Difference In Serum Ferritin Levels Research Articles

A real-world analysis of roxadustat effectiveness and safety in managing renal anemia among patients on maintenance hemodialysis: An observational study.

We aimed to compare the clinical efficacy and safety of roxadustat with erythropoiesis-stimulating agents, particularly erythropoietin (EPO), in the treatment of maintenance hemodialysis patients with renal anemia. A prospective cohort study was carried out at the Nephrology Department of the Nantong First People's Hospital and Nantong University Affiliated Hospital from December 2020 to December 2021. We compared hemoglobin (Hb) levels, serum ferritin (SF) levels, and adverse cardiovascular events between the roxadustat and EPO groups at 1, 3, and 6 months into the treatment. A total of 209 patients participated in the study, with 112 in the roxadustat group and 97 in the EPO group. At baseline, no statistically significant differences were observed between the 2 groups in terms of age, gender, weight, dialysis modality and duration, previous EPO dosage, Hb levels, SF levels, transferrin saturation, heart function classification, and blood pressure levels (P > .05). After 1 month, Hb levels in the roxadustat group were significantly higher than those in the EPO group (P < .05). However, no statistically significant differences were found between the 2 groups at 3 and 6 months (P > .05). Additionally, there were no significant differences in SF levels and the occurrence of adverse cardiovascular events between the 2 groups after treatment (P > .05). Roxadustat was superior to EPO in the initial treatment phase, while its cardiovascular safety was comparable to that of EPO.

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.

Iron-deficiency anemia in relation to body mass index among Iraqi primigravida women.

Anemia affects approximately half a billion women of reproductive age worldwide, with 31% of pregnant women in Iraq aged 15-49 years experiencing anemia. This condition is associated with increased risks of maternal and fetal morbidity and mortality, including stillbirths, miscarriages, prematurity, and low birth weight. This study investigated the correlation between iron-deficiency anemia (IDA) and body mass index (BMI) among primigravidae in Iraq. One hundred primiparous women in their third trimester were recruited from Baghdad Medical City Teaching Hospital and Teaching Hospital of Obstetrics and Gynecology in Karbala. Participants were categorized into four groups based on BMI: underweight (BMI < 18.5 kg/m^2), normal weight (BMI 18.5-24.9 kg/m^2), overweight (BMI 25-29.9 kg/m^2), and obese (BMI ≥ 30 kg/m^2). Demographic and medical history data were collected from the participants, and hematological investigations were conducted to measure hemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), and serum ferritin levels. Statistical significance was determined at p<0.05. The study enrolled 100 primiparous women, including 10 underweight, 24 normal weight, 28 overweight, and 38 obese participants. Analysis revealed a significant decrease in Hb levels among obese individuals compared to the normal weight group. Moreover, a significant difference in serum ferritin levels was observed between the obese and the other three groups (underweight, normal weight, and overweight). The findings indicated an inverse correlation between high BMI and serum ferritin and Hb levels. The study concluded that anemia is more common in obese pregnant women compared to normal-weight women. Furthermore, it demonstrates varying trends of iron-deficiency anemia (IDA) in relation to the body mass index (BMI) of pregnant women.

The association between triglyceride-glucose index and hyperferritinemia in patients with type 2 diabetes mellitus.

To investigate the relationship between the triglyceride-glucose (TyG) index and serum ferritin (SF) levels in patients with type 2 diabetes mellitus (T2DM). A total of 881 T2DM patients were divided into T1(TyG index < 1.66), T2 (1.66 ≤ TyG index < 2.21), and T3 (TyG index ≥ 2.21) groups according to the tertiles of the TyG index. The differences in SF levels and the prevalence of hyperferritinemia (SF ≥ 300ng/mL for male or SF ≥ 150ng/mL for female) were compared. The independent correlations between the TyG index and SF, and between hyperferritinemia and TyG in T2DM patients were analyzed, respectively. SF levels in male T2DM patients were higher in the T3 group (250.12ng/mL) than in the T1 and T2 groups (180.45 and 196.56ng/mL, both p < 0.01),while in female patients with T2DM,SF levels were higher in the T3 group (157.25ng/mL) than in the T1 group (111.06ng/mL, p < 0.05).The prevalence of hyperferritinemia in male T2DM patients was higher in the T3 group (31.3%) than those in the T1 and T2 groups (10.4% and 17.3%, both p < 0.05).The TyG index was positively correlated with SF levels in T2DM patients (R = 0.178, p < 0.001).TyG index was independently and positively correlated with SF levels after adjusting for confounders (β = 0.097, 95%CI [2.870,38.148], p = 0.023).The TyG index was positively independently correlated with hyperferritinemia in male T2DM patients (OR = 1.651, 95%CI [1.120,2.432], p = 0.011). In parallel with increasing TyG index SF levels gradually increased. The TyG index was positively correlated with SF levels in patients with T2DM and was positively correlated with hyperferritinemia in male T2DM patients.

