Decrease In Hemoglobin Levels Research Articles

Spontaneous Large Renal Pelvis Haematoma in Ureteropelvic Junction Obstruction: A Rare Case Report

Spontaneous Large Renal Pelvis Haematoma in Ureteropelvic Junction Obstruction: A Rare Case Report

Case report: Decreased hemoglobin and multiple organ failure caused by ceftizoxime-induced immune hemolytic anemia in a Chinese patient with malignant rectal cancer

BackgroundDrug-induced immune hemolytic anemia (DIIHA) is a rare but serious condition, with an estimated incidence of one in 100,000 cases, associated with various antibiotics. This study reports on a case of ceftizoxime-induced hemolysis observed in a patient in China.Case descriptionA Chinese patient diagnosed with malignant rectal cancer underwent antimicrobial therapy after laparoscopic partial recto-sigmoid resection (L-Dixon). After receiving four doses of ceftizoxime, the patient developed symptoms including rash, itchy skin, and chest distress, followed by a rapid decline in hemoglobin levels, the presence of hemoglobin in the urine (hemoglobinuria), renal failure, and disseminated intravascular coagulation. Laboratory analysis revealed high-titer antibodies against ceftizoxime and red blood cells (RBCs) in the patient’s serum, including immunoglobulin M (IgM) (1:128) antibodies and immunoglobulin G (IgG) (1:8) antibodies, with noted crossreactivity to ceftriaxone. Significant improvement in the patient’s hemolytic symptoms was observed following immediate discontinuation of the drug, two plasma exchanges, and extensive RBC transfusion.ConclusionThis case, together with previous reports, underscores the importance of considering DIIHA in patients who exhibit unexplained decreases in hemoglobin levels following antibiotic therapy. A thorough examination of the patient’s medical history can provide crucial insights for diagnosing DIIHA. The effective management of DIIHA includes immediate cessation of the implicated drug, plasma exchange, and transfusion support based on the identification of specific drug-dependent antibodies through serological testing.

Patient with suspected co-infection of hemorrhagic fever with renal syndrome and malaria: a case report

BackgroundHemorrhagic fever with renal syndrome (HFRS) is a natural epidemic disease that can be caused by the Hantaan virus (HTNV). Malaria is caused by plasmodium and can be transmitted by a mosquito bite. The similar manifestations shared by these disorders pose a challenge for clinicians in differential diagnosis, in particular, coupled with a false-positive serological test.Case presentationA 46-year-old man was admitted for fever and chills for over 10 days and was suspected of being co-infected with HFRS and malaria due to a history of travel to malaria-endemic areas and a positive HTNV-immunoglobulin M (IgM) test. Although leukocytosis, thrombocytopenia, renal injury, lymphocytosis, overexpression of interleukin-6, and procalcitonin were observed during the hospitalization, the hypotensive, oliguria, and polyuria phases of the HFRS course were not observed. Instead, typical symptoms of malaria were found, including a progressive decrease in erythrocytes and hemoglobin levels with signs of anemia. Furthermore, because the patient had no history of exposure to HFRS endemic areas, exposure to an HTNV-infected rodent, or a positive HTNV-IgG test, and false serological tests of IgM can be caused by various factors, the HFRS coinfection with malaria was ruled out.ConclusionMisdiagnosis can be easily induced by a false serological test, in particular the IgM test which can be influenced by various factors. A combination of health history, epidemiology, physical examination, precise application of specific examinations involving tests of conventional laboratory parameters as well as well-accepted methods such as the immunochromatographic (ICG) test, real-time reverse transcription-polymerase chain reaction (PCR), and Western blot (WB), and acquaintance with disorders with similar manifestations will contribute to the precise diagnosis in clinical treatment.

