مجله علوم پزشکی رازی
سال بیست و دوم شماره 12 (پیاپی 141، اسفند 1394)

Deficiencies in micronutrients are a major health issue in all ages , especially children, in developing countries. Severe or long-term iron deficiency will lead to iron deficiency anemia and thus affect children’s growth and development. This review article tried to determine the neurodevelopmental effects of deficiency in this micronutrient among children. A comprehensive search was conducted on PubMed, Web of Science, ISI, Scopus, Google Scholar, IranMedex, and SID databases. “Iron deficiency”, “child”, “infant”, “development”, and “developmental delay” were used as keywords. A total of 150 articles on the relation between iron deficiency and developmental and nervous system disorders in children were retrieved. After further evaluations, 88 articles were excluded and only 62 articles (published during 1989-2014) were considered. Findings: Review of the literature revealed relations between iron deficiency in infants and impairment of neurotransmitter metabolism, hypomyelination in the brain, attention deficit, reduced learning ability, Ô
Deficiencies in micronutrients are a major health issue in all ages, especially children, in developing countries. Severe or long-term iron deficiency will lead to iron deficiency anemia and thus affect children’s growth and development. This review article tried to determine the neurodevelopmental effects of deficiency in this micronutrient among children.
A comprehensive search was conducted on PubMed, Web of Science, ISI, Scopus, Google Scholar, Iran Medex, and SID databases. “Iron deficiency”, “child”, “infant”, “development”, and “developmental delay” were used as keywords. A total of 150 articles on the relation between iron deficiency and developmental and nervous system disorders in children were retrieved. After further evaluations, 88 articles were excluded and only 62 articles (published during 1989-2014) were considered.
Review of the literature revealed relations between iron deficiency in infants and impairment of neurotransmitter metabolism, hypo myelination in the brain, attention deficit, reduced learning ability, cognitive disability, auditory system disorders, abnormal sleep patterns, and developmental delay.
Apparently, iron deficiency exerts undeniable neurodevelopmental effects in children. Considering the significance of children in the future of a country, appropriate measures need to be taken to ensure timely prevention, diagnosis, and treatment of iron deficiency.
ognitive disability, auditory system disorders, abnormal sleep patterns, and developmental delay. Apparently, iron deficiency exerts undeniable neurodevelopmental effects in children. Considering the significance of children in the future of a country, appropriate measures need to be taken to ensure timely prevention, diagnosis, and treatment of iron deficiency.

Colorectal cancer is the fourth most common cancer in the world. It is the third largest risk factor for cancer individuals. The number of new cases is rising since 1975. Hyper activities of EGFR family have been reported in various cancers. The purpose of this study was to investigate the expression levels of HER2 in colorectal cancer and its possible association with advanced stages of disease.
In this study 20 samples of colorectal cancer paraffin block and 10 non-tumor individual samples were collected. After de-paraffin, RNA molecules were extracted from samples by RNX plus solution, after that CDNA was synthetized by reverse transcription method and finally the relative HER2 gene expression was evaluated by Real Time PCR.
In 20 cases of colorectal cancer compared with non-tumor samples, over expression of HER2 gene was observed. The increased expression compared with non-tumor samples observed in all patient samples and the amount of over expressed HER2 in patients with stage III was more than stage II and I. expression levels were also increased by increasing the age. The observation showed that the increased expression of HER2 occurs from the early stages of the disease.
Due to the increased HER2 expression in colorectal cancer, it is clear that the HER2 assessment can be considered as a valuable prognostic factor for screening especially in early stages of disease.

