Cases Of Anemia Research Articles

Risk Factors for Low Birth Weight Babies in Women Delivered in a Tertiarry Referral Hospital

Background: Low birth weight is an important indicator of reproductive health and general health status of population. LBW is considered as the single most important predictor of infant mortality, especially of deaths within the first month of life. It is also a significant determinant of infant and childhood morbidity, particularly of neurodevelopmental impairments such as mental retardation and learning disabilities. This study aimed to determine the risk factors associated with low birth weight. Material & Methods: It was a prospective cross sectional observational study carried out in the Department of Obstetrics & Gynaecology, Dhaka Medical College, Dhaka, during the period of January 2012 to June 2012. Total 308 samples were included in this study. All women ≥28 weeks of pregnancy who delivered a LBW baby during six months of study period were selected. The database was processed by the application of statistical package SPSS for windows version 24. Results: This study shows most frequent maternal age group was 20-25 years. The mean maternal age was 23.86±4.82 years. Fifty three percent (53%)were female and 46.76% were male babies. Low birth weight was associated with inadequate Antental care, pre-delivery weight <55 kg, height <145 cm, low socio-economic status, and anemia. ln LBW babies’ mother having regular antenatal care (23.8%\. The incidence of mild anemia was 10.71 o/o, moderate anemia 32.79% and there were 2.60% cases of severe anemia. Maternal factors including maternal height (27.92%), maternal weight (36.36%), anaemia (43.50%), placenta praevia (12.18%), eclampsia (20.29%), PROM (24.35%), preterm labour (15.42%), severe PET (8.12%), twin pregnancy (17.86%), heart disease (2.44%) and DM (1.620/o) were associated with low birth weight. 62.01% mothers had average food intake, 37.99o/o had poor food intake. Conclusion: The incidence of low birth weight is 19.05%. Maternal height, maternal weight, ANC, anemia, eclampsia, preeclampsia, PROM, preterm labor, sever PET, twin pregnancy and heart disease were associated with low birth weight. There is a need for national prospective research project to study the low birth weight problem at the national level. There is also a need to discourage teenage pregnancies and to encourage utilization of mother and child health services, and treat concomitant illnesses during pregnancy. Maternal malnutrition, inadequate antenatal care and poor weight gain during pregnancy are significant predictors for delivery of a low birth weight neonate.

Etiological Profile of Macrocytic Anemia in Patients Attending a Tertiary Care Hospital in Nepal

Introduction: The morphological classification of anemia often correlates with the cause of red cell deficiency. Megaloblastic and non-megaloblastic macrocytic anemias are important causes of anemia in at least 1.7% of hospital patients. Vitamin B12 and folate deficiency are rampant in underdeveloped countries. In Nepal, there is a lack of local data evaluating the etiological profile of macrocytic anemia. Methods: A descriptive hospital-based study was conducted, and thirty-five cases of anemia according to the WHO criteria were included after informed consent. Clinical history, physical examination, complete hemogram (including hemoglobin level, red cell indices, total leucocyte count, platelet count, and reticulocyte count), and a peripheral blood smear were obtained per structured proforma. Appropriate biochemical investigations were acquired. Statistical analyses were performed as per standard statistical protocols. Results: The mean age of the patients in our study was 42.40 (±10.29) years. There was a slight male predominance (n=20; 57.14%). Most cases (n=27;77.14%) of macrocytic anemia were megaloblastic. Vitamin B12 deficiency (n=13; 48.14%) was the commonest identifiable cause in megaloblastic group, while liver disease accounts for half of the cases (n=4; 50%) of non-megaloblastic group. The mean hemoglobin was lower (9.94±1.43 g/dl) in megaloblastic anemia compared to non-megaloblastic macrocytic anemia (10.96±1.24 g/dl). Conclusion: The present study showed that megaloblastic anemia was the most common cause of macrocytic anemia, primarily due to vitamin B12 and folate deficiency. Non-megaloblastic anemia was mainly attributed to liver diseases.

