Frequency Of Iron Deficiency Anemia Research Articles

Evaluation and Management of Severe Childhood Anemia: A Single Center Experience

Aim: The aim of this study was to determine the frequency of iron deficiency anemia in patients with severe anemia, and to investigate and compare the difference in the hematological parameters between patients with and without iron deficiency anemia.Material and Methods: A total of 119 patients diagnosed with severe anemia between January 2012 and July 2014 were retrospectively analyzed in this study. Demographic and clinical characteristics of severe anemia patients were evaluated. Patients were evaluated in terms of iron deficiency anemia, and clinical characteristic and laboratory findings of the patients with and without iron deficiency anemia were compared.Results: Of the 119 cases 49 (41.2%) were male and 70 (58.8%) were female, mean age was 6.7±6.2 years. Various comorbidities were present in the patients. In all patients, the group with a hemoglobin value below 6 g/dL had a significantly lower platelet count than those equal to or above 6 g/dL (p=0.037). It was found that 52 (43.7%) of all cases had iron deficiency anemia and 27 (51.9%) of them were aged 5 to 18 years. Patients with iron deficiency anemia had lower ferritin level (p<0.001) than patients without iron deficiency anemia, while platelet count was higher in patients with iron deficiency anemia (p=0.001).Conclusion: In patients with severe anemia, a significant decrease in platelet count was found with hemoglobin value below 6 g/dL. In order to reduce the need for red blood cells transfusion, early diagnosis of iron deficiency anemia is important and iron supplementation should be given earlier.

The impact of iron deficiency correction in pregnant women on the perinatal period and children’s health status

Purpose. To identify the effects of gestational iron deficiency anemia after treatment with iron-containing drugs during the perinatal period on the health status of full-term children during their 1st year of life.Patients and methods.The authors carried out a prospective observational cohort study of full-term infants of I & II health group from their birth to twelve months. The course of pregnancy and labor was analyzed retrospectively. Hemoglobin, serum ferritin and C-reactive protein were measured in the six and twelve months old children and their mothers in 6 months after giving birth. We examined 140 couples of mother-child with gestational anemia (Group 1) and 166 couples without anemia during pregnancy (Group 2) in 6 months after giving birth, and in 12 months – 103 and 131 couples respectively. All women with iron deficiency anemia (Group 1) received therapy during pregnancy. Results. Gestational anemia is associated with threatened miscarriage (Odds Ratio (OR) 3.496; 95% CI 2.013–6.072), chronic placental insufficiency (OR 1.907; 95% CI 1.025–3.548), delivery by cesarean section (OR 2.729; 95% CI 1.651–4.502), increased infectious morbidity in pregnant women (OR 1.079; 95% CI 1.025–3.548) and insufficient lactation (OR 1.990; 95% CI 1.209– 3.277). Treated anemia during pregnancy is not associated with low birth weight and low weight of 6 and 12 months old children. 8.6% of 6 months old children suffered from iron deficiency anemia, which is two times lower than in the group without anemia (p=0.007). The frequency of iron deficiency anemia did not differ in 12 months old children (р=0.543). Conclusion: Iron supplementation reduces the negative impact of anemia on child’s health, including anthropometric indicators, iron stores, and risk of infectious diseases. The indirect effect is maintained through the adverse course of the perinatal period and the low duration of lactation.

Amino Acid Chelated Iron versus Ferrous Fumarate in the Treatment of Iron Deficiency Anemia with Pregnancy : Randomized Controlled Trial

