Maternal Anemia and its Effect on Cord Hemoglobin.

Background: Maternal anemia is a common problem during pregnancy and it can lead to adverse consequences in both the mother and the fetus. Aim of study: To determine the effect of maternal anemia on fetal cord blood hemoglobin. Materials and Methods : The study was conducted over a period of one year in Gian Sagar Medical College and Hospital, a rural medical college near Chandigarh. A total of 248 pregnant women in labour were included in the study. 108 of the women were anemic with hemoglobin of less than 11g/dl. 138 women had hemoglobin more than 11gm/dl and they formed the control group. After delivery of the baby, the cord was clamped and divided. Blood for hemoglobin assessment was taken from the cord and sent for analysis. The results of cord hemoglobin were compared between the two groups. Results: Cord blood hemoglobin was lower in neonates born to anemic mothers as compared to non anemic mothers.

Nutritional Anemia in the Medical Students.

Background: Nutritional anaemia is very much prevalent and largely undiagnosed among students in Professional Institutes. Various socio-demographic characteristics like age, sex, social class, dietary habits, and infections are the etiological factors for nutritional anaemia. Objectives: To study the nutritional anaemia and its correlates among the MBBS. Medical Students of Rohilkhand Medical College and Hospital, Bareilly in Western U.P. Materials and Methods: The study was done on 100 MBBS students. Haemoglobin estimation was performed by Sahli’s Haemoglobinometer and observations were interpreted as per the WHO criteria. The data was analyzed by SPSS Statistical software. Results: In the present study on 100 Medical students, 32.0% students were anaemic, out of which 44.0% were girls and 20.0% boys. 25.0% students had mild anaemia. Majority (81.8%) of anaemic students were undernourished as per their Body Mass Index. Conclusions: Haemoglobin estimation of students at the time of entrance to Medical Colleges should be done. Iron and folic acid tablets and deworming drugs in therapeutic doses should be provided to anaemic students. The students should be motivated and educated to take balanced diet, rich in green leafy vegetables and fruits as nutritional anaemia is totally preventable.

Dialysis adequacy and kidney disease outcomes quality initiative goals achievement in an Iranian hemodialysis population

We conducted this study to measure hemodialysis adequacy and determine to what extent some Kidney Disease Outcomes Quality Initiative [KDOQI] goals are achieved in our patients. In a cross-sectional study in Pars province, Iran, we assessed 632 patients on hemodialysis in 15 dialysis centers. The Kt/V was calculated, and data on serum levels of albumin, cholesterol, and triglyceride, hemoglobin level, blood pressure, body weight, and body mass index were collected. The values were compared with the KDOQI recommended target values. The mean age of the patients was 54.36 +/- 16.34 years. The mean Kt/V was 0.97 +/- 0.42, which was significantly higher in those who received 3 dialysis sessions per week than those on 2 dialysis sessions per week [P = .03]. Only 32.1% of all patients achieved the Kt/V goal. Seventy-four percent of the patients had a serum albumin equal or greater than 4 g/dL. Hemoglobin levels were between 4.6 g/dL and 16.8 g/dL, and half of the patients had attainment of the hemoglobin target. Cholesterol target was reached in 40% of patients. Only 43 patients [6.8%] attained all targets recommended by the KDOQI guidelines. The target values, except for serum albumin, were not reached in our patients. We conclude that it is necessary to provide essential equipment of dialysis centers such as dialysis machine and trained staffs, and also to raise awareness of KDOQI goals among patients and physicians

Effect of anemia and hyperhomocysteinemia on mortality of patients on hemodialysis