The Effect of Delayed Cord Clamping (DCC) on Haemoglobin Levels and Oxygen Saturation Levels in Newborns

Background: The case of iron deficiency anaemia in infants is a serious health problem because it interferes with mental and cognitive development. DCC prolongs blood flow from the placenta to the baby through the umbilical cord, increases blood volume, and optimizes oxygen transfusion which might prevent anemia and promote effective self-breathing. Objective: To determine the effect of DCC on Haemoglobin Levels and Oxygen Saturation Levels in Newborns. Method: Experimental research with Post-test Only Control Group design. The total Sampling method was used on 30 newborns as the samples, with 15 intervention groups and 15 control groups. Data collection used the Delayed Cord Clamping procedure, observation sheets, Easy Touch GCHb tool, and Baby SpO2. An Independent T-test was used to process the data. Results: Based on the experiment on 30 infants, it found that the average hemoglobin level of new-borns with the Delayed Cord Clamping treatment was 22.07 gr/dL higher than the hemoglobin level of new-borns without the Delayed Cord Clamping treatment of 17.79 gr/dL. In addition, the average oxygen saturation level of newborns with the Delayed Cord Clamping treatment was 87.4% more than that of newborns without the Delayed Cord Clamping treatment of 77.4%. Conclusion: DCC affects Haemoglobin Levels and Oxygen Saturation Levels in Newborns in the Work Area of the Aikmel Regional Health Centre. There is a need to increase information about the benefits of DCC among health workers.

Modern approach to transfusion therapy of massive hemorrhage due to abnormally invasive placenta

Abnormally invasive placenta (AIP), or according to modern terminology PAS (placenta accrete spectrum disorders), is one of the most dangerous obstetric pathologies of pregnancy. It is quite often accompanied by massive blood loss during childbirth. Indicators of placenta accretion are increasing sharply, taking into account the frequency of delivery by cesarean section (CS).The objective: to determine the effectiveness of the blood loss recovery program in the case of delivery of pregnant women with AIP according to modern principles of transfusion therapy of massive blood loss with the use of innovative methods of surgical hemostasis.Materials and methods. At the clinical bases of the Department of Obstetrics and Gynecology N 1 of the Shupyk National Healthcare University of Ukraine during 2018–2023, 49 pregnant women with Placenta рercreta 3a,b were operated by fundal SC.The main group included 19 pregnant women with antenatally diagnosed Placenta percreta, who were delivered by fundal SC followed by hysterectomy with fallopian tubes and restoration of blood loss according to the principles of Damage Control Resuscitation – DCR (during 2021–2023) with priority given to transfusion with blood products with minimization infusion therapy; the comparison group included 30 pregnant women with a similar diagnosis and surgical approach, who had the recovery of massive blood loss in accordance with order No. 205 of the Ministry of Health of Ukraine “Obstetric bleeding” with the priority of rapid infusion therapy with crystalloids (2018-2020).Results. All pregnant women from Pl. percreta were delivered by CS and had hysterectomy at 35–37 weeks of pregnancy with lower median laparotomy and endotracheal anesthesia. The study groups did not differ in terms of the volume of surgery, but differed in the program of transfusion therapy to restore blood loss.In the main group, in which the early start of transfusion therapy using single-group fresh-frozen plasma and erythrocyte mass was applied, a significantly lower frequency of the development of the syndrome of disseminated intravascular blood coagulation, relaparotomy, cases of severe postoperative anemia and a shorter length of stay in the obstetric hospital were determined (p<0.05).Conclusions. The use of innovative surgical technologies, tranexamic acid preparations and early initiation of transfusion therapy with blood preparations with minimization of crystalloid infusion, according to the Damage Control Resuscitation strategy, in the development of massive intraoperative bleeding in cases of Placenta percreta allows to reduce the volume of blood loss and to prevent severe intra- and postoperative complication.

Prevalence and Risk Factors for Iron Deficiency Anemia among Children under Five and Women of Reproductive Age in Pakistan: Findings from the National Nutrition Survey 2018.

