Ferrous Sulfate Group Research Articles

Haematological effect of a bi-herbal composition on phenyl hydrazine-induced anaemia in Albino Wistar rats

Picralima nitida and Cymbopogon citratus are plants known for their anti-inflammatory, antioxidant, and haematopoietic properties. This study aimed to determine the haematological effect of a dual herb composition of these plants on phenylhydrazine-induced anaemia in albino Wistar rats. Sixty adult male rats were divided into six groups: control, phenylhydrazine group, ferrous sulphate group, and three groups receiving phenylhydrazine plus 100 mg/kg, 200 mg/kg, and 400 mg/kg of the extract. Haematological parameters were measured using an autoanalyzer and analyzed with SPSS software V22. The red blood cell count was significantly higher in the control group compared to other groups (p<0.05). Haemoglobin was significantly higher in the control, ferrous sulphate, 100 mg/kg, and 400 mg/kg groups compared to the phenylhydrazine and 200 mg/kg groups (p<0.05). Mean cell volume was significantly lower in the control group compared to all other groups (p<0.05). Mean cell haemoglobin was significantly lower in the control group compared to other groups while MCHC was higher in the control group compared to phenylhydrazine, ferrous sulphate, 100mg/kg and 200mg/kg groups (p<0.05). RDWSD was significantly lower in the control group compared to all other groups (p<0.05). Total white blood cell count was significantly lower in the control and phenylhydrazine groups compared to others (p<0.05). Lymphocyte was significantly higher in the ferrous sulphate group compared to others, while monocyte count was significantly lower in the control, phenylhydrazine, and ferrous sulphate groups (p<0.05). Neutrophil was significantly higher in the control and phenylhydrazine groups (p<0.05). Platelet was significantly lower in the control group compared to ferrous sulphate, 200 mg/kg, and 400 mg/kg groups (p<0.05). Mean platelet volume was significantly lower in the control, phenylhydrazine, ferrous sulphate, and 100 mg/kg groups compared to the 400 mg/kg group (p<0.05). The study concludes that the biherbal formulation of the plants caused significant alterations in haematological parameters.

Intravenous versus oral iron for anaemia among pregnant women in Nigeria (IVON): an open-label, randomised controlled trial

Oral iron for anaemia in pregnancy is often not well tolerated, with poor adherence. Iron administered intravenously might address these tolerance and adherence issues. We investigated the effectiveness and safety of intravenous ferric carboxymaltose versus oral ferrous sulphate on anaemia and iron deficiency among pregnant women in Nigeria. We did a multicentre, open-label, parallel, randomised controlled trial of pregnant women (aged 15-49 years) with haemoglobin (Hb) concentrations of less than 10 g/dL at 20-32 weeks' gestation from 11 primary, secondary, or tertiary health facilities in Nigeria (five in Lagos and six in Kano). Exclusion criteria included vaginal bleeding, blood transfusion or major surgery within the past 3 months, symptomatic anaemia, anaemia known to be unrelated to iron deficiency, clinically confirmed malabsorption syndrome, previous hypersensitivity to any form of iron, pre-existing maternal depression or other major psychiatric illness, immune-related diseases, such as systemic lupus erythematosus or rheumatoid arthritis, or severe allergic reactions. Participants were randomly assigned (1:1) by nurses and doctors using a web-based randomisation service to either receive a single dose of intravenous ferric carboxymaltose (20 mg/kg to a maximum of 1000 mg) or oral ferrous sulphate (200 mg; 65 mg elemental iron) three times daily until 6 weeks postpartum. The study was primarily unmasked. Primary outcomes were maternal anaemia (Hb <11 g/dL) at 36 weeks' gestation and preterm birth at before 37 weeks' gestation, with analysis by intention to treat in participants with available data. This study was registered at the ISRCTN registry on Dec 10, 2020 (ISRCTN63484804) and on ClinicalTrials.gov (NCT04976179) on April 7, 2021. Between Aug 10, 2021, and Dec 15, 2022, 13 724 pregnant women were screened for eligibility. 12 668 were excluded due to ineligibility for inclusion, and 1056 provided consent to participate and were randomly assigned to either the intravenous or oral administration groups. 527 were assigned to the intravenous ferric carboxymaltose group and 529 were assigned to the oral ferrous sulphate group. 518 in the intravenous group were assessed at 36 weeks' gestational age and after 518 deliveries, and 511 completed the 6 weeks postpartum visit. 513 in the oral ferrous sulphate group were assessed at 36 weeks' gestational age and after 512 deliveries, and 501 completed the 6 weeks postpartum visit. No significant difference was found in anaemia at 36 weeks (299 [58%] of 517 in the intravenous group vs 305 [61%] of 503 in the oral group; risk ratio 0·95, 95% CI 0·85-1·06; p=0·36), nor in preterm birth (73 [14%] of 518 vs 77 [15%] of 513; 0·94, 0·70-1·26; p=0·66). There were no significant differences in adverse events. The most common adverse events were diarrhoea (in six participants) and vomiting (in three participants) in the oral group and fatigue (in two participants) and headache (in two participants) in the intravenous group. Although the effect on overall anaemia did not differ, intravenous iron reduced the prevalence of iron deficiency to a greater extent than oral iron and was considered to be safe. We recommend that intravenous iron be considered for anaemic pregnant women in Nigeria and similar settings. Bill & Melinda Gates Foundation.