Anemia and hyperhomocysteinemia are risk factor of mortality of patients on dialysis. This study was conducted to assess the relationship of hemoglobin and homocysteine levels and mortality of patients on hemodialysis. Fifty patients on hemodialysis and 20 healthy individuals were enrolled in the study. Blood samples were drawn for measurement of hematological parameters, serum iron, serum ferritin, transferrin saturation, and homocysteine levels. The patients were followed up for 1 year to determine the mortality rate and evaluate its association with anemia and hyperhomocysteinemia. The majority the patients [54%] were not on erythropoietin therapy. Forty-three patients [86%] were anemic [hemoglobin < 11 g/dL]. Serum ferritin was high [> 500 ng/mL] in 33 patients [66%]. Mortality was 28% in 1 year [33% in anemic patients versus no death among patients with a hemoglobin level greater than 11 g/dL]. The relative risk of mortality was increased by 1.58 with every 1 g/dL decrease in hemoglobin level. All of the patients had a high homocysteine level, and a significant difference was observed between the homocysteine levels of the patients on hemodialysis and the control group [P < .001]. Hyperhomocysteinemia did not affect mortality. In multivariate Cox regression analysis, only hemoglobin level was associated with mortality. Almost all of our patients on hemodialysis were anemic and this condition was a risk factor of mortality. Iron stores, however, were adequate in more than half of the patients. The reason of anemia could be untreated erythropoietin deficiency. Hyperhomocysteinemia was present in the majority of the patients, but it did not independently affect mortality

effect of the ketogenic diet on the growth and biochemical parameters of the children with resistant epilepsy

The aim of this study was to evaluate the effect of the ketogenic diet on the growth parameters of the children with resistant epilepsy. A total of 36 children with resistant epilepsy who were 2 to 7 year old were put on the ketogenic diet. Their growth and biochemical parameters were studied at the beginning of the study and after 3 months. Weight decreased in all patients. Serum levels of hemoglobin, calcium, and blood sugar decreased significantly but remained in the normal range. Creatinine did not change, but BUN showed a significant increase. We can lower the complications of ketogenic diets by using more unsaturated fat, more water, and more minerals

comparison of hemoglobin and mean corpuscular volume in gestational Diabetes Mellitus women and healthy women

Screening methods of gestational diabetes mellitus [GDM] diagnosis is controversy. The survey of relation between GDM and its risk factors helps to determine screening methods. This study was performed to find weather the prevalence of gestational diabetes mellitus [GDM] is influenced by higher hemoglobin [Hb] level and mean corpuscular volume [MCV] before 14 weeks gestation in GDM women and healthy women. In this case-control study, 33 pregnant women with GDM in case group [diagnosed according to the Carpenter and Costan criteria] were compared with 33 pregnant women in control group without GDM after 24-28 weeks' gestation. Data were gathered using a questionnaire and a data registration form by interview and biophysical methods. The data were analysed by descriptive and inferential statistics [Chi-squared, Fisher exact test, two samples Kolmogrov-Smirnov test, and Pearson correlation coefficient]. There was no significant difference between two groups in demographic factors and medical history. T-test showed a significant difference between the amount of Hb in the control group [13.23 +/- 0.078 gr/dl] and the case group [12.23 +/- 0.70 gr/dl] before 14 weeks gestation [P<0.001]. There was no significant difference between MCV level in two groups [P=0.294]. Also MCV level before 14 weeks' gestation was 86.92+ 4.51 fl in the case group and 85/56+5/84 fl in the control group. The result showed that GDM women had higher Hb level than the control group before 14 weeks' gestation. It seems that a high maternal Hb in the first trimester is a risk factor for GDM and it can be used for screening and diagnosing of GDM. Also more investigations of the logic of routine iron supplementation in pregnant women who have a high level of Hb are suggested

[Assessment of body mass index and its relationship with iron status indices among women in rural areas of Kerman province, Iran]