Physical activity in the workplace has significant effects on different aspects of employee’s health. It can be effective in increasing the productivity and decreasing staff’s absents and turn-over. Physical activity is affected by multiple factors. The purpose of current research is systematic review of individual, environmental and organizational determinants of physical activity in the workplace.
Relevant articles searched in electronic databases including Scopus, PubMed, Web of Science, Sportdiscus, Cochrane Library and Google Scholar from 2000 to 2013. Studies which were qualified based on inclusion criteria were entered to review. Quality assessment of studies was done by using two tools including New Castle-Ottawa Scale and Quality Assessment Tools for Quantitative Studies Tool. In next stage, required information was extracted from the studies and results of the studies were reported narratively.
17 articles were eligible to include in review. Study Quality assessment showed that 18% (n: 3) of studies were categorized as high, 59% (n: 10) moderate and 23% (n: 4) low quality. Individual determinants were demographic, psychological characteristics and lack of time. Environmental determinants were social-cultural, physical and economical environments. Related organizational factors were work time and shift, job type, facilities, financial and environmental support.
Individual, environmental and organizational factors play a role in staff’s physical activity. Identifying these factors can be used in health promotion interventions and programs in the workplace.

Musculoskeletal disorders are the most common occupational injuries and constitute a huge global health problem with substantial economic and human cost as well as negative impact on the quality of life. The aim of this study was to determine the prevalence of musculoskeletal disorders and level of risk among the workers of the assembly line of a battery factory.
In this descriptive cross-sectional study performed in 2013, 138 workers aged between 20 and 46 years from assemble line of a battery construction company that have been selected randomly and filled out the NORDIC questionnaire.
Also, for the assessing physical posture during work, RULA method were applied and filled out by researcher. Statistical analyzing were done by SPSS (v.21).
On the basis of the findings of this study majority of the recruited population suffer from upper back 42 Workers(%30.4) and neck pain 36 workers (%26.1) and lower back pain 25 workers (%18.1) then by knee pain 16 workers (%11.6) respectively. Also results of RULA method analyzing showed that risk level score for 31.2, 53.1 and 15.6% of all postures were 4, 3 and 2 respectively.
The prevalence of MSDs in the workers was high. Most of postures are needed to be corrected because of high score in RULA method. Based on the obtained results, the most significant ergonomic problems in workers were found to be awkward postures, manual material handling and back bending and twisting.

Several lines of evidence suggest the role of leukocyte in platelet activation. Since pro-inflammatory mediator CD40 ligand (CD40L) has been considered as a marker of platelet activation that reflecting platelet storage lesion (PSL), we evaluated the effect of leukoreduction processes on thereby the levels of expressed CD40L in Platelet Concentrates (PCs).
In present study PRP-PCs were subdivided into two groups of usual platelets (non-filtered) and leuko-reduced platelets following pre-storage filtration. Using flow-cytometry method, the levels of platelet CD40L expression were analyzed for each group in day 1, 3 and 5 post-storage.
In non-filtered products, CD40L expression on days 1, 3 and 5 after storage were 35±5.06, 62±5.84 and 82±6.1, respectively. CD40L expression showed significant increases in day 3 and 5 after storage compared to day 1 (p This study has demonstrated that pre-storage leukoreduction of PCs can reduce CD40L expression during platelet storage, the finding that suggests the effect of leukocytes in the promotion of PSL. In addition, considering the importance of CD40L in inflammatory function, it seems leuko-reduced platelet products decrease the adverse effects of platelet transfusion especially in susceptible recipients.

Iron is one of most important element of body need during pregnancy that plays a significant role in developing and growth of fetus and safe delivery. Iron deficiency anemia is one of the most common problems of pregnancy that can induce premature labor and can increase risk of fetal mortality, post-partum bleeding and neonatal distress. This study has been conducted to evaluate the prevalence of anemia and some of its related factors in pregnant women whom covered by a health center affiliated to Zahedan University of Medical Sciences -2013.
This descriptive analytic study has evaluated 1194 pregnant woman referred to 3 health centers covered by Zahedan University of Medical Sciences, Iran. In each center one observer interviewed with 56 pregnant women. Hb level and other required information obtained from their family health documents and a special questionnaire that contained 4 parts: demographic data (8 items), maternal data (12 items), nutritional & smoking data (7 items) & Lab data (1 item). All data were analyzed using analytic statistics and Chi square and logistic regression through SPSS v. 19.
Overall prevalence of anemia in this study was 46.6% (in range of 22.2- 71.2). Significant difference was observed among the means of cities (p Comparison between results of this study and other national study- that reported mean prevalence of anemia in pregnant mother 21.5%, it was shown that prevalence of anemia in pregnant mothers of this state (Sistan & Baluchestan) is times of mean of country that maybe is influenced by economic and cultural factors. Thus, there is the need of special attention to safe nutrition program and effort for regular use of supplemental iron and folic acid and avoiding of water pipe and tobacco smoking in this area.

