Development Of Iron Deficiency Anemia Research Articles

Iron Deficiency Anemia in Patients with Chronic Renal Insufficiency at Tertiary Care Hospital in Northern Punjab

Anemia is a frequently encountered complication of chronic kidney disease (CKD) leading to worse outcomes in terms of quality of life and premature death. However, the current prevalence of iron deficiency anemia (IDA) in CKD is understudied in Pakistan. Objective: To assess the frequency of IDA in patients with CKD at Bewal International Hospital, Gujar Khan, Pakistan. Methods: A cross-sectional was executed at the Department of Nephrology, Bewal International Hospital, Pakistan from January 1, 2022, to June 30, 2022. The study comprised 97 patients aged >13 years of either gender having CKD (GFR <60 ml/min/1.73m²) for at least 90 days. All patients were tested for serum creatinine, ferritin, and hemoglobin levels. IDA was considered if hemoglobin was ≤12 mg/dL in women and ≤13 mg/dL in men. Results: Among 97 patients, there were 57(58.7%) males and 40(41.3%) females. The mean age was 51.23 ± 12.99 years while the mean disease duration was 6.01 ± 1.610 years. 57(58.7%) patients had IDA. IDA was more frequent in women with CKD (67.5%), compared to men (52.64%). However, this association was statically insignificant (p>0.05). When data was stratified, a substantial association was found between IDA and the stage of CKD (p=0.007). There was no significant association between IDA and disease duration (p>0.05). Conclusions: It was concluded that anemia is common in CKD patients, with a high prevalence in females. Stage 3–5 CKD is significantly associated with developing iron deficiency anemia. Early identification and timely management can avoid unfavorable outcomes in these patients.

New options for replenishing the iron stores in patients with abnormal uterine bleeding

Introduction. The high incidence of abnormal uterine bleeding (AUB) (over 30%) among patients of reproductive age is accompanied by the development of iron deficiency anaemia (IDA), which, in turn, is a social problem among global burden diseases throughout the world.Aim. To evaluate the clinical efficacy and compliance with the Vojea complex regimen to prevent IDA in women with abnormal uterine bleeding.Materials and methods. A multicentre clinical observational study was conducted in 6 health care facilities and women’s health clinics in Yekaterinburg and Moscow. The study included 52 patients with latent iron deficiency (serum ferritin level < 15 ng/ml) who were diagnosed with abnormal uterine bleeding (AUB) due to ovulatory dysfunction. All patients received Vojea complex at a dose of 1 tablet QD for 3 months while taking pharmaceutical therapy for AUB. The clinical and laboratory efficacy and medication compliance were assessed at 30, 60 and 90 days after initiation of treatment.Results. Starting from the 1st month of treatment with the study complex, positive trends in clinical and laboratory findings were observed in both groups. After the three-month therapy with Vojea, ferritin levels increased 5.4 times (a clinically significant growth was reported after the two-month intake), plasma folate levels increased 4.9 times and red blood cell folate concentrations increased by 45%. The complex therapy helped reach and maintain the average red blood cell folate concentration >400 ng/ml (906 nmol/l). Side effects included isolated events of gastrointestinal dyspepsia and individual intolerance. All patients reported good and excellent tolerance of the complex, which ensured high compliance with the drug regimen (92%).Conclusion. The three-month therapy with Vojea complex as part of the combination approach to the treatment of AUB in women with latent iron deficiency showed high clinical and laboratory efficacy, as well as good compliance with the drug regimen.

The effect of Dadih for the prevention of iron deficiency anemia in adolescent girls 12-15 years old

Adolescent girls are at risk of developing iron deficiency anemia. Dadih has high nutritional value and iron and probiotics. This study aimed to analyze the effect of administering Dadih to prevent iron deficiency anemia in adolescent girls aged 12-15. This study used a randomized controlled trial pre-posttest group design, which consisted of an intervention and control group totalling 40 participants taken randomly at the Sumatera Thawalib Parabek Bukittinggi Islamic Boarding School from February to June 2023. In both groups, serum ferritin and hemoglobin levels were measured before and after treatment for 14 days. The intervention group was administered 100 g of Dadih 1x a day, and the control group was administered a placebo. Data analysis was performed using the Wilcoxon statistical and Paired T-test at a 95%CI. Results: There was a significant difference in the hemoglobin levels before and after treatment (p=0,003). There was no significant difference in serum ferritin levels before and after treatment (p=0,191). In conclusion, the administration of 100 g of dadih did not increase serum ferritin and hemoglobin levels, and the independent administration of 100 g of Dadih to prevent iron deficiency anemia still needs to be considered.

