Evaluation of Iron Supplementation Effects on Plasma Lipid Levels in Pregnant Women

Backgrounds: Iron supplementation is most widely used approach of controlling the global problem of iron deficiency anemia especially in pregnant anemic women.Anemia is one of the most frequent complications related to pregnancy. Normal physiological changes in pregnancy affect the hemoglobin (Hb),Epidemiological studies have shown high serum iron concentrations following abnormal levels of blood lipids are risk factors for coronary artery disease and myocardial infarction.Both iron deficiency anemia and dyslipidaemia are widely prevalent public health problems, especially in the Sudanese pregnant women.Objectives: The aim of present study wasto measure the serum level of lipids profile in anemic pregnant women compared to non anemic pregnant women.Methodology and Study Population:The analytical case control study conducted inobstetrics and gynecology centre, Omdurman city, Khartoum state. One hundred subjects knownwith 50 pregnant anemic as case groups and 50 non anemic pregnant women as control groups were enrolled in this study, with match age and sex, the age ranged between (20 to 40 years) and their mean (31.7±4.34). The serum lipid profile was analyzed using spectrophotometric method. Results: The (mean±SD) ofHb, HDL, LDL, TG and TC in anemic pregnant women respectively were (68.15±9.35, 46.06±9.62, 114.14±36.86, 170.38±54.57. 197.16±46.83). While the(mean±SD) ofHb, HDL, LDL, TG and TC in non anemic pregnant women respectivelywere (79.76±7.22, 47.44±9.65, 140.00±40.76, 189.72±37.89, 224.38±45.09). The concentration of Hb was highly significantly decrease in anemic pregnant compare to non anemic pregnantwomen with p value(p=0.000). The level serum of LDL, TG andTC were significantly decrease in anemic pregnant compare to non anemic pregnant women with p value (p= 0.001, 0.042, 0.004) respectively. The age of study population were no correlation with serum LDL(r= -0.155, p= 0.283), HDL(r= -0.019, p=0.898) and TC(r=0.68, p=0.640). And also their positive correlation between age and serum TG (r= 0.286, P=0.044). Conclusion:The anemic pregnant women hadasignificantly decreased of Hb and serum LDL, TG and TC and also their positive correlation between age and serum TG

A Prospective Tertiary Care Hospital Based Study on Prevalence of Anemia in Non-Dialysis Chronic Kidney Cases

Background: A decrease in the glomerular filtration rate (GFR) shows chronic kidney disease (CKD). It may develop any structural or functional renal abnormalities. Methods: 140 total number of cases were included. This study was conducted in the Department of Pathology in Krishna Mohan Medical College & Hospital, Mathura, U.P, India. Result: The mean fasting blood sugar was 133.29 ± 12.63; the mean Post prandial blood sugar was 155.82 ± 12.56. The mean Hb1Ac were 6.16 ± 1.36 and serum creatinine was 3.76 ± 1.36 mg/dl. Finally, the mean hemoglobin for the whole sample was 10.74 ± 2.17 gm%. Conclusion: This study concludes that in future one could carried out research on large sample size along with a matched control group, simultaneous assessment of other biochemical parameters, and burden of various other metabolic for better results.

Date Supplement and Iron Salts Plus Physical Activity on Efficiency of Iron Absorption

The aim of this study was to investigate the effect of date supplement and iron plus physical activity on anemic femalestudents. This study includes 40 anemic female students, from the new valley university; they were divided into four equalgroups ten in each group; 1st group ingested “date” plus exercise, 2nd group ingested date without exercise, 3rd groupsupplemented with iron salts with exercise, 4th group supplemented with iron salts without exercise, pre/post-test VO2max,pulse rate, Hb, iron, ferritin and O2 were determined. 5 ml venous blood was drawn from all participants for the pre/postvariables. Dose of date sheet was (10 gm) twice daily, and dose of iron salts was one capsule (5mg) daily. Results: Resultsindicated that date supplement, and iron together with exercise affect positively the anemic female students. Conclusion:black dates and iron with or without hulls, are effective, safe and cheap supplements for improving hemoglobin andrestoring iron stores to correct iron deficiency.

