Pre-and post-donation ferritin level of blood donors attending University of Calabar Teaching Hospital, Donor Clinic in Southern Nigeria

While trying to save the patient via blood transfusion, the safety of the blood donor is paramount. This study evaluated the pre-and post-donation ferritin and packed cell volume (PCV) of donors attending University of Calabar Teaching Hospital.Method: The study adopted descriptive longitudinal approach. A total of 18 donors with age range of 18 ­48years were enrolled and followed up for 30 days post-donation. The serum ferritin was analyzed using ELISA method while the PCV was analyzed using the microhematocrit method. Difference between means was performed using repeated measure ANOVA while post hoc was done using Bonferroni adjustment. Prediction of return to baseline values were performed using logistic regression. Alpha value was placed at 0.05 There was a decline in ferritin and packed cell volume from pre-to post-donation. The decline in ferritin was imminent until day 14 when recovery was initiated. Significant difference was observed between the pre-donation ferritin and the rest of the days except day 30. There was also a decline in PCV from pre-donation all through with recovery noticeable after day 7. The PCV of the pre-donation was only comparable to the day 30 post-donation. Approximately 5.6% (n=1) of the subjects was iron deficient pre-donation.Approximately 25% (n=4) of the subject have returned to baseline PCV while 0% of the subjects have returned to baseline ferritin at day 30 post-donation.Conclusion: For the safety of the donor, donation interval should be widened, and iron supplement followed up

Effects of lactoprotein iron chelates on iron deficiency anaemia in rats / 预防医学

Objective@#To investigate the effects of lactoprotein iron chelates on rats with iron deficiency anaemia (IDA), so as to provide insights into developing and utilizing novel iron supplements.@*Methods@#Seventy weaning female SPF-graded rats of the SD strain were randomly divided into the control group (A), model group (B), ferrous sulfate group (C), lactoferrin group (D), lactoferrin iron chelate group (E), Casein oligopeptide iron chelate group (F) and whey protein oligopeptide iron chelate group (G), with 10 rats in each group. The rats in group A were fed with normal diet, and the others were fed with poor iron diet for IDA modeling. The corresponding interventions were given by intragastric administration once a day. The iron ion concentrations of group C, E, F and G were 2.0 mg/kg, and the protein and oligopeptide concentrations of group D, E, F and G were 2 000 mg/kg. Body weight and hemoglobin of rats were measured weekly during 21-day intervention. At the end, peripheral blood samples were collected, and blood routine, iron metabolism and liver function indicators were determined. @*Results@#After the intervention, among blood routine indicators, the rats in group C, E, F and G showed elevated hemoglobin, red blood cell, mean corpuscular volume and hematocrit, and decreased free protoporphyrin and mean corpuscular hemoglobin concentration when compared with the rats in group B (all P<0.05); among iron metabolism indicators, the rats in group C, E and G showed elevated serum ferritin, the rats in group C, E, F and G showed elevated serum iron, the rats in group C, D, E, F and G showed decreased unsaturated iron binding capacity and total iron binding capacity when compared with the rats in group B (all P<0.05); among liver function indicators, the rats in group E and G showed decreased alanine transaminase when compared with the rats in group B (both P<0.05). @*Conclusions@#Lactoprotein alone could not completely improve IDA in rats compared with traditional iron supplement (ferrous sulfate). Lactoprotein iron chelate, especially whey protein oligopeptide iron chelate, could significantly improve IDA, iron reserve and liver function damage in rats.

A case of Osler-Weber-Rendu syndrome associated with portal hypertension

Osler-Weber-Rendu syndrome is a rare autosomal dominant vascular disorder, characterised by multiple telangiectasesof the skin and mucous membranes with recurrent nasal and gastrointestinal bleedings and arteriovenous malformations of various organ systems. It is also called as hereditary hemorrhagic telangiectasia (HHT). The occurrence of telangiectases in the stomach and small bowel can result in chronic bleeding and anaemia. We report a rare case of 39 year old female with Osler Weber Rendu syndrome associated with portal hypertension. She had recurrent nasal and gastrointestinal bleeding, and presented with complaints of progressive dyspnea NYHA class III. On further evaluation she was found to have portal hypertension, which is a rare association.

