Frequency Of Anemia In Patients Research Articles

Prevalence of Anemia in Community-Acquired Pneumonia Patients

The frequency of anemia in intensive care units is well documented. Less is known, however, about the prevalence of anaemia in hospitalised patients with community-acquired pneumonia, which is one of the common reasons for hospitalisation, affecting both healthy and co-morbid individuals and is usually not accompanied with acute blood loss. Objective: To determine the frequency of anemia in patients presenting with pneumonia. Methods: This descriptive cross-sectional study was conducted with pneumonia patients at Department of Medicine Pulmonology in HDU/ICU Jinnah Hospital, Lahore curing thr period of three months. The 345 subjects with mean age 44.4 ± 9.4 (range: 20 – 60) years, male to female ratio 1:1.12, diagnosed with pneumonia underwent assessment of hemoglobin levels at presentation. Relationship between anemia and other co-morbidities has been evaluated that included duration of pneumonia, obesity, diabetes mellitus and hypertension to diagnose anemia. Results: The mean duration of pneumonia symptoms was 8.7 ± 6.9 (range: 2-25) days whereas the mean hemoglobin concentration was found 12.3 ± 6.9 g/dL ranged from 7.1 – 14.6 g/dL. The prevalence of anemia was found to be 37.7% and 215 (62.3%) of the 345 patients have shown normal hemoglobin levels. Female gender, higher age, greater duration of pneumonia symptoms and presence of diabetes mellitus significantly correlated with anemia in pneumonia (p-value < 0.05). Whereas, the hypertension and obesity did not have any significant effects on anemia in pneumonia (p-value > 0.05). Conclusions: Anemia was present in significant number of patients with pneumonia and was associated with female gender, Diabetes ,Hypertension and prolonged duration of pneumonia.

Frequency of Anemia in Patients with Newly Diagnosed Pulmonary Tuberculosis Presenting at Dr Ruth KM Pfau Civil Hospital Karachi

Frequency of Anemia in Patients with Newly Diagnosed Pulmonary Tuberculosis Presenting at Dr Ruth KM Pfau Civil Hospital Karachi

Frequency of anemia in patients with Pulmonary Tuberculosis.

Background: Tuberculosis affects millions of people across the globe annually. Pakistan is ranked 5th among the leading TB countries in the world. Anemia is a common observation among TB patients with the multifactorial phenomenon. The present study aimed to determine the frequency of anemia in patients with pulmonary TB and its classification as per the severity and morphological characteristics. Methodology: This retrospective cross-sectional study was conducted at DHQ Hospital Timergara, Lower Dir. A total of 109 TB patients were enrolled and underwent physical and systemic examination. Blood samples were collected to estimate complete blood counts (CBC), liver and renal function tests (LFT; RFT), serum albumin, and C-reactive protein (CRP) levels. Abdominal ultrasound was performed when any organomegaly was suspected. Hemoglobin was estimated using an automated analyzer (SYSMEX-SP100), and it was repeated via manual method among doubted cases. Written informed consent was obtained from all patients before inclusion, and the collected data was analyzed using SPSS version 22.0. Results: There was a female majority (54%) in the studied sample, with a mean age of 38 ± 15.3 years. Majority of them belonged to low socioeconomic status (80%). Moreover, 43% of them were from Dir Lower, 30% from Dir Upper, while the remaining were from Bajaur district, Chitral, and Malakand Swat districts. Anemia was found in 82.56% of the enrolled TB patients. Most patients were moderately weak (Hb < 10 g/dl > 7 g/dl), and microcytic anemia was found in more than 80% of the anemic patients. CRP level was raised in 70% of these patients, and there was hypoalbuminemia in 80%. Furthermore, females were more anemic than males. Conclusion: In our study, anemia was prevalent in TB patients, specifically microcytic anemia. Hence, TB patients must be monitored for dietary deficiencies and/or inflammatory modulators to avoid such complications.

