Common Cause Of Anemia Research Articles

Frequency of Megaloblastic Anemia in Pediatric Patients Presenting with Peripheral Cytopenia

Background: Anemia influences approximately 20 million people around the world mostly women and children. Megaloblastic anemia, a common cause of anemia caused by ineffective erythropoiesis, commonly manifested by peripheral blood cytopenia. Objective: To find out the frequency of megaloblastic anemia in pediatric patients presenting with peripheral cytopenia Methodology: This descriptive cross sectional study was carried out at the Department of Hematology, Hayatabad Medical Complex, Peshawar from 19 Feb, 2019 to 19 Aug, 2019. All the participants were selected based on inclusion criteria. Hematological profile was recorded for the entire participant. Automated hematology analyzer was used for all the blood counts. Data analysis was carried out by using IBM SPSS version 23. Results: Totally 175 patients were enrolled in our study. There were 117 (66.85%) males patients whereas female patients were 58 (33.14%). Based on age distribution, 65 (37.14%) patients were recorded in 5-10 years age group, 110 (62.85%) patients were recorded in 11-15 years age group. Mean and SDs for age was recorded as 12.3+3.19. Megaloblastic anemia was observed in 23 (13.14%) patients. Conclusion: Our study concludes that megaloblastic anemia is highly prevalent in pediatric patients presenting with peripheral cytopenia. Pancytopenia is a common condition in our pediatric patients caused by failure of bone marrow and leukemia. Keywords: Anemia, Bone Marrow, Megaloblastic, Pancytopenia

SKRINING ANEMIA SEBAGAI UPAYA PENINGKATAN KESEHATAN IBU HAMIL DI PRAKTIK MANDIRI BIDAN TANJUNG DELITUA

Iron deficiency is the most common cause of anemia in pregnancy. Complications that can occur from anemia in pregnant women are postpartum hemorrhage, low birth weight babies, premature birth and impaired fetal growth and development. Iron tablets are given once a day for 90 days during pregnancy. The survey at the Tanjung Clinic District Deli Tua that every pregnant woman is given antenatal care, education about the health condition of the mother and fetus and the administration of iron tablets, however monitoring of maternal health conditions through checking hemoglobin must still be carried out to ensure the effectiveness of iron tablets given to pregnant women. For this reason, PkM is carried out as a screening for anemia in pregnancy. This community service was carried out at PMB Tanjung Deli Tua in the form of physical examinations for pregnant women, checking hemoglobin levels with an easy touch device, giving iron tablets and providing education about the benefits and how to consume iron tablets correctly. The results obtained were that the majority of LiLA of pregnant women were 23.5 cm (95.4%) and the majority of pregnant women were secondary (52.2%). Then it was found out of 46 pregnant women who were examined 1 person (2%) had anemia. Through this PkM activity, it is necessary to collaborate with the nearest puskesmas to provide additional food for pregnant women who experience anemia and KEK.

Prevalence of anaemia among adolescent girls in a rural area of Central Kerala, South India

Background: Adolescence lays the foundation for future health. Anaemia among adolescent girls has become a significant public health issue. The state of Kerala has few reported studies in this regard. The current study was conducted to determine the prevalence of anaemia in adolescent girls in a rural area of central Kerala and to find out the factors associated with anaemia among them.Methods: A cross sectional study was conducted among 194 adolescent girls of Tholur panchayath in Thrissur district, Kerala. The study participants were randomly selected from the adolescent registers maintained in anganwadies. A semi-structured questionnaire was administered after getting informed assent and consent from the participants and their guardians respectively. All the participants were clinically examined, anthropometric measurements were taken and 2 CC of EDTA anti-coagulated blood samples were collected to test haemoglobin.Results: The prevalence of anaemia among the participants is found to be 26.3% (95% CI: 17.4-37.34). Out of the total anaemic girls, 94% were mildly anaemic (Hb between 10-11.9 g/dl) and the remaining were moderately anaemic (Hb between 7-9.9 g/dl). Anaemia was significantly higher in the age group between 10-14 years (39.5%), compared to 15-19 years (15.6%). Lower frequency of intake of green leafy vegetable and wholegrain cereals were found to have significant association with anaemia.Conclusions: Anaemia remains a moderate public health hazard among the adolescent girls, with roughly every fourth girl becoming anaemic. Nutritional inadequacies were shown to be the most common cause of anaemia, which was found to be greater in the early teenage period.

