Introduction: COVID-19 infection (SARS-CoV-2) is associated with high morbidity and mortality rates, and worse outcomes have been reported for various morbidities. The impact of pre-existing hypothyroidism on COVID-19 outcomes is unclear. Objectives: This study aimed to evaluate the frequency of treated hypothyroidism and its effect on disease complications in COVID-19 patients in Razi hospital of Ahvaz. Patients and Methods: This cross-sectional study was conducted on patients with a laboratory and computed tomography (CT) confirmed COVID-19 diagnosis between August 2021 and December 2021 in Razi hospital in Ahvaz. The medical records of all patients were reviewed, and patient's characteristics and outcomes related to COVID-19, including severe disease, hospitalization in intensive care unit (ICU), need for mechanical or invasive ventilation, and all-cause mortality, was collected. The presence of hypothyroidism was identified based on the patient's medical history in the medical record. Results: Of 850 patients with COVID-19 positive, 59 patients (6.9%) had pre-existing hypothyroidism and received thyroid hormone replacement therapy. Hypothyroidism was not associated with increased risk of ICU admission (odds ratio [OR]: 0.447; 95% CI: 0.216-0.925, P = 0.030), severe disease (OR: 1.237; 95% CI: 0.6882.223, P = 0.447) mechanical ventilation (OR: 1.785; 95% CI: 0.894-3.562; P = 0.064) and death (OR: 0.997; 95% CI: 0.478-2.080; P = 0.993). Conclusion: Our study showed that underlying hypothyroidism does not lead to worse outcomes and complications in patients with COVID-19. It suggests that hypothyroidism is not associated with a worse prognosis and should not be considered among the comorbidities that indicate a risk factor for COVID-19 severity and its complication.

ABSTRACT Background and Aims Hypertriglyceridemia‐induced acute pancreatitis (HTGAP) is a distinct clinical subtype of acute pancreatitis (AP), but comparative data remain limited. This study aimed to compare risk factors, disease severity, and clinical outcomes between patients with HTGAP and non‐HTGAP. Methods A single‐center retrospective case‐control study was conducted using medical records of patients diagnosed with AP who were admitted to Imam Hospital (Ahvaz, Iran) between May 2020 and May 2025. Patients were categorized into HTGAP (n = 150) and non‐HTGAP (n = 150) groups. Demographic data, severity scores, clinical complications, and length of hospital stay were compared between the two groups. Results HTGAP was associated with significantly higher rates of complications, including acute respiratory distress syndrome, acute peripancreatic fluid collection, sepsis, acute necrotizing pancreatitis, pancreatic pseudocyst, walled‐off or infected pancreatic necrosis, and renal failure (p < 0.05). HTGAP patients were younger and had higher body mass index than non‐HTGAP patients (p < 0.001). They also had significantly higher mean Ranson (3.18 vs. 2.53), 24‐h Acute Physiology, Chronic Health Evaluation II (APACHE II) (9.78 vs. 6.88), and modified computed tomography severity index (MCTSI) scores (7.08 vs. 4.54), as well as longer hospital stays (9.44 vs. 5.00 days), compared with non‐HTGAP patients (p < 0.001). No in‐hospital mortality occurred. Conclusion HTGAP was associated with a more severe clinical profile and higher complication rates than non‐HTGAP, highlighting the need for early recognition and careful management. Interpretation of these findings is limited by the retrospective single‐center design and absence of multivariable adjustment.

