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Background and Objective: Patients experience full stress condition after open heart surgery. Foot reflexology massage has a potential impact on the comfort of patients with special care. This study was done to evaluate the effect of soles of feet reflexology massage on feeling of comfort in open heart surgery patients.
Methods: This clinical trial study was done on 70 patients who were divided into intervention and control groups using permutable blocking method. 35 patients in interventional group were received Soles of feet Reflexology Massage after mesearment of vital sigins for six days. 35 patients in the control group did not receive any intervention received routine care. Data gathering tools were demographic items and HCQ questionnaire, which was completed in two stages, 24 hours after surgery, before massage and the 6th day after massage.
Results: The mean total comfort score in the intervention group was 103.1±9.04 and 110.63±7.6 before and after the intervention, respectively. This differnce was not significant. The mean total comfort score in control group was 105.14±10.37 and 111.29±7.56 perior and the end of study, respectively, this difernce was not significant. Also, there was no significant difference between considering the mean scors of comfort between the tow in the intervention and control groups.
Conclusion: Reflexotherapy massage had no effect on feeling of comfort in open heart surgery patients.

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Arachnoid cysts have primary and secondary types. The prevalence of Arachnoid cysts is about 1% of all tumors in cranial cavity. Based on anatomic position, arachnoid cyst can cause different clinical manifestations including hemiparesis, increase intracranial pressure, macrocephaly and isolated headache and stop body growth. The natural course of the disease is not exactly clear. Some of patients have no symptoms during life and some of them may show some symptoms after a while. This case report is about a 10 years boy who had no sign except generalized headache. Anatomic position of the cyst was in right temporal lobe of the brain on the temporal, parietal and the great wing of sphenoid bones. Arachnoid cyst diagnosed through MRI and CT-Scan. Patient treated with ibuprofen for three days and then patient followed up to treat with surgery method when other clinical symptoms appeare in the patient.

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Background and Objective: The synthesis of uncoupling protein 1 (UCP1) in adipose tissue plays an important role in providing resistance and prevention of fat accumulation, weight gain and obesity. This study was done to evaluate the effect of eight weeks aerobic training with moderate and high intensities on serum levels of Irisin and UCP1 white adipose tissue in obese male rats.
Methods: In this experimental study, 24 adult obese male Wistar rats (weight: 250 to 300 gr, BMI>30g/cm²) were randomly assigned into three groups including moderate aerobic training intensity, high intensity aerobic training and control group. The aerobic exercise training was included 8 weeks (5 sessions/per-week for 60 min per session). All training groups carried out aerobic training with 28 m/min (moderate intensity), aerobic training with 34 m/min (high intensity) on treadmill. 48 hours after the training period, the level of UCP1 and Irisin protein was measured.
Results: The level of UCP-1 in adipose tissue and serum Irisin in both aerobic training intensities increased compared to control group, but this increase only in aerobic training group with a moderate intensity was singnificant (p<0.05).
Conclusion: Eight weeks aerobic training with moderate intensity leads to increase of UCP-1 in adipose tissue and Irisin levels.

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Background and Objective: The phenomenon of aging is one of the evolutionary stages of life and it is an inevitable part of human society that can lead to poor balance and consequent harm, loss of independence and early death. This study was done to determine the effect of Pilates exercise on functional balance of elderly men.
Methods: This quasi-experimental study was done on 28 elderly men with an average age of above 60 years. Subjects were non-randomly divided into intervention and control groups. Eldely men in intervention group were received Pilates training for 6 weeks, 3 sessions per week. To measure the functional balance was used of the timed up and go test. Pre-test and post-test of was done for functional balance in intervention and control groups.
Results: The functional balance significantly reduced in intervention group (10.11±0.53 sec) in compared to controls (12.61±1.14 sec) (p<0.05).
Conclusion: Pilates training have an important role in improving the performance balance of elderly men.