Anemia remains a global public health problem, especially in developing countries. It affects primarily children under five (CU5), women of reproductive age (WRA), and pregnant women due to their higher need for iron. The most common form of anemia is iron-deficiency anemia (IDA). IDA is estimated to cause half of all anemia cases and one million deaths per year worldwide. However, there remains a lack of well-documented and biochemically assessed prevalence of IDA based on the representative population-based samples globally and regionally. In this study, we aimed to assess the National Nutrition Survey (NNS) 2018 to identify the prevalence and risk factors of IDA in Pakistani CU5 and WRA. Secondary analysis was conducted on the NNS 2018, a cross-sectional survey, which collected data on dietary practices, malnutrition, and food insecurity. Anemia was defined as hemoglobin levels < 11.0 g/dL in children and 12.0 g/dL in women. IDA was defined as low hemoglobin and low ferritin (<12 ng/mL) levels, adjusted for inflammation using AGP and CRP biomarkers in CU5 and WRA. Univariate and multivariable logistic regressions were conducted using Stata statistical software (version 16). We also compared the IDA rates of NNS 2018 and 2011. A total of 17,814 CU5 and 22,114 WRA were included in the analysis. Of the CU5, 28.9% had IDA, while 18.4% of WRA reported to experience IDA. Among the CU5, IDA was most prevalent among male children aged 6-23 months living in rural areas and with the presence of diarrhea and fevers in the last 2 weeks. Children whose mothers had no education, were aged 20-34 years, and employed, had a higher prevalence of IDA. Married WRA, who are employed, living in rural areas, and with no education, had a higher prevalence of IDA. In the multivariable logistic regression, children aged 6-23 months (AOR = 1.19, 95% CI [1.08-1.33], p < 0.001) and with the presence of diarrhea in the last 2 weeks (AOR = 1.32, 95% CI [1.13-1.54], p < 0.001) or fever (AOR = 1.16, 95% CI [1.02-1.32], p = 0.02) had higher odds of IDA. At the household level, the odds of IDA among CU5 were higher in the poorest households (AOR = 1.27, 95% CI [1.08-1.50], p = 0.005), with ≥5 CU5 (AOR = 1.99, 95% CI [1.28-3.11], p = 0.002), and with no access to improved sanitation facilities (AOR = 1.17, 95% CI [1.02-1.34], p = 0.026). For WRA, the multivariable logistic regression found that the odds of IDA were higher among women with vitamin A deficiency (Severe: AOR = 1.26, 95% CI [1.05-1.52], p = 0.013; Mild: AOR = 1.36, 95% CI [1.23-1.51], p < 0.001), zinc deficiency (AOR = 1.42, 95% CI [1.28-1.57], p < 0.001), no education (AOR = 1.53, 95% CI [1.30-1.81], p < 0.001), and from severely food insecure households (AOR = 1.20, 95% CI [1.07-1.34], p = 0.001). The odds of IDA were lower among women whose body mass index was overweight (AOR = 0.77, 95% CI [0.69-0.86], p < 0.001) or obese (AOR = 0.71, 95% CI [0.62-0.81], p < 0.001). The child's age, presence of diarrhea or fever, place of residence, household size, wealth status, and access to sanitation facilities were significantly associated with IDA among CU5 in Pakistan. For WRA, education, body mass index, vitamin A and zinc status, household food security status, wealth status, and access to sanitation facilities were significantly associated with IDA. Large, well-established, government-funded programmes focused on micronutrient supplementation, food fortification, the diversification of food supplies, and the treatment and prevention of infectious and parasitic diseases are needed to prevent IDA and all forms of anemia among children and women in Pakistan.