Comparative evaluation of anti-anemic effect of Sucrosomial iron in experimental model of iron deficiency anemia in Wistar rats

Abstract Anemia is a grave public health issue that affects 25% of the global population. Conventional iron formulations used in treatment have drawbacks such as poor bioavailability and gastric intolerability. The current study aimed to evaluate the anti-anemic effects of different iron salts in Wistar rats with iron deficiency anemia (IDA). IDA was induced by the validated pre-clinical model by retro-orbital bloodletting (1 ml) for 21 days along with an iron-deficient diet in Wistar rats. The rats (n=48) were assigned into 8 groups: Control group, IDA rats, IDA rats receiving either vehicle or different iron salts (ferrous sulfate, ferrous ascorbate, ferrous fumarate, and Sucrosomial iron) for 21 days at a dose of 30 mg/kg p.o. Hematological parameters and iron store indices were assessed at each visit. Anemia induction markedly reduced hemoglobin levels in all IDA groups on day 21. In contrast, iron supplements showed significant improvement in hematological profile after 21 days of treatment. Interestingly, the Sucrosomial iron-supplemented group (group 8) showed significantly higher improvement in hemoglobin levels and hematocrit than did conventional iron supplements such as ferrous sulfate (group 5), ferrous ascorbate (group 6) and ferrous fumarate (group 7) (p &lt;0.05 for each group, respectively). Sucrosomial iron also showed slightly better improvement in iron store indices (serum iron &amp; ferritin levels, total iron binding capacity and transferrin saturation [%]) when compared with other iron supplements (non-significant difference). Authors concluded that Sucrosomial iron has a significant potential to improve IDA in Wistar rats compared to conventional iron salts. Sucrosomial iron can be useful for the management of IDA either prophylactically or therapeutically.

Maternal Fatigue after Postpartum Anemia Treatment with Intravenous Ferric Carboxymaltose vs. Intravenous Ferric Derisomaltose vs. Oral Ferrous Sulphate: A Randomized Controlled Trial

(1) Background: Postpartum anemia is a common maternal complication and is recognized as a cause of impaired quality of life, reduced cognitive abilities, and fatigue. Efficient iron supplementation for the treatment of postpartum anemia is an essential component of high-quality maternal care. The optimal mode of iron supplementation has not been determined yet, whether oral or intravenous. The objective of this study was to compare postpartum anemia treatment with intravenous ferric carboxymaltose, intravenous ferric derisomaltose, and oral ferrous sulfate. (2) Methods: A single-center, open-label, randomized controlled trial. Women with hemoglobin &lt; 100 g/L within 48 h postpartum were randomly allocated to receive intravenous ferric carboxymaltose, intravenous ferric derisomaltose, or oral ferrous sulfate. Intravenous iron was given in one or two doses, while ferrous sulfate was given as two 80 mg tablets once daily. The primary outcome was maternal fatigue measured by the Multidimensional Fatigue Inventory (MFI) six weeks postpartum. Hemoglobin, ferritin, and transferrin saturation levels were analyzed as secondary outcomes. A Kruskal–Wallis test was used for group comparison (p &lt; 0.05 significant). (3) Results: Three hundred women were included. The MFI score at six weeks postpartum did not differ between groups (median 38 (inter-quartile range (IQR) 29–47) in the ferric carboxymaltose group, median 34 (IQR 26–42) in the ferric derisomaltose group, and median 36 (IQR 25–47) in the ferrous sulfate group; p = 0.26). Participants receiving oral iron had lower levels of hemoglobin (135 (131–139) vs. 134 (129–139) vs. 131 (125–137) g/L; p = 0.008), ferritin (273 (198–377) vs. 187 (155–246) vs. 24 (17–37) µg/L; p &lt; 0.001) and transferrin saturation (34 (28–38) vs. 30 (23–37) vs. 24 (17–37) %; p &lt; 0.001) than those receiving ferric carboxymaltose or ferric derisomaltose. (4) Conclusions: Intravenous ferric carboxymaltose, intravenous ferric derisomaltose, and oral ferrous sulfate had similar impacts on maternal fatigue at six weeks postpartum despite improved laboratory parameters in the intravenous groups.

