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Background: It is unknown if the clinical manifestations and phenotype of disease are comparable between early- and elderlyonset inflammatory bowel disease (IBD). We aimed to seek differences in disease phenotype, course, complications, and treatment between early- and elderly-onset IBD patients. Methods: This retrospective cohort study on registered IBD patients in the Iranian Registry of Crohn's and Colitis (IRCC) compared demographics, disease phenotype, disease activity, IBD-related surgery and medications between early- and elderly-onset IBD. A generalized linear regression model was used to investigate the relative risk of age at diagnosis adjusted for gender and disease duration for the outcomes. Results: From 10 048 IBD patients, 749 with early-onset (7.5%), and 472 (4.7%) elderly-onset IBD were enrolled: 855 (63.1%) ulcerative colitis (UC) and 366 (26.9%) Crohn's disease (CD). Left-sided colitis was more frequent among elderly-onset UC patients (P < 0.001). Ileum and ileocolonic locations were the most common types in elderly-onset and early-onset CD patients, respectively. In comparison with elderly-onset UC, early-onset cases more often used prednisolone (22.1% vs. 11.4%, P = 0.001), immunomodulators (44.9% vs 25.2%, P < 0.001) and anti-tumor necrosis factors (TNF) (20.1% vs 11.9%, P = 0.002). Elderly-onset UC patients had 0.7 times lower risk of aggressive phenotype (95%CI:0.6-0.9, P = 0.005). Early-onset CD was associated with higher use of prednisolone (27.7% vs 8.1%, P < 0.001), immunomodulators (58.7% vs 41.8%, P = 0.005) and anti-TNF (49.6% vs 35.4%, P = 0.006). Conclusion: Early-onset IBD was associated with a more aggressive phenotype and higher prednisolone, immunomodulators, and anti-TNF use. [ABSTRACT FROM AUTHOR]

Background. Telemedicine has recently become a more important platform for the delivery of health interventions such as blood glucose monitoring and a range of other health concerns. Objectives. The purpose of this systematic review and meta-analysis is to examine the effect of different types of telemedicine compared to standard care on glycated haemoglobin (HbA1C) level and other glucose-related indicators for persons with diabetes in the Middle East and North Africa (MENA) region. Material and methods. The following electronic databases were searched from 1990 to February 2022; MEDLINE, Embase, Scopus and the Cochrane Library. A total of six randomised controlled trials met the inclusion criteria and were included in the data for the meta-analysis. Results. Six randomised controlled trials (n = 461 individuals) comparing telemedicine standard care in people with type 2 diabetes in the MENA region were included. The mean difference in HbA1c between the control and telemedicine groups was -0.52 (95% CI, -0.79, -0.25) (p < 0.001), showing better HbA1C scores in patients receiving telemedicine than those receiving standard care only. The study’s heterogeneity was quite low, with an I2 value of 1% (p = 0.55). The evidence surrounding the impacts of telemedicine on all categories of cholesterol was low and insignificant. Conclusions. The evidence gathered in this systematic analysis shows that using telemedicine in comparison to standard care improves HbA1c levels in persons with type 2 diabetes in the MENA region. [ABSTRACT FROM AUTHOR]