Homeopathic Approach In Iron Deficiency Anaemia

In present global worming most common disease in women is anaemia.This condition also seen in during pregnancy also. In my study also find out which miasmas are more prominent during pregnancy may be responsible for iron deficiency anaemia.

Intravenous ferric carboxymaltose for anaemia in pregnancy

Background: Anaemia in pregnancy is associated with unfavourable consequences both for the mother and the fetus and is a major cause of maternal and perinatal mortality and morbidity.Methods: The study was conducted over a period of one year in which 100 pregnant females who met the inclusion criteria were administered ferric carboxymaltose (FCM) preparation.Results: There was significant rise in mean haemoglobin and serum ferritin after transfusion of ferric maltose in the patients with very less adverse effects.Conclusions: FCM, because of its high efficacy and safety can revolutionize the management of iron deficiency anaemia (IDA) in pregnancy.

A comparative study of efficacy, safety and compliance of oral iron versus intravenous iron sucrose in treatment of iron deficiency anaemia of pregnancy

Background: Iron deficiency anemia is the most common form of anemia and nutritional disorder worldwide. Oral iron therapy and blood transfusion has many drawbacks like noncompliance and risk of transmittable infections and transfusion reaction. The modern alternative therapy is treatment with intravenous iron. Present study compares the efficacy, safety and tolerability between intravenous iron sucrose and oral iron in iron deficiency anemia during 20-36 weeks of pregnancy.Methods: It was a randomized controlled study between December 2017 to September 2019. 200 patients attending antenatal OPD in Al Ameen Medical College, with haemoglobin levels between 7-9.9 gm/dl and serum ferritin of <15 ng/ml were enrolled. In intravenous group, 200 mg iron sucrose in 100ml normal saline was infused alternate day till the required dose was met. The oral group received 200 mg of oral iron ascorbate along with folic acid 1.5 mg per day for 6 weeks.  Treatment efficacy was assessed by Hb and serum ferritin after 3 and 6 weeks.Results: Out of 200 patients, an increase in Hb was observed in both groups, rising from 9.7 g/dl to 10.3 g/dl and 10.9 g/dl after 3 weeks and 6 weeks respectively in oral group and from 8.6 g/dl to 9.8 g/dl and 10.8 g/dl after 3 weeks and 6 weeks respectively in intravenous group. Similar results were seen in ferritin levels. Rise in Hb and ferritin levels were greater in intravenous group than in oral group.Conclusions: Intravenous iron sucrose appears to be a better treatment option in comparison with oral iron, without serious side effects, better compliance and improved efficacy in correction of anaemia of pregnancy.

Sehgal index and its comparison with Mentzer's index and Green and King index in assessment of peripheral blood smear with marked anisopoikilocytosis

Background: Mild microcytic hypochromic anaemias due to iron deficiency (IDA) and beta thalassemia trait(β-TT) continue to be a cause of significant burden to the society, particularly in the poorer developing countries. The objective of the present study was to study the RBC based indices in patients of marked anisopoikilocytosis in determining the etiology of it, to standardize few automated red cell parameters, and also objective grading of RBC morphology on peripheral smear and interpreting its utility in indicating a diagnosis. Also, to establish a relation between value of RBC indices with that of degree of anisocytosis.Methods: A total of 500 patients diagnosed with mild microcytic hypochromic anaemia on complete blood count and peripheral blood film were included in the study. Hb, RBC count, MCV, MCH and RDW obtained from the electronic cell counter were used to calculate discrimination indices by various mathematical formulae. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden’s index (YI) were calculated.Results: Green and King index demonstrated the lowest sensitivity of 70.51%. Mentzer index demonstrated the highest specificity of 96.80%. The highest and lowest PPV were found for Mentzer index (97.09%) and Sehgal index (92.81%) respectively. Sehgal’s index demonstrated the highest NPV of 95.96% and lowest NPV was exhibited by G and K (87.9%). The highest and the lowest values for Youden’s index were shown by Sehgal’s index (87.82%) and G and K index (68.47%).Conclusions: Sehgal’s index followed by Mentzer index are highly sensitive and reasonably specific in differentiating β-TT from IDA and none of the indices is 100% sensitive and specific. Though HbA2 estimation is the gold standard for diagnosing β-TT, in developing countries, Sehgal index followed by Mentzer et al, index can be used to screen mild microcytic hypochromic anaemia cases to eliminate as many false positive cases as possible to reduce the financial cost.