A Comparative Study between Effect of Physical Activity and ADAM, Vs Iron Salts on Some Physical Traces of Underground Water

Iron deficiency is estimated to be the most common cause of anemia worldwide. The purpose of this study was to investigatethe effect of dietary supplement ADAM (olive oil, vinegar and sodium chloride) and traditional iron salts, together withphysical activity on anemic female students. Our study consists of forty anemic female students divided into four equalgroups, ten students in each group; 1st group ingested ADAM with exercise, 2nd group ingested ADAM without exercise,3rd group supplemented with traditional iron salts with exercise, 4th group supplemented with traditional iron salts withoutexercise. Blood samples were drawn (5ml) for analysis of hemoglobin by spectrophotometer, iron, total iron bindingcapacity and ferritin by Radioimmunoassay, O2 using gas analyzer. The variables exerted VO2max using Harvard step test,heart rate by pulse meter, fitness index by equation; the variables were detected (pre-post) training program. Results: Theresults indicated a positive result for ADAM with physical activity compared with ADAM alone, also iron with physicalactivity variables overcome the variables of iron salts alone while, ADAM with physical activity variables exceed iron saltswith physical activity. Conclusion: using physical activity with ADAM, induces a positive result in curing female anemicstudents from traces of underground water.

Laboratory evidence for the hematopoietic potential of Beta vulgaris leaf and stalk extract in a phenylhydrazine model of anemia

This study was designed to provide laboratory evidence supporting the hematopoietic effect of Beta vulgaris (beet) leaf aqueous extract in phenylhydrazine-induced anemia model in albino rats. Extraction of the leaves/stalks was done by maceration in 30% hydro-ethanol for 48 h. An intraperitoneal injection of 20 mg/kg phenylhydrazine was applied for two consecutive days to develop hemolytic anemia on the 4th day after the 1st injection in 24 of 30 male albino rats. The animals were divided into 5 groups and received the following treatments: standard (ferrous ascorbate + folic acid; 13.5 + 0.135 mg/kg), B. vulgaris extract (100 and 200 mg/kg), or left untreated (normal and diseased controls). Blood samples were taken at 0, 4, 8, and 12 days of the experiment for hematological and clinico-chemical analysis. Beet leaf extract significantly restored the levels of red blood cells, white blood cells, hemoglobin, and hematocrit in dose- and time-dependent manners. Blood indices have been significantly corrected. Erythropoietin level was maintained at higher levels. Erythrocytic membrane oxidation biomarker (malondialdehyde) level was significantly reduced compared to the anemic untreated group. The extract exhibited potent, concentration (4-512 μg/mL)-dependent antioxidant activity indicated by the 2,2-diphenyl-1-picryl-hydrazyl (DPPH) assay, with IC50 value of 37.91 μg/mL. Beet leaf extract resulted in detection of flavonoid and phenolic compounds that may underlie its hematinic properties. These findings may indicate B. vulgaris as a good natural source for pharmaceutical preparations with hematopoietic effects and treatment of anemia and/or associated conditions.

Bilateral macular hemorrhage due to megaloblastic anemia: A rare case report.

We report a case of a 17‑year‑old female patient who presented with sudden, painless, nonprogressive diminished vision in both eyes (best corrected visual acuity in right eye ‑ 6/60 and left eye ‑ 6/36). An ophthalmological evaluation revealed bilateral pale tarsal conjunctiva and bilateral macular hemorrhage. Hematological evaluation revealed the presence of megalocytic anemia (with hemoglobin ‑ 4.9 g%). General examination showed severe pallor. On systemic examination, no abnormality was detected, confirmed by ultrasonography abdomen. Other causes of severe anemia have been ruled out. Intraocular pressure in both eyes was 12 mmHg. This case documents the rare occurrence of bilateral subinternal limiting membrane macular hemorrhage with megaloblastic anemia without thrombocytopenia and other retinal features of anemic retinopathy.