Immunohematological evaluation of red cell alloimmunization and statistical assessment of various adsorption techniques in warm autoimmune hemolytic anemia

Adsorption techniques are widely applied to detect underlying masked alloantibodies in warm autoimmune hemolytic anemia (WAIHA). We established various adsorption techniques with an aim to detect alloimmunization in WAIHA This study conducted over a period of nine years included 298 patients of WAIHA. Complete immunohematological evaluation was performed on these 298 samples following departmental protocols. Clinical and laboratory details of patients were obtained from patient files. Various adsorption methods were performed and statistically evaluated in the study. Out of 479 cases of autoimmune hemolytic anemia, WAIHA comprised of 62.2 % (N = 298). A total of 139 (46.6 %) serum samples revealed autoantibodies. Adsorption study was performed in 101 (72.7 %) indicated samples and 24 (23.8 %) of these showed 26 alloantibodies. Among the patients subjected to adsorption study hemolytic marker were significantly deranged in the alloimmunization group (p < 0.01). Polyethylene glycol (PEG) adsorption was the quickest (52.2–54.6 min) of all adsorption techniques with minimum (1.3–1.5) numbers of adsorptions needing for complete removal of serum antibodies. The LISS-papain (LP) technique was found to be more sensitive and specific compared to the other two techniques. The agreement between PEG adsorption and LP adsorption was found to be ‘perfect’ (96.4 %) with a Cohen’s kappa (k) value of 0.9. We conclude that identification of alloantibody specificities underlying a warm autoantibody is critical for a safe and effective transfusion. All WAIHA patients with history of blood transfusion, pregnancy or both should be subjected to adsorption study. Selection of a suitable adsorption technique depends on multiple important factors.

Prevalence and Risk Factors of Anemia in Inflammatory Bowel Diseases: A Case-Control Study.

Introduction Inflammatory bowel diseases (IBDs) including Crohn's disease and ulcerative colitis may induce anemia, ranging from 25% to 75% depending on the study population and diagnostic criteria. It might negatively impact their health and quality of life. Objectives The aim of this work is to study the effectiveness and safety of treatments for anemia in patients with IBD. Methodology This case-control study compared patients with IBD who have anemia (cases; n=60) with patients who have IBD but do not have anemia (controls; n=60) from June 2019 to August 2021 in Hayatabad Medical Complex, Peshawar, Pakistan. Data were collected through interviews, from patients` medical records, and from lab test reports. Statistical analysis was performed using SPSS, Version 23.0 (IBM Corp., Armonk, NY). Results Cases had a greater mean age (45.2 years) than controls (42.8 years). Cases included 60% females and controls 45%. Also, cases earned less (p = 0.019). Anemic patients (group 1) had lower mean hemoglobin (10.2 g/dL) and iron than non-anemic controls (group 2) (p = 0.042 and 0.009, respectively). Anemia increased Crohn's Disease Activity Index and Mayo Score. Group 1 has iron deficiency anemia, whereas group 2 has chronic disease. Group 1 reacts rapidly, but gastrointestinal side effects, allergies, and iron overload are more prevalent. Conclusion IBD patients exhibited low hemoglobin and iron, suggesting anemia. Anemia increased disease activity, but not statistically. IBD patients need iron and anemia treatment. Comparing groups demonstrates differences in anemia types, iron replacement history, treatment response, and bad effects, proposing targeted iron supplementation for deficiency anemia and managing chronic illness factors for chronic disease anemia. IBD anemia treatment involves individualization.

A clinical analysis of Candida tropicalis bloodstream infections associated with hematological diseases, and antifungal susceptibility: a retrospective survey.

