Prevalence and aetiology of anaemia in lymphoid malignancies.

BACKGROUND: We prospectively studied the prevalence, type and causes of anaemia in newly diagnosed patients with lymphoid malignancies. METHODS: Between January 2007 and June 2008, a total of 316 newly diagnosed, consecutive patients (aged 15 years or above) of Hodgkin lymphoma, non-Hodgkin lymphoma and chronic lymphocytic leukaemia with anaemia (haemoglobin <11 g/dl), were analysed to determine the prevalence and a subgroup of 46 patients was analysed for the cause of anaemia. RESULTS: Hodgkin lymphoma, non-Hodgkin lymphoma and chronic lymphocytic leukaemia were the diagnoses in 81 (25.8%), 203 (64.7%) and 30 (9.6%) patients, respectively. Anaemia was present in 134 patients (42.4%). Anaemia of chronic disease was present in 33/46 (71.7%) and iron deficiency in 18/46 (39.1%) patients. Vitamin B12 and/or folate deficiency was detected in 10/46 (21.7%) patients (B12 deficiency alone in 7, folate deficiency alone in 1 and combined B12 and folate deficiency in 2). Autoimmune haemolytic anaemia was detected in 5/46 (10.9%) although direct Coombs test was positive in 17/46 (37%) patients. Among patients with Hodgkin lymphoma and non-Hodgkin lymphoma, anaemia due to bone marrow involvement was present in 16/40 (40%). In most patients with bone marrow involvement, anaemia was due to other causes. In only 3 patients, anaemia was attributable to bone marrow involvement alone. Anaemia was multifactorial in 18/46 (39.1%) patients. Nutritional deficiency alone or in combination was present in 22/46 (47.8%) patients. CONCLUSION: Anaemia is common in lymphoid malignancies at initial presentation. Besides managing anaemia of chronic disease and bone marrow involvement, nutritional and autoimmune causes should be ruled out.

Overweight and obesity among schoolchildren in Manipur, India.

BACKGROUND: The prevalence of overweight and obesity and their associated factors among schoolchildren in Manipur has not been studied. METHODS: We did a cross-sectional study among 3356 schoolchildren of classes VIII to XII in Imphal West district, Manipur between September 2005 and August 2006. The characteristics of the respondents and related variables such as parental build, watching television, eating habits, playing of video/computer games and outdoor games, dietary pattern and knowledge of obesity were assessed using a questionnaire. Height, weight, waist circumference, hip circumference, fat percentage, fat mass and fat-free mass were measured. Body mass index (BMI) and waist-hip ratio for each student were calculated. RESULTS: The BMI of the sampled students was lower than the corresponding WHO and International Obesity Task Force standards. Using the WHO standard, the prevalence of overweight was 4.2% and of obesity 0.8%. Using multivariate logistic regression, mother being reported to be obese (OR 1.9, 95% CI 1.4-2.6), watching television for > 2 hours a day (OR 2.052, 95% CI 1.191-3.536), higher family income (OR 5.844, 95% CI 2.135-15.99), not eating other type of vegetables in the past 1 week (OR 2.338, 95% CI 1.04-5.24) and waist-hip ratio (OR 7.737, 95% CI 4.429-13.51) were found to be independent predictors of a higher BMI. Mother's literacy below class X (OR 0.6, 95% CI 0.378-0.997) and eating between major meals (OR 0.447, 95% CI 0.293-0.681) were significant predictors of a lower BMI. CONCLUSION: The prevalence of overweight and obesity among schoolchildren in the Imphal West district of Manipur is low. The possible reasons for this include a more traditional low-fat diet, less exposure to sedentary past-times and a greater time spent playing outdoors.