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Background and Objective: Divorce as a life crisis can lead to emotional and behavioral problems. This study was done to determine the effectiveness of group based reality therapy based on Glasser choice theory on the general health and obsessive beliefs of divorced women.
Methods: In this quasi-experimental study 30 divorced women were non-randomly divided into the two interventions and control groups (15 participants in each group). Perior of the study the general health questionnaire (GHQ) (anxiety, social function, somatic symptoms and depression) and obsessive thoughts questionnaire (OBQ-44) (responsibility, perfectionisn and importance of thoughts) were completed by subjects in both groups. Counselling with Glasser approach was performed for intervention group through 8 group sessions once a week and lasted for 120 minutes. Control group received no intervention. At the end of the study, Post-test was performed from both groups.
Results: Group training based on reality therapy in intervention group's participants caused a significant reduction in all items of the two variables, general health and obsessive thoughts in compared to the control group (P<0.05).
Conclusion: Group based reality therapy based on Glasser choice theory improves general health of divorced women and reduces their obsessive beliefs.

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Background and Objective: The results of surgical treatment, successfulness and methods of evaluation in gender dysphoria are highly variable. This study was done to determine the status of sexual function in patients with impaired gender identity after sexual re-assignment male to female surgery.
Methods: This cross-sectional study, conducted on 40 patients referred to surgery clinic in Tehran during 2014-2015. Female sexual function index (FSFI) questionnaire was used to assess the status of sexual function.
Results: Ninety- five percent of patients had a healthy sexual desire and arousal. Also, 75%, 55.4% and 27.5% of patients had satisfaction, moisture content and good orgasm, respectively. The pain was tolerable in 25% of cases; however, in terms of overall sexual function, only 12.5% of patients had a satisfactory sexual performance. The relationship between education, occupation, residence and previous history of mental illness with sexual function was not significant. Also, 42.9% of patients who had not desirable sexual performance, had a history of drug abuse, and all these subjects reported desirable sexual performance.
Conclusion: Sexual function in cases that have undergone surgery was not suitable. Sexual pain and anorgasmia were important factors in this condition.

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Background and Objective: Parents of children with autism have difficulty in their daily activities and social relationships and have a low quality of life. The negative effect of having a low intelligence or disabled child is more likely to cause tension and pressure on mother than the other family members. This study was conducted to determine the quality of life of mothers with autism children compared to mothers with normal children.
Methods: This case-control study was performed on 36 mothers with autistic child and 114 mothers with healthy children in Gorgan (Iran) during 2015. Sampling was done randomly and the data gathering tool was SF-36 quality of life standard questionnaire.
Results: The quality of life of mothers with autistic child had a significant reduction in comparison with the quality of life of mothers with healthy child (P<0.05). Also, items of quality of life including  general health, social function, and role limitation due to psychological, emotional and physical functioning in the group of mothers with autistic children were significantly lower than mothers with healthy ones (P<0.05).
Conclusion: Mothers with autistic children had low quality of life. Therefore, it is recommended to design suitable programs for improving the health status and quality of life as a priority of health care plans.

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Background and Objective: All organisms for managing behaviors require to use of cognitive patterns of the central and peripheral nervous system. This study was done to compare the metacognitive beliefs and tolerance of ambiguity in depressed, anxious and normal people.
Methods: This descriptive-analytic study was done on 120 depressed, anxious and normal people depressed, anxious and normal people in psychiatric clinic of Zare hospital in Sari city north of Iran during 2017. To measure ambiguity in depressed, anxious and normal people the tolerance for ambiguity scale of lane, wells metacognitive scale, Beck anxiety inventory (BDI) and Beck depression inventory (BDI) were used in this study.
Results: Tolerance of ambiguity significantly increased in depressed and anxious groups in comparison with controls (P<0.05). Positive worry beliefs significantly reduced in depressed group in comparison with controls (P<0.05). Negative meta-cognitive beliefs about the thoughts and metacognitive beliefs significantly reduced in depressed group in compared to control group (P<0.05).
Conclusion: This study emphasized the extent of anxiety and depression disorders in relation to in- effective metacognitive problems. These ineffective beliefs can cause a decrease in psychological tolerance.
 