Prevalence of obesity has increased steadily and markedly in both Westernized and non-Westernized countries. Few studies have examined the relationship of anthropometric indices with iron status indices. The objective of the present study was to assess the body mass index [BMI] status and its relationship with iron status indices among reproductive age group women in rural areas of Kerman province, Iran. In this cross-sectional study, 370 reproductive age group women [20-45 years old] were selected. General information data were gathered from each person using questionnaires and face-to-face interviews. Body weight and height was measured for each subject and BMI was calculated. Venous blood samples were drawn from subjects and plasma separated. In the study, iron status was assessed by measuring the concentrations of hemoglobin, plasma ferritin and hematocrit. Data were analyzed using one-way analysis of variance [ANOVA] and pearson's correlation coefficient tests. The mean BMI of subjects was 24.3 Kg/m[2]. 19.7% and 15.9% of subjects were overweight and obese respectively. Mean BMI significantly increased with age [p<0.0001] and number of pregnancy [p<0.002]. Furthermore, BMI was positively associated with age [r =0.32, p<0.0001] and number of pregnancy [r = 0.26, p<0.003]. Mean hemoglobin and plasma ferritin concentrations were significantly greater in higher weight and BMI quartiles. The hematocrit was also significantly greater in higher BMI quartiles. From these observations, it is concluded that obesity and overweight are important nutritional problems in rural women in Kerman province. In addition, obese women had higher iron stores than did the non-obese women. Therefore, obese reproductive age women are at low risk of depleting iron stores

Prevalence and severity of anemia in pediatric hemodialysis patients

To determine the prevalence and severity of anemia, and to identify independent predictors for anemia in children on hemodialysis. We conducted this cross sectional study on 25 children aged 7?20 years receiving hemodialysis from September 2005 to January 2006 in Isfahan University of Medical Sciences, Isfahan, Iran. A total of 22 [82%] patients had hemoglobin [Hb] level of <11 g/dL [anemia] and 12 [48%] patients had Hb values <8 g/dL [severe anemia]. The mean age was 15.5 +/- 3.7 years. Mean time on hemodialysis was 20.44 +/- 15.25 months. Anemia was more common and severe among children who were on dialysis <6 months. There was an inverse relation between severity of anemia and duration of hemodialysis [r=-0.465, p=0.019]. Nearly all patients were treated with recombinant human erythropoietin [rHuEPO]. Children with severe anemia received a slightly higher dose of erythropoietin [r=0.202 p=0.09]. There was a correlation between serum albumin and Hb level [r=0.511, p=0.01]. Intact parathyroid hormone [iPTH] levels were >200 pg/mL in 16 patients [66%] and >400 pg/mL in 9 patients [37.5%]. There was a reverse correlation between iPTH level >200 pg/mL and Hb level [r=-0.505, p=0.046]. The prevalence of anemia in our study appears to be higher than that reported in the other studies in spite of extensive use of rHuEPO and iron supplementation. We found this to be especially true for patients who were on dialysis <6 months and with low albumin and severe hyperparathyroidism

Prevalence of anaemia in 2-12- year-old Iranian children

Haemoglobin levels were used to estimate the prevalence of anaemia in children 2- 12 years old in the Islamic Republic of Iran. The study was part of the National Health and Disease Survey in 1999 that used a cluster sample of 1 in 1000 of the Iranian population. Of 4170 children aged 2- 6 years, 7.3% were diagnosed with mild anaemia, 2.5% moderate anaemia and 1.0% severe anaemia [WHO definitions]. Of 8461 children aged 7- 12 years, 10.9% were diagnosed with mild anaemia, 3.0% moderate anaemia and 1.1% severe anaemia. The prevalence of anaemia was significantly higher in rural than urban areas

Frequency of iron deficiency anaemia in pregnancy

Haemoglobin concentration, haematocrit and red cell indices were used to assess the prevalence of iron deficiency anaemia in 103 pregnant women attending Lady Atchison Hospital, Lahore. Iron deficiency Anaemia was present in 41.75% women based on Hb less than 11 g/dl in addition to abnormal haematocrit and red cell indices. Lower mean values for Hb concentration were obtained in women in 2[nd] [10.1 gm/dl] and 3[rd] [9.6 gm/dl] trimester of pregnancy indicating decreasing iron stores. Anaemia prevalence was directly related to the number of previous pregnancies. It increased with parity being 92% in grand multigravidae and 25% in primigravidae indicating that grand multiparous women were particularly at risk. The prevalence of anaemia remained high [65.06%] in low-income women suggesting poor iron nutrition both before and during pregnancy in this group. The higher prevalence of anaemia among the pregnant women [41.75%] and among women during the third trimester [64%] suggests that these groups are at a greater health and nutrition risk. It is possible that early detection and enrolment in public health program may improve iron nutrition status during pregnancy and reduce poor pregnancy outcomes

