Reduction of ovarian reserves and activation of necroptosis to in vivo air pollution exposures.

We investigated the association between air pollution and changes in ovarian follicles, anti-mullerian hormone (AMH) levels, the occurrence of necroptosis cell death by activation of receptor-interacting protein kinase 3 (RIPK3) and, the activation of mixed lineage kinase domain-like (MLKL) proteins. Forty-two female Wistar rats were divided into three groups of 14 each, which were exposed to real-ambient air, filtered air and purified air (control) in two periods of 3 and 5 months. The results showed that the number of ovarian follicles decreased in the group exposed to real-ambient air versus the control group (P < 0.0001). The trend of age-related AMH changes with respect to exposure to air pollutants was affected and its levels decreased after 3 months of exposure. The MLKL increased in the group exposed to the real-ambient air compared to the control group (P = 0.033). Apparently long-term exposure to air pollution can reduce ovarian reserves.

Long-term exposure to air pollution and anti-mullerian hormone rate of decline: a population-based cohort study in Tehran, Iran.

Anti-mullerian hormone (AMH) concentration is a marker of ovarian reserve that decreases with age. However, a decrease in AMH may occur more rapidly under the influence of environmental factors. The present study investigated the association between long-term exposure to ambient air pollutants with serum concentrations of AMH and the AMH rate of decline. This study included 806 women with median age of 43 years (interquartile range: 38-48) participating in the Tehran Lipid and Glucose Study (TLGS) that were followed from 2005 to 2017. The AMH concentration and the demographic, anthropometric, and personal health parameters of the study participants were obtained from the TLGS cohort database. Air pollutant data were collected from the monitoring stations and the individual exposures were estimated by previously developed land use regression (LUR) models. Multiple linear regression analysis was used to estimate linear relationships between the air pollutant exposures and serum concentration of AMH and with the AMH declination rate. The results show no statistically significant associations between exposures to any of the air pollutants (including PM10, PM2.5, SO2, NO, NO2, NOX, and benzene, toluene, ethylbenzene, p-xylene, m-xylene, o-xylene (BTEX), and total BTEX) with serum concentration of AMH. Compared to the first tertile, no statistically significant associations were observed between the second or third tertiles of air pollutants, with the AMH rate of decline. In this study, we did not find significant association between air pollution and AMH in middle age women in Tehran, Iran. Future work may study such associations in younger women.

Smartphone Application for Celiac Patients: Assessing Its Effect on Gastrointestinal Symptoms in a Randomized Controlled Clinical Trial.

Introduction: Considering the lack of inclusive Persian application for celiac patients that covers all aspects of the GFD, we developed a Persian-language application for patients with CD and assessed the effectiveness of a three-month educational intervention delivered via smartphone application compared with standard care on gastrointestinal symptom rating scale (GSRS) score in patients with celiac disease. Methods: In the present parallel randomized controlled clinical trial, 60 patients with CD were assigned randomly to receive education through a smartphone application (n = 30) or conventional clinical education (n = 30). The patients were asked to use it for getting the required information for three months. We assessed the gastrointestinal symptoms using the gastrointestinal symptom rating scale (GSRS) questionnaire at baseline and three months after interventions. The GSRS total score, celiac disease GSRS (CD-GSRS) score, abdominal pain, reflux, diarrhea, constipation, and indigestion scores were calculated. Results: Out of 60 randomized patients, 58 patients completed the study. In comparison to baseline, the mean score of CD-GSRS score (p = 0.001), and indigestion subscore (p < 0.001) were significantly decreased in the intervention group. The results of the between-group comparisons showed that there was a significant difference between the two groups only in the mean score of indigestion (p = 0.002). Conclusion: According to the results, using a smartphone application for providing information to patients with celiac disease had a significant positive effect on indigestion symptoms compared with routine clinic education. Trial Registration. This trial is registered with the Iranian registry of clinical trials (IRCT code: IRCT20170117032004N2; trial registry date: 2019.6.26).

Burden of diseases attributed to traffic noise in the metropolis of Tehran in 2017.