Red Dragon Fruit Education as Prevention of Anemia in Pregnant Mothers

Iron requirements increase during pregnancy due to fetal and placental requirements and physiological changes such as increased blood volume and red blood cell count. An increase in these levels can also lead to a decrease in hemoglobin and hematocrit levels, resulting in increased prevalence of anaemia and iron deficiency in pregnancy. Dragon fruit is a fruit that is rich in antioxidants and calcium and is relatively high in iron. The purpose of the community service activities that will be carried out is to provide education about the use of red dragon fruit as an attempt to prevent anemia in pregnant mothers and is planned to be implemented on Monday, January 29th, 2024 in Bidan Nurachmi Palembang Independent Practice. The method of community dedication is by giving the approval, the participants of this community service activities are pregnant mothers of Trimester I to III of 10 people. All participants followed the activity from start to finish, were active in the discussion, and were well evaluated. Evaluation is done with pre and post test assessments by filling in the questionnaire that has been provided. The pre-test assessment results obtained an average score of 51 and an average post-test score of 86, from the evaluation results can be concluded there was an increase in the average score participants so there is an improvement in knowledge and understanding about the use of red dragon fruit as an attempt to prevent anemia in pregnant mothers.

Flank versus prone position in percutaneous nephrolithotomy: a meta-analysis of randomized controlled studies.

The objective of this study is to assess the safety and efficacy of the flank position in percutaneous nephrolithotomy (PCNL). We searched PubMed, Embase, SCOPUS, the Cochrane database libraries, and the Chinese Biomedical Literature Database, and randomized controlled trials (RCTs) assessing PCNL in flank position are included in this meta-analysis. The related trials met the inclusion criteria were analyzed using RevMan 5.4. Seven randomized controlled trials were included, involving a total of 587 patients. We found that there was a lower decrease in hemoglobin levels in the flank position group compared to prone-position group (mean difference [MD] = -0.15, 95% confidence interval (CI) -0.22 to -0.08, P < 0.00001). Moreover, our meta-analysis demonstrated no significant differences between groups regarding stone-free rate (relative risk [RR] = 1.00, 95% CI 0.93 to 1.06, P = 0.92), operative time(MD = 0.76, 95% CI -5.31 to 6.83, P < 0.00001), hospital stay (MD = 0.03, 95% CI - 0.32 to 0.32, P < 0.00001), and complications Clavien grade I (RR = 1.01, 95% CI 0.98 to 1.05, P = 0.54), Clavien grade II (RR = 1, 95% CI 0.97 to 1.02, P = 0.78), and Clavien grade III (RR = 1, 95% CI 0.98 to 1.03, P = 0.77). The use of flank position for PCNL is associated with reduced hemoglobin change without an increase in complications. This positioning technique can be considered safe for patients with nephrolithiasis and may be particularly suitable for high-risk individuals such as those who are obese or have decreased cardiopulmonary function. However, further randomized trials are needed to confirm these findings.

Analysis of factors affecting intraoperative hemorrhage during percutaneous nephrolithotomy and establishment of nomogram model.

Intraoperative hemorrhage is an important factor affecting intraoperative safety and postoperative patient recovery in percutaneous nephrolithotomy (PCNL). This study aimed to identify the factors that influence intraoperative hemorrhage during PCNL and develop a predictive nomogram model based on these factors.A total of 118 patients who underwent PCNL at the Department of Urology, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from January 2021 to September 2023 was included in this study. The patients were divided into a hemorrhage group (58 cases) and a control group (60 cases) based on the decrease in hemoglobin levels after surgery. The clinical data of all patients were collected, and both univariate analysis and multivariate logistic regression analysis were conducted to identify the independent risk factors for intraoperative hemorrhage during PCNL. The independent risk factors were used to construct a nomogram model using R software. Additionally, receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA) were utilized to evaluate the model.Multivariate logistic regression analysis revealed that diabetes, long operation time and low psoas muscle mass index (PMI) were independent risk factors for intraoperative hemorrhage during PCNL (P < 0.05). A nomogram model was developed incorporating these factors, and the areas under the ROC curve (AUCs) in the training set and validation set were 0.740 (95% CI: 0.637-0.843) and 0.742 (95% CI: 0.554-0.931), respectively. The calibration curve and Hosmer-Lemeshow test (P = 0.719) of the model proved that the model was well fitted and calibrated. The results of the DCA showed that the model had high value for clinical application.Diabetes, long operation time and low PMI were found to be independent risk factors for intraoperative hemorrhage during PCNL. The nomogram model based on these factors can be used to predict the risk of intraoperative hemorrhage, which is beneficial for perioperative intervention in high-risk groups to improve the safety of surgery and reduce the incidence of postoperative complications.