Effectivity of Iron Supplementation With and Without Vitamin C for Increasing Hemoglobin Levels Among Women Aged 16-21 Years Old

Anemia can be caused by a decrease in hemoglobin (Hb) levels, chronic disease, severe bleeding, nutritional deficiency, and infectious diseases. Iron deficiency is the most common cause of anemia (50%). Vitamin C has an important role in increasing absorption of iron in the body which can indirectly affect the increase in Hb formation. This study was conducted to determine whether iron and vitamin C supplementation affect the changes of Hb levels in women. This study was done by quasi experimental with single blind pretest posttest control group and with a stratified random sampling technique. Respondents were female students in Faculty of Medicine UNIKA Atma Jaya. The total number of sample was 58 which was categorized into two groups. The first group was given iron and vitamin C supplementation. The second was only given iron supplementation. There were 16 respondents (27,6%) aged 16-18 and 42 respondents (72,4%) aged 19-21. The average change in Hb level before and after intervention in group 1 was 1,934 g/dL, and P = 0,000 (P <0,05), the average change in Hb level before and after intervention in group 2 was 1,086 g/dL, and P = 0,000 (P <0,05). The difference of change in Hb levels in groups 1 and 2 had an average of 0,848 g/dL, and P = 0,005 (P <0,05). For conclusion, Iron and vitamin C supplementation has a greater impact on the changes of Hb levels compared to iron supplementation only.

ANEMIA TREATMENT PATTERNS AND OUTCOMES AMONG A NATIONAL COHORT OF PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Abstract BACKGROUND Anemia is a common complication of inflammatory bowel disease (IBD) and can have a significant negative impact on quality of life by causing fatigue and reduced exercise tolerance. However, system wide patterns of anemia recognition and treatment are lacking. The aim of our study is to identify practice patterns of screening for anemia, assessment of iron stores, and administration of iron repletion therapy among a national cohort of patients with IBD. METHODS We conducted a retrospective cohort study of patients with IBD in the national Veterans Affairs (VA) dataset from 2000-2017. IBD patients were identified using a previously validated algorithm using administrative codes for Crohn’s disease (CD) and ulcerative colitis (UC). Laboratory values, patient demographics, and medical treatment data were extracted from the national VA datasets. Anemia was defined as hemoglobin < 13 g/dL in males and < 12g/dL in females. Initial observation of anemia during the study period was considered index anemia date. Analyses were descriptive of proportion of IBD patients with anemia, treatment, or outcomes. Temporal trends were presented as number patients by calendar year. RESULTS Of the 89,687 patients with IBD identified from 2000-2017, 50,781 (56%) were found to have anemia at least once during the study period. The number of IBD patients with anemia increased five-fold during the study period from 3,260 to 15,579 unique patients per calendar year. Testing for iron deficiency among patients with anemia was low- only 36% of anemic patients had iron studies completed within 6 months of anemia result. Of anemic patients who completed iron studies, the vast majority (89%) were consistent with iron deficiency anemia. Of patients with low iron stores, only 23% of patients received iron therapy within 6 months of lab result. Of patients with anemia, only 19% had anemia resolve within 1 year. Hospitalization within 5 years was observed in 30% of patients with anemia, with 60% of hospitalizations occurring within 1 year of index anemia date. IBD-associated surgery within 5 years of index anemia date was observed in only 2% of patients. CONCLUSIONS In a large national cohort of IBD patients, anemia is a common and undertreated complication, and is frequently followed by hospitalization and steroid use. Although iron deficiency is the most common cause of anemia, adequate iron testing and treatment is lacking, which may contribute to the low rates of anemia resolution. Interventions to improve anemia testing and treatment for iron deficiency anemia are needed.

Efficacy of Combination of Iron Pyrophosphate and Folic Acid in Management of Iron Deficiency- A Retrospective Study

Background: Iron deficiency is the most common cause of anemia, especially in reproductive-aged women. If not treated, it leads to weakness, fatigue, menorrhagia, amenorrhea in females and can cause serious consequences such as heart problems and complications in pregnant ladies such as premature births and low birth weight babies. Thus, it is necessary to prescribe iron supplementation in iron-deficient women to avoid complications in the later stage. Objective: The objective of this study was to evaluate the efficacy of the combination of ferric pyrophosphate and folic acid in reproductive-aged women who suffered from iron deficiency. Methods: Electronic medical records of 100 reproductive-aged women deficient in iron were analyzed. The baseline hemoglobin and iron parameters were noted. They were prescribed a 30 mg tablet combination of ferric pyrophosphate and folic acid, and the parameters were noted at 4 weeks, 8 weeks, and 12 weeks. The data was statistically analyzed by SPSS version 26.0. Results: The hemoglobin (hemoglobin, total erythrocytes, mean corpuscular volume, red cell distribution width, haematocrit) and iron parameters (serum iron, ferritin, transferrin saturation, serum transferrin) showed significant improvement in week 4, which continued till week 12. The RDW levels showed much improvement after week 4 till week 12. Conclusion: Our study concluded that the combination of ferric pyrophosphate and folic acid in tablet form significantly improves the hemoglobin and iron parameters within 4 weeks and showed further improvement until 12 weeks without any complaint of side effects.