Background: Polycystic ovary syndrome (PCOS) represents the most common endocrine disorder in women of reproductive age, driving hyperandrogenism, ovulatory dysfunction and metabolic disturbances through elevated testosterone, anti-M & uuml;llerian hormone (AMH) and reduced sex hormone-binding globulin (SHBG). However effective natural interventions to resolve these hormonal imbalances remain elusive. Aim: Here, we demonstrate effects of ginger supplementation on serum hormones and clinical symptoms in women with PCOS. Methods: In a parallel randomized, double-blind, placebo-controlled trial 45 women with PCOS received 2 g/day ginger or placebo for 12 weeks. Serum total testosterone, SHBG, AMH, free androgen index (FAI) and statuses of hirsutism, amenorrhea, dysmenorrhea and hair loss were evaluated at baseline and endpoint using univariate and intention-to-treat analyses. Results: Ginger supplementation significantly decreased total testosterone (-0.14 f 0.27 ng/mL vs.-0.003 f 0.14 ng/mL; P = 0.02) and FAI (-0.08 f 1.51 vs. 0.03 f 0.88; P = 0.002) compared to placebo (n = 45). It also increased SHBG (3.82 f 10.63 nmol/L vs.-2.17 f 10.64 nmol/L; P = 0.002). Fewer women in ginger group experienced amenorrhea (8 [35%] vs. 15 [68%]; P = 0.02) and dysmenorrhea (4 [17%] vs. 10 [45%]; P = 0.04). These effects persisted after adjustment for baseline values. Conclusion: Ginger supplementation demonstrated a promising effect to ameliorate hyperandrogenism and menstrual irregularities in PCOS, paving the way for natural therapeutics in endocrine management. However larger RCTs with a dose-dependent approach are warranted.

Background:Polycystic ovary syndrome (PCOS) has various causes that are largely unknown. The present study was aimed to evaluate metabolic and biochemical markers as well as body mass index (BMI) related to PCOS among two groups including patients and healthy controls. Methods:A case-control study included women younger than 45 years who did not suffer from obesity. Women with male-factor infertility served as the control group, while patients detected with PCOS via the Rotterdam criteria made up the case group. There were 86 randomly selected participants in each group. Fasting blood sugar (FBS), lipid profiles, alanine aminotransferase (ALT) and other biochemical tests were gathered with demographic data, medical records, physical exams and anthropometric measurements. Ultrasound, liver enzyme levels and medical history were utilized to diagnose non-alcoholic fatty liver disease (NAFLD). Results:About 172 women were selected for the research; 86 had PCOS, while the remaining 86 were healthy controls. A younger mean age and a higher BMI were found in women with PCOS. The findings showed that mild to moderate fatty liver was more prevalent in the PCOS group than the control one (P = 0.04). Although metabolic indices, liver enzymes, hematologic parameters and hormone levels did not alter significantly, the PCOS group had lower fasting blood sugar levels (P = 0.029). The correlation between total cholesterol and PCOS was still poor after adjusting for age in logistic regression analysis. Still, it became statistically insignificant after adjusting for BMI index. Conclusion:Non-obese women with PCOS had a higher prevalence of fatty liver, with minor differences in metabolic parameters, and BMI partly mediated these associations.

Background: The purpose of this work was to assess insulin resistance (HOMA-IR) and metabolic syndrome prevalency among patients with and without thyroid nodules. Materials and Methods: This case-control study was done on 86 patients with normal TSH level (0.5–4.5 mIU/L) and thyroid nodules, who referred to Imam Khomeini Hospital (Ahvaz, Iran). Besides, 43 non-nodule patients with normal TSH level and normal thyroid ultrasonic images were enrolled randomly from the general population as the control group. The parameters of metabolic syndrome including height, weight, hip circumference, waist circumference (WC), body mass index (BMI), and persistence of high blood pressure were assessed in two groups. The fasting blood sugar (FBS), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and insulin levels were measured. The diagnosis of insulin resistance was made when the homeostasis model assessment of insulin resistance (HOMA-IR) index was ≥2.5. Results: The mean value of insulin resistance was considerably higher in nodule patients than the control group (3.02 ± 1.92 vs. 1.10 ± 1.55; P < 0.001). HOMA-IR was seen in 49 (57.0%) and 4 (9.3%) in thyroid nodule and the control group patients, respectively (P < 0.0001). WC, BMI, FBS, TG, TC, LDL-C, HDL-C, and insulin levels were significantly higher in the nodular group than the control group. Conclusions: Our study illustrates that there is an association between HOMA-IR and thyroid nodules. The thyroid nodules patients have higher HOMA-IR value compared to other groups. Also, the most of metabolic syndrome parameters were considerably higher in the thyroid nodule group.

