---

Background and objectives: Atherosclerotic cardiovascular disease is the leading cause of death in industrialized countries. High level of plasma lipids including cholesterol and triglycerides is one of the most important risk factors of atherosclerosis. Previous studies have shown that three members of the ATP-binding cassette, subfamily G (ABCG4, ABCG5 and ABCG8) are involved in transporting sterols across membranes. The purpose of this study was to assess the effect of high-intensity resistance training (HIRT) and aerobic exercise (AE) on expression of the ABCG4, ABCG5 and ABCG8 genes in female athletes.
Methods: Twenty-four female athletes from the Khorasan Province (Iran) were randomly selected and assigned into three groups: control (N=8), AE (N=8) and HIRT (N=8). The subjects in the HIRT group and the AE group performed exercise at intensity of 75-80% of 1-repetion maximum and 75-80% of maximum heart rate, respectively. Blood samples were collected at baseline and immediately after the exercise session. After isolation of lymphocytes by centrifugation and purification of mRNA, gene expression changes were investigated by Real-Time-PCR. Data were analyzed using one-way ANOVA and the Tukey's test.
Results: Both training protocols significantly increased the expression of ABCG4, ABCG5 and ABCG8 in the subjects (P<0.05), and there was no significant difference in the expression of these genes between the experimental groups (P>0.05).
Conclusion: A single session of HIRT and AE may have beneficial effects on prevention of atherosclerosis. 

---

---

      Conclusion: Overall, the bioinformatical analysis of the designed protein showed that the recombinant lipase-subtilisin protein has a stable structure both in vitro and in vivo, a negative normalized B-factor and lipolytic and proteolytic activities, which makes it suitable for treatment of lipid and protein contaminations.

---

Background and objectives: Dried Black Curd (DBC), also known as Gharahghorut (Persian), is a dairy product produced from curd of yogurt or doogh. The aim of this study was to evaluate microbial contamination of industrially and traditionally produced DBC in Iran.
 
Methods: Four DBC brands holding certification of the Institute of Standards and Industrial Research of Iran (ISIRI), Iran Ministry of Health and Medical Education (IMHME) and ISO were purchased from a market in Tehran, Iran. Microbial monitoring for presence of coliform, Escherichia coli, coagulase-positive Staphylococcus aureus, mold and yeast was performed using different basic, enriched, selective and differential media including peptone water agar, MacCankey agar, blood agar and brain heart infusion agar, etc. according to the ISIRI standards (No.13299).
 
Results: None of the tested samples had microbial contamination. However, in one traditional DBC sample, the population of mold and yeast was higher than the acceptable level defined by the ISIRI standard.
 
Conclusion: We found no contamination with coagulase-positive S. aureus, E. coli and coliforms in four brands of traditionally and industrially produced DBC in Iran. This indicates that the hygienic practices designated by the IMHME are well-implemented in the industrial sector. However, the mold and yeast contamination in traditionally produced DBC should be prevented by applying hygienic practices during the process of manufacturing and distribution.

---

Background and objectives: Gouda Cheese is regarded as a high quality and one of the most popular cheeses in the world. The defining characteristics of Gouda cheese are its yellow color, great aroma and taste of caramel sweetness. The cheese should be well chilled before waxing, to get better seal. The seal is very important to prevent contamination with molds and putrefactive bacteria. Cheese wax is made from paraffin with additional microcrystalline to make pliable for better seal. The aim of this study was to investigate antibacterial effects of Gouda cheese wax.
Methods: Gouda cheese wax samples were collected from four different manufacturers in Iran. The total count of coliforms, Escherichia coli, Salmonella, coagulase-positive Staphylococcus and mold and yeast on the samples was determined. The antimicrobial activities of Gouda cheese wax against E. coli, S. aureus, Saccharomyces cerevisiae, Aspergillus brazilissis and Salmonella enterica were investigated by determining minimum bactericidal concentration and minimum inhibitory concentration.
Results: The results indicated that all Gouda cheese wax samples were prepared in accordance with the national standards. In addition, the examined wax samples had no antimicrobial properties against the tested microorganisms.
Conclusions: The wax used in production of Gouda cheese in Iran has no antimicrobial properties.

---

Background and objectives: Diagnosis glucose intolerance in pregnancy is very important in preventing maternal and fetal complications. In this study, we compared hematological and biochemical characteristics of healthy pregnant women and women with gestational diabetes mellitus (GDM) to find predisposing and prognostic variables of GDM.