To assess the clinical features and outcomes of hematological disease patients with Candida tropicalis bloodstream infections and determine the antifungal susceptibility of C. tropicalis. This is a retrospective, single-center, observational study conducted in the Department of Hematology at The First Affiliated Hospital of Guangxi Medical University from January 2013 to December 2021. A total of 26 hematological disease patients with C. tropicalis bloodstream infections were enrolled, and their clinical features, treatment plans, and prognoses were assessed. Univariate analysis was performed by Kaplan-Meier analysis and multivariate analysis was conducted using a Cox regression model. The antifungal susceptibility of C. tropicalis was determined from patient blood cultures. The patients had a mean age of 35 years (range: 10-65 years), 50% were male (13/26) and 88.5% had hematologic malignancies (23/26) while the remaining three patients included two cases of severe aplastic anemia and one case of β-thalassemia. All patients had neutropenia. Seven patients were initially given azole alone (26.9%), five of whom failed treatment and died (71.4%). Fifteen patients were treated with echinocandin (57.7%), three of whom failed treatment and died (20.0%), and eight patients were treated with amphotericin B (30.8%), two of whom failed treatment and died (25.0%). The total and attributable mortality rates were 42.3 and 34.6%, respectively. Univariate analysis showed that there are six risk factors for attributable deaths among hematological disease patients with C. tropicalis blood infections. These risk factors included septic shock, Pitt bacteremia scores ≥4, procalcitonin levels ≥10 ng/mL, positive plasma (1,3)- β-D glucan assay, serum albumin levels <30.0 g/L, time from fever to antifungal treatment initiation ≥5 days and time between neutropenia and antifungal treatment ≥10 days. Moreover, skin and mucosal infections and a treatment schedule that included amphotericin B and drug combinations are protective factors for attributable deaths. Multivariate analysis showed that septic shock (p = 0.006) was an independent risk factor for attributable death. All isolates were sensitive to flucytosine and amphotericin B. The intermediate or resistance of C. tropicalis to fluconazole, itraconazole and voriconazole were 41.7, 50, and 41.7%, respectively. Hematological disease patients with C. tropicalis bloodstream infections had a high mortality rate, and early antifungal therapy significantly reduced mortality. Candida tropicalis was highly resistant to azole drugs and sensitive to flucytosine and amphotericin B. According to our study, the preferred agent is amphotericin B and drug combinations should be considered for severe infections.

Gata1s mutant mice display persistent defects in the erythroid lineage.

GATA1 mutations that result in loss of the N-terminal 83 amino acids are a feature of myeloid leukemia in children with Down syndrome, rare familial cases of dyserythropoietic anemia, and a subset of cases of Diamond-Blackfan anemia. The Gata1s mouse model, which expresses only the short GATA1 isoform that begins at methionine 84, has been shown to have a defect in hematopoiesis, especially impaired erythropoiesis with expanded megakaryopoiesis, during gestation. However, these mice reportedly did not show any postnatal phenotype. Here, we demonstrate that Gata1s mutant mice display macrocytic anemia and features of aberrant megakaryopoiesis throughout life, culminating in profound splenomegaly and bone marrow fibrosis. These data support the use of this animal model for studies of GATA1 deficiencies.

A rare case report of scleral necrosis in a patient with aplastic anemia

A 15-year-old male presented with swelling and redness in the right eye of 1-month duration. The patient was a known case of aplastic anemia. Clinical examination revealed bilateral retinal hemorrhages and scleral necrosis in the right eye. The patient was treated with topical fortified Vancomycin and lubricating eye drops and received blood transfusion. There was an improvement in ocular condition following the initiation of therapy. Scleral necrosis is a rare but potentially blinding complication in patients with aplastic anemia. Ophthalmologists should be aware of this complication and follow-up such patients closely.

Assessment of peripheral nerve conduction in iron deficiency anemia patients in Indian rural adult population attending a tertiary care hospital