Although road traffic noise is the most important source of environmental noise emission in large cities, little is known about health burden. The present study was conducted to estimate the burden of diseases attributed to traffic noise in the metropolis of Tehran in 2017. Using noise maps provided by the municipality of Tehran, we calculated population exposure distribution in term of Ldn and Lnight and the number of DALYs lost due to ischemic heart disease, hypertension, high sleep disturbance, annoyance and stroke endpoints based on the World Health Organization Environmental Noise Guidelines for the European Region. We applied published dose-response functions to estimate the traffic noise burden for high sleep disturbance and annoyance. We estimated 61,284 DALYs or 697 DALYs per 100,000 population attributed to traffic noise in Tehran for the reference year 2017. Highly sleep disturbance with a share of 58.74% of the DALYs was recognized as the most important contributor of disease burden, and noise annoyance with a share of 23.12% was ranked next. Ischemic heart disease (11.71%), stroke (5.12%), and hypertension (1.31%) were ranked third to fourth, respectively, in terms of the burden of disease caused by environmental noise. A considerable fraction of the population of Tehran lives in areas with an environmental noise higher than the standard level. The findings showed that traffic noise pollution is an important environmental risk factor in Tehran imposes the greatest burden on the community, mainly through highly sleep disturbance and noise annoyance endpoints.

The effect of group-based education on gastrointestinal symptoms and quality of life in patients with celiac disease: randomized controlled clinical trial.

BACKGROUND: In this trial, we investigated the effect of a group-based education program on gastrointestinal (GI) symptoms and quality of life (QOL) in patients with celiac disease (CD). METHOD: In the present study, 130 patients with CD who were on a GFD for at least 3 months, randomly assigned to receive group-based education (n = 66) or routine education in the celiac clinic (n = 64) for 3 months. We assessed gastrointestinal symptoms and quality of life using the gastrointestinal symptom rating scale (GSRS) questionnaire and SF-36 questionnaire at baseline and 3 months after interventions. RESULTS: The mean age of the participants was 37.57 ± 9.59 years. There were no significant differences between the two groups regarding the baseline values. Results showed that the mean score of total GSRS score in the intervention group was significantly lower compared with the control group 3 months post-intervention (p = 0.04). Also, there was a significant difference in the mean score of SF-36 between the two groups 3 months post-intervention (p = 0.02). CONCLUSION: Results showed that group-based education was an effective intervention in patients with celiac disease to improve gastrointestinal symptoms and quality of life. Trial registration IRCT code: IRCT20080904001197N21; registration date: 5/23/2019.

Effects of ambient air pollutants on hospital admissions and deaths for cardiovascular diseases: a time series analysis in Tehran.

Short-term exposures to air pollution have been associated with various adverse health effects. In this study, we investigated the associations between ambient air pollutants with the number of hospital admissions and mortality from cardiovascular diseases (CVDs). This time series study was conducted in Tehran for the years 2014-2017 (1220 day). We collected the ambient air pollutant concentration data from the regulatory monitoring stations. The health data were obtained from the Ministry of Health and Medical Education. A distributed lag non-linear model (DLNM) was used for the analyses. Total CVDs and ischemic heart disease (IHD) admissions were associated with CO for each 1 mg/m3 increase at lags of 6 and 7 days. Also, there was a positive association between total CVDs (RR 1.01; 1.001 to 1.03), IHD (RR 1.04; 1.006 to 1.07), and cerebrovascular diseases (RR 1.03; 1.005 to 1.07) mortality with SO2 at a lag of 4 days. PM2.5 and PM10 were associated with cerebrovascular disease admissions in females aged 16-65 years and 16 years and younger for each 10 µg/m3 increase, respectively. Short-term exposure to SO2, NO2, and CO was associated with hospital admissions and mortality for CVDs, IHD, cerebrovascular diseases, and other cardiovascular diseases at different lags. Moreover, females were more affected by ambient air pollutants than males in terms of their burden of CVDs. Therefore, identifying the likely harmful effects of pollutants given their current concentrations requires the planning and implementation of strategies to reduce air pollution.

Synergistic effect of royal jelly in combination with glycerol and dimethyl sulfoxide on cryoprotection of Romanov ram sperm.

