Effect of irritable bowel syndrome on sleep quality and quality of life of inflammatory bowel disease in clinical remission

Background: Inflammatory bowel disease (IBD) as a chronic and debilitating disease is affected by sleep disturbance which increases the risk of malignancy. Sleep disturbance is more common in irritable bowel syndrome (IBS) and few reported studies have assessed its role in IBD. We evaluated the effect of IBS on sleep quality and quality of life (QOL) of IBD patients in clinical remission. Methods: In a cross‑sectional study, 115 IBD patients in clinical remission aged from 14 to 70 years referred to gastroenterology outpatient departments and private gastroenterology offices from 2007 to 2016. Patients considered in four groups (with/without IBS). The Revised “Rome III criteria” used for diagnosing IBS. Pittsburgh Sleep Quality Index questionnaire and the health‑related QOL questionnaire used for evaluating sleep quality and QOL. Results: About 85 (73.9%) cases had ulcerative colitis (UC) and 30 (26.1%) cases had Crohn’s disease (CD). Forty (34.8%) cases had IBD + IBS. Poor sleep quality in UC + IBS (OR: 0.018, P = 0.003) and UC (OR: 0.016, P = 0.002) was less than CD. Diseases extent in left side colitis (OR: 0.064, P = 0.016) were less than with pancolitis. Sleep quality affected by quality of life (IBDQ) (P = 0.048). Mean quality of life (IBDQ) in patients who had poor sleep was 11% less than those with good sleep. Conclusions: The syndrome of IBS affects the sleep quality of IBD in clinical remission, especially in CD. Its additive effect with IBD may worsen symptoms that correlated with sleep disturbance, such as pain, psychological and physical condition, and QOL. Keywords: Inflammatory bowel diseases, irritable bowel syndrome, quality of life, slee

Q-T interval prolongation in cirrhosis: Relationship and severity

Background: Cirrhosis as the final stage of progressive fibrosis of liver can affect other organs such as lungs, kidneys and heart. "Cirrhotic cardiomyopathy" involves the electrophysiological abnormalities such as QT interval prolongation. We assessed correlation between corrected QT interval prolongation and severity of cirrhosis based on Child Classification in each ECG lead. Methods: In this case-control study, the patients attending the outpatient clinic and inpatient department of internal medicine of Velayat Hospital in Qazvin were enrolled from September 2014 to July 2015. Total samples were 74 patients, half of which were used as controls. Cirrhosis severity was determined as per Child Classification. Both groups had Ca2+, Mg2+, K+ tested and 12- lead ECG was obtained. The QT interval was corrected by two different formulas: (1) QTc=QT/√RR (QTc1); (2) QTc=QT+1.75 (heart rate-60) (QTc2). To analyze the data, the software SPSS Version 16 and Mann-Whitney, Pearson’s chisquare test-Kruskal-Wallis, and t-tests were used. Results: The mean of QTc1 and QTc2 was longer in cirrhotics than the control group. There was a significant correlation between Child score and length of QTc1 in leads: III (p=0.032), AVL (p=0.041), V2 (p=0.049), V6 (p=0.015). There were significant differences in length of QTc1 in leads: V3 (p=0.031) and V6 (p=0.021); and QTc2 in lead V3 (p=0.039) between Child Classification. Conclusions: Cirrhosis can induce QTc interval prolongation. Lead V3 has statistically significant correlation with the severity of cirrhosis based on child classification. We propose that QT interval prolongation be added as a criterion for prioritizing liver transplantation

Effect of irritable bowel syndrome on sleep quality and quality of life of inflammatory bowel disease in clinical remission