Resilience and challenges of peritoneal dialysis survivors in the aftermath of the 2023 Kahramanmaraş earthquake

Resilience and challenges of peritoneal dialysis survivors in the aftermath of the 2023 Kahramanmaraş earthquake

Evaluation of Epidemiological Risk Features and Hematological Parameters in the Lymphoma Patients in the Larkana Region

Background: Hodgkin lymphoma (HL) is a type of lymphatic cancer that is distinctly characterized and classified into various subtypes, with varying prognoses based on the stage at diagnosis and treatment modalities. Despite advances in treatment, the specific demographic and clinical factors influencing treatment outcomes and the incidence of side effects, such as chemotherapy-induced anemia and neutropenia, remain under-explored, particularly in diverse regional settings. Objective: This study aims to evaluate the epidemiological risk features and hematological parameters of lymphoma patients in the Larkana region, with a focus on the impact of chemotherapy on these parameters. Methods: A case-control study was conducted over twelve months at Linar Hospital in Larkana, involving 40 participants aged between 10 and 70 years. Informed consent was obtained, aligning with ethical standards akin to the Declaration of Helsinki. Two types of blood samples were collected pre- and post-chemotherapy for hematological analysis including total leukocyte count, hemoglobin, and platelet levels, which were assessed using Complete Blood Count (CBC) containers with EDTA. Statistical analysis was performed using Microsoft Excel 2010 and SPSS Version 23, utilizing descriptive statistics and the Student's t-test. Results: The study documented a decrease in mean hemoglobin levels from 11.42 ± 1.74 g/dL before chemotherapy to 10.65 ± 1.55 g/dL after (p = 0.001), mean white blood cell count from 7.30 ± 2.6 × 10^3/uL to 5.71 ± 2.1 × 10^3/uL (p = 0.003), and platelet count from 297.52 ± 116.2 × 10^3/uL to 230.2 ± 72.6 × 10^3/uL (p = 0.001). These findings indicate a significant hematological impact associated with chemotherapy. Conclusion: The significant reduction in critical hematological parameters among lymphoma patients’ post-chemotherapy highlights the need for rigorous monitoring and tailored management strategies to mitigate treatment side effects. The findings emphasize the importance of comprehensive patient care and support in improving treatment outcomes in lymphoma.

Impact of Anemia on the Determination of Glycated Haemoglobin by High-Performance Liquid Chromatography in Diabetic Patients

Introduction: Glycated haemoglobin is considered an objective element in monitoring glycaemic control in diabetic patients. High-performance liquid chromatography (HPLC) is the reference method for measuring HbA1c. However, even this method can be affected by certain conditions such as anemia. Purpose: To study the impact of anaemia on the measurement of glycated haemoglobin levels by HPLC in diabetic patients. Methodology: We conducted a prospective, descriptive and comprehensive study from November 2022 to April 2023, on 06 months at the Mali Hospital, measuring glycated haemoglobin, blood glucose and haematological parameters (CBC). Results: We included 71 diabetic patients, 42.3% were men and 57.7% women. In our study population, 33.8% were anaemic, among them 16.9% were women and 16.9% men. The age group [50-80] years constituted the majority (n = 14) of anaemic patients. The most common type of anaemia in our diabetic patients was normocytic anaemia. HbA1c &gt;7% was found in 91.6% (n=22) of our anaemic patients. The mean haemoglobin level was not statistically significantly different from the HbA1c level (P = 0.0595). There was a statistically significant difference between MCHC and HbA1c (P = 0.04). To our knowledge, we did not observe any significant impact of anaemia on the measurement of HbA1c by the HPLC method. Conclusion: Our study showed a high frequency of normocytic anaemia in diabetic patients. We also noted that the reliability of HPLC in measuring HbA1c was not affected by a minor decrease in total haemoglobin levels.