Efficacy of Ferrous Bis-Glycinate versus Ferrous Sulphate in Children with Iron Deficiency Anemia

Iron deficiency anemia is a common pediatric disease and oral iron supplementation is the usual treatment. Newer formulations has been developed to treat iron deficiency anemia in children. Objective: To compare the efficacy of ferrous Bis-Glycinate in children with iron deficiency anemia to the conventional therapy with ferrous sulphate. Methods: In this open labelled prospective clinical trial was performed in children with iron deficiency anemia. Two groups were made, one group was given ferrous sulphate and the other group ferrous bis-glycinate at a dose of 5 mg/kg/day, single daily dose. Patient were followed 04 weekly till 12 weeks and then baselines reviewed. Results: Out of these total 108 children, 64 (59.3%) were male while the remaining 40.7% were female, with mean age was 27.48 in months with SD of 14.1. Iron therapy succefully raised Hb by 3.49 gm/dl as a whole with in Iron Bis –glycinate group as 3.85d/dl while 3.13gm /dl in ferrous sulphate group. The frequency of gastrointestinal adverse symptoms were less in bis-glycinate group. Conclusions: It was concluded that ferrous bis-glyicante has better efficacy to ferrous sulphate in term of Hb rising and has less gastrointestinal side effects.

Different iron sources affected haemoglobin and myoglobin synthesis, and gene expression related to iron metabolism in skeletal muscle in piglets

ABSTRACT This study was carried out to investigate the effect of different iron sources on haemoglobin and myoglobin (Mb) synthesis, and the mRNA expression of the key genes related to iron metabolism in the skeletal muscle of piglets. Forty-eight piglets were assigned into four treatments including control group, ferrous sulphate (FeSO4) group, ferrous glycinate (Fe-Gly) group and amino acid-Fe(II)-chelator complexes group. The results showed that iron supplementation increased Mb concentration in muscles (P < 0.05). In addition, iron supplementation increased hephaestin (HEPH) expression in the longissimus dorsi muscle (P < 0.1), decreased transferrin receptor 1 (TFR1) expression in the longissimus dorsi muscle (P < 0.05) and increased lipocalin 2 (Lcn2) expression in gastrocnemius muscle, respectively (P < 0.05). In summary, compared with high-dose inorganic iron, low-dose organic iron supplements have the same effects in haemoglobin and myoglobin biosynthesis, and mobilize iron in muscles into circulation.

COMPARISON OF FERROUS SULPHATE WITH COLLOIDAL IRON IN THE TREATMENT OF IRON DEFICIENCY ANEMIA IN CHILDREN

Background: Anemia is a major health problem throughout the world andchildren under 5 years of age are at highest risk. Nutritional deficiency isthe mostcommoncauseofanemiainchildrenunder2yearsofageduetohighrateofgrowthandincreaseddemandofiron,vitaminB12andfolicacid.According to WHO, 1 out of every 2 pre-school children are suffering from IDA indevelopingcountries. Different oral iron preparations are available totreatIDA.Hence, this study was done to compare the therapeutic efficacy andside effects offerroussulphatewithcolloidalironinthetreatmentofIDAinchildren. OBJECTIVES: 1. TocomparethetherapeuticefficacyofferroussulphatewithcolloidalironinthetreatmentofIDAinchildrenaged6monthsto18years. 2. Tocomparethesideeffectsbetweenthetwogroups. Methods: This randomizedcontrol study was conducted in MVJ medicalcollegeandresearchhospital,Hoskote,Bangalore.Eligiblechildrenwererandomized to 2 groups. Group A consisting of 75 children were given ferroussulphateinadoseof3mg/kg/dayofelementalirononcedailyfor4weeks.GroupBconsistingof75childrenweregivencolloidalironinadoseof3mg/kg/dayof elemental iron once daily for 4 weeks. Reticulocyte countbetween the twogroupswas checked at the end of one week and haemoglobinat the end of onemonth. Side effects and compliance of the two ironformulations were checked onfollowup. Results: The mean rise in the reticulocyte count at the end of 1 week is higherincolloidalironincomparisontoferroussulphategroup.Themeanriseinhaemoglobin at the end of one month is more in colloidal iron compared to ferroussulphate group, however the difference is not statistically significant. Compliancewith colloidal iron is better than ferrous sulphate group, as nausea is comparativelymorewithferroussulphategroupwhichattributedtodecreasedcompliancewhichisstatisticallysignificant. Conclusion: Colloidal iron and ferrous sulphate are found to be equallyefficacious in thetreatment of iron deficiency anemia. However, owing to its goodcompliance and lesser GI side effects, colloidal iron is found to bepreferable overferroussulphate. Hence, the study suggests the use of colloidal iron to treat IDA in children between 6 months to 18 years.