Evaluation of anemia in rheumatoid arthritis patients and the effect of biological therapy on anemia of chronic disease

Objective. The aim of the study was to evaluate the frequency of anemia in patients with rheumatoid arthritis (RA), observe the change of anemia with biological disease-modifying anti-rheumatic drugs (bDMARDs) treatment and examine factors associated with anemia change before and after treatment. Methods. The frequency of anemia before treatment was evaluated in 401 patients who received bDMARD therapy for 1 year. Patients' hemoglobin (HB), ferritin, transferrin saturation, mean corpuscular volume (MCV), hematocrit (HCT), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels and disease activity score (DAS)28 were recorded. The data obtained before and 1 year after the treatment of patients with anemia of chronic disease (ACD) were compared and anemia evaluations of the patients were made. Results Anemia was detected in 45.9% of 401 patients. Iron deficiency anemia (IDA) was observed in 58.2% of the 184 patients with anemia, ACD and ACD/IDA (mixed type) was observed in 31.5%. While ESR, CRP and DAS28 values decreased in the first year of bDMARD treatment, HB levels increased. When the increase in hemoglobin levels and decrease DAS28 were compared between adalimumab and sertolizumab, no significant difference was found. High basal ferritin and lower HB levels were found to be factors affecting HB change before and after treatment. Conclusions While disease activity is controlled with bDMARD treatment, an increase in HB levels is also observed. ACD improves with disease treatment. High basal ferritin and lower HB levels were the most important factors associated with HB change.

Frequency of anemia in patients with pulmonary TB presenting at Nishtar Hospital Multan

Objective: The present study aimed to determine the frequency of anemia in patients with pulmonary TB presenting at Nishtar Hospital Multan and its classification as per the severity and morphological characteristics.
 Methods: This retrospective cross-sectional study was conducted at Nishtar Hospital Multan. A total of 109 TB patients were enrolled and underwent physical and systemic examination. Blood samples were collected to estimate complete blood counts (CBC), liver and renal function tests (LFT; RFT), serum albumin, and C - reactive protein (CRP) levels. Abdominal ultrasound was performed when suspected of any organomegaly. Hemoglobin was estimated using an automated analyzer (SYSMEX-SP100) and repeated manually among doubted cases. Before inclusion, written informed consent was obtained from all patients before inclusion, and the collected data was analyzed using SPSS version 22.0.
 Results: The female majority (54%) in the studied sample, with a mean age of 38 ± 15.3 years, and most belonged to low socioeconomic status (80%). Moreover, 43% were from Multan, 30% from D.G. Khan, and the remaining were from Khanewal, Layyah, and Vehari districts. Anemia was found in 82.56% of the enrolled TB patients. Most patients were moderately weak (Hb < 10 g/dl > 7 g/dl), and microcytic anemia was found in more than 80% of the anemic patients. CRP level was raised in 70% of these patients, and there was hypoalbuminemia in 80%. Furthermore, females were more anemic than males.
 Conclusion: In our study, anemia was prevalent in TB patients, specifically microcytic anemia. Hence, TB patients must be monitored for dietary deficiencies and inflammatory modulators to avoid such complications