Serum Ferritin Increased the Predictive Value of the International Staging System/Revised International Staging System for Overall Survival

Background Multiple myeloma (MM) is a terminally differentiated plasma cell hematological malignancy. MM remained an incurable disease, accounting for 20% of deaths of hematological malignancies, despite continuous improvements in its treatment. The revised international staging system (RISS) is commonly used in patients with de novo MM, but it has limitations in predicting prognosis. Hence, better prognostic biomarkers and more optimized staging are yet to be explored. Methods This retrospective study reviewed 357 patients with MM at our institution from May 2013 to May 2018 and included a total of 302 patients. Differences in serum ferritin levels between patients with relapse/non-relapse and survival/death were assessed. Multivariate-adjusted Cox regression and K-M curve were conducted to analyze the effect of different serum ferritin levels on progression-free survival (PFS) and overall survival (OS) in 7 years. Further, the receiver operating characteristic (ROC) curve analysis was used to evaluate the role of serum ferritin level in increasing the international staging system (ISS) and RISS in prognosis prediction. Multivariate linear regression and binomial logistic regression assessed the association of serum ferritin level with optimal induction therapy response. Results The serum ferritin level of patients with MM with recurrence was significantly higher than that of patients without recurrence (P < 0.0001), and the serum ferritin level of patients with all-cause death was significantly higher than that of patients who were still alive during the 7-year follow-up period (P < 0.0001). Smooth curve fitting analysis showed that serum ferritin levels were associated with relapse and death occurrences. The K-M curve analysis indicated that MM patients with high ferritin levels (≥577.47 ng/ml) had shorter PFS (P < 0.0056) and OS (P = 0.0014) than those with ferritin levels of <577.47 ng/ml. Multivariate Cox regression analysis adjusted for potential variables showed that MM patients with high serum ferritin had poor PFS (hazard ratio [HR] = 2.07, 95% confidence interval [CI]: 1.33-3.23, P = 0.0012) and OS (HR = 1.84, 95%CI: 1.08-3.16, P = 0.0258), with independent correlation. The prediction model of ROC analysis based on Cox regression showed that ferritin had a predictive value for PFS (ORferritin = 2.158, Pferritin = 0.0219) and OS (ORferritin = 2.2480, Pferritin = 0.0196). Additionally, the ROC curve showed that serum ferritin could increase the predictive value of ISS and RISS for OS. Multivariate regression analysis showed that serum ferritin levels had no significant independently effect on the optimal response within induction therapy. Conclusion This retrospective study showed that baseline serum ferritin levels were associated with prognosis in patients with MM, and patients with higher serum ferritin have poorer PFS and OS. Serum ferritin could increase the prediction value of ISS and RISS for OS.

Analysis of Serum Ferritin Level and Its Clinical Value in Advanced Gastric Cancer

Objective: To investigate the concentration and clinical significance of serum ferritin (SF) in patients diagnosed with advanced gastric cancer before and after treatment. Methods: Forty patients with advanced gastric cancer diagnosed by cytology or pathology in our hospital were selected, including 25 males and 15 females, aged from 48 to 85 years, and the median age was 61.0 years. 40 healthy volunteers matched with age and education were selected as the control group. In order to study the changes of SF level in the treatment of advanced gastric cancer, we divided the patients into effective group (efficacy evaluation as partial remission or complete remission), ineffective group (efficacy evaluation as no remission) and recurrence group according to the efficacy after treatment. Then the difference of SF level between different groups and the relationship between SF level and curative effect were analyzed. There was no significant difference in gender and age among all groups. Results: The SF levels in the newly diagnosed group, stage III patient group and stage IV patient group were significantly higher than those in the control group. The level of SF in stage IV patients was significantly higher than that in stage III patients. There were significant differences in SF level between the effective treatment group, the newly diagnosed group and the ineffective treatment group, but there was no significant difference in SF level between the newly diagnosed group and the ineffective treatment group. Conclusion: SF level has a certain value in the auxiliary diagnosis of gastric cancer, and it also has a certain guiding significance for the evaluation of curative effect and prognosis after treatment.