Synthesis of Ferrous Fumarate from Indonesian Iron Sand and In Vivo Body Weight Gain Test in Rats

Iron deficiency anemia (IDA) is a health problem in Indonesia. Prevention and treatment of IDA is carried out by giving fortified foods and oral iron therapy. Both can use ferrous fumarate which is made with reacting bivalent iron and disodium fumarate. Bivalent iron can be obtained from iron sand in Indonesia. This study aims to synthesize ferrous fumarate from Indonesian iron sand, which is from Malang, Sukabumi, and Cianjur area, and to determine its absorption through in vivo body weight gain test in male Wistar white rats (Rattus norvegicus). First, ferrous fumarate was synthesized through reaction of ferrous sulfate, which was made from Indonesian iron sand with the highest iron content, which was from Sukabumi area, and disodium fumarate. Second, in vivo body weight gain test was conducted to 3 rat groups (negative control, ferrous sulfate group, and ferrous fumarate group, respectively) and monitored for two weeks. The results showed that ferrous fumarate was successfully obtained as brownish red-orange fine powder with yield of 62.17 ± 1.66 %. In addition, the in vivo body weight test suggested that the rats from ferrous fumarate group showed similar weight gain (35.1%) compared to those from the ferrous sulfate group (30.6%), indicating a possibility of iron absorption from ferrous fumarate.

Effects of Iron Salts on Demineralization and Discoloration of Primary Incisor Enamel Subjected to Artificial Cariogenic Challenge versus Saline Immersion

This study aimed to assess the effects of iron salts on the demineralization and discoloration of primary incisor enamel subjected to artificial cariogenic challenge (ACC) versus saline immersion. In this in vitro experimental study, 90 primary incisors were evaluated in 10 groups (n = 9). Five groups were subjected to ACC, and the other five were immersed in saline. Ferrous sulfate, ferrous fumarate, ferrous ammonium citrate, and ferrous gluconate were added to both saline and cariogenic solutions. The solutions were refreshed every 48 h. After 14 days, the teeth were removed from the media and their demineralization was inspected via scanning electron microscopy (SEM). Energy-dispersive X-ray spectroscopy (EDX) was also performed. The color of the specimens was measured at baseline and after the intervention using the Vita Shade Guide. Data were analyzed by the Kruskal-Wallis test, one-way ANOVA, and Tukey's test. The color change of specimens subjected to ACC was greater than the color change of those in saline (p = 0.083). The teeth subjected to ACC showed greater iron uptake than did those in saline (p = 0.023). SEM assessment revealed a regular pattern of enamel prisms, with some broken prisms and superficial cracks in the teeth immersed in saline. The teeth subjected to ACC showed numerous fractures and cracks, which were greater in the ferrous sulfate group. Immersion in ACC increased the structural porosities and led to greater iron uptake and, consequently, higher discoloration. The maximum structural changes and subsequent staining were noted in the ferrous sulfate group, followed by ferrous ammonium citrate, ferrous fumarate, and ferrous gluconate.

Effects of food-derived oligopeptide iron chelates on liver injury and gut microbiota homeostasis in iron-deficiency anemia female rats: a pilot study.

Iron deficiency (ID) is the biggest cause of anemia. This pilot study aimed to investigate the effects of food-derived oligopeptide iron chelates on ameliorating liver injury and restoring gut microbiota homeostasis in iron-deficiency anemia (IDA) female rats. Female Sprague-Dawley rats at 21 days old were selected and randomly divided into a control group (N = 4) and an ID model group (N = 16). The ID model group was fed an iron-deficient diet containing 4 mg kg-1 iron for 28 days to generate the IDA rat model and then randomly subdivided into four groups (N = 4 for each group): ID group, ferrous sulfate group, marine fish oligopeptide iron chelate (MCOP-Fe) group, and whey protein oligopeptide iron chelate (WPP-Fe) group. Iron supplements were given to rats in the three intervention groups once per day via intragastric administration for three weeks. After iron supplementation, the hemoglobin levels in the three intervention groups were significantly improved, with the MCOP-Fe and WPP-Fe groups returning to normal. The ALT and AST levels in the ID group increased significantly, while levels in all intervention groups decreased to normal levels. Liver glutathione in the WPP-Fe group was increased, while the activity of superoxide dismutase also tended to be higher. In addition, 16S rRNA gene sequencing showed that IDA resulted in changes to intestinal microbiota. After intervention, the WPP-Fe group showed increased alpha diversity of intestinal microbes. Therefore, MCOP-Fe and WPP-Fe may improve the iron status of IDA female rats as well as ameliorate liver damage, with WPP-Fe showing a greater potential in improving gut microbiota imbalance.

