Razi Journal of Medical Sciences

---

  Background : Febrile convulsion (FC) is one of the most common seizure disorders in childhood period. Some trace elements such as magnesium may contribute in pathogenesis of FC. The aim of our study was to compare serum level of magnesium in children with FC and febrile patients without seizure.

  Methods: This prospective, case – control study included two groups of patients with 6-60 month of age with FC and fever without seizure respectively .Forty – seven cases were enrolled in each groups. The serum levels of magnesium were measured by spectrophotometery. Data were analyzed by T-test and Chi-square.

  Results: Mean age of cases with FC and febrile patients without seizure were 26.3±18.99 and 23.28±19.11 months respectively .There were 24 male and 23 female in FC group , 26 male and 21 female in another group. The mean age and sex distribution were similar in these two groups.

  Mean levels of magnesium were 1.96±0.28 mg/dl and 2.15±0.24mg/dl in cases with FC and febrile patients without seizure respectively and there was a significant difference (p= 0.001). The magnesium level was significantly lower in FC patients.

  Conclusion: In our study Serum level of magnesium was lower in FC group in comparison with patients with fever but without seizure. .Magnesium may play an important role in producing seizure in febrile children. In future the use of supplemental magnesium may prevent febrile seizure.

---

Factor XIII deficiency is a bleeding disorder that its prevalence in the general population is about 1 in 2 million people around the world. In Iran, the high rate of consanguineous marriages lead to high rate of disorder with 473 factor XIII deficient patients that is about 12 times higher than the global Prevalence of disorder. The study, is a comprehensive review of all aspects of factor XIII deficiency in Iran. The distribution of the disease in different parts of Iran shows that the province is not only the largest number of patients with factor XIII deficiency in Iran, but also the world's highest incidence of the disease has been reported in this area. In Iranian patients, bleeding from the umbilical cord ,hematoma, prolonged bleeding are the most common clinical presentations. Several disease-causing mutation in Iranian patients with the most common mutation factor XIII deficiency that Trp187Arg southeast of Iran. Traditionally, patients with factor XIII deficiency treated with fresh frozen plasma or cryoprecipitate in Iran until 2009, that factor XIII concentrates for the treatment of patients became available. Several studies on the efficacy and safety of prophylactic regimes in different situations with valuable findings have been evaluated.

---

Background: Seizure is a transient occurrence of signs or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. Seizures are described as sudden abnormal neuronal discharges that are clinically manifested by behavioral, autonomic, motor, and sensory disturbances. Seizure is the most common neurologic problem in children. On the other hands, the most common nutritional problem in developing countries is iron deficiency. Due to the high incidence of seizures in children and its role in causing mortality and morbidity in this age group, recognizing and controlling the factors affecting seizures can have a significant impact on reducing mortality and morbidity. After the first seizure of unknown origin in children the risk of recurrence is about 50% and after the second seizure of unknown origin, the risk of recurrence is 80% epilepsy may be diagnosed only after a child has had two or more seizures of unknown origin over a period of more than 24 hours. The term of unknown origin implies that there was no close association between seizures and disease, electrolyte disturbances, fever, or acute brain injury. On the other hand, the most common microelement deficiency is iron deficiency, which affects at least 1.3 percent of the world's population. The most common clinical manifestation of iron deficiency is anemia, but other organs may also be affected. The possibility of lowering the seizure threshold and increasing the risk of seizures by anemia has been investigated in many studies in patients with febrile seizures, but A few studies has pointed to association between iron deficiency and the first unprovoked seizure without fever. Also the results of these studies are controversial. The effects of iron deficiency in an evolving brain include: changes in the evolutionary mechanism of hippocampal neurons, impaired energy metabolism, delayed myelin maturation, decreased visual and auditory stimulus potentials, and changes in synaptic neurotransmitter systems including norepinephrine, dopamine , Glutamate, GABA (gamma aminobutyric acid) and serotonin, which can cause iron deficiency symptoms. The results of some studies have shown that iron deficiency may increase the seizure threshold because iron lipid peroxidation by the brain can lead to seizures. In addition, the uptake and release of dopamine, gamma-aminobutyric acid, and other neurotransmitters by cell membranes can be affected by iron. Therefore, the seizure threshold increases following iron deficiency. Iron deficiency anemia reduces the activity of excitatory neurotransmitters such as monoamine oxidase and aldehyde oxidase, resulting in neuronal stimulation and a lower risk of seizures. Research on the relationship between iron deficiency and seizures has shown conflicting results regarding iron status in children with febrile seizures and non-febrile seizures due to the high prevalence of iron deficiency anemia and Due to the effects of anemia and the possibility of its effect on the occurrence of seizures in children this study was carried out to determine the relation of iron deficiency anemia with first unprovoked seizure
Methods: This study is a case-control study. The study population included 172 children aged 3 months to 16 years old who referred to the neurology clinic of Hazrat Ali Asghar (AS) Children's Educational and Medical Center in Tehran Sciences due to their first afebrile seizure during 2017-2019. Samples were divided into case and control groups based on the reason of hospitalization Control group included of 86 children (3month-16years old) referring for other causes to this center from 2017-2019. Non-febrile seizures based on clinical manifestations in the form of cyanosis, rotation of the head or eyes, clonic movements of the seizure in the face or limbs, a sensory disturbance such as paraesthesia or localized pain in a specific area, increased tone or stiffness, loose or decreased movements, stiffness and Rhythmic muscle relaxation is defined as a disorder or lack of consciousness without fever before and after a seizure. All selected cases were infants and children with non-febrile seizures for the first time in which there were no underlying problems.The children with fever or any type of chronic systemic disease (cardiac, renal, metabolic, confectious) and the children with the history of using drugs or blood iron transfusion for treatment of anemia were excluded. Cell blood count (CBC), Serum ferritin, iron and total iron binding capacity (TIBC) were measured in all of children. Iron deficiency anemia was diagnosed by the values of CBC, ferritin, serum iron and TIBC based on the Nelson text book of pediatrics.To analyze the data, descriptive analysis including statistical indices of frequency, frequency percentage, mean and standard deviation was used. Also for analytical analysis, demographic findings and mean hemoglobin and ferritin were compared between the control and case groups. Data were analyzed by chi-square and independent T-test and SPSS 22 software and the significance level was considered less than 0.05.
Results: From 172 participants, 73 (%42 ) were girls and 99 (%57) were boys, the average age in case  group was 6.4±3.75 years old, and in control group was 5.79 ±3.65 years old. From 86 patients with seizure 34 (%0.39) were girls and 52 (%0.60) were boys. In case group serum iron average was 55.1±28.4 µg/dl. Hb in 24 persons (%27.9) and ferritin in 14 persons (%16.3) was in the lower limits of normal. In the control group serum iron average was 51.8±25.79 µg/dl. Ferritin in 20 persons (%23.3) and Hb in persons (%27.9) was in the lower limits of normal. In the case group14 persons (%16.3) and in the control group 20 persons (%23.3) had iron deficiency anemia .the difference statistically was meaningless. (P value >0.05)
Conclusion: In this study, the prevalence of iron deficiency anemia in the group with the first febrile seizures of unknown origin was not higher than the group referring to other causes.There was no statistically significant differences between the first unprovoked seizure without fever and iron deficiency anemia in our study. However the more comprehensive studies should be done in this regard.

