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Objective: Most polycystic ovary syndrome (PCOS) patients have metabolic abnormalities in which insulin resistance (IR) plays a pivotal role. Cinnamon is a herbal medicine with insulinotropic properties. This pilot study aimed to evaluate the effects of cinnamon on ovarian volume, androgenic profile, and metabolic and anthropometric parameters in women with PCOS. Materials and Methods: A single-center, double-blind, randomized, placebo-controlled trial was carried out on 39 overweight / obese women with PCOS. For six months, subjects in the cinnamon (500 mg) (n=19) and placebo (n=20) groups were given three capsules daily. Before and after the intervention, the variables were assessed. The data was analyzed using the GraphPad Prism software. Results: After the intervention, the two intervention and control groups had significant differences in abdominal subcutaneous fat and ovarian volume, but they did not differ significantly in terms of body mass index (BMI). Also, after the intervention, no significant difference was observed between the two groups in terms of lipid profile and the concentration of androgenic biomarkers of insulin resistance. Conclusion: Cinnamon supplementation improves ovarian volume and subcutaneous abdominal fat but has no effect on anthropometric parameters, lipid profile, insulin resistance, or androgen hormones. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) is a chronic disease inducing short-term and longterm complications including sexual dysfunction (SD) which can consequently reduce patients' quality of life. Given the limited literature on frequency of SD in men experiencing diabetes in northern Iran, the present study was conducted in the city of Sari in Mazandaran Province, with the aim of investigating SD in men with type II diabetes. Methods: Using a descriptive cross-sectional research design, a total number of 350 male patients suffering from type II diabetes referring to endocrinology clinics in the city of Sari in. The patients were requested to fill out the demographic questionnaire, depression, anxiety and stress scale-21 items (DASS-21) and the 15-question International Index of Erectile Function (IIEF). The data were analyzed using the IBM SPSS statistics software. Results: The average period of time in which the patients were facing diabetes was 3.65±5.75 years. The IIEF mean score was equal to 16.98±43.79. Erectile dysfunction (ED) was also evident in 152 patients (62.2%). Moreover, increase in age had significantly decreased the IIEF scores (p<0.001). The chance of being affected with ED among diabetic patients above 50 was 11.21 times as much as those below 50 years of age (odds ratio (OR): 11.21, 95% confidence interval (CI): 6.40-19.62). Conclusion: Concerning the high prevalence rate of ED in men suffering from type II diabetes, doctors are required to directly ask them about sexual disorders in follow-up visits. Furthermore, using screening questionnaires can be helpful in identifying this problem. [ABSTRACT FROM AUTHOR]

Background: Persistent thyroglossal duct leads to a fibrous cyst formation named thyroglossal cyst which is the most common form of congenital cyst and usually located in the midline neck below the hyoid bone. Rarely the thyroglossal cyst is associated with thyroid cancer. Although the Sistrunk procedure is often considered adequate, currently there is no clear consensus on the optimal management of thyroglossal duct cyst especially duct cyst carcinoma. In addition, there is no consensus about concurrent thyroidectomy in patients with thyroglossal cyst duct carcinoma. Case presentation: In this article, we present four patients with thyroglossal duct cyst and papillary thyroid cancer. Papillary thyroid cancer was located into the thyroglossal duct cyst (thyroglossal duct carcinoma) in two patients and two patients had thyroglossal duct cyst with thyroid carcinoma in thyroid tissue. Cervical lymph nodes were involved in one of the three patients. Sistrunk procedure and total thyroidectomy were performed for all. The thyroid lobes were not involved in patients with thyroid duct cyst carcinoma. Tumor or thyroglossal duct cyst recurrence did not occur in any of the patients in follow-up. Conclusion: The correlation between thyroglossal cyst and papillary thyroid carcinoma is high. In subjects with thyroglossal duct cyst, in addition to cyst assessment, thyroid gland and neck lymph nodes should be evaluated for malignancy. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate the effects of a hydroalcoholic extract of Juglans regia L. leaves on blood glucose level and cardiovascular risk factors in type 2 diabetic patients. Methods: In this randomized, double-blind, placebo-controlled, parallel-group (2 arms) clinical trial, 50 diabetic patients were divided into two groups: treatment group (receive the capsules containing 100 mg J. regia leaf extract) and control group (receive the capsules containing placebo, microcrystallin cellulose). Baseline participant data were matched between the two arms of the study. We administered the prepared capsules to the patients twice daily for 8 weeks. Blood glucose level, glycosylated hemoglobin (HbA1c) level, body weight, body mass index, blood pressure, lipid profile, serum insulin, and insulin resistance were compared between the two groups before and after the intervention. P < 0.05 was considered significant. Results: After excluding eleven patients, 20 received J. regia leaf extract and 20 patients received placebo. The J. regia leaf extract did not significantly change the blood glucose and insulin resistance condition. However, in this group, body weight, body mass index, and systolic blood pressure significantly decreased compared with the baseline measurements (P = 0.028, P = 0.030, and P = 0.005, respectively). The lipid profile did not change significantly compared with the baseline measurements. In the control group, postprandial glucose and HbA1c levels significantly decreased after the intervention (P = 0.030 and P = 0.028, respectively). The other variables were not significantly different in this group. At the end of the study, the variables were not significantly different between the two groups. Conclusion: In this double-blind study, 200 mg/d of J. regia leaf extract had no significant effect on blood glucose level and HOMA-IR score in patients with type 2 diabetes. However, the J. regia leaf extract was effective in reducing body weight and blood pressure. An accidental finding of our study was that microcrystalline cellulose, a widely used placebo in clinical trials, led to a reduction in blood glucose level. Trial registration: Iranian Registry of Clinical Trials (IRCT: 138901203180 N2, 2010/6/6); retrospectively registered. [ABSTRACT FROM AUTHOR]