Clinico-aetiological Analysis of Anaemia along with Haematological Parameters in Children and Adolescents: A Retrospective Study from a Tertiary Care Hospital, Chhattisgarh, India

Introduction: Anaemia is defined as a decreased concentration of blood haemoglobin. World Health Organization (WHO) estimates that 42% of children less than 5 years of age worldwide are anaemic and prevalence of anaemia in India in children 6-59 months for year 2019 was 53.4%. Childhood anaemia not only affects physical health but cognitive and social development as well. Aim: To determine various causes of anaemia in children in age groups 1-5 years, 6-12 years and 13 to 18 years and to determine clinical features and haematological investigations in moderate to severe anaemia. Materials and Methods: This retrospective, observational study was conducted in Department of Paediatrics, Shri Shankaracharya Institute of Medical Sciences, Bhilai, Charttisgarh, India, from September 2021 to December 2021. The data collection was done retrospectively over a period of 2 years, from September 2019 to September 2021 from patients case records which were available from Medical Record Department. A total of 300 patients from age 1 year to 18 years who were admitted in the paediatric ward with anaemia were included for study. Anaemia was defined and severity categorised based on WHO definition. The aetiology of anaemia was analysed based on Complete Blood Count (CBC) and investigations including serum ferritin, vitamin B12 level, bone marrow examination, High Performance Liquid Chromatography (HPLC) and other relevant investigations. Data was entered in a excel sheet and analysed using software Statistical Package for the Social Sciences (SPSS) version 21.0. Statistical test used was student’s t-test for paired and unpaired data for continuous variables. The p-value <0.05 was considered significant. Results: Out of total 300 patients, 148 (49.3%) were males and 152 (50.7%) were females. Most of the patients were in 1-5 years of age (45.6%), followed by 13-18 years age (29.4%) and 6-12 years (25%). Total 95 (31.6%) patients had mild, 112 (37.3%) had moderate and 93 (31%) had severe anaemia. The three most common causes of anaemia were iron deficiency in 77 patients (37.5%), haemolytic anaemia in 54 patients (26.3%) and vitamin B12 deficiency in 34 patients (16.5%). Mean Red Cell Distribution Width (RDW )(31.1±10.1%) values and mean of Mean Corpuscular Volume (MCV) (98.2±15.2 fL) were higher in vitamin B12 deficiency patients as compared to iron deficiency patients mean RDW (17.2±3.5%) and mean of MCV (58.14±7.3 fL), this difference was found to be significant with p-value <0.001. Conclusion: Most of the patients had moderate anaemia. Iron deficiency was most common cause of anaemia overall in children and especially below 13 years followed by haemolytic anaemia mainly sickle cell anaemia and Vitamin B12 deficiency anaemia. The MCV and RDW values from CBC can be used to identify two most common causes of nutritional anaemia.

Retinal nerve fiber layer thickness evaluation in iron deficiency anemia patients using optical coherence tomography

Background Anemia is a widespread public health problem. Iron deficiency is the most common cause of anemia. Hemoglobin (Hb) concentration was supposed to affect the retinal nerve fiber layer thickness (RNFLT).Objective The aim of this study was to evaluate the influence of iron deficiency anemia (IDA) on the peripapillary RNFLT using optical coherence tomography (OCT).Patients and methods A total of 30 patients with IDA with Hb less than 12 g/dl were enrolled in the study. Optic disk and RNFL parameters obtained by Topcon OCT in these patients were compared with those of age-matched and sex-matched nonanemic 30 individuals. The anemia group was also divided according to the Hb concentration into three groups: mild, moderate, and severe.Results The average age of the IDA cases and the controls was 23.38±9.06 years (range=15–30 years), and 25.37±7.64 years (range=15–30 years), respectively (P=0.09). The average right eye RNFLT in IDA patients was 98.20±10.98 µm compared with 106.30±14.05 µm in the control group (P=0.001), while in the left eye, it was 98.87±12.24 µm in the IDA group, and 105.30±6.59 µm in the control group (P=0.015). The average nasal and inferior RNFLT of the IDA group were thinner than the control group in the right eye (P=0.003 and 0.045, respectively) and in the left eye (P=0.016 and 0.038, respectively). There was a positive association between average RNFLT and Hb concentration in the right eye (r=0.554) and in the left eye (r=0.561), which was statistically significant (P=0.001). In addition, there was a positive correlation between nasal and inferior RNFLT and Hb concentration in the right eye (P=0.002 and 0.001, respectively) and in the left eye (P=0.001 and 0.002, respectively). The degree of thinning was related to the severity of anemia as the RNFL thinning was significantly more in severe anemia cases than in mild and moderate ones.Conclusions The peripapillary RNFLT measured by OCT was significantly thinner in the IDA patients in the average, inferior, and nasal quadrants, with more thinning in the severe than in mild and moderate groups. This finding may have a significant effect, as these pseudoglaucomatous changes could be misdiagnosed as glaucoma or other neuro-ophthalmological disorders.