Methods: In this study, 80 pregnant women (at 24-28 weeks of pregnancy) were divided into a GDM group and non-GDM group by performing oral glucose tolerance test using 75 g glucose according to the International Association of the Diabetes and Pregnancy Study Groups criteria.
Results: The mean age of women with GDM was significantly higher than those without GDM (p=0.048). Other variables including body mass index, gestational age and daily sleep duration did not differ significantly between the two groups (P>0.05). There was a significant association between family history of diabetes and incidence of GDM (p=0.040). In addition, the C-peptide level was significantly higher in pregnant women with GDM (p=0.004).
Conclusion: Considering the role of C-peptide in predicting metabolic syndrome, it is suggested to use this factor for identification of GDM patients.

---

Background and objectives: Bacterial contamination of wounds is a serious problem, particularly in burn patients. Gram-positive bacteria are the predominant cause of infection in newly hospitalized burn cases. This study aimed to survey the prevalence and antibiotic resistance pattern of gram-positive bacterial isolates among burn patients in Rasht, North of Iran.
Methods: This cross-sectional study was conducted on burn patients with a positive culture for gram-positive isolates who were hospitalized in the Velayat Burn Center in Rasht, North of Iran, during 2017-2020. The isolates were identified using standard microbiological methods. Moreover, the antibiotic resistance pattern was determined by the disk diffusion method.
Results: During the study period, 671 bacterial cultures were obtained, of which a total of 16 gram-positive isolates were taken from the patients. The frequency of coagulase-negative staphylococci (CoNS), Staphylococcus aureus, and Enterococcus spp. was 68.7%, 18.8%, and 12.5%, respectively. In addition, the highest rate of resistance in CoNS isolates was against trimethoprim/sulfamethoxazole. The highest rate of resistant among S. aureus isolates was recorded against penicillin. Moreover, Enterococcus faecalis isolates showed a high level of resistance to ampicillin, erythromycin, tetracycline, gentamicin, and ciprofloxacin. All isolates were susceptible to teicoplanin. Moreover, the frequency of methicillin-resistant S. aureus isolates was 66.7%.
Conclusion: Given the increasing prevalence of drug-resistant strains, especially in susceptible burn patients, it is imperative to analyze the bacterial etiology of nosocomial infections periodically and epidemiologically.

---

Background and objectives: Previous investigations have shown that physical activity can improve insulin sensitivity and body composition by reducing the concentration of inflammatory biomarkers. The study aimed at evaluating effects of eight weeks of resistance training and high-intensity interval training on adropin, blood glucose markers, and body composition in overweight females.
Methods: sixteen overweight females (mean age: 30 ± 4.3 years and body mass index= 29 ± 2.6 kg/m²) were randomly assigned to a resistance training group (n=8) and a high-intensity interval training group (n=8). Participants in both groups trained three times a week for eight weeks. Body composition and serum level of blood markers were determined at baseline and after the last training session.
Results: Body mass, body fat percentage, and waist-hip ratio decreased significantly in both groups (p<0.05). VO_2max significantly increased in both groups, while the changes in the resistance training group were greater than in the high-intensity interval training group (p<0.05). Insulin and HOMA-IR concentrations decreased significantly in the resistance training group (p<0.05).
Conclusion: Eight weeks of both training procedures could significantly decrease body composition markers. However, the training duration was not sufficient to alter fating blood sugar or adropin concentrations.

---

Background and objectives: Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease caused by the accumulation of large amounts of fat in the hepatocytes. Given that atorvastatin is effective for treatment of NAFLD, the present study investigated effects of high-fat/fructose diet (HFFD) with atorvastatin on liver enzymes and lipid profile in a NAFLD rat model.
Methods: Thirty-two male Wistar rats were divided into four groups: 1) normal control, 2) HFFD control, 3) HFFD + atorvastatin, and 4) normal + atorvastatin. The groups received HFFD for 15 weeks to induce hepatosteatosis. Atorvastatin was administrated at the dose of 10 mg/kg/day. Lipid profile and liver enzymes were measured after eight weeks of intervention.
Results: Triglyceride, cholesterol, gamma-glutamyl transferase, and aspartate transaminase were significantly reduced in the HFFD + atorvastatin group compared with the HFFD control group. In addition, cholesterol, high-density lipoprotein, alkaline phosphatase, and gamma-glutamyl transferase were significantly increased in the normal + atorvastatin group compared with the normal control group. Low-density lipoprotein increased significantly in the HFFD + atorvastatin group and the normal + atorvastatin group compared with other groups. There was a significant difference in the alanine transaminase levels between the groups taking atorvastatin. In fact, alanine transaminase level was lowest in the normal + atorvastatin group.
Conclusion: Atorvastatin improves the lipid profile and fatty liver and controls liver enzymes. Therefore, it can be used with caution to improve the lipid profile and reduce the complications of NAFLD.