Objective: Psoriasis (Pso) is associated with an increased risk of cardiovascular involvement. Metabolic syndrome (MetS) includes a group of classic cardiovascular risk factors with pro-inflammatory condition. The aim of the present study was to evaluate and compare the frequency of MetS in Pso patients with and without arthritis. Materials and Methods: This cross-sectional study was conducted on 48 Pso patients with psoriatic arthritis (PsA), 48 Pso patients without arthritis and 48 age matched controls. The demographic, clinical and laboratory features of the subjects were compared. Disease activity, damage and functional activity were assessed using functional indices. The MetS was diagnosed according to the definitions of the 2005 National Cholesterol Education Program (NCEP/ATP III) and International Diabetes Federation (IDF). The three groups were compared in terms of MetS components frequency. Data analysis was performed in SPSS (version 19) at a significance level of <0.05. Results: The mean ages of the Pso and PsA groups were 42.40±8.8 and 45.00±10.3 years, respectively. Based on the NCEP/ATP III and IDF criteria, 21 (43.8%) and 26 (54.2%) Pso patients, 28 (58.3%) and 29 (60.4%) PsA patients, and 12 (25%) and 11 (22.9%) controls were diagnosed with MetS, respectively (P< 0.05). Furthermore, high waist circumference and hypertension were more prevalent in the PsA patients (P< 0.05). Conclusion: The frequency of MetS was found to be more prevalent in the Pso and PsA groups compared to the controls. The relationship between MetS and cardiovascular consequences highlights the importance of investigating the role of this condition in the management of patients, especially PsA cases. [ABSTRACT FROM AUTHOR]

Objective: There are some studies about the good effects of herbal medicine on blood glucose. This study was designed to evaluate the synergism effect of Peganum Harmala (P.harmala), Quercus Infectoria (Q.i), Vaccinium Myrtillus (V.myrtillus), Citrullos Colocynthis (C.colocynthis), Securigera Securidaca (S.s) on blood glucosein type 2 diabetic patients. Materials and Methods: Twenty four type 2 diabetic patients were enrolled in this cross over double- blinded clinical trial for receiving two months herbal medication and placebo. The subjects divided into two groups randomly. One group received herbal medication (the doses of 25mg/person of V.myrtillus, S.s and Mazoj and 62.5mg C.colocynthis, P.harmala) and the other group received placebo for 8 weeks. After washout period the herbal medication and placebo were replaced for the next 8 weeks. T-test and Chi-square were used for the comparison of variables between two groups. Results: After two months, mean fasting blood glucose was 135±27.1 and 139±36.8 mg/dl, (P-value=0.64), and mean glycosylated hemoglobin was 6.5±0.75 and 6.6±0.97 percent, with herbal medication and placebo, respectively (P-value=0.51). About 15.4% of patients after herbal medication and 15.4 % after placebo consumption had 0.8% reduction in HbA1C (P-value=1/0). The mean HOMA IR index, after two months intervention with herbal medication or placebo, was 2.9±1.95 and 3.9±1.97, respectively (P-value=0.05). Conclusion: low dose combination of P.harmala, Q.i, V.myrtillus, C.colocynthis, S.s may improve the insulin sensitivity and we did not find significant effect on blood glucose with low dose of this combination. [ABSTRACT FROM AUTHOR]