Introduction:Metabolic surgery (MS) has been demonstrated to achieve sustained weight loss with significant improvement of metabolic parameters, including reduced cardiovascular diseases and diabetes. This study aimed to evaluate the effect of MS on obesity outcomes and cardiovascular risk factors in Iranian non-diabetic obese patients. Methods:This retrospective follow-up study included non-diabetic obese patients with a body mass index (BMI) of 30 kg/m 2 or higher who underwent MS (LSG or GB) in a single institution in Ahvaz, Iran, from April 2019 to March 2023. Of the 162 reviewed patients, 139 subjects (85.80%) who completed one-year follow-up visits were included in this study. Medical history, anthropometric, biochemical parameters, comorbidities and Framingham risk score (FRS) were evaluated at baseline and annual visits after MS. Results:The mean weight and BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), FRS, lipid profile, liver enzymes and fasting blood glucose (FBS) were significantly improved 12 months postoperatively. The percentage of total weight loss (%TWL) and BMI loss (%BMI) was 30.32±8.14 and 30.32±8.14, respectively, at the one-year follow-up after surgery. At one-year follow-up, a significant resolution of hypertension and dyslipidemia was observed in 44.4% and 73.9% of patients, respectively, and this improvement was stable throughout the follow-up period, with no significant difference between procedures. The type of MS had no effect on changes in weight and BMI at one-year and long-term follow-up after surgery (P>0.05), except the mean weight loss was greater with RYGB than LSG at one-year follow-up.

Type 2 diabetes mellitus (T2DM) and obesity are closely interlinked conditions, contributing significantly to health complications. Metabolic surgery (MS) could help to improve metabolic conditions, including diabetes, hypertension, and hyperlipidemia, which are significant risk factors for cardiovascular disease. This study aimed to evaluate the short-term and long-term effects of MS on obesity outcomes and the Framingham Risk Score (FRS) in Iranian diabetic patients. This multicenter, retrospective study included T2DM patients with body mass index (BMI) ≥ 30 kg/m² who underwent MS in Ahvaz, Iran, from 2019 to 2023. Of the 151 patients, 105 with a follow-up of at least one year were included. Among them, 29 patients (27.6%) had a long-term follow-up (four to five years). Anthropometric and biochemical parameters, comorbidities, and FRS were evaluated at baseline and at one-year and long-term follow-ups. One year postoperatively, there were significant reductions in weight, BMI, systolic and diastolic blood pressure, FRS, triglycerides, low-density lipoprotein (LDL), liver enzymes, fasting blood glucose, and hemoglobin A1c (HbA1c), with an increase in high-density lipoprotein (HDL) levels. The percentage of total weight loss (%TWL) and excess weight loss (%EWL) were 29.13 ± 8.42 and 71.03 ± 20.88, respectively. The median FRS decreased from 11.70 pre-surgery to 4.50 and 6.30 at one-year and long-term follow-ups (P<0.0001). Complete remission of T2DM, hypertension, and hyperlipidemia was achieved in 75.2%, 48.2%, and 35.1% of patients, respectively, and improvements were sustained throughout the follow-up period. The type of MS had no significant impact on changes in weight or BMI (P>0.05). Surgery-related side effects were observed in four cases (3.80%). MS is a safe and effective procedure for reducing obesity-related complications, including T2DM, hypertension, hyperlipidemia, and cardiovascular risk in both the short and long term. These findings highlight the promising potential of MS in managing diabetes.