Мультисистемний запальний синдром MIS-C у дітей після перенесеної інфекції COVID-19

In recent years, the number of reported cases of multisystem inflammatory syndrome (MIS-C - Multisystem Inflammatory Syndrome in Children) in children after COVID-19 infection has been increasing. This syndrome usually manifests itself 4-8 weeks after the disease. It is necessary to learn how to diagnose it in time and prevent possible complications from the gastrointestinal tract, cardiovascular and other systems, and to pay attention to the prevention of children from COVID-19 infection through vaccination. Purpose - to analyze the information from the current professional literature on the peculiarities of diagnosis, course and treatment of MIS-C in children after COVID-19 infection to expand the knowledge of doctors about this pathology by presenting clinical case. We present a clinical case of MIS-C in a child after COVID-19 infection. The literature data from PubMed, Medscape, CDC, Mayo Clinic were analyzed. The peculiarity of the presented case is the long-term damage to the cardiovascular and respiratory systems, skin lesions, and the development of iron deficiency anemia. During her hospital stay, the girl's condition was severe due to asthenic, anemic syndrome, and cardiovascular damage. Conclusions. The presented clinical observation confirms the complexity of the algorithm for diagnosing complications of COVID infection in children, especially in their asymptomatic course. Thus, pediatricians should be alert to the development of multisystem inflammatory syndrome MIS-C in children after COVID-19 infection and increase the level of knowledge about the correct diagnostic algorithm in such cases. The study was conducted in accordance with the principles of the Declaration of Helsinki. The informed consent of the child’s parents was obtained for the study. No conflict of interests was declared by the authors.

Possible link between statin and iron deficiency anemia: A South Korean nationwide population-based cohort study.

An extensive evaluation of disease occurrence after statin use based on a "hypothesis-free" approach remains scarce. To examine the effect of statin use on the potential risk of developing diseases, a propensity score-matched cohort study was executed using data from the National Sample Cohort in South Korea. A total of 7847 statin users and 39,235 nonstatin users were included in the final analysis. The period of statin use was defined as our main time-dependent exposure and was divided into three periods: current, recent, and past. The main outcomes were defined as new-onset diseases with ≥100 events based on the International Statistical Classification of Diseases, 10th Revision. We calculated the adjusted hazard ratios and 95% confidence intervals (CIs) using Cox regression. We found that statin use significantly increased the risk of developing iron deficiency anemia up to 5.04 times (95% CI, 2.11 to 12.03). Therefore, the iron levels of patients using statins should be monitored carefully.

Abnormal uterine bleeding (clinical lecture)

Abnormal uterine bleeding (AUB) not related to pregnancy has been one of the leading reasons for visiting a gynecologist for many years. The incidence of AUB is approximately 30% among patients of reproductive age and can increase to 70% during the perimenopausal period. Recurrent AUB leads to the development of iron deficiency anemia, significantly reducing the quality of life, and also resulting in additional costs for hygiene products.
 This clinical lecture provides a modern classification of AUB. It focuses on the main mechanisms of development of this pathology in adolescence and reproductive age. The causes of AUB are analyzed, and the classification, symptomatology, and clinical presentation of the studied conditions are presented. The lecture covers international criteria for pathologic uterine bleeding, clinical criteria for assessing bleeding severity according to MansfieldVodeJorgensen scale and estimation of blood loss volume according to Algover index. Detailed consideration is given to the issues of differential diagnosis, general principles of therapy, and indications for traditional, hormonal, and surgical hemostasis. The lecture also outlines the algorithm of diagnostic search for patients in the adolescent, reproductive, postmenopausal age groups, as well as for patients on the background of menopausal hormonal therapy.

Iron deficiency and sexual dysfunction in women.