[Anemia in patients with hypothyroidism]

In hypothyroidism reduction of oxygen demand and supply can reduce the synthesis of erythropoietin and cause anemia. Autoimmune mechanisms causing hypothyroidism can also cause vitamin B12 deficiency and related anemias. Furthermore absorption of iron and other elements are disturbed and further accelerates anemia. Menorrhagia, is another cause of iron loss. Changes in WBC are not significant and platelet function may change which is not clinically important. We studied 30 new cases of hypothyroidism. Control group [32 person] was chosen among individuals having simple goiter and normal thyroid function tests. We compared hematological parameters in patients and control group. Comparison was made between patients with severe [TSH>70] and mild [TSH<70] hypothyroidism and relationship between severity and duration of hypothyroidism with these parameters. 1-anemia was found in 56.7% of patients [10% macrocytic, 16.7% normochrome normocytic and 30% hypochromic microcytic]. In control group 40.625% were anemic [6.25% macrocytic, 3.125% normochromic normocytic and 31.25% hypochromic microcytic].2- Hemoglobin, hematocrit and number of RBCs had statistically significant difference between patients and control group. 3- MCH, MCHC and MCV had no statistically significant difference between patients and control group. 4- There was no significant difference in the number of WBC and platelets between patients and control group. 5- No relationship was found between blood parameters and duration of the disease. 6- There was no correlation between severity of disease and hemoglobin and hematocrit values but MCHC was significantly lower in patients with severe hypothyroidism. Erythroid lineage showed the most important changes in hypothyroidism. All 3 types of anemia were found. Hemoglobin, hematocrit, and number of RBC showed marked decrease in patients compared with controls. White blood cells and platelets had no changes in hypothyroid patients

frequency and age presentation of G6PD deficiency in 200 patients of hemolytic anaemia

To determine the frequency of G6PD deficiency in the etiology of anaemia and jaundice and to determine the most common age of presentation with anaemia and jaundice due to G6PD deficiency in adults. We did a hospital based study in the department of Medicine Khyber Teaching Hospital Peshawar from June 2003 to December 2003. The data of adult patients with signs and symptoms of anaemia and jaundice was collected on structured proforma. The clinical presentation and laboratory investigation results were documented. Out of 200 patients studied, 24 [12%] patients were found to be deficient in G6PD enzyme. The male to female ratio was 21:3 [87.5% and 12.5%] respectively. The age of appearance of jaundice in adults varied [most common age from 13 to 17 years]. The most common signs and symptoms were jaundice, anaemia and haemoglobinuria. All G6PD deficient patients except one recovered spontaneously when the offending precipltating factor were stopped or treated. One [0.5%] died because of rapid fall of haemoglobin and delayed recognition of the condition and subsequent blood transfusion. G6PD deficiency is not an uncommon cause of jaundice and anaemia in our patients. The jaundice due to G6PD mainly affects the adults in 2nd or 3rd decade. Therefore all the children and adults with jaundice and anaemia should be screened for G6PD status