Comparative study on efficacy, tolerability, and cost of different iron supplements among antenatal women with iron-deficiency anemia

Background: Anemia is one of the most common medical complications encountered during pregnancy. India is among the countries with maximum prevalence of anemia in the world. The commonly used treatment for iron-deficiency anemia is oral iron preparations such as ferrous sulfate, ferrous gluconate, ferrous ascorbate, ferrous fumarate, and parenteral iron sucrose. Aims and Objectives: The aims of this study were to assess the mean change in the hemoglobin levels from baseline up to 60th day of treatment with different iron supplements and to assess its cost effectiveness ratio. Materials and Methods: This was a prospective interventional clinical end point study conducted at Sri Venkateshwaraa Medical College Hospital and Research Center, Puducherry, India, from December 2019 to December 2020, among 84 antenatal women (&gt;14 weeks) with iron-deficiency anemia. After getting ethics committee approval, the participants who fulfilled the inclusion and exclusion criteria were randomized to respective treatment groups. Group 1 (n = 21) received ferrous sulfate 200 mg, Group 2 (n = 21) received ferrous ascorbate 200 mg, Group 3 (n = 21) received ferrous fumarate 200 mg twice daily for a period of 60 days, and Group 4 (n = 21) received Iron sucrose 200 mg, based on iron requirement in divided doses and administered once in 2 weeks for a period of 60 days. Hemoglobin (Hb), RBC count, mean corpuscular volume, mea n corpuscular Hb (MCH), MCHC, WBC, platelet count, and cost of the treatment were assessed before and at the end of 60 days. Data were analyzed using GraphPad Prism software version 7.0 using Student “t”-test and one-way ANOVA. Results: We observed a significant (P &lt; 0.001) rise in the mean Hb level from 10.4 ± 0.4, 10.4 ± 0.5, 10.4 ± 0.5 and 8.5 ± 0.3 to 11.2 ± 0.6 (P = 0.0001), 11.1 ± 0.6 (P = 0.0001), 11.3 ± 0.8(P = 0.0001), and 10.9 ± 0.6 (P = 0.0001) in Group 1, 2, 3, and 4, respectively. The average cost effectiveness ratio, with respect to Groups 1, 2, 3, and 4 was Rs. 675, Rs. 1782.9, Rs. 1110.7, and Rs. 786.7 per increase in Hb%, respectively. Conclusion: The outcome of this study proved the effective role of various oral ferrous iron preparations and all of them were found to be equally efficacious in improving the Hb concentration. However, the injectable iron sucrose showed a significant improvement in mean hemoglobin percentage compared to the various oral preparations. However, on analyzing the cost-effectiveness ratio, it was found out that the cost incurred per increase in Hb% was less in ferrous sulfate group, followed by iron sucrose, ferrous fumarate, and ferrous ascorbate. The results of this study can be helpful in pharmacoeconomical decision making while selecting a cost effective iron supplement for treating iron-deficiency anemia.

Lactoferrin: A Promising New Player in Treatment of Iron Deficiency Anemia in Patients on Regular Hemodialysis: A Randomized Controlled Trial.

Hepcidin is secreted in inflammatory states as in patients on regular hemodialysis (HD). Therefore, novel agents modulating hepcidin secretion may have the potential to effectively reverse anemia in HD patients. Bovine milk derivative lactoferrin (BLF) is a glycoprotein that was found to decrease serum interleukin-6, therefore, having anti-inflammatory properties. Thus, it can downregulate hepcidin secretion in various inflammatory states including patients on regular HD, so improving iron absorption and utilization in those patients. In addition, BLF is a source of iron as each BLF molecule chelates two ferric ions. We started an interventional study. Seventy patients on regular HD with iron deficiency anemia received 100 mg of 20%-30% iron-saturated BLF (corresponding to 70-84 μg of elemental iron) orally b.i.d for 6 months. We compared those patients with another 70 patients on regular HD with iron deficiency anemia who were given 576 mg of ferrous glycine sulfate (corresponding to 100 mg of elemental iron) orally b.i.d for 6 months. BLF significantly decreased serum hepcidin level (from 340-350 ng/mL to 101-112 ng/mL), P <0.0001 and significantly increased hemoglobin (Hb) concentration (from 7.5-8.1 g/dL to 9.3-10 g/dL), P <0.0001, and transferrin saturation (TSAT) (from 5%-9% to 26%-31%), P <0.0001. Furthermore, ferrous glycine sulfate significantly decreased serum hepcidin level (from 335-350 ng/mL to 330--341 ng/mL), P <0.0001, and significantly increased Hb (from 7.5-8.1 to 7.6-8.5 g/dL), P <0.0001, and TSAT (from 5%-9% to 7%-12%), P <0.0001. However, the magnitude of decrease in serum hepcidin level and rise in Hb and TSAT in the BLF group was significantly higher than in the ferrous glycine sulfate group, P <0.0001. Oral BLF can be considered a promising novel agent in treatment of iron deficiency anemia in patients on regular HD.

