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IntroductionThere 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.MethodsThis 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).ResultsA 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.ConclusionVaccination 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.

Introduction: Gestational diabetes is one of the most common pregnancy complications, which has negative consequences for both mother and fetus. A crucial treatment strategy is modifying the mother's diet. The present study was performed with aim to determine the effects of low carbohydrate (LC) diets on the outcomes of gestational diabetes. Methods: In this systematic review, search was done with the keywords including low carbohydrate diet, carbohydrate restriction, ketogenic diet, gestational diabetes, hyperglycemia, glucose intolerance, insulin resistance, and clinical trials in Persian and English languages in databases of Medline, PubMed, Embase, Science Direct, Magiran, ISD, ISC, and Cochrane until March 2023. Results: This systematic review examined seven studies. Some studies showed that carbohydrate restriction can have beneficial effects on metabolic outcomes, glycemic control, less insulin therapy needs, delivery method, and fetal weight. The LC diet did not lead to ketonemia in pregnant women. However, in other studies, adherence to the LC regimen did not reduce the number of women requiring insulin. There were no significant differences between the groups in terms of insulin dose or time of insulin treatment initiation, and both groups had similar pregnancy outcomes. Conclusion: Adherence to the low carbohydrate diet (about 40%) in pregnant mothers with gestational diabetes could have beneficial effects on some metabolic outcomes, delivery method, weight and health of the fetus. It did not lead to ketonemia in pregnant mothers. However, there are contradictions in the findings of the studies due to the amount and type of carbohydrates. It is recommended to conduct more clinical trials with different percentages of carbohydrates and a higher sample size.