Frequency of Anemia in Patients with Acute Coronary Syndrome

Introduction: The WHO defines anemia as a condition wherein the hemoglobin level falls below 13 grams per liter in males and 12 grams per liter in females. It is a process that involves supplying the body with oxygen, and it is relevant for the management of acute coronary syndrome. The prevalence of this condition is highly variable globally, and it has been observed in around 10 to 58% of all cases. This study was conducted to evaluate the frequncy of this condition in patients with ACS. Methodology: The research was conducted between December 1, 2020, and May 31, 2021, at the Punjab Institute of Cardiology in Lahore. Men and women between the ages of 30 and 70 who presented with ACS were included in the study. Patients with end-stage liver disease, malignancy, or anemia due to any other cause i.e. aplastic anemia, hemolytic anemia, or anemia of chronic disease were excluded. Detailed clinical and socio-demographic information was collected in age, gender, weight, height, body mass index (BMI), smoking, diabetes mellitus, hypertension, and dyslipidemia recorded on a predesigned proforma. Then 5 ml of venous sample was drawn for each case and their hemoglobin level was assessed by using Certeza HB-101 (Germany) machine and anemia was labeled. Results: Participants' ages from 30 to 70 years old, with the mean age being 55.9. Seventy-two percent of the patients were between the ages of 51 and 70. The gender breakdown of the 76 patients was 58 men (76.32%) and 18 girls (23.68%). Twenty-two individuals (28.95%) were discovered to have anemia with their Acute Coronary Syndrome. Practical Implication: The advice that high-risk individuals with acute coronary syndrome be screened for anemia and treated promptly if they are found to have the condition. Conclusion: This study concluded that there is high frequency of anemia in patients with acute coronary syndrome. Keywords: Acute Coronary Syndrome, Anemia, Mortality, Coronary artery disease,

Frequency of anemia in patients presenting with ulcerative colitis

Introduction: Anemia appears to be the most common extra intestinal manifestation of inflammatory bowel disease and has been associated with a wide range of complications such as impaired quality of life, an increased rate of hospital admissions and even mortality. Objective: To determine the frequency of anemia in patients presenting with ulcerative colitis. Material and methods;This Cross Sectional Study was conducted in the Department of Gastroenterology, ATH, Abbottabad from 20th September 2020 to 20th March 2021. A total of 109 patients of both gender with ulcerative colitis were included in the study. Venous blood was collected from all patients in sodium EDTA tube by a 3rd year resident and was immediately sent to hospital laboratory. Hemoglobin < 11 g/dL was recorded as anemia and noted. Results: Age range in this study was from 18 to 60 years with mean age of 41.550±6.56 years, mean duration of complain was 9.862±2.57 months and mean weight was 80.091±7.60 Kg. Male patients were 63.3% and females were 36.7%. Anemia was observed in 14.7% Patients presenting with ulcerative colitis. Conclusion: In conclusion, we found a high incidence and prevalence of anaemia in patients presenting with ulcerative colitis.

Evaluation of hematological parameters in patients with leprosy in Southern Nigeria.

Leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae that mostly result in immunological reactions that affect the skin, peripheral nervous system and mucosa of the upper respiratory tract. This study aimed to evaluate hematological parameters among subjects with leprosy and deduce biomarkers for onset of leprosy reaction. This was a cross-sectional study performed from September 1, 2018 to August 1, 2019. Sixty patients with leprosy (30 on multidrug therapy (MDT) and 30 that had completed MDT) and 30 apparently healthy controls were enrolled. Hematology auto-analyzer (Sysmex KX-21N by Sysmex Corporation Kobe, Japan) was used in sample analysis. ANOVA and Kruskal Wallis were used for mean comparison. Eta squared was used to assess effect size. Sensitivity and specificity were assessed using receiver operator characteristic (ROC) curve. Association was checked using bivariate logistics regression. The majority (68.3%) of the patients with leprosy were males and a larger proportion were either farmers or unemployed. The prevalence of leprosy reaction in the studied population was 40%. The following parameters were significantly (p<0.05) reduced: red cell count, hemoglobin and hematocrit in patients with leprosy compared to controls. Total white cell count, absolute lymphocyte, neutrophil, monocyte and eosinophil counts were significantly elevated in patients with leprosy compared to controls. The hemoglobin and mean corpuscular volume of patients with leprosy on treatment were significantly higher compared to those who had completed treatment, while the mean corpuscular hemoglobin concentration was significantly reduced. Overall, 65% of patients with leprosy were anemic. Eosinophil count showed good biomarker potential for leprosy reaction onset with AUC 0.709. Sex and absolute eosinophil count were associated with leprosy reaction (OR=11.194; 95%CI: 1.775-70.586). This study has shown a high frequency of anemia in patients with leprosy, both those on treatment and those that had completed MDT, necessitating incorporation of post treatment plan in the management of leprosy. This study has reported absolute eosinophil as potential biomarker of leprosy reaction.