The Prevalence and Significance of Leukopenia Induced by Intravenous Iron Therapy in a Large Cohort of Females with Iron Deficiency Anemia (IDA).

Introduction:Iron deficiency anemia (IDA) is the most common cause of anemia in both developed and developing countries. Leukopenia is an infrequent side effect of iron therapy reported in the literature as sporadic cases.Objective:To assess the prevalence of leukopenia, neutropenia and/or lymphocytopenia and its possible clinical impact if any, after intravenous iron therapy in adult patients with IDA.Patients and Methods:This is a retrospective study conducted in Hamad Medical Corporation, Doha (Qatar). The clinical and biochemical data of 1.567 females (mean age: 29.5 years) with IDA who attended the Hematology Clinic and were treated with intravenous (i.v.) iron therapy were collected and analysed. Complete and differential blood counts and iron profile were studied before and after i.v. iron therapy. In addition, cases who developed infections during the time of leukopenia were noted and checked for possible complications.Results:30 cases (1.91%) developed leukopenia,15 cases (0.95%) developed neutropenia and 12 cases (0.76%) developed lymphocytopenia. All had normal white blood cell counts before treatment. Two patients (6.66%) had infection. One had upper respiratory tract infection and the other had urinary tract infection, the latter was treated with antibiotics. There was no reported other infection during or after i.v. iron therapy.Conclusions:Leukopenia in form of neutropenia or lymphocytopenia may occur as a side effect of i.v. iron therapy, however, its clinical significance appears to be limited. (www.actabiomedica.it)

LITERATURE REVIEW: DAMPAK ANEMIA DEFISIENSI BESI PADA IBU HAMIL

In general, the most common cause of anaemia in pregnancy is iron deficiency, which arises from maternal-fetal iron transfer, which is often exacerbated by a decrease in maternal iron stores. According to the World Health Organization (WHO), pregnancy anaemia is a global health problem that affects almost half of pregnant women. The purpose of this study was to conduct a journal review of explanatory and experimental articles published in the last 5 years starting in 2016 on deficiency anaemia in pregnancy. The research method is carried out by literature study using an electronic reference library through Medline, PubMed, NCBI, Science Direct and Proquest by investigating the impact of anaemia in pregnant women. The results literature from research in various developing and developed countries show that there is an impact that occurs when the mother had anaemia during pregnancy, namely prematurity, low birth weight, postpartum hemorrhage, maternal mortality, cesarean delivery and mental development of children. The conclusion is that there are several effects of anaemia in pregnant women, which are prematurity, low birth weight, postpartum hemorrhage, maternal mortality, cesarean delivery and children's mental development.

Multigravida Women With Moderate to Severe Anaemia in Third Trimester: Fetomaternal Outcomes.

Background & Objectives: Anaemia has been reported to be associated with adverse pregnancy outcomes, especially when presenting in the last trimester. In addition to prevalent common causes of anaemia in pregnant women, poor replenishment of iron stores after a pregnancy event is specific to women with higher birth orders. Anaemic women presenting in the third trimester are more prone to maternal complications such as infections, toxaemia, antepartum haemorrhage, cardiac failure, pre-eclampsia as well as fetal hazards too such as low birth weight, pre-term deliveries, developmental anomalies, and even neonatal death. When presented near term there are higher chances of feto-maternal morbidity and mortality. In the current study, analysis is done of feto-maternal outcomes, routes of delivery of women, causes of anaemia in multigravida women in the third trimester suffering from moderate to severe anaemia in a tertiary care centre of Western Rajasthan of India.Methods: A prospective observational clinical study was conducted on patients attending Geetanjali Hospital over a period of 18 months. A total of 70 consecutive multigravida pregnant women having moderate to severe anaemia in the third trimester were selected. Statistical analysis of the data collected was done and a p-value <0.05 was taken as significant.Results: Moderate and severe anaemia in the study population were 44.28% and 55.71%, respectively. The mean haemoglobin level of all study groups was 7.0 gm%. Pre-eclampsia, placenta praevia, postpartum haemorrhage (PPH), congestive cardiac failure (CHF), neonatal intensive care unit (NICU) admission, preterm birth (PTB), low birth weight (LBW), intrauterine death (IUD), low Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score, and birth asphyxia records were investigated. Of the patients studied, 18.57% had PPH, 15.71% had pre-eclampsia, 8.57% had IUD, and 37.14% newborns were LBW.Interpretations and Conclusion: Multiparity itself is a major risk factor of anemia. Anemia presenting in the third trimester of pregnancy is a proxy indicator of care received by gravid women in the early antenatal period. In combination, a multigravida in the third trimester with less time to restock iron and vitamin stores may result in considerable maternal as well as perinatal mortality and morbidity.

