Limb‐girdle muscular dystrophies (LGMDs) are a highly heterogeneous group of neuromuscular disorders that are associated with weakness and wasting of muscles in legs and arms. Signs and symptoms may begin at any age and usually worsen by time. LGMDs are autosomal disorders with different types and their prevalence is not the same in different areas. New technologies such as next‐generation sequencing can accelerate their diagnosis. Several important pathological mechanisms that are involved in the pathology of the LGMD include abnormalities in dystrophin–glycoprotein complex, the sarcomere, glycosylation of dystroglycan, vesicle and molecular trafficking, signal transduction pathways, and nuclear functions. Here, we provide a comprehensive review that integrates LGMD clinical manifestations, prevalence, and some pathological mechanisms involved in LGMDs.

The outbreak of COVID-19 has had destructive influences on social and economic systems as well as many aspects of human life. In this study, we aimed to estimate the economic effects of COVID-19 at the individual and societal levels during a fiscal year. This cost of illness analysis was used to estimate the economic burden of COVID-19 in Iran. Data of the COVID-19 patients referred to the hospitals affiliated to Bushehr University of Medical Sciences in 2021 were collected through the Hospital Information System (HIS). The study methodology was based upon the human capital approach and bottom-up technique. The COVID-19 pandemic has resulted in 9711 confirmed hospital cases and 717 deaths in Bushehr province during the study period. The direct and indirect costs were estimated to be $1446.06 and $3081.44 per patient. The economic burden for the province and country was estimated to be $43.97 and $2680.88 million. The results showed that the economic burden of this disease particularly premature death costs is remarkably high. Therefore, in order to increase the resiliency of the health system and the stability in service delivery, preventive-oriented strategies have to be more seriously considered by policymakers.

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Background: Multiple Sclerosis (MS) is a chronic and inflammatory disease that can affect the patients' quality of life and impose many costs on them. Several types of medicine are used to change the course of the disease, treat disease -related attacks, and treat the symptoms of multiple sclerosis. Objectives: The aim of this study was to determine and compare the cost-effectiveness and cost -utility of CinnoVex versus ReciGen as the first line treatment in patients with relapsing-remitting multiple sclerosis in Iran, Fars province, in 2016. Methods: This study was a cost -effectiveness and cost -utility study, in which a Markov model was used. A sample of 178 patients with MS was randomly selected. The costs were summed up from the societal perspective, and the study outcomes were QALY and the mean of relapse was avoided. To collect the required data, the cost data collection form, Kurtzke Expanded Disability Status Scale, and EQ -5D questionnaire were used. To analyze the data collected, the TreeAge Pro 2011 and Excel 2010 software were used as well. Results:The results showed that the mean cost for ReciGen and CinnoVex patients were 349.84 and 289.92 USD, respectively. In addition, the QALY means were 0.291 and 0.297 and the means of relapse avoided were 0.309 and 0.239 for ReciGen and CinnoVex patients, respectively. The one -way sensitivity analysis showed that the results of the model were sensitive to effectiveness and utility of both medicines, but had little sensitivity to other parameters. Conclusions: According to the results, ReciGen was more cost -effective in terms of relapse avoided and CinnoVex was more costeffective in terms of QALY. Therefore, ReciGen and CinnoVex can be the preferred options for physicians and for health policymakers and managers, respectively.

Introduction Multiple sclerosis (MS) is an inflammatory disease in which the myelin sheaths of the nerve cells in the brain and spinal cord, which are responsible for communication, are destroyed and cause physical signs and symptoms. According to studies, anti-CD20 monoclonal antibodies have significant results in the treatment of this disease. Thus, the aim of the present study was to determine the cost-effectiveness of rituximab against natalizumab in the patients with RRMS in southern Iran in 2020. Methods This is an economic evaluation including cost-effectiveness analysis in which the Markov model with a lifetime horizon was used. The study sample consisted of 120 patients randomly selected from among those referred to the MS Association and the Special Diseases Unit of Shiraz University of Medical Sciences. In this study, the costs were collected from a societal perspective, and the outcomes were obtained in the form of Quality Adjusted Life Years (QALY) and the mean relapse rate. The TreeAge pro 2020 and Excel 2016 software were used for data analysis. Results The comparative study of rituximab and natalizumab showed that the patients receiving rituximab had lower costs ($ 58,307.93 vs. $ 354,174.85) and more QALYs (7.77 vs. 7.65). In addition, the incidence of relapse by rituximab was lower compared to natalizumab (1.15 vs. 2.57). The probabilistic one-way sensitivity analysis showed the robustness of the results. The scatter plots also showed that rituximab was more cost-effective for the patients in 100% of the simulations for the threshold of < $ 37,641. Discussion and conclusion According to the results of this study, rituximab had higher cost-effectiveness than natalizumab. Therefore, it could be a priority for RRMS patients compared to natalizumab because it reduced treatment costs and increased effectiveness.