Analysis of the Role of Age Factors on Hemoglobin, Leukocyte and Platelet Levels in Breast Cancer Patients Post Chemotherapy 3 Cycles at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Introduction: Breast cancer is one of the most common cancers in women. Chemotherapy is one of the main modalities in the treatment of breast cancer, but it can cause hematological side effects such as anemia, leukopenia, and thrombocytopenia. Age is one factor that is thought to influence these side effects.&#x0D; Methods: This study used an analytical observational design with data collected from medical records of breast cancer patients who had undergone 3 cycles of chemotherapy at Dr. Mohammad Hoesin General Hospital Palembang. Data on hemoglobin, leukocyte, and platelet levels before and after chemotherapy were analyzed using the t-test and ANOVA.&#x0D; Results: A significant decrease in hemoglobin levels was observed in patients aged &gt; 60 years after chemotherapy (p &lt; 0.05). Leukocyte levels showed fluctuations, especially in patients aged &lt;40 years, while platelet levels fluctuated more in patients aged &lt;40 years and decreased in the age group 40-60 years after chemotherapy.&#x0D; Conclusion: Age does not significantly influence the decrease in hemoglobin, leukocyte, and platelet levels in breast cancer patients after chemotherapy.

Efficacy and Safety of Microsomal Ferric Pyrophosphate Supplement for Iron Deficiency Anemia in Pregnancy.

Introduction Anemia during pregnancy is characterized by decreased hemoglobin levels. Iron deficiency poses a significant global health concern, especially in pregnant women, where increased iron demands are crucial for both maternal and fetal well-being. Method In the current study, we investigated the effectiveness and safety of 30 mg SunActiveTM Fe (Taiyo GmbH, Yokkaichi, Japan), emulsified microsomalTM ferric pyrophosphate (EMFP) tablets in treating iron deficiency anemia in 27 second-trimester singleton pregnant women. Results Our study results demonstrated that hemoglobin levelsincreased significantly within 30 days of treatment and continued to remain higher than baseline throughout the study. Serum ferritin levels exhibited a 6.61-fold increase, maintaining elevated levels consistently. Serum iron also increased significantly by 46.9%. Additionally, symptoms such as nausea, breathlessness, dizziness, irritability, and heartburn were notably reduced, leading to improved quality of life. Subjects reported decreased overall fatigue, indicating an enhanced quality of life. Babies born during the study showed healthy birth weights, with uncomplicated deliveries. High treatment compliance of 99.5% underscored patient commitment to the study. Furthermore, the investigational product demonstrated a favorable safety profile, with only two mild adverse events observed, unrelated to the treatment. Conclusion These findings suggest that EMFP could be a valuable therapeutic option for managing iron deficiency anemia in pregnant women, promoting better maternal and fetal outcomes. Further research with an increased sample size is warrantedto delve into the underlying mechanisms behind these positive outcomes, nonetheless, our study provides a promising foundation for addressing this critical health issue.

Surgical site infection following cesarean section and its predictors in Ethiopia: A systematic review and meta-analysis.