Ideals take foundation for individual action and formed behavior. The purpose of the current study is explanation of women's ideals fertility. In this context, variables, age, independence of women in three dimensions, economic, decision making and mobility, fatalistic attitude to fertility, gender preference, emotional need of child for the older age, the attitude to the economic costs of children, attitudes to comfort parents, attitudes to the nurture of children, number of siblings as a sign of habitus of individuals, wife education and husband education are Selected and were examined their effect on ideals fertility.
This study is a survey. Data collection was conducted through a questionnaire made by researcher. The population statistical is married women aged 15 to 49 in the city of Nasimshar that studied 304 married women aged 15 to 49 to the multi-stage cluster sample in March 2015.
Multivariate linear regressions results indicate that emotional needed of children for older age with control other variables are the greatest impact on women's ideals fertility even the impact of other variables that were significant in the bivariate analysis is also done through this variable. Variables, independent decision making, attitude to the economic costs of children and husband education were variables that with control the other variables held theirs significant. In general, the independent variables could explain 20 percent of variability of the dependent variable.
If policy-makers want to intervention in the fertility to adjust its, should Provide appropriate economic context for families. The emotional needs of the child do not disappear although the sequence of more children reduced by the economic and social changes and that is the context of the continuing fertility and prevent further decline.

Hemoglobin is a protein in red blood cells, and the role of that is to transport the oxygen and carbon dioxide in the blood. This protein has a heme group that is a prosthetic group. Hemoglobin is known as a potent inducer for heme oxygenase enzyme. Also the administration of CO releasing compounds (CORMs) can reduce the neuropathic pain. So this study is based on the assumption that intrathecal administration of hemoglobin can be lead to elevation of CO production and reduction in thermal and chemical pain and inflammation.
The male Wistar rats (200-250 g) were randomly divided into 3 groups included saline treatment, acute treatment of hemoglobin and chronic treatment of hemoglobin (1mg/ml) for 5 constitutive days. Thermal pain sensation was assessed using Tail flick test before and 5 minutes after i.t. injection and responses of chemical pain to sub plantar formalin (2.5%, 5µl) injection were recorded for one hour. Paw volume was measured before treatments and one hour after sub-plantar injection of formalin for inflammatory edema assessment using plethysmometery test.
Results from this experiment showed that acute and chronic i.t. injection of hemoglobin reduced the chemical pain (p Hemoglobin reduces pain sensation and inflammation probably due to increasing the level of CO in spinal cord tissue. This effect was higher in chronic group that is possibly due to the effects of hemoglobin on the heme oxygenase gene expression.

Vitamin D deficiency is a major problem worldwide and it may also play a key role in the pathogenesis of type 2 diabetes. The aim of this study was to evaluate the effect of regular aerobic exercise on plasma levels of 25- hydroxy vitamin D and insulin resistance in hypertensive postmenopausal women with type 2 diabetes mellitus (T2DM).
Twenty sedentary postmenopausal women with T2DM were randomly assigned to control and exercise groups (n=10). Training program consisted of 25-40 minutes of aerobic exercise at 50-70 percent of maximal heart rate, 3 sessions per week for 8 weeks. The levels of 25-(OH) D and fasting glucose and insulin was evaluated by radioimmunoassay and enzymatic colorimetric and ELIZA method, respectively. Insulin resistance was calculated with the HOMA-IR equation. Data were analyzed by paired and independent t tests. The level of statistical significance was set at p˂0.05.
After 8 weeks exercise training, a significant reduction in both systolic and diastolic blood pressure values, fasting glucose, and insulin resistance was seen which was accompanied by markedly increase of 25-(OH)D in hypertensive postmenopausal women with T2DM (p˂0.05).
Regular aerobic exercise can erduce the resting systolic and diastolic blood pressure, glucose, insulin and insulin resistance in postmenopausal women with T2DM and this protective effect of exercise may be related to improved vitamin D deficiency.