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Background and Objective: The diazinon insecticide is a strong acetylcholinesterase controller at the nerve terminals. This study was conducted to determine the effect of diazinon on functional tests and tissue alterations in rat liver.
Methods: In this experimental study, 40 adult male Wistar rats were allocated into 5 groups including the first, second and third experimental groups were received 50, 100 and 150 mg/kg/bw of diazinon, respectively, orally during 21 days. The control group did not receive any medication and the sham group received solvent. At the end of study, blood samples were obtained from animals and Alanine transaminase (ALT), Aspartate transaminase (AST), Alkaline phosphatase (ALP) hepatic enzymes, total protein, albumin and bilirubin were measured. After anesthesia the liver of animals were removed and evaluated by hematoxylin eosin histological staining methods.
Results: The level of AST and ALT enzymes in the experimental groups receiving 100 and 150 mg/kg/bw doses of diazinon significantly increased in compared to the control group (p<0.05). The level of ALP of animals in all groups receiving diazinon was significantly higher than the control group (P<0.05). Total protein level significantly reduced in all groups receiving diazinon compared to the control group (P<0.05). The level of albumin in the experimental group receiving 150 mg/kg/bw dose of diazinon significantly reduced in comparision with controls. In the experimental groups, tissue samples showed more necrosis with increasing doses of diazinon.
Conclusion: Diazinon increases level of liver enzymes and decreased total protein and albumin level and causes the histological alterations in rat liver.

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Background and Objective: Diabetic mellitus nephropathy is one of the most important implication factors in kidney´s physiological function in diabetes mellitus. Having major role in filtration, in hyperglycemic condition kidney has shown more damages in comparison with other tissues. This study was done to determine the effect of combined Atorvastatin and Zinc oxide on the biochemical and histopathological alterations in kidney of diabetic rats.

Methods: In this experimental study, 40 female Wistar rats were randomly allocated into five groups including normal control (NC), diabetic control (DC), diabetic rats treated with atorvastatin (20mg/kg/bw daily, orally) (D+A), Zinc oxide (30mg/kg/bw daily, orally) (D+Z) and combination of each drug in half dose (daily, orally) (D+A+Z). Diabetes induced in rats by a single intraperitoneal injection of 60mg/kg/bw streptozotocin-diabetic.Animals treated for one month. At the end of the study, kidney weight and body weight and biochemical factors including creatinine and urea were measured to assess renal function. For determing the histopathology of kidney tissue, sections with 4-5 micrometer were stained with hematoxylin and eosin.

Results: The level of serum creatinine and urea was significantly increased in diabetic rats in compare to controls (P<0.05). Treatment of diabetic rats with half doses of combination of atorvastatin and Zinc oxide reduced the level of creatinine, urea and renal tissue damage in comparision with diabetic rats without treatment (P<0.05).

Conclusion: This study showed that the combination of atorvastatin and Zinc oxide has effect on controlling diabetic nephropathy.

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Background and Objective: The mental health of cancer patients impaired by suffering, future worriness, and fear of death. This study was conducted to determine the effect of acceptance and commitment based training on the difficulty of emotion regulation and mental health in women with breast cancer.
Methods: In this clinical trial study, 30 female patients with breast cancer were randomly divided into control and intervention groups (n=15). The intervention group received 8 sessions of 90 minutes of acceptance and commitment procedures. Before and after the treatment and two months there after, all participants were evaluated and compared with the Gratz-Romer 2004 and General Health Questionnaire (GHQ-28).
Results: Emotion regulation score in the intervention group was singnificantly reduced from 113.52±4.16 to 104.67±3.96 (P<0.05). Emotion regulation score remained low in the intervention group in the follow up period (104.17±3.58); but the mean in the control group did not show any significant reduction. In the intervention group after the treatment, the total score of mental health reduced from (46.81±4.21) to (33.18±3.39) (P<0.05). This score was 33.12±3.33 in the follow-up period in the intervention group; but no significant reduction was observed in the control group.
Conclusion: Acceptance and commitment technique training can improves mental health and emotion regulation in women with breast cancer.

