Assessing the sleep quality and depression-anxiety-stress in irritable bowel syndrome patients / Avaliação da qualidade do sono e de depressão, ansiedade e estresse em pacientes com síndrome do intestino irritável

ABSTRACT BACKGROUND Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders with chronic abdominal pain and altered bowel habit without any organic reason. Sleep disorders may be associated to IBS. OBJECTIVE We aimed to assess sleep disturbances and depression-anxiety-stress in IBS patients. METHODS In this analytical cross sectional study from November 2013 to May 2014, A total of 123 IBS patients were recruited by simple random sampling. IBS was diagnosed using ROME-III criteria. Demographic and basic data were driven from all patients then Pittsburg Sleep Quality Index questionnaire was utilized to estimate sleep quality and DASS (depression anxiety stress scale) questionnaire was filled out for depression, anxiety and stress. RESULTS The mean age of patients was 29±9, where 48 cases (39%) were male. Twelve cases (10%) had a background disease. Types of IBS in patients were included 38% diarrhea, 42% constipation and 20% mixed. From all IBS patients 87 (71%) cases had depression, 97 (79%) patients stress, 94 (76%) patients had anxiety. Seventy-six (62%) cases of IBS patients had poor sleep quality. Simultaneously employing predictors demonstrate that gender, background disease, and type of IBS did not statistically significant. On the other hand, depression (P=0.034, OR=2.35), anxiety (P=0.011, OR=3.022), and stress (P=0.029, OR=2.77) were significantly effect on sleep quality in poor sleepers. CONCLUSION Many of IBS patients is suffering from poor sleep quality. It seems that sleep disorder should be considered and treated in this patients.

RESUMO CONTEXTO A síndrome do intestino irritável (SII) é um dos transtornos gastrointestinais funcionais mais comuns, com dor abdominal crônica e alteração do hábito intestinal sem motivo orgânico aparente. Distúrbios do sono podem estar associados à SII. OBJETIVO Avaliar distúrbios do sono e sinais de depressão, ansiedade e estresse em pacientes com SII. MÉTODOS Através de estudo analítico transversal, observou-se entre de novembro de 2013 e maio 2014, um total de 123 pacientes com SII, recrutados por amostragem aleatória simples. A SII foi diagnosticada usando-se os critérios de Roma III. Dados demográficos e básicos foram obtidos de todos os pacientes e o questionário de índice de qualidade de sono de Pittsburg foi utilizado para estimar a qualidade do sono; o questionário DASS (escala de depressão ansiedade stress) foi preenchido para depressão, ansiedade e stress. RESULTADOS A média de idade dos pacientes foi de 29±9 anos, sendo 48 (39%) do sexo masculino. Doze (10%) tinham alguma doença associada. Nos subtipos de SII foram incluídos 38% com diarreia, 42% com constipação e 20% de forma alternada. Do total, 87 (71%), pacientes tinham depressão, o estresse foi observado em 97 (79%) e 94 (76%) tinham ansiedade. Setenta e seis (62%) pacientes com SII tinham sono de má qualidade. A análise de preditores, empregados simultaneamente, demonstrou que o gênero, a doença associada e o tipo de SII não foram estatisticamente significantes. Por outro lado, depressão (P=0,034, OR=2,35), ansiedade (P=0.011, OR=3.022) e stress (P=0,029, OR=2,77) contribuíram significativamente no efeito da má qualidade do sono. CONCLUSÃO A maioria dos pacientes com SII tem sono de má qualidade. Recomenda-se que o distúrbio do sono deva ser considerado e tratado nestes pacientes.

ASSESSING THE SLEEP QUALITY AND DEPRESSION-ANXIETY-STRESS IN IRRITABLE BOWEL SYNDROME PATIENTS.

BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders with chronic abdominal pain and altered bowel habit without any organic reason. Sleep disorders may be associated to IBS. OBJECTIVE: We aimed to assess sleep disturbances and depression-anxiety-stress in IBS patients. METHODS: In this analytical cross sectional study from November 2013 to May 2014, A total of 123 IBS patients were recruited by simple random sampling. IBS was diagnosed using ROME-III criteria. Demographic and basic data were driven from all patients then Pittsburg Sleep Quality Index questionnaire was utilized to estimate sleep quality and DASS (depression anxiety stress scale) questionnaire was filled out for depression, anxiety and stress. RESULTS: The mean age of patients was 29±9, where 48 cases (39%) were male. Twelve cases (10%) had a background disease. Types of IBS in patients were included 38% diarrhea, 42% constipation and 20% mixed. From all IBS patients 87 (71%) cases had depression, 97 (79%) patients stress, 94 (76%) patients had anxiety. Seventy-six (62%) cases of IBS patients had poor sleep quality. Simultaneously employing predictors demonstrate that gender, background disease, and type of IBS did not statistically significant. On the other hand, depression (P=0.034, OR=2.35), anxiety (P=0.011, OR=3.022), and stress (P=0.029, OR=2.77) were significantly effect on sleep quality in poor sleepers. CONCLUSION: Many of IBS patients is suffering from poor sleep quality. It seems that sleep disorder should be considered and treated in this patients.