Serum Biomarkers Associated with Malnutrition and Nutritional Risk in Elderly Primary Care Patients: A Cross-sectional Study from Bosnia and Herzegovina.

BackgroundThe aim of the study was to determine the ability of ferritin, haemoglobin, albumin and total cholesterol to identify nutritional risk and malnutrition among elderly primary care patients.MethodsThe cross-sectional study included 446 elderly adults over 65 years of age from four areas of Bosnia and Herzegovina. In addition to anthropometric, functional, cognitive and biochemical indicators, nutritional status was evaluated using 24-hour recall of meals, the Mini Nutritional Assessment (MNA), and Seniors in the Community: Risk Evaluation for Eating and Nutrition, Version II (SCREEN II).ResultsMalnourished/at-risk study respondents had lower mean levels of haemoglobin (P=0.001) and total cholesterol (P<0.001), compared to those with normal nutritional status. Albumin levels significantly differed regarding nutritional status (P=0.004), but not nutritional risk level (P=0.521). Significant differences in serum ferritin levels were not found between malnourished and normally nourished study respondents (P=0.779) Determinants of albumin level were eating more than three meals a day (P<0.001), fewer than two portions of fruit and vegetables a day (P=0.024), drinking one glass of wine (P<0.001) and reporting functional independence (P=0.011). The AUC curves for serum ferritin, albumin and total cholesterol levels in men and women, as well as for haemoglobin levels in women, were poor to fair (AUC<0.800).ConclusionAlthough ferritin, haemoglobin, albumin and total cholesterol may be useful biomarkers of nutritional status, their accuracy in diagnosing malnutrition and nutritional risk among elderly primary health care patients is limited.

THE LEVELS OF FERRITIN SERUM AS A BIOMARKER TO DISTINGUISH BETWEEN ACTIVE AND INACTIVE SYSTEMIC LUPUS ERYTHEMATOSUS

Introduction: The Characteristic recurrence of SLE (Systemic Lupus Erythematosus) patients cannot be predicted. Lack of a reliable parameter that can predict an active clinical phase precludes the way to explore effective preventive strategies for disease relapse, while clinicians should balance the toxicity effect of prolonged use of immunosuppressive therapy. Aim: Knowing the function of serum ferritin as a biomarker to distinguish between active and inactive SLE Methods: Cross-sectional research was conducted at the hospital general of Haji Adam Malik Medan from August to September 2019 in 65 SLE patients. Patients conducted a serum ferritin test and in value by using the MexSledai score. Data analysis using the Mann-Whitney test in SPSS 20th. Result: Median (Min-max) serum ferritin levels of active SLE group 1519 (18.6-2218) ng/mL while inactive SLE Group is 250 (10.5-2000) ng/mL. There are significant differences in serum ferritin levels between active and inactive SLE groups (p = 0,004). ROC curve plot on was found the value of the serum ferritin cutoff can be used to diagnose active SLE. Cutoff value for ferritin levels is (486.0 ng/mL) with a sensitivity value (100.0%) and specificity (90.5%). Conclusion: Serum ferritin levels can be used as a biomarker to distinguish active and inactive SLE.

7. Life-threatening adult-onset Still’s disease

7. Life-threatening adult-onset Still’s disease

Association between serum levels of hepcidin and ferritin in patients with thalassemia major and intermedia, the role of iron chelator