Sexual dysfunction negatively affects approximately 40% to 50% of adult women across various stages of life. Common risk factors include sexual traumas, relationship problems, chronic conditions, medication side effects, and poor physical health, including iron deficiency. This review summarizes a presentation from a symposium that discussed the types and causes of sexual dysfunction at key times in women's lives, focusing on the relationship between iron deficiency and sexual dysfunction. The symposium was held at the XV Annual European Urogynaecological Association Congress, Antibes, France, in October 2022. Symposium content was identified through literature searches of PubMed. Original research, review articles, and Cochrane analyses discussing sexual dysfunction in association with iron deficiency/anemia were included. Iron deficiency in women is commonly caused by abnormal uterine bleeding, but women may develop iron deficiency anemia (IDA) because of increased iron needs or reduced iron intake/absorption. Treatment with oral iron supplementation has been shown to improve sexual function in women with IDA. Ferrous sulphate is considered as a standard of care for oral iron treatment; prolonged-release iron formulations have improved tolerability, enabling lower doses and better tolerability. IDA and sexual dysfunction are related, so the identification of sexual dysfunction or iron deficiency in a woman should prompt an investigation of the other condition. Testing for iron deficiency is an inexpensive and simple step that can be routinely included in the workup of women with sexual dysfunction. Once identified, IDA and sexual dysfunction in women should be treated and followed to optimize quality of life.

РАЗРАБОТКА КИШЕЧНОРАСТВОРИМЫХ МАТРИЧНЫХ ТАБЛЕТОК С ГУМИНОВЫМИ ПРОИЗВОДНЫМИ

Medicines based on compounds of iron, copper and zinc occupy a certain place in the pharmaceutical market. A lack of iron in the body can contribute to the development of iron deficiency anemia, and in the case of copper and zinc, a deficiency in the immune response and inflammation caused by lipid peroxidation, which ultimately leads to various joint diseases such as arthritis. The basis of the treatment and prevention of diseases is the use of chelates of salts of iron, copper and zinc, the effectiveness of which largely depends on their stability and the degree of release of trace elements in various parts of the gastrointestinal tract. Therefore, there is a need to create new long-acting drugs with a certain solubility and sufficient bioavailability. This study is devoted to the development of the optimal composition of iron, copper and zinc humate matrix tablets for oral administration.

The role of <i>Helicobacter pylori</i> in the development of iron defi ciency anaemia in children

A review article is devoted to the analysis of scientific and literary data published over the past 10 years, devoted to the problem of studying the role of Helicobacter pylori in the development of iron deficiency anaemia in children and adolescents. Comparative data of domestic and foreign scientists on the mechanism of exposure of Helicobacter pylori (НР) to the pathogenesis of resistant iron deficiency anaemia in children are given.It was determined that the development of iron deficiency anaemia in children with HP infection is influenced by many mechanisms, therefore, in the treatment of children with this pathology, the appointment of anti- HP bacterial therapy with ferrotherapy, taking into account age-related characteristics and needs, is justified.

Frequency of Iron Deficiency Anaemia in Exclusively Breastfed and Infants Fed on Cow’s Milk

Introduction: Iron is the most prevalent nutrient deficiency in infants and young children around the world despite its importance for healthy brain development. Infants who drink whole cow's milk or other animal milks are at a greater risk of developing iron deficiency anaemia. In our culture, cow's milk consumption is widespread. There were no local studies available on iron deficiency anemia in infants using different types of milk so need for the present study was felt. Objectives: The objectives of this study were to determine the frequency of exclusively breastfed and cow’s milk fed infants at 3 month of age and to compare the frequency of iron deficiency anemia in exclusively breastfed and cow’s milk fed infants. Study Design: It was a cross-sectional study. Setting and Duration: Research was conducted at the Medical Outpatient Department of The Children’s Hospital and The Institute of Child Health Lahore from 08/02/2022 to 07/08/2022. Material and Methods: This study involved 220 infants of both genders at 3 months of age presenting for vaccination. Outcome variables were frequency of exclusive breast feeding and iron deficiency anemia. All patients' guardians signed an informed consent form. Results: There were 115 (52.3%) male and 105 (47.7%) female patients in the study group. The Hb of the patients ranged from 7.6 g/dl to 14.5 g/dl with a mean of 11.00±1.98 g/dl while the serum iron level ranged from 41 µg/dl to 115 µg/dl with a mean of 67.94±22.99 µg/dl. Majority of the parents (56.4%) belonged to poor class and 46.4% mothers were illiterate. The frequency of exclusive breastfed infants was 45 (20.5%). There was no significant difference in the frequency of exclusive breast feeding across gender (p=0.873), socioeconomic (p=0.900) and educational (p=0.858) status. 76 (34.5%) Infants had iron deficiency anemia. The frequency of iron deficiency anemia was higher among infants on cow’s milk (37.7% vs. 22.2%) as compared to those on exclusive breast feeding however the observed difference was statistically insignificant (p=0.051). Similar insignificant difference was observed across gender, socioeconomic and educational status groups. Conclusion: The frequency of exclusive breastfed infants was 45 (20.5%). There was no significant difference in the frequency of exclusive breast feeding across gender (p=0.873), socioeconomic (p=0.900) and educational (p=0.858) status. 76 (34.5%) Infants had iron deficiency anemia. The frequency of iron deficiency anemia was insignificantly higher among infants on cow’s milk (37.7% vs. 22.2%; p=0.051) as compared to those on exclusive breast feeding. Similar insignificant difference was observed across gender, socioeconomic and educational status groups. Keywords: Exclusive Breast Feeding, Cow’s Milk Feeding, Iron Deficiency Anemia