Obesity and Overweight decrease plasma levels of ghrelin and obestatin. Studies on the effects of exercise on ghrelin and obestatin, especially in human, are few and limited. The aim of this study was assessing effect of 12 weeks combined exercise (Aerobic-resistance) on plasma levels of ghrelin and obestatin in obese adolescents.
Thirty obese adolescents were willing to cooperate voluntarily; they were randomly divided in two groups: experimental group (BMI 31.046±3.55Kg/m2, BF% 34.74±2.71) and control group (BMI 30.404±3.198Kg/m2, BF% 35.06±2.465). Then, the experimental group received combined exercise program aerobic training consisted of running on a treadmill for 20 minutes at 60-70% of maximal oxygen consumption (VO2max) and (intensity resistance training 70% of one repetition maximum (1RM) for 2 sets of 10 repetitions per movement) for 12 weeks (three sessions per week). The control group received no intervention but were followed. Variables including weight, body fat percentage, BMI, VO2max were measured in both groups before and after exercises. Blood samples were collected in two stages, 48 hours before and after exercise to measure of plasma levels of ghrelin and obestatin. Paired t-test was used for intergroup comparisons and independent t-test was used for comparison between the two groups. All statistical calculations were performed through SPSS software version 19.
The findings showed that values of weight, body fat percentage, BMI performed after 12 weeks of combined exercise (aerobic - resistance) significantly decreased. VO2max, plasma levels of ghrelin and obestatin significantly increased (p We can conclude that 12 weeks of combined exercise (aerobic - resistance) reduced weight, body fat percentage, and BMI; while it increased plasma levels of ghrelin and obestatin.

Bone loss in spinal cord injured patients is common problem. Based on high prevalence of osteoporosis in these patients, this study was designed for the first time to evaluate bone mineral density and related markers in spinal cord injured patients.
Inpatients with chronic spinal cord injury who was referring to the clinic of spinal cord injury research center were recruited. Anthropometric, bone mineral density, serum levels of phosphorus, 25(OH)D, ALP, CTX, osteocalcin, PTH, calcitonin and food intake were evaluated.
There was a significant difference in bone density of lumbar and femoral site groups. Serum level of CTX in male group was significantly higher than femoral group (r=0.23). Time since injury was related positively to T. Score and Z. Score lumbar bone mineral density. Patients who was injured at lumbar level had the highest calcitonin level (p=0.04). Mean intake of calcium was 565.7±270mg/day in female group and 835.3±755mg/day in male group, in both it was lower than the recommended amount.
Our study showed that vitamin D and calcium deficiency are common problem and these patients had different grades of low mineral density.

Job burnout is a term to describe the negative changes in attitudes and behavior of people exposed to work stress. This study aimed to measure the intensity of burnout among rural health workers and to determine its related factors in Northeastern provinces of Iran.
In this cross-sectional study a total of 548 rural health workers (Behvarz) working in medical universities of Shahroud, Sabzevar, Neishabour, Bojnourd and Semnan randomly were selected and investigated through Maslach Burnout Inventory. Data were analyzed using proportional ordered logistic regression and chi-square tests.
Most of the participants (71%) were female and married (90%). 14.6% of the participants were completely satisfied with their income and 7.4% with their essential facilities. Despite moderate satisfaction with their income and essential facilities, more than 75% of the rural health workers were highly interested in their job. The mean score of the intensity of emotional exhaustion, lack of personal accomplishment, depersonalization, conflict and burnout among the participants were 16.9±15.60, 35.5±13.54, 4.8±5.07, 6.1±4.66, and 63.1±25.14, respectively. Significant relationships were observed between burnout and factors including satisfaction with income and essential facilities, interest in job, gender, and place of residence.
Although burnout among rural health workers is low, the intensity of emotional exhaustion, lack of personal accomplishment in health workers with experience of over 10 years is high. The opportunity to transfer high experienced workers to health houses close to city center, and providing the opportunity of continuation of education and academic and job promotion can improve the situation.