Background: Iron deficiency anemia (IDA) is the most common nutritional deficiency anemia in India. Peripheral neuropathy can result due to iron deficiency as it disrupts myelination and neuronal energetics in neuronal functioning. Nerve conduction studies (NCS) can quantitatively detect peripheral nerve dysfunction. This study was conducted to observe effect of IDA on peripheral nerve conduction velocity in adults using neuroelectrophysiological techniques with the aim to recommend Complete Blood Count for serologic evaluation of patients with peripheral neuropathy in Indian population. Objectives: This study aims to compare motor and sensory nerve conduction study parameters between controls and IDA patients and evaluate the effect of various grades of IDA on motor and sensory nerves. Methodology: 30 newly diagnosed patients of IDA in age group of 20-45 yrs and 30 healthy controls in same age group were recruited in this study. NCS was conducted on bilateral motor and sensory median and ulnar nerves in Neurophysiology laboratory using Neurosoft machine. Neuroelectrophysiological data of both the groups was evaluated and analysed using Student’s unpaired t test. Also, patients were categorised as mild, moderate and severe anemia cases and one way ANOVA was used for comparison among patients with various grades of anemia. Results: CMAP (compound muscle action potential), SNAP (sensory nerve action potential) and nerve conduction velocity (NCV) of bilateral median and ulnar nerves was reduced and DL (distal latency) was increased in bilateral median and ulnar nerves in patients with IDA compared to controls. The results were statistically significant (p=0.001). A highly significant difference between motor and sensory nerve conduction values between mild, moderate and severe IDA patients was also observed (p=0.001). Conclusion: The results of the study confirmed peripheral nerves involvement in IDA patients. As severity of anemia increases, peripheral neuropathy worsens. These results can be extrapolated for screening patients with peripheral neuropathy for iron deficiency as a routine part of diagnostic approach for peripheral neuropathy.

Clinical Efficacy and Nursing Care of Fetal Intrauterine Blood Transfusion: Previous Experience Review

To summarize the clinical efficacy and nursing experience of intrauterine blood transfusion (IUT) treatment for fetal anemia cases. The clinical data of 4 fetal anemia cases receiving IUT in Beijing Obstetrics and Gynecology Hospital, Capital Medical University between 2020 and 2022 were collected. Four pregnant women aged 24-38 years were included in the study. They carried fetuses with anemia of unknown causes. The four pregnant women developed anxiety after they were informed of the diagnosis of fetal anemia. One-on-one psychological counseling before the IUT procedure and one-on-one companionship over the course of the surgery were provided for the pregnant women. In addition, they were closely monitored for blood transfusion reactions. Postprocedural observation of the puncture site and 24-hour monitoring of the newborns were also conducted. The four pregnant women underwent 1-3 times of IUT in the second and third trimesters, with the minimum gestational age at the time of IUT being 25 + weeks and the blood transfusion volume being 20-107 mL/time. Two pregnant women experienced irregular uterine contractions during IUT in the third trimester. Other than that, all other IUT treatments were successful. After IUT, there was a significant improvement in fetal hemoglobin, peak systolic velocity of the middle cerebral artery (MCA-PSV), and cardiothoracic area ratio. One case did not give birth in our hospital and the outcome of the fetus was not known. The other three fetuses achieved good outcomes. Positive preprocedural psychological counseling for pregnant women, close intraoprocedural and postprocedural pregnancy monitoring, and the prevention of maternal and fetal complications are the key to improving the clinical efficacy of IUT and achieving a good fetal outcome.

Diagnostic Dilemma of Hemolytic Anemia: A Reveal Secondary to Gastric Adenocarcinoma

Here is a case report of a 62-year-old female who presented to our hospital with complaints of abdominal pain, unresolving severe anemia, bleeding per rectum with history of multiple blood transfusions at outside hospital. On initial investigations, the findings directed towards case of hemolytic anemia. The cause of hemolytic anemia was still unknown even after extensive clinical and laboratory investigations. Bone marrow biopsy was done, which revealed metastatic adenocarcinoma and diagnosis of cancer-related microangiopathic haemolytic anaemia (CR-MAHA) was established. Endoscopic biopsy was done from gastric growth which revealed gastric adenocarcinoma and final diagnosis of microangiopathic hemolytic anemia secondary to gastric adenocarcinoma was made.&#x0D; The patient’s haematological parameters improved with chemotherapy directed against the gastric adenocarcinoma. Our case supports the findings of various literature which indicates that the gastric cancer-associated MAHA responds well to the treatment with chemotherapy for primary carcinoma.

