International Journal of Endocrinology and Metabolism
Volume:20 Issue: 1, Jan 2022

The time interval between the age at menarche and regulation of menstrual cycles (menstrual cycle developmental trajectory) is considered an indicator of the reproductive system's function later in life. This study aimed to summarize the factors affecting this trajectory.

A comprehensive literature search in PubMed, Scopus, Google Scholar, and Web of Science was performed to identify studies investigating factors influencing the regularity of the menstrual cycle in adolescents.

The interval between menarche and the onset of the regular menstrual cycle in adolescent girls may vary from several months to several years. Several factors, including genetic, race/ethnicity, intrauterine situation, social factors, geographical factors, lifestyle, and chronic diseases, are considered the predisposing factors for the trajectory.

Age at menarche and the onset of regular menstrual cycles are directly and indirectly influenced by several genetic, environmental, and lifestyle factors. Understanding these factors may improve our practice in managing irregular menstrual cycles that commonly happen in the first years after menarche.

Getting feedback from the journals’ editorial office upon the peer-review process, revising the manuscript, and responding to reviewers’ comments are the essential parts of scientific publishing. The process of revising seems cumbersome and time-consuming as authors must be engaged probably with many comments and requested changes. Authors are advised to approach the reviewer as a consultant rather than an adversary. They should carefully read and understand comments and then decide how to proceed with each requested change/suggestion. In the case of serious disagreement with reviewer comments or misunderstanding, authors can defer the issue to the editor. Preparing a scientific and well-organized "response to reviews" and the revised version of the manuscript can increase the chance of acceptance. Here, we provide a practical guide on dealing with different types of comments (i.e., minor or major revisions, conflicting comments, or those that authors disagree with or cannot adhere to) and how to craft a response to reviews. We also provide the dos and don'ts for making a successful revision.

Changes in thyroid function test (TFT) in COVID-19 patients have been reported in several studies. However, some features such as thyrotoxicosis are inconsistent in these studies. In addition, some drugs such as heparin interfere with the free T4 assay.

This study was designed to examine TFT abnormalities in COVID-19, utilizing direct and indirect methods of free T4 assay.

This prospective cross-sectional study was conducted on 131 hospitalized COVID-19 patients. Serum levels of total T3, TSH, T3RU, and total T4 were measured. The free T4 assay was performed using direct (free T4) and indirect (free thyroxin index or FT4I) methods. The patients were categorized into different TFT groups. The clinical characteristics, laboratory findings, and outcomes were compared between the groups.

The frequencies of Nonthyroidal Illness (NTI), subclinical/overt hypothyroidism and subclinical/overt thyrotoxicosis were 51.7, 6.9, and 6.9%, respectively. Besides, 6 and 8.1% of the patients had isolated high free T4 and isolated high FT4I without any other TFT abnormality, respectively. The lymphocyte percent was lower in the subclinical/overt group than in other TFT groups (P = 0.002). Atrial Fibrillation (AF) was found in 37.5% of subclinical/overt thyrotoxicosis patients versus 1.7% in the NTI and nil in the other three groups (P < 0.001).

In addition to the reported TFT abnormalities in COVID-19 in previous studies, some new features like isolated hyperthyroxinemia were found in our study. We found a strong association between subclinical/overt thyrotoxicosis and AF. Regarding the high prevalence of AF in hospitalized COVID-19 patients, the thyroid function test is rational in COVID-19 patients with this arrhythmia.

Diabetes is a prevalent chronic medical comorbid condition worldwide. Diabetes mellitus is associated with various sleep disorders.

We aimed to determine the prevalence of poor sleep and the main factors of sleep interruptions in patients with diabetes mellitus. We further evaluated the association of sleep interruptions with glycemic control in this cohort.

We conducted a cross-sectional study on 266 patients with type 1 and type 2 diabetes who were recruited from a university outpatient endocrinology clinic. Patients completed a checklist including demographic and disease-related characteristics in addition to the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Using the PSQI cutoff score of 5, we created two subgroups of good sleepers (GS) and poor sleepers (PS).

Our results showed that good sleeper and poor sleeper diabetic patients were significantly different regarding sex, employment status, BMI, presence of diabetes-related complications, HbA1c, and 2-hour postprandial blood sugar (2HPPBS) (all significant at P < 0.05). The most prevalent factors of sleep interruptions were “waking up to use a bathroom”, “feeling hot”, “pain”, “having coughs or snores”, and “bad dreams”. Among the subjective factors of sleep interruption, problems with sleep initiation, maintenance, or early morning awakenings in addition to having pain or respiratory problems such as coughing or snoring had the most effects on HbA1c.

Our study showed significant subjective sleep disturbances (both quality and quantity) in patients with diabetes mellitus (both type I and II) and its association with diabetes control. We further identified the main factors that led to sleep interruptions in this cohort.

Community Readiness Improvement for Tackling Childhood Obesity (CRITCO) study has been developed based on the community readiness model (CRM) to improve the readiness of targeted local communities from two diverse socioeconomic districts of Tehran for tackling childhood obesity (CO) of late primary school children (10 - 12 years of age).

This study aimed to describe the rationale and process of developing the fourth phase of CRITCO study by developing an intervention package.

The readiness level data was used to analyze strengths, weaknesses, opportunities, and threats (SWOT) of four intervention sites to guide proper strategies in partnership with key community members. Then, the action plan was developed as a living document to guide a 6-month quasi-experimental community-based intervention around the six dimensions of CRM. Finally, the community engagement process, outcome, and evaluation process were explained.

The current report described the action plan and strategy development of the CRITCO study. Expectedly, this study can provide valuable information to guide the public health policymakers in planning and executing relevant interventions.

Malignant sellar gliomas are very rare phenomena. To date, only few cases of sellar and suprasellar glioblastomas have been reported, most of which originate from the optic nerve or optic chiasm.

We present a 34-year-old woman with malignant endo-suprasellar glioma, originating from the pituitary stalk, which was initially classified as a macroprolactinoma.

Although malignant sellar gliomas can mimic the clinical, endocrinological, and radiological features of pituitary macroadenomas, rapid progression without appropriate hormonal activity suggests their diagnosis. Considering the high malignant potential of sellar glioblastomas, it is important to discuss the specific features of these tumors and to investigate the possibility of differential diagnosis in the preoperative stage, which can be useful for early selection of the treatment plan.

Addison disease is a relatively uncommon endocrine disease resulting from adrenal insufficiency. Psychiatric symptoms are among its rare primary and particularly isolated clinical symptoms. This report presents a case with adrenal insufficiency manifested by the psychotic syndrome.

A 28-year-old Iranian female with a history of immune thrombocytopenic purpura (ITP) and asthma since childhood presented with a 13-month history of progressive depression with insomnia and nightmare symptoms. After being prescribed haloperidol, clomipramine, and clonazepam for eight months, abdominal pain and weight loss due to anorexia started. Her physical examination showed skin hyperpigmentation in the elbow, knee, ankle, and buccal mucosa. Physical examination and initial laboratory tests suggested adrenal insufficiency. Addison disease was confirmed according to the laboratory tests and abdominal CT. The symptoms were significantly improved using intravenous hydrocortisone treatment. The patient remained calm and had a normal sleep without depressive symptoms or psychosis after 72 hours of treatment. During one year of follow-up, the patient was in good general condition without psychological symptoms.

This report shows that psychotic disorder can be the first manifestation of Addison disease. Therefore, physicians should be informed about the neuropsychiatric symptoms of adrenal insufficiency, especially when the patient lacks a family or personal history of psychiatric illness.