COVID-19 vaccines breakthrough infection and adverse reactions in medical students: a nationwide survey in Iran.

Introduction: There are different types of COVID-19 vaccines approved worldwide. Since no national studies focus on vaccine-related adverse reactions and breakthrough cases, this study aimed to investigate the rate of adverse events and COVID-19 infection in medical students in Iran. Methods: This retrospective cohort study included Iranian medical students who received two doses of COVID-19 vaccines. The medical team gathered the demographic characteristics, comorbidities, type of vaccine, adverse events following vaccination, and history of COVID-19 infection data through a phone interview. The frequency of adverse events and breakthrough infection was stratified by vaccine type (ChAdOx1-S, Gam-COVID-Vac, and BIBP-CorV). Results: A total of 3,591 medical students enrolled in this study, of which 57.02% were females, with a mean age of 23.31 + 4.87. A PCR-confirmed and suspicious-for-COVID-19 breakthrough infection rate of 4.51 and 7.02% was detected, respectively. There was no significant relation between breakthrough infection and gender, BMI, blood groups, and comorbidities. However, there was a significant difference in breakthrough infection rate among different types of vaccines (p = 0.001) and history of COVID-19 infection (p = 0.001). A total of 16 participants were hospitalized due to COVID-19 infection after vaccination for reasons such as dyspnea, abnormal imaging, or decreased oxygen saturation. No severe infection or death was observed in the studied population. Conclusion: Vaccination prevented severe COVID-19 infection, although a high breakthrough infection rate was evident among Iranian medical students during the Delta variant's peak. Vaccine effectiveness may be fragile during emerging new variants and in high-exposure settings. Moreover, adverse events are rare, and the benefits of vaccination outweigh the side effects. However, many limitations challenged this study, and the results should be cautious.

Cross-sectional study of passive opiate smoking in relation to stroke and some of stroke attributable risk factors in women.

Opiate use is related to neuropathological disorders, stroke and stroke attributable risk factors. However, secondary exposure to opiate in relation to the above-mentioned complications is studied only in animal models and remains to be evaluated in human populations. We tested whether passive exposure to opiate is associated with stroke and the known stroke predictive factors. We carried out a cross-sectional study of 1541 never smoker women who participated in the Rafsanjan Cohort Study (RCS) with their husbands (2015-2017 recruitment phase). RCS is one of the 19 geographic districts of the Prospective Epidemiological Research Studies in Iran (PERSIAN cohort study). Unadjusted and adjusted multiple logistic regression analyses were performed to evaluate the relationship between second-hand opiate exposure (husband opiate smoking after marriage) and the odds ratio of stroke and the following stroke risk factors and predictive parameters: overweight/obesity (BMI > 25), cholesterol (chol) > 200 mg/dl, fasting blood sugar (FBS) > 125 mg/dl, low density lipoprotein (LDL) > 100 mg/dl, triglyceride (TG) > = 150 mg/dl, hypertension, diabetes, and chronic headache. We observed a significant increased adjusted odds ratio (OR) of stroke (OR = 3.43, 95% CI:1.33-8.82) and its risk factors LDL > 100 mg/dl (OR = 1.37, 95% CI:1.01-1.87) and FBS > 125 mg/dl (OR = 1.58, 95% CI:1.08-2.30) in women associated with husbands' opiate smoking. This relationship was observed after adjusting for the confounding parameters including age, education years, and first-degree family history of the relevant diseases. The increased odds ratio for stroke and high LDL displayed a dose-sensitive trend with years of husband's opiate smoking after marriage (respective p-trends: 0.02 & 0.01). We did not observe a significant association between passive opiate smoking and high TG, high Chol or the diseases diabetes, hypertension and chronic headache. However, 89% increased odds ratio of chronic headache was observed to be associated with passive opiate smoking for more than 10 years (OR = 1.89, 95% CI:1.02-3.50). We found an increased risk of stroke and high LDL and FBS in women associated with passive opiate smoking. Furthermore, a dose-sensitive connection was found between the risks of stroke, high LDL and chronic headache with the years of passive opiate exposure. Our results point to the necessity of the future analyses, which further assess whether passive opiate exposure could be considered as an independent risk factor for stroke and metabolic diseases.

Comparative effects of red and white grapes on oxidative markers and lipidemic parameters in adult hypercholesterolemic humans.