Background: The relationship between various blood glucose-lowering treatments for type 2 diabetes mellitus (T2DM) and the mortality and complication rates of COVID-19 infection holds significant relevance. Objectives: This retrospective study aimed to investigate the clinical progression of COVID-19 in T2DM patients previously treated with sitagliptin, metformin, or a combination of both. Methods: The study reviewed the medical records of T2DM patients with COVID-19 who had received treatment with sitagliptin, metformin, or both. Participants were selected from those admitted to Naft Hospital in Ahvaz, Iran, from March 2020 to March 2022. Data on mortality and adverse outcomes related to COVID-19 were gathered from the medical records. Results: The study included 529 diabetic patients treated with metformin (n = 197), sitagliptin (n = 231), or both (n = 101) for a minimum of three months. The overall mortality rate among diabetic patients was 15.1%, with the metformin group showing the highest mortality rate at 28.9% (P < 0.0001). Significant differences were observed among the three treatment groups in terms of the frequency of acute respiratory failure (P < 0.0001), stroke (P = 0.002), pulmonary embolism (P < 0.0001), and the necessity for ICU admission (P < 0.0001). Nonetheless, the incidence of myocardial infarction did not significantly differ between the groups. Conclusions: The findings suggest that sitagliptin use for blood sugar control in T2DM patients may help reduce adverse outcomes and the risk of death due to COVID-19. Mortality and morbidity rates were found to be higher in patients treated with metformin compared to those in the other groups.

Background: Thyroid nodule is a common finding of the endocrine system. Despite thyroid nodules in most cases being symptom-free and mostly benign, there are always malignancy risks. This study aimed to evaluate the frequency of types of thyroid nodules according to histopathology characteristics in Ahvaz hospitals. Materials and Methods: This retrospective cross-sectional study was performed on patients with thyroid nodules with histopathological diagnosis referred to the educational hospitals of Ahvaz Jundishapur University of Medical Sciences and private endocrine clinics in Ahvaz from 2018 to 2021. Demographic characteristics, clinical history, histopathological results, ultrasonographic findings, and the presence of lymphadenopathy were collected from the patient’s medical records. Results: A total of 380 patients with thyroid nodules with a mean age of 41.2 ± 12.28 years, 79.37% of whom were female were included in the study. A total of 267 (70/3%) cases were benign. Malignancy was found in 113 (29.7%) patients in which papillary thyroid cancer was the commonest histological diagnosis (n = 99; 87.61%). Age between 30 and 45 years (P = 0.001), bilateral involvement (P = 0.028), nodules size (P = 0.004), and lymph node involvement (P < 0.0001) were significantly associated with malignancy of thyroid nodules. However, there was no significant relationship between malignancy with gender (P = 0.450), BMI (P = 0.258), and history of head and neck radiotherapy (P = 0.200). There was no significant relationship between high thyroid stimulating hormone (TSH) and the type of malignancy (P = 0.059). Conclusion: Malignant thyroid nodules were associated with factors including age between 30 and 40 years, bilateral nodules, and lymphadenopathy. Therefore, it is important to consider these risk factors in the management and risk assessment of thyroid nodules.

Introduction:Effects of levothyroxine therapy on the lipid profile of hypothyroid patients lead to decrease in the risk of cardiovascular diseases and mortality. Objective:Overt or subclinical hypothyroid dysfunction has negative effects on lipid metabolism and leads to hypercholesterolemia that in turn increases the risk of cardiovascular diseases and mortality. In this matter, several interventional studies investigated the effects of levothyroxine therapy on the lipid profile of hypothyroid patients, and conflicting results have been obtained. The current research aims to investigate the effect of levothyroxine replacement on cholesterol levels in hypothyroid patients. Methods:The present prospective study examined 112 patients (mean age of 43.80 ± 14.36 years) with overt hypothyroidism. To do so, 72.3% of patients were females. Levothyroxine replacement therapy was prescribed for patients, and they were examined monthly to evaluate the effects of therapy on their lipid profiles. After reaching normal thyroid stimulating hormone (TSH), the patients' laboratory parameters, including TSH, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides, were surveyed. Results:After Levothyroxine therapy, there was a significant reduction in mean TSH (62.03 vs. 2.33 ± 1.95; P < 0.0001), triglycerides (145.57 ± 88.65 vs. 121.91 ± 59.52, P = 0.002), cholesterol (203.90 ± 53.73 vs. 166.65 ± 40.07, P < 0.0001), and serum LDL (123.61 ± 45.03 vs. 95.99 ± 24.20, P < 0.0001), but the mean value of serum HDL did not show any significant change (54.18 ± 16.60 vs. 51.59 ± 18.38, P = 0.274). Conclusions:Levothyroxine therapy has beneficial effects on lipid profile in patients with overt hypothyroidism because it decreases serum triglyceride, total cholesterol, and LDL. However, levothyroxine therapy does not significantly change HDL levels.