Evaluation of Frequency and Type of Severe Anemia in Patients Referred to the Baqiyatallah Hospital in Tehran in Six Months; A Descriptive Cross-Sectional Study

Purpose: To investigate the frequency and types of severe unknown anemia in patients referred to the Baqiyatallah Hospital (Tehran) for six months.&#x0D; Methods: In this descriptive cross-sectional study, the patients with severe unknown anemia referred to the Baqiyatallah Hospital (Tehran, Iran) were selected over six months. Following consideration of inclusion and exclusion criteria, 230 patients with severe anemia (hemoglobin (Hb) &gt; 8gr/dl) were included. Complete medical history was obtained from the patients and additional biochemical blood analyses were applied to determine the frequency and type of anemia. SPSS (v.19) software was used to analyze the findings and the significance level was defined as a p-value &lt;0.05.&#x0D; Results: In chronic disease anemia (47.5%), gastrointestinal bleeding-associated anemia (29%), bleeding malignancies anemia (21.5%), and aplastic anemia (2%). There were significant differences (p&lt;0.05) in the frequency of different types of normocytic anemia. The highest frequency was detected in folate deficiency anemia (46%), hypothyroidism anemia (34%), and B12 deficiency anemia (20%), respectively. The hemolytic anemia represented a significant difference (p&lt;0.05) in comparison with sickle cell anemia (95%). Also, sickle cell anemia showed a significant difference (p&lt;0.05) between thalacemia-associated anemia (95%) and malignancy-related anemia (95%)&#x0D; Conclusion: Respectively, the highest frequency of anemia in patients was found in chronic diseases and gastrointestinal bleeding. It is suggested that more attention should be paid to the type of anemia of patients referred to the urgency of hospitals.

The Co-Existence of Anaemia in Chronic Psychiatric Disorders: A Study at Tertiary Care Hospital

Objective: To study the frequency of anaemia in various chronic psychiatric disorders in an adult population.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and study duration: Creek General Hospital, Karachi Pakistan, from Feb to May 2021.&#x0D; Methodology: Two hundred and six patients were enrolled in the outpatient clinics after informed consent. Adult patients of 18 to 50 years who were clinically diagnosed with a psychiatric disorder by a certified psychiatrist and had no organicity were included in the study. Anaemia was defined as haemoglobin less than 13 gm/dl for males and less than 12 gm/dl in females. The severity of anaemia was classified into mild, moderate and severe according to the haemoglobin range by WHO criteria. The type of anaemia was categorized into microcytic, normocytic and macrocytic according to the value of mean corpuscle volume.&#x0D; Results: The overall frequency of anaemia in patients suffering from psychiatric disorders was 126 (61.2%) out of 206 persons. Among the anaemic, 20 (58.8%) had schizophrenia; depression was present in 35 (63.6%), generalized anxiety disorder in 39 (57.4%), somatoform disorders in 20 (62.5%) and 12 (70.6%) in bipolar subjects. Among those who were anaemic, a normocytic value was found in 28 (13.6%) adults, microcytic in 95 (46.0%) patients and macrocytic in 4 (1.9%). The severity of anaemia among anaemic was highest in the mild group. Sixty-nine males (53.6%) and 89 females (65%) were anaemic. (p=0.078). Anaemia was found highest in the 40-50 years age group.&#x0D; Conclusion: Anaemia was frequently found in adults suffering from chronic psychiatric disorders.

