Iron Deficiency Anemia During Pregnancy In The Lower North Of Thailand- Prevalence And Associated Factors

This study was to evaluate the prevalence of iron deficiency anemia and the associated factors of anemia during pregnancy in the lower north of Thailand. A prospective study was conducted in pregnant women who attended the antenatal care clinic at Naresuan University hospital, Phitsanulok, from May 2008 - May 2010. All subjects were from the lower northern region of Thailand. A complete blood count and serum ferritin was performed in every case. Anemia during pregnancy was defined according to World Health Organization criterion as the hemoglobin less than 11 g/dL. Iron deficiency anemia was the anemia with a serum ferritin of less than 15 mg/L. Four hundred and one pregnant women were recruited for the study. Teenage pregnancy was 27%. The gestational age at the first visit ranged from 5 to 38 weeks and the iron supplement was found in 30% of cases. Anemia was found in 70 cases (17.5%). Twenty-four cases (6.0% of 401) had iron deficiency anemia but 61 cases were at the stage of iron deficient erythropoiesis without anemia. Associated factor for iron deficiency anemia was gestational age. This study confirmed a high prevalence of anemia and iron deficiency anemia. High proportion of pregnancies with iron deficient erythropoiesis was warranted.

Clinical score and arterial oxygen saturation in children with wheezing associated respiratory illness (WARI).

OBJECTIVES: To determine the correlation between clinical score (based on respiratory rate, chest wall retractions, air entry, wheezing, consciousness and audible wheezing) and arterial oxygen saturation (SaO2: measured by pulse oximetry) as well as the most appropriate total score for predicting hypoxemia (SaO2 < or = 95%) in children diagnosed to have wheezing associated respiratory illness (WARI). SUBJECTS: 70 children (1 month-5 years old) hospitalized in the Department of Pediatrics, Chulalongkorn Hospital with the diagnosis of WARI from January 1, 1996 to December 31, 1996 were studied. Half of them were diagnosed to have acute lower respiratory tract infection (LRI) with wheezing while the remainder had reactive airway disease (RAD). DESIGN: Cross sectional, analytical study. METHODS: In each group of patients, the clinical score and SaO2 were assessed by the same pediatrician throughout the study. The correlation between the clinical signs and SaO2 as well as the cut off point of total score for predicting hypoxemia were analyzed. The sensitivity, specificity and accuracy of that total score in predicting hypoxemia were also calculated. RESULT: In both groups of patients (acute LRI with wheezing and RAD group), the clinical signs correlated with SaO2 were wheezing (rs = -0.67 and -0.47 respectively) and chest wall retractions (rs = -0.57 and -0.59 respectively). Total score was also correlated with SaO2 (rs = -0.68 and -0.5 respectively). The cut off point of total score in predicting hypoxemia was 4 providing 80 per cent sensitivity in both groups with accuracy 74.3 per cent and 80 per cent respectively. CONCLUSION: This clinical score may be used to assess the severity of hypoxemia in WARI patients. Wheezing, chest wall retractions and total score correlated well with SaO2. The total score > 4 was most appropriate in predicting hypoxemia in both children with RAD and wheezing associated with LRI.

Decreased suppressor T-lymphocytes in women who received progestogen injections.

Decreased levels of suppressor T-cells (CD8+) were found in 17 normal women who received progestogen (Depoprovera) injection, 150 mg intramuscularly every three months for contraceptive purposes, for more than 30 months. The helper: suppressor T-cells (CD4+ : CD8+ ratio) was significantly elevated in this group compared to 30 normal female controls. No significant change of T-lymphocyte was found in 53 normal women who received the injection for less than 30 months or who received combined oral contraceptive pills. In conclusion, long term progestogen injection induced a lowering of suppressor T-cell levels, which is the same immunological change found in several autoimmune diseases.