INTRODUCTION:In this study, we aimed to compare metabolic risk factors, lipid indices, healthy eating index, and physical activity among premenopausal, menopausal, and postmenopausal women.METHODS:In this cross-sectional study, a total of 4,732 women participating in the Hoveyzeh Cohort Study were placed into three groups of premenopausal (n=736), menopausal (n=396), and postmenopausal (n=917) women, according to the inclusion and exclusion criteria .RESULTS:The prevalence of metabolic syndrome was 43.3%, 55.6%, and 62.8% in premenopausal, menopausal, and postmenopausal women, respectively. After menopause, the prevalence of hypertension (50.2%), dyslipidemia (61.2%), diabetes (37.7%), and abdominal obesity according to the Iranian guidelines (75.9%) was higher than before menopause. Based on the results, cardiovascular disease had the highest prevalence after menopause (23%). The weight-adjusted waist index (WWI) had the highest odds ratio (OR) among indices, with values of 2.94 and 1.93 in menopausal and postmenopausal women, respectively (P<0.001). According to the Healthy Eating Index-2015 (HEI-2015), the total consumption of fruits, vegetables, seafood, and protein was higher in premenopausal women than in postmenopausal women, and the consumption of foods containing sugar was higher in menopausal women than in premenopausal women. The results showed that the level of physical activity was the highest and the lowest in premenopausal and postmenopausal women, respectively (P<0.001).CONCLUSION:Menopause leads to an increase in the prevalence of metabolic syndrome. The Atherogenic Index of Plasma (AIP), Triglyceride Glucose (TyG) index, WWI, and physical activity index increased in postmenopausal women compared to premenopausal women. The TyG index, WWI, and HEI-2015 did not show significant differences between the groups, based on the multiple regression analysis.

Iron deficiency anaemia (IDA) and diabetes mellitus (DM) are most prevalent disease, that diabetic patients are more prone to IDA. Therefore, the main aim of this study was to investigate the relationship between patients with diabetes and IDA in relation to taking iron pills daily and every other day to reduce the effects related to it. Ninety-one participants were enroled and randomly divided into two groups, with a final analysis cohort of 72 patients. The primary focus was on changes in serum Hb and Ferritin levels. The screening phase lasted 24 weeks, leading to 72 eligible participants meeting the criteria for entry into the study. Additionally, the study examined alternations in Hb and Hb A1C levels after treating patients with iron deficiency. The Hb and ferritin level contrasts between groups were not significant (P = 0.096 and P = 0.500, respectively). The relationship between Hb A1C and Hb levels before and after treatment was positive and significant (r 2 = 0.187). The results of the present study show that although the effectiveness of using oral iron supplements did not have a significant difference in terms of increasing haemoglobin and ferritin, the use of oral iron once every other day was more effective than the use of oral iron every day, and also in this study Like other studies, this result concluded that there is a negative correlation between Hb A1C and Hb, and to check the status of Hb A1C in diabetics, the level of Hb should be considered first.