Patients with beta-thalassemia suffer from iron overload, and hepcidin, as the main regulator of iron hemostasis, can indicate iron overload better than serum ferritin, but changes in serum hepcidin levels are affected by the type of thalassemia (major or intermediate) and by type of treatments. The present study aimed to determine the correlation between serum levels of hepcidin and ferritin in patients with thalassemia major and intermedia under chelation therapy. This cohort study investigated 143 patients with thalassemia (122 patients with thalassemia major and 21 patients with and thalassemia intermedia) who referred to Thalassemia Center of Qom University of Medical Sciences, Qom, Iran. The serum level of ferritin was measured twice in all patients: in the beginning and after taking iron chelator by ECL method. Hepcidin was assayed at the end of the study by ELISA methods. Demographic data and clinical history of the patients (type of disease, type of drugs used, and blood transfusion history) were completely recorded. The mean serum level of hepcidin in the TM group (2249.62 ± 1547.37 ng/ml) was greater than the TI group (1482.43 ± 1314.26 ng/ml) (p = 0.007). However, there was no meaningful difference in serum ferritin level between the two groups (2997.74 ± 2545.66 vs. 2670.62 ± 2670.04 ng/ml, p > 0.05). Serum ferritin and hepcidin levels were not correlated both in TM or TI patients (p > 0.05). However, evaluating the trend of changes in serum levels of ferritin with hepcidin showed a significant association. High serum levels of ferritin indicated high iron overload in both groups, TM and TI, which decreased after treatment with chelators. The higher hepcidin levels in TM patients in comparison to TI patients could reflect the higher iron overload in these patients. However, further cellular studies are needed to evaluate the accuracy of these tests in the assessment of iron overload.

Is it useful to measure serum ferritin level in systemic lupus erythematosus patients?

BackgroundSerum ferritin is elevated due to various conditions as inflammation and malignancy and could be up regulated in systemic lupus erythematosus (SLE). Aim of workTo evaluate serum ferritin level in SLE patients and correlate it with different clinical and laboratory parameters as well as disease activity. Patients and methodsThe study was carried out on 46 SLE patients and 20 matched controls. SLE Disease Activity Index (SLEDAI) was assessed and patients subdivided into severe (SLEDAI ≥ 11) and mild to moderate (SLEDAI < 11) activity. Serum ferritin, iron and total iron binding capacity (TIBC) levels were assessed. ResultsThey were 40 females and 6 males with a mean age of 36.7 ± 10.3 years and disease duration of 4.9 ± 2.3 years. Serum ferritin was significantly higher in patients than controls (163.5 ± 27.8 vs. 47.1 ± 10.6 ng/ml, p = 0.009). In patients, serum iron (49.2 ± 4.5 mg/dl) and TIBC (284.2 ± 80.8 mg/dl) were comparable with those in controls. Serum ferritin was significantly higher in patients with severe (220.9 ± 50.7 ng/ml) than those with mild-moderate activity (122.9 ± 29.7 ng/ml; p < 0.001). Serum ferritin was significantly higher in patients with anemia (p < 0.001) and thrombocytopenia (p = 0.03) and lower in those with leucopenia (p < 0.001) compared to those without. Ferritin significantly correlated only with hemoglobin (r = 0.5, p = 0.02), platelet count (r = 0.65, p = 0.03) and inversely with leucocytic count (r = −0.08, p = 0.006). ConclusionSerum ferritin is elevated significantly in SLE patients especially those with severe activity. A remarkable difference in serum ferritin levels in patients with hematological manifestations was found making it a potentially useful inflammatory marker for disease activity in patients with blood dyscrasia.

Clinical significance of serum ferritin detection in myelodysplastic syndromes

Objective To investigate the clinical significance of serum ferritin (SF) detection in myelodysplastic syndromes (MDS). Methods A total of 42 cases of MDS without blood transfusion who were admitted to General Hospital of Huainan Eastern Hospital Group from January 2010 to July 2017 were collected. There were 27 males and 15 females, aged 46-90 years old with a median age of 72 years old. In 42 cases of MDS, 10 cases had refractory anemia (RA), 4 cases had refractory anemia with ring increased iron bead young cell (RARS), 8 cases had refractory blood cells decreased with more dysplasia (RCMD), and 20 cases had refractory anemia with primitive cells increased (RAEB). According to the International Prognostic Scoring System, 22 cases had low risk, and 20 cases had high risk. At the same time, 40 healthy checkers were chosen as healthy control group. SF levels were measured and compared between the MDS patients and healthy controls. Results The SF level in the MDS group was significantly higher than that in the healthy control group [(479±267) ng/ml vs. (153±56) ng/ml], and the difference was statistically significant (t = 7.379, P < 0.05). The difference in SF levels among the patients with different subtypes of MDS was statistically significant (F = 4.81, P = 0.006). Among them, the RA group had the lowest SF level, while the RAEB group had the highest, and the difference between the two groups was statistically significant [(346±257) ng/ml vs. (818±443) ng/ml, P = 0.005]. The SF level in the low-risk group was lower than that in the high-risk group [(456±238) ng/ml vs. (788±467) ng/ml], and the difference was statistically significant (t = 2.867, P = 0.008). Conclusion Patients with MDS show a significant increase in SF level, and high-risk patients are associated with iron overload, and SF may be an auxiliary indicator for judging the prognosis of MDS. Key words: Myelodysplastic syndromes; Serum ferritin; Prognosis

Iron status in small for gestational age and appropriate for gestational age infants at birth.

