---

Background: Post ischemic myocardial reperfusion can impair CABG outcomes and cause increased mortality, hospital stay and costs. Then, increased oxygen free radicals lead to lipid peroxidation and sulfhydryl group oxidation. The aim of this study is to evaluate whether N-acetylcysteine and Vitamin C as antioxidants could effect postoperative outcomes of on-pump CABG.

Materials and Methods: In this clinical trial, patients who had undergone CABG were studied in 4 groups receiving Vitamin C, N-acetylcysteine, Vitamin C & N-acetylcysteine and traditional drugs. The study population consisted of 50 patients in each group. Data were recorded in a checklist and analyzed by using SPSS 20.

Results: Mean pump time, ICU stay, hospital stay, the distribution of troponin positive serum, arrhythmia and need for reoperation were significantly different between groups. Gender distribution, mean cross-clamp time, serum creatinine level before and after surgery, the need for inotropic drugs and required dose level of it, showed no significant differences between groups.

Conclusion: It seems that the combination of N-acetylcysteine and  Vitamin C had a stronger effect on the defference between the mean of pump time, hospital length stay and  length of ICU stay versus the administration of N-acetylcysteine or Vitamin C alone.

---

---

Background and Aim: Coronary Artery Disease (CAD) is one of the leading causes of death and mortality in today's societies. Physical activity increases some of the influential factors for this disease. The purpose of this study was to investigate the effect of 8 weeks of aerobic and resistance training on endostatin in patients with Coronary Artery Bypass Graft (CABG).
Methods & Materials: The study participants were 24 male patients who were randomly divided into the experimental (n=12) and control (n=12) groups with Mean±SD age of 55.37±6.90 years, weight 75.45±5.87 kg, height 173.27±3.36 cm and body mass index of 25.11±1.55 kg/m2. The experimental group performed 8 weeks of aerobic and resistance training (3 sessions per week and 1.5 hours per session) based on the measurements, while the control group did not exercise during this period. To measure endostatin concentrations, blood samples were taken 48 hours before and 48 hours after the last training session while all subjects were fasting. Data were analyzed using the Shapiro-Wilk test to normalize the data and Student t-test in independent and correlated groups at the significant level of 0.05.
Ethical Considerations: This article was ethically approved by Azad University of Neyshabur  (Ethics Code IR.IAU.NEYSHABUR.REC.1398.018) and with the Clinical Trial Code IRCT20191228045916N1 in the Iranian Registry of Clinical Trials.
Results: The present study showed that the aerobic and resistance training group significantly decreased endostatin concentrations (P=0.001) (t=1.672) compared with the control group. 
Conclusion: Based on the findings, aerobic and resistance training decreases endostatin concentrations, known as an anti-angiogenic factor.

---

Background and Aim: Considering the increasing use of dental implants in replacing lost teeth, the odds of failure over time in this treatment are inevitable, as with other dental treatments; thus, it requires careful and regular follow-up. Accordingly, the present study aimed to evaluate the awareness and attitude of general dentists about the follow-up of the dental implants to create baseline information to schedule future workshops concerning dental implants.
Methods & Materials: In this analytic cross-sectional study, 98 general dentists of Arak City, Iran were evaluated. Questionnaires were designed in 3 sections, as follows: demographic, awareness, and attitude. After checking the validity and reliability of the questionnaires, they were distributed among the research participants. The obtained data were analyzed using descriptive analysis, Chi-squared test, and Independent Samples t-tests. The significance level was considered 0.05.
Ethical Considerations: This article was approved by the Ethics Committee of Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1397.283).
Results: The average score of awareness of the questionnaires was equal to 10.8 (based on the score of 0-19); the mean score of attitude was measured as 12.8 (based on the score of 7-21). Fifty-Three of the explored dentists had performed implant treatment, whose awareness and attitude toward implants follow-up were significantly higher than those of the dentists who did not perform such treatment (P=0.0001). Work experience presented no significant effect on the examined dentists’ awareness and attitude (P>0.05).
Conclusion: General dentists have low awareness and attitude about implant follow-up. Follow-up plays an important role in the long-term success of implant therapy; therefore, dental education/retraining programs should be reviewed in this field.

---

Background and Aim: Needlestick injury (NSJ) is a common occupational health problem among dental healthcare workers, putting them at significant risk for blood-borne infections. This study aimed to investigate occupational exposure to NSJ and the psychological factors associated with it among dentistry students.
Methods & Materials: This descriptive cross-sectional study was carried out on students in the Arak school of dentistry training curriculum in the last three years in 2018. The questionnaires included questions about students’ awareness of NSJ conditions, the frequency of vaccinations, and antibody titration tests. The SCL-90 (Symptom checklist-90) questionnaire assessed psychological factors after NSJ in four dimensions of anxiety, phobia, self-morbidity, and depression. Data analysis was performed using descriptive statistical methods and a chi-square test.
Ethical Considerations: The study was approved by the Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1397.269).
Results: Of the eighty students surveyed, 59 students had experienced NSJ at least once. However, only 25.4% of students had reported the NSJ occurrence. The highest incidence rate of NSJ was reported in the endodontics section. In addition, 80% of students had received hepatitis B vaccinations. Based on the SCL-90 test, the anxiety dimension was more affected by NSJ than the other dimensions.
Conclusion: Despite the high prevalence of NSJ in dental students, the rate of reporting after the accident is very low. Also, due to the lack of attention to vaccination in some students, there is a need for more infection control training. Based on the SCL-90 test, the occurrence of NS is effective in causing psychological problems.