Background: Anemia is a major health problem. Iron deficiency is the most common cause of anemia during pregnancy. Suboptimal iron content in the average mother’s diet and the presence of insufficient iron stores during the reproductive years are causes for this predominance. In many developing countries, iron deficiency anemia (IDA) in pregnancy is more of a rule than an exception with a prevalence of 52%. In the Western societies, the frequency of IDA is approximately 25% in pregnant women not taking iron supplements and less than 5% in women taking iron supplements. Anemia has a significant impact on the health of the fetus and the mother. It can be associated with increased preterm labour, preeclampsia, and maternal sepsis. It can also lead to fetal loss or even perinatal deaths.Aim: To find out whether there is a difference between amino acid chelated iron and iron salts (ferrous fumarate) in effect, safety, adverse effects and outcomes in treatment of iron deficiency anemia during pregnancy.Patients and Methods: The study was conducted on pregnant women attending the antenatal care in the outpatient clinic at Ain-Shams University Maternity Hospital in the period from February 2019 to July 2019, with diagnosis of iron deficiency anemia between 14 -18 weeks with hemoglobin (HB) level 8–10.5g/dL, and serum ferritin <15μg/l. One hundred fifty pregnant women who met the criteria were randomized in to 2 groups (iron chelated amino acid “IAAC” group and ferrous fumarate “FF” group). Hemoglobin level, blood indices, serum iron and serum ferritin levels were measured in both groups at 4, 8, 12 weeks of treatment.Results: There was a significant hematological improvement (mean HB level, blood indices, serum iron and ferritin levels) in both groups which was significantly higher in IAAC group.Conclusion: Iron amino acid chelate achieves faster cure rate than ferrous fumarate in women with iron deficiency anemia in pregnancy as regards mean HB and serum ferritin level. Iron amino acid chelate is associated with fewer side effects than ferrous fumarate.

Causes of pancytopenia based on bone marrow examination in adult patients presenting at Muhimbili National Hospital

Background Pancytopenia is the simultaneous presence of anaemia, leucopenia and thrombocytopenia. The aetiological spectrum of pancytopenia is wide and variable. We aimed to determine the common causes of pancytopenia by analyzing bone marrow aspiration records of adult patients seen at Muhimbili National Hospital, a tertiary care centre. Methods This was a retrospective descriptive cross-sectional study of all adult patients who presented with pancytopenia for a period of one year from January 2013 to December 2013. All patients with pancytopenia, i.e. Hb < 10 g/dl, WBC < 4 x 109/l and platelet count < 150 x 109/l; aged ≥ 18 years; and of both sexes were included in the study. The data obtained were entered on excel sheets, cleaned and analyzed for averages and ranges for numerical data. Categorical data were summarized by averages of frequencies and proportion. Results A total number of 216 adult patients had bone marrow examination in one year. A full blood picture was retrieved in 153 patients and among these, 26.8% (n = 41) had pancytopenia. The common causes of pancytopenia were aplastic anaemia (48.8%); haematological malignancies (29.3%); and nutritional anaemia (17.0%). Acute myeloid leukaemia was the commonest malignancy comprising 50% of all haematological neoplasms and iron deficiency occurred in 71.4% of nutritionally anaemic patients. Conclusion Aplastic anaemia was the most common aetiological factor followed by haematological malignancies among adult patients presenting with pancytopenia at Muhimbili National Hospital. The high frequency of iron deficiency anaemia with pancytopenia was unusual. Key words: pancytopenia, aetiology, bone marrow, adult patients

Effects of 6-months of oral ferrous and ferric supplement therapy in patients who were hospitalized for decompensated chronic heart failure.

ObjectiveAnemia is common in patients with chronic heart failure (CHF). This study aimed to examine the frequency of iron deficiency anemia in patients with CHF. We investigated the effects of oral ferrous or ferric supplementation on prognosis of CHF and quality of life.MethodsA total of 201 patients with chronic decompensated heart failure were enrolled in a 6-month prospective study. Patients were randomly assigned to two groups. Patients in group I (n = 100) received ferrous fumarate and those in group II (n = 101) received ferric hydroxide polymaltose complex. Quality of life was measured by the 6-minute walking test (6MWT).ResultsA total of 49% of the patients had iron-dependent anemia in group I and 53.3% were anemic in group II. In group I, the number of anemic patients was significantly lower at 6 months after admission compared with at initial admission (49% versus 45%). Significant improvements were observed in hemoglobin values, the 6MWT distance, and New York Heart Association class after 6 months in both groups.ConclusionsIron deficiency is a significant comorbidity in CHF, even without anemia. Iron should be replaced orally or intravenously because it significantly improves the quality of life of patients.