PurposeThis study compared the iron statuses of small for gestational age (SGA) and appropriate for gestational age (AGA) infants at birth.MethodsThe clinical data of 904 newborn infants admitted to the neonatal intensive care unit were reviewed. Blood samples were drawn from the infants within 24 hours after birth. Serum ferritin level was used as a marker of total iron status.ResultsIn this study, 115 SGA (GA, 36.5±2.9 weeks; birth weight [BW], 1,975±594.5 g) and 717 AGA (GA, 35.1±3.5 weeks; BW, 2,420.3±768.7 g) infants were included. The SGA infants had higher hematocrit levels (50.6%±5.8% vs. 47.7%±5.7%, P<0.05) than the AGA infants. No difference in serum ferritin level (ng/mL) was found between the groups (mean [95% confidence interval]: SGA vs. AGA infants, 139.0 [70.0–237.0] vs. 141.0 [82.5–228.5]). After adjusting for gestational age, the SGA infants had lower ferritin levels (147.1 ng/mL [116.3–178.0 ng/mL] vs. 189.4 ng/mL [178.0–200.8 ng/ mL], P<0.05). Total body iron stores were also lower in the SGA infants than in the AGA infants (185.6 [153.4–211.7] vs 202.2 [168.7–241.9], P<0.05).ConclusionThe SGA infants had lower ferritin and total body iron stores than the AGA infants. The SGA infants affected by maternal hypertension who were born at late preterm had an additional risk of inadequate iron store. Iron deficiency should be monitored in these infants during follow-up.

Efficacy and Safety of Wheat Grass in Thalassemic Children on Regular Blood Transfusion.

Background: In thalassemia, mutations either in alpha or beta chain synthesis results in low hemoglobin (Hb). Wheatgrass has been used for many years for health purposes. Some reports suggest the beneficial effect of wheatgrass on transfusion requirements. Folic acid is also known to play an important role in several biochemical reactions. In some patients with thalassemia, the supplementation of folic acid is useful.Objective: To evaluate the efficacy and safety of wheatgrass in children with thalassemia receiving chronic blood transfusions.Material and methods: In this randomized prospective study, 69 children with thalassemia were divided into the wheatgrass group and the control group (no wheatgrass). Both groups received a regular blood transfusion and folic acid. The treatment duration was 18 months. Anthropometric parameters, number of transfusions, and amount of blood transfused were compared within and between the groups at the end of the therapy. Clinical examinations, laboratory investigations, and ultrasounds for liver and spleen span were performed at the baseline and then every six months till 18 months. Adverse effects (if any) were noted on every visit. Quality of life (QOL) was evaluated before and at the end of the study using a questionnaire.Results: Sixty-nine (study group (n=45; mean age 6.35 ± 2.65 yrs); control group (n=24; 4.86 ± 2.77 yrs)) patients were enrolled, of which 12 from the study group and three from the control group did not complete the study. The difference in liver size within the wheatgrass group was significant (P <0.021) only at 18 months but not in the control group at any time point. The difference in spleen size was significant within the wheatgrass group (P<0.005) as well as the control group (P<0.001) at 18 months only. The difference in serum ferritin levels was not significant between the two groups. The increase in serum ferritin levels at the end of the study was significant in the control group when compared to the baseline (P<0.01). There was no difference in the average number of transfusions or in the blood transfusion requirement between the two groups. The difference in the QOL at the start and end was significant in the wheatgrass group (P<0.05).Conclusion: Wheatgrass appears to play a promising role in children with thalassemia receiving chronic blood transfusions.