---

Background and objectives: In recent years, exercise immunology studies have focused on key components of immune function, such as immune cells, immunoglobulins, and messenger molecules, as well as the effects of environmental and exercise factors. The aim of this study was to evaluate effects of 8 weeks of selected training on serum levels of interleukin (IL)-4, IL-6, and motor performance in elite water polo players.
Methods: For this purpose, 20 male water polo players (mean age: 23 years) were randomly divided into an experimental group (n=10, selected water polo training) and a control group (n=10, traditional water polo training). The selected water polo training was performed for 8 weeks, 6 sessions per week. The intensity of training was controlled using maximum heart rate (80-100%) and increased by 5% every week. Water polo performance tests included a record of 50 meters swimming, 100 meters high swimming, 200 meters’ breaststroke, 6 ×50 meters swimming, and 400 meters swimming. To evaluate the serum levels of IL-6 and IL-4, venous blood (5 ml) was taken in the pretest and posttest stages. The serum levels of IL-4 and IL-6 were measured by sandwich enzyme-linked immunosorbent assay. Mean values were compared using the t-test, at significant level of 0.05.
Results: The selected water polo training significantly changed IL-4 levels in elite water polo players (p<0.05). However, IL-6 levels and performance of the subjects did not change significantly.
Conclusion: The selected swimming exercises could relatively improve swimming stagnation of water polo players. However, due to the limited knowledge in this regard, there is a need for further research.

---

Background and objectives: Mycotic keratitis is a fungal infection of the cornea that can cause blindness. Its incidence, risk factors, and the etiological agents vary worldwide and nationwide. Therefore, proper documentation of these data is essential for better disease management. In this review, we aimed to make a clear picture of this infection in the Middle East.
Methods: Data on fungal keratitis from 1986 to 2018 in the Middle East were systematically collected from five English databases (PubMed, Scopus, Science Direct, Web of Science, and Google Scholar) and four Persian databases (Magiran, Scientific Information Database, IranMedex, and Irandoc). A total of 35 studies were included in the review.
Result: The pooled prevalence of fungal keratitis in the Middle East was estimated at 26% (95% confidence interval: 19-32%; I2=98.88%, p<0.001)  using random-effect model, with considerable variation among the countries. The prevalence of fungal keratitis was highest in Egypt (36%) and Iran (34%) and lowest in Oman (9%). Aspergillus and Fusarium spp. were the most common causative agents (28%) among filamentous fungi, and Candida (13%) was the predominant yeast species causing fungal keratitis. Based on the data, fungal keratitis was more prevalent in males (39%) than in females (23%).
Conclusion: Our study is the first systematic review on mycotic keratitis among the Middle Eastern countries. These epidemiological estimates can be used by policy makers to improve treatment strategies, especially in this part of the world.
Background and objectives: Mycotic keratitis is a fungal infection of the cornea that can cause blindness. Its incidence, risk factors, and the etiological agents vary worldwide and nationwide. Therefore, proper documentation of these data is essential for better disease management. In this review, we aimed to make a clear picture of this infection in the Middle East.
Methods: Data on fungal keratitis from 1986 to 2018 in the Middle East were systematically collected from five English databases (PubMed, Scopus, Science Direct, Web of Science, and Google Scholar) and four Persian databases (Magiran, Scientific Information Database, IranMedex, and Irandoc). A total of 35 studies were included in the review.
Result: The pooled prevalence of fungal keratitis in the Middle East was estimated at 26% (95% confidence interval: 19-32%; I2=98.88%, p<0.001)  using random-effect model, with considerable variation among the countries. The prevalence of fungal keratitis was highest in Egypt (36%) and Iran (34%) and lowest in Oman (9%). Aspergillus and Fusarium spp. were the most common causative agents (28%) among filamentous fungi, and Candida (13%) was the predominant yeast species causing fungal keratitis. Based on the data, fungal keratitis was more prevalent in males (39%) than in females (23%).
Conclusion: Our study is the first systematic review on mycotic keratitis among the Middle Eastern countries. These epidemiological estimates can be used by policy makers to improve treatment strategies, especially in this part of the world.
 

---

Background: The hepatitis B virus (HBV) is a major public health problem worldwide. Vertical and horizontal transmission of HBV could affect neonates and partners. This transmission can vary in populations. Also, high-risk behaviors and clinical records affect the transmission of this virus. Due to the lack of information on vaginal discharge related to HBV in the north of Iran, we aimed to assess the presence of HBV in pregnant women's vaginal secretion referred to Sayyad Shirazi Hospital in Gorgan City, north of Iran.
Methods: This cross-sectional study was performed on 315 cervicovaginal lavages from pregnant women. Viral DNA was extracted, and the gene fragments of the virus were checked by polymerase chain reaction (PCR). Clinical, demographic, and behavioral data were entered into SPSS version 16. The chi-square tests were used to determine any association between categorical data.
Results: Hepatitis B virus DNA was detected in 2.2% (7/315) of samples. The age range of patients was from 14 to 43 years. Anal sex (P = 0.043) and not using a condom (P = 0.047) were significantly associated with HBV-positive cases. Abortion, unusual discharge, and some other clinical and demographic information showed no related statistical correlation.
Conclusion: The results showed a similar rate of infection in the general Iranian population. In pregnant women, the risk of HBV transmission and chronic HBV can be critical in newborns; therefore, it is strongly recommended to conduct screening and provide management for women during pregnancy.

