sepehr sadeghi

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Obstructive Sleep Apnea Syndrome in Children Referred to a Sleep Clinic

Journal of sleep sciences, Jul 27, 2016

Background and Objective: Failure in diagnosis and treatment of sleep apnea in children lead to p... more Background and Objective: Failure in diagnosis and treatment of sleep apnea in children lead to physical and mental growth retardation, cardiopulmonary, and/or behavioral disorders. This study was aimed to evaluate polysomnographic (PSG) and clinical findings of sleep apnea in children referred to a sleep clinic in Qazvin, Iran. Materials and Methods: This cross-sectional study was conducted among 50 children and adolescents < 18 years old in Qazvin. All children referred to a pediatric sleep clinic during the years 2008-2009 were enrolled in this study, consecutively. These children were referred for suspected obstructive sleep apnea (OSA). BEARS and Children's Sleep Habits Questionnaire were completed by parents. Subjects underwent overnight full PSG. Data were analyzed using descriptive statistics and chi-square test. Results: A total of 50 subjects participated in this study. A mean age was 7.8 ± 5.2 years. 40 (80%) subjects were male. The most common cause for referral was snoring (18 patients, 36%). Daily hyperactivity and insomnia were reported in 20 (40%) and 16 (32%) subjects, respectively. 12 (24%) children had normal sleep pattern, 30 (60%) OSA and 8 (16%) other sleep disorders. No significant associations were seen between PSG results and body mass index or sex. The majority of children referred to the sleep clinic had sleep apnea which indicates that many cases of the disease remain unknown. It is necessary to increase the knowledge of the public and medical staff about signs and symptoms of sleep breathing disorders to screen the patients and referral to sleep clinics.

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Antimicrobial Resistance Pattern of Shigella Species Isolated in Children with Shigellosis

Pediatric Research, Nov 1, 2011

Background and aims: Shigellosis is a common infectious disease in children. Inappropriate treatm... more Background and aims: Shigellosis is a common infectious disease in children. Inappropriate treatment with antimicrobial agents may result in severe complications and death. Identification of resistance pattern of shigella microorganism in each country is necessary. The aim of this study was to evaluate the sensitivity and resistance pattern of shigella in children with shigellosis. : In this cross sectional study, 103 children with definitely diagnosis of shigellosis were evaluated. This study was conducted in Qods children hospital affiliated to Qazvin University of Medical Sciences (Iran) in 2009-2010. Demographic, clinical and laboratory findings of patients were recorded. Data were analyzed by statistical methods. Results: Mean age of patients was 54/5±28/9 months (ranges: 20 days to 140 months). 49/5% were male and remainder females. Most of patients (68%) were under 5 years. Most of children (67%) were urban. Shigellosis was common during summer (50/5%).The most common clinical findings were fever (97/1%) and diarrhea (81.6%).The isolated organisms were Shigella sonnei (77/7%) flexneri (11.6%), dysenteriae (5.8%) and boydii (4.9%). All of species were sensitive to Aminoglycoside, Cephalexin and Ciprofloxacine. Resistance to ,trimethoprim-suIfamethoxazole ,Ampicilln, nalidixic acid and ceftriaxone were 85/1%, 45.8%, 63.8% and 20%, respectively. There was not significant differences between Shigella species and seizure, bandemia and bloody diarrhea The mean of hospitalization was 4.02 ±2.11 days. The most of shigella species were resistant to Trimetoprime-sulfamethoxasole, Ampicillin and nalidixic acid.

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Particle Swarm Optimization

Handbook of Research on Machine Learning Innovations and Trends, 2017

Optimization algorithms are necessary to solve many problems such as parameter tuning. Particle S... more Optimization algorithms are necessary to solve many problems such as parameter tuning. Particle Swarm Optimization (PSO) is one of these optimization algorithms. The aim of PSO is to search for the optimal solution in the search space. This paper highlights the basic background needed to understand and implement the PSO algorithm. This paper starts with basic definitions of the PSO algorithm and how the particles are moved in the search space to find the optimal or near optimal solution. Moreover, a numerical example is illustrated to show how the particles are moved in a convex optimization problem. Another numerical example is illustrated to show how the PSO trapped in a local minima problem. Two experiments are conducted to show how the PSO searches for the optimal parameters in one-dimensional and two-dimensional spaces to solve machine learning problems.