Case report: Pyruvate kinase deficiency in an infant

Pyruvate kinase deficiency is a rare cause of hemolytic anaemia. We report a case of Non-spherocytic hemolytic anaemia due to a deficiency of the red cell Pyruvate kinase enzyme due to a homozygous type of autosomal recessive inheritance. The child underwent a double volume Exchange Transfusion and received blood transfusions for Rapid Hemolysis on the first day of life. In this report, we stress the need for consideration of Red cell Pyruvate kinase enzyme deficiency as one of the differentials of Non-immune hemolytic anaemia. The study will help human geneticists and paediatricians with early identification or screening.

Iron Deficiency in Pregnancy: A Brief Review

This paper highlights iron deficiency anaemia in pregnancy; its prevalence, causes, screening, and management. Iron deficiency is a spectrum that ranges from iron depletion to iron deficiency anaemia. Iron deficiency is the most common and leading cause of anaemia in pregnancy both in developed and underdeveloped countries. The incidence of iron deficiency anaemia varies worldwide depending on differences in race, socioeconomic factors, nutritional status, health condition, and the frequency of parasitic illnesses. Untreated Iron deficiency has significant adverse foetal and maternal consequences. The management of iron deficiency anaemia includes education regarding dietary modification, specifically ways to enhance iron absorption and iron supplementation. Although oral supplementation is typically the mainstay of treatment, more severe cases of iron deficiency anaemia may require intravenous supplementation.

Septic pericarditis in a complicated case of non-associated immune-mediated hemolytic anemia in a Jack Russel terrier

A three-year-old, male, intact Jack Russel terrier was referred for severe regenerative anemia and was diagnosed with non-associated immune-mediated hemolytic anemia. Treatment was implemented according to the ACVIM guidelines (Swann et al., 2019). As no response was seen eleven days later despite two immunosuppressive drugs, intravenous immunoglobulins (IVIG, 1 g/kg) were administered. Three days later, septic shock and diffuse intravascular coagulation (DIC) developed. Echocardiography revealed pericardial effusion with cardiac tamponade and thrombus in the right atrium. Fluid analysis confirmed septic pericarditis. A pericardial drain was placed following immediate reoccurrence of the pericardial effusion. Despite a stable hematocrit for several days following IVIG administration, a decrease in hematocrit was subsequently noted and splenectomy was performed. In total, six blood transfusions were given. Two years after presentation and intensive follow-up, immunosuppressive therapy was tapered, and the dog had excellent quality of life.

411 Long term laboratory safety of dupilumab in patients aged 6 months to 5 years with moderate-to-severe atopic dermatitis

Abstract Systemic treatments often require laboratory monitoring. Here we report 52-week laboratory safety data for dupilumab-treated children aged 6 months to 5 years with moderate-to-severe AD. LIBERTY AD PED-OLE (NCT02612454) is an open-label extension study of children aged 6 months to &amp;lt;18 years with moderate-to-severe AD. This analysis includes hematologic and chemistry laboratory parameters in children aged 6 months to 5 years treated with dupilumab every 4 weeks (q4w; 200 mg: ≥5 to &amp;lt;15 kg; 300 mg: ≥15 to &amp;lt;30 kg). Of the 180 patients enrolled, 122 (67.8%) completed up to 16 weeks and 30 (16.7%) completed up to 52 weeks. Mean (SD) eosinophil counts increased slightly from baseline [1.15 × 109/L (1.18) ] to Week 16 [1.5 × 109/L (1.91)], but then decreased below baseline by Week 52 [0.80 × 109/L (0.64)]. Mean (SD) platelet counts were relatively stable with a modest decrease from baseline [388.7 × 109/L (102.51)] to Week 52 [356.1 × 109/L (107.48)]. Chemistry parameters remained within the normal reference ranges. One patient (0.6%) reported a mild case of anemia, and one patient (0.6%) reported a mild case of thrombocytopenia, which were resolving and resolved at the time of this interim analysis, respectively. Overall safety was consistent with the known dupilumab safety profile. No clinically meaningful changes in hematologic and chemistry parameters were observed during 52 weeks of dupilumab treatment. As with adults, adolescents and older children, routine laboratory monitoring is unnecessary in children aged 6 months to 5 years with moderate-to-severe AD.