---

Background: Although public health interventions have slowed the spread of SARS CoV 2 infections, the worldwide pandemic of COVID 19 is progressing. Thus, effective and safe vaccination against SARS CoV 2 is an important tool for controlling the COVID 19 pandemic. Now in the early stages of COVID 19 vaccination, vaccinated individuals are interested in using antibody tests to confirm vaccination success and estimate the time of protection. Here, we assessed anti spike IgG responses in the general population 2 weeks after the second dose of the Sputnik V vaccine.
Methods: This study included blood samples of 67 individuals without a previous SARS CoV 2 infection taken 14 days after the second dose of the Sputnik V vaccine. Anti spike IgG responses were assessed with an enzyme linked immunosorbent assay (ELISA).
Results: Anti spike IgG was detected in 55 (82.1%) of 67 samples 14 days after the second dose of the Sputnik V vaccine. Antibody levels were significantly lower in males than in females, and 9 (75%) of 12 seronegative individuals were males.
Conclusion: Vaccination resulted in detectable anti spike IgG in 82.1% of individuals, and gender may be an important factor in the humoral response.

---

Background: The outcome of hospitalized COVID-19 patients is predictable according to demographic, clinical, laboratory, and imaging risk factors. We aimed to determine the best outcome predictors and their trends during 30 days of hospitalization.
Methods: This retrospective study was conducted on moderate to severe hospitalized COVID-19 patients from 26 January 2020 to 13 January 2021. The length of stay in the hospital was considered as the time interval between admission and discharge, and the patient's final condition was defined as either dead or alive. Demographic, clinical, and laboratory data were collected from the hospital information system. The generalized additive model and the Cox regression model were used to model data.
Results: Of the 1520 hospitalized COVID-19 patients, 232 (15.26%) died and 1288 survived or reached the end of 30 days of hospitalization. We selected demographic, clinical, and 131 independent laboratory variables. Blood urea nitrogen (BUN) had a nearly double average in the dead group (44.603 [± 25.408] mg/dL) than the survived group (21.304 [± 13.318] mg/dL), and the lymphocyte (Lymph) count showed the opposite trend. The estimated hazard ratio (HR) of these 2 factors was higher than 1 and was statistically significant. In daily stay trends, the hazard function of them also increased rapidly after 15 days.
Conclusion: Blood urea nitrogen and complete blood count provide strong predictive clues about the prognosis of hospitalized COVID-19 patients, and rapid dynamic changes in the second week can predict a poor outcome in these patients.

---

Background: Vulvovaginal candidiasis (VVC) remains one of the most common infections of the female genital tract. This local study was conducted to identify the spectrum of Candida species associated with VVC and recurrent vulvovaginal candidiasis (RVVC) using different phenotypic and genotypic methods and assess their fluconazole susceptibility.
Methods: High vaginal swabs were collected from 576 patients with VVC. Swabs were subjected to KOH 10% and cultured on Sabouraud dextrose agar. The species identification of Candida isolates was made using phenotypic methods, including the germ tube test, corn meal agar (CMA), CHROMagar Candida, and PCR-RFLP as the best genotypic methods for confirmation of Candida species in vulvovaginal candidiasis. Fluconazole susceptibility testing was performed using the disk diffusion method.
Results: The data were analyzed using the chi-square test. The prevalence of candidiasis was 61%. The socio-demographic profile corresponded to a woman aged 29.14 ± 4.8 years on average, pregnant (77%), diabetic (19%), with hypertension (10%), recurrent (9%), a history of fluconazole use (4%), and under 30 years of age (73%).
Vaginal swab cultures yielded Candida growth in 352 cases (61%). Candida albicans was the predominant isolated species (78%), while the most common non-albicans species were C. glabrata (14.7%), C. parapsilosis (4.2%), C. tropicalis (2.8%), and C. krusei (0.56%). Isolates of C. glabrata and C. krusei exhibited the highest rate of DDS resistance among all isolates tested.
Conclusion: C. albicans was the most common species. Careful periodical surveillance is needed to identify any changes in the susceptibility patterns to fluconazole with the increased use of this antifungal agent in Sayad Shirazi tertiary care hospital, Iran.