The present study compared the effects of consuming red versus white whole grapes on oxidative and lipidemic indices in people with hypercholesterolemia. Sixty nine patients were randomized into three groups. The two treatment groups consumed 500 g of either Condori red grapes or Shahroodi white grapes daily for 8 weeks, and the third group served as a control. Plasma glucose, triacylglycerol (TG), cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), thiobarbituric acid reactive substances (TBARS) and total antioxidant capacity (TAC) were determined by colorimetric methods at baseline and at the end of the study. In addition, the polyphenol and fiber content of the two grape varieties was measured. TBARS was reduced in both study groups compared to the control group, and the reduction was greater in the group that consumed red grapes compared to the white grapes. TAC was increased significantly in both red and white grape consuming groups compared to the control group. Total cholesterol and LDL-C were decreased in the red grape group compared to the control group. No significant changes in fasting blood glucose, TG or HDL-C were observed among the groups. The results of this study suggest that consumption of the whole fruit of red grapes has more potent anti-oxidative and hypolipidemic effects compared to the white grapes in hyperlipidemic adult humans. Hence, the whole fruit of red grapes may be an excellent fruit choice not only to prevent oxidative stress related metabolic disorders but also cholesterol related cardiovascular diseases, particularly in hyperlipidemic adult humans.

Effect of EPA and vitamin C on superoxide dismutase, glutathione peroxidase, total antioxidant capacity and malondialdehyde in type 2 diabetic patients.

OBJECTIVES: The aim of this study is to investigate the effect of eicosapentaenoic acid combined with vitamin C in comparison with the pure form of eicosapentaenoic acid on the serum concentration of malondialdehyde, erythrocyte activity of superoxide dismutase, glutathione peroxidase, and the serum level of total antioxidant capacity in patients with type 2 diabetes. METHODS: Eighty one male diabetic patients, aged 33-63 years, were randomly assigned to one of 4 groups. The subjects consumed 500 mg/d pure eicosapentaenoic acid, 200 mg/d vitamin C, 500 mg eicosapentaenoic acid and 200 mg/d vitamin C or placebo depending on their groups. In fasting blood samples, superoxide dismutase and glutathione peroxidase activities were determined via the enzymatic method (Randox kit) and the serum total antioxidant capacity, malondialdehyde and vitamin C concentrations were estimated by colorimetric methods. RESULTS: Administration of pure eicosapentaenoic acid in diabetic patients increased superoxide dismutase by 4%, glutathione peroxidase 53%, total antioxidant capacity 36% and decreased malondialdehyde significantly by 25%. Prescription of eicosapentaenoic acid combined with vitamin C demonstrated a significant increment for superoxide dismutase activity by 3% and for glutathione peroxidase activity by 52% during the study, but no significant change was seen for total antioxidant capacity and malondialdehyde, respectively. There was a significant decrease in FBS and HbA1c following prescription of eicosapentaenoic acid with/without vitamin C along the study, although these changes were not significant between the study groups. CONCLUSION: It is concluded that prescription of eicosapentaenoic acid in the pure form reduces oxidative stress in type 2 diabetic patients; albeit, it does not alleviate hyperglycemia. Combination of vitamin C and eicosapentaenoic acid does not improve antioxidant property of eicosapentaenoic acid.

Effects of eicosapentaenoic acid and vitamin C on glycemic indices, blood pressure, and serum lipids in type 2 diabetic Iranian males.

BACKGROUND: Eicosapentaenoic acid (EPA) is the principal ω-3 fatty acids in marine oils. Fasting blood sugar (FBS), HbA1c and some of the plasma lipids and lipoproteins has been negatively related to the intake of ω-3 fatty acids and ascorbic acid, in some studies. Therefore, the purpose of this study was to assess the effects of EPA and/or vitamin C on glycemic indices, blood pressure, and plasma lipids in type 2 diabetic Iranian males. METHODS: Sixty five men with type 2 diabetes were enrolled into the study between April 2 and June 27, 2008. Venous blood samples were obtained from all participants after 10 hours of fasting, at the baseline and after the intervention. Subjects received 500 mg EPA and/or 200 mg vitamin C and/or placebo depending on their groups. For eight weeks, 15 participants received EPA supplements with vitamin C (group 1), 16 took EPA supplements and vitamin C placebo (group 2), 17 took EPA placebo and vitamin C (group 3), and 17 received EPA placebo and vitamin C placebo (group 4), daily. RESULTS: There were significant decreases in FBS, HbA1C, LDL-C and TG in groups 1, 2, 3 and 4 (p < 0.01), but significant decreases in TC were shown only in groups 1, 2 and 3 (p < 0.01). There was a significant increase in HDL-C in all groups (p < 0.01). CONCLUSIONS: In summary, it is concluded that, eight weeks of taking EPA + vitamin C supplementation improved the plasma levels of cardiovascular markers but didn't reduce BP.