Iron Deficiency Status of Children at 9 and 24 Months Who Received Iron Prophylaxis

Objective: Iron deficiency is the most frequent cause of anemia in children aged 4-24 months in the world. In our country, since 2004, iron prophylaxis is been started to all children from the 4th month on upon the recommendation of the Ministry of Health. The aim of this study is to determine the frequency of iron deficiency anemia in children with iron prophylaxis at 9 months of age and to determine the frequency of iron deficiency anemia at 24 months of age for those who were continuing to receive prophlaxis or treatment for iron deficiency until 1 years of age. Methods: This retrospective descriptive study was performed on a total of 96 children, 54 of whom were male and 42 were female, followed up in Healthy Child Outpatient Clinic of Bakirkoy Sadi Konuk Education and Research Hospital. The frequency of iron deficiency anemia was studied by measuring birth weights, weight and blood hemoglobin, hematocrit, mean erythrocyte volume, erythrocyte distribution width, iron, iron binding capacity, ferritin values in children at the 9th months, who were started iron prophlaxis at 4 months. Children who were diagnosed with iron deficiency anemia at the 9th months were started on iron at a treatment dose whereas children who were normoanemic continued to receive iron prophylaxis until 12 months of age. When children were 24 months old, they were re-evaluated with the same parameters, frequency of iron deficiency anemia was investigated and iron deficiency anemia at 9th and 24th months were compared. In order to determine the socioeconomic level of the study group, the educational status of the parents were investigated. Results: Iron deficiency anemia was seen in 44,8% of the 9 months-old children whose iron prophylaxis was started at postnatal 4. months. Iron deficiency anemia was seen in 33% of 24 monthsold children whose iron prophylaxis, or treatment was discontinued when they were 12 months old. Anemic children at 2 years of age were also anemic when they were 9 months old. Conclusion: Iron deficiency anemia continues to be a health problem in the children of families with high socioeconomic status who are followed-up routinely in healthy child follow-up clinic.

The frequency of iron deficiency anemia and beta thalassemia carriers involunteers of marriage

Introduction: Thalassemia is one of the most important diseases associated with mild microcytic anemia, beta-thalassemia minor. This anemia usually does not require treatment, but it is important to screen for this anemia, especially before marriage, to prevent the birth of a newborn with thalassemia major in parents with β-thalassemia minor. Therefore, the aim of this study was to evaluate the prevalence of thalassemia and iron deficiency anemia in married couples of Ahwaz. Methods: This study is a cross-sectional and descriptive study. 5 cc of blood were prepared in two tubes containing EDTA and Hemoglobin, MCV, MCH, RDW were determined by the System KX21 solenoid and the amount of ferritin, iron, and TIBC was also found in the serum sample. Blood samples from the MCV, MCH low electrophoresis and HbA2 measurements are measured. Results: In this study 16281 couples (32,562) marriage volunteers who were referred to health centers in east and west of Ahwaz were studied. The results showed that the mean of ferritin, MCV and MCH hemoglobin was higher in males than in females. Of the 32,562 people surveyed (5.86%), 1908 had thalassemia minor, of which 966 (5.93%) and 942 (5.79%) were female. In addition, (30.44%), 3041 (10.69%) were 1741 males and (99.7%) were 1,300 women with alpha thalassemia. Of the 32,562 patients (55.1%), 504 had an anemia. Of these, were 284 (74.1%) men and 220 (1.25%) women. Conclusion: The results of this study showed that the prevalence of iron deficiency anemia, thalassemia minor and sickle cell anemia in β-thalassemia carriers were higher among those referring to Ahwaz health center than other cases. On the other hand, in the case of thalassemia continued beta-thalassemia screening of couples in this city can effectively prevent the birth of a newborn with thalassemia major and impose unwanted treatment costs.

Frequency of iron deficiency anemia in pregnant and non-pregnant women suffering from restless legs syndrome

ABSTRACTObjectives. Restless Legs Syndrome is a movement disorder characterized by unpleasant sensations in the legs described as a burning, tingling, etc. Symptoms become worse in the evening and are relieved by moving the limbs. The idiopathic form of the disease is associated with a lack of dopamine, and the secondary form is associated with iron deficiency anemia, pregnancy, and kidney disease. The aim of this study was to investigate the incidence of iron deficiency anemia in pregnant women and non-pregnant women suffering from RLS.Methods. The study was conducted on a sample of 231 pregnant women aged 18–50. The pregnant women were interviewed at the outpatient clinic of the Department of Gynaecology and Obstetrics. This study also included a control group of 231 age-compatible non-pregnant women. Women who met the international criteria for diagnosing the syndrome filled in a sociodemographic questionnaire.Results. A statistically significant association between the existence of iron deficiency anemia and RLS in the sample of the examined women was proven (p < 0.001). It was also shown that RLS is more frequent in a sample of anemic pregnant women than non-anemic pregnant women (p = 0.008).Conclusion. Iron deficiency anemia is related with RLS. Pregnant women with RLS are more likely to be anemic than pregnant women without RLS.

