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Abstract Background and Objective: Of the most common hypochromic microcytic anemia are iron deficiency anemia and minor thalassemia, which are common in Iran and their differential diagnosis is extremely important. The level of 25-hydroxy vitamin D is the indication of vitamin D blood status. The aim of this study was to compare serum levels of vitamin D in people with minor thalassemia and iron deficiency anemia with healthy subjects in order to investigate the relationship between vitamin D deficiency and iron absorption. Material and Methods: In this case-control study, 24 patients with minor thalassemia, 20 patients with iron deficiency anemia and 24 healthy individuals participated. Groups were matched for age and sex. Testing of Vitamin D level by ELISA, ferritin by quantitative luminescence method and HbA2 by column chromatography was carried out. Results: The number of individuals with low level of vitamin D in iron deficiency group is 15 (75%), in minor thalassemia group is 8 (33/3%) and in the control group 11 (45.8%). Conclusion: In this study, the highest percentage of vitamin D deficiency is observed in cases with iron deficiency anemia. Because of association between vitamin D and anemia, iron and vitamin D supplementation is recommended to enrich the diet. Keywords: Anemia Minor Thalassemia Iron Deficiency Anemia Vitamin D

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Abstract Background and Objective: Iron deficiency anemia is one of the most common nutritional problems in the world. This research aimed at determining the prevalence of iron deficiency anemia in one of the most endangered age group in Baft, Iran. Material and Method: this cross-sectional study was conducted on 325 high school students selected via simple random sampling (165boysand 160girls). The participants with MCV≤ 80µm or MCH ≤ 27 Pg who had simultaneously TIBC ≤ 15 % or Ferritin ≤ 1 5 ng/ml were considered as an iron deficiency anemia. Results: considering MCV and MCH, the prevalence of iron deficiency anemia in girls (14.37%) and boys (2.42%) was significantly different (P <0.05). Conclusion: The prevalence of anemia in high school students of Baft is significantly high in comparison with other studies. To increase students' intellectual and physical performance, Screening and treatment of iron deficiency are recommended. Keywords: Anemia Iron Deficiency Baft Students

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       The paper titled“Comparison of the serum vitamin D level in patients with iron deficiency anemia, beta thalassemia with the control subjects”  was assesesd and the following needs to be explained(1).

Usually , the rational for the research should be explaied in  introduction part. This part is too long and contains unnecessary information which  does not help to address the possible association of vitamin D deficiency, neither with  a genetic condition such as beta thalassemia a minor, nor with  iron deficiency anemia. to address these issues, the writer should refer to  some physiologic or pathophysiologic explanation of the research.

Regarding the design method, I should say that; there is not such a method as “descriptive-analytical cross sectional” design. Cross sectional descriptive researche is  meant to answer epidemiologic questions and have some obligations such as random sampling, which was not the case in this study (2). On the other hand,  analytical studies are designed to find the role of a risk factor in developing an outcome. Case-control studies and cohort  studies are the examples of analytical designs. In this case,  vitamin D deficiency is not the risk factor for neither iron deficiency nor the beta thalassemia. Thus, there is  no reason for selecting such a method. However, an association of two nutritional disorders is well known and is addressed in the discussion of the paper (1). I believe this paper is the result of an irrational sampling.

The sample size should be explained in any research methodology whether the  study is cross-sectional or analytic, but in this article  the sample size  is not rationalized.

Given an important point in analytical researche is the way that confounding variables are being dealt with,  this paper does not mentioned these variables such as job, sun exposure, diet and specially using nutritional supplement are not addressed. However, two important variants of age and gender have been matched (1).

There are a  large number of researche regarding vitamin D deficiency in Iran that are not addressed in this paper. In some of these, the definition of vitamin D deficiency is on the basis of serum parathyroid hormone (PTH) (3). In a systematic review and meta analysis of Heshmat et al. 77% of Iranian population had vitamin D deficiency (4). This high prevalence could be associated with any, even unrelated condition.

Result should be started with introducing the groups including the matched variables such as age and gender. For showing the results, table is better than the the text. without statistical tests and P values, explaining the difference is  not acceptable in scientific writings.

Discussion part of the paper was mostly the repetition of the introduction. I was not convinced by the discussion. It seems that the concept of “association” was confused with " causation" .

Kosarian, M. (MD)

Professor of Pediatrics, Thalasemia Research Center,

Mazandaran University of Medical Sciences, Sari, Iran

            The main objective of this study was to compare the lack of vitamin D or association of iron deficiency anemia with healthy individuals.

the case group were the  patients with iron deficiency anemia and the  two controls  were Thalassemia Minor and  Healthy people.  The Thalassemia Minor Group, in  a microcytic anemia, was similar to the control group. the cause of microcytic is genetic  rather  iron deficiency.

 The Sampling was census.The  participants were the students who have been enrolled in that year; therefore, the Random sampling is not considered.

The design of a research  defines the  type of the study.

The printed research was designed in two categories: Cross sectional study (The Nutritional Target) and Analytic (comparison between the three groups)

Sinct all the participants  were students, the impact of the job, nutrition and… other factors, were the same.

Considering the prevalence of vitamin D deficiency, less than 50 percent, in control group shows that this deficiency could be varied in different groups.

This study basically was designed just to express the association or lack of association of iron deficiency anemia.

As shown in the results and discussion, The amount of vitamin D deficiency in patients with iron deficiency was more than the control group.

Given that Vitamin D deficiency in patients with iron deficiency brings about  Various complications for Growth and health, this study largely emphasizes follow-up of these patients.