Unusual symptoms of iron deficiency anemia (2 clinical observations)

Iron deficiency is a leading cause of anemia, the most common malnutrition worldwide, affecting 42% of children worldwide. Most often, iron deficiency occurs in children of the first year of life and adolescents; its prevalence in adolescents has pronounced gender differences. In Russia, it is much more common in girls in 17.231.0% of cases, which is 1.6 times higher than in boys. The presence of delayed adverse effects of iron deficiency at an early age has been established, therefore, timely correction of sideropenic conditions in young children is important for the prevention of long-term consequences of a childs development. The article presents two clinical cases of iron deficiency anemia in adolescent girls who had iron deficiency in the first year of life. On the example of the first clinical observation, we observe the development of alopecia against the background of severe sideropenia as part of the epithelial syndrome with iron deficiency anemia of moderate severity. Iron deficiency in this case is multifactorial maternal anemia during pregnancy, spontaneous subarachnoid hemorrhage, shunt infection, and uncorrected iron deficiency in the first two years. The second clinical example illustrates iron deficiency anemia of mixed genesis in a teenage girl, which was the result of insufficient iron stores at birth, alimentary insufficiency, aggravated against the background of heavy, prolonged menstruation. In this case, there is no hair loss, despite the more severe course of anemia, a long refractory period with iron therapy. The data of clinical cases confirm the significance of low iron stores at birth in the risk of developing iron deficiency anemia in puberty. During the examination of children, the need to take into account the state of the gastrointestinal tract in the algorithm for diagnosing the state of the gastrointestinal tract (detection of malabsorption, blood loss) was shown.

Iron Profile in Term Small for Gestational Age Infants at 10 Weeks of Age and Correlation With Maternal Iron Profile: A Prospective Cohort Study

Term small for gestational age (SGA) babies are at risk for developing iron deficiency anemia. The association between maternal and infant iron stores is not clear. To assess proportion of term SGA neonates developing iron deficiency anemia by 10 weeks of age, and measure correlation between iron profile and hepcidin of babies at birth and at 10 weeks of age with maternal iron profile. Prospective cohort study conducted from November, 2018 to April, 2020. 120 term SGA babies and their mothers. Hemogram, iron profile and serum hepcidin (every fourth case) estimated in mother, cord blood and baby at 10 weeks. Babies developing anemia at 6 weeks detected by hemogram and ferritin were started on iron supplementation and excluded from the study. Proportion of babies developing iron deficiency anemia at 10 weeks of age. 35 (29.2%) of 120 term SGA babies developed anemia (hemoglobin <9 g/dL) at 6 weeks. Proportion of infants who developed iron deficiency anemia (hemoglobin <9 g/dL and serum ferritin <40 µ/dL) at 6 and 10 weeks of age was 14.2% and 23.3%, respectively. No significant correlation was found bet-ween hemoglobin, iron and hepcidin of the baby in cord blood and at 10 weeks of age with that of mothers. Serum hepcidin in babies at birth (137.5 ng/mL) were higher than maternal values (128 ng/mL). A significant proportion of term SGA infants deve-loped anemia during early infancy, irrespective of maternal iron status.