Background: Periodontal disease in diabetic patients can compromise a patient's ability to maintain a proper metabolic control and may be associated with diabetic complication. Aims: This study was designed to evaluate the frequency of periodontal disease in patients with type 2 diabetes mellitus (DM) and how this was related with the presence of diabetic retinopathy (DR). Materials and Methods: A comparison was made of periodontal parameters (plaque index (PI), community periodontal index of treatment needs (CPITN), periodontal disease severity measured in quartiles of probing depth (PD), and clinical attachment loss (CAL)) in a group of diabetic patients with retinopathy (n = 84) versus a group of diabetic patients without retinopathy (n = 129). In addition, 73 age- and sex-matched individuals were selected to serve as the control group. Analysis was performed to evaluate the relationships between periodontal disease and DR. Results: In terms of PI, no statistically significant differences were observed, so, oral hygiene was similar in both groups. Diabetic patients with retinopathy had greater CPITN (P < 0.001) and more severe periodontal disease (P < 0.001) than no retinopathy. Also, our results indicated a relationship between type 2 DM and periodontal disease. Conclusions: The patients with diabetes retinopathy appear to show increased periodontal disease susceptibility. [ABSTRACT FROM AUTHOR]

Hyperprolactinemia occurs along with many physiological and non-physiological factors. The most important non-physiological pathologic cause of this disorder is prolactin-secreting tumor or prolactinoma. Prolactinoma is one of the common causes of hypogondism and infertility in women and a common pituitary tumor in men leading to visual impairment and impotency. Dopamine agonists are effective for prolactinoma management in majority of patients even in pituitary macroadenoma cases and few patients may require surgery. Since misdiagnosis of prolactinoma can cause mistreatment with costly drugs, precise evaluation, accurate diagnosis, understanding indications of treatment, duration of treatment and follow up are of high importance. [ABSTRACT FROM AUTHOR]

Background: Logotherapy encourages the individual to find meaning in life, which is recognized as the driving force of every individual in their lifetime. Diabetes, caused by the impairment in metabolism of glucose, fat, and protein, is associated with lack of secretion or dysfunction of insulin. This study aims to investigate the effectiveness of logotherapy on death anxiety, hope, depression, and proper use of glucose control medication in diabetic patients with depression. Methods: The population in the present quasiexperimental pretest–posttest study with control group is comprised of diabetic patients with depression attending Baghban Endocrine Clinic in Sari. A sample of 40 diabetic patients (20 in the trial and 20 in the control group) entered the study. Data were collected using Templer Death Anxiety Scale, Miller Hope Scale, Beck's Depression Inventory, and Medication Adherence Scale. Covariance analysis was used to evaluate the effectiveness of logotherapy on death anxiety, hope, depression, and proper use of glucose control medication, where P value lower than 0.05 is considered significant. Results: Death anxiety and depression of diabetic patients with depression were reduced by following logotherapy training, and their hope was increased. The results confirmed the effectiveness of logotherapy training on death anxiety, hope, and depression in diabetic patients with depression (P < 0.05). Logotherapy was effective on proper use of blood- glucose drugs in depressed diabetic patients and 19% of changes in scores of proper use of medication were caused by the effectiveness of logotherapy (P < 0.05). Conclusions: Logotherapy appears to be a suitable psychological treatment for diabetic patients with depression. [ABSTRACT FROM AUTHOR]