Evaluation of Anemia Frequency and Types in Patients with Subclinical and Clinical Hypothyroidism in the Endemic Goiter Region

ABSTRACT&#x0D; Objective: Hypothyroidism is a disease that occurs as a result of thyroid hormone deficiency or rarely, due to ineffectiveness at the tissue level. While the prevalence of clinical hypothyroidism is reported to be 2-5% worldwide, of subclinical hypothyroidism it is 4-8.5%, with the prevalence of subclinical hypothyroidism in women over 60 years of age being 14-20%. Hypothyroidism affects many organs and systems in the body, one of which is the hematopoietic system. Thyroid hormone deficiency plays a role in the development of microcytic, normocytic and macrocytic anemia. The frequency of anemia in patients with hypothyroidism varies between 20-60%. In this study, our aim was to determine the regional prevalence of subclinical and clinical hypothyroidism in adult patients in our region and to evaluate the frequency and types of anemia in patients with hypothyroidism.&#x0D; &#x0D; Method and Material: This study was prospectively conducted between 01.12.2012 and 01.05.2013 at the outpatient clinic of Recep Tayyip Erdogan University Faculty of Medicine Endocrinology. Included in the study were 96 patients who had subclinical hypothyroidism, 30 patients who had clinical hypothyroidism, and 100 healthy controls. Normal fT4 and fT3, high TSH values were used for the diagnosis of subclinical hypothyroidism, and low fT4 and/or fT3, high TSH values were used for the diagnosis of clinical hypothyroidism. The diagnosis of anemia was based on subclinical hypothyroidism, clinical hypothyroidism, and control group Hb value

Frequency of Anemia in Patients Admitted with Acute Decompensated Heart Failure in Tertiary Care Cardiac Hospital

Introduction: Anemia is one of the potential comorbid condition in patients with acute decompensated heart failure (ADHF) which is linked to higher morbidity and mortality rates. Worldwide, its prevalence ranges from 4% to &gt;70% in hospitalized patients with ADHF. Unfortunately data is lacking from our region and hence we aimed to conduct this study to scientifically fill the present gap by evaluating the actual burden of anemia in patients hospitalized with ADHF in a tertiary care hospital of Karachi, Pakistan.&#x0D; Patients and Methods: This was a hospital based study conducted in the Department of Cardiology, Tabba Heart Institute, Karachi From 1st November 2019 to 30th April 2020. A total of 203 patients with ADHF with age &gt;35 years and &lt;80 years were selected. A blood sample was taken to determine the hemoglobin levels and hemoglobin (Hb) levels &lt;12.0 g/dL in women and &lt;13.0 g/dL in men were taken as cut-off for anemia.&#x0D; Results: Overall mean and SD of age was 63.70±10.53 years and among them most of were males (n = 116, 57.1%). The overall prevalence of anemia in patients with ADHF was quite high and 63.5% (n = 129). Only three condition, hypertension, diabetes mellitus, and current smoking habits had significant association with the occurrence of anemia in patients with ADHF, p value &lt;0.05.&#x0D; Conclusion: In conclusion, the results showed that anemia is an independent risk for HF. Anemia was observed in one-third of the study population. More prevalent in male gender, elderly patients of age above 60 years, and associated with other comorbids.

Frequency of anemia in patients with preterm labour.

Objective: To determine the frequency of anemia in pregnant women with preterm labour. Study Design: Cross Sectional Study. Setting: Department of Obstetrics &amp; Gynecology, Jinnah International Hospital (Teaching Hospital of Women Medical College), Abbottabad. Period: July 2020 to December 2020. Material &amp; Methods: The study comprised 171 females with a singleton pregnancy on ultrasound, gestational age of 24 to 37 weeks on ultrasound, parity 0-4 and preterm labour. Patients with history of cervical insufficiency, vaginal infection in last one year and urinary tract infection in last one year were excluded. Venous blood was collected from all 171 women in sodium EDTA tube by a 3rd year resident and was immediately sent to laboratory. Hemoglobin &lt; 9 g/dL was recorded as anemia. Results: The participants in this study ranged in age from 18 to 40 years, with mean age of 28.274±3.48 years, mean gestational age was 30.473±3.37 weeks, mean parity1.064±1.28 and mean weight was 73.836±9.74. Anemia was seen in 41.5% patients. Conclusion: The study gave us the information about the importance of iron deficiency anemia as a risk factor for preterm labor.