FREQUENCY, DISTRIBUTION AND DETERMINANTS OF IRON DEFICIENCY ANEMIA AMONG THIRD TRIMESTER INDOOR PREGNANT WOMEN

Background: Iron deficiency anemia is a common health problem during pregnancy in developing countries. The objectives of this study were to determine the frequency, distribution &amp; determinants of iron deficiency anemia among third trimester pregnant women in our population. Materials &amp; Methods: This cross-sectional study was conducted in Department of Gynecology and Obstetrics, Hayatabad Medical Complex, Peshawar, Pakistan from October 2015 to March 2016. Sample size was 360 calculated through an online calculator. The inclusion criteria was third trimester pregnant women. Demographic variables were age in years, age groups and social class. Research variables were Hb in mg/dL, presence of iron deficiency anemia, grades of iron deficiency anemia (mild/ moderate/ severe) and iron intake (yes/no). Numeric variables such as age in years and Hb were analyzed as mean and SD, whereas rest of the variables being categorical as count and percentages. Chi-square tests of association was computed. Result: The mean age of the sample was 29.31 ±6.99 and CI of 27.92-30.70. The mean hemoglobin level was 10.33 ±1.7 and 95% CI of 9.99-10.67. The overall frequency of iron deficiency anemia was found out to be 52%, in which 25% were mild, 22% moderate and 5% were severely anemic. Women with middle class had higher frequency of 145 cases. Association of iron deficiency anemia with social class (χ2=7.95, p

IRON DEFICIENCY ANEMIA BY SERUM FERRITIN LEVELS AT A TERTIARY CARE HOSPITAL

Background : Iron deficiency anemia (IDA) during pregnancy is a common nutritional disorder with adverse effects for the baby, such as premature birth and low birth weight, and the mother, such as cardiovascular symptoms and reduced physical and mental strength. Objective; To determine the frequency of iron deficiency anemia by serum ferritin levels at a tertiary care hospital. Material and Methods; All the patients who meet inclusion criteria of this study were registered from Department of Gynecology and Obstetrics, Nishtar Hospital Multan. Proper permission was taken from Institutional Ethical Committee to conduct this study. Examination was done including general physical examination. Venous blood sample (3 ml) was taken and sent to the Pathology Laboratory of the Hospital for serum ferritin levels estimation to diagnose iron deficiency anemia. Data was entered and analyzed by SPSS version 20. Results; Our study comprised of a total of 382 patients meeting inclusion criteria of our study. Mean gestational age of our study cases was 29.21 ± 7.16 weeks and 198 (51.8 %) had gestational age up to 30 weeks. Mean age of our study cases was 26.77 ± 4.29 years (with minimum age of our study cases was 20 years while maximum age was 36 years). Our study results have indicated that majority of our study cases i.e. 298 (78.0 %) were aged up to 30 years. Of these 382 study cases, 156 (40.8 %) belonged to rural areas and 226 (59.2 %) belonged to urban areas. Monthly family income up to Rs. 25000 was noted in 213 (55.8%) while more than Rs. 25000 was noted in 169 (44.2%). Of these 382 study cases, 241 (63.1%) were illiterate and 141 (36.9%) were literate. Mean duration of marriage was 5.17 ± 2.41 years and 199 (52.1%) had duration of marriage more than 5 years. Mean body mass index of our study cases was 25.82 ± 2.44 kg/m 2 and obesity was present in 56 (14.7 %) of our study cases. Mean serum Ferritin level was 11.43 ± 3.98 mg/dl and iron deficiency anemia was noted in 213 (55.8%) of our study cases. Conclusion; Very high frequency of iron deficiency anemia was noted in our study among pregnant women. Iron Deficiency anemia was significantly associated with gestational age, age, residential status, low family income and duration of marriage. All the clinicians should screen these pregnant ladies for serum ferritin levels at the start of pregnancy and should counsel them for better awareness which will lead to proper management of iron deficiency anemia. Keywords; Iron Deficiency anemia, Pregnancy, Ferritin level. DOI : 10.7176/JMPB/52-10

The Prevalence and Predictors of Iron Deficiency Anemia among Rural Infants in Nablus Governorate.