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Background and Objective: Depression is the most common psychiatric diagnosis. It causes major health problems. Women are more likely to develop depression than men. This study was done to investigate the effect of group mindfulness-based cognitive therapy on reducing depression and improving the quality of life of female students.
Methods: This quasi-experimental study was performed on 26 female students. Students non-randomly were divided into control and intervention groups. Students in intervention group were received the two periods (8 sessions, 2 hours at week) of training in mindfulness-based cognitive therapy. All the participants filled out Beck depression inventory II (BDI-II) and World Health Organization Quality of Life – BREF (WHOQOL-BREF) in perior and after the study.
Results: In the intervention group the mean and standard deviation of pre-test and post-test scores of BDI-II was 20.23±6.98 and 13.38±4.97, respectively (P<0.05). In the intervention group, mean and standard deviation of pre-test and post-test scores of WHOQOL-BREF questionnaire was 66.77±13.39 and 86.84±10.60, respectively (P<0.05). Also, the mean scores of post-test of quality of life in all subgroups items  was significantly increased in compared to the pre-test in the intervention group (P<0.05).
Conclusion: Mindfulness-based cognitive therapy increases the quality of life and reduced depression in female students.

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Background and Objective: Due to high incidence and mortality of gasteric cancer and important of clinical symptoms to early diagnosis and tertment; this stady was done to determine the survival rate of gasteric cancer in Golestan provience (north of Iran).
Methods: This retrospective cohort stady was done on 131 patients (77.9% males and 22.1% females) with adeno carcinoma gasteric cancer wich diagosed during 2007-09 in northern Iran. Age, sex, job, nationality and tribe clincal presentation kind of treatment food regiemns, survival collected from archive. In cases whom nesacery data completed with telophone calling or face to face interview. Survival rate of patients for 1, 3 and 5 years were determined using caplan Mayer method.
Results: First symptom in 31.3% of patients was abdominl pain and distance between the first symptom and diagnosis was 1-14 months. 34.4% of patient did not receive any treatment. Survivial rate for 1, 3 and 5 years was 37.4%, 13% and 6.1%, respectively. Age, gender and ethnicity did not not altere survival rate but type of treatment had significant relation to survival rate (P<0.05).
Conclusion: The diagnosis of gasteric cancer in early stage and surgical treatment can help a better survival rate in patients with adeno carcinoma gasteric cancer in northern Iran.

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Selenium is an essential mineral found naturally in soil, water, and some foods. Today, selenium, as an antioxidant, is one of the vital elements in the human body. Although the human body needs a small amount of selenium daily, recent studies have shown that the same small amount of selenium is essential for maintaining healthy body function. It is challenging to choose the right dose of selenium. According to several studies in this present review, a daily supplement of 31.5-200 micrograms seems beneficial since the amount of selenium in various diseases is less than the amount in healthy people. The articles published in PubMed, Web of Science, Google Scholar and SCOPUS databases were screened and collected based on the keywords including selenium, oxidant, antioxidant, diabetes, cancer, toxicity, heart disease and liver disease. These keywords were chosen because of the antioxidant role of selenium as well as the prominent role of oxidation in the progression of these diseases. 150 articles published over a period of 20 years from 2000 to 2020 were used in this study. Articles about nano-seleniums, non-dietary supplements, and diseases caused by the underlying disease of metabolic syndrome were excluded and finally 121 articles were included in the study. A limited number of studies show that patients with multiple disorders may need to take higher doses of selenium (82.4 to 200 micrograms) than healthy people. In this study, selenium's antioxidant role in chronic metabolic disorders, including hyperlipidemia and hyperglycemia, and some cancers, were investigated. Also, the clinical significance of selenium deficiency in metabolic diseases, as well as clinical and experimental observations on the effect of selenium dietary supplements in the treatment of chronic metabolic diseases such as diabetes and atherosclerosis, and cancers, are briefly mentioned. Besides, the recommended toxicity and dose of selenium have been discussed.

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Background and Objective: Hemoptysis is defined as the expectoration of blood from the lower respiratory tract. Bronchiolitis, bronchogenic carcinoma, and bronchiectasis are the most common causes of hemoptysis in developed countries, while infections caused by Mycobacterium tuberculosis are the most common cause in endemic countries. This study was conducted to determine the frequency of causes of hemoptysis and some related factors.
Methods: This descriptive-analytical study was done on 68 patients (37 men and 31 women, average age 56.85±17.27 years) who were referred to the Shahid Sayyad Shirazi Hospital in Gorgan, north of Iran during 2014-16 with the complaint of hemoptysis. Demographic information, cause of hemoptysis and history of illness or drug abuse were extracted from the patients’ records.
Results: Based on the results, 42.6%, 45.6%, and 17.6% of the patients had a history of smoking, drug abuse, and diabetes, respectively. The most frequent causes of hemoptysis were bronchiectasis (25%), pneumonia (20.6%), tuberculosis, and lung cancer (16.4%). Gender was determined as an independent risk factor for hemoptysis (P<0.05). The most common causes of hemoptysis were bronchiectasis, lung cancer and pneumonia in men, and tuberculosis and bronchiectasis in women. Age, drug abuse, smoking, and diabetes had no significant association with the occurrence of hemoptysis.
Conclusion: Bronchiectasis, tuberculosis, and lung cancer are the main causes of hemoptysis, and gender is an independent risk factor for hemoptysis in the study area.
 