Worldwide, surgery related deaths within 30 days of the procedure accounts the third contributor among all causes of deaths, with an estimated 4.2 million people annually and half of these deaths occur in low and middle income countries. To determine the pooled prevalence of surgical site infection following cesarean section and its predictors in Ethiopia. A systematic review and meta-analysis were conducted by using PRISMA guideline. An appropriate and comprehensive search of PubMed, MEDLINE, EMBASE, CINAHL, Google Scholar, HINARI and Scopus was done. This SRMA included all articles conducted in all regional state of Ethiopia reporting the prevalence/proportion/incidence of SSI after cesarean section and/or associated factors. All observational study designs were included in this SRMA. Articles which lack our outcome of interest: SSI following cesarean section and its predictors were excluded from this SRMA. The I2 statistic was used to quantify heterogeneity across studies. Funnel plot asymmetry and Egger's tests were used to check for publication bias. A random effect model was used to estimate the pooled prevalence of SSI. Adjusted Odds Ratio (OR) with 95% Confidence Interval (CI) was also considered to determine the association of identified variables with SSI. Statistical analysis was conducted using STATA version 17 software. Initially 6334 studies were identified and finally 19 studies were found eligible for the analysis. Studies with a score of 7 and above were included for the final systematic review and meta-analysis. The review was comprised of 14 cross sectional studies, 4 cohort and one case control studies. The pooled estimate of SSI in Ethiopia was 11.13% (95%CI, 9.29-12.97%). Prolonged labor (AOR = 3.16, 95% CI; (2.14-4.68)), chorioamnionitis (AOR = 4.26, 95% CI; (1.99-8.91)), prolonged PROM (AOR = 3.80, 95% CI; (2.51-5.62)), repeated vaginal examination (AOR = 3.80, 95% CI; (2.45-5.88)), decreased hemoglobin level (AOR = 4.57, 95%CI; (3.16-6.60)), vertical skin incision (AOR = 3.09, 95% CI; (2.04-4.67)) and general anesthesia (AOR = 1.82, 95% CI (1.21-2.75)) are significantly associated with SSI after cesarean section in Ethiopia. SSI after cesarean section in Ethiopia is high. Prolonged labor, chorioamnionits, prolonged PROM, repeated vaginal examination, decreased Hgb level, vertical skin incision and general anesthesia were positively associated. Thus, evidence based intra-partum care should be practiced.

The Potency of Typical Plants of Central Sulawesi Province to Prevent Iron Deficiency Anemia: Experimental Study

Background: Central Sulawesi falls within the Wallacea region, making it home to various endemic flora and fauna. One distinctive plant in Central Sulawesi is the Moringa tree. The Moringa tree, especially its leaves, was often used as a culinary ingredient known as sayurkelor in the traditional cuisine of the Kaili ethnic group in Central Sulawesi Province. Objective: This research aimed to determine the effectiveness of moringa leaf extract in increasing hemoglobin levels and erythrocyte count. Method: Twenty-four male Wistar rats strain (Rattusnorvegicus) 9−10 weeks old and 200−250 grams were divided into four groups (n=6), normal as a no treatment, negative control, ethanol extract, and positive control during the 15thday. Blood samples on the 15thday were administered to determine blood count. Result: The resultsof this study showed differences in hemoglobin and erythrocyte levels in the four experimental groups.The significant difference in average hemoglobin levels between Group 2 and Group 3 with a P-value &lt;0.05 (P value 0.00). The difference between Group 2 and Group 4 is significant with a P-value &lt;0.05 (P value 0.00), and the difference between Group 3 and Group 4 is significant with a P-value &lt;0.05 (P value 0.03). the significant difference in the average erythrocyte counts between Group 2 and Group 3 with a P-value &lt;0.05 (P value 0.00). The difference between Group 2 and Group 4 is not significant with a P-value &gt;0.05 (P value 0.07). The difference between Group 3 and Group 4 has a P-value &gt;0.05 (P value 0.63). Conclusion: The research results indicate that pregnant Wistar rats experienced hemodilution characterized by a decrease in hemoglobin and erythrocyte levels during pregnancy. However, after being given ethanol extract from moringa leaves, there was an increase in hemoglobin and erythrocyte levels. Keywords: Extract; ethanol; moringa; oleifera; hemoglobin

Segmental artery angioembolization as an efficient treatment modality for delayed hematuria with normal angiography: two case reports