---

On average, patients suffering from non-alcoholic steatohepatitis after about seven years, their disease turns into fibrosis and reversibility at this stage becomes very difficult because this disease is an irreversible stage of the disease. Fatty liver is non-alcoholic (2). Researches have come to the conclusion that liver inflammation and insulin resistance decrease and insulin sensitivity increases with sports activity (3). TNF-α has a high inflammatory effect; So that different agents and species of this family and their receptors play a role in NASH disease and liver fibrosis (5). However, exercise increases prostaglandins and cAMP. The mentioned hormones inhibit the function of TNF-α (6). On the other hand, anti-inflammatory cytokines increase due to exercise and inhibit the increase of TNF-α. With the increase in production and secretion of TNF-α, other inflammatory factors such as TGF-β1 signaling are activated and fibrosis signaling will start in liver cells (5). TGF-β1 (Transforming growth factor beta 1) is one of the members of the large family of transforming growth factors beta (TGF-β) and a key cytokine in obesity and insulin resistance (7). In a research, during 48 weeks of applying a high-fat diet to rats, they found that steatosis occurs in the liver of rats from the eighth week onwards, and the amount of TGF-β1 in them increased significantly. In the end, they came to the conclusion that this factor can be one of the main characteristics of determining the degree of liver fibrosis in patients with NASH (10). High-intensity interval training (HIIT) is one of the new training models whose positive effects have been identified in a variety of metabolic diseases (13). On the other hand, there are very few researches about the effect of aquatic environment and swimming on the improvement of metabolism and inflammation in NASH patients. Based on the results of a systematic review in 2018, it was shown that endurance exercise in water improved systemic inflammation and weight control (18). Despite the conflicting results in this field and the beneficial effects of exercise in water and also human's innate interest in water, the effect of high-intensity interval exercise in water in patients with non-alcoholic steatohepatitis has not been observed by the researchers of this study. Therefore, the effect of eight weeks of high-intensity interval training in water on inflammatory factors in patients with non-alcoholic steatohepatitis was investigated.
Materials and methods
In this study, eight-week-old rats were divided into two groups: healthy (n=20) and high-fat diet (HFD) (n=20). After eight weeks and proof of disease induction, the HFD group was randomly divided into two groups: control-disease (n=9) and exercise-disease (n=9); Also, the healthy group was divided into two groups: control-healthy (n=9) and exercise-healthy (n=9). The rats in the training group performed HIIT swimming training, including 20 times of 30 seconds of swimming with 30 seconds of rest between each time, for eight weeks (three days a week). One-way ANOVA and Bonferroni's post hoc test (P<0.05) were used to determine the difference between groups.
Ethical Considerations
The proposal of this study has been approved by the Ethics Committee of Shiraz University of Medical Sciences (IR.SUMS.REHAB.REC.1400.008).
Findings:
As shown in diagram 1; Based on the results of the one-way analysis of variance test, it can be said that there was a significant difference between the mean TNF-α blood serum (P=0.001). According to the results of Bonferroni's post hoc test, these differences in blood serum TNF-α variable between the control-healthy and control-disease groups (P=0.001), exercise-disease (P=0.001) and exercise-healthy (P=0.002), control-disease with exercise-disease (P=0.012) and exercise-healthy (P=0.001), exercise-healthy with exercise-disease (P=0.002) was.
According to graph 2, it can be seen that there is no significant difference in TGFβ1 variable in all four groups (p=0.068). However, by comparing the averages, it is found that the amount of TGFβ1 protein has decreased by 49.1968% in the patient-exercise group after high-intensity intermittent swimming exercise compared to the control-patient group. Meanwhile, this protein in the exercise-healthy group was reduced by 45.2741% compared to the control-patient. Figure 1 shows the protein bands related to TGFβ1 protein.
Discussion and conclusion: The results of the present research showed that high-intensity intermittent swimming exercises reduce inflammatory and fibrotic factors, and in general, it can be concluded that eight weeks of high-intensity intermittent swimming exercises improve the inflammatory and fibrotic factors associated with non-alcoholic steatohepatitis. . However, to obtain a definitive result, this type of exercise should be studied in human studies in this patient community.
Appreciation and thanks: This article is taken from the master's thesis in sports physiology (first author) of Zand Institute of Higher Education, Shiraz, with ethics code IR.SUMS.REHAB.REC.1400.008. In the end, we sincerely thank all friends and colleagues who helped us during the stages of this research.
Conflict of interest:The authors of this article have no mutual benefit from its publication.
Authors' share (participation rate): All four authors participated in the preparation of this article.
Key words: high-intensity swimming interval training, non-alcoholic steatohepatitis, tumor necrosis factor alpha, transforming growth factor beta