Objective: Metabolic syndrome is a potential side effect of atypical antipsychotics which are the current standard treatment for schizophrenia. Therefore, we aimed to examine the effect of barberry root (Berberis vulgaris) on the prevention of metabolic syndrome caused by atypical antipsychotic drugs in patients with schizophrenia. Method : Our research was a three-blind randomized clinical trial. The participants included all patients who were diagnosed with schizophrenia through the SCID-5 questionnaire and based on the DSM-5-TR criteria by two psychiatric experts. These patients were randomly divided into intervention and placebo groups. During a three-month treatment period, the intervention group received three 500 mg capsules of barberry root extract daily, whereas the placebo group received the same capsules containing 500 mg of starch powder. Metabolic syndrome variables including fasting blood glucose, serum lipids (triglyceride and cholesterol), blood pressure, weight and waist circumference were measured before and after the treatment as outcome measure. Chi-square and t-tests were used for data analysis using SPSS-22 software. Results: At the beginning of the study, there was no significant difference between the intervention group (n = 41) and the placebo group (n = 47) in terms of demographic factors, and pre-treatment assessments including weight, waist size, fasting blood HDL, fasting blood triglycerides and systolic and diastolic blood pressure and fasting blood glucose (P > 0.05). Within group analysis showed that some metabolic factors significantly increased in both groups after the treatment (P < 0.05). Indeed, in both groups, metabolic syndrome measures worsened after the three-month treatment period. The parameters of weight and waist size were significantly higher in the intervention group than the placebo group after treatment (P < 0.05). Conclusion: Barberry root extract was not able to control the Effects of antipsychotic drugs on metabolic syndrome in schizophrenia.

This study aimed to investigate the effects of rutin flavonoid in type 2 diabetes mellitus (T2DM) patients. In this trial (double-blind, placebo-controlled), 50 T2DM patients (supplement, n = 25 and placebo, n = 25) were randomized and supplemented with 500 mg rutin or placebo per day for 3-months. At the beginning and at the end of the study, metabolic parameters including fasting blood glucose (FBG), insulin, glycosylated hemoglobin (HbA1c), homeostasis model assessment of insulin resistance (HOMO-IR), quantitative insulin sensitivity check index (QUICKI), homeostasis model assessment of beta-cell function (HOMA-beta), triglyceride (TG), total cholesterol (CHOL), high-density and low-density lipoprotein cholesterol (HDL-c and LDL-c), and atherogenic index of plasma (AIP), inflammatory and oxidative stress markers such as interleukin 6 (IL-6), total antioxidant capacity (TAC), and malondialdehyde (MDA) and brain-derived neurotrophic factor (BDNF) were assessed. The results showed a significant decrease in FBG, insulin, HbA1c, HOMO-IR, LDL-c, TG, VLDL, CHOL, LDL-c.HDL-c ratio, AIP, IL-6, and MDA and a significant increase in HDL-c, QUICKI index, BDNF, and TAC compared with the initial value (p for all <.05). In the adjusted model, the mean changes of FBG, insulin, HbA1c, HOMO-IR, LDL-c, CHOL, LDL.HDL ratio, AIP, MDA, and IL-6 were significantly lower and mean changes of QUICKI index, HDL-c, and TAC were significantly higher in the rutin group compared with the placebo group (adjusted p for all <.05). It seems that rutin may have beneficial effects on improving metabolic parameters, BDNF, and inflammatory and oxidative stress factors in T2DM patients.

Introduction: Gestational diabetes is the strongest predictor of diabetes in the future. This study was performed aimed to determine the association between the Hypertriglyceridemic waist phenotype of first trimester and the incidence of gestational diabetes. Methods: This case-control study was designed using the data of gestational diabetes outcomes cohort study. Among 9630 screened mothers in cohort study, 260 women with GDM and 260 healthy pregnant women were compared in terms of clinical, biochemical, and demographic indicators. Gestational diabetes (GDM) was defined by the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. Waist circumference and triglyceride levels of all mothers were measured in the first trimester of pregnancy. Data were analyzed by SPSS software (version 23) and Chi-square tests, independent t, univariate and multivariate regression. P<0.05 was considered statistically significant. Results: According to Logistic regression results, the incidence of gestational diabetes was not significantly associated with triglycerides above 150 mg/dL (OR = 1.03 (0.95% CI: 0.52-2.04, P= 0.91)). Waist circumference above 85 cm was associated with a higher risk of developing GDM (OR = 1.72 (0.95% CI: 1.17-2.53, P = 0.005)). The risk of GDM occurrence in mothers with a waist circumference of more than 85 cm and a triglyceride greater than 150 mg /dL was more than the two indicators alone (OR = 3.21 (0.95% CI: 1.71-6.03, P<0.001). Conclusion: The combined index of triglyceride and waist circumference of pregnant women in the first trimester of pregnancy is a relatively good indicator for predicting gestational diabetes.