Frequency of Anemia in Patients Presented with Chronic Obstructive Pulmonary Disease

Background: Multiple western studies have focused on anemia in COPD and observed that anemia is more prevalent in COPD patients than Polycythemia. Anemia significantly increases the morbidity and deteriorates the functional status of COPD patients. Objectives: The objective of current study was to determine the frequency of anemia in Chronic Obstructive Pulmonary Disease (COPD) patients present in a tertiary care hospital. Study Design: Retrospective Material and Methods:Two hundred COPD patients fulfilling the inclusion criteria were selected for the study. Hemoglobin (Hb) level test was done on all patients. Hb level was calculated byAutomated Blood Cell Analyzer and anemia was labeled at Hb&lt;13g/dL Results: The mean of patients’ age was 56.65+ 7.95 years. 181 (90.5%) patients were male and 19 (9.5%) patients were female. The mean Hemoglobin level (Hb) of the patients was 13.46 + 1.45 g/dL. 48 patients (24%) were anemic and 152 patients (76%) were non anemic. Conclusion: The conclusion of the study is there is frequent occurrence of anemia in patients with chronic obstructive pulmonary disease (COPD), as in current study the frequency of anemia was found in 24.0% patients. Keywords:Chronic Obstructive Pulmonary Disease (COPD), Anemia, Frequency

Changes in renal function in patients with hypertension and chronic obstructive pulmonary disease according to retrospective analysis of medical records

Background. Hypertension determines both the social and economic component of the impact on the health of the population with a tendency to a significant increase in this pathology rate. Another common disease that can be prevented and treated is a chronic obstructive pulmonary disease (COPD). The concept of comorbidity implies the formation of relationships and interactions due to the common pathogenetic mechanisms, namely chronic inflammation, oxidative stress, and endothelial dysfunction. Hypertension is both a cause and a consequence of chronic kidney disease (CKD) and contributes to its progression. Patients with COPD have a higher risk of comorbidities. Aim. To study the dynamics of renal function and frequency of CKD development in patients with hypertension and COPD based on the retrospective analysis of case reports and outpatient medical records. Materials and methods. According to the criteria of inclusion and exclusion from the study, 188 patients were selected, which were divided into three groups by the clinical diagnosis: group 1 consisted of 64 patients with hypertension, group 2 — 58 patients with hypertension and chronic obstructive pulmonary disease, and group 3 — 66 patients with chronic obstructive pulmonary disease. The average age of patients with hypertension was 61.0 (57.0; 72.0) years, patients with hypertension and COPD — 62.3 (11.5), the average age of patients with COPD — 58.5 (55.0; 62.00). The physical examination, the laboratory tests of blood and urine were analyzed in all patients by studying the case reports and outpatient medical records. The obtained results were processed using biostatistical methods (Statistica v.6.1). Results. Important significance between the frequency of anemia in patients was not found, but there was a tendency to increase in anemia frequency in hypertensive patients — 14.1 % and in the comorbidity of hypertension and COPD — 8.6 %. The lowest incidence of anemia was recorded in patients with COPD and was 7.6 %. The level of total cholesterol in the respective groups did not differ statistically and was equal to 4.8 (4.2; 5.3), 4.7 (4.0; 5.4), and 5.3 (4.5; 5.9) mmol/l. The highest values ​​of total blood cholesterol were determined in patients with hypertension and chronic obstructive pulmonary disease. The highest level of blood creatinine was determined in patients with hypertension and COPD, and the lowest — in patients with COPD. Thus, the patients with hypertension had the lowest GFR and the patients with COPD had the highest one. Conclusions. COPD has a tightening effect on the renal function of patients with hypertension and leads to an increase in blood creatinine levels with statistical significance. Also, in the group of patients with hypertension and comorbid pathology, a higher incidence of anemia was registered than in the group of patients with COPD. But, in turn, the filtration function of the kidneys, which was determined by GFR, was the lowest in hypertension.

