Is There a Relation between Hypothyroidism and Polycystic Ovary Syndrome and its Metabolic Components?

BACKGROUND: Polycystic Ovary Syndrome (PCOS) is one of the most prevalent endocrine illnesses among women of reproductive age. PCOS is linked to several issues, including hypothyroidism and metabolic disorders. Hypothyroidism seems to be associated with insulin resistance and other metabolic factors. OBJECTIVE: The present study aimed to evaluate the incidence of hypothyroidism in PCOS patients and compare it with healthy controls. Moreover, the impact of hypothyroidism on metabolic parameters, particularly insulin resistance, in PCOS patients was also examined. METHODS: This study was conducted on 41 women with PCOS and 41 healthy women as controls from March to November, 2018. Participants' demographic information was recorded. Thyroid function tests were compared between the case and control groups. Metabolic parameters were examined between hypothyroid and euthyroid PCOS individuals. RESULTS: Patients with PCOS displayed a greater incidence of hypothyroidism and a higher level of anti-thyroid peroxidase antibodies compared to the control group. High-density lipoprotein (HDL) cholesterol was substantially higher in hypothyroid PCOS patients than in non-hypothyroid individuals, although no significant changes were observed in other metabolic markers. Hypothyroid PCOS patients and those without hypothyroidism did not differ in insulin resistance. Autoimmunity was not found to be linked to a higher risk of metabolic problems. CONCLUSION: As evidenced by the results of this study, PCOS patients had a higher prevalence of subclinical hypothyroidism than healthy subjects. Metabolic indicators, except for HDL, were not different between PCOS patients with and without hypothyroidism.

Impact of Various Risk Factors on the Positive Fecal Immunochemical Test for Colorectal Cancer in the Iranian Population.

Background: Colorectal cancer (CRC) is the most prevalent cancer with high mortality worldwide. We aimed to evaluate the incidence of CRC based on the positive fecal immunochemical test (FIT) result in the Iranian population. Methods: The present study was conducted on the health assessment data recorded in the SINA (Integrated Health Information System) in 2018 and 2019 from individuals who had participated in the national program, including asymptomatic people aged 50-69 years or had risk factors of CRC such as family or past personal history of CRC as well as symptomatic individuals, for the early detection and prevention of CRC in Mashhad, Iran. Results: The study participants included 140,463 eligible individuals, of whom 8258 (5.88%) and 145 (2.21%) were positive for FIT and diagnosed with colon cancer, respectively. Unfortunately, only 654 people had undergone colonoscopy. Our results indicated that age, fast food intake (≥two units per day), family history of CRC in first or second-degree relatives, some gastrointestinal diseases such as inflammatory bowel disease (IBD) and CRC, as well as bleeding per anus, constipation, abdominal cramp, and losing body weight were associated with increased risk of positive FIT. However, some other factors, including having a hard job, physical activity, and Iranian nationality (compared to non-Iranians), were associated with a low risk of positive FIT screening tests for CRC. Conclusion: A high number of high-risk persons in Mashhad were positive for the FIT test in 2018-2019, and many of them were diagnosed with CRC, according to the colonoscopy results. Therefore, screening is highly recommended as the first step in the early detection of CRC.

The effects of high dose vitamin D supplementation as a nutritional intervention strategy on biochemical and inflammatory factors in adults with COVID-19: Study protocol for a randomized controlled trial.

Introduction: Low serum vitamin D has been shown to be a risk factor for Coronavirus 2019 (COVID-19). The aim of this study was to assess the effects of high dose vitamin D supplementation on hs-CRP, ESR and clinical outcomes, including duration of hospitalization, quality of life and New York Heart Association (NYHA) Functional Classification, in adults with COVID-19. Methods: This double-blind, randomized control trial will be conducted on patients with RT-PCR and/or chest CT scan diagnosis of COVID-19 admitted in Imam Reza Hospital, Mashhad, Iran. Participants will be randomized into control and intervention groups based on randomization sampling. The intervention group will receive soft gel containing 50,000 IU vitamin D on the first day followed by 10,000 IU/day through a supplement drop daily for 29 days. The control group will receive 1000 IU vitamin D daily through supplement drop and a placebo soft gel. All participants will undergo laboratory assessment including inflammatory markers, serum 25)OH)D, complete blood count (CBC), liver and renal profile, lipid profile and erythrocyte sedimentation rate (ESR) at baseline and at day 30. The mortality rate will be recorded in both groups. Results: Data will be presented using descriptive statistics. Comparison of changes in study parameters over the study period will be performed using analysis of covariance adjusting for possible confounders. Conclusions: The findings of this will provide evidence on the effects of high dose vitamin D supplementation on inflammatory markers in hospitalized COVID-19 patients.