The iron revolution: Keeping abreast of the developments in iron therapy.

A recent review of iron homeostasis published in the Journal of Clinical Investigation1 (JCI) elegantly reviewed the role of iron homeostasis in mammalian physiology. Unfortunately, this was counter-balanced by a disappointing failure of the authors to acknowledge the recent revolution in iron therapy with newer therapies of intravenous iron transforming the management of a number of disabling conditions. Iron deficiency is the commonest nutritional deficiency worldwide, affecting over two billion people, and is the commonest cause of anemia. It ranks as a World Health Organization top five cause of disability and causes an average of 8 years living with disability. The last decade has seen a pivotal change in our understanding of iron metabolism and the introduction of new treatments which offer a potential cure to iron deficiency in one treatment; indeed, a revolution which will support the WHO target to cut the global incidence of anemia by half by 2025.2 There are no conflicts of interest to declare. Data sharing not applicable - no new data generated.

A CLINICO-PATHOLOGICAL STUDY OF ANEMIA IN GERIATRIC AGE GROUP

Anemia in geriatric age (&gt;60 years) is one of the major health problem in India and other countries around the globe. It causes increased morbidity, mortality and also affects quality of life. Symptoms associated with anemia like shortness of breath, fatiguability due to anemia could also be attributed to aging process, therefore anemia is often easily overlooked in elderly. Clinico-haematological patterns and morphological types of anemia in geriatric age (&gt;60 years) are manifold, hence this study was done to determine them and to know more about the associated disorders. The present study was conducted in a tertiary care center of South India for two years. 1000 patients who were 60 years and above and clinically diagnosed as anemic were included in this study. Routine haematological investigations including peripheral blood smear examination and complete hemogram were done. Special investigations were done whenever required. Female population was the most affected geriatric population with most of them belonging to 60-69 years of age. The most common cause of anemia was found to be anemia of chronic disease. Despite modern diagnostic advances, anemia in geriatric patients still remains under-reported and inadequately investigated, necessitating evaluation of even mild anaemias. Prompt diagnosis and denite categorization helps in appropriate management of anemias

Iron deficiency in preschool non-anemic Egyptian children

BackgroundIron deficiency anemia remains a common cause of anemia in young children. The term iron deficiency without anemia, or the so-called latent iron deficiency, has become increasingly significant as it is not only difficult to identify this condition in non-anemic children, but it also adversely affects neurocognitive development, and unfortunately, some of these effects may be irreversible and not respond to treatment. This cross-sectional study was conducted to evaluate iron status in 68 apparently healthy, non-anemic Egyptian children aged 1–6 years. They were subjected to detailed history-taking, physical examination, complete blood count, and tests for serum iron, total iron binding capacity, serum ferritin, and transferrin saturation.ResultsLow serum ferritin level and low transferrin saturation were detected in 41.2% and 47% of the children, respectively. Iron deficiency parameters were significantly affected among toddlers aged “1” to “3” years compared with preschool children, and boys were found to be more affected than girls of the same age group.ConclusionsA normal hemoglobin level does not exclude iron deficiency, which should be screened in healthy children to prevent the possible long-term effects of iron deficiency on their cognition and mental development.

Prevalence of Thrombocytopenia Among Iron Deficiency Anemia in Arab Population in Qatar