Bier´s spot: um diagnóstico pouco reconhecido / Bier´s spot: an almost unknown diagnosis

Bier´s spot são pequenas máculas hipopigmentadas, circundadas por área eritematosa, transitórias e assintomáticas, distribuídas preferencialmente em membros. De etiologia vascular e fisiopatologia ainda não completamente esclarecida, a maioria dos casos é observada em adultos jovens, com poucos casos até então relatados em adolescentes. Este relato traz o caso de uma adolescente de 14 anos que procurou nosso serviço, relatando apresentar, há dois anos, máculas hipocrômicas em membros inferiores; estas se tornavam mais evidentes quando a paciente permanecia em ortostase e cediam à vitropressão por isquemia da área eritematosa circunjacente.

Evaluación de dieta purificada para la obtención de biomodelo de ratas anémicas / Evaluation of a purified diet to obtain a biomodel of anemic rats

Introducción: el desarrollo científico y tecnológico en las ciencias biológicas y biomédicas ha sido posible gracias a la utilización de modelos animales experimentales. La anemia por deficiencia de hierro (Fe), afecta aproximadamente a la tercera parte de la población mundial. La rata recién destetada ha sido el modelo animal más empleado en la obtención de un biomodelo experimental de anemia. Para la obtención de anemia se utiliza el método de depleción de la hemoglobina (Hb), mediante una alimentación basada en una dieta deficiente en Fe. Objetivo: el objetivo de este trabajo fue evaluar la eficacia de una dieta purificada a partir de caseína en la obtención de ratas anémicas. Métodos: se utilizaron 40 ratas Sprague Dawley recién destetadas (21-24 días), la mitad de cada sexo. Se alojaron en grupos de 3 del mismo sexo en cajas de acero inoxidable con piso de rejillas. Durante 8 semanas se les administró agua desionizada y una dieta de caseína al 12,58 por ciento de proteínas y 1,28 mgFe/Kg. Cada dos semanas se midió el peso corporal y a partir de la cuarta semana, la concentración de Hb. Resultados: se obtuvo un incremento significativo del peso corporal sin observarse diferencias entre hembras y machos. Se tomó como criterio de obtención de la anemia aquellos animales cuya Hb disminuyó al menos en un 30 por ciento del valor inicial promedio por grupo. El porcentaje de animales anémicos a las 8 semanas fue superior en las hembras (75 por ciento), mientras que en machos (60 por ciento). La dieta utilizada en este estudio permitió obtener ratas anémicas en el sexo hembras con una eficiencia aceptable, en relación al porcentaje de animales anémicos y al incremento del peso corporal. Conclusiones: la dieta utilizada en este estudio permitió obtener ratas anémicas en el sexo hembras con una eficiencia aceptable, en relación al porcentaje de animales anémicos y al incremento del peso corporal

Introduction: the scientific and technological development of biological and biomedical sciences has been possible due to the use of experimental animal models. Iron- (Fe-) deficiency anemia affects about one third of the world population. Just weaned rats have been the animal model most commonly used to obtain an experimental biomodel of anemia. The disease is obtained by the hemoglobin (Hb) depletion method, feeding the animal an iron-deficient diet. Objective: evaluate the efficacy of a purified diet based on casein to obtain anemic rats. Method: a study was conducted of 40 just weaned (21-24 days) Sprague Dawley rats, 20 of each sex. The animals were housed in groups of 3 rats of the same sex in stainless steel boxes with mesh bottoms. For 8 weeks the animals were administered deionized water and a casein diet of 12.58 percent protein and 1.28 mgFe/kg. Body weight was measured every two weeks. Hb concentration was gauged from the fourth week onwards. Results: a significant increase in body weight was obtained, with no differences between male and female rats. The criterion for anemia was at least a 30 percent decrease in Hb with respect to the average baseline value per group. The percentage of anemic animals at 8 weeks was higher for females (75 percent ) than for males (60 percent ) Conclusions: the diet used for the study made it possible to obtain female anemic rats with acceptable efficiency in relation to the percentage of anemic animals and the increase in body weight

An Acquired Anemic Patch Developed after a Cyst Excision: Is It a Variant of Nevus Anemicus?