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Background and Objective: Multiple sclerosis (MS) is a common neurological disease that increases oxidative stress and causes immune system disorders. Curcumin is the active component of turmeric with anti-inflammatory properties. This study was conducted to determine the effects of curcumin on cortisol, catalase, and nerve growth factor (NGF) expression in an animal model of MS.
Methods: This experimental study was conducted on 30 female Wistar rats. Experimental autoimmune encephalomyelitis (EAE) was chosen as an experimental model of MS. The rats were divided into 3 groups of 10, including a healthy control group, an affected group, and a group treated with curcumin. The disease was induced by immunization of rats with homogenized guinea pig spinal cord and Freund's complete adjuvant. Then, the immunized animals were allocated into two equal groups. Treatment with curcumin (100 mg/kg daily) was started 12 days after the immunization when the rats showed the first symptoms of neurologic disability. The treatment was continued until day 24 post-immunization. Simultaneously, the EAE group received the medicine solvent (distilled water). Finally, the rats' weights as well as cortisol, catalase, and NGF levels were measured in the study groups.
Results: Curcumin significantly increased the level of cortisol to a level equal to that of healthy rats (P<0.05). It also significantly increased the expression of NGF and reduced the amount of catalase in the affected rats (P<0.05). The curcumin administration significantly increased the overall weight of rats with MS but had no significant effect on the spleen weight of the treated rats.
Conclusion: Curcumin can be beneficial for treating EAE by reducing the destructive effects of oxidative damage and increasing NGF.
 

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Background and Objective: Acrylamide is a neurotoxic agent that increases oxidative stress by creating an imbalance between the production and removal of free radicals, which in turn contributes to the pathogenesis of some neurodegenerative disorders. Thymoquinone extracted from Nigella satvia has prominent antioxidant effects. The objective of this study was to evaluate the effects of thymoquinone on hippocampal oxidative stress and neuronal density following acrylamide administration in male rats.
Methods: In this experimental study, 28 male Wistar rats aged 10-12 weeks and weighing 180-200 g were randomly divided into 4 groups of 7 rats: control, acrylamide, acrylamide + thymoquinone treatment (1 mg/kg), and acrylamide + thymoquinone treatment (5 mg/kg). For induction of brain injury, 50 mg/kg of acrylamide was injected intraperitoneally. Two days after the acrylamide injection, the rats were sacrificed, and malondialdehyde (MDA), glutathione (GSH), and catalase levels were measured in hippocampal homogenate. Evaluation of neuronal density in hippocampal CA1 region was also performed by Nissl staining.
Results: Acrylamide injection significantly increased MDA level and reduced GSH content and catalase activity in comparison with the control group (P<0.05). Administration of 5 mg/kg thymoquinone significantly reduced MDA level (P<0.05) but improved GSH and catalase activity in comparison with the acrylamide group (P<0.05). In addition, neuron density of hippocampal CA1 region did not differ significantly between the groups.
Conclusion: Thymoquinone can attenuate oxidative stress markers in a dose-dependent manner.
 

