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Blood transfusion service is a vital part of our health care system. Stringent blood donor screening and medical examination plays a vital role in maintaining the quality and safety of blood components. Voluntary non-remunerated blood donors form the backbone of blood transfusion services. However, regular donation by such voluntary donors may cause significant depletion of iron stores in the body. This has the potential to adversely affect the donor's health, and also to lower the quality of blood being collected subsequently. Even though a pre-donation hemoglobin estimation is routinely done in blood centres, it may fail to recognize subclinical iron store depletion. Testing Ferritin level of all donors is not cost effective and practical in resource limited centres. This study was aimed to identify any significant changes in hematological parameters over repeated blood donations, that may point towards a potential Iron deficiency in an otherwise healthy donor. This was a cross sectional study involving 138 whole blood donors who had attended the blood centre, Department of Transfusion Medicine, Government Medical college, Thiruvananthapuram. The study subjects were categorized into 2 groups based on the number of donations and a Complete blood count (CBC) was done for each group. Data was analyzed using SPSS software, quantitative variables expressed as Mean and Standard Deviation, p value <0.05 was considered statistically significant. Results were analysed by Independent Samples T test. Statistically significant variables were further analysed using Kruskal-Wallis test. Second time blood donors constituted major part of sample size (20/138). Mean Hemoglobin value showed no significant change among the two donor categories. Mean corpuscular volume (MCV) of repeat whole blood donors is significantly lower than infrequent donors independent samples T test, tvalue=3.309. (p-value=0.001). Donors were further subdivided into 5 groups in the order of increasing number of donations and significant difference was observed in MCV and proved by Kruskal-Wallis test(H=19.1344) As per our study, a significant reduction in MCV among repeat donors with a normal hemoglobin value compared to infrequent donors. This might point towards an impending Iron deficiency anemia in near future. A prompt detection of subclinical iron deficiency in voluntary blood donors is the need of the hour since it can cause adverse consequences in donor health and can considerably lower the donor availability as well. Blood centres should take measures like routine Iron stores evaluation of regular repeat donors, educating donors regarding the importance of maintaing a healthy diet, Iron tablet supplementation to prevent donor Iron deficiency anemia (IDA) etc.
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Introduction: Good glycemic control has been defined as achieving a target of fasting plasma glucose level of between 80 and 110 mg/dl, or glycosylated haemoglobin (HbA1C) of <7.0%. Poor glycemic control is highly correlated with chronic conditions related to the damaging effects of hyperglycaemia, resulting in serious complications. To restrict and delay the complications of diabetes mellitus, good glycemic control is essential. Objective: To identify the determinants associated with poor glycemic control among Type 2 diabetes mellitus patients. Method: A cross sectional study was conducted among 403 confirmed type 2 diabetic patients who attendedone of the tertiary care hospitals of North India over a period of six months (July- December 2021). The collected data was analysed using IBM SPSS version 28. Chi-square test was applied to compare various determinants of glycemic control. A p-value of <0.05 was considered to be statistically significant. Results: Out of 403 participants, 57.6% had poor glycemic control of diabetic condition. Higher age of participants, illiteracy, being overweight, having positive history of smoking and alcohol, longer duration of diabetes, participants taking both oral and insulin treatment for diabetes, taking medicine irregularly were the significant determinants of poor glycemic control. Conclusion: Higher percentage(57.6%) of poor glycemic control was observed in the study.To improve the glycemic control, efforts should be made towards improving modifiable factors like overweight, smoking, alcohol, regularity of medication etc. Good lifestyle interventions help in control of poor glycemic control.