Epidemiological and Clinical Characteristics of Patients with Middle East Respiratory Syndrome Coronavirus in Iran in 2014.

The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was a great global concern in 2014. It has a wide range of manifestations that may differ in each area as well as high mortality. In this study, we report the epidemiological characteristics, history, clinical, and paraclinical information of all 5 patients from Iran with laboratory-confirmed MERS-CoV. All patients were from Kerman province. None of them had a history of travel, contact with animals, or consumption of camel milk products, however, all of the patients had contact with a person who had been in Saudi-Arabia and experienced respiratory infection. One of the 5 patients was a man and 2 passed away from the disease. Fever and respiratory symptoms were the most common symptoms, and 2 patients had watery diarrhea. Alveolar patterns were observed in all available chest radiograms, and 3 patients had elevated liver aminotransferase levels. Two of these patients had leukopenia, and none had renal failure. In conclusion, the results of this study underscore the need for all patients with acute respiratory symptoms with contact with a person who has recently traveled to Saudi-Arabia and experienced respiratory infection to be investigated for MERS-CoV.

Fasting Blood Glucose and Insulin Level in Opium Addict versus Non-Addict Individuals.

BACKGROUND: Many of lay person believe that opium lowers blood glucose. However some studies show the opposite results. In this study, we tried to evaluate the effect of opium on blood glucose and insulin resistance. METHODS: This comparative study including 53 addicts in case groups who used opium just in the form of smoking and 55 non-addicts in a control group, took part in the study, after proving not to be opium users. After taking blood samples, their fasting blood glucose (FBG), fasting blood insulin and lipid profiles were evaluated. Furthermore, insulin resistance index was analyzed via the homeostatic model assessment of insulin resistance (HOMA-IR) formula with the cut-off points of 7.2 and 7.1. FINDINGS: Age and gender were not significantly different between the groups. There was no significant difference regarding the prevalence of insulin resistance between the two groups, according to the cut-off points of 7.1 and 7.2 (P = 0.196 and P = 0.248, respectively). Mean insulin resistance index was not significantly different between the two groups (P = 0.325). In the case group, fasting blood insulin was considerably lower (P = 0.025) and fasting blood sugar (FBS) was significantly higher (P = 0.016) than the control group. CONCLUSION: According to the level of insulin and FBS in addicts, it does not seem that opium has a significant effect on reducing the blood glucose and insulin resistance.

The safety assessment of saffron (Crocus sativus L.) on sympathovagal balance and heart rate variability; a comparison with amiodarone.

Dry stigmas of the Crocus sativus L. (Saffron) are well known in world as a popular flavouring and therapeutic agent. The anxiolytic, antidepressant, anticonvulsant and antiarrhythmic effects of saffron suggest that it may affect the autonomic control of the heart. This study assessed its safety on cardiac sympathovagal balance and heart rate variability in rat. Experimental groups were control, Saf50, Saf100, Saf200 (received saffron at dosages of 50 and 100 and 200 mg/kg/d, orally, respectively) and Amio (received 30 mg/mL/kg/d of amiodarone, orally, for 7 days) groups. On day 8, the frequency domain and time domain indices of animals' electrocardiograms were calculated. The heart rate decreased and RR interval increased in Saf200 and Amio groups (P<.05 vs other groups). Square root of the mean squared differences of successive RR intervals enhanced in all treated groups, however, was only significant in Amio group (P<.05). The SD1/SD2 ratio was higher in Saf200 and Amio groups. Both low-frequency (LF) and high-frequency (HF) parameters were higher, and the LF/HF ratio was non-significantly lower in treated groups. The findings suggest that saffron not only has no harmful effect on activity of cardiac autonomic nervous system, but it may improve the stability of heart sympathovagal balance in normal rat.