Prevalence of Thrombocytopenia among Iron Deficiency Anemia in Arab population in QatarINTRODUCTION / BACKGROUNDIron deficiency anemia is a common cause of anemia, and account for almost half of the causes of all anemias. It is well known and common that iron deficiency anemia can be with thrombocytosis, A study reviewed 450 patients with a diagnosis of anemia between 2002 and 2006 was performed in which 143 of them were having IDA found that 31% of them were having associated thrombocytosis (4).A retrospective study conducted in Turkey found that Iron deficiency anemia and thrombocytopenia found in 13 from 615 patients (2.1%) (5). IDA and thrombocytopenia are found in certain ethnicity where we don t have data from studies about Arab Population.Materials and MethodsWe retrospectively reviewed the electronic medical records of patients attended hematology/ IV iron room clinics with the diagnosis of IDA over 2 years from the period between December 2017 to December 2019 in Hamad Medical Corporation, Qatar. Complete blood count and iron parameters were collected and analyzed. Thrombocytopenia was defined as Platelet count of less than 150 × 109/L. Statistical analysis was done using mean and SD and paired t test to compare variables after versus before treatment.Depending on previous studies available in the literature, the prevalence of IDA and thrombocytopenia reported from the study done in Turkey (2.1%), based on this we expect the prevalence estimates in Arab population is 3% (with margin of error +/- %) and confidence level 95%, the required sample size needed would be a total of 1744 participants +- 0.8. The adequate sample size was determined using the following statistical equation:Inclusion Criteria: •Arab Female who is diagnosed with iron deficiency anemia or iron depleted and receive iron therapy.Exclusion criteria: •Extreme age less than 18 and above 65•Any chronic organ dysfunction or failure•Previous bariatric surgery or gastrostomy•Malignancy (Known or discovered at any time during study follow up)Results:Out of 1752 cases of IDA, 39 cases had thrombocytopenia, (2.2 %) (table 1) with mean age of 41.38. The mean Platelet count was 108 x 10^9 in patients with thrombocytopenia while it was 325 x 10^9 in non-thrombocytopenia patients. Platelets count mean increased to 179 x 10^9 after iron replacement (p < 0.05). Analysis of thrombocytopenia according to nationalities was obtained which showed 28 cases among Qatari's (2.2%), 4.1 % in Egyptians, 3.8% in Yemenis, 3.1% Sudanese, 2.9%,2.7% in Jordanian and Syrian respectively and 1.1% in other nationalities (table 2).Discussion:Qatar is multinational country with large number of expatriates working in it. In our study thrombocytopenia occurred in 39 cases out of 1752 cases included in the study which represent 2.2% of them. Most of our patients were of Qatari nationality 1327 in which 28 cases of thrombocytopenia were found, with 3.8 % in Egyptian the 2nd most common Arab residents in Qatar. Further analysis according to nationalities revealed 3.1%, 2.9%, 2.7% in Yemenis, Sudanese and Jordanian patients, with 1.1% in other patients from other Arab nationalities.Comparison of blood parameters including platelet count before and after iv iron therapy were obtained which showed mean platelet count was 108 x 10^9 which increased to 179 x 10^9 after iron therapy, The mechanisms for the thrombocytopenia associated with IDA are not well established, although iron plays a critical role both in the synthesis of platelets and in the regulation of thrombopoiesis.Other blood parameters including WBC, ANC, Lymphocyte count showed decremental responses after iron therapy with WBC dropped from 6.3 to 6.1, ANC from 3.5 to 2.7 and lymphocyte count from 1.9 to 1.8 in thrombocytopenic patients.Conclusion:The prevalence of thrombocytopenia among IDA in Qatar was 2.2%, which normalized after iv iron therapy. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Perioperative Anemia Management in Women Undergoing Gynecologic Procedures: A 10 Year Multisite Study

BackgroundPreoperative anemia is a known risk factor for adverse patient outcomes. In women undergoing gynecologic surgery, preoperative anemia is independently associated with increased 30-day mortality, surgical complications, and hospital re-admission. Women with abnormal uterine bleeding and women undergoing gynecologic surgery remain under-studied and over-transfused. Patient blood management (PBM) initiatives are emerging from growing awareness of adverse outcomes associated with preoperative anemia. PBM efforts involve optimizing red cell mass and limiting unnecessary red blood cell (RBC) transfusions, with the goal of improving outcomes. Iron deficiency is a common cause of anemia in women with gynecologic sources of blood loss, and early identification and repletion of iron stores is an important component of PBM. Our research evaluated perioperative RBC utilization and intravenous (IV) iron use in women undergoing gynecologic procedures at three large academic hospitals.MethodsThis retrospective cohort study used data from the Transfusion Registry for Utilization Surveillance and Tracking database, a multihospital database network in Ontario, Canada. Canadian Classification of Health Interventions codes were used to identify women aged 15 and older who underwent gynecologic surgery with a hospital admission between January 1, 2010 and December 31, 2019 at three academic hospitals. Patients undergoing gynecologic surgery with malignant and non-malignant conditions were included. Patients who were pregnant and immediately postpartum were excluded. Collected data included patient demographics, laboratory investigations, RBC utilization, IV iron use, hospital length of admission, intensive care unit (ICU) admission, and in-hospital mortality. Data was collected from 90 days prior to gynecologic surgery to 30 days post gynecologic surgery. Only the first gynecologic surgery per patient was included in the analysis. Patients with an underlying malignancy were analyzed separately from patients without a malignancy diagnosis.ResultsA total of 4,822 patients with a gynecologic surgery were identified during the study period, with 4,842 hospital admissions. 3,687 patients had a malignancy diagnosis.We identified that 27.3% of all gynecologic surgery patients were anemic (hemoglobin (Hb) <120 g/L) on preoperative bloodwork. In the malignancy group, 798 patients (21.6%) received at least 1 unit RBC in the perioperative period, with 2.9% transfused in the 90 days prior to surgery, 12.6% transfused on the day of surgery, and 13.0% transfused within 30 days post-surgery. Of the non-malignancy patients, 58 patients (5.1%) had at least 1 unit RBC in the perioperative period, with 0.8% transfused in the 90 days prior to surgery, 1.9% transfused on the day of surgery, and 3.4% transfused within 30 days post-surgery (Table 1).Only 0.6% of patients in the malignancy group and 0.4% of patients in the non-malignancy group received IV iron in the perioperative period.Patients with a preoperative Hb< 120 g/L had an increased rate of ICU admission and longer hospital admission compared to patients with a preoperative Hb > 120 g/L; adverse outcomes were higher in patients with Hb< 80 g/L (Table 2). A logistic regression model adjusting for baseline characteristics demonstrated an association between preoperative anemia and ICU admission compared to non-anemic patients: for Hb 80-120 g/L, odds ratio (OR) 1.53, 95% CI 1.27-1.85, P <.0001; for Hb<80 g/L, OR 2.81, 95% CI 1.45-5.46, P=.0022.There was no significant change in transfusion rates from 2010 to 2019 (Figure 1).ConclusionOur retrospective cohort study of women undergoing gynecologic surgery is consistent with the findings of previous studies demonstrating that preoperative anemia is associated with adverse clinical outcomes in this population. IV iron was under-utilized in our study cohort; increased use of IV iron may have reduced unnecessary perioperative transfusions. 1 in 6 women in our study were transfused in the perioperative period. The appropriateness of these transfusions and the potential for preventing RBC transfusion in this patient population warrant further investigation. In contrast to other surgical specialties, transfusion rates in the gynecologic surgery population have been static over the past decade, suggesting a need for further PBM initiatives in this group. [Display omitted] DisclosuresZeller: Canadian Blood Services: Consultancy, Research Funding; Pfizer: Membership on an entity's Board of Directors or advisory committees, Research Funding; Canadian Insitutes of Health Research: Research Funding; American Society of Hematology: Honoraria.