Serum iron parameters in liver cirrhosis

The liver plays a fundamental role in iron homeostasis. Iron parameters change, especially ferritin, need to be evaluated in patients with liver cirrhosis. Serum ferritin could predict the prognosis of patients with decompensated cirrhosis since it reflects immunemediated and infectious stimuli. Ferritin could express the severity of liver disease and possible subsequent complications. Finally, it might reflect an iron overload condition resulting in significant morbidity and early mortality. 70 patients with decompensated liver cirrhosis divided into three Child-Pugh subgroups. Serum iron parameters include serum iron (SI), total iron binding capacity (TIBC) and ferritin was measured in these groups. From these 70 patients, 30 (42.9%) with HbsAg positive, 26 (37.1%) with anti-HCV positive and 14 (20%) with both HbsAg and anti-HCV positive. Of the 70 patients, 14 (20%) had CTP Class A cirrhosis, 17 (24.3%) had CTP Class B cirrhosis, and 39 (55.7%) had CTP C cirrhosis. The median (range) value of serum iron was 36 (10-345) μg/dl, TIBC was 160 (59-520) μg/dl, Ferritin was 253.5 (8-6078) ng/ml and the transferrin saturation was 22.9 (3.65-216.98) %.We found a significant difference in serum ferritin level with CTP score. Ferritin levels increased as Child-Pugh class progressed (p<0.001).

Comparison of the Mean Serum Ferritin Levels in Thalassaemia Major Patients after Giving Deferasirox and Deferoxamine

Objective: To compare the mean serum ferritin levels in thalassaemia major patients after giving deferasirox and deferoxamine. This is a randomised control trial conducted at the Department of Paediatrics, Civil Hospital, Karachi from 29th January 2014 to 28th July 2014.&#x0D; Methods: A total of 160 patients of either gender, with age between 1 to 14 years, who received blood transfusion at least once a month for one year and had serum ferritin &gt;1000 mcg/L were included. Each enrolled patient was randomly allocated to group-A (deferoxamine) or group-B (deferasirox). Pre- and post-treatment iron profile was done in both groups to assess the iron status in the body. De- scriptive statistics were applied to calculate mean and standard deviation for the quantitative vari- ables. Frequencies and percentages were calculated for the qualitative variables. Independent sample t-test was applied to compare mean change in serum ferritin level in both groups. Effect modifiers were controlled by stratification. Paired t-test was also applied post stratification and p- value £ 0.05 was considered as significant.&#x0D; Results: Overall there were 96 male and 64 female patients. The overall mean age of study subjects was 7.54 ± 4.21 years. In the deferasirox group, mean age was 6.35 ± 4.11 years, mean weight wasv18.01 ± 6.74 kg, mean height was 102.04 ± 19.48 cm, and mean duration of transfusion was 7.48 ± 3.99 months/year. In the deferoxamine group, mean age was 8.74 ± 3.97 years, mean weight was 20.44 ± 6.77 kg, mean height was 102.19 ± 20.85 cm, and mean duration of transfusion was 8.14 ± 3.55 months/year. In the deferasirox group, before treatment mean serum ferritin level was 1385.73 ± 117.01 mcg/L. After treatment mean serum ferritin level was reduced to 1047.59 ± 117.08 mcg/L. In the deferoxamine group, before treatment mean serum ferritin level was 1362.58 ± 134.42 mcg/L. Af- ter treatment mean serum ferritin level was reduced to 1124.36 ± 134.52 mcg/L. Post-treatment the serum ferritin level between two groups was significantly different with p&lt;0.01. The mean difference in serum ferritin level in pre- and post-treatment among two groups was highly significant with p&lt;0.01.&#x0D; Conclusion: Deferasirox is an effective, safe and tolerable chelation therapy for the treatment of thalassaemia major with iron overload due to its ability to provide constant chelation coverage and potential to improve compliance.

Prevalence and Determinants of Iron Deficiency Anemia in Adolescents Girls of Low Income Communities in Lahore