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Background: Anaemia is prevalent among cases with acute coronary syndrome (ACS) and has been linked to poor clinical prognosis. Guidelines for cases with ST-segment elevation myocardial infarction (STEMI) recommend timely primary percutaneous coronary intervention (pPCI) as the preferred reperfusion strategy. If timely pPCI cannot be performed, a pharmacoinvasive strategy (PI) is recommended within 12 hours of symptom onset. The aim of this work was to study and assess the impact of hemoglobin level as a predictor of MACE and short-term outcomes in cases treated with Primary PCI vs pharmacoinvasive strategy. Methods: This prospective case-control observational study was conducted on 100 cases that were divided into 2 groups. Group I consisted of 50 anaemic cases & group II consisted of 50 cases that were not anaemic. Both groups were subdivided into A subgroups that underwent revascularization by pPCI and B subgroups that underwent revascularization by pharmacoinvasive strategy. Results: There was no significant difference in LVEF, infarct site and final TIMI flow, the anaemic groups showed statistically significant more total MACE than non-anaemic groups whether revascularized by pPCI or pharmacoinvasive strategy. As expected, anaemic cases tended to have higher bleeding complications especially those undergoing pharmacoinvasive strategy. The anaemic cases also were less likely to be discharged on RAAS and beta blockers. Conclusions: Anaemic cases whether revascularized with pPCI or pharmacoinvasive strategy tend to have higher incidence of MACE and major bleeding with no significant difference in mortality. There was no significant difference between LVEF between the study groups.
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Background: The association of combustive emission has been inter-related with haematologic parameters and a likelihoodto pro-inflammatory state. This research is aimed at assessing the impact of vehicular emission on erythrocyte level and red cell indices of occupationally exposed subjects.Methods:The level of haemoglobin concentration, haematocrit, red blood cells, mean cell volume, mean cell haemoglobin, mean cell haemoglobin concentration, and red cell distribution width were determined in four hundred subjects with the aid of Mythic 22 haematology autoanalyser.Results:The comparison of the haemoglobin and haematocrit shows that the value of mean ± standard error value of generator exposed and mechanics respectively were significantly higher than the other groups (p< 0.03). On the otherhand, the red blood cell count for generator exposed and mechanics ranked higherthan the other groups (p< 0.03). The mean cell volume (MCV) of generator exposed and mechanics were 86.57±0.08 fl and 84.49±1.04 fl respectively while control and drivers had values of 93.24±1.13 fl and 93.22±1.13 fl respectively (p< 0.03). The mechanics recorded a mean cell haemoglobin (MCH) of 26.92±0.40 pg which was significantly lower (p< 0.04) than the control (30.37±0.47 pg), generator exposed (39.68±6.38 pg) and drivers (30.42±0.47 pg). Conclusion:The differences amongst the groups and none of the groups were within the medically acceptable ranges which is a pointer to the fact that there might be an underlying inflammatory condition which might be due to occupational exposure
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Con motivo de conocer el estado de salud de poblaciones silvestres de la concha prieta Anadara tuberculosa se estudiaron los parámetros hemocitarios (viabilidad, conteo total y diferencial, estabilidad lisosomal, fragilidad osmótica) y la química sanguínea (hemoglobina-Hb, proteínas, triglicéridos, glucosa, lactato deshidrogenasa-LDH y catalasa-CAT). Se extrajo hemolinfa en reproductores salvajes aparentemente sanos colectados en la isla Corazón, río Chone, Ecuador. La viabilidad celular fue elevada, con presencia de 5 morfotipos: eritrocitos (74%), granulocitos traslucidos (6%), amebocitos (3%), hialinocitos (12%), blastocitos (5%). Los hemocitos presentaron membranas lisosomales estables al rojo neutro durante 240 min y una fragilidad osmótica media (FO50) de 4.8‰. Las concentraciones de Hb, proteínas, lípidos y glucosa denotan la función respiratoria y reservas energéticas durante los cambios de marea. La actividad de LDH está vinculada al metabolismo anaeróbico y CAT a la capacidad de mantener el equilibrio redox del sistema inmunitario. Los parámetros hemocitarios y química de la hemolinfa pueden servir como índices fisiológicos normales de referencia en reproductores de A. tuberculosa.