The need to screen for anaemia in female populations

Objectives: Anemia is the commonest disease to affect women’s health. 1 in 10 women will have anemia at any point in time and 1 in 3 women suffer with anemia at some point in their lifetime. The commonest cause of anaemia is iron deficiency (ID). Iron deficiency anaemia (IDA) is particularly common in women, due to increased iron loss from menstrual bleeding. Women who experience heavy menstrual bleeding (HMB) are at an even greater risk of both ID and IDA. Despite high prevalence rates, awareness is poor. This is relevant for women undertaking sport as anemia can lead to reduced physical performance. There is no current screening program or recommendation for testing of anemia for women. Therefore, we assessed a simple screening tool to predict anemia in women. Methods: 300 apparently fit and healthy women attending a national fitness festival randomly completed a Female Health Questionnaire (FHQ) about; previous iron status, menstrual blood loss (based on 4 symptoms), diet, and motherhood. Participants were asked to self-report any symptoms of iron deficiency, including; brain fog, palpitations, shortness of breath, restless legs, hair loss, and pica. Results were compared to fingerprick haemoglobin levels with anemia defined as [Hb]<120 g/L. Results: Average age was 31.21 years (s.d.7.72), average [Hb] was 131.76g/L (s.d.11.5) and 36 (12%) had anemia. A history of iron deficiency was reported by 127 (43.49%), 127 (43.49%) reported heavy menstrual bleeding (HMB), 75 were vegetarian (18%) or vegan (8%) and 33 were mothers (11%). In total 80 reported taking time off work (median 20, range 1-50, total 1612 days). Overall, the FHQ reporting of risk factors or symptoms relating to anemia appeared nonspecific, with little correlation to haemoglobin levels. However, those with HMB were significantly more likely to report a history of ID (51.18% vs. 37.58%, p=0.024) and there was a significant correlation between HMB and the overall self-reporting of symptoms relating to anemia (r=0.252, p<0.001). Women who reported the symptom of HMB were significantly more likely to report symptoms of brainfog (p=0.002), palpitations (p=0.009), restlessness in the legs (p=0.010) and or pica (p=0.001). Further, women with anemia more commonly reported HMB (58.33% vs. 41.57%, p=0.04), and those with HMB were more likely to report days off (39.37% vs. 18.18%, p<0.001). Conclusions: Anemia was common in apparently fit and healthy women, particularly those with HMB. A simple screening tool for HMB and testing for anemia is recommended in women undertaking exercise. Conflict of interest statement: Dr. Richards reports grants from UK, NIHR HTA, grants from Australian, NHMRC, grants, personal fees and non-financial support from Pharmocosmos, grants, personal fees and non-financial support from Vifor Pharma, grants from NIHR EME, personal fees from Medtronic, grants from Australian MRFF. The above listed grant providers played no formal role in this research project. Outside the submitted work; and TR is a regular speaker at national and international conferences on anaemia, blood transfusion, wound healing and vascular diseases for which he has received expenses for travel, accommodation and sundries. TR has worked with several agencies promoting meetings or healthcare. TR is a director of The Iron Clinic Ltd and director of Veincare London Ltd also TR is the vascular lead for 18-week wait Ltd. All other authors acknowledge no conflict of interest of relevance to the submission of this abstract.