Background and purpose: Thyroid nodules are quite common witch are found in clinical or ultrasound examinations. They are detected in 4-8% of clinical examinations and 7-15% are malignant. TSH is one of the growth factors for nodule growth. Controversial reports are published on the effect of TSH on thyroid nodule malignancy. This study aimed at investigating the effect of TSH in predicting malignancy in thyroid nodules. Materials and methods: In this cross sectional research, 500 patients were studied. Serum TSH level was measured prior to fine needle aspiration (FNA). Data analysis was done applying inferential statistics. Results: The patients were 457 (91.4%) females and 43 (8.6%) males and the mean age was 43.43±13.9 years. Among the patients 240 had single nodule and 260 had multiple thyroid nodules (P=0.08). The mean size of nodules in benign and malignant nodules were 26.1±12.2 and 27.3±9.8 mm, respectively (P=0.6). Malignant and benign nodules were observed in 31 (6.2%) and 469 (93.8%) patients. Mean TSH level was 3.3±6.9 and 2.4±2 in patients with benign and malignant nodules, respectively (P= 0.47). To investigate the association between TSH and FNA cytology, TSH levels were divided into <0.5, 4.9-0.5, and ≥5 using person correlation. This study showed no significant difference between the three groups (P= 0.3). Conclusion: TSH alone is not a suitable marker for predicting thyroid malignancy. [ABSTRACT FROM AUTHOR]

Background: Sexual dysfunction (SD) is one of the important problems in diabetic patients. The present study aimed to determine the prevalence of sexual problems in Iranian women with type 2 diabetes mellitus. Methods: A cross-sectional study was conducted among type 2 diabetic women who visited two outpatient endocrine clinics, namely Imam Hospital and Tuba clinic (Sari, Iran) in 2012. Patients were asked to complete two validated questionnaires: Female Sexual Function Index (FSFI) and The Hospital Anxiety and Depression Scale (HADS) as well as a demographic questionnaire. Analysis was performed using descriptive and analytical tests. P<0.05 was considered to be significant. Results: One hundred and fifty women with type 2 diabetes were investigated. Most of the cases aged 40-44 years old. The mean of the total score of the FSFI questionnaire was 22. The prevalence of sexual dysfunction was 78.7% (CI: 71.4-84.4); among these, 58% (CI: 50.0-65.6) reported problems in lubrication, 50% (CI: 42.1-57.9) complained of decreased sexual desire, 50% (CI: 42.1-57.9) had problems with arousal, 47.3% (CI: 39.5-55.3) had dyspareunia, 32.7% (CI: 25.7-40.5) complained of orgasmic dysfunction and 42.7% (CI: 35.0-50.7) reported problems in sexual satisfaction. With regard to the results of the HADS questionnaire, 58.7% (CI: 50.7-66.2) of the patients had depression and 96.7% (CI: 92.4-98.6) had anxiety. Conclusion: This study showed the high prevalence of sexual dysfunction in diabetic women, especially among those complaining of depression. Health care professionals dealing with diabetic patients should be aware of possible presence of sexual dysfunction in female patients. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (DM) and chronic periodontitis (CP) show common pathophysiological features. We investigated the serum levels of IL-23 and IL-35 in people with type 2 DM and CP., Methods: In a cross-sectional study, 72 patients were divided into four equal groups: group A, participants without type 2 DM and CP; group B, patients with type 2 DM without CP; group C, patients with CP and without type 2 DM; and group D, patients with type 2 DM and CP. Demographic data were obtained and periodontal conditions including clinical attachment loss, bleeding on probing, plaque index, gingival index, and probing depth was evaluated on all existing teeth. Fasting blood sugar (FBS) levels, hemoglobin (Hb) A1c, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were assessed. In addition, serum levels of IL-23 and 35 were measured using enzyme-linked immunosorbent assay., Results: The serum levels of IL-23 and 35 showed no significant differences between all groups (P>0.05). A significant positive correlation between the serum concentration of IL-23 and clinical attachment loss in the control group (r: 0.548, P=0.019) was detected. A significant negative correlation between IL-35 and the plaque index in group B (r: -0.578, P=0.012), plus significant negative correlations between IL-23 with ESR (r: -0.487, P=0.040) and CRP (r: -0.498, P=0.035) in groups C and D were also detected., Conclusion: Despite significant associations of serum concentration of IL-23 and 35 with certain periodontal and inflammatory indices, neither type 2 DM nor CP differentially affects serum levels of these two cytokines., Competing Interests: The authors declare that none of them have a conflict of interest and there is no duality of interest associated with this manuscript.