In this work we studied the health status of wild populations of the black shell Anadara tuberculosa, haemocyte parameters (viability, total and differential count, lysosomal stability, osmotic fragility) and blood chemistry (haemoglobin-Hb, proteins, triglycerides, glucose, lactate dehydrogenase-LDH and catalase-CAT). Haemolymph was extracted from apparently healthy wild broodstock collected from Corazón Island, Chone River, Ecuador. Cell viability was high, with 5 morphotypes present: erythrocytes (74%), colorless granulocytes (6%), amebocytes (3%), hyalinocytes (12%), blastocytes (5%). Haemocytes showed stable lysosomal membranes to neutral red for 240 min and a mean osmotic fragility (OF50) was 4.8‰. Hb, protein, lipid and glucose concentrations denote respiratory function and energy reserves during tidal changes. LDH activity is linked to anaerobic metabolism and CAT denotes the ability to maintain the redox balance of the immune system. The haemocitary parameters and haemolymph chemistry can serve as normal physiological reference indices in A. tuberculosa broodstock.
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Background: The aim is to assess effect of tranexamic acid on haemoglobin level during surgeries around hip.Material & Methods:This was a prospective follow up study conducted in Mahender Reddy Institute of medical sciences, Chevella over a period of two years from June 2020 to June 2022. A total number of 123 patients who underwent hip surgeries by four different surgeons were selected for this study. Proximal femoral nailing (PFN) for intertrochantric fractures by surgeon A, dynamic hip screw (DHS) for intertrochantric fractures by surgeon B, total hip replacements by surgeon C and hemiarthroplasty by surgeon D were included for this study. The patients were grouped as treatment and control group. The treatment group and control group were selected by purposive sampling. In the treatment group, the patients undergoing surgeries around hip joint received single dose of intravenous tranexamic acid 10 mg/kg body weight 10 minutes before skin incision and equal volume of saline was injected in the control group. Intra operative blood loss was calculated by galvanometric method, weighing the sponges used and soiled by blood during surgery and measuring the amount of blood collected in suction apparatus used during the surgery. The haemoglobin level assessed post operatively and compared with preoperative haemoglobin level. The amount of fluid collected in the post-operative drain were also measured. Results:In the treatment group, 11 patients out of 16 had blood loss below 300 ml, and 5 patients had blood loss more than 300 ml. In control group 5 patients out of 15 had blood loss below 300 ml. 10 patients had blood loss more than 300 ml. Among the 25 patients of hemiarthroplasty group, 11 out of 13 patients of treatment group had drain below 100 ml on the first post operative day. In control group only 2 patients out of 12 had drain less than 100 ml. In DHS group, in the treatment group, 10 out of 11 patients had preoperative and post operative haemoglobin difference less than 1mg/dl. In control group, 12 out of 12 patients had preoperative and post operative Hb difference more than 1mg/dl.Conclusions:Tranexamic acid administrated before surgical incision is efficient in reducing bleeding during common surgeries around the hip joint. Especially surgery where more amount of blood loss was expected, like total joint replacement and hemiarthroplasty, the drug had shown significant benefit compared with the control group.
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Aim:This study aimed at evaluating the deferral pattern among blood donors, in order to draw out lessons that will help canvass for a strengthened policy framework and encourage better outcomes in voluntary blood donation. Study Design:This was a retrospective study. Place and Duration of Study:All the data were sourced from the central database of donors, as recorded by the Haematology Department of Babcock University Teaching Hospital Ilisan-Remo, Ogun state, Nigeria. The data used spanned through a period of 5 years, from 2017 to 2021. Methodology:A total of 7,362voluntary and non-remunerated blood donors were included in this study. Their records were accessed and used for the study. Data were analysed using SPSS version 25. The level of statisticalsignificance was set at P < 0.05.Results:In this study, half (50.2%) of the entire population of volunteers were between the ages of 18 and 30 years while only 3.7% of them were between 51 and 60 years of age. There were more male volunteers for blood donation compared to the females who only represented 10.8% of the population. 61% of the voluntary donorswere accepted for blood donation while 39% were regarded as unfit and hence, deferred. The 3 main reasons for deferral in this study were inadequate hemoglobin (54.7% of deferral cases), unmatched blood group (30.9%) and transfusion transmissible infections (14.4%). Age and gender had a statistically significant (P < 0.05) relationship with the pattern of deferral of the volunteers. Conclusion:The high deferral rate observed in this study may reveal an urgent need for a community-based intervention and targeted efforts by necessary agencies to help improve the general health status of possible future voluntary blood donors.