Parenteral iron therapy in malnourished children

To evaluate the safety and efficacy of intravenous iron sucrose complex in the treatment of iron deficiency anemia in malnourished children who are unable to tolerate oral iron supplementation or are unresponsive to oral supplementation because of gastrointestinal dysfunction or iron malabsorption. Prospective interventional study. This study was carried out at Department of Paediatrics Combined Military Hospital Quetta over 24 months of period from 1st November 2002 to 31st October 2004. Each selected patient was given total calculated amount of iron sucrose complex. The iron deficit was calculated by using following formula: Total Iron Deficit [mg] = Body wt [Kg] x [target Hb - Actual Hb] x 0.24 + Depot Iron [mg]. Target Hb is 13 G/dl and depot iron is 15 mg/Kg. Iron sucrose complex was diluted in 0.9% Normal saline and was given intravenously over 3-4 hours. To assess the efficacy of Iron sucrose complex serial samples were analyzed for Hemoglobin [HB], Hematocrit [Hct], Red Blood cell indices, Reticulocyte count and serum Ferritin. Total iron deficit was administered over 2 to 3 weeks time. A total of 17 malnourished children with weight for age below -2SD, completed intravenous iron sucrose infusion. Tolerance of intravenous iron sucrose was good except in one, who had transient episode of lethargy. Mean Hemoglobin at presentation was 6.6G/dl [Range: 4.9G/dl-8.4G/dl]. Six weeks after giving intravenous iron therapy mean Hemoglobin was 10.5 G/dl, with average increase of 3.9G/dl [range 3.0G/dl-5.3G/dl]. Intravenous iron supplementation with Iron sucrose complex is quite safe and efficient way of replenishing iron body stores and significantly increasing the hemoglobin concentration in malnourished iron deficient children

Prevalence and severity of anemia in pediatric hemodialysis patients, a single center study

This study was conducted to determine the prevalence and severity of anemia in children and adolescents on chronic hemodialysis, and to identify independent predictors of anemia in children on hemodialysis. This cross-sectional study was performed between September 2005 and January 2006. The study population consisted of 25 patients aged 7+20 years on chronic hemodialysis from pediatric hemodialysis centers in Isfahan. A total of 22 [88%] patients had hemoglobin levels of <11 g/dL [anemic] and 12 patients [48%] had hemoglobin levels of <8 g/dL [severe anemia]. The mean age of these patients was 15.5 +/- 3.7 years. Mean time on chronic dialysis was 20.44 +/- 15.25 months. Anemia was more common and more severe among children who were on dialysis for less than 6 months. There was an inverse relationship between the severity of anemia and duration of hemodialysis [P = 0.019, r = - 0.465]. Nearly all patients were treated with erythropoietin, Children with more severe anemia received slightly higher dose of erythropoietin [P = 0.09, r = 0.202]. There was a significant difference between serum albumin values in anemic patients and patients without anemia [P = 0.023]. There was a correlation between serum albumin and hemoglobin level [r = 0.511, P = 0.01]. Intact PTH levels were >200 pg/ml in 16 patients [66%] and >400 pg/ml in 9 patients [37. 5%]. There was a reverse correlation between intact PTH level >200 pg/ml and hemoglobin level [r = -0.505, P = 0.046]. The prevalence of anemia in hemodialysis children in Isfahan appears to be higher than that reported in the other studies in spite of extensive use of rHuEPO and iron supplementation. We found this to be especially true for patients new on hemodialysis [less than 6 months] and in those with low albumin and severe hyperparathyroidism

Comparative study of HB-concentration and platelet-count in relation with stress in adults

114-male student of 1st year and 2nd year M.B.B.S [mean age 24 years], were subjected to mental stress of class test examination and the Hb percent and platelet count were analyzed. The results were compared with the results which were taking after resting period given to them. All the participants were healthy and the selection was based on their well being and consent. The mean and standard deviation of differences in between stress and rest observations for both, the Hb percent and platelet count were calculated. The results were evaluated for level of significance by 95 percent confidence interval and student's paired t-test. There was a significant increase in Hb percent [P<0.001] with 2.08 percent increment during stress and in platelet count [P<0.001] with 17.15 percent increment at the time of mental stress. Our findings were in agreement with most of workers but contradictory to some others who were of the view that the increments were due to the stress induced catecholamine only and were not depending on the type and nature of stress

Micronutrients status in Saudi Arabia

In the last three decades, Saudi Arabia witnessed rapid changes in health, education, social services and agriculture. These changes had a profound impact on food consumption patterns, health and nutritional status, particularly on the micronutrients status of Saudis. We have reviewed the available literature on the micronutrients status in Saudi Arabia. The results reveal the need of formulated studies to determine the prevalence and causes of vitamin A deficiency and there are very few studies on the zinc status in the Kingdom. Data shows that iron deficiency anemia, vitamin D deficiency and iodine deficiency [in few areas] do exist in Saudi Arabia. Ameliorative measures are presented to combat this public health problem

