Economic Burden of Epidermolysis Bullosa Disease in Iran

Background: Epidermolysis bullosa (EB) is prevalent in Iran and incurs direct and indirect costs on the health care system and the patient.Therefore, this study was conducted to estimate the economic burden of this disease in Iran. Methods: Tins study includes all patients with EB disease who had been referred to the medical centers of Iran in 2019-2020 for treatment of their disease, especially Hazrat Fatimah Hospital and their medical records are available in Iran EB Patients Association (IEBPA). In estimating the economic burden of diseases and costing studies. wre calculated the average direct and indirect costs for a patient and used it to estimate the costs of the patient population. In this study, a prevalence approach was used to calculate the economic burden of this disease. For this purpose, the existing cases of the disease in 2019-2020 were calculated. The data collected from the questionnaires that were completed through interviews with patients as well as the data extracted from the review of their files were entered into Excel software and analyzed. Results: The total direct medical costs of direct non-medical and indirect are equal to 7.319.428.315 & 5.390.440.775 and 45.875.654.514 Rials respectively, and the total economic burden of the disease and the average of each patient is 58.585.514.604 and 155.890.789 respectively. Conclusion: High indirect costs, especially informal care, represent the socio-economic burden of this disease and constitute more than half of the total indirect costs. Therefore, the obvious gap and hidden social costs of this disease are related to health policymakers, especially when they want to study the impact of this disease on different income classes of families

The Effectiveness of Psychosocial Model-Based Therapy on Social Skills in People With PTSD After Burn

Objective Because burns are one of the traumatic events that causes Post-Traumatic Stress Disorder (PTSD) and the scar caused by an accident causes changes in the skin and the appearance of the patient, these people will have problems in their social relationships that affect their lives and social skills. Therefore, the present study was conducted with the aim of evaluating the effectiveness of psychosocial model-based treatment plan on social skills of people with PTSD resulting from burn. Materials & Methods The present study was carried out in two stages. In the first stage, following the review of literature and therapeutic theories and concepts based on the psychosocial perspective, a plan was developed. Then, in order to validate the treatment program, 10 specialists and experts in clinical and health psychology department were consulted to determine the validity of the proposed plan. In the second stage, after designing and validating the program, a quasi-experimental design with pre-test and post-test design with control group was implemented. The statistical population included all female patients referring to Tehran Shahid Motahari Burn Rescue Hospital in 2017. They were evaluated in a two stage sampling. In the first step, according to simple random sampling method, a semi-structured diagnostic interview was conducted based on DSM-5 psychiatric disorders criteria by a clinical psychologist and by performing a PTSD checklist screening. In the second stage based on simple random sampling method, 30 patients were selected from the subjects with PTSD (In each group of 15 people, with a drop in the post-test phase, 13 patients in examination group and 15 in the control group remained). The psychosocial treatment program was conducted in 12 sessions and followed up for two months in the experimental group. Measurement tools including semi-structured diagnostic interviews based on DSM-5, PTSD Checklist-5 (PCL-5) and Social Skills Inventory (SSI) were used to collect data, and the results were analyzed in SPSS V. 22 by performing MANCOVA to examine the effect of intervention and dependent t test on the survival of the treatment.  Results The results showed that the program had acceptable content validity so that the Content Validity Index (CVI) based on the Lawshe method for the treatment program was 0.85 (with a minimum acceptable value of 0.62 for this number of specialists), and the CVI based on the Waltz and Bausell method for the treatment program was 0.92 (The minimum acceptable value is 0.79). Accordingly, the content validity and the CVI of the program are acceptable. The results of the treatment intervention showed that considering the higher mean scores of the experimental group compared to control group in the post-test and follow up stage, the psychosocial model-based program improved social skills, including social expression, emotional expression, social sensitivity, emotional sensitivity, social control, and emotional control in people with PTSD due to burn injuries (P<0.05). The results of t dependent test to determine the survival rate of treatment by comparing pretest and follow-up of the experimental group showed that the effect of the plan on improving social skills remained in the follow-up phase (P<0.05). Conclusion Based on the results, patients with PTSD due to burned scar have a disadvantage in terms of proper social communication and social skills. Also a psychosocial model-based therapeutic program can effectively improve the social skills of patients with PTSD due to burns