Case series: Rare cases of thyroid storm in COVID-19 patients.

Thyroid storm is an uncommon life-threatening thyroid dysfunction which was observed for the first time among patients infected with Coronavirus 2019 (COVID-19). The diagnosis and treatment of the rare thyroid distinctions such as thyroid storm in COVID-19-infected patients should be critically considered alongside common treatments of COVID-19 infection.

Assessment of insulin resistance in patients with primary hyperparathyroidism before and after Parathyroidectomy.

BACKGROUND: Primary hyperparathyroidism (PHPT) can lead to renal and skeletal disorders, as well as insulin resistance and impaired glucose metabolism. The current study aimed to assess the effects of parathyroidectomy on insulin resistance in patients with PHPT. MATERIALS AND METHODS: The present study was conducted on 65 patients with PHPT and indications for parathyroidectomy who were referred to the endocrinology clinics of Mashhad University of Medical Sciences. Thereafter, the demographic characteristics of the patients were recorded. Blood tests, including haemoglobin A1c (HbA1c), fasting blood glucose (FBG) and insulin levels, were assessed one week before and three months after the surgery. The insulin resistance score (HOMA-IR) was calculated and compared using the relevant formula. RESULTS: A total of 65 participants with a mean age of 45.44 ± 9.59 years were included in the current study. In one-month postoperative tests, mean scores of FBG (p < .05), insulin level (p < .05) and HbA1c (p < .05) were significantly reduced. Moreover, the HOMA-IR index decreased in 51 patients after the surgery. CONCLUSION: According to our findings, parathyroidectomy can be effective in the reduction of insulin resistance and corresponding complications in patients with PHPT in the present short-term study. However, it has yet to be confirmed as a treatment method for insulin resistance in these patients. Future long-term studies are required to be done to investigate the effect of parathyroidectomy on insulin resistance.

An effective drug against COVID-19: reality or dream?

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is well known as a novel member of the coronavirus family which caused a sudden outbreak of Coronavirus disease-2019 (COVID-19) in China that quickly developed into a global pandemic. No effective approaches are found as yet for the therapy and epidemiological control of this new virus. We searched the literature in PubMed, Scopus, Web of Knowledge, Google Scholar, and MeSH, for articles and abstracts describing SARS-CoV-2, COVID-19, pneumonia, clinical trials, drug, treatment, and medicine.Areas covered: The present study aimed to comprehensively overview the current literature on effective anti-SARS-CoV-2 drugs.Expert opinion: Since the beginning of this pandemic disease, many studies have been conducted to find effective drugs to prevent COVID-19, because there are no specific drugs for the treatment of this disease. Most of these drugs with the antiviral potential effect toward COVID-19 are already used as the treatment of other infectious diseases. Some drugs that show the promising therapeutic potential in the initial clinical studies include remdesivir as an inhibitor of RNA-dependent RNA polymerase and favipiravir as an inhibitor of virus replication. Currently, remdesivir received the FDA authorizes to use as an experimental drug for emergency use in COVID-19 patients.

Evaluation of Bone Mineral Density in Perimenopausal Period.

BACKGROUND: The menopausal transition called perimenopause, happens after the reproductive years, and is specified with irregular menstrual cycles, perimenopause symptoms and hormonal changes. Women going through peri menopausal period are vulnerable to bone loss . Osteoporosis is one of the most common debilitating metabolic bone diseases, especially in the women almost around 50 years. This study was intended to evaluate the prevalence of osteopenia/osteoporosis amongst asymptomatic individuals during the menopause transition period. METHODS: A total of 714 asymptomatic peri-menopausal female volunteers were recruited through a billboard invitation for participation in the study. The subjects were selected based on already defined inclusion and exclusion criteria. The project, which was conducted between 2010 and 2014 was affiliated to the Educational and Therapeutic Center, Imam Reza Hospital, Mashhad, Iran. Bone Mineral Densitometry (BMD) measured by DEXA (dual-energy X-ray absorptiometry) was carried out on two distinct sites, the proximal femur and the lumbar vertebrae from L1 to L4. Pertained data were analyzed. RESULTS: The mean age of the subjects was 49.7±2.years. The overall prevalence of osteopenia and osteoporosis in these peri-menopausal individuals were 37.6 % and 10% respectively. Thirty five point two percent of 714 women presented with osteopenia and eight percent of them have osteoporosis in the femoral neck, respectively. Nonetheless, BMD values at the lumbar spine indicated 41.6% and 12% of individual participants being affected by osteopenia and osteoporosis. CONCLUSION: In general osteopenia or osteoporosis, occurred in 48% of this study population, implying that special attention is required for the bone health status of Iranian women who undergo menopause.Level of evidence: II.