Determination of the frequency of anemia in patients with ankylozan spondilitis and its change with biological DMARD therapy

Amaç: Çalışmanın amacı ankilozan spondilit(AS) hastalarında anemi sıklığını değerlendirmek ve aneminin biyolojik hastalık modifiye edici ilaç (bDMARDs) tedavisi ile değişimini gözlemlemektir. &#x0D; Gereç ve Yöntem: Çalışmaya AS tanısı alan, Fiziksel Tıp ve Rehabilitasyon polikliniğinde takipli 137 hasta dahil edildi. Hastaların hemoglobin(HGB), ferritin, demir, demir bağlama kapasitesi, eritrosit hacmi (MCV), hemotokrit(HCT), eritrosit sedimentasyon hızı (ESH), C-reaktif protein(CRP) düzeyleri hastane veri kayıt sistemi incelenerek kaydedildi. Tedavi öncesi ve tedaviden 1 yıl sonra elde edilen veriler karşılaştırıldı ve ile hastaların anemi değerlendirmeleri yapıldı. Adalimumab ve golimumab kullanan hastalarda hemoglobin değerlerinde oluşan artış karşılaştırıldı.&#x0D; Bulgular: Çalışmaya alınan 99 hastanın 56’sında (%56,5) anemi saptandı. Hastaların 49’unda (%49,4) demir eksikliği anemisi, 7’sinde (%7) kronik hastalık anemisi saptandı. bDMARDs tedavisinin 52.haftasında incelenen tüm hastalarda ESH ve CRP değerlerinde gerileme ile birlikte, eritrosit sayılarında ve HGB seviyelerinde yükselme saptandı. Tüm hastalarda HGB seviyelerinde anlamlı artış olduğu görüldü. Adalimumab ve golimumab arasında hemoglobin seviyelerinde oluşan artış karşılaştırıldığında anlamlı farklılık saptanmadı.&#x0D; Sonuç: Hastalığın kontrol altına alınmasında etkili olan bDMARDs tedavisi ile AS hastalarının anemi düzeylerinde iyileşme görülebilir.

Anaemia: A risk factor for death and adverse outcomes following surgery for acute lower limb ischaemia.

Acute limb ischaemia (ALI) forms a significant part of the vascular surgery workload and carries with it high rates of morbidity and mortality. Anaemia is also common amongst vascular surgical patients and has been linked with poor outcomes in some subgroups. We aimed to assess the frequency of anaemia in patients with ALI and its impact on survival and complications following revascularisation to help direct future efforts to optimise outcomes in this patient group. A retrospective analysis of prospectively collected departmental data on patients undergoing surgical intervention for ALI between 2014 and 2018 was performed. Anaemia was defined as a pre-operative haemoglobin (Hb) of <120g/L for women and <130g/L for men. The primary outcome was overall survival, assessed with the Kaplan-Meier estimator, with application of Cox proportional hazard modelling to adjust for confounding covariates. There were 158 patients who underwent treatment for ALI: 89 (56.3%) of these were non-anaemic with a mean Hb of 146 (SD = 18.4), and 69 (43.7%) were anaemic with a mean Hb of 106 (SD = 13.4). Anaemic patients had a significantly higher risk of death than their non-anaemic counterparts on univariate analysis (HR = 2.11, 95% CIs, 1.28-3.5, p = 0.0036). There was ongoing divergence in survival up to around 6months between anaemic and non-anaemic groups. Under the Cox model, anaemia was similarly significant as a predictor of death (HR = 2.15, 95% CIs, 1.17-3.95, p = 0.013), accounting for recorded comorbidities, medication use and blood transfusion. Anaemia is a significant and independent risk factor for death following revascularisation for ALI and can be potentially be modified. Vascular surgical centres should ensure they have robust pathways in place to identify and consider treating anaemia. There is scope for further work to assess how to best optimise a patient's levels of circulating haemoglobin.