Ferric Carboxymaltose Versus Ferrous Glycine Sulfate For Treatment of Iron Deficiency Anemia and Their Effect On Vitamin B12 And Folic Acid: A Retrospective Study

Aim Anemia is a major public health problem, affecting about one-third of the world's population, and is most commonly caused by iron deficiency. Iron deficiency anemia requires oral or intravenous iron replacement therapy. The purpose of this study was to assess the change in several hematological parameters, vitamin B12, and folic acid from baseline to the first month of follow-up following therapy with oral ferrous glycine sulfate or intravenous ferric carboxymaltose. Methods: All patients who received oral ferrous glycine sulfate or intravenous ferric carboxymaltose for the treatment of iron deficiency anemia between January 1, 2016, and December 31, 2018, were included in the trial. Along with age and gender information, values of hemoglobin, ferritin, transferrin saturation, mean corpuscular volume, vitamin B12, and folic acid were derived from patients’ records at the beginning of treatment and first month follow-up. Results: Laboratory values obtained after treatment showed statistically significant improvement in both groups (intra group, p&amp;lt;0.001). When the percentage of change between groups was compared: Percentage-based increases in hemoglobin, mean corpuscular volume, transferrin saturation and ferritin values were significantly higher in the ferric carboxymaltose group (p&amp;lt;0.001). The percentage decrease in vitamin B12 and folic acid values was higher in the ferric carboxymaltose group (p=0.005 and p=0.01, respectively) when compared with oral ferrous glycine sulfate group. Conclusions: According to the findings of our study, iron deficiency anemia can be treated very successfully using ferric carboxymaltose; however, it should be remembered that concurrent supplementation of elements such vitamin B12 and folic acid is necessary for the appropriate progression of erythropoiesis.

Comparison of Efficacy of Ferrous Sulfate and Carbonyl Iron on the Blood Film of Iron Deficiency Anemia in Pregnant Women

Background: Iron deficiency anemia is the most common and important public health problem all over the world in the risk group of antenatal women. Research is going on to improve the iron status of the pregnant women with different forms of iron available. In this regard Carbonyl Iron is showing promising result in improving the red cell mass with better compliance. Objective: The purpose of present study was to compare the efficacy of Ferrous Sulfate and Carbonyl Iron in the blood film of iron deficiency anemia in pregnant women. Methodology: An observational prospective study in obstetric and gynae out – patient department of Sir Salimullah Medical College and Mitford Hospital. Women between 16 – 28 weeks of pregnancy with haemoglobin level 7 – 10 gm/dl and with microcytic hypochromic blood film were included in this study. Pregnant women in 1st and 3rd trimester of pregnancy were excluded from the study. Among the study population one group was given tablet Ferrous Sulfate and another group was given capsule Carbonyl Iron. Results: At the end of study (after 12 weeks) MCV, MCH, MCHC level were more increased incase of Carbonyl Iron group than Ferrous Sulfate group which is statistically significant. Conclusion: Carbonyl Iron is more effective than Ferrous Sulfate in the treatment of iron deficiency anemia in pregnancy. J Shaheed Suhrawardy Med Coll 2021; 13(1): 46-49

Iron Supplementation in Anemic Pregnant Women: A Comparison of Different Prescription Options in Pakistan