Iron deficiency anemia (IDA) in infants and young children remains a significant public health problem in most developing countries. IDA had short and long-term adverse impacts on infants' health and development. We aimed to assess the frequency of IDA and associated risk factors among infants aged between 9-12 months in rural areas of Nablus Governorate. A cross-sectional study. The study was conducted between Jan and Mar 2015. A random sample of 654 infants aged 9-12 months were selected from thirty villages in Nablus Governorate, Central Highlands of the West Bank, north of Jerusalem. Data were collected using pre-designed structured interviewing questionnaire, complete blood count analysis and anthropometric measurements were done. The prevalence of anemia and IDA among infants was 34.6%, and 32.6%, respectively. Predictors of IDA were increased in infants' age OR=1.19 (95% CI: 1.02, 1.40), maternal anemia during the third trimester OR=2.39 (95% CI: 1.55, 3.71), birth spacing less than three years OR=2.86 (95%CI: 1.58, 5.18), exclusive breastfeeding during the first six months OR=2.40 (95% CI: 1.46, 3.95), early OR=1.64 (95%CI: 1.03, 2.613) and late introduction of complementary feeding OR=2.26 (95% CI: 1.27, 4.05), and non-compliance to iron supplement in the correct frequency and duration during pregnancy OR=1.81 (95% CI: 1.19, 2.75). Different dietary and non-dietary risk factors for IDA should be considered for any intervention aimed to reduce the prevalence of IDA among infants.

Frequency of Iron Deficiency Anemia in Nulliparous Pregnant Females during Last Trimester

Frequency of Iron Deficiency Anemia in Nulliparous Pregnant Females during Last Trimester

Iron deficiency and iron deficiency anemia in blood donors at a tertiary care hospital in Islamabad, Pakistan

Objective: The aim of this study was to evaluate the frequency of iron deficiency anemia among the blood donors. Methods: A prospective, single center cross-sectional study was conducted in the Department of Blood Transfusion Services, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan, from February 2017 to June 2017. A total of 528 blood donors who donated blood without prior screening for hemoglobin levels were enrolled for this study. Blood samples were tested for six hematological and five biochemical parameters including hemoglobin level, red cell count, packed cell volume, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, serum ferritin, iron, total iron binding capacity, transferrin saturation, and unsaturated iron binding capacity. Results: Of 528 blood donors, 251 (47.53%) were first-time donors, 203 (38.44%) had donated twice previously but not in the past 12 months, and 74 (14.01%) were regular donors with minimum three donations per year. All of the donors were males with a mean age of 29.2 years (range = 18–56 years). Of these, the regular donors showed the reduction in mean values of the parameters studied. Conclusion: The blood bank management needs to review the donor selection criteria for donation. Regular voluntary donors should be given an iron supplement to prevent the depletion of iron stores.

Anemia in women of childbearing age with rheumatoid arthritis in a family medicine: therapeutic and gynecological facets

28 patients with rheumatoid arthritis (RA), complicated by anemia were examined. Peculiarities of formation of anemia in women of child bearing age compared with RA patients in the postmenopausal period were shown. The frequency of iron deficiency anemia (IDA) in women of reproductive age with RA was higher than in postmenopausal women with RA. The most likely cause of IDA is menstrual dysfunc tion. The need for therapeutic and preventive measures (iron replace ment, normalization of the menstrual cycle) in these patients by fami ly doctor was justified.

A Time Interval of More Than 18Months Between a Pregnancy and a Roux-en-Y Gastric Bypass Increases the Risk of Iron Deficiency and Anaemia in Pregnancy.