Sperm fertility decreases significantly after freezing. Providing a suitable and useful diluent compound for freezing ram sperm can increase the efficiency of artificial insemination and consequently, the reproductive performance of sheep. Various biological properties such as antibacterial, anti-cancer, immunosuppressive, antioxidant and reproductive properties of royal jelly (RJ) are well known. The aim of this study was to investigate the possible synergistic effect of royal jelly in combination with glycerol and dimethyl sulfoxide (DMSO) in sperm cryopreservation extender of Romanov ram. The pooled semen samples from 5 Romanov rams were allocated into 3 experiments. The effect of 6% DMSO, 6% glycerol and a combination of 3% DMSO +3% glycerol co-supplemented with 1, 2 and 3% RJ was evaluated in 3 experiments. Samples were frozen by conventional slow freezing method and post-thaw parameters of total motility, progressive motility, plasma membrane integrity, DNA damage, apoptosis, enzyme activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx), total antioxidant capacity (TAC) and malondialdehyde (MDA) were evaluated. The results showed that the percentage of motility, progressive motility, TAC, GPx, SOD and all sperm kinematic parameters except LIN in the group containing 2% RJ + 6% DMSO was higher than the control group (p < 0.05). Some parameters such as progressive motility, sperm membrane integrity, TAC, GPx, VAP, VCL, STR and SRT in the group containing 2% RJ + 6% DMSO were more than (p < 0.05) in the sperm group containing 1% RJ + 6% DMSO. MDA values in sperm groups containing 2% RJ + 6% DMSO were significantly (p < 0.05) lower than the sperm containing 1% royal jelly and the control group. In the sperm group containing 2% RJ + 6% glycerol, sperm membrane integrity, TAC, GPx, SOD, progressive motility and all sperm kinematic parameters except VAP were higher and MDA values and sperm abnormalities were lower than the control group (p < 0.05). The sperm group containing 1% RJ and 3% DMSO +3% glycerol had higher motility, progressive motility, membrane integrity, and all sperm kinematic parameters except VSL; and lower sperm abnormalities, DNA damage, apoptosis and MDA than the control group (p < 0.05). As a general conclusion of this study, the addition of 2% RJ + 3% DMSO and 3% glycerol to the freezing extender improved microscopic and biochemical ram sperm parameters after the freeze-thaw process. Hence, moderate concentrations of royal jelly (2%) are sufficient to protect sperm from freezing damage, and high (3%) and low (1%) concentrations do not have a good cryoprotective effect.

Risk of gestational diabetes mellitus by pre-pregnancy body mass index: A systematic review and meta-analysis.

Gestational diabetes mellitus (GDM) is serious health challenges. This study aimed at determining the risk of GDM among pregnant women by pre-pregnancy BMI. Five electronic databases including Medline (PubMed), Scopus, Embase, Web of Science and Google Scholar were searched for literature published form 2015 to January 1, 2021. The pooled estimate risk of GDM among pregnant women was 16.8% (95% CI: 15.3-18.4). The risk of GDM in underweight/normal group and overweight/obese group were 10.7% (95% CI: 9.1-12.4) and 23% (95% CI: 20.2-25.9), respectively. The risk of GDM is high among overweight/obese pregnant women.

Relationship between ambient black carbon and daily mortality in Tehran, Iran: a distributed lag nonlinear time series analysis.

PURPOSE: The aim of the present study was to investigate the effect of short-term exposure to ambient black carbon (BC) on daily cause-specific mortality, including mortality due to respiratory, cardiovascular, ischemic heart and cerebrovascular diseases in Tehran, Iran. MATERIALS AND METHODS: Daily non-accidental death counts, meteorological data and hourly concentrations of air pollutants from 2014 to 2017 were collected in Tehran. A distributed lag non-linear model was used to assess the association between exposure to BC and daily mortality. RESULTS: The mean daily BC concentration during the study period was 3.96 ± 1.19 µg/m3. The results indicated that BC was significantly associated with cardiovascular, ischemic heart disease, and cerebrovascular mortality, but not with respiratory mortality. In first model, each 10 µg/m3 increase in at lag 3, lag 4 and lag 5 were associated with cardiovascular mortality in 16-65 year age group with the relative risks (RRs) of 1.17 (95 % CI: 1.02-1.33), 1.17 (95 % CI: 1.04-1.31) and 1.12 (95 % CI: 1.02-1.24), respectively. The highest mortality rate per 10 µg/m3 increase in exposure was found for ischemic heart diseases with RR of 3.98 (95 % CI: 1.04-1.81, lag 01) for 16-65 age group. Cerebrovascular mortality was associated with 10 µg/m3 increases in non-cumulative exposure with RR of 1.17 (95 % 1.009-1.35, lag 5) in the age group ≥ 65 years. In the second model for a 10 µg/m3 increase in BC, cardiovascular mortality at specific lag days (5 and 6 days) in the age group ≤ 16 years were associated with RR of 1.34 (95 % CI 1.08-1.66) and 1.35(95 % CI 1.02-1.77), respectively. CONCLUSIONS: This study in Tehran found significant effects of BC exposure on daily mortality for cardiovascular, ischemic heart disease, cerebrovascular disease. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40201-021-00659-0.