Effectiveness of psychosocial treatment on emotion regulation in people with posttraumatic stress disorder after burn injuries

Background: Burn is one of the traumatic events that causes posttraumatic stress disorder (PTSD). The burn survivors often experience major psychological problems. Objective: This study evaluated the effectiveness of psychosocial model-based treatment plan on emotion regulation strategies in people with PTSD after burn injury. Methods: The research method was semi experimental with pretest-posttest design with control group. All patients referring to Tehran Shahid Motahari Burn Rescue Hospital participated by using simple random sampling method in 2017. Thirty patients with PTSD diagnosis were selected to the experimental and control groups. The treatment program was conducted during 12 sessions and followed up after two months in the experimental group. The tools of study included a structured diagnostic interview based on the 5th edition of diagnostic and statistical guide (DSM-5), PTSD index (PCL-5) and emotion regulation questionnaire (ERQ). The results were analyzed by multivariate analysis of covariance and t correlation. Findings: The results showed that the treatment program increased the re-evaluation component (as a positive emotion regulation strategy) and decreased repression scores (as a negative strategy) in PTSD patients due to burn injuries and this effect has been lasting for two months. Conclusion: Based on the results, it can be concluded that psychosocial therapeutic program is an effective program for PTSD patients and can affect their emotion regulation strategies

Comparison of the Results of Phalloplasty Using Radial Free Forearm Flap and Anterolateral Thigh in Iran from 2014 to 2019

Introduction Due to the worldwide growing number of transgender individuals openly identifying themselves, including in Iran, these individuals need more attention and support. This study compares patient satisfaction and quality of life after female-to-male gender confirmation surgery using an anterolateral thigh (ALT) flap and radial forearm free flap (RFFF)

Global, regional, and national burden of other musculoskeletal disorders, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021

Background Musculoskeletal disorders include more than 150 different conditions affecting joints, muscles, bones, ligaments, tendons, and the spine. To capture all health loss from death and disability due to musculoskeletal disorders, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) includes a residual musculoskeletal category for conditions other than osteoarthritis, rheumatoid arthritis, gout, low back pain, and neck pain. This category is called other musculoskeletal disorders and includes, for example, systemic lupus erythematosus and spondylopathies. We provide updated estimates of the prevalence, mortality, and disability attributable to other musculoskeletal disorders and forecasted prevalence to 2050. Methods Prevalence of other musculoskeletal disorders was estimated in 204 countries and territories from 1990 to 2020 using data from 68 sources across 23 countries from which subtraction of cases of rheumatoid arthritis, osteoarthritis, low back pain, neck pain, and gout from the total number of cases of musculoskeletal disorders was possible. Data were analysed with Bayesian meta-regression models to estimate prevalence by year, age, sex, and location. Years lived with disability (YLDs) were estimated from prevalence and disability weights. Mortality attributed to other musculoskeletal disorders was estimated using vital registration data. Prevalence was forecast to 2050 by regressing prevalence estimates from 1990 to 2020 with Socio-demographic Index as a predictor, then multiplying by population forecasts. Findings Globally, 494 million (95% uncertainty interval 431–564) people had other musculoskeletal disorders in 2020, an increase of 123·4% (116·9–129·3) in total cases from 221 million (192–253) in 1990. Cases of other musculoskeletal disorders are projected to increase by 115% (107–124) from 2020 to 2050, to an estimated 1060 million (95% UI 964–1170) prevalent cases in 2050; most regions were projected to have at least a 50% increase in cases between 2020 and 2050. The global age-standardised prevalence of other musculoskeletal disorders was 47·4% (44·9–49·4) higher in females than in males and increased with age to a peak at 65–69 years in male and female sexes. In 2020, other musculoskeletal disorders was the sixth ranked cause of YLDs globally (42·7 million [29·4–60·0]) and was associated with 83 100 deaths (73 600–91 600). Interpretation Other musculoskeletal disorders were responsible for a large number of global YLDs in 2020. Until individual conditions and risk factors are more explicitly quantified, policy responses to this burden remain a challenge. Temporal trends and geographical differences in estimates of non-fatal disease burden should not be overinterpreted as they are based on sparse, low-quality data.Global, regional, and national burden of other musculoskeletal disorders, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021publishedVersio