Background &amp; objectives: Many pregnant women in Pakistan have iron deficiency anemia (IDA), a dietary deficit. It affects both the mother's and the foetal' health. Oral iron supplementation usually relieves IDA symptoms. Oral iron supplements are hazardous to the GI mucosa, and sensitivity is common. Poor therapeutic compliance leads to treatment failure. Ferrous ascorbate (FeA) and iron hydroxide polymaltose complex (IPC) reportedly improve gastrointestinal discomfort and increase patient compliance compared to ferrous sulphate (FS). These preparations reportedly improve hemoglobin levels and iron stores more quickly than FS. This analysis compared FS's efficacy and safety to IPC and FeA. Place of Study: Rashid Latif Medical College Lahore Duration of Study: February 2019 and October 2021 Methods: It was a randomized, parallel, open label, investigation among pregnant women of gestational age from 10 to 28 weeks with moderate anemia. Patients were randomly selected to receive either FS, IPC or FeA. They were then followed up for 3 months to look for improvement in the hemoglobin levels and other hematological indicators or any adverse drug response. Results: With the exception of 3 months, when the FeA group had a significantly higher hemoglobin level in comparison to the FS group (P &lt;0.05), the hemoglobin levels were comparable across the three groups. The overall risk profiles for side effects were likewise equal across the research groups, with the exception of epigastric discomfort, which was more frequently reported in the FS group. Conclusions: The findings of the study indicated that FS, IPC, and FeA all have an efficacy and safety profile in the treatment of IDA associated with pregnancy that is comparable to one another. Keywords Anemia, ferrous ascorbate , ferrous sulphate ,iron hydroxide polymaltose ,pregnancy

Lactoferrin for iron-deficiency anemia in children with inflammatory bowel disease: a clinical trial

BackgroundIron-deficiency anemia (IDA) is common in children with inflammatory bowel disease (IBD); however, oral iron supplements are commonly associated with poor compliance due to gastrointestinal side effects. We compared the effect of lactoferrin versus oral ferrous sulfate for the treatment of IDA in children with IBD.MethodsNinety-two IBD children with IDA were included but only 80 children completed the study and they were randomized into two groups: ferrous sulfate group (n = 40) who received ferrous sulfate 6 mg/kg/day for 3 months and lactoferrin group (n = 40) who received lactoferrin 100 mg/day for 3 months. Complete blood count, serum iron, total iron-binding capacity (TIBC), transferrin saturation (TS), serum ferritin, interleukin-6 (IL-6), and hepcidin 25 were measured before and after the treatment.ResultsHemoglobin (Hb), mean corpuscular volume, serum iron, TS, and serum ferritin significantly increased, while TIBC decreased significantly after the administration of either ferrous sulfate or lactoferrin compared to their baseline data. In addition, lactoferrin significantly increased Hb, serum iron, TS, and serum ferritin compared to ferrous sulfate. Moreover, lactoferrin significantly decreased IL-6 and hepcidin levels.ConclusionLactoferrin is a promising effective treatment with fewer side effects than oral elemental iron in children with IBD and IDA.Clinical trial registrationThe study was registered at www.pactr.org (PACTR202002763901803).ImpactIron-deficiency anemia (IDA) in children with inflammatory bowel disease (IBD) is treated with oral iron therapy; however, oral iron supplements are commonly associated with poor compliance due to gastrointestinal side effects.To the best of our knowledge, our study was the first in pediatrics that compared the effect of lactoferrin versus oral ferrous sulfate as an iron supplement for the treatment of IDA in children with IBD.We found that lactoferrin is a promising effective treatment with fewer side effects than oral elemental iron in children with IBD and IDA.

Rationale and design of the open-label, prospective, randomized study of the efficacy of intravenous versus oral iron deficiency therapy in improving left ventricular systolic function in patients with myocardial infarction (OPERA-MI)

Aim. Iron has a protective effect on cardiomyocytes during hypoxia, while iron deficiency (ID) directly affects its function, disrupting mitochondrial respiration, reducing their contractility and relaxation. Some studies have shown that ID is a predictor of adverse outcomes in patients with acute coronary syndrome (ACS). However, the impact of ID and its treatment, quality of life and prognosis of patients with ID and myocardial infarction (MI) has not been fully established. The study aim is to determine the effectiveness of intravenous ferric carboxymaltose (FCM) compared with oral iron (ferrous sulfate) in relation to left ventricular (LV) systolic function, assessed by echocardiography.Material and methods. This open-label, prospective, randomized study includes 360 patients with or without ID who were hospitalized with acute myocardial infarction (MI). Patients with ID will be randomized (1:1) to intravenous FCM and oral ferrous sulfate therapy. Treatment in groups will be started at the time of hospitalization. Patients without ID will form the control group. The follow-up period for patients will be 1 year. The primary endpoint was a reduction in LV wall motion score index (WMSI) in the FCM group compared to the ferrous sulfate group. The key secondary endpoint is a composite endpoint of cardiovascular death, non-fatal MI and stroke, and hospitalization for decompensated heart failure.Conclusion. The OPERA-MI study will determine the effect of ID treatment with intravenous FCM compared with oral ferrous sulfate on WMSI, which reflects LV systolic function.

