Economic Burden of Inflammatory Bowel Disease in Shiraz, Iran.

BACKGROUND: The epidemiological burden of chronic diseases and their risk factors is increasing all over the world, especially in developing and low-income countries. Inflammatory bowel disease (IBD) is one of the chronic diseases which has imposed a great financial burden on individuals and the society. OBJECTIVES: The current study aimed at estimating the economic burden of IBD among 90 patients with IBD who referred to Namazi hospital and Motahari clinic of Shiraz in 2019. The costs to patients were monitored for a year to detect their expenses. METHODS: This study is descriptive cross-sectional and from a social perspective. The cost-of-illness method, based on the human capital theory, has been used. Both direct and indirect costs have been estimated using a prevalence approach and bottom-up method. Hospital costs were extracted from patients' records and the accounting system of Namazi Hospital. Outpatient expenses were obtained according to the number of outpatient visits and the average cost of visit were obtained by interviewing patients. Socio-economic status, medical expenses and number of days absent from work were determined using a valid and reliable questionnaire. Assessment of the cost of hospital care was made on the basis of the average daily. Non-medical direct costs such as transportation and residence, etc. were also calculated. RESULTS: The total annual economic costs of IBD per patient were estimated at 1229.74 USD. Finally, increased use of health care as well as lost productivity leads to increased disease costs. CONCLUSION: IBD imposes a substantial economic burden on patients, families and the society. Establishing a correct diagnosis early, management of IBD worsening, and appropriate treatment can reduce the costs of treatment and lost production to some extent. Therefore, policymakers should take this into consideration and according to available health resources, provide services and facilities for the prevention and treatment of the disease.

The Role of Gut Microbiota in Inflammatory Bowel Disease-Current State of the Art.

The human microbiome comprises the genomes of the microbiota that live on and within humans, such as protozoa, archaea, eukaryotes, viruses, and most bacteria. Gastrointestinal disorders such as inflammatory bowel disease, colon cancer, celiac disease, and irritable bowel syndrome can all be triggered by a change in gut flora. The alteration of the gut microbiota (also known as "gut dysbiosis") is affected by host genetics, nutrition, antibiotics, and inflammation, and it is associated with the development of inflammatory bowel disease (IBD). Also, intestinal epithelial dysfunction, altered autophagy, and immune hyperactivation are frequently detected in individuals with severe IBD, which may be attributed to impaired miRNA expression functions. While the exact mechanisms of how Gut Microbiota may cause IBD and intestinal epithelial dysfunction are still debated, recent data point toward the possibility that hormones, gender and miRNAs expression are modifiable contributors to IBD. This review summarizes the current evidence for an association between hormones, gender and miRNAs and Gut Microbiota in IBD and discusses potential mechanisms by which gut microbiota may impact IBD. The study also outlines critical unanswered topics that need to be solved to enhance IBD prevention and treatment in people with gut dysbiosis.

Recent findings on the role of microRNAs in genetic kidney diseases.

BACKGROUND: MicroRNAs (miRNAs) are non-coding, endogenous, single-stranded, small (21-25 nucleotides) RNAs. Various target genes at the post-transcriptional stage are modulated by miRNAs that are involved in the regulation of a variety of biological processes such as embryonic development, differentiation, proliferation, apoptosis, inflammation, and metabolic homeostasis. Abnormal miRNA expression is strongly associated with the pathogenesis of multiple common human diseases including cardiovascular diseases, cancer, hepatitis, and metabolic diseases. METHODS AND RESULTS: Various signaling pathways including transforming growth factor-ß, apoptosis, and Wnt signaling pathways have also been characterized to play an essential role in kidney diseases. Most importantly, miRNA-targeted pharmaceutical manipulation has represented a promising new therapeutic approach against kidney diseases. Furthermore, miRNAs such as miR-30e-5p, miR-98-5p, miR-30d-5p, miR-30a-5p, miR-194-5p, and miR-192-5p may be potentially employed as biomarkers for various human kidney diseases. CONCLUSIONS: A significant correlation has also been found between some miRNAs and the clinical markers of renal function like baseline estimated glomerular filtration rate (eGFR). Classification of miRNAs in different genetic renal disorders may promote discoveries in developing innovative therapeutic interventions and treatment tools. Herein, the recent advances in miRNAs associated with renal pathogenesis, emphasizing genetic kidney diseases and development, have been summarized.

Post-Infectious Irritable Bowel Syndrome after an Epidemic of Gastroenteritis in South of Iran.

Background: Irritable bowel syndrome (IBS) is a chronic disabling condition without a well-defined etiology. Infectious gastroenteritis (IGE) has been linked to this syndrome. There are few data from Iran on this association. Methods: In August 2018, an epidemic of IGE caused by Escherichia coli occurred in a village in the west of Shiraz in southern Iran. One year after this epidemic, the occurrence of IBS was surveyed in those who suffered from IGE based on Rome IV criteria in that village. Results: Of 179 patients included in the present study, 17 patients (9.5%) had post-infectious (PI)-IBS. There was no difference in age, sex, antibiotic use, hematochezia, duration of infectious diarrhea, fever, and weight loss at the time of IGE between those with and without PI-IBS. Conclusion: PI-IBS is common after IGE, but no risk factor for its development was found in this study.

Type II diabetes and personality; a study to explore other psychosomatic aspects of diabetes.

BACKGROUND: As one of the most common chronic diseases, diabetes and its control are affected by the patients' psychological and spiritual attributes. The present study investigates the relationship between glycemic control in patients with type II diabetes and personality traits, defense mechanisms and spirituality. METHOD: The present cross-sectional study was conducted on 400 Iranian patients with type II diabetes, 64% were men. Participants completed the NEO Personality Inventory, the Defense Style Questionnaire (DSQ) and the Spiritual Assessment Inventory (SAI) and then underwent a blood sampling for the assessment of HbA1C levels. RESULTS: Of the five personality traits, extraversion (r = -0.13 and P < 0.01) and conscientiousness (r = -0.13 and P < 0.01) had significant negative relationships with HbA1C HbA1C levels, while neuroticism had a significant positive relationship with HbA1C levels (r = 0.12 and P < 0.05). Of the defense styles assessed, the neurotic style was found to have a significant negative relationship with HbA1C levels (r = -0.1 and P < 0.05). Also, of the spirituality elements, impression management had significant relationship with glycemic control (r = 0.17 and P < 0.001). CONCLUSION: According to data, Extraversion and conscientiousness can help control blood sugar while anxiety and negative emotions have detrimental effects on glycemic control. As a result considering psychological counselling beside medical interventions can help to better treatment.