Hb Levels Research Articles

Septic paravertebral abscess and inferior vena cava thrombosis complicated by uro-sepsis: Case report

Paravertebral abscess is an uncommon and potentially dangerous illness characterized by the buildup of pus in the anatomical area surrounding the spinal column. A 65-year-old female, who has diabetes and high blood pressure, came in with intense discomfort in her lower back that spreads to her lower limbs, making it difficult for her to move. She also has a high fever, excessive sweating, and has lost a large amount of weight. The blood tests indicate the following abnormalities: low Hb level of 9.6 g/dl, low MCV of 70 fl, elevated total white blood cell count of 15.8 × 109/L, elevated neutrophil count of 12.4 × 109/L, normal lymphocyte count of 2.8 × 109/L, high platelet count of 485 × 109/L, and elevated ESR of 110 mm/hr. The level of phosphatase was raised to 247 U/L, which is beyond the usual range of 40-150 U/L. The blood film reveals the presence of hypochromic microcytic red blood cells, which are indicative of iron deficiency anemia. There is also evidence of neutrophil leukocytosis in the white blood cells, with no immature cells observed. Additionally, an increase in platelets is observed in the film. The D-dimer level is 2009 ng/ml, which is within the normal range of less than 500 ng/ml. The CRP level is 48 gm/l, which is above the usual range of less than 6 gm/l. The bone marrow testing yielded normal results. The blood culture indicated the presence of Streptococcus epidermidis growth. Radiological tests revealed that a CE-MRI of the dorsal and lumbar spine indicated the presence of a para-aortic abscess together with septic thrombosis of the inferior vena cava. Paravertebral abscess is a critical emergent condition required a necessary therapy protocols to stabilize the patient status. The timing of intervention is crucial in cases of paravertebral abscess, as the existence of a mass can led to spinal cord compression.

Efektifitas Komsumsi Tablet Fe dengan Air Jeruk Nipis terhadap Peningkatan Kadar HB Ibu Hamil Anemia Ringan Trimester III

Background: Anemia is a body condition where the hemoglobin level in red blood cells is lower than the normal standard. Pregnant women are said to be anemic if their Hb content is <11gr/dL. According to WHO, the prevalence of pregnant women throughout the world who experience anemia is 41.8%. The percentage of anemia in pregnant women in Indonesia is 37.1%. For the Special Region of Yogyakarta, the prevalence in pregnant women is 19.01%, and the highest incidence of anemia is in Bantul Regency (27.67%). Data from the Bantul District Health Service, from 27 Community Health Centers, there are 5 Community Health Centers with the highest number of anemia, namely at Sewon II Community Health Center. From this data, Sewon II Community Health Center is in second place. Objective: To determine the effectiveness of consuming fe tablets with lime juice on increasing Hb levels in mildly anemic pregnant women at the Sewon II Bantul Community Health Center, Yogyakarta. Method: This quasi-experiment research uses a one group pretest-posttest design. The sample in the study consisted of 30 pregnant women. The sampling technique uses total sampling. The research instrument gave lime to pregnant women with mild anemia for 2 weeks. Then the hemoglobin level was checked before and after drinking lime using a hemoglobin meter checking device in collaboration with the Puskesmas lab section. Results: The results of this research are based on univariate analysis of the characteristics of respondents aged 20-35 years as many as 26 (86.3%) respondents, the majority have a high school education as many as 26 (86.7%) respondents, the occupation of respondents is housewives 28 (93.3%) ) respondents. The results of the bivariate analysis showed that there was a significant effect on the average value of increasing hemoglobin levels before (10.21) and after drinking lime (11.23) with an average of (1.02). Conclusion: Based on the research results, it can be concluded that there is an effect of giving lime juice on hemoglobin levels in pregnant women in the second trimester at the Sewon II Bantul Community Health Center.