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Obstructive sleep apnea syndrome in children: Risk assessment

Pediatric Pulmonology, 2017

I read with interest the study by Joosten et al. on the evaluation of obstructive sleep apnea syn... more I read with interest the study by Joosten et al. on the evaluation of obstructive sleep apnea syndrome (OSAS) in children. The authors summarized the causes of OSAS by upper airway obstruction such as adenotonsillar hypertrophy, obesity, craniofacial abnormalities, and neuromuscular disorders. The symptoms of OSAS by intermittent upper airway obstruction is recognized by parental report of snoring and/or apneic events in children, which relate to the increased daytime sleepiness, hyperactivity, poor school performance, inadequate somatic growth rate, or enuresis. Polysomnography is the gold standard method for the diagnosis of OSAS, and nocturnal oximetry and/or sleep questionnaires is useful for the screening of OSAS. I have some concerns about their report. First, Baker et al. evaluated predictors of sleep apnea severity in 224 adolescents, aged 12-17 years old, by excluding past history of tonsillectomy/adenoidectomy. Adjusted odds ratios (95%CIs) of male, tonsillar hypertrophy, and obesity for severe OSAS, defined as apnea hypopnea index (AHI) >10, were 2.3 (1.2-4.3), 3.8 (2.0-7.1), and 2.2 (1.4-3.6), respectively. In contrast, age and ethnicity did not predict severe OSAS by multivariate logistic regression analysis. In contrast, Erdim et al. investigated the association between metabolic syndrome and AHI in 104 obese adolescents, aged 11 years or older, presenting no significant association between metabolic syndrome and AHI. They did not use severe OSA as an indicator and they did not adjust confounding variables, and risk factors of OSAS in children should be evaluated with special reference to the severity of OSAS by adjusting several confounders. Second, the severity of OSAS in children is judged by the appropriate cut-off point of AHI, which is different from that in adults. In addition, the health information of OSAS in children is not enough in comparison with those in adults. Further studies are needed to confirm the health effect of OSAS in children. Finally, Kang et al. conducted a meta-analysis to evaluate the effect of lingual tonsillectomy on subsequent pediatric OSAS. Although only four studies were used for the analysis, they concluded that lingual tonsillectomy was effective for pediatric OSAS with improvement in the AHI and the minimum oxygen saturation. As a half of the patients showed postoperative AHI >5 in their meta-analysis, long-term effects should be evaluated by further studies.

Methods and Apparatus for Facilitating Guideline Compliance

A Typology Model for Creativity Managers Based on Reference Points and Their Characteristics

Procedia - Social and Behavioral Sciences, 2012

The purpose of this study is to introduce a model that presents four types of entrepreneurial man... more The purpose of this study is to introduce a model that presents four types of entrepreneurial manager s based on their characteristics. These characteristics include opportunity ability, locus of control, creativity, diligence, risk taking, nee ds for achievement, operator, challenge ability, visionary, continues learning, and relation with staff. To achieve this model, these characteristics were evaluated in 250 Iranian managers with two reference points. The first reference point is attention to a ) internal factors and b) external factors and the second reference point is types of his/her organizational control a) based on planning control or b) based on strategic control. The main question is "are there any significant differences between the entrepreneurial characteristics based on four reference point's condition"? The result being achieved by the quali tative method "case study and grounded theory" show a four typology model of entrepreneurship that each typology specified with its own entrepreneurial characteristics. 2011 Published by Elsevier Ltd.

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Methods and Apparatus for Providing Guidance to Medical Professionals

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