The Persian Translation and validation of the celiac disease quality of life questionnaire (CDQOL).

BACKGROUND: Considering the importance of having a celiac disease-specific measure of the quality of life (QOL) in Persian, the present study aimed to translate the celiac disease quality of life questionnaire (CDQOL) into Persian and evaluate its psychometric properties. METHODS: In this cross-sectional study, the Forward-Backward translation method was used. The content validation ratio (CVR) and the content validity index (CVI) were used for content validity assessment. The construct validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) on 220 celiac patients who were selected randomly from the celiac disease (CD) registry database. The correlations between the result of the Persian version of CDQOL (PCDQOL), self-rated QOL, and short form-36 (SF36) were analyzed using the Pearson correlation test. The internal consistency and test-retest reliability were measured through Cronbach's alpha and intraclass correlation coefficient (ICC). RESULTS: In the present study, 220 celiac patients with a mean age of 35.54 ± 10.29 years participated. The mean CVI, CVR, and impact score of PCDQOL were 0.98, 0.96, and 4.82 respectively. Using EFA, four factors have extracted that had a good fit in CFA (Chi-square/DF = 1.74, RMSEA: 0.08, and CFI: 0.90, and NFI: 0.90). The results showed that there was a moderate to high correlation between PCDQOL, SF36 (r: 0.587, p = 0.02), and self-rated QOL (r: 0.64, p < 0.001). The questionnaire had high internal consistency (Cronbach alpha: 0.93) and test-retest reliability (ICC: 0.96 [0.86-0.99]). CONCLUSION: The PCDQOL questionnaire could be used by physicians and nutritionists to assess HRQOL in celiac patients in Iran.

The Effect of Group-Based Education on Knowledge and Adherence to a Gluten-Free Diet in Patients with Celiac Disease: Randomized Controlled Clinical Trial.

BACKGROUND: Considering the importance of educational programs on compliance of patients with celiac disease with a gluten-free diet (GFD), we investigated the effect of a group-based education program on knowledge and adherence to a GFD in patients with celiac disease. METHOD: In the present controlled clinical trial, patients in the intervention group (n = 66) underwent a three-session group-based educational program, and patients in the control group (n = 64) received routine education in visits to the clinic. The primary outcomes were knowledge and adherence to a GFD. Participant knowledge was assessed by a validated author-designed questionnaire. Adherence rate was evaluated by the Persian version of celiac disease adherence test (CDAT) questionnaire. Results were analyzed based on intention-to-treat (ITT) analysis. RESULTS: Results of the ANCOVA test showed that the mean score of knowledge about celiac disease and gluten in the intervention group was significantly higher compared with the control group immediately after intervention (p = 0.002) and 3 months post-intervention (p = 0.03). In terms of gluten-free food item selection, the intervention group achieved a significantly better score than the control group immediately after intervention (p < 0.001) as well as 3 months post-intervention (p < 0.001). Additionally, there was a significant difference in the CDAT score between the two groups 3 months post-intervention (p = 0.02). CONCLUSION: Evidence suggests that group-based education was an effective intervention among patients with celiac disease to improve knowledge and adherence to a GFD. Trial registration IRCT code: IRCT20080904001197N21; registration date: 5/23/2019.

Development and effectiveness assessment of a Persian-language smartphone application for celiac patients: A randomized controlled clinical trial.