Evaluation of efficacy of injection ferric carboxymaltose in pregnant women

Background: Iron deficiency anaemia (IDA) continues to be a very common problem in developing countries leading to a spectrum of adverse events in pregnant women. The objective of this study was to determine the efficacy, side effects and tolerance of ferric carboxymaltose as compared to available iron preparations for the prophylaxis and treatment of mild to moderate iron deficiency anaemia during pregnancy.Methods: One-year clinical study (from June 2017 to May 2018). A total 100 patients were enrolled after matching inclusion and exclusion criteria. The efficacy assessment was performed during 4, 8, and 12 weeks of starting therapy. If the patient is not responding to therapy in either arm as documented by no rise or fall in haemoglobin levels patients may be removed from study for other therapy. Treatment duration up to 12 weeks. Safety and efficacy follow-up visit at 4, 8 and 12 weeks. Institutional ethics committee permission was taken.Results: On intra-group comparisons there was significant increase in haemoglobin levels at 8 and 12 weeks in oral iron group as compared to day 1 haemoglobin levels while there was significant increase in haemoglobin levels at 4, 8 and 12 weeks in IV iron group as compared to day 1 haemoglobin levels. On intergroup comparisons between oral and IV iron group, there was significant increase in haemoglobin levels at 4, 8 and 12 weeks in IV iron group as compared oral iron group haemoglobin levels.Conclusions: Intravenous iron therapy with ferric carboxymaltose causes significant improvement in haemoglobin more quickly and more effective in correcting iron deficiency anaemia in pregnancy compared to oral treatment in terms of increase in haemoglobin levels at 4, 8 and 12 weeks. Intravenous ferric carboxymaltose is safe and effective option for pregnant women with iron deficiency anaemia.

A Study on the Effect of Iron Deficiency Anaemia on Haemoglobin A1c Levels in Non-Diabetic Adults.

Iron deficiency anaemia is a common entity in India. Diabetic parameters may fluctuate with respect to the haemoglobin variants and nutritional anaemia. However, the exact association between them has not been fully elucidated. We aimed to estimate and compare the diabetic parameters and the levels of glycosylated haemoglobin (HbA1c) among anaemics and non-anaemics in non- diabetic patients.METHODSA comparative study was done in the Department of General Medicine, over a period of one-and-a-half years where 50 non-diabetic IDA patients as cases and 50 non- diabetic non-anaemic patients as controls were enrolled in the study. Iron profile and HbA1c levels were measured and compared at baseline. IDA patients were treated with iron supplements and the effects on the HbA1c levels after 3 months of treatment of iron deficiency were noted and analyzed. The data was entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. A P value of <0.05 was considered to be statistically significant.RESULTSWe found that anaemic patients had significantly higher fasting and random blood sugar levels with more patients in the pre-diabetic range as per HbA1c levels. The glycosylated Hb levels were significantly higher in Group A patients. (p<0.05). After initiating IDA treatment, there was a significant improvement in all the haematological parameters at 3 months follow up. There was a significant decrease in the HbA1c levels after three months of anaemia treatment. (p<0.0001).CONCLUSIONSIron deficiency anaemia has an inverse correlation with HbA1c levels. After correction of iron deficiency in the anaemic subjects, in most of the cases, the HbA1c levels declined to near normal values.