Background: Accurate evaluation of response to treatment in differentiated thyroid cancer (DTC) is the sine qua non of preventing over-treatment in low-risk patients and implementing appropriate interventions in high-risk individuals.Objectives: This study aimed to assess the response to therapy in DTC patients based on dynamic stratification method.Methods: In this cross-sectional study, 154 medical records of subjects with DTC (with at least 6 months after total thyroidectomy) and referred to endocrinology clinics in Ahvaz, Iran, from April 2020 to May 2021 were examined. Patients were stratified accord-ing to a dynamic risk stratification system (informed by their specific clinical, histopathological, and ultrasonography findings, and other diagnostic imagines) into four groups: Excellent response (ER), indeterminate response (IR), biochemical incomplete response (BIR), and structural incomplete response (SIR).Results: For a mean follow-up period of 28.59 months, excellent response to treatment was observed in 92 patients (59.7%), indeter-minate response to treatment was found in 32 patients (20.8%), biochemical incomplete response was detected in 2 patients (1.3%), and structural incomplete response was seen in 28 patients (18.2%). In the group with low risk of recurrence, ER and IR were observed in 79.2% and 15.6% of the patients, respectively (P < 0.0001). In the group with an intermediate risk of recurrence, ER was found in 32% of the patients, while IR and SIR + BIR were seen in 34% and 34% of the patients, respectively (P < 0.0001). No cases of ER or IR were observed in the group with high risk (P = 0.001).Conclusions: In sum, response to treatment significantly varied based on dynamic risk stratification, with ER being highest in the low-risk group, less likely in moderate risk group, and undetected in the high-risk group.

Background: The aim of this study was to assess the prevalence of insulin resistance (HOMA-IR) between patients with and without thyroid nodules. Materials and Methods: This case–control study was performed on 86 patients with normal Thyroid-stimulating hormone (TSH) level (0.5–4.5 mIU/L) with thyroid nodules, who referred to Imam Khomeini and Golestan Hospitals (Ahvaz, Iran). Furthermore, 43 nonnodule patients with normal TSH level and normal thyroid ultrasonography were recruited from the general population as control group. The insulin resistance was evaluated for them made and the HOMA-IR ≥2.5 was defined as insulin resistance. Results: The mean of HOMA-IR value was significantly higher in thyroid nodule patients compared to controls (3.02 ± 1.92 vs. 1.10 ± 1.55; P < 0.001). Insulin resistance was seen in 49 thyroid nodule patients (57.0%), and 4 patients (9.3%) in the control group (P < 0.0001). Waist circumference, body mass index, fasting blood sugar, triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and insulin levels were significantly higher in the thyroid nodule group. Conclusions: Our study shows there is an association between insulin resistance and thyroid nodules. The patients with thyroid nodules have higher HOMA-IR value.