BackgroundPercutaneous nephrolithotomy is the most commonly used modality for the removal of kidney stones larger than 2 cm in size. Like other stone removal methods, percutaneous nephrolithotomy also has some complications, including bleeding and delayed hematuria. These complications are improved with conservative management and bed rest most of the time. However, it may require more invasive treatments. Angioembolization following an abnormal renal angiography is an efficient treatment modality for delayed hematuria. Furthermore, nephrectomy is suggested in uncontrolled cases of delayed hematuria when renal angiography is normal.Case presentationWe described two cases of uncontrolled delayed hematuria after percutaneous nephrolithotomy and angioembolization were carried out rather than potential nephrectomies. The first case was a 61-year-old Iranian man with left kidney stones, for whom percutaneous nephrolithotomy was planned. The patient was referred to the hospital after discharge with massive hematuria and had normal angiographic findings. An angioembolization was suggested for the patient and was carried out. His hematuria was dramatically improved within 30 minutes, and his hemoglobin level started to increase 2 days later. The second case was a 53-year-old Iranian man with kidney stones who was a candidate for right kidney percutaneous nephrolithotomy. The patient was referred to the hospital 4 days after discharge with a decreased hemoglobin level and massive hematuria. The patient had normal angiographic findings and was planned for angioembolization to control his hemorrhage, which dramatically decreased after the angioembolization within 60 minutes.ConclusionEmbolization of the segmental arteries of the targeted calyx can eliminate hematuria of the patient and prevent further nephrectomy.

DELINEATION OF HEMATOLOGICAL CHANGES OCCURRING IN STORED CITRATE PHOSPHATE DEXTROSE ADENINE CPDA-1 BLOOD

Objectives: To study the changes in red cell indices and counts over a period of 42 days in blood stored in blood bags. Materials and Methods: This research was done in Blood Bank, Khyber Teaching Hospital, Peshawar in collaboration with the main laboratory, Khyber Teaching Hospital, Peshawar. About 450 ml of whole blood was taken from 200 donors into Citrate Phosphate Dextrose Adenine blood bags. The storage temperature for the blood bags was maintained between 2–8°C. Blood samples were collected from blood bags. At days 1 and 42, using a haematology analyser, parameters including haemoglobin, RBC count, WBC count, haematocrit, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration and platelet counts were measured. Mean and standard deviation were used for quantitative variables. Frequency and percentages were used for qualitative variables. Results: Through days 1 to 42, Haemoglobin (Hb) level decreased from 13.4gm/dl to 12.78 gm/dl, white cell count (WBC) decreased from 6.03x109/l to 2.95 x109/l, platelets count fell from 207 x109/l to 121 x109/l, neutrophils decreased from 59.6% to 23.8% while lymphocyte count increased from 28.36% to 66.3%. Conclusion: There is a decrease in haemoglobin level and white cell count over a period of 42 days of storage of blood bags. Lymphocyte counts increased during the storage duration of blood bags.

Serological detection of Rickettsia spp. and evaluation of blood parameters in pet dogs and cats from Bangkok and neighboring provinces.

Rickettsiosis is caused by Orientia spp. and Rickettsia spp., arthropod-borne zoonotic intracellular bacteria. The close relationships between pet dogs, cats and owners increase the risk of rickettsial transmission, with limited studies on the seroprevalence in pets. This study investigated the prevalence of rickettsia exposure among dogs and cats in Bangkok and neighboring provinces. The samples from 367 dogs and 187 cats used in this study were leftover serum samples from routine laboratory testing stored at the Veterinary Teaching Hospital. In-house Enzyme-linked immunosorbent assay (ELISA) tests included IgG against the scrub typhus group (STG), typhus group (TG), and spotted fever group (SFG). The seroprevalence in pet dogs was 30.25% (111/367), including 21.53% for STG, 4.36% for TG, and 1.09% for SFG. Co-seroprevalence consisted of 2.72% for STG and TG, 0.27% for STG and SFG, and 0.27% for pangroup infection. The prevalence in cats was 62.56% (117/187), including 28.34% for STG, 4.28% for TG, and 6.42% for STG. Co-seroprevalence in cats consisted of STG and TG (4.28%), STG and SFG (5.35%), TG and SFG (3.21%), and three-group infection (10.69%). No significant difference in seroprevalence for the three serogroups was observed in any of the 64 districts sampled. The mean hematocrit level significantly decreased in seropositive dogs (P<0.05). Seropositive dogs and cats were detected in significantly greater numbers of anemia cases than nonanemia cases (P<0.05) (odds ratio: 7.93, 0.44, p = 0.00, p = 0.01). A significantly higher number of seropositive cats had decreased hemoglobin levels (P<0.05) (odds ratio: 3.63, p = 0.00). The seropositive samples significantly differed among older cats (P<0.05). These high exposures in pet dogs and cats could constitute important relationship dynamics between companion animals and rickettsial vectors. Significantly decreased hematocrit and hemoglobin levels indicated anemia in the exposed dogs and cats. The study findings will raise awareness of this neglected disease among pet owners and veterinary hospital personnel and aid in future public health preventative planning.