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Background & objectives: Sickle cell disease (SCD) constitutes frequently inherited haemoglobin disorders and poses a significant health burden in India. Hydroxyurea (HU), the most commonly used drug, has shown promising results in the clinical management of SCD. The present systematic review was undertaken to assess the efficacy and toxicity of HU in Indian sickle cell patients. Methods: A systematic review of studies on HU therapy was conducted to identify the application of HU and its outcome(s) across India. PubMed, Scopus and Cochrane Library was used as data sources for various studies on the efficacy and toxicity of HU therapy for treatment for SCD in India published between January 2001 and October 2021. Two authors independently extracted the data on study design, patient characteristics and therapeutic outcomes of HU in order to determine the study quality of the present review. Results: Overall, 14 studies were included for a systematic analysis. Of these 11 were prospective, two cross-sectional and one double-blind randomized controlled trial. Low-dose HU (10 mg/kg/day) was found to reduce the rates of vaso-occlusive crisis and hospitalization as well as decreased the requirement of blood transfusion in SCD patients. The foetal haemoglobin (HbF) level was recorded in 13 (80%) studies all of whom reported an elevation in the HbF levels, with a mean increase in per cent HbF from 15.8 to 21.4 per cent across studies. The common adverse events were reversible, mild-to-moderate cytopenia and anaemia. Interpretation & conclusions: The findings of the present review suggest that there is still insufficient information presently to determine the long-term or major adverse effects on organ damage, fertility as well as pregnancy on the use of HU therapy for SCD. Long-term multi-centric studies are thus required to address these problems.
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Background Gestational Diabetes Mellitus [GDM] is de?ned as Carbohydrate intolerance with recognition or onset during pregnancy and resolves postpartum. Prevalence of GDM in India varies from 3.8 - 21% with different demography and diagnostic methods used. As early diagnosis and control of maternal hyperglycaemia plays a vital role in prevention of adverse outcomes, universal screening is almost mandatory due to high prevalence, we need a simple economical, feasible test with higher sensitivity to diagnose GDM. To compare diagnostic accuracy of two non- Aim fasting tests DIPSI & HBAIC and fasting WHO criteria for diagnosis of GDM. To compare DIPSI with WHO criteria as Objectives standard. To compare HBA1C with WHO criteria as standard This study was done on 100 ANC cases to compare Results: diagnostic accuracy of DIPSI & HBAIC with fasting World Health Organization Glucose Tolerance Test. Mean age of participants was 27.18±4.60 years. 39% patients were in age group of 21 to 25 years and 34% patients were in age group of 26 to 30 years. Majority (45%) of the patients were in gestational age of 26 to 30 weeks. In this study, gestational diabetes mellitus was diagnosed in 47 (47%) patients according to WHO GTT, in 48 (48%) patients according to DIPSI and in 34 (34%) patients according to Glycated Haemoglobin. Mean gestational age of patients during diagnosis of gestational diabetes mellitus was 29.21±2.84 weeks by DIPSI, 28.83±2.82 weeks by WHO GTT and 29.29±3.15 weeks by Glycated Haemoglobin. Mean blood sugar parameters of gestational diabetes mellitus women were 174.96±16.58 mg/dl by DIPSI, 173.21±17.58 mg/dl by WHO GTT and 9.41±1.91 gm% by Glycated Haemoglobin. The sensitivity of DIPSI with regard to WHO GTT was 89.36%, speci?city 88.68%, positive predictive value 87.50%, negative predictive value 90.38%, diagnostic accuracy 89.00% and chi square value of 60.78. These values convey that DIPSI is as good as gold standard WHO GTT criteria. The sensitivity of Glycated Haemoglobin with regard to WHO GTT was 51.06%, speci?city 81.13%, positive predictive value 70.59%, negative predictive value 65.15%, diagnostic accuracy 67.00% and chi square value of 11.51. These values convey that Glycated Haemoglobin is not as good as gold standard WHO GTT. Based on ?ndings from this study it can be concluded that DIPSI is Conclusions: equally as good as World Health Organization Glucose Tolerance Test criteria in diagnosing gestational diabetes mellitus in antenatal women of south India. Since DIPSI does not require fasting it is more feasible than World Health Organization criteria. Glycated haemoglobin estimation is another test to detect diabetes mellitus which does not require fasting however its results are not close to gold standard WHO criteria unlike DIPSI