Comparative Analysis of Red Cell Parameters of First-time and Repeat Blood Donors: A Descriptive Study

Introduction: Blood transfusion services form an essential component of any healthcare system and it is imperative to provide adequate and safe blood for management of patients. Voluntary blood donors form the backbone of this service. However, regular donation by such voluntary donors may cause significant depletion of iron stores in the body. This has the potential to adversely affect the donor’s health, and also to lower the quality of blood being collected subsequently. The temporary deferral of such donors also causes reluctance to return for future blood donations, leading to decrease in size of the donor pool. The prompt detection of subclinical iron deficiency in voluntary blood donors is the need of the hour. Aim: To compare and analyse the difference in red cell parameters of first-time and repeat blood donors. Materials and Methods: A descriptive study was conducted by the Department of Blood Bank and Pathology at Rajarshi Dashrath Autonomous State Medical College, Ayodhya, Uttar Pradesh, India, from July 2021 to December 2022. After prospective donors were assessed for suitability of blood donation, written informed consent was obtained, and 5 mL venous blood was collected into an Ethylenediaminetetraacetic Acid (EDTA)- anticoagulated vial via the antecubital fossa. Complete blood count was performed within one hour of collection using an automated haematology analyser. The parameters analysed in the study were Red Blood Cell (RBC) count, haemoglobin, Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), and Red cell Distribution Width (RDW). The generated data was compiled and statistical analysis, with Kruskal-Wallis test (at a p-value of 0.05) and post-hoc Dunn test was performed to determine the significant differences, if any. Results: The study included 455 participants, out of which 210 were repeat blood donors. The significant differences for MCV, MCH and RDW between groups defined by number of donations (p-value &lt;0.001) was observed. The difference was most significant between the donors having five or more donations compared to donors having no previous donations. No significant differences were observed for other parameters, with p-values for RBC count, haemoglobin, and MCHC being 0.3, 0.07, and 0.09, respectively. Conclusion: Repeat blood donors having low MCV and MCH along with high RDW, with haemoglobin values within normal range, are most susceptible to having subclinical iron deficiency, which needs to be identified and managed pre-emptively, before development of Iron Deficiency Anaemia (IDA). This is necessary in order to retain regular and repeat voluntary blood donors, and also to ensure adequate quality of collected blood.

Роль бактерий рода Desulfovibrio sp. в патологии человека

Bacteria of the genus Desulfovibrio sp. They are widespread in the environment – they are found in soil, wastewater, bottom sediments. The effect of these microorganisms on the development of pathological conditions in humans has not been fully established. Bacteria of the genus Desulfovibrio sp., gram-negative, curved microorganisms,non-spore – forming, slow-growing, anaerobic. Objective. Identification of pathogenetic features of the effect of sulfate-reducing bacteria of the genus Desulfovibrio sp. on the human. Patients and methods.167 patients who signed a voluntary informed consent was conducted among patients who applied to the Federal State Budgetary Institution "Central Research Institute of Epidemiology" for an examination of intestinal microbiocenosis. Microbiological examination of the biomaterial was carried out using traditional microbiological methods. The following blood parameters were used to assess iron metabolism in the body: hemoglobin, serum iron, ferritin, transferrin, unsaturated iron binding capacity of serum and the percentage of transferrin saturation with iron. Statistical data analysis was performed using standard descriptive statistics methods using Excel (Microsoft Corporation, 2019, USA). The statistical significance of the differences in the compared indicators was assessed using the Student's t-test the significance level of p &lt; 0.05 (t &gt; 2). Results. Bacteria of the genus Desulfovibrio sp. were found in 66 patients (39.5%). In the group of patients whose examination revealed bacteria of the genus Desulfovibrio sp., the number of people with anemia was 16, without anemia was 50. Among patients with the absence of bacteria of the genus Desulfovibrio sp. in the microbiocenosis. laboratory-confirmed iron metabolism disorder with the development of anemia was detected in 11 people, the absence of anemia in 90. The calculation of the odds ratio showed that the risk of anemia increases 2.6 times [95% CI 1.13–6.08] in the presence of bacteria of the genus Desulfovibrio sp in the intestine. Conclusion. It can be assumed that bacteria of the genus Desulfovibrio sp. is one of the etiological factor of the development of iron deficiency anemia in humans. Key words: microbiocenosis, iron deficiency anemia, Desulfovibrio desulfuricans