A case of pigmented fungiform papillae of tongue in a young female with iron deficiency anaemia

Fungiform papillae are red/pink, mushroom shaped projections located on the tip and dorsolateral part of tongue. It harbours several taste buds. Pigmented fungiform papillae is a not so common benign condition which involves pigment deposition in fungiform papillae. Authors report a case of 35 years female who presented with history of blackish spots over tongue for past 10 years with no other associated symptom. Patient had conjunctival pallor (moderate) and rest of the examination was normal. Investigations showed iron deficiency anaemia with Hb. of 9.5 mg/dl. A clinical diagnosis of Pigmented Fungiform Papillae (PFP) with associated Iron Deficiency Anaemia (IDA) was made. Patient was explained in detail about the benign nature of disease and was put on oral iron therapy. Follow up after 2 months was advised.

A randomized controlled trial on lactoferrin versus ferrous sulphate for the treatment of mild to moderate iron deficiency anaemia in pregnancy

Background: One of the important factors associated with maternal and foetal complications during pregnancy is Anaemia. Various oral preparations of iron are available, and each has different bioavailability, efficacy and adverse effects. Lactoferrin is a naturally existing iron-binding multifunctional glycoprotein, and a member of a transferrin family, thus belonging to those proteins capable of binding and transferring iron. Lactoferrin has considerably less gastrointestinal side effects than ferrous sulfate and is very useful as well as promising alternative to ferrous sulphate.Methods: Prospective randomized controlled study. Total 100 females with 24 to 36 weeks of pregnancy with haemoglobin between 8 to 10 grams were included out of which 50 patients were given ferrous sulphate 200 mg BD and 50 patients were given lactoferrin 250 mg BD daily for 8 weeks. Various haematological parameters and the adverse effects of both the drugs were studied at registration, 4 weeks and 8 weeks and compared.Results: Thus, after this study authors can say that the rise in haemoglobin with lactoferrin was 1.58 g/dl while with ferrous sulphate it was 1.67 g/dl at 8 weeks. Adverse effects were much lesser in Group A taking lactoferrin compared to Group B.Conclusions: Thus, lactoferrin has the advantage over ferrous sulphate in having   less side effects and increasing the compliance and thus the efficacy of the drug compared to ferrous sulphate.

Study of hematological profile in patients with chronic kidney disease

Background: Chronic Kidney Disease (CKD) with its high prevalence, morbidity and mortality, has become an important public health problem. The incidence and prevalence of CKD is increasing worldwide, including India. CKD is associated with a variety of hematological abnormalities, include anaemia, infections and bleeding diathesis. Anaemia is the most consistent hematological abnormality and is associated with poor quality of life and poor cardiovascular outcomes.Methods: A hospital based cross-sectional observational study was done to detect the prevalence of haematological abnormalities, correlation of anaemia with CKD stage and evaluation of iron deficiency. Newly diagnosed CKD (stages 3 to 5) patients were included in this study. Presence of anaemia (Hb%, haematocrit, MCV, peripheral smear), iron deficiency (TSAT, serum ferritin), thrombocytopenia, leucocyte count and coagulation abnormalities (PT, APTT) in different stages of CKD were studied.Results: All the subjects in study group had anaemia which was normocytic and normochromic and of moderate degree in most patients. The severity of anaemia progressed with stage of the disease. Iron deficiency was significantly prevalent (52% in the study population, with transferrin saturation (TSAT) <20%). WBC count was not significantly altered. There was mild thrombocytopenia in a few patients. Bleeding time or other in vitro tests of platelet function were not measured. The coagulation parameters, PT and APTT, were not significantly altered.Conclusions: All CKD patients should be screened for iron deficiency anaemia for its early treatment and to decrease morbidity.