Edukasi Konsumsi Tablet Fe dan Susu Kedelai untuk pencegahan Anemia pada Ibu Hamil di Bidan Praktek Mandiri Muzilatulnisma Kota Jambi

Anemia is the biggest public health problem in the world, especially in the group of pregnant women. The prevalence of anemia in pregnant women worldwide is 41.8%, the prevalence of anemia in pregnant women in developed countries is 18%, while the average prevalence of anemia in pregnant women in developing countries is around 63.5% - 80%. the results of basic health research (Riskesdas) in 2013 the prevalence of pregnant women with anemia in Indonesia was 37.1%. cases of anemia in pregnant women is due to iron deficiency. The risk of pregnant women who experience anemia face the risk of death in pregnancy. Every year there are 500 thousand postnatal maternal deaths worldwide, as much as 20-40% of the main causes of death are anemia. BPM muzilatulnisma is a clinic that serves maternal and child health in the city of Jambi which has been standardized as a Delima midwife and as a certified mom and baby treatment clinic. Consumption of Fe tablets and soy milk is one way to prevent anemia in pregnant women. This community service is carried out by providing education through counseling for pregnant women about anemia prevention. held from March to August 2022 at the Muzilatulnisma Independent Practice Midwife, Jambi City. The purpose of this service activity is to provide education by providing health education/counseling on how to prevent anemia in pregnant women. With the hope of increasing the knowledge and awareness of pregnant women in consuming Fe tablets and soy milk in the prevention of anemia. The results obtained after community service was carried out were an increase in knowledge of pregnant women about anemia prevention at BPM Muzilatulnisma Jambi City. The implementation of community service activities carried out by providing education (counseling) using leaflets was able to increase the knowledge of pregnant women about anemia prevention.

Severe Anemia among Blood Donors in an Area Where Blood Donation Is Sought to Save the Lives of Children with Severe Malaria—Anemia in Blood Donors

Introduction: Severe anemia caused by severe malaria remains concentrated in children under 5 years old in Africa. In addition to blood-transfusion-related infections that pose a health concern, transfusion of severely anemic blood to a patient with severe anemia is another important concern. Method: Following the observation of a case of severe anemia in a blood donor, we conducted a secondary data analysis from a previous study to assess the frequency of anemia in blood donors in San, Mali. Results: In total, out of 140 volunteers, 13 (9%, 95% CI: 5.43–15.41) blood donors had moderate to severe anemia, based on Mali hemoglobin (Hb) normal values (10.5–16.5 g/dL, MRTC-GLP laboratory). In particular, we observed one case of severe anemia with an Hb level of 6.5 g/dL. Conclusions: To the best of our knowledge, this is the first report of severe anemia in blood donors in a malaria endemic area in Mali.

Sclerosing angiomatoid nodular transformation, a rare splenic tumor with increasing incidence.

SANT (sclerosing angiomatoid nodular transformation) tumor is a rare splenic tumor of unknown etiology and vascular lineage, first described in 2004. Most cases are asymptomatic, although cases of anemia or abdominal pain in association with growth have been described. Spontaneous ruptures have not been described. Radiologically it presents a radial pattern with centripetal filling in dynamic MRI, being a characteristic feature, but not pathognomonic. It may present hypermetabolism in PET-CT. Its incidence is increasing since its description as an independent clinical and histopathological entity, especially in the oncological patients follow-up. Due to its radiological resemblance to metastatic lesions and its growth despite being a vascular lesion, splenectomy is indicated following the principles of oncologic surgery until a definitive diagnosis is made. It presents a benign behavior, requiring neither treatment nor specific subsequent surveillance. Two diagnosed cases of SANT are presented, as well as a review of the clinical, radiological and histopathological characteristics of this little-known splenic lesion.