A 53-year-old male presented with a 6-year duration of a child's-palm sized hypopigmented patch located on his neck. He had a history of surgical excision of an epidermal cyst on the neck, and the hypopigmented patch developed about one month after the excision next to the surgery site. Application of cold or heat did not make the lesion distinct from the surrounding skin. Pressure on the lesion by a glass slide made the lesion indistinguishable from surrounding uninvolved lesions. Giving friction to the lesion failed to induce erythematous change, making it clearly visible. Histologically, the lesion showed normal findings with adequate numbers of melanocytes in the basal layer. Herein, we present an interesting case of an acquired anemic patch which developed after a cyst excision. We postulate that nerve damage after surgery that regulates the vascular tone of cutaneous vessels may have been an inducing event of the anemic patch in this patient.

Síndrome cardio-renal anémico / Cardio-renal anemia syndrome

Las interacciones entre el corazón y el riñón se han convertido en un área de considerable interés, dada la interdependencia de los mismos. Esto motivó la definición y conceptualización del síndrome cardio-renal anémico, que incluye interacciones bidireccionales, donde alteraciones, tanto agudas como crónicas de cualquier órgano, pueden afectar indistintamente la función renal o la ventricular. El tratamiento, involucra el bloqueo del eje renina angiotensina aldosterona y durante una descompensación aguda es válido el soporte dialítico para control de la volemia. La anemia, es multifactorial, se debe tratar de manera oportuna con hierro endovenoso y eritropoyetina recombinante, reduciendo al mínimo el soporte transfusional. El manejo, la definición y el pronóstico del síndrome cardio-renal anémico aún sigue siendo controversial y es un reto para el internista moderno (Acta Med Colomb 2011; 36: 141-144).

The interactions between the heart and the kidney have become an area of considerable interest, given their interdependence. This led to the definition and conceptualization of cardio-renal anemic syndrome, which includes a bidirectional interaction: acute or chronic injuries of any organ indiscriminately affect renal or ventricular function. Treatment involves blocking the rennin-angiotensin-aldosterone axis and, during acute decompensation, dialytic support for volemic control. Anemia is due to multiple causesand must be treated promptly with intravenous iron and recombinant erythropoietin, to minimize the need for transfusions. Management, definition and prognosis of cardio-renal anemic syndrome are still controversial and represent a challenge for the modern internist (Acta Med Colomb 2011; 36: 141-144).

Hemoglobin S/hemoglobin city of hope compound heterozygote with a subsaharan genetic background and severe bone marrow hypoplasia

Hemoglobin City of Hope (HbCH) (HBB: c.208G>A, beta 69 (E13)Gly>Ser) is a rare, anomalous change. Seven independent carriers reported so far, had not displayed any hematological manifestations. The ethnic origin of the known instances is presumably heterogeneous, although they are mainly Mediterraneans or equatorial West Africans. We describe the case of a compound heterozygote in trans for Hb S (Glu6Val) and Hb City of Hope (Gly69Ser) in an anemic two year-old boy with a severe immune-deficient phenotype and fatal chronic parvovirus B19 infection. Haplotype with the Hb S was Bantu; while it was a mixed atypical Benin/Cameroon for Hb CH. Remote ancestral origin of the City of Hope mutation in this family seems to be SubSaharan African. The compound heterozygosis in trans for hemoglobins S and City of Hope, jointly with an unfavorable HBB control region background and a viral chronic infection, seemed the cause of the fatal outcome in the patient. When accompanied by other Hb deleterious mutations in trans, Hb CH should not be considered any longer as an innocuous or functionally silent variant.

La hemoglobina City of Hope (HbCH) (HBB: c.208G>A, beta 69 (E13)Gly>Ser) es una variante infrecuente, considerada como anómala. Ninguno de los siete heterocigotos simples, genéticamente no relacionados, reportados hasta ahora, ha mostrado hemopatología. El origen étnico de esos casos es presuntamente heterogéneo, pero la mayoría parece mediterráneo o africano-ecuatorial occidental. Se describe el caso de un niño de dos años de edad con fenotipo hipoplásico mieloeritroideo severo e infección crónica por parvovirus B19, heterocigoto compuesto en trans para las hemoglobinas S (Glu6Val) y City of Hope (Gly69Ser ). El haplotipo en fase con la Hb S fue Bantú, mientras que el de la Hb CH fue un combinado atípico Benin/Camerún. El origen ancestral remoto de la mutación City of Hope (y de la Hb S) en esta familia es africano subsahariano. La heterocigosis compuesta en trans para las hemoglobinas S y City of Hope y una secuencia génica predisponente en la región de control de HBB, conjuntamente con la infección por parvovirus B19 pueden ser la causa del curso fatal del paciente. En presencia de otras mutaciones de hemoglobina deletéreas, la Hb City of Hope no debiera ser considerada una variante inocua o funcionalmente silenciosa.