Assessment of Reticulocyte-haemoglobin Equivalent (Ret-He) as a Diagnostic Indicator for Iron Deficiency Anaemia

@#Introduction: Iron deficiency anaemia (IDA) is the most common cause of anaemia. The diagnosis of IDA, however, remains a challenge and is a problem worldwide. Serum iron study is commonly used for IDA diagnosis but there are some limitations. This study was conducted to evaluate reticulocyte-haemoglobin equivalent (Ret-He) as a screening tool for IDA diagnosis in adults. Method: This is a comparative case control study conducted in Hospital Tengku Ampuan Afzan, Kuantan consisting of adult patients with iron deficiency anaemia and a healthy control group. Haematological parameters (Hb, RBC count, MCV, MCH, RDW) inclusive of Ret-He and serum iron parameters (serum iron, transferrin saturation and serum ferritin) were measured. Correlation between Ret-He with other haematological and serum iron parameters were analysed. Results: There were 103 IDA adult patients with majority of them being female (85.4%) with median age of 36 years old. Malay ethnicity (79.6%) contributed to the larger proportion of adult IDA patients. The Ret-He value for patient and control groups were 16.50 ± 4.90 pg and 34.80 ± 1.97 pg, respectively. Ret-He was 89.32% sensitive and 100% specific with 100% positive predictive value (PPV) and 73.11% negative predictive value (NPV) when compared to transferrin saturation. There was significant correlation between Hb, MCH, MCV, RDW and serum iron, transferrin saturation and serum ferritin parameters with Ret-He. Conclusion: Ret-He together with a complete blood count, may serve as an alternative to the serum iron parameters for screening of IDA in adults.

Selection of Acid Salts: A Critical Step in Creating an Acidic Condition for Plasma Iron Release and Measurement

@#Introduction: Iron deficiency anaemia (IDA) is the most common cause of anaemia worldwide. Determination of body iron status is necessary to diagnose IDA. This can be measured using a biochemistry assessment of the serum/ plasma. Plasma/serum iron quantitation is also important in diagnosing iron overload disorders. However, iron studies are limited due to high cost and lack of access to biochemical analysers. Therefore, a cost- and technical-effective method is needed to measure human plasma iron concentration. Plasma iron is mainly transferrin-bound and an acidic plasmic condition is necessary to release the iron. This study investigated various candidate acid salts to achieve the acidic condition needed for plasma iron release. Method: Ten powdered or crystallised acid salts were studied for their water solubility as well as their pH reduction capability in revised simulated body fluid (r-SBF) and commercially available human plasma without any change in colour or form. Results: Six acid salts studied were discontinued from further investigation because they were insoluble in water. Another two candidates were unsuitable as they precipitated in r-SBF and human plasma. Maleic acid formed a jelly-like texture after a certain amount of time in human plasma. Only citric acid met all the criteria of a suitable acid salt to be investigated further as part of the reagent for a spontaneous plasma iron measurement. Conclusion: Citric acid, which is a colourless and odourless acid salt, was selected to lower the human plasma pH to an acidic condition for transferrin-bound iron release.

Date Palm and Goat Milk Improve Haematological Parameters and Availability of Functional Iron in Iron Deficient Rats

@#Introduction: Iron deficiency anaemia (IDA) is endemic especially in the under-developed and developing countries and is a major public health concern. Improving nutrition is one of the ways to alleviate this condition. Consumption of locally available and affordable food such as date palm and goat milk which are rich in iron is one of the ways to overcome IDA. This study is aimed at evaluating the effect of date palm and goat milk supplementation on haematological parameters and iron bioavailability in IDA rats. Methods: 24 male Wistar rats were randomly divided into normal control and IDA group. The normal control was fed with normal diet and water ad libitum while the IDA group were fed on iron-deficient diet for two weeks to induce iron deficiency. The IDA rats were further divided into subgroups; each being supplemented with date palm, goat milk, a combination of date palm and goat milk, and ferrous fumarate as positive control. Blood were collected after 28 days for haematological parameters and iron profile determination. Iron bioavailability was assessed using the haemoglobin regeneration efficiency (HRE) index. Data was analysed by Student T Test and ANOVA using SPSS 23.0 software with p value < 0.05 considered as statistically significant. Results: Supplementation of date palm and goat milk for 28 days significantly improved Hb, RBC, PCV, MCV, MCH, serum iron and transferrin saturation (p<0.05) in all treatment groups compared to normal control. The iron bioavailability of date palm and goat milk supplemented rats was similar to that of the positive control. Conclusion: Supplementation of date palm and goat milk in IDA rats improves haematological parameters and iron bioavailability.