Background: Inflammatory bowel disease (IBD) as a chronic and debilitating disease is affected by sleep disturbance which increases the risk of malignancy. Sleep disturbance is more common in irritable bowel syndrome (IBS) and few reported studies have assessed its role in IBD. We evaluated the effect of IBS on sleep quality and quality of life (QOL) of IBD patients in clinical remission. Methods: In a cross-sectional study, 115 IBD patients in clinical remission aged from 14 to 70 years referred to gastroenterology outpatient departments and private gastroenterology offices from 2007 to 2016. Patients considered in four groups (with/without IBS). The Revised “Rome III criteria” used for diagnosing IBS. Pittsburgh Sleep Quality Index questionnaire and the health-related QOL questionnaire used for evaluating sleep quality and QOL. Results: About 85 (73.9%) cases had ulcerative colitis (UC) and 30 (26.1%) cases had Crohn's disease (CD). Forty (34.8%) cases had IBD + IBS. Poor sleep quality in UC + IBS (OR: 0.018, P = 0.003) and UC (OR: 0.016, P = 0.002) was less than CD. Diseases extent in left side colitis (OR: 0.064, P = 0.016) were less than with pancolitis. Sleep quality affected by quality of life (IBDQ) (P = 0.048). Mean quality of life (IBDQ) in patients who had poor sleep was 11% less than those with good sleep. Conclusions: The syndrome of IBS affects the sleep quality of IBD in clinical remission, especially in CD. Its additive effect with IBD may worsen symptoms that correlated with sleep disturbance, such as pain, psychological and physical condition, and QOL

Evaluation of the effective factors on Bipolar I Disorder frequent recurrence in a 5 years longitudinal study using generalized estimation equations method

Background and Purpose: Patients with Bipolar I Disorder recurrence experiences mood variation between manic and depression during the time. Hence, that is need to the longitudinal study on Bipolar Disorder patients. This study aims to evaluate the effective factors on Bipolar I Disorder frequent recurrence in 5 years longitudinal study using generalized estimation equations (GEE) method. Materials and Methods: Data were collected with repeated measurements on 255 Bipolar I Disorder patients in mazandaran, Iran, in a longitudinal study between 2007 and 2011. The outcome variable is Bipolar I Disorder recurrence, and the predictor variables are as follows: sex, age of onset, family history (Grade 1), economic status and education level. In this paper, SAS PROC GENMOD was used to apply GEE regression to the assessment of parameters corresponding to the factors causing recurrence. Results: The age was among 13-55 years and the average of age of onset was 24.1 years. Almost of patients were male and had economic status with (upper/middle) deciles and also had a diploma and under diploma education level. The results of GEE method showed that the covariate of family history (Grade 1) increased the odds of recurrence (odds ratio [OR] >1; P < 0.0500); and age of onset decreased the odds of recurrence in patients with Bipolar I Disorder (OR <1; P < 0.0500). Conclusion: Predictor variables in recurrence Bipolar I Disorder include first-degree relatives&rsquo; psychiatric family history and age of onset. Understanding this factors, and educate patients, and their families are valuable for the prevention and planning the treatment

The Relationship Between Bridging Integrator 1 Gene Polymorphism and Susceptibility to Alzheimer’s Disease

Background: Alzheimer’s Disease (AD) is the most common type of dementia. The role of genetic factors in AD development remains non-demonstrated. Objectives: In this study, we aimed to investigate the association between one of the BIN1 gene’s single-nucleotide polymorphisms (SNP) rs744373 and Late-Onset Alzheimer’s Disease (LOAD) in an Iranian population in Guilan Province. Materials & Methods: In this case-control study, 110 patients with LOAD and 110 unrelated healthy controls were recruited. Polymerase chain reaction-restriction length polymorphism (PCRRFLP) was performed for genotyping the BIN1 gene’s SNP rs744373. Electrophoresis was thereafter conducted using agarose gel and DNA-safe stain, and the gels were visualized under an Ultraviolet (UV) trans-illuminator. The allelic and genotypic frequencies were determined. Results: The frequency of allele T (Wild-type allele) in the control and the LOAD groups was 70.9% (n=159) and 58.6% (n=129), respectively (P=0.007). The frequency of allele C in the LOAD group (41.4%) (n=91) was significantly higher than that of the control group (29.1%) (n=64) (P=0.007). BIN’s homozygous genotype (CC) frequency was significantly higher in the LOAD group than in the control group (P=0.043). Conclusion: The rs744373 SNP of the BIN1 gene is significantly associated with the risk of developing AD in the studied population