Assessing the factors influencing the severity of anemia in tribal women of Malkangiri, Odisha, India

Background: Anemia is a serious public health concern with a high prevalence in tribal communities' women in India. Despite several implementations to strengthen the maternal health and nutrition program, anemia persists. Objectives: The objectives of this study were to estimate anemia prevalence and to examine the predictors of anemia among Koya and Matia tribal women in a district of Odisha, Malkangiri. Materials and Methods: For this study, a cross-sectional survey was conducted among 519 tribal (Koya- 326) and (Matia- 193) women aged 15-49 years. A pre-tested schedule was used to collect data on different demographic variables, and a Hemoglobin (Hb) meter was used to estimate Hb level. Prevalence of anemia among tribal women was estimated and Chi-Square and Multinomial logistics regression were used to find the association. Results: The mean hemoglobin value in the overall sample (n=519) was 7.86±1.77. The results showed that 34.35% of Koya and 33.67% of Matia were severely anemic, while 56.13% of Koya and 55.43% of Matia were moderately anemic, and mild anemia was reported to be 3.68 in Koya and 4.14 in Matia's women. Early marriage, women's age at first childbirth, parity, were major factors influencing the severity of anemia. Conclusion: The high prevalence of anemia among both communities' tribal women necessitates immediate action through targeted interventions to enhance and ensure widespread coverage of anemia control programs, especially in tribal areas.

Adaptability of clinical pharmacist led interventions in the management of anemia of chronic renal disease: optimizing care

Renal anemia is a common comorbidity in chronic kidney disease (CKD) patients, typically treated with erythropoiesis-stimulating agents (ESAs) like erythropoietin. However, both over- and under-treatment are prevalent. In 2008, the Pharmacy Council of India introduced the Pharm.D course to enhance pharmaceutical care in clinical settings. While extensive studies in other countries highlight the benefits of clinical pharmacists' interventions, Indian research on this topic is limited. This prospective randomized controlled trial included CKD patients not on dialysis, with serum creatinine levels of 2-6 mg/dL and hemoglobin (Hb) levels below 12 g/dL. Participants were divided into three subgroups based on baseline Hb levels: < 10 g/dL (Group I), 10-12 g/dL (Group II), and >12 g/dL (Group III). ESAs and iron supplements were adjusted to maintain Hb levels of 10-12 g/dL. Quality of life was assessed using the Short Form Health Survey-36 questionnaire. Out of 448 participants, those in the pharmacist intervention group showed a significant shift towards Group II by the trial's end, compared to the control group. The study demonstrated a significant improvement in quality of life and physical performance, particularly for those in Group II, indicating that maintaining Hb levels at 10-12 g/dL is optimal for Indian CKD patients. This trial exemplifies the profound impact clinical pharmacists can have on patient care, highlighting their crucial role in improving healthcare outcomes through active participation and targeted interventions in clinical settings.

Nutritional Status and Growth Outcomes in Pediatric Idiopathic Growth Hormone Deficiency: A Retrospective Study in Turkey

Objective: Growth and development in children are significantly influenced by nutritional status. Nutritional deficiencies such as low hemoglobin (Hb), ferritin, vitamin B12, and vitamin D have been linked to impaired growth. This study aims to evaluate the impact of these nutritional markers on growth outcomes in children with idiopathic growth hormone deficiency (IGHD) undergoing recombinant growth hormone therapy (rhGH). Material and Methods: A cross-sectional, retrospective study was conducted on 100 children with IGHD, aged under 16, diagnosed between 2000 and 2023. Data were collected from medical records, including height, body mass index (BMI), pubertal status, bone age, and nutritional markers [Hb, ferritin, vitamin B12, 25-hydroxy-vitamin D3 (25(OH)D3]. Growth parameters were assessed at the start and end of the first year of rhGH treatment. Results: The cohort had a median age of 11.3 years; 30% were female, and 50% were prepubertal. The median height standard deviation score (SDS) was -2.8, and median BMI SDS was -0.7. Prevalence of nutritional deficiencies included 23% with low Hb, 31% with low ferritin, 44% with low 25(OH)D3, and 15% with low vitamin B12. Despite these deficiencies, no significant differences were observed in height SDS or growth velocity when grouped by nutritional markers or supplementation status. Growth velocity showed a significant positive correlation with Hb levels and mid-parental height (MPH). Conclusion: Nutritional deficiencies were common among IGHD patients; there was no significant difference in terms of growth-related metrics in the first year of the rhGH therapy in comparisons between the groups with and without common nutritional deficiencies. This finding underscores the resilience of growth in the presence of these deficiencies. In contrast, growth velocity correlated positively with Hb levels and MPH, suggesting that these factors may play a significant role in influencing growth. Further research with larger samples and extended follow-up is needed to explore the long-term impact of nutritional supplementation on growth in IGHD.

