics in gram positive bacteria were Ciprofloxacin[73.5%], Imipenem[70.5%], Ceftriaxon [50%] and in gram negative bacteria Ciprofloxacin [76.8%],Imipenem [73.2%] and Co-Trimoxazole [44.6%].The most resistance antibiotic against gram positive bacteria were Co-Trimoxazole [35.3%], Gentamicin [32.4%], Ceftriaxon [29.4%] and in gram negative bacteria were, Ceftriaxon, Gentamicin, Cefotaxime [73.2%]. It seems that Ciprofloxacin and Imipenem are the most appropriate antibiotics for experimental treatment prior to obtaining blood culture results in this hospital

[Educational purpose and medical student's achievements in clinical training in an university hospital in Kermanshah]

One of the most important components of educational technology is an educational plan. Medical education needs to evaluate regular educational achievements particularly in clinical training. This study was carried out to investigate medical students achievement compare to educational prepuces in clinical training in Kermanshah Emam Reza hospital. In this descriptive-analytical study. 135 students in level of replacement and internship were selected through satisfied random sampling method during the first semester of year 2008. Data was collected using researchers planned questionnaire. 15 experts in medical education area confirmed its face and content validity. To confirm the reliability of the questionnaire were checked Spearma-Brown in a pilot study [r=0.86]. Data were analyzed using SPSS13. The finding indicated that 11.1% of students were not achieved, 85.2% moderately achieved and only 3.7% of them were completely achieved to educational aims in clinical training. No significant differences were observed between gender, year of study and level of study. However there were statistically significant difference associations between students' achievement to educational aims in clinical training and introducing training objectives, evaluation methods and having an introduction session at the beginning of clinical training as well as induction training in the emergency ward. This study reveals that there are still some spaces and opportunities for increasing the medical students' achievements to educational aims in clinical training. This study recommended that at the beginning of clinical training with use of: aim, evaluation methods, justify session presented to the students and use of emergency wards for education, could increase achievement to educational aims in clinical training in medical students

Target-controlled infusion anesthesia with propofol and remifentanil compared with manually controlled infusion anesthesia in mastoidectomy surgeries

Target-controlled infusion [TCI] system is increasingly used in anesthesia to control the concentration of selected drugs in the plasma or at the site of drug effect [effect-site]. The performance of propofol TCI delivery when combined with remifentanil in patients undergoing elective surgeries has been investigated. Our aim in this study was to assess the anesthesia profile of the propofol and remifentanil target controlled infusion [TCI] anesthesia as compared to the manually controlled infusion [MCI], in mastoidectomy surgery, where a bloodless field is of utmost importance to the surgeon. Sixty patients, aged 18-60 years ASA I-II enrolled in the study, were divided into two equal groups. Group MCI received propofol and remifentanil by conventionaldose-weight infusion method, and Group TCI received propofol 4 micro g/ml and remifentanil 4 ng/ml as effect-site target concentration. The hemodynamic variability, recovery profile, postoperative nausea and vomiting [PONV], surgeons satisfaction were assessed. Results were analyzed by SPSS version 11.5. The two groups were comparable with respect to age, ASA class, sex, weight, basal vital signs, operation time. The blood pressure and pulse were above desired levels in some data points in the MCI Group [P

Correlation between bispectral index and predicted effect-site concentration of propofol in different levels of target-controlled, propofol induced sedation in healthy volunteers

Bispectral Index is an objective tool to assess electroencephalographic activity and measure the effect of certain sedatives and hypnotics on the brain. In addition, there are certain subjective tools such as the observer's assessment of alertness and sedation which are used. The correlation between BIS and the concentration of propofol in the brain, and the relationship between these subjective and objective tools in assessing sedation levels are the subject of this study. Thirty healthy volunteers enrolled in this prospective observational study. They were sedated with a target controlled infusion of propofol with an initial target of 0.8 microg.mL[-1] and an increase in target to 0.2 microg.mL[-1] ten minutes after equilibration of the predicted and set target concentrations. In each sedation score, the Bispectral Index value and predicted effect site concentration of propofol were recorded and analyzed. Analysis of variance and significant differences between groups were analyzed by paired f-test. Correlations between Bispectral Index and effect site concentration of propofol at each sedation score and the relationship of BIS and effect site concentration of propofol to each sedation score were assessed and analyzed by nonparametric Spearman's rho [p]. The means of Bispectral Index and effect site concentration of propofol at each sedation score showed a significant difference with the following score. Additionally, Bispectral Index and effect site concentration of propofol showed a significant negative correlation in sedation scores 3 and 2 when inducing sedation. In other sedation scores or when reversing the sedation, no strong correlation was noted. Both Bispectral Index and effect site concentration of propofol indicate a good estimate of sedation levels; however their correlations are significant and negative only at moderate and deep sedation levels, and during the induction of sedation