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Background: Anemia is a common complication in chronic kidney disease (CKD), and is associated with a reduced quality of life, and increased morbidity and mortality. The mechanisms involved in ananaemiassociated with CKD are diverse and complex. They include a decrease in endogenous erythropoietin (EPO) production, absolute and/or functional iron deficiency, and inflammation with increased hepcidin levels, among others. Objective: The objective of our study was to investigate the prevalence and severity of anaemia in pre-dialysis patients, and chronic kidney disease patients in Bangladesh.Material & Methods:This was a case-control prospective study conducted with over 300 Bangladeshi non-patients as the control group A and 87 with different stages of chronic kidney disease (CKD) patients as the case group B in the department of Nephrology BSMMU from April’2004 to June 2006. The normal people who had no history of diabetes mellitus, hypertension, or CKD and were not on any medication were controlled and different stages of the CKD patients who had no history of blood transfusion, erythropoietin and parental iron infusion were cases.Results:Out of 300 normal populations male was 158(52.7%) and the female was 142(47.3%) and the mean haemoglobin level of the male was 13.94 g/dl and the female was 12.29 g/dl. Among males 24(15.2%) and females 55(38.7%) were anaemic and the overall prevalence of anaemia was noted at 26.3%. Of the total anaemic people, 25% was microcytic anemia. Out of 87 CKD patients, 56 (64%) were male and 31 (36%) were female. The overall prevalence of anaemia in CKD patients was 95.4%. The haemoglobin level was <11g/dl in 57.14% patients with CCr 30-59 ml/min/1.73m2 which increases to 87.5 % in patients with CCr 15-29 ml/min/1.73m2, which also increases to 94.2 % in patients with CCr<15 ml/min/1.73m2. Mean haemoglobin was observed at 8.6 g/dl, 9.54 g/dl and 11.25 g/dl in stage V, stage IV and stage III CKD patients respectively. Anaemia appeared at 43.53 ml/min/1.73 m2 of CCR.Conclusions:The results demonstrate that patient with reduced renal function is more likely to have anaemia and the prevalence and severity of anaemia increase with declining kidney function. CCr and TSAT is the important predictor of anaemia. In a significant number of the CKD, patient anaemia was associated with iron deficiency.
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Background :The common cold and flu syndrome primarily affects the upper respiratory tract, along with a low fever and some systemic symptoms such as sore throat, cough, nasal decongestion, headache, and so on. Several clinical studies have shown that combining analgesics, antihistaminics, and decongestants provides better symptom relief in the common cold. The current post-marketing surveillance study was designed to look into the safety and efficacy of commercially available Flucold Drops in the Indian population. Methodology :A current prospective, single arm, multicenter, post-marketing clinical study included 224 subjects, 220 of whom completed the study. All patients were given Flucold Drops for three days and then monitored for the next six days. During the study, the incidence of adverse events (AE) and serious adverse events (SAE) was assessed. The efficacy of the Flucold Drops was evaluated using VAS score changes from the beginning to the end of the treatment. The product’s safety was also evaluated using blood biomarkers such as haemoglobin, platelet count, SGOT, SGPT, and creatinine level. Results : Results show the reduction in symptomatic score of common cold and flu syndrome observed after 2rd follow-up visit (0.202+0.325 to 0.139+0.231). During the study, no intervention-related adverse events were observed. Furthermore, no Serious Adverse Events (SAE) were observed in the study or follow-up period. The study found no changes in the levels of blood biomarkers (haemoglobin, platelets, SGOT, SGPT, and creatinine). Conclusions : Flucold Drops are safe and effective in the treatment of common cold and flu syndrome in Children and infants.