Iron deficiency and anemia in junior women's competitive sport

An iron deficient athlete is likely to develop iron deficiency anemia, a pathology that may lead to a decrease in performance. If adult athletes, women and men, are aware of the need for regular monitoring, young people under 18 are not necessarily aware of the risks associated with competitive sports practice in the presence of anemia. Even if the guidelines are well known and described, a lack of regular monitoring is found for the aforementioned age group. In junior female athletes practicing basketball, a significant rate of iron deficiency or even iron deficiency anemia was found during annual analyses. The authors wish to emphasize the importance of regular medical and laboratory follow-up for younger athletes who often no longer have a pediatrician and no attending physician.

Prevalence, complications and treatment of iron deficiency in pregnancy

Iron deficiency anemia is the most common form of anemia in pregnancy, occurring in approximately 30-40% of cases. The causes of the occurrence and maintenance of iron deficiency in pregnancy are represented by the perpetuation of a pattern characterized by the occurrence of heavy menstrual bleeding during puberty, precarious and insufficient nutritional intake and, finally, the occurrence of pregnancy with increased iron requirements. The diagnosis of iron deficiency anemia is established based on the decrease in hemoglobin and ferritin levels, with a cut-off value established at 11 g/dL in the case of hemoglobin. Effects on the mother range from asthenia, difficulty concentrating to thyroid disorders or postpartum depression. Maternal-fetal consequences, such as postpartum hemorrhages, low birth weight and premature birth, are significantly reduced by adequate supplementation with iron preparations, orally or intravenously, during pregnancy. Thus, a correct and complete follow-up of the pregnant woman includes, according to the guidelines, the hemoglobin dosage when the patient is taken into account, with the repetition of its dosage at 28 weeks of pregnancy. In Romania, the guidelines recommend ferritin dosing in cases at risk of developing iron deficiency anemia (adolescent girls, twin pregnancies, pregnancies less than a year apart). The choice is oral supplementation in order to prevent the onset of anemia, with the mention of adverse effects of frequent gastrointestinal cause. There is the possibility of parenteral administration in case of severe iron deficiency anemia (Hb<7 g/dL) preoperatively or before the time of birth, or in case of intolerance to oral therapy. Despite all the measures implemented in recent years, the prevalence of anemia continues to be high, a fact that requires a better prevention and education campaigns, especially in countries with low socioeconomic status.

Alterations in some Physiological and Inflammatory Markers in Iron-Deficient Obese Adults in the Kurdistan Region, Iraq

Background: Iron homeostasis is crucial to many physiological functions in the human body, such as cellular activity, erythropoiesis, and the innate immune response. Iron deficiency anemia may occur from obesity's ability to disturb iron homeostasis. Obesity may be seen as a pre-inflammatory condition with mild, ongoing systemic inflammation. Additionally, an increase in hepcidin levels by chronic inflammation causes iron insufficiency in obese people. For this reason, this current experiment is designed to investigate the iron profile and some hematological and inflammatory parameters in obese adults in the Kurdistan region-Iraq. Subjects and Methods: The cross-sectional study was designed within the context of a medium private laboratory with participants being common people involved, 200 adults participated in this study and were allocated into two groups according to BMI (control group (BMI ≤ 29.9): N=100 and obese group (BMI &gt;30): N=100). Oxygen saturation (SpO2) and pulse rate were assessed. Blood sera (once) was obtained for iron profiles (s. Iron, Ferritin, Hepcidin) and inflammatory levels (c-reactive protein (CRP), interleukin 6 (IL-6)). Results: Our findings highlighted that all inflammatory markers increased significantly in the obese groups in both sexes and a positive correlation with BMI and a significant decrease in iron in the obese group. Conclusions: This research reveals that hepcidin levels in obese adult people contribute to the development of iron deficiency anemia due to increased inflammation.