Frequency of Anaemia in Patients with Musculoskeletal Pain

Frequency of Anaemia in Patients with Musculoskeletal Pain

Frequency of anemia in patients with increased level of parathyroid hormone among patients on maintenance hemodialysis.

Objectives: One of the most frequently occurring complication of end stage renal disease is anemia. It can be defined as decrease in red blood cells with hemoglobin concentration less than 12 g/dl in women and less than 13 g/dl in men. Parathyroid hormone levels are also raised among patients with end stage renal disease to maintain serum calcium levels. The objective of this study is to evaluate the degree of anemia in patients with end stage renal disease currently on maintenance hemodialysis and have raised PTH levels. Study Design: Cross-sectional study. Setting: Kidney Center, Karachi. Period: November 2015 to July 2016. Material &amp; Method: Patients undergoing maintenance hemodialysis during the study duration with PTH levels greater than 300 ng/L were included in the study. Patients with other co-morbid conditions like chronic liver disease and hypersplenism were excluded from the study. Results: The total number of patients on maintenance hemodialysis in the kidney center that matched our inclusion criteria was 110. Amongst them there were 47.3% (n=52) males and 52.7% (n=58) females. The mean age of patients in our study is 50.15 ± 12.92 years. The mean PTH level of patients was found to be 642 ± 405.9U. Since all the participants of the study are on maintenance dialysis, the mean duration of hemodialysis was found to be 4.2 ± 3.19 months. The mean hemoglobin level of patients was found to be 9.75 ± 1.47 g/dl. Conclusion: Patients with hyperparathyroidism and undergoing maintenance hemodialysis frequently develops anemia. Many factors account for this including raised PTH levels causing bone marrow fibrosis, decreased production of erythropoietin and resistance of produced erythropoietin are some factors responsible for the anemia.

Cold Agglutinin Disease Prevalence and Immunoglobulin M levels in Patients with Splenomegaly from Endemic Areas for Malaria in Rwanda

Background: Inhabitants from malaria endemic zones often present with enlarged spleen, mainly due to hyper reactive malarial splenomegaly (HMS), and it is seen more commonly associated with elevated levels of Immunoglobulin M (IgM). Cold agglutinin disease is an acquired autoimmune hemolytic anemia (AIHA) that is usually due to cold-reacting IgM autoantibodies directed against red cell antigens. The study was conducted in response to the observed high frequency of transfusion dependent anemia in patients with splenomegaly from malaria endemic zones in southern province of Rwanda. The objectives of this study were to determine the prevalence of cold agglutinin disease and to assess the distribution of IgM antibodies among these patients. Methodology: This was a descriptive, cross-sectional study conducted over a period of six months from June 2016 to December 2016. The study enrolled adult population from malaria endemic areas of the southern province of Rwanda with unexplained splenomegaly. Blood samples for testing IgM levels, cold agglutinin, FBC, and markers of hemolysis were collected from peripheral health settings and analyzed at the laboratory of Butare University Teaching Hospital. Results: During the study period, we enrolled 188 participants with enlarged spleen. One hundred twenty-five (66%) were females and 34% were males. The mean (±SD) age of the study participants was 35.6 ± 15.2 years. Out of 188 participants, only 4.8% were found with significantly positive Cold Agglutinin Titer (CAT) (≥1:64) and 84% of participants were found to have elevated serum IgM level. Hemoglobin level, white blood count and platelets count decrease with severity of splenomegaly, while IgM level increases with spleen size. Conclusion: Among patients with splenomegaly from malaria endemic areas, IgM levels correlate with the stages of splenomegaly while cold agglutinin disease plays a small role in the etiology of anemia.