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Glycated Haemoglobin (HbA1c) gives a measure of long term Glycemic control. However, how the values of HbA1c affects the outcome in various comorbidities and its effect on the short term and long term outcome of these comorbidities remains a matter of Grey Zone. Cardiovascular Diseases, Chronic Kidney Disease, Anemia, Chronic Liver Disease etc, can alter the interpretation of HbA1C level, where it may not reflect the appropriate Glycemic control. Hence this review is done to look for the evidence and appropriateness of HbA1c as Diagnostic and Prognostic marker for Glycemic control in various clinical scenario.
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Comparative observational study was carried out on the prevalence of malaria among pregnant women attending antenatal clinics in General Hospital, Bori (GHB) and Braithwaite Memorial Specialist Hospital, Port Harcourt (BMSH). Four hundred women were involved in this study of which two hundred per study location. Pregnant women with pyrexia of unknown origin, HIV and those on anti malarial drugs were excluded. Consents were obtained from participants and confidentiality upheld. Ethical approval was obtained from the ministry of health and from the selected health facilities. Sample collection was performed according to the recommended reference guideline for phlebotomy. Collected samples were used to assay for Haemoglobin using cyanomethamoglobin method, and malaria parasite using the Giemsa staining technique. Statistical analysis was performed for percentage, frequency, for descriptive statistics and inferences deduced at p-value=0.05. All statistical analyses were performed using Statistical Package for Social Sciences. Questionnaires were issued to obtain their demographic data. The prevalence of malaria was high among pregnant women with haemoglobin level 8.0–10.9g/dl from BMSH (17.9%) and GHB (35.9%). Infection was not dependent on locality at P-value < 0.05. Awareness of malaria in pregnancy should be supported. Anaemiain pregnancy should be treated and comorbidity of malaria and anaemia in pregnancy should be handled with urgency.
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Background: Dyslipidemia is one of the common conditions associated with poor glycemic control in Type 2 diabetes mellitus (T2DM) patients. It is associated with an increased risk of cardiovascular disease which is the leading cause of death in these patients. Glycated Hemoglobin (HbA1c) is the gold standard test for monitoring glycemic control. Thus, the level of HbA1c could potentially be utilized as a possible biomarker for predicting the risk of dyslipidemia. However, there is a discrepancy in the data available till now regarding the relationship between HbA1c and the lipid profile. Hence, it requires further studies. Aim and Objectives: The present study was conducted to assess the role of glycemic control (as indicated by HbA1c level in blood) on lipid profile of patients with T2DM. Materials and Methods: This was an analytical cross-sectional study done over a period of 5 months. Total 165 participants were randomly selected from out patient department OPD of which 138 were diagnosed cases of T2DM and 27 were age and sex-matched non-diabetic healthy individuals. Patients of T2DM were sub grouped based on American Diabetic Association Criteria (2013) as having either controlled diabetes with HbA1c ?7% or uncontrolled diabetes with HbA1c >7%. Blood samples collected from all the participants were analyzed for HbA1c and lipid profile using standard methods. The collected data were analyzed with Statistical Package for the Social Sciences software using appropriate statistical method. Results: In the present study, we found a significant positive correlation between HbA1c and total cholesterol, Triglyceride, Low-density lipoproteins, and very low-density lipoproteins (P < 0.01) though high-density lipoprotein was not significantly correlated with HbA1c level. Conclusion: We concluded that apart from a reliable index of glycemic control, HbA1c can also be used as a predictor of dyslipidemia in T2DM patients, and thus regular monitoring of it can help us to reduce the mortality of these patients.