Comparative study of efficacy of oral iron versus parenteral iron in the treatment of iron deficiency anaemia

Background: Iron deficiency anaemia (IDA) is one of the most widespread nutritional deficiency and common medical conditions seen in everyday clinical practice. IDA has a substantial haematological complication with potentially serious clinical consequences that often may require iron therapy. In most patients, body stores of iron can be restored by oral iron therapy but parenteral iron therapy results rapid correction of haemoglobin levels, faster and higher replenishment of iron stores with better compliance. The study was to compare the efficacy of oral iron (ferrous sulphate) with parenteral iron (iron sucrose) to treat iron deficiency anaemia. Methods: 221 patients were included in the study. 101 patients were given oral iron in the form of ferrous sulphate containing 67 mg of elemental iron three times daily. 120 patients were treated with iron sucrose. After a 25 mg test dose on the first infusion only, this was given at a dose of 300 mg by intravenous infusion diluted in 250 ml of normal saline, every alternate day. Haemoglobin level and serum ferritin of both groups were done before iron therapy, 3 weeks and 12 weeks after iron therapy. Results: The mean±SD rise of haemoglobin concentration 3 weeks after iron therapy in iron sucrose group was 11.2±0.60 g/dL, while in ferrous sulphate group was 9.0±0.58 g/dL. The mean±SD ferritin 3 weeks after iron therapy in iron sucrose group was 81.0±15.18 ng/mL, while in ferrous sulphate group was 27.0±12.22 ng/mL. The mean±SD haemoglobin concentration 12 weeks after iron therapy in iron sucrose group was 12.2±0.60 g/dL, while in ferrous sulphate group was 11.0±0.58 g/dL. The mean±SD ferritin 12 weeks after iron therapy in iron sucrose group was 82.0±16.17 ng/mL, while in ferrous sulphate group was 52.0±12.22 ng/mL. No serious adverse events were reported in either the ferrous sulphate group or iron sucrose group. Conclusion: Iron sucrose causes higher rise in haemoglobin level and serum ferritin as compared to oral iron therapy.

Comparison of the effect of ferrous sulfate and ferrous gluconate on prophylaxis of iron deficiency in toddlers 6-24 months old: A randomized clinical trial

Iron deficiency anemia (IDA) is one of the most common anemias, especially in children 4-23 months. Therefore, prophylaxis is necessary to improve iron status as well as reduce IDA in Toddlers. The aim of this study was to compare the efficacy of daily supplementation with ferrous gluconate (FG) and ferrous sulfate (FS) on iron status in toddlers. A total of 120 healthy toddlers were divided randomly into 2 groups at the Amir-Kabir Hospital, Arak, Iran and received FS and FG from March 2020 to December 2020. Iron status was evaluated at baseline and after 6 months of supplementation. The statistical significance of the differences in iron status between FS and FG groups was calculated using Student's t-test and the Pearson' s Chi-square test for qualitative variables. SPSS software (version 16, Chicago, IL, USA) was used for statistical analysis. Comparison of iron status of FS and FG groups toddlers at baseline and after 6 months of supplementation showed that there was a significant difference in hemoglobin (Hb) (10.46 vs. 12.45, P = 0.001) and ferritin level (28.08 vs. 59.63, P = 0.001). Although prophylaxis with FG led to a higher Hb and ferritin levels, our study recommended that both FG and FS supplements were effective for prophylactic use in the prevention of IDA. However, FG was more effective than FS because FG group that received FG supplementation indicated a higher Hb and ferritin levels in comparison to the FS group that received FS supplementation.

Effects of Iron Supplementation on Attention Deficit Hyperactivity Disorder in Children Treated with Methylphenidate.

ObjectiveTo evaluate the effect of iron on the attention deficit hyperactivity disorder, treated with methylphenidate.MethodsThis double-blind, randomized placebo-controlled clinical trial was performed on 50 children with attention deficit hyperactivity disorder under the treatment of methylphenidate, with ferritin levels below 30 ng/ml and absence of anemia. They were randomly assigned into two groups of ferrous sulfate and placebo, for 12 weeks. Conners' Parent Rating Scale (CPRS) was used to assess the outcome in the first, sixth, and twelfth weeks.ResultsAlmost all CPRS subscales improved in the ferrous sulfate group from the baseline to the endpoint, although only the changes in conduct subscale scores were significant (p = 0.003). There was no significant difference in score changes between two groups in intergroup comparison. Also, the score of learning problems (p = 0.007) in the first six weeks, and conduct (p = 0.023) and psychosomatic (p = 0.018) subscales in the second six weeks were improved in the ferrous sulfate group compared with the placebo group.ConclusionOur study showed promising effects of iron supplementation in the improvement of subscales of the CPRS.