Evaluation of safety and efficacy of intravenous iron sucrose therapy for moderate anaemia in antenatal women

Background: Prevalence of iron deficiency anaemia is high in developing countries like India. Treatment of iron deficiency anaemia in pregnancy is very important to bring down maternal mortality rate as blood loss during delivery can lead to death of the patient. The aim and objective of our study is to evaluate the efficacy and safety of intravenous iron sucrose infusions in antenatal women admitted in hospital suffering from moderate iron deficiency anaemia. Special emphasis was given to observe adverse drug effects.Methods: This was a prospective observational study conducted in Obstetrics and Gynaecology department, Government General Hospital, Rangaraya Medical College, Kakinada, Andhra Pradesh. Study period was two months and study population included antenatal women with gestational age less than 37 weeks with moderate iron deficiency anaemia. Peripheral smear was examined for microcytic hypochromic anaemia and they were treated with intravenous infusion of iron sucrose. Haemoglobin levels were checked before and 5 weeks after iron infusions. Monitoring was done for adverse reactions.Results: Out of 322 admissions, 95% were found to be anaemic. 72 patients were suffering from moderate anaemia from which 25 have been included and treated with intravenous iron sucrose infusions. They were observed for efficacy and safety parameters. Two minor adverse events were reported (fever with chills and angioedema of lips) and they were excluded from study. Mean haemoglobin concentration was found to be raised from 7.08±0.73 (SD) to 11.33±0.48 (SD) within 5 weeks for 23 patients.Conclusions: Iron sucrose infusion is safe and effective for anaemia in pregnancy.

Study of outcome of the treatment with intravenous iron sucrose in moderately anaemic pregnant women

Background: Moderate anaemia seen in about 15-20% of pregnant women. Iron sucrose complex which is used intravenously for the correction of Iron deficiency anaemia. The drug has been able to raise the haemoglobin to satisfactory level when used in moderately anaemic iron deficient pregnant women. The objective of this study was to study the improvement of Hb% after treatment with intravenous Iron sucrose complex in moderately anaemic pregnant women belonging to 24-32 weeks of gestational age.Methods: 50 antenatal patients between gestational age 24-32 weeks with hemoglobin between 8-9.5g/dl were selected and included in this study. They were subjected to blood hemoglobin estimation, hematocrit and peripheral smear study. In each infusion, the maximum total dose administered was 200 mg iron sucrose in 100 ml of normal saline, slow IV infused over 30 minutes. Monitoring was done throughout the infusion to observe for any side effects.Results: Mean hemoglobin among the 50 patients before starting the therapy was 8.172g/dl and the mean hemoglobin at the end of one month of completing the therapy was 11.066g/dl. The rise in mean hemoglobin i.e. the difference in the mean hemoglobin before and after treatment was 2.894g/dl. The p value is 0.0001 which is statistically significant. The mean hematocrit of the 50 patients studied before starting the treatment was 26.772% with a standard deviation of 1.914. The mean hematocrit after completing the therapy was 33.872% with a standard deviation of 1.321. The difference in the mean hematocrit was 7.100% with a p value of 0.0001 which is statistically significant.Conclusions: Intravenous iron sucrose complex is well tolerated and highly efficacious in improving hemoglobin, hematocrit in the treatment of iron deficiency anaemia in antenatal women.