AbstractBackground: Iron deficiency anemia (IDA) in adolescent girls has strong health implications during re-productive years. Current research aimed to assess prevalence and determinants of iron deficiency anemia in adolescent girls of low income families residing in semi urban communities of Lahore, Pakistan.Method: This cross sectional analytical study selected 116 unmarried adolescent girls between the ages of 13 – 19 years from low income families through convenience sampling from semi-urban communities. Dietary data was collected using 3 – day recall, whereas a self-constructed, structured questionnaire was used to collect data on socio-demographic factors. Hemoglobin and serum Ferritin levels were assessed along with an assessment of clinical signs and symptoms of folate and iron deficiency. Data was enteredand analyzed using SPSS version 21.Results: IDA was present in 68.8% of adolescent girls, of which 40.2% were moderately (8 – 10 gm/dl) and 28.8% were mildly (10.9 – 11.9 gm/dl) anemic. Working status (p &lt; 0.041), source of dietary iron (p &lt; 0.001), frequency of heme iron consumption (p &lt; 0.001), protein consumption/day (p &lt; 0.001) and HEI score (p &lt; 0.001) showed statistically significant association with IDA. Binary regression analysis showed frequency of heme iron consumption [AOR = 29.13, 95% CI (9.627 to 88.203)] and HEI score [AOR = 6.877, 95% CI (.065 to 44.405]) to be the most significantly associated determinant of IDA. Mean Hb level was also significantly different between working and nonworking adolescents (p = 0.001, 95% CI = -1.124 to -0.322). Significant mean difference in serum Ferritin levels between working and nonworking adolescents (p = 0.04 [95% CI = -21.89 to -0.50]) was also observed. 94% and 91% girls showed signs and symptoms of iron and folate deficiency respectively. How-ever BMI, age, educational status of the girls and their parents were not found to be associated with IDA.Conclusion: Prevalence of IDA was alarmingly high in adolescent girls of low socioeconomic class. Working status, source of dietary iron, frequency of heme iron consumption, protein consumption/day and HEI score were found to be determining anemia. Nutrition education targeting IDA is the need of the day to control and prevent this public health epidemic.

Risk factors for anemia in the early stages of chronic kidney disease

To identify the early markers of anemia in chronic kidney disease (CKD) in patients with chronic glomerulonephritis (CGN) and glomerulonephritis (GN) in systemic diseases. Seventy-nine patients with some male preponderance who were aged 21 to 65 years (45.3±11.1 years) and had CKD (CGN and GN) in systemic diseases (systemic lupus erythematosus and Wegener's granulomatosis) in the early stages (Stages I-II) of CKD were examined. GN was diagnosed by a lifetime renal biopsy. Systemic diseases were diagnosed according to the criteria for each nosological entity. The stages of CKD were defined according to the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) criteria; the glomerular filtration rate (GFR) was calculated using the CKD EPI equation (2012). According to the presence or absence of anemia, all the patients included in the study were divided into 2 groups: 1) 43 (54.4%) anemic patients; 2) 36 (45.6%) non-anemic patients (a control group). In addition to general clinical examination adopted for a nephrology department, special studies, such as determination of the serum levels of hepcidin, interferon-γ (IFN-γ), soluble Klotho protein (s-Klotho), as well as iron, ferritin, and transferrin saturation (TSAT) ratio, were performed to solve the set tasks. Forty-three anemic patients who had a hemoglobin level of 110 (100; 119) g/l and 36 control patients who had the similar values were noted to have statistically significantly (p<0.001) higher levels of IFN-γ (11 (10; 14) and 0.2 (0.09; 0.6) ng/ml), hepcidin (26 (25; 27) and 5.1 (3.8; 5.9) ng/ml) and C-reactive protein (1.5 (1.1; 2.1) and 0.3 (0.2; 0.6) mg/dl), and lower levels of s-Klotho protein (12 (10; 18) pg/ml) and TSAT (18 (14; 19)%. Forty-three patients with anemia were also found to have a statistically significantly (p<0.01) lower GFR (65 (62; 87) and 80.5 (62; 90) ml/min) and higher systolic blood pressure (145 (125; 160) and 120 (115; 16) mm Hg) as compared with those in 36 control patients. At the same time, the compared groups displayed no statistically significant differences in serum ferritin levels (123 (110; 150) and 115 (100; 140) µg/l). Among 43 CKD patients with anemia, its detection rate in the presence of systemic diseases was 3.2 times higher than that in CGN patients (41.7 and 12.7%). ROC analysis revealed that in the CKD patients with CGN and GN, the serum hepcidin level ≥ 25 ng/ml, with the sensitivity and specificity being of 89.7% and 74%, respectively (p > 0.001), was associated with the development of anemia. Moreover, the hemoglobin level of<120 g/ l was found to have an independent impact on the risk of reducing serum s-Klotho production. In Stage I-II CKD patients with CGN and GN in the presence of systemic diseases, elevated serum hepcidin levels should be regarded as a predictor for anemia of chronic disease (ACD). Herewith, the decrease in hemoglobin levels <120 g/l is associated with the reduced production of the nephroprotective factor s-Klotho. The treatment of ACD for Stages I-II CKD should encompass intravenous administration of iron in order to increase its content and availability for erythropoiesis.