The aim of the study is to explore the impact of time between Roux-en-Y gastric bypass (RYGB) and pregnancy on obstetrical outcome and nutritional derangements. In a retrospective cross-sectional study of pregnant women admitted for antenatal care at two tertiary hospitals, we examined 153 women with RYGB and a singleton pregnancy of at least 24weeks. The women were stratified according to a pregnancy <18months (40 women) or ≥18months (113 women) after RYGB. Main outcome measures were nutritional parameters and glycated haemoglobin 1Ac (HbA1c) in second and third trimester of pregnancy, gestational hypertension, length of pregnancy, mode of delivery and foetal birth weight. The two groups were comparable regarding age, parity and prepregnancy body mass index. The frequency of iron deficiency anaemia (ferritin <12μg/L and haemoglobin <6.5mmol/L/10.5g/dL) was significantly higher in the late group, 29 vs. 8% in the early group, p = 0.010. No differences were found for vitamin B12, vitamin D and zinc. Median HbA1c was significantly higher in the late group than in the early group (33 vs. 31mmol/mol, p = 0.027). There were no significant differences in the risk of adverse pregnancy outcome or birth weight between the two groups. A long surgery-to-pregnancy time interval after a RYGB increases the risk of iron deficiency anaemia but not of other nutritional deficits. Time interval does not seem to have an adverse effect on the obstetrical outcome, including intrauterine growth restriction. Specific attention is needed on iron deficit with increasing surgery-to-pregnancy time interval.

Delayed Umbilical Cord Clamping in the 21st Century: Indications for Practice.

Health care providers have debated the timing of umbilical cord clamping since the days of Aristotle. Delayed cord clamping was the mainstay of practice until about the 1950s when it was changed to immediate clamping on the basis of a series of blood volume studies combined with the introduction of active management of the third stage of labor. However, in recent years, several systematic reviews advise that delayed cord clamping should be used in all births for at least 30 to 60 seconds. The purpose of this article is to discuss the physiology of umbilical cord clamping, the potential benefits and adverse effects of delayed cord clamping, and how this affects the advanced practice nurse. A search of PubMed, Cochrane Reviews, and Clinical Key was used to find relevant research on the topic of umbilical cord clamping. Potential benefits of delayed cord clamping include decreased frequency of iron-deficiency anemia in the first year of life with improved neurodevelopmental outcomes in term infants, reduced need for blood transfusions, possible autologous transfusion of stem cells, and a decreased incidence of intraventricular hemorrhage. Apprehension exists regarding the feasibility of the practice as well as the potential hindrance of immediate resuscitation. There is a need to begin to look for populations for which delayed cord clamping can be implemented. Recommendations are inconsistent on the patient population and timing; therefore, further studies are needed to understand the multiple variables that affect timing of umbilical cord clamping.

ANEMIC PATIENTS

Pregnant women are particularly considered to be the most vulnerable groupbecause of the additional demands that are made on maternal stores during pregnancy. Theiron deficiency anemia is the most common nutritional deficiency problems in females and isresponsible of high maternal death rate in our society. Objectives: To determine the relationshipof frequency and severity of iron deficiency anemia to preterm labor and eventual perinatalout come in anemic patients. Study Design: It was a case control study. Study Setting: InObstetrics and Gynecology Unit-III, Sir Ganga Ram hospital, Lahore from July 2012 to June2013. Methodology: The study was conducted on 200 patients (100 cases and 100 controls)were studied. Cases were patients admitted in labor room with preterm labor and Controlswere females in labor at term at. Convenience sampling was done. On admission relevanthistory taking examination and investigation were done. The data was collected on a Performa.Results: There were 50 patients with anemia amongst the patients with preterm labor. In thecontrol group, 40 patients were suffering from anemia. In the patients with preterm labor themean hemoglobin was 9.83 grams/deciliter. In the control group the mean hemoglobin was10.3gm/dl. (Pregnant women having hemoglobin &lt;10gm/dl are considered to be anemic). Theodds ratio was calculated to be 3.4 and P value was &lt;0.05. Conclusions: Iron deficiencyanemia was associated with increased risk for low birth weight, preterm delivery, and perinatalmortality. The frequency of iron-deficiency anemia was seen in both groups of pregnant women.