OBJECTIVES: We aimed to design a Persian-language application for celiac patients and assess its effectiveness on patients` knowledge and adherence to a gluten-free diet (GFD). METHODS: In the present randomized controlled clinical trial, 60 patients were randomly assigned to receive education through a smartphone application (n = 30) or conventional clinical education (n = 30). The primary outcomes were assessing knowledge about celiac disease and GFD, and adherence to GFD that were assessed at baseline and three months after interventions. The knowledge and adherence were assessed by a valid author-designed knowledge questionnaire and the validated celiac disease adherence test (CDAT) respectively. RESULTS: The mean disease duration was 4.38 ± 3.27 years. The mean post-intervention score of knowledge about gluten-free foods was significantly higher in the intervention group compared with the placebo group after adjusting for baseline values and characteristics (p-value = 0.03). There was a significant difference in post-intervention CDAT values between the two groups (p-value = 0.01). CONCLUSION: The smartphone application had a significant effect on celiac patients` knowledge about gluten-free foods and adherence to GFD. PRACTICE IMPLICATIONS: The smartphone applications can be designed according to each country's particular circumstances and can be suggested by nutritionists and physicians to use by celiac patients.

Psychometric properties of the Persian version of the celiac disease adherence test questionnaire.

BACKGROUND: A gluten-free diet (GFD) is the only effective treatment for celiac patients and assessing adherence to this diet is important. Celiac disease Adherence Test (CDAT) is a valid English-language questionnaire that is used for assessing the adherence to the GFD. In the present study, we aimed to translate the CDAT questionnaire in Persian and evaluate its validity and reliability. METHODS: In the present cross-sectional study, CDAT was translated and back-translated by three bilingual professional translators. Content validity was evaluated by 12 gastroenterologists and nutritionists. To assess the construct validity, 230 patients with celiac disease were randomly selected from the national celiac disease registry database. Internal consistency of the items and test-retest reliability were assessed by Cronbach's alpha and Intraclass Correlation Coefficient (ICC). To assess the convergent validity of the questionnaire, the correlation coefficient between the CDAT score and anti-tissue transglutaminase immunoglobulin A (anti-t-TG-IgA) titer was assessed. RESULTS: The content validity index, content validity ratio, and impact score of the Persian version of CDAT (Pv-CDAT) were 0.97, 0.95, and 4.61 respectively. Three significant factors were extracted and according to the confirmatory factor analysis the three-factor model had adequate fitness (chi-square p-value of 0.74, root mean error of approximation: 0.001 [95% CI: 0.001-0.083], comparative fit index: 1, standardized root mean squared residual: 0.04, and coefficient of determination: 0.78). The questionnaire had good feasibility with the floor effect of 3.1% and the ceiling effect of 0.4%. Moreover, it has high internal consistency (Cronbach-alpha: 0.71) and test-retest reliability (ICC: 0.78). The correlations between CDAT categories and anti-tTG-IgA categories showed a significant correlation between the two tests (r = 0.53; P < 0.001). CONCLUSIONS: The results of the present study showed that the Pv-CDAT questionnaire with high validity, reliability, and internal consistency can be used for assessing adherence to the GFD in adult celiac patients in Iran.

Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida parapsilosis Species Complex Blood Isolates.

Clonal expansion of fluconazole resistant (FLZ-R) Candida parapsilosis isolates is increasingly being identified in many countries, while there is no study exploring the antifungal susceptibility pattern, genetic diversity, and clinical information for Iranian C. parapsilosis blood isolates. Candida parapsilosis species complex blood isolates (n = 98) were recovered from nine hospitals located in three major cities, identified by MALDI-TOF MS, and their genetic relatedness was examined by AFLP fingerprinting. Antifungal susceptibility testing followed CLSI-M27-A3 and ERG11, MRR1 and hotspots 1/2 (HS1/2) of FKS1 were sequenced to assess the azole and echinocandin resistance mechanisms, respectively. Ninety-four C. parapsilosis and four Candida orthopsilosis isolates were identified from 90 patients. Only 43 patients received systemic antifungal drugs with fluconazole as the main antifungal used. The overall mortality rate was 46.6% (42/90) and death mostly occurred for those receiving systemic antifungals (25/43) relative to those not treated (17/47). Although, antifungal-resistance was rare, one isolate was multidrug-resistant (FLZ = 16 µg/ml and micafungin = 8 µg/ml) and the infected patient showed therapeutic failure to FLZ prophylaxis. Mutations causing azole and echinocandin resistance were not found in the genes studied. AFLP revealed five genotypes (G) and G1 was the main one (59/94; 62.7%). Clinical outcome was significantly associated with city (P = 0.02, α <0.05) and Mashhad was significantly associated with mortality (P = 0.03, α <0.05). Overall, we found a low level of antifungal resistance for Iranian C. parapsilosis blood isolates, but the noted MDR strain can potentially become the source of future infections and challenge the antifungal therapy in antifungal-naïve patients. AFLP typing results warrants confirmation using other resolutive typing methods.