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Background and Objective: Celiac disease is a malabsorption disorder that could result in various psychological consequences if patients do not adhere to a gluten-free diet. This study aimed to determine the frequency of major depressive disorder and its relationship with adherence to a gluten-free diet among patients with celiac disease.
Methods: This descriptive-analytical study was conducted on 47 patients with celiac disease (30 women and 17 men) with an average age of 40.88 ± 10.7 years who had been referred to the Golestan Research Center of Gastroenterology and Hepatology during the summer of 2019. Patients were invited to complete a 13-item Beck Inventory. Celiac Dietary Adherence Test (CDAT) was used to assess adherence from the patients' point of view, and Standardized Dietician Evaluation (SDE) was used to evaluate adherence to the diet from the interviewer's perspective.
Results: Overall, 28 people (59.6%) with celiac disease reported some degree of depression. Based on the SDE, the adherence rate of patients to a gluten-free diet was 83%. The association between adherence to a gluten-free diet and the prevalence of depression was not significant. There was also no significant association between the prevalence of depression and the gender and age of patients.
Conclusion: Based on the results, a high percentage of patients with celiac disease have symptoms of depression. However, there is no significant relationship between adherence to a gluten-free diet and the prevalence of depression.
 

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Background and Objective: Thyroid masses are one of the most common reasons for patients to visit endocrinology clinics. Fine needle aspiration (FNA) is used to reduce thyroid surgery for benign lesions. This study was done to determine the diagnostic accuracy of FNA of thyroid mass(s) compared with histological results in Medical Centers, Gorgan, Iran.
Methods: In this descriptive-analytical study, 102 patients (12 males and 90 females) were diagnosed with a thyroid mass and referred for surgery to Medical Centers, Gorgan, Iran during 2020-21. FNA was performed, and the samples were sent to the pathology department for examination. The result of cytology was recorded in the checklist. According to cytology results, some patients were referred for surgery. Then, the surgical pathology results were compared with the cytology findings. In addition, the sensitivity and specificity of the results of the cytology of thyroid masses were calculated compared to the results of pathology.
Results: FNA, mass size, and the patient’s main complaint had a significant relationship with histological results (P<0.05). According to FNA findings compared to pathology, sensitivity was 74%, specificity was 88.1%, positive predictive value was 88.1%, negative predictive value was 74%, false positive rate was 12%, false negative rate was 26%, and accuracy was 80.4%.
Conclusion: FNA remains a key tool in evaluating thyroid nodule(s). Improving FNA techniques is necessary to increase the accuracy of FNA.

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Background and Objective: Obesity is a well-known public health problem that affects people of all ages. It has myriad effects on several body tissues, including the thyroid, in both human and animal models. Some treatments, such as dietary modification and physical activity, may be effective or ineffective in reducing obesity. Accordingly, the present research investigated the effects of obesity on thyroid tissue and the impact of diet modification and aerobic exercises on histopathological and hormonal changes in the thyroid tissue of obese male rats.
Methods: In this experimental study, for obesity induction, 50 three-week-old male Wistar rats were exposed to a high-fat diet (including 40% fat, 40% protein, and 20% carbohydrate) for 12 weeks. Then, 25 rats were randomly divided into 5 groups: healthy control, obese + high-fat diet, obese + normal diet, obese + high-fat diet + aerobic, obese + normal diet + aerobic. After the induction of obesity, 2 groups were given a standard diet (including 20% fat, 10% protein, and 70% carbohydrates). Aerobic exercises for 8 weeks included 30 minutes per day, 8 m/min, and 5 days per week. After anesthesia, an autopsy was performed, and the thyroid tissue was sent to the laboratory for histopathological studies. Also, 5 cc of blood was taken to study TSH, T3, and T4 using a radioimmunoassay kit.
Results: The serum levels of TSH hormone increased slightly in the high-fat diet groups compared to the control group and the normal diet with/without aerobic activity group. Also, the amount of T3 hormone in the group receiving a normal diet along with aerobic activity was significantly lower than in the control, high-fat diet, and high-fat diet along with aerobic activity groups (P<0.05). The T4 hormone increased significantly in all obesity groups compared to the control group (P<0.05), and these values were at the level of the control group (P<0.05) only in the group receiving the normal diet along with aerobic activity. Regarding the histopathological results, many changes were found in the follicular, parafollicular, and follicle cells of the thyroid tissue in the obesity group continuing the high-fat diet; these changes were significantly reduced in the groups for which the diet was changed to the normal diet alone and with aerobic activity.
Conclusion: Induction of obesity causes significant structural and biochemical changes in the thyroid, and the combination of diet modification and aerobic activity is more effective in alleviating these changes.