Red cell size factor is a sensitive index in the early diagnosis of nondigestive tract cancer-related anemia: An observational study.

Cancer-related anemia (CRA) is a common comorbidity in cancer patients, and it can lead to a worse prognosis. The aim of this cross-sectional study is to investigate the clinical value of the red cell size factor (Rsf) in the early diagnosis of nondigestive tract CRA. A total of 231 patients with nondigestive tract solid cancer were included, and they were divided into anemic and nonanemic subjects according to the hemoglobin (Hb) levels. A BC-7500 blood analyzer was used to detect the indices of red blood cell and reticulocyte, and the mean corpuscular volume (MCV), mean reticulocyte volume (MRV), reticulocyte hemoglobin (RHE) content, and reticulocyte production index were observed. Subsequently, the Rsf was calculated. Receiver operating characteristic curve analysis was used to evaluate the identifying power of Rsf for anemia diagnosed by the combination of RHE and reticulocyte production index. The adjusted-multivariate analysis and quartiles were used to assess the relation of reduced Rsf level with the risk and incidence of anemia diagnosed by combining the MCV, MCH, and mean corpuscular hemoglobin concentration (MCHC), respectively. Rsf levels showed no statistical differences between anemia and nonanemia subjects grouped by Hb (P > .05). Rsf has a high correlation with the RHE level (R > 0.900, P < .001), or MCV, mean corpuscular hemoglobin (MCH), and MCHC in anemia patients (r: 0.435-0.802, P < .001). Receiver operating characteristic curves showed that Rsf had the highest overall area under curve of 0.886 (95% confidence interval: 0.845-0.927) in identifying anemia of cancer patients (P < .001). When the optimal cutoff values of Rsf were set at 97.05 fl in males and 94.95 fl in females, the sensitivity and specificity were 0.94 and 0.76, and 0.98 and 0.75, respectively. Being treated as a categorical variable, Rsf had a highest odds ratio value of 30.626 (12.552-74.726; P < .001) for the risk of anemia. The increment of Rsf quartiles was highly associated with the decreased incidence of overall anemia (P trend < 0.001). The study suggests that decreased Rsf level is a potentially powerful predictor of overt anemia in nondigestive tract cancer, and it can be used as a convenient, practical, cost-free, and sensitive index in early diagnosis of nondigestive tract CRA.

Prediction the Occurrence of Thalassemia With Hematological Phenotype by Diagnosis of Abnormal HbA1c.