---

Background & Aims: Women's employment is one of the most important issues of gender equality and essential for economic development. Which has been accompanied by a significant growth in the social status of women in society (2). However, most working women face a number of challenges with the pressures of work and housekeeping that can be affected by the type of job and its demands (7).
Women in different occupations are viewed in such a way that among the general public, characteristics such as sensitive and affection are related to the feminine gender role schemas, and characteristics such as aggression and courage are related to the masculine gender role schemas. Comparatively, it has led to the presence of men in high-powered social roles (management and politics) and the presence of women in low-power social roles (education and care) in jobs (10).
On the other hand, women's employment in traditional masculine occupations such as politics exposes them to double anxiety, which is rooted in gender stereotypes and hinders the promotion of women's success in these occupations and endangers their mental health (20). However, according to the World Health Organization statement (2015) on the reduction of psychosocial and occupational stress by 2020, it seems that a full understanding of the mental health of occupational workers, especially women, is necessary (24). So, considering the importance of the role and position of women in the family and society, it seems that employment in occupations that are considered masculine in terms of gender stereotypes can affect the gender role schemes and mental health of women working in these occupations. Therefore, the researcher seeks to answer the question of whether there is a difference between mental health and gender role schemas in women working in political and non-political governmental organizations?
Methods: The present study is a quantitative study. To conduct this research using the formula "Comparison of the average of two societies" among all women working in political governmental organizations(included: Khorasan Razavi Governor's Office, Mashhad Governor's Office, Representation of the Ministry of Foreign Affairs in the North and East of the Country)and women working in  non-political governmental organizations (included: Education, University of Medical Sciences, Welfare and…) in Mashhad in 2020, 114 women working in the political systems and 384 women working in the non-political systems , were selected as a sample. Then Bem sex role inventory (including 30 questions and 3 subscales) and Goldberg general health questionnaire (including 28 questions and 4 subscales) were distributed and collected among the samples. Finally, Kolmogorov-Smirnov and independent t-tests were used to analyze the data.
Results: The results showed that there was a statistically significant difference between the two groups of women working in political and non-political governmental organizations in
terms of the mean score of the masculine gender role schemas (p = 0.001). However, there were no significant difference between the two groups of women working in political and non-political governmental organizations in terms of the mean score of feminine gender role schemas and social desirability scale (p>0.05) (Table 1).
It was also found that there were a significant difference between the two groups of women working in political and non-political governmental organizations in terms of the mean total score of mental health and the subscales of physical symptoms and anxiety and insomnia (p<0.05). But there were no significant difference between the two groups of women working in political and non-political governmental organizations in terms of mean scores of social dysfunction and depression (p>0.05) (Table 2).
Conclusion: The results showed that there were no significant difference between the two groups in terms of mean scores of feminine gender role schemas and social desirability scale. However, the average score of the masculine gender role schemas in women working in political governmental organizations is significantly higher than women working in non-political governmental organizations.it seems that though women's employment and changing their social role from housekeeping to bread-winner in the community and family have been accompanied by increasing independence, self-confidence and strengthening masculine  gender characteristics in both groups of women working in political and non-political governmental organizations, However, women's employment in political governmental organizations that are not commensurate with their gender role (compared to women working in non-political governmental organizations, which is more commensurate with the feminine gender role of women), has further strengthened the reciprocal behaviors of gender stereotypes and the masculine gender role schemas.
On the other hand, it was found that women working in non-political governmental organizations have significantly better mental health status than women working in political governmental organizations. It seems that most women working in masculine jobs, receive less support from men due to their limited number of them in these jobs and their lower control and decision-making power, which can greatly affect their mental health.Whereas, women working in feminine jobs often receive more support from both groups of women and men working in these workplaces due to higher control and decision-making power, and therefore, have a better mental health status (35).