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@#Introduction: The high prevalence of chronic energy deficiency (CED) and anaemia among pregnant women in Indonesia is worrying. Nusa Tenggara Timur (NTT) is one of the provinces in Indonesia with the highest prevalence of CED. This study aimed to determine the effect of fortified milk supplementation on changes in mid-upper arm circumference (MUAC) and haemoglobin level among pregnant women. Methods: This quasi-experimental study was conducted in three locations of Community Health Centers in NTT from May to August 2019. Purposive sampling was used to recruit 69 pregnant women who were divided into two groups based on haemoglobin levels; the intervention group consisted of 31 pregnant women with haemoglobin levels below 11 g/dL, and control group consisted of 38 pregnant women with haemoglobin levels above 11 g/dL. Intervention group was provided with fortified milk supplementation, while control group received education about prevention of CED and anaemia. Data were analysed using regression discontinuity design with haemoglobin of 11 g/dL as cut-off. Results: Using regression discontinuity method, we were able to determine the effect of milk supplementation based on haemoglobin levels and confirm the result that milk supplementation significantly increased MUAC by 4.69 cm. Despite no discontinuity found, a positive increase of 0.98 g/dL in haemoglobin level was important to note. Conclusion: Milk supplementation of 300 kcal/day for three months significantly increased MUAC and to some extent, increased haemoglobin level. Thus, it should be considered when planning nutrition programmes to improve the nutritional status of pregnant women.
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@#Alpha (α)-thalassaemia is a common genetic disorder worldwide caused by the deletion and rarely non-deletional mutations of the α-globin gene. Nearly 70 types of non-deletional mutations have been reported worldwide, and this review focuses on the common ones affecting α-thalassaemia patients. The common mutations are initiation codon mutation, codon 30, haemoglobin (Hb) Constant Spring, Hb Quang Sze, Hb Adana and Hb Evora. The haematological parameters of non-deletional mutations usually show mild changes. However, a severe reduction in haemoglobin level, mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV), and mean corpuscular haemoglobin count (MCHC) has been observed among compound heterozygous HbH disease, involving both deletional and non-deletional mutations. Although non-deletional mutations are rarely reported, it requires the study of more cases to understand the clinical phenotypes that lead to severe clinical manifestations.
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Background: Anaemia in pregnancy is a known public health problem in South Africa. Maternal, perinatal morbidity and mortality are known to be associated with anaemia in pregnancy. Very little is known from literature with regards to the progression of anaemia during the antenatal period of pregnancy. Objectives: To estimate haemoglobin levels, the prevalence and determinants of anaemia at different gestational ages and to show the trend. Method: A retrospective cohort (follow-up) study was conducted using the antenatal clinic register. Prevalence rates of anaemia (haemoglobin < 11 g/dl) at different gestational ages were measured. Factors associated with anaemia were assessed using chisquare test and stepwise multivariate logistic regression analysis. Results: A total of 801 pregnant women were enrolled at the booking visit and followed-up during their antenatal period. The prevalence of anaemia at the booking visit was 37%. The prevalence of anaemia at 20, 26, 32 and 36 weeks of gestation were 36.6%, 39.6%, 39.8% and 29.2% respectively. Binary logistic regression at the booking visit showed that teenage women were 2.5 times more likely to have anaemia (OR=2.5, p=0.005) than older women. Women who booked during the first trimester were 60% less likely to have anaemia (OR= 0.40, P=0.005) at the booking visit and 62% less likely to be anaemic at 36 weeks of gestation (OR=0.38, p=0.013) compared to those who booked late for antenatal care. Conclusion: Prevalence of anaemia during pregnancy was high. Early booking for antenatal care was a predictor for lower rate of anaemia. Thus, health education strategy should be encouraged for early antenatal booking
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Prenatal Care , Hemoglobins , Pregnancy , Anger Management Therapy , Anemia, Aplastic , South Africa , PrevalenceABSTRACT