Background: Hirsutism is a common symptom presenting to primary care endocrinologists, gynecologists, and dermatologists. Management is usually a long and troublesome process. This study was designed to evaluate the effect of fennel topical gel on mild to moderate idiopathic hirsutism., Methods: The randomized, double-blind, placebo-controlled clinical trial was carried out from 2009 to 2011, in Sari, Iran. Forty four women with mild to moderate idiopathic hirsutism were randomly divided to case and control groups, each group included 22 cases. The case group received fennel gel 3% and the control group received placebo. The effect of fennel gel 3% was defined as reduction of thickness of facial hair in micrometer by microscope in comparison with placebo. Measurements were performed at zero time and 24 weeks after treatment. This study was registered in the Iranian Registry of Clinical Trial (www.irct.ir) with registration number 138901213672N1., Results: The mean age of patients was 26.9±6.7 and 25.6±4.3 years in case and control groups, respectively. Hair thickness was similar between the two groups before intervention. The hair thickness reduced from 97.9±31.5 to 75.6±26.7 micron in patients receiving fennel gel after 24 weeks (P<0.001). Four patients complained of itching (3 in case group) and 4 patients complained of irritation and itching (3 in case group). However, this difference was not statistically significant., Conclusion: The study indicated that fennel gel 3% is effective in decreasing hair thickness in women with idiopathic mild to moderate hirsutism.

Background: Anemia may be considered to be an independent risk factor for the development of diabetic retinopathy (DR) in patients with renal failure. The purpose of this study was to investigate the association between blood hemoglobin level and retinopathy in diabetic patients with normal renal function tests., Methods: From 2009 to 2011, 1100 diabetic patients underwent retinal examination. Among them, 159 subjects were diagnosed to have DR and were compared with 318 diabetic subjects with normal retinal examination as the control group. The level of hemoglobin (Hb), Hb A1C, serum iron, ferritin, and total iron binding capacity were compared between these two groups., Results: Among the 159 patients with DR, 112 (70.4%) had mild to moderate no proliferative retinopathy (NPDR) and 47 (29.6%) had advanced retinopathy (severe NPDR or proliferative). The mean hemoglobin level in case and control group was 12.15±1.50 and 12.73±1.38 g/dl, respectively (p<0.001). Anemia was seen in 45.9% and 26.1% in the case and the control groups, respectively (p<0.001). Ferritin <15ng/ml was seen in 7.4% and 6.1% of patients with and without DR, respectively (p=0.8)., Conclusion: The results show that diabetic patients with retinopathy have lower level of hemoglobin and higher frequency of anemia. It is suggested that the level of hemoglobin should be evaluated periodically in diabetic patients.

Unlabelled: Background : Nowadays, drug and observation are advised to patients with lymphocytic hypophysitis and in some cases with nonfunctioning pituitary macoadenoma, instead of surgery., Case Presentation: In this article, we report a woman with nonfunctional pituitary macroadenoma and panhypopitutarism and negative criteria for lymphocytic hypophysitis associated with increased liver enzymes. After three months adenoma rapidly regressed and liver function tests were normal without any treatment. Conclusion : Seemingly, viral infection as one of the factors may be considered in cases with spontaneous regressed pituitary nonfunctional adenoma.

Background: Hyperprolactinemia is the most common endocrine disorder in hypothalamic-pituitary axis and has been reported in variable levels in patients with overt primary hypothyroidism. We decided to determine the prevalence of hyperprolactinemia and clinical related symptoms in subclinical hypothyroidism patients., Methods: In this cross sectional study, prolactin levels of 481 subclinical hypothyroid patients were assessed. Prolactin measurement was performed using chemiluminescent immunoassay. Data were collected and analyzed., Results: Sixty-two (13%) patients were males and 419 (87%) were females. The mean age of the patients was 32.53±10.13 years. Ninty-eight patients (91 females 7 males) had high prolactin. Prevalence of hyperprolactinemia in subclinical hypothyroidism was 20.4%. (11% in men and 22% in women, p=0.05). There was no correlation between the serum TSH and prolactin level. Clinical symptom prevalence was not different between patients with and without hyperprolactinemia., Conclusion: This study showed that prevalence of hyperprolactinemia in subclinical hypothyroidism is notable and this disorder is more common in female subclinical hypothyroidism than the men.