¿Qué hacer cuando la anemia se interpone en la insuficiencia cardíaca crónica? / What to do when anemia stands in chronic heart failure? / ¿O que fazer quando chega a anemia na insuficiência cardíaca crà´nica?

Desde hace muchos años conocemos las consecuencias fisiopatológicas de la anemia en el aparato cardiovascular. Estudios multicéntricos demostraron que es un factor de riesgo independiente de mortalidad y morbilidad en insuficiencia cardíaca crónica, por lo que su corrección mejora la sobrevida de estos pacientes. Tiene una prevalencia elevada, en algunas series, cercana al 60%. Las causas de anemia en pacientes con insuficiencia cardíaca crónica son numerosas y muchas veces se asocian como formas etiológicas mixtas, por lo cual resulta difícil llegar a su diagnóstico y luego encontrar el tratamiento específico. Los recursos terapéuticos disponibles son la transfusión, el hierro endovenoso y la eritropoyetina con sus derivados; todos ellos con potenciales efectos indeseados. No está claramente definido el umbral mínimo de hemoglobina donde se incrementa la mortalidad o el punto donde deberíamos comenzar a actuar. Tampoco está definido hasta donde llevar los niveles de hemoglobina para evitar los efectos indeseados de la terapéutica. Por todos estos motivos, la anemia es un verdadero problema para el cardiólogo. Si bien actualmente, podemos delimitar algunas pautas como: descartar causas frecuentes de anemia (pérdidas gastrointestinales), evaluar los depósitos de hierro y el uso de eritropoyetina en un selecto grupo de pacientes, todavía no existe consenso en las guías de insuficiencia cardíaca.

For many years we have known the pathophysiological consequences of anemia in the cardiovascular system. Multicenter studies showed that it is an independent risk factor of mortality and morbidity in chronic heart failure, so its correction improves survival in these patients. It has a high prevalence, in some series approaches 60%. The causes of anemia in patients with chronic heart failure are numerous and are often associated as mixed aetiological forms; these makes difficult our reach to a diagnosis and then find the specific treatment. Therapeutic resources available are transfusion, intravenous iron and erythropoietin with its derivatives; all with potential unwanted effects. It is not clearly defined the minimum threshold of hemoglobin where increases mortality or the point where we should start working. And it is not defined how far carrying hemoglobin levels to avoid unwanted effects of therapy. For all these reasons, anemia is a real problem for the cardiologist. While we can now define some guidelines like: rule out common causes of anemia (gastrointestinal losses), evaluate iron deposits and use erythropoietin in a select group of patients, there is still no consensus on the heart failure guidelines.

Por muitos anos nós sabemos as conseqà»ências fisiopatológicas da anemia no sistema cardiovascular. Estudos multicêntricos mostraram que é um fator de risco independente de mortalidade e morbidade em insuficiência cardíaca crà´nica, por isso a sua correção melhora a sobrevida destes pacientes. Ele tem uma alta prevalência, em algumas séries chega aos 60%. As causas da anemia em pacientes com insuficiência cardíaca crà´nica são numerosas e estão freqà»entemente associadas como formas etiológicas mistas, o que torna difícil chegar a um diagnóstico e, em seguida, encontrar o tratamento específico. Os recursos terapêuticos disponíveis são: transfusão, ferro endovenoso e eritropoietina com seus derivados, todos com potenciais efeitos indesejáveis. Não está claramente definido o limite mínimo de hemoglobina, onde aumenta a mortalidade ou o ponto onde devemos comeà§ar a trabalhar. Também não é definida, na medida do aumento dos níveis de hemoglobina para evitar os efeitos indesejáveis da terapia. Por todas estas razàµes, a anemia é um problema real para o cardiologista. Enquanto nós podemos agora definir algumas diretrizes como: excluir causas comuns de anemia (perdas gastrointestinais), avaliar os depósitos de ferro e eritropoietina uso em um grupo seleto de pacientes, ainda não há consenso sobre as orientações da insuficiência cardíaca.