Prevalence of hepatitis E virus [HEV] antibody in pregnant women of Karachi

This study was aimed at determining the prevalence of HEV in Karachi. Prevalence of hepatitis E antibody in pregnant women was carried out in 65 pregnant women. They had history of acute viral hepatitis while 15 control pregnant women were included having no history of jaundice. The statistical outcome of the present study indicates prevalence of HEV as 57% in pregnant women with jaundice. Majority of the patients [85%] were from lower socio-economic strata, with mean age of 25 years. All these patients had hemoglobin less than 10mg%. The mean ALT level in HEV positive cases was 452 IU/L over a range of 102-5328. It was also observed that HEV affected more women in the last trimester [62%] and in primigravida [67%]. It was observed that it was more common in last trimester and in primigravida. Majority of the patients [85%] were from lower socio-economic strata. Conclusions: The findings of the present study proved the presence of HEV in pregnant women and confirmed that HEV is endemic in Karachi. The study confirms that it occurs in last trimester and in young adult

Prevalence of anaemia in women at District Headquarter Hospital Gilgit

A preliminary survey was conducted to estimate the prevalence of anaemia in females [aged 14-65 years] attending Gynae OPD of District Headquarter Hospital, Gilgit. Haemoglobin [Hb] was estimated for each patient. Out of 447 patients, 376 females were pregnant and 71 were non-pregnant with different reproductive complaints. Considering 11 g/dl as normal limits of Hb level for the study population, 43.1% patients were found to be anaemic. 55.48% patients had Hb level between 11-14 g/dl

Effect of iron supplementation on serum iron level in young healthy adults

The study was designed to see the effect of high doses of iron supplementation on the serum iron level. Sixty young healthy students from Punjab Medical College Faisalabad were included in the study as experimental group while 10 other students were enrolled as a control group for comparison. In order to study the effect on persons having almost a uniform diet, only students residing in the hostel were enrolled. Their serum levels of iron were measured by means of atomic absorption spectroscopy. Then the students in experimental group were divided into two groups A and B, and were prescribed 150 and 300 mgs/day of iron sulphate [equivalent to 28 mg and 56 mg of elemental iron] respectively for a period of 30 days. The serum levels of iron were analyzed again. The mean serum iron levels were increased from 106.5 to 124.50 [micro]g/dl in group A and from 107.8 to 132.1 [micro]g/dl in group B. The percentage rise was more in the group A as compared to the group B. The results suggested that high dose iron supplementation in young healthy individuals increases the serum iron level according to the physiological needs of the body and further excess of dietary iron may go waste into the faeces

Diabetes mellitus. Prevalence of retinopathy

OBJECTIVE: To study the prevalence of retinopathy in association with duration of the disease, age at the onset, treatment, haemoglobin [Hb] levels, obesity and glycemic control as measured by means of glycosylated [HbAlc] levels. STUDY DESIGN: A cross-sectional study comprising 1340 diabetic patients was carried out. Retinopathy was evaluated by means of direct and indirect ophthalmoscopy and retinal photographs. It was calculated that the prevalence of retinopathy was significantly higher in early diabetics [p<0.006]. The prevalence of severity of retinopathy was higher in patients with HbALC >12% [p<0.01]. It was found out that frequency of retinopathy was twice in those that had the Hb levels <12g/dl as compared to Hb levels >12g/dl. Diabetic retinopathy had a positive association with the duration of the disease. With an age at the diagnosis <30 years, the prevalence of retinopathy was 62% whereas with an age of diagnosis >30% years, the prevalence of retinopathy was 54% in insulin treated and 22% in non-insulin treated patients. CONCLUSIONS: Early diagnosis with good glycemic control decreases the risk of developing diabetic retinopathy