Background: Diabetes mellitus is a chronic and progressive endocrine disorder that may result in macro and microvascular complications. Objective: This study assessed some biochemical analytes in Nigerians who were recently (≤ 6 months) diagnosed with Type 2 diabetes mellitus (T2DM). Methods: 160 T2DM and 90 non-diabetic control participated in this study. Blood samples were collected and analyzed for Heart-type fatty acid-binding protein (HFABP), high sensitivity C-reactive protein (hs-CRP), electrolytes, lipid and renal profile parameters, glycated haemoglobin (HBA1C) and fasting blood glucose (FBG), using standard guidelines. Result: The body mass index (BMI) of the T2DM volunteers was higher than control (P <0.001). The lipid profile, potassium, glucose, HBA1C, urea and creatinine values were elevated (P <0.001) while estimated glomerular filtration rate (eGFR) was lower (P<0.05) in diabetes. The median HFABP and hs-CRP were raised (P <0.05) in T2DM. Positive associations existed between FBG and urea (P <0.001), Creatinine and HBAIC (P <0.001). A logistic regression analysis, shows that an increased BMI, HBA1C, FBG, Cholesterol, urea and creatinine were associated with higher odds (p<0.001) of cardiovascular and renal complications. Conclusion: Elevated hs-CRP, glycated haemoglobin, urea and creatinine among T2DM increase the odds of cardiovascular and renal insults in this population
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Glycated Hemoglobin , Diabetes Mellitus, Type 2 , Renal Insufficiency, Chronic , C-Reactive Protein , NigeriaABSTRACT
Objectives: This study aimed to determine the effects of family-integrated diabetes education on diabetes knowthe ledge of patients and family members, as well as its impact on patients' glycosylated haemoglobin (A1C). Design: The design was a two-group Pretest Posttest quasi-experimental. Setting: The study took place at the diabetes clinics of two tertiary hospitals in southwestern Nigeria. Participants: People Living with Diabetes (PLWD) and family members aged 18 years and over and without cognitive impairment were placed, as clusters, into either a control group (CG) or an intervention group (IG) The CG comprised 88 patients and 88 family members while IG comprised 82 patients and 82 family members. Of these, 78 and 74 patients completed the study in CG and IG, respectively. Interventions: PLWD in IG along with their family members were given an educational intervention on diabetes management and collaborative support with an information booklet provided. This was followed by three (3) complimentary Short Messaging Service (SMS). Main outcome measures: A1C and diabetes knowledge. Results: Over half (52.4%) and about a fifth (18.2%) of family members and patients, respectively, had never had diabetes education. There was a statistically significant increase in the knowledge of patients and family members in IG. Unlike CG, the A1C of patients in IG improved significantly at three and six-month post-intervention, (p<0.01). Regression showed an independent effect of family members' knowledge on IG's A1C. Conclusions: Improved family members' diabetes knowledge positively impacted patients' glucose level. There is a need to integrate family members into diabetes care better
Subject(s)
Humans , Family , Hemoglobins , Diabetes Mellitus , Patient Medication Knowledge , KeratinsABSTRACT
Objectives: This study aimed to determine the effects of family-integrated diabetes education on diabetes knowthe ledge of patients and family members, as well as its impact on patients' glycosylated haemoglobin (A1C). Design: The design was a two-group Pretest Posttest quasi-experimental. Setting: The study took place at the diabetes clinics of two tertiary hospitals in southwestern Nigeria. Participants: People Living with Diabetes (PLWD) and family members aged 18 years and over and without cognitive impairment were placed, as clusters, into either a control group (CG) or an intervention group (IG) The CG comprised 88 patients and 88 family members while IG comprised 82 patients and 82 family members. Of these, 78 and 74 patients completed the study in CG and IG, respectively. Interventions: PLWD in IG along with their family members were given an educational intervention on diabetes management and collaborative support with an information booklet provided. This was followed by three (3) complimentary Short Messaging Service (SMS).Main outcome measures: A1C and diabetes knowledge. Results: Over half (52.4%) and about a fifth (18.2%) of family members and patients, respectively, had never had diabetes education. There was a statistically significant increase in the knowledge of patients and family members in IG. Unlike CG, the A1C of patients in IG improved significantly at three and six-month post-intervention, (p<0.01). Regression showed an independent effect of family members' knowledge on IG's A1C. Conclusions: Improved family members' diabetes knowledge positively impacted patients' glucose level. There is a need to integrate family members into diabetes care better.