The association between hemoglobin level and sarcopenia in Chinese patients with Crohn’s disease

Sarcopenia and anemia are common complications in patients with Crohn’s Disease (CD). However, few studies have shown the association between sarcopenia and hemoglobin levels in CD patients. This retrospective study aimed to explore such association in Chinese patients with CD. Two hundred and twelve adult CD inpatients who underwent computed tomography (CT) or magnetic resonance imaging (MRI) examinations from July 2019 to December 2021 were included in the study. Sarcopenia was defined according to the cutoff value of skeletal muscle index of lumbar spine 3 (SMI-L3) (< 44.77cm2/m2 for males and < 32.5cm2/m2 for females). The CD patients were divided into two groups based on the presence or absence of sarcopenia. Clinical data, hemoglobin levels, and other laboratory data were retrospectively collected. The association between hemoglobin levels and sarcopenia was analyzed by univariable and multivariable logistic regression analysis. Sarcopenia occurred in 114 CD patients (53.8%). Compared to patients without sarcopenia, patients with sarcopenia had a lower proportion of L1 (30.7% vs. 45.8%, p = 0.032) and B1 classification (58.8% vs. 72.4%, p = 0.037). Patients with sarcopenia had significantly lower levels of hemoglobin (Hb) (116.5 ± 22.8 vs. 128.1 ± 21.0, p < 0.001). The prevalence of sarcopenia increased with the decrease in hemoglobin level (p for trend < 0.05). Linear regression analysis showed that hemoglobin levels were associated with SMI-L3 (β = 0.091, p = 0.001). Multivariable logistic regression analysis found that higher hemoglobin levels (OR:0.944; 95% CI: 0.947,0.998; p = 0.036) were independent protective factors for sarcopenia. Lower hemoglobin levels are independently associated factors of sarcopenia in adult Chinese patients with CD.

Possible role of cardiovascular stress induced by the volume load as a cause of anemia in hemodialysis patients: a case of a maintenance hemodialysis patient with a literature review

BackgroundAlthough a deficiency in erythropoietin relative to decreased hemoglobin levels is presumed to be the predominant cause of renal anemia, other factors may also exist that are not fully understood.Case presentationA 58-year-old man with pyelonephritis who had been on hemodialysis for 18 years presented a gradually decreasing serum creatinine level, possibly due to voluntary dietary restrictions, accompanied by a gradual increase in the cardiothoracic ratio from 48% to 56%. Concomitantly, his hemoglobin level decreased gradually from 14.5 to 8.7 g/dL by 6 months. Although he had no symptoms of heart failure and his left ventricular ejection fraction was 66.3%, which was almost identical to his condition 2 years prior, a drastic reduction in posthemodialysis body weight from 71.0 to 68.6 kg in 9 days was performed without apparent intrahemodialysis hypotension. His cardiothoracic ratio and serum prehemodialysis N-terminal pro-brain natriuretic peptide level decreased steeply, from 56% to 49% by 2 weeks and from 6139 to 647 pg/mL by 8 weeks, followed by a gradual increase in his hemoglobin level from 8.7 to 15.1 g/dL by 3 months. The patient was administered 50 mg/day sodium ferrous citrate but no erythropoietin-stimulating agents or hypoxia-inducible factor prolyl hydroxylase inhibitors. Although a modest increase in the serum protein level was observed immediately after the rapid reduction in posthemodialysis body weight, the patient’s hemoglobin level increased markedly and gradually, suggesting an improvement in anemia rather than hemoconcentration.ConclusionsCardiovascular stress induced by the volume load is one of the causes of anemia in hemodialysis patients.