Comparison of diet quality between celiac patients and non-celiac people in East Azerbaijan-Iran.

BACKGROUND: Considering the lifelong dietary restriction in celiac patients, it is important to assess the diet quality in these patients. Hence, this study aimed to investigate the diet quality in adult celiac patients and compare it with that of the non-celiac people. METHODS: In the present cross-sectional study, 130 celiac patients were selected from the celiac disease (CD) registry database of East Azerbaijan province, Iran. Non-celiac people (n = 464) was selected from the major lifestyle promotion project conducted in the East Azerbaijan district. The dietary intake data was obtained by an 80-item semi-quantitative food frequency questionnaire. Diet quality was assessed using the healthy eating index-2015 (HEI-2015). RESULTS: The mean total HEI score was significantly higher in the celiac group compared with the non-celiac people (P < 0.001) and 68.5% of non-celiac people and 17.4% of celiac patients had poor diet quality. After adjusting for confounding factors, the mean score of total HEI in adherents to gluten-free diet (GFD) was significantly higher compared with non-adherents (P = 0.007). CONCLUSIONS: Although the mean total HEI score was higher in celiac patients compared with the non-celiac people, about 17.5% of patients had poor diet quality and the scores of whole grains and dairy products group were very low in our population. Accordingly, it seems that educational programs should be held for the celiac patients and non-celiac people to increase their nutritional literacy and enable them to select healthy gluten-free alternatives.

Short-term effects of particulate matter during desert and non-desert dust days on mortality in Iran.

BACKGROUND: Increased atmospheric particulate matter (PM) concentrations are commonly observed during desert dust days in Iran, but there is still no evidence of their effects on human health. We aimed to evaluate the association between daily mortality and exposure to PM10 and PM2.5 during dust and non-dust days in Tehran and Ahvaz, two major Middle Eastern cities with different sources, intensity, and frequency of desert dust days. METHODS: We identified desert dust days based on exceeding a daily PM10 concentration threshold of 150 µg/m3 between 2014 and 2017, checking for low PM2.5/PM10 ratio typical of dust days. We used a time-stratified case-crossover design to estimate the short-term effects of PM10 and PM2.5 concentrations on daily mortality during dust and non-dust days. Data was analyzed using conditional Poisson regression models. RESULTS: Higher concentrations of PM and frequency of desert dust days were observed in Ahvaz rather than Tehran. In Ahvaz, the effect of PM10 at lag 0 was much higher during dust days, an increment of 10 µg/m3 was associated with 3.28% (95%CI = [2.42, 4.15]) increase of daily mortality, than non-dust days, 1.03% (95%CI = [-0.02, 2.08]), while in Tehran, was slightly higher during non-dust days, 0.72% (95%CI = [0.23, 1.23]), than in dust days, 0.49% (95%CI = [-0.22, 1.20]). No statistically significant associations were observed between PM2.5 and daily mortality in Ahvaz, while in Teheran the effect of PM2.5 increased significantly during non-dust days at lag 2, 1.89% (95%CI = [0.83, 1.2.95] and lag 3, 1.88% (95%CI = [0.83, 1.2.95]). CONCLUSION: The study provides evidence that exposure to PM during Middle East dust days is an important risk factor to human health in arid regions and areas affected by desert dust events.

Antifungal susceptibility of non-albicans Candida spp. isolated from raw milk and human blood in Alborz and Tehran provinces.

BACKGROUND AND OBJECTIVES: Recent reports indicate high prevalence of fungal infections due to non-albicans Candida spp. which are present in various environments such as raw milk. The quality of milk for fungal normal flora was investigated in this study. MATERIALS AND METHODS: A total of 262 milk samples were collected directly from milk collection tanks indesignated dairy farms and cultured in SDA media. By further analysis of grown yeasts, 69 non-albicans Candida strains were identified. Antifungal susceptibility of the isolated species, were evaluated against amphotericin B, itraconazole, fluconazole and flucytosine. Fifty two non-albicans clinical samples isolated from human blood have been evaluated along. RESULTS: Antifungal susceptibility evaluation in non-albicans strains isolated from milk revealed Candida glabrata and Candida tropicalis to be 100% sensitive to flucytosine and fluconazole. Candida krusei showed 94% and 80% sensitivity to flucytosine and fluconazole respectively. Candida parapsilosis indicated 72.72% sensitivity to fluconazole. CONCLUSION: Evaluation of non-albicans Candida species in raw milk and antifungal susceptibility patterns of these isolates-compare with non-albicansisolates from human blood, may help physicians to choose an appropriate medication for diseases needing long-term treatment, especially for diseases caused by local strains.