Anemia of Chronic Disease in Rhenumatoid Arthritis And Its Realationship With Disease Activities

Anemia is a frequent cause of morbidity in patients with Rheumatoid Arthritis (RA) that reduces quality of life. This observational cross sectional study was carried out in Rheumatology OPD and Medicine Indoor of Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2009 to December 2010 to find out the frequency of Anemia of Chronic Disease (ACD) and relative frequency of pure ACD and ACD with coexistent Iron Deficiency Anemia (IDA) in RA and to describe the relationship between ACD and disease activity of RA patients. For this purpose a total of 130 RA patients were enrolled according to the inclusion and exclusion criteria of the study and divided into ACD group and non anemic group on the basis of hemoglobin level (11g/dl in females and &lt;12g/dl in males). ACD group of patients again divided into pure ACD and ACD with co-existent IDA subgroups on the basis of ratio of Soluble Transferrin Receptor (sTfR) to log ferritin (sTfR­F index).Patients with sTfR-F index value&lt;1 were classified as pure ACD and sTfR-F index value &gt;1 were classified as ACD with coexistent IDA. Disease activity were assessed by modified Disease Activity Score (DAS-28), Tender joint count, Swollen joint count, Morning stiffness in minutes, Health Assessment Questionnaire (HAQ) Erythrocyte Sedimentation Rate (ESR) in mm in 1st hour and Rheumatoid Factor (RF) positivity. Out of 130 patients, estimated frequency of ACD was 59%.Among the ACD patients, 16% were found to have pure ACD and 84% had both ACD and IDA. Disease activity parameters were compared between ACD group and non anemic group and then pure ACD and ACD with co­existent IDA subgroups of patients. We found significantly higher mean DAS-28 score ,tender joint count, swollen joint count, HAQ score and mean ESR in ACD group of patients as compared to non anemic RA patients. When differing levels of disease activity indices were compared, we also found significant difference between ACD and non anemic groups. Patients with pure ACD subgroups had significantly higher mean DAS-28, tender joint count, swollen joint count and HAQ score as compared to ACD with co-existent IDA subgroups of patients. When comparing differing levels of disease activity indices, no significant difference was observed between pure ACD and ACD with coexistent IDA patients with RA. This it can be said in conclusion that ACD is frequently encountered with high frequency of iron deficiency anemia among rheumatoid arthritis patents. RA patents with ACD tend to have severe disease than non anemic RA patents but pure ACD patints not necessarily had severe disease as compared to combined ACD and IDA. JCMCTA 2015 ; 26 (1) : 14-20

Iron deficiency anemia in an Egyptian pediatric population: A cross-sectional study

The aim of this study is to assess the frequency of iron deficiency anemia (IDA) and associated sociodemographic factors among children between 6 months and 12 years of age. This cross-sectional study enrolled 300 children from June 2011 to June 2012 visiting the pediatric outpatient clinics of Al-Fayoum University Hospital. Data were collected using a structured interview questionnaire. Sociodemographic variables studied included sex, residence, family size, fathers' education, mothers' education, and crowding index. Included patients were evaluated clinically and laboratory for complete blood picture, serum iron, serum ferritin, and transferrin saturation. It was found that 64% of studied children had IDA (20% mild, 41.7% moderate, and 2.3% severe). The logistic regression analysis found that children from rural areas, those from low social class and those of low maternal educational level had a higher risk for IDA than other children. Infants with IDA were found to consume foods with low iron content 50% below recommended daily allowance. The high frequency of IDA is a severe public health problem in developing countries like Egypt, especially in children from rural areas, those from low social class and those of low maternal educational level. Iron-rich foods should be advised by health care providers. Prophylactic iron supplements should be given to all infants from 6 to 23 months.

Enhancing endogenous stem cells in the newborn via delayed umbilical cord clamping

There is currently no consensus among clinicians and scientists over the appropriate or optimal timing for umbilical cord clamping. However, many clinical studies have suggested that delayed cord clamping is associated with various neonatal benefits including increased blood volume, reduced need for blood transfusion, increased cerebral oxygenation in pre-term infants, and decreased frequency of iron deficiency anemia in term infants. Human umbilical cord blood contains significant amounts of stem and progenitor cells and is currently used in the treatment of several life-threatening diseases. We propose that delayed cord clamping be encouraged as it enhances blood flow from the placenta to the neonate, which is accompanied by an increase supply of valuable stem and progenitor cells, as well as may improve blood oxygenation and increase blood volume, altogether reducing the infant's susceptibility to both neonatal and age-related diseases.