Protective effects of Helicteres isora L. fruit extract on phenylhydrazine-induced hemolytic anemia in rats

BackgroundAnemia is a serious global public health problem that affects young children and pregnant women with an increased risk of maternal and child mortality. Helicteres isora L. (Family: Malvaceae) has significant antioxidant properties responsible for its medicinal properties. The present study was conducted to investigate the protective effects of aqueous fruit extract of Helicteres isora L. (AEHI) on phenylhydrazine-induced hemolytic anemia in rats. MethodsThe fruits of Helicteres isora L. (H. isora L.) were extracted with distilled water to obtain the AEHI. The AEHI was subjected to preliminary phytochemical analysis, iron estimation and in-vitro antioxidant assay. The HPTLC fingerprinting followed by HR-LCMS analysis of the isolated HPTLC fraction of AEHI was carried out to investigate the phytoconstitutents. Male Wistar albino rats were administered phenylhydrazine (40 mg/kg, i.p.) for two consecutive days to induce anemia. The effects of AEHI were investigated at three oral doses viz. 250, 500 and 750 mg/kg once daily for 13 days by estimating blood parameters and pathological changes in the liver, heart, spleen, kidney, lungs and bone marrow. ResultsThe phytochemical analysis showed the presence of alkaloids, tannins, phenolic compounds, carbohydrates and steroids in the AEHI. The iron content of AEHI was found to be 208 µg/ml. In-vitro antioxidant assays, the IC50 value of AEHI was found to be 90.01 µg/ml. Phenylhydrazine administration caused a significant decrease in red blood cells, hemoglobin, and hematocrit levels. These decreased levels were significantly improved by AEHI in a dose-dependent manner. Pathological changes in the liver, heart, spleen, kidney, lungs and bone marrow were prevented by AEHI treatment. ConclusionIt is concluded that the AEHI provides significant protection against phenylhydrazine-induced hemolytic anemia.

Systemic risk factors of retinopathy in patients with systemic lupus erythematosus.

To investigate the risk factors of lupus retinopathy (LR) in patients with systemic lupus erythematosus (SLE). This is a retrospective, cross-sectional study. LR patients admitted at Peking Union Medical College Hospital from June 2013 to April 2023 were reviewed. Age- and gender-matched SLE patients without retinopathy were selected as controls. Medical records including clinical manifestations, laboratory data and ophthalmic examination were collected. Univariate and multivariate logistic regression analyses were conducted. One hundred and twelve LR patients (198 eyes) were included, with 12 cases (14 eyes) presenting with retinal macrovascular obstruction, and 100 cases (184 eyes) only exhibiting microvasculopathy. Multivariate analysis indicated the presence of haemolytic anaemia, decreased haemoglobin (HGB) and higher relative percentage of neutrophils were independent risk factors for LR (p < 0.05). The first two were also risk factors for retinal microvasculopathy, whereas secondary antiphospholipid syndrome (APS) was for macrovascular obstruction. In male group, LR had significant associations with decreased HGB, no matter which types of retinopathy (p < 0.05). In female group, LR was significantly associated with haemolytic anaemia, presence of antiphospholipid antibodies, decreased white blood cells and relative high percentage of neutrophils. Specifically, haemolytic anaemia (p = 0.002) was significantly associated with retinal microvasculopathy, and APS (p = 0.003) was significantly associated with macrovasculature obstruction. LR was related to haemolytic anaemia, decreased HGB levels and higher percentage of neutrophils. Retinal microvasculopathy accounted for most cases and macrovasculature obstructions were rare. Male and female patients have distinct risk factors. Early ophthalmic screening is recommended especially for those with risk factors of LR.