Introduction: Hypovitaminosis D and thyroid disorders are associated with negative consequences during pregnancy. Regarding to the importance and prevalence of these two and the limited and contradictory information on their relationship, the present study was performed aimed to investigate the relationship between the level of 25-hydroxyvitamin D and thyroid function tests in the first trimester of pregnancy. Methods: This cross-sectional study was conducted in 2019 on 200 women in the first trimester of pregnancy. Serum levels of 25 hydroxyvitamin D (to check vitamin D), total thyroxine (TT4), and thyroid-stimulating hormone (TSH) (to check thyroid function) and thyroid peroxidase (TPO) antibodies (to check autoimmunity) were measured. Data were analyzed by SPSS statistical software (version 25) and Spearman's correlation coefficient and Kruskal-Wallis and Mann-Whitney tests. P<0.05 was considered statistically significant. Results: There was no statistically significant difference in the mean level of TSH and T4 for different levels of vitamin D (p=0.272 and p=0.538, respectively), although in the group that were in the euthyroid range based on TSH (0.2 to 3.9 mg international units per liter), vitamin D level was significantly higher (p=0.013). A significant inverse relationship was found between deficient and insufficient levels of vitamin D with positive TPO antibody titer (p=0.034 and p=0.019, respectively). Conclusion: It seems that there is a relationship between vitamin D deficiency and thyroid autoimmunity, as well as between sufficient vitamin D levels and being in a euthyroid state, so it is suggested to correct vitamin D deficiency in women before attempting to pregnancy.

Background: Brain microstructural changes in white matter (WM) and gray matter (GM) of type 2 diabetes mellitus (T2DM) patients can be explained using Diffusion Tensor Imaging (DTI) method. Increased oxidative stress has been recognized the key factor in T2DM induce neural damage. Rutin flavonoid plays protective roles in several oxidative stress-mediated neurodegenerative disorders. So, the effects of rutin on WM and GM continuous changes in T2DM patients requires to be more investigated. Method: We will conduct a 3 months, double-blind, randomized controlled clinical trial to examine the effects of rutin supplementation on WM and GM changes in 26 T2DM cases. The intervention group (n=13) and the control group (n=13) will receive one tablet of 1 g rutin/day and one tablet of 1 g placebo/day after meals, respectively. Before and after the intervention, DTI will perform at 1.5 Tesla, followed by an analysis employing tract-based spatial statistics (TBSS) to explore the changes in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (λ1), and radial diffusivity (λ23) among the rutin and placebo treated groups. A receiver operating characteristic (ROC) test will use to evaluate the performance of DTI criteria for cutting off the two T2DM groups. Discussion: We will demonstrate the diverse influences of rutin supplementation on WM and GM integrity on T2DM patients. Since, rutin may regulate neurotoxicity, oxidative stress, inflammatory reaction and nitric oxide production in nervous system; for the first time, the effects of rutin on WM and GM alterations will be evaluated by DTI in T2DM patients. Trial registration: Iran Clinical Trials Registry, registration number: IRCT20151128025274N6. Registered on 10 January 2021, https://fa.irct.ir/user/trial/53283/view

Background and Objective: Diabetic patients experience a plethora of emotional problems in addition to physiological physical problems, which can affect the course of their disease. Therefore, the purpose of the present study was to investigate the effectiveness of compassion-focused therapy (CFT) in alexithymia, adaptive behavior, treatment adherence, and blood sugar of patients with type 2 diabetes. Materials and Methods: In this study, a quasi-experimental design with pretest-posttest and control group was adopted. The study population included the patients with type 2 diabetes in Ahvaz, Iran, in 2020 referring to my center. The sample size (n=30) was selected using convenience sampling, and the participants were randomly and equally assigned to the experimental (CFT) and control groups. To collect study data, the Toronto Alexithymia Scale, Psychosocial Adjustment to Illness Scale, Treatment Adherence Questionnaire, and blood sugar test were used. The CFT group received eight sessions of intervention (each session lasting for 2 h). Multivariate analysis of covariance was used to analyze the data. Results: The obtained results showed that CFT had a significant effect on alexithymia (F=9.27;P=0.006), adaptive behavior (F=6.75;P=0.016), and treatment adherence (F=15.26;P=0.001) of patients with type 2 diabetes in the posttest. There was no significant difference between the experimental and control groups in the blood sugar test (F=0.08;P=0.786). Conclusion: Based on the obtained findings, it can be concluded that CFT is effective in increasing the level of adaptive behavior and treatment adherence.