Evaluating iron deficiency anaemia in the third trimester of pregnancy with haematological parameters and serum ferritin concentration

Background: Iron deficiency is the commonest cause of anaemia and at least half of anaemia cases will have causes other than iron deficiency. The objective of this study was to determine the prevalence of iron deficiency anaemia among antenatal mothers based on haematological parameters and serum ferritin levels.Methods: This was a hospital based cross sectional study, conducted at Meenakshi Medical College and Research Institute, Kancheepuram from January 2017 to June 2018. Two hundred antenatal mothers who were diagnosed with anaemia in the third trimester of pregnancy were evaluated by haematological parameters and serum ferritin assay.Results: 38% of women had mild anaemia, 50% had moderate anaemia and 12% had severe anaemia. On peripheral smear, 60% had microcytic hypochromic anaemia indicating iron deficiency, and 12% had megaloblastic anaemia. In 41% of cases, the mean corpuscular volume was <82fL indicative of iron deficiency. Among the 120 women diagnosed with iron deficiency anaemia on smear, the mean ferritin level was 16.62±73.42 (less than 30µg/l). There was a statistically significant low levels of serum ferritin levels in those diagnosed with iron deficiency anaemia (P < 0.05). The serum ferritin level was >160µg/lit in 19% of cases.Conclusions: Based on the haematological parameters and serum ferritin estimation, in 60% of cases, anaemia was due to iron deficiency. Before initiating treatment, it is important to differentiate various types of anaemia, so that appropriate treatment can be given.

Compare the safety and efficacy of intravenous iron supplementation with iron sucrose to the oral supplementation with ferrous ascorbate in subjects with post-partum anemia

Background: The post-partum period is challenging enough for most new mothers. Recovering from birth, learning to parent, and taking care of her child requires lot of energy. Having anemia in postpartum period can make this process much more difficult. According to WHO, in India incidence of anemia in postnatal mother is around 58% and according to ICMR prevalence of anemia in Tamil Nadu population 76% during pregnancy. The objective of this study was to compare the efficacy of intravenous iron supplementation with Iron sucrose to the oral supplementation with ferrous ascorbate in management of patient with post-partum anemia. To study the safety and side effects of these two preparations.Methods: This was a prospective study conducted on 100 post-partum anemic women in KG Hospital  in Coimbatore, October 2012 to November 2013 with hemoglobin less than 10g/dl but more than 6g/dl within 24-48 hours of delivery ,after satisfying inclusion and exclusion criteria were included in the study.Results: Mean hemoglobin of oral group was 8.49±0.75 and mean hemoglobin of IV group was 8.43±0.76; 24 hours after delivery. After treatment, that is after 4 weeks mean hemoglobin of oral group was 10.38±0.79 and mean hemoglobin of IV group was 11.20±0.71.on comparing both groups, the increase in hemoglobin in the IV groups was significant. Reticulocyte count and other parameters increased significantly after four wks of starting therapy in IV group compare to the oral group. No major side effects or anaphylactic reactions were noted during study period.Conclusions: Intravenous iron sucrose complex is safe, convenient and effective in postpartum anemic women as compared with the oral ferrous ascorbate. Intravenous iron sucrose have shorter treatment periods, increased likelihood of compliance, a lack of gastrointestinal side effects, and rapid replenishment of iron stores, making them superior to oral ferrous ascorbate.

An observational study on anaemia in children admitted to a tertiary teaching hospital with first episode of febrile seizures

Background: The association between anaemia and iron deficiency anaemia with febrile seizures is still not very well understood. The purpose of this study was to describe the occurrence of anaemia in children admitted with first episode of febrile seizures.Methods: This was a hospital based prospective study conducted at Central Referral Hospital, Gangtok, Sikkim, India from December 2012 to May 2014 on 50 children in the age group of 6 to 60 months admitted with first episode of febrile seizures. Detailed history and physical examination were performed and findings recorded and complete blood count, serum electrolytes and random blood sugar were done in all children. Mentzer Index was calculated from the haematological data.Results: The mean age in this study was 24.88'13.22 months. 74% of the cases were males. Twenty-eight children (56%) had anaemia out of which twenty-seven had Iron deficiency anaemia. The statistical analysis of qualitative data using Chi-square test with Yate's correction revealed no statistically significant difference between number of children with anaemia and no anaemia (p value=0.1493) and also between number of children with Iron deficiency anaemia and children with no Iron deficiency anaemia (p value=0.4478).Conclusions: This study did not reveal a higher occurrence of anaemia as well as iron deficiency anaemia in children admitted with first episode of febrile seizures.