Endotoxin and Der p1 allergen levels in indoor air and settled dust in day-care centers in Tehran, Iran.

BACKGROUND: Allergens like endotoxin and mite allergen Der p 1 are associated with early wheezing and asthma morbidity. Day-care centers can be an important source of exposure to allergens. The aim of this study was to evaluate children's exposure to endotoxin and mite allergen (Der p 1) associated with total suspended particulate matter (TSP) and settled dust in day-care centers in two phases in years of 2015 and 2016 in Tehran city, Iran. METHODS: Endotoxin and mite allergen Der p 1 in TSP and settled dust were measured in 23 day-care centers in Tehran. After collecting dust samples and weighting them, and then their extraction, Endotoxin and Der p 1 allergen were determined using QCL-1000 Endpoint chromogenic LAL Assay and ELISA, respectively. RESULTS: The mean concentrations of endotoxin and mite allergen Der p 1 in settled dust were 0.3 EU/mg and 0.2 ng/mg, respectively. The mean concentration of endotoxin and mite allergen Der p 1 in indoor air TSP were 0.8 EU/m3 and 0.4 ng/m3, respectively. A significant negative correlation was found between endotoxin both in settled dust and in TSP with measured relative humidity in winter. Also, moderate correlation was observed between Der p 1 in settled dust and relative humidity in winter; however, the correlation between allergen in TSP and relative humidity was not significant. CONCLUSION: Day-care centers can be an important source of endotoxin and Der p 1 allergen, so, implementation of proper interventions in these places can reduce exposure to them.

The effect of prepregnancy body mass index on the risk of gestational diabetes mellitus: A systematic review and dose-response meta-analysis.

This study was conducted to investigate the effect of the prepregnancy BMI on the risk of gestational diabetes mellitus (GDM). Five electronic databases, including PubMed, Scopus, Embase, Web of Science, and Google Scholar, were searched for literature published until 1 January 2018. The two-stage, random effect meta-analysis was performed to compare the dose-response relationship between BMI and GDM. As well as studies with categorized BMI, studies that treat BMI as a continuous variable were analysed. A total of 33 observational studies with an overall sample size of 962 966 women and 42 211 patients with GDM were included in analysis. The pooled estimate of GDM risk in the underweight, overweight, and obese pregnant women was 0.68, 2.01, and 3.98 using the adjusted OR and 0.34, 1.52, and 2.24 using the adjusted RR. The GDM risk increased 4% per unit of increase in BMI with both the crude and adjusted OR/RR models. Also, the risk of GDM increased 19% with the crude model and 14% with the adjusted model. The existence of dose-response relationship between the pre-pregnancy BMI and GDM can strengthen the scientific background for vigorous public health interventions for the control of pre-pregnancy BMI as well as the weight gain during pregnancy.

Molecular characterization of a Squalene epoxidase gene in dermatophyte pathogen Trichophyton tonsurans.

BACKGROUND: Trichophyton tonsurans is one of the dermatophyte fungi which invades the skin and hair of human. Several properties of this fungus have been investigated so far. However a few studies were carried out in the field of molecular biology of this fungus. In the present study, we tried to identify the Squalene epoxidase gene which is related to synthesis of ergosterol in this fungus. METHODS: Pairs of 23 and 24 nucleotides primers were designed from highly conserved regions of the similar genes in other fungi. Mentioned primers were utilized in PCR by using isolated genomic DNA of T. tonsurans whereas the PCR fragments were then sequenced. RESULTS AND CONCLUSION: Nucleotides (n = 558) have been sequenced from this new gene which encodes a polypeptide with 186 amino acids. Sequences comparison in gene data banks (NCBI, NIH) for this part of DNA and its deduced amino acid revealed significant homology with members of the eukaryotic Squalene epoxidase.