TO ASSESS THE ACCURACY AND RELIABILITY OF PALLOR IN THE ORAL CAVITY AND PALPEBRAL CONJUNCTIVA TO CLINICALLY DIAGNOSE ANAEMIA IN MIDDLE AGED FEMALE PATIENTS BY USING HAEMOGLOBIN AS THE REFERENCE STANDARD

Abstract

Aim: To accurately determine the reliability of pallor on the dorsal surface of tongue and/or palpebral conjunctiva to diagnose anaemia in middle aged female patients, by using haemoglobin as the reference standard. To correlate pallor with different grades of anaemia according to WHO criteria. Objective: A cost effective chair side clinical observation of pallor to diagnose anaemia in middle aged female patients and to provide counselling thereby reducing the prevalence of anaemia and its associated morbidities, especially in poor resource setting. Method: Between 1st June 2022 to 30th Aug 2022, all female dental outpatients between 40-65 years of age were prospectively examined. Among these subjects,100 female patients with pallor on the dorsal surface of tongue and/or palpebral conjunctiva who met the specified inclusion and exclusion criteria, provided informed consent, and who had undergone blood test within one day of clinical pallor detection were enrolled in the study. Based on haemoglobin levels, anaemia was divided into mild, moderate, and severe according to WHO criterion (Hb: <12g/dl). Anaemia was divided into mild (Hb: 11-11.99 g/dl), moderate (Hb: 7-10.99 g/dl), and severe (Hb: < 7g/dl). Data was expressed as frequency and percentages. Result: In the present study, 82% of subjects with either conjunctival pallor or tongue pallor or both were anaemic with laboratory proven haemoglobin levels < 12 g/dl which was found to be statistically significant. 14.6% subjects were diagnosed with mild anaemia, 51.2% with moderate anaemia, and 34.1% with severe anaemia. Among patients with mild and moderate anaemia, conjunctival pallor out performed tongue pallor whereas in subjects with severe anaemia, tongue pallor outperformed conjunctival pallor. Detecting pallor in a female patient is a dependable sign of anaemia. Furthermore, identifying tongue surface pallor is a strong signal of severe anaemia in female patients whereas conjunctival pallor is a good indicator for mild and moderate anaemia. The effective implementation of dietary counselling has the potential to significantly reduce the prevalence of anaemia.