O cotidiano das famílias de crianças e adolescentes portadores de anemia falciforme / The day-to-day life of families with children and adolescents with sickle cell anemia

A anemia falciforme (AF) é a doença mais comum entre as hemoglobinopatias, caracterizada por uma mutação genética que compromete as funções das hemácias, desencadeando crises de vaso-oclusão e predisposições às infecções. O objetivo deste trabalho foi analisar o cotidiano das famílias com filho portador de AF. Foi feito estudo descritivo, exploratório e qualitativo. O método utilizado foi a gravação de dez entrevistas semiestruturadas com os familiares de menores de 18 anos portadores de AF, atendidos em outubro de 2007 no Hemope. A seleção dos sujeitos foi residir e ter parentesco em primeiro grau do paciente. O critério de exclusão foi a criança apresentar risco de morte. O tamanho da amostra seguiu os critérios de saturação dos discursos de Mynaio.12 Na avaliação empregou-se a técnica de "Análise de Conteúdo" de Bardin.13 As falas obtidas foram transcritas integralmente e agrupadas de acordo com a semelhança, buscando os sentimentos relevantes que originaram códigos e temas: 1. Tema: Envolvimento da família (subtema: exclusividade da atenção; códigos: superproteção, abrindo mão de outros papéis, sobrecarga materna, aprendendo com a doença); 2. Tema: Impacto da doença (subtema: doença crônica afetando a família; códigos: não aceitação, temor da morte); 3. Tema: Enfrentando desafios (subtemas: redes de apoio, serviço de saúde; códigos: apoio espiritual, profissional e familiar; estrutura hospitalar). Verificamos dificuldades na aceitação da doença pela família e uma sobrecarga materna na realização dos cuidados. Os modelos assistenciais devem permitir que a família atue como coparticipante nos cuidados de forma a facilitar a adaptação do paciente à doença.

Sickle cell anemic is a common disorder among hemoglobinopatias, characterized by a genetic mutation which affects the function of the red blood cells, causing episodes of vaso-occlusion and predisposing sufferers to infections. This study aims at describing the day-to-day life of families with children and adolescents with sickle cell anemia. This was a descriptive, exploratory, qualitative investigation. Data collection was achieved by recording semi-structured interviews with relatives of ten under 18-year-old patients with sickle cell anemia attended in the Hemope Clinic in October 2006. The selection criteria of interviewees were that they lived with and were first degree relatives of the patient. The exclusion criterion was that the patient was at risk of death. The sample size followed the criteria of saturation discussed by Mynaio. The technique of "Analysis of Content" described by Bardin was used in the evaluation. The interviews were completely transcribed and grouped according to their similarities, searching for relevant feelings originating from codes and themes: 1. Theme: Involvement of the family (Exclusiveness of attention; codes: overprotection, relinquishing other roles, overload of mother, learning with the illness); 2: Theme: Impact of the illness (chronic illness affecting family; codes: non-acceptance, fear of death); 3. Theme: Facing challenges (Support networks, Healthcare services; codes: spiritual, professional, and family support; hospital structure). We verified difficulties in the acceptance of the illness by the family and the burden of the mother with necessary patient care. In conclusion, healthcare assistance models should allow the family to act as a co-participant in the care of the patient in order to facilitate the patient's adaptation to the disease.

Concentration of IL-6 in serum in anemic and non-anemic pregnant women

124 pregnant women were examined and monitored at the Military Hospital No 103. The incidence of real physiological and anemia was 75.8% (among them real anemia is 35.5%). IL-6 level in the group with anemic pregnant women was higher than in the group without anemia. There is a negative correlation betweeb IL-6 concentration and Hb level with a coefficient r = -0.8. Low Hb level in anemic pregnant women was often associated with IL-6 increasing phenomenon, when Hb level increased, IL-6 concentration deseased