A Cost-Benefit and Accurate Method for Assessing Microalbuminuria: Single versus Frequent Urine Analysis

Background. The purpose of this study was to answer the question whether a single testing for microalbuminuria results in a reliable conclusion leading costs saving. Methods. This current cross-sectional study included a total of 126 consecutive persons. Microalbuminuria was assessed by collection of two fasting random urine specimens on arrival to the clinic as well as one week later in the morning. Results. In overall, 17 out of 126 participants suffered from microalbuminuria that, among them, 12 subjects were also diagnosed as microalbuminuria once assessing this factor with a sensitivity of 70.6%, a specificity of 100%, a PPV of 100%, a NPV of 95.6%, and an accuracy of 96.0%. The measured sensitivity, specificity, PVV, NPV, and accuracy in hypertensive patients were 73.3%, 100%, 100%, 94.8%, and 95.5%, respectively. Also, these rates in nonhypertensive groups were 50.0%, 100%, 100%, 97.3%, and 97.4%, respectively. According to the ROC curve analysis, a single measurement of UACR had a high value for discriminating defected from normal renal function state (c=0.989). Urinary albumin concentration in a single measurement had also high discriminative value for diagnosis of damaged kidney (c=0.995). Conclusion. The single testing of both UACR and urine albumin level rather frequent testing leads to high diagnostic sensitivity, specificity, and accuracy as well as high predictive values in total population and also in hypertensive subgroups

Fatal Suicide and Modelling its Risk Factors in a Prevalent Area of Iran

Background and objectives: This paper aimed to study the epidemiology of suicide and causes related to fatal suicide in Ilam province, west of Iran. Methods: All data related to attempted suicide and fatal suicide during 2011-2012 were extracted from the suicide registry of authorized directorates in Ilam Province, Iran. Risk factors for fatal suicide were evaluated using logistic regression modeling and discrimination of model assessed using ROC curve. Results: A total of 1537 registered cases were analyzed, among which 130 were recorded as fatal suicides (1227 attempted suicides). Overall, 805 (52.4) cases were female, 9.2 had a history of suicide, 59.3 were married and 63.3 of cases were aged under 24 years. The most common suicide method was overdose of medications (75.5). In multivariable analysis, male gender (OR: 0.50; CI 95 0.25 to 0.99) and higher education (OR: 0.36; CI 95 0.20 to 0.65) were protective factors and application of physical methods (OR: 11.61; 95 CI 5.40 to 24.95) was a risk factor for fatal suicide. Conclusions: Female gender, low education level and use of physical methods of suicide were revealed as risk factors of fatal suicide. We suggest population based case-control studies based on the suicide registry data for further assessing the risk factors of suicide in Ilam