Despite no beneficial effect of LT4 therapy in reducing preterm delivery in SCH-TPOAb- women with a TSH cut point of 2.5 to 4 mIU/L, LT4 could precisely decrease this complication using the newly recommended cutoff ≥4.0 mIU/L.

Background Obese women with polycystic ovary syndrome (PCOS) may face additional barriers in achieving weight loss. We aimed to compare the effects of the hypocaloric low glycemic index (LGI) diet on anthropometric variables and insulin resistance in women with and without PCOS and investigate the effect of this diet on the clinical and hormonal features of PCOS women. Methods This interventional study was carried out at the Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Of 108 women invited for the purpose of the present study, 62 participants (PCOS = 28, non-PCOS = 34) followed a 24-week energy restricted LGI diet. Anthropometric, biochemical, hormonal and clinical measurements were documented at baseline, 12 weeks and 24 weeks with intervention. Results The percentages of weight loss achieved by both the PCOS and non-PCOS groups did not differ significantly (PCOS: -8.04% vs. non-PCOS: -8.09%). No significant difference in decrease of homeostatic model assessment of insulin resistance (HOMA-IR) was observed between the two groups (PCOS = − 0.83 ± 0.33, non PCOS = − 0.79 ± 0.28, P = 0.83). In PCOS women, significant reduction in total testosterone (− 0.91 ± 0.33 nmol/L, P = 0.006), FAI (− 4.47 ± 1.1, P < 0.001) and increase in SHBG (38.98 ± 11.02 nmol/L, P < 0.001) were observed. Menstrual irregularity was improved in 80% of women with PCOS and a significant decrease (32.1%) in occurrence of acne was reported. Conclusions This diet has equally beneficial effects on anthropometric and metabolic characteristics of overweight women with and without PCOS. Trial registration This study is registered in the Iranian Randomized Clinical Trials Registry (IRCT, code: IRCT2016092129909N1 ).

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These findings provide the insight that, as reflected through significantly higher average levels of AMH in PCOS women, their predicted reproductive lifespan could be 2 years longer than their normo-ovulatory counterparts.

Background Ovarian reserve, vital for reproductive function, can be adversely affected by thyroid diseases. Despite alternations of thyroid hormones with ageing, data on interactions between the overtime trend of thyroid functions and ovarian reserve status has rarely been reported. We aimed to examine the overtime trend of thyroid hormones, thyroid peroxidase antibody (TPO Ab) and their associations with ovarian reserve status, identified by levels of age specific anti-mullerian hormone (AMH) in reproductive aged women, who participated in 12-year cohort of Tehran Thyroid Study (TTS). Methods Reproductive age women( n = 775) without any thyroid disease or ovarian dysfunction were selected from the Tehran Thyroid Study cohort. Participants were divided into four age specific AMH quartiles (Q1-Q4), Q1, the lowest and Q4, the highest. AMH was measured at the initiation of study and thyroid stimulating hormone (TSH), free T4 (FT4), and TPO Ab were measured at baseline and at three follow up visits. Results At baseline, there was no statistically significant difference in thyroid hormones between women of the four quartiles, although TPO Ab levels were higher in women of Q1. During the follow ups, FT4 was decreased in all quartiles ( p < 0.05), whereas TPO Ab increased in Q1 ( p = 0.02). Odds ratio of overall TPO Ab positivity in women of Q1 was 2.08 fold higher than those in Q4. (OR: 2.08, 95%CI: 1.16, 3.72; p = 0.01). Conclusion Women with the lowest ovarian reserves had higher levels of TPO Ab, with a positive trend of this antibody overtime in comparison to other quartiles, indicating that this group may be at a higher risk of hypothyroidism over time.

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Background: Despite existing evidence regarding the role of testosterone as a protective factor for the kidney function in male adults, there are conflicting and inconclusive results on the influence of testosterone deficiency on developing chronic kidney disease (CKD).Objective: This study aimed to investigate the incidence and hazard ratio of CKD among male adults with low testosterone levels compared to controls with normal testosterone levels. Materials and Methods: During a 15-year follow-up study, a total of 1277 eligible male adults aged 20-80 year consisting of 605 males with low testosterone levels (< 350 ng/dL) and 672 controls with normal levels participating in the Tehran Lipid andGlucose Study were recruited. Cox's proportional hazards models were applied to estimate hazard ratios of CKD between the groups after adjusting for confounders. Results:The total cumulative incidence rate of CKD at the median follow-up time of approximately 11.2 years was 21/1000 (95% CI: 18/1000, 25/1000) and 18/1000 (95% CI: 16/1000, 22/1000) in the low and normal testosterone groups, respectively (P = .2). The multivariate Cox model adjusted for age, body mass index, dyslipidemia, hypertension, diabetes, and smoking showed that HR of developing CKD in the male adults with low testosterone levels was significantly higher than those with normal levels (HR = 1.38; 95% CI: 1.05, 1.80). Discussion and conclusion:This study shows a higher hazard ratio of CKD progression in male adults with hypogonadism compared to those with normal levels in their later life. Therefore, timely diagnosis and treatment of kidney diseases in hypogonadal men can prevent the morbidity and mortality from CKD.

Background:The heel-lancing procedure is a common tissue damaging procedure routinely performed in premature neonates and causes pain. Therefore, efforts should be made to relieve this pain. Objectives: This study aimed to assess the effect of kangaroo mother care (KMC) for a brief duration of 15 minutes on pain intensity of heel lance in preterm newborns admitted to neonatal intensive care units. Patients and Methods:In this clinical trial with crossover design, 64 vitally stable preterm neonates between 30-36 weeks of gestational age, who needed at least two heel lances, were randomly allocated to two groups. In group A, neonates received KMC 15 minutes before, during, and two minutes after the first heel lancing procedure. In group B, neonates were kept in prone position in incubator 15 minutes before lancing. For second heel lancing, the neonates in group A were put in incubator and group B received KMC. Premature Infant Pain Profile (PIPP) was scored during and within two minutes after finishing the procedure in both conditions. Results: The mean score of pain intensity during the intervention was significantly lower in the KMC position (P < 0/000). Mean score of pain intensity at two minutes after intervention was also significantly lower in the KMC position (P < 0/000). Conclusions: KMC before and during heel lancing is a natural, easy to use, and cost-effective method to decrease pain in premature neonates. It is consistent with modern strategy of family-centered care in neonatal units.