The Effect of Family-Based Iron Education on FE Tablet Consumption Compliance in Pregnant Women in the Era of the COVID-19 Pandemic at UPTD Puskesmas Palaran

Pregnant women who fail to take iron supplements can develop iron deficiency anemia which increases the risk of maternal bleeding. Family-based education can increase pregnant women's adherence to taking Fe tablets regularly. The purpose of this study was to determine the effect of family-based iron education on adherence to consumption of Fe tablets in pregnant women during the COVID-19 pandemic at the Palaran Health Center UPTD. The design of this study is a quasi-experimental pre-test and post-test control design. The total sample is 32 pregnant women taken by purposive sampling. The results of the Chi square statistical test for the level of adherence with a p value of 0.001 ≤ α = 0.05 and paired t-test and independent tests for differences and increased knowledge of pregnant women. It was concluded that there was an effect of family-based education on adherence to consumption of Fe tablets in pregnant women (p value 0.001).

Erythropoietin as a prophylactic measure against anemia in critically ill patients: A combined prospective and retrospective study

Background &amp; Objective: Critically sick patients often develop moderate to severe anemia, due to various factors. We tested the hypothesis that administering prophylactic recombinant human erythropoietin (rHuEPO) together with early identification and correction of iron deficiency anemia in traumatic brain injury patients would have a positive effect on the incidence of RBCs transfusions.&#x0D; Methodology: One hundred and seventeen head-trauma patients were enrolled. They received 40,000 units of prophylactic rHuEPO, starting on day three after admission and continuing at weekly intervals for 6 weeks, with follow-up of iron biomarkers. Any patient developing iron deficiency anemia was prescribed oral or intravenous iron supplement. The incidence of RBCs transfusion was recorded.&#x0D; Results: The number of RBCs transfusion was significantly less in the prospective group (27.35%) than the retrospective group (42.86%). Hemoglobin and hematocrit levels were significantly less in the first and second weeks after admission and then began to rise. Serum iron, transferrin saturation, and ferritin were at their lowest levels in the fourth week. Meanwhile, total iron binding capacity was higher in the fourth week and lower in the sixth.&#x0D; Conclusion: The administration of prophylactic rHuEPO with early discovery and correction of iron deficiency anemia resulted in a significant reduction in the incidence of RBCs transfusion in the head-trauma patients.&#x0D; Abbreviations: rHuEPO: recombinant human erythropoietin, RBC: red blood cell, ICU: intensive care unit, TBI: traumatic brain injury, GCS: Glasgow Coma Scale, APACHE: Acute Physiology and Chronic Health Evaluation&#x0D; Citation: Amer AF, Elatrozy HI, El Mourad MB. Erythropoietin as a prophylactic measure against anemia in critically ill patients: A combined prospective and retrospective study. Anaesth. pain intensive care 2022;26(5):633−639.&#x0D; DOI: 10.35975/apic.v26i5.1481&#x0D;

Haemoglobin and iron store status in low birth weight babies and effect of early iron supplementation on them A randomized and open label study

Deficiency of iron affects multiple organ systems, and poor neurodevelopment is the most worrisome effect. Low birth weight neonates are more likely to develop iron deficiency anemia than term counterparts. The guidelines for supplementation of iron in LBW neonates are poorly defined with varying recommendations pertaining to the intiation. Hence this study focuses on the effect of early iron supplementation and iron store status in them.In this randomized open label interventional study, 48 LBW neonates (EI group) were administered iron supplementation (at 2 weeks or earlier when full feeds were achieved), and other 48 were controls. All neonates were assessed for hemoglobin level, RBC count and iron status indicators (Hematocrit, Serum Ferritin) at or after 6 weeks of postnatal age. The post-intervention values of mean haemoglobin (cases 12.68±1.51g/dl, Controls – 11.38 ± 1.03g/dl), mean serum ferritin (cases: 238.45 ng/ml, CONTROLS- 175.68 ng/ml), mean RBC count (cases: 3.94 million/mm, and mean hematocrit (cases: 33.16±3.75%, controls 34.04±3.45%)were noted, and the % change at 6 weeks follow up in mean Hb among - 25.19%, 31.45% (0.01); % change in mean ferritin at follow up: cases 15.13%, controls 32.99% (0.001); % change in mean RBC count at follow up: cases 19.21%, 33.82% (0.001)] when compared to pre- inetervention values was noted. Though the haematological parameters decreased in both groups, the levels were comparatively higher in the cases compared to the controls, and iron store status was better in early iron-supplemented infants. Iron supplementation in LBW neonates started as early as 2 weeks postnataly, improves the iron stores and decreases the risk of iron deficiency in these infants.