Reviewing EKGs in Thalassemia Patients to Evaluate Their Cardiac Function

Introduction: There are more than 18000 thalassemia patients in Iran. In a current study, a high rate of mortality in these patients due to heart failure, is shown. Main factors for evaluating this disorder in thalassemia patients were their electrocardiograms (EKGs) and Serum Ferritin Levels (SFLs). Methods: We studied the cardiac function in 91 patients (73 major and 18 intermediate thalassemia patients) treated in Zafar Thalassemia Center, of whom 35 (38.45%) were male and 56 (61.55%) were female. The Factors in this study contains: EKGs, mean annual serum ferritin (at least, three SFL had been recorded in each patient treatment file in 2009), mean annual hemoglobin (Hb) levels and mean annual hematocrit (Hct) levels (average, 12 recorded hematocrit levels during 2009). Results: Our findings have shown that Q-T interval did not correlate with ferritin (r = 0.05, P > 0.05). In both patients with LVH and without LVH, there was no significant difference in SFL (P > 0.05). Although, the mean rate among the thalassemia patients was 85.34 ± 12.91, it did not correlate significantly with QRS duration and P-R Interval (r = -0.08, P > 0.05). In addition, ferritin did not correlate significantly with QRS duration and P-R Interval (r = 0.1, r = 0.05 and P > 0.05, P > 0.05). Furthermore, there was no difference in SFL in patients with normal cardiac axis and those with cardiac axis deviation. Conclusion: There is no correlation between SFL and variations in EKG. Although EKG is an available method for checking cardiac function in thalassemic patients, especially in developing countries, physicians cannot rely on it for diagnosis or prognosis of cardiac failure in thalassemia patients. Therefore, other methods such as MRIT2* and Echocardiography are suggested to be used periodically in order to check the cardiac function in thalassemia patients.

Seroprevalence of Antibodies to Helicobacter Pylori Six Virulent Antigens in Asymptomatic Adult Beta Thalassemic Patients

1.1.Introduction: The idea that Helicobacter pylori (H. pylori) might confer benefit to humans by impairing iron absorption has engendered considerable controversy among investigators.The aim of the present study was to compare the seroprevalence of antiH. pylori in asymptomatic beta thalassemia major (s TM) patients and normal controls. 1.2.Materials and methods:40 proven adults s TM cases (group 1) and 40 age and sex-matched healthy controls (group 2) were the subject of the study. The mean age of adults' s TM was 21.5±4.97years. Twenty two (55%) were males and 18 (45%) were females. Serum samples from all patients and controls were examined for specific IgG antibodies to the followingH. pylori six virulent antigens: cagA (cytotoxin-associated gene A), vacA (vacuolating cytotoxin A), UreA (urease A), p30 (OMP), p25 (OMP) and p19 (OMP) using H. pylori LINE ImmunoblotAssay. Serum samples from all patients were examined also for HCV-RNA viral load by Real Time PCR. 1.3.Results:There was a statistically significantly higher seroprevalence of H. pylori among adult s TM patients than among the controls [14/40 (35%) vs. 9/40 (22.5%)] respectively (X2=82.538, p=0.000).Antibodies against cagA and vacA were absent in the healthy seropositive controls. There was no statistically significant difference between H. pylori IgG-positive (14 cases) and negative (22 cases) s TM as regards age (t=0.633, p=0.432), sex (x2=0.175, p=0.676), hemoglobin value (t=0.332, p=0.568), serum ferritin level (t=0.394, p=0.394) and presence of HCV. Antibodies to the six virulent antigens of H. pyloriwere higher in splenectomized than non splenectomized patients. Antibodies to cagA and vacA were significantly higher in splenectomized than non splenectomized patients (p=0.015 and 0.044 for cagA and vacA respectively). 1.4.Conclusion:There was higher H. pylori seroprevalence in asymptomatic b-TM cases than among controls, being more frequently in splenectomized than non splenectomized patients. No difference in serum ferritin level between H. pylori seropositive and seronegative cases.