The Effect of Moringa Oleifera on Hemoglobin Level in Pregnancy

Anemia is a form of the body's compensation mechanism for decreasing hemoglobin levels. Anemia in pregnancy is a condition in which hemoglobin is below normal, which is below 11 g/dl. The most common cause of anemia in pregnancy is iron deficiency. Moringa leaves are one type of food that is rich in iron which can overcome anemia. The purpose of the study was to determine the effect of giving Moringa leaf soup on hemoglobin levels of pregnant women in the third trimester at the Oepoi Health Center, Kupang City in 2021. Quasy Experimental research design with a two group pre-test and post-test design. The study population was all pregnant women. The sampling technique is purposive sampling. The sample was 32 pregnant women. Statistical test using t-test. The location of this research was carried out at the Oepoi Health Center, Kupang City from July to August 2021. The research instrument was observation sheet and Hb measuring instrument. The results showed that the average hemoglobin of pregnant women before the intervention in the experimental group was 9.813 g/dl with a standard deviation of 0.57. The hemoglobin level of pregnant women after being given Moringa leaf soup in the experimental group was 11.494 g/dl with a standard deviation of 1.24. The average hemoglobin in pregnant women before intervention in the control group was 9.825 g/dl with a standard deviation of 0.61. The average hemoglobin in pregnant women after the intervention in the control group was 9.675 g/dl with a standard deviation of 1.28. Analysis using the t-test obtained a significance value of 0.000 &lt;0.05. It can be concluded that there was a significant effect between giving Moringa leaf soup on hemoglobin levels in TM III pregnant women. It is hoped that in addition to consuming Fe tablets, it is also recommended to consume foods high in iron such as Moringa leaves to increase hemoglobin in pregnant women.

Iron Status in Preschool Children with Normal Hemoglobin, Egypt

BACKGROUND: Iron deficiency (ID) anemia remains a common cause of anemia in young children. However, the more significant than anemia itself is the ID without anemia that also adversely affect neurocognitive development and unfortunately some of these effects may be irreversible. AIM: This study is a cross-sectional study aimed to asses iron status in preschool children with normal hemoglobin (Hgb) level attending Assiut University Children Hospital. METHODS: The cross-sectional study including 68 apparently healthy children aged 1–6 years old during the period from January 1, 2015 to June 30, 2015, They were subjected to detailed history, physical examination, and the following laboratory investigations: Complete blood count, Serum iron, Total Iron Binding Capacity, Serum ferritin, and Transferrin saturation. RESULTS: Low serum ferritin and low transferrin saturation were detected in 41.2% and 47% respectively of our studied children who have normal Hgb levels. CONCLUSION: Normal Hgb doesn’t exclude ID that should be screened in healthy children to prevent the possible long-term effects of ID on their cognation and mental development.

1037 Early Detection and Management of Preoperative Anaemia in An Elective Vascular Surgery Cohort

Abstract Introduction Iron deficiency anaemia is the most common cause of anaemia in the surgical population. Patients receiving transfusions during major surgery encounter more adverse outcomes compared to those that do not, indicating the early management of pre-operative anemia is likely to reduce major surgical patient morbidity and mortality. Previous studies have demonstrated that 33% of patients undergoing major vascular surgery operations are anaemic (haemaglobin, Hb, &amp;lt;130g/L). Aim We aim to reduce the proportion of anaemic patients undergoing major vascular surgery by 50%. Method A point-of-care HemoCue machine was used to measure Hb in patients who were referred for elective major surgery in 11 vascular clinics. Patients with Hb &amp;lt; 130g/L were prescribed a 1-month course of Ferrous Sulfate (200mg TDS), and a letter was sent to their GP requesting iron function tests. Post-intervention Hb levels were rechecked following the preoperative anaesthetics review. Results 11 patients were referred for major surgery, of which 4 were identified as anaemic (36%). The mean Hb concentration was 121.3g/L, which increased to 137.3g/L following oral iron therapy. The mean duration of follow up was 36 days (range 0-94 days). Conclusions The implementation of a HemoCue machine to identify and manage preoperative anaemia was successful in our pilot study. Further work should include full integration of our pathway into current vascular clinics without student support. This will enable evaluation of the impact of our intervention on a wider scale.