The current investigation aims to analyze the occurrence of thalassemia in patients who participated in hemoglobin A1c (HbA1c) testing in clinical laboratory showing high hemoglobin F (HbF) level (≥ 1.5%) or abnormal Hb peak and predict the main influence factors by using different statistical models. The current investigation is a single-center retrospective cohort study. HbA1c concentration was detected by using TOSOH HLC-723G8 glycated hemoglobin analyzer. SNaPshot SNP (Single Nucleotide Polymorphism) typing and AccuCopy technology were employed to detect mutations in thalassemia-related pathogenic genes. A total of 126 patients endured high HbF levels or abnormal Hb peak during HbA1c detection, and 66.7% of subjects (n = 84) showed thalassemia mutations. Three heterozygosity mutations, including c.52A>T (p.K18*), c.-78A>G, and c.126_129delCTTT(p.F42Lfs*19) present in HBB gene, were also identified. --SEA/αα mutation demonstrated the youngest ages (p < 0.001). 17 M (p < 0.001) and 41/42 M (p < 0.01) mutations with β-thalassemia showed higher HbF levels compared with patients without thalassemia mutations. Except for -α3.7, mutations in thalassemia showed lower levels of mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) compared with patients without thalassemia mutations. Patients with thalassemia mutations showed younger age (p < 0.001), lower Hb (p < 0.001), MCV and MCH levels (p < 0.001), higher red blood cell (RBC)count (p < 0.001), and platelet distribution width (PDW) level (p = 0.007) than patients without thalassemia mutations. Three statistical models indicate MCV is the most valuable independent factor for predicting thalassemia and ROC (receiver operating characteristic) curves analysis of AUC (Area Under the Curve) of 0.855 (95% CI [0.787-0.923], p < 0.001) with MCV. High HbF level (≥ 1.5%) or abnormal Hb peak present in HbA1c testing indicated high incident rate of thalassemia. MCV is the most valuable independent predicting factor for subjects having thalassemia.

A Multicenter Retrospective Chart Review Study Estimating the Prevalence of Iron Deficiency Anemia Among Infants, Toddlers, and Children in Riyadh, Saudi Arabia.

Background Iron deficiency anemia (IDA) is a prevalent nutritional disorder affecting children worldwide, leading to potential long-term cognitive and developmental deficits. This study aimed to determine the prevalence of IDA among healthy children attending Dr. Sulaiman Al-Habib Hospital Group in Riyadh, SAU, and explore the relationship between IDA and various demographic factors, including age, gender, and nationality. Methodology A retrospective chart review was conducted from July 2023 to August 2023 at Dr. Sulaiman Al-Habib Hospital Group, in Riyadh, Saudi Arabia. The study included 498 children aged 0.58 to 17 years, selected through a cluster sampling technique. Data on demographic characteristics and laboratory results, including hemoglobin (Hb) levels, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), ferritin, and RBC, were collected. Iron deficiency anemia was diagnosed based on Hb levels and other hematological indices. Statistical analysis was performed using SPSS Statistics version 23.0 (IBM Corp., Armonk, NY, USA). Results The prevalence of IDA among the study population was 9.2%, with 72.3% of the cases classified as mild and 27.7% as moderate. No cases of severe anemia were found. Infants had the highest prevalence of IDA (16.9%), followed by toddlers (12.0%), preschool children (7.2%), and school-age children (0.8%). Gender analysis revealed a prevalence of 9.7% in males and 8.6% in females, with no significant difference between genders (p = 0.659). All non-Saudi participants were free of IDA, whereas 9.3% of Saudi participants had IDA, though this difference was not statistically significant (p = 0.761). Conclusion The study found a relatively low prevalence of IDA among healthy children attending Dr. Sulaiman Al-Habib Hospital Group in Riyadh, SAU, with the highest prevalence observed among infants. These findings highlight the need for targeted interventions to prevent IDA, particularly in younger children. Routine screening and early treatment are crucial to mitigate the potential long-term effects of IDA on child development. Further research with larger and more diverse samples is recommended to validate these findings and explore additional factors influencing IDA prevalence.

Adherence to patient blood management strategy in patients with gastrointestinal bleeding: a prospective nationwide multicenter study.

Patient blood management (PBM) adherence in clinical practice is unclear. This real-world practice study assessed the management of patients with gastrointestinal (GI) bleeding after the implementation of the PBM strategy. This was a nationwide multicenter and prospective study involving consecutive adults with GI bleeding between March 2019 and March 2021. Patients were examined according to hemoglobin (Hb) level at admission (<7 g/dl, n = 93; 7-8 g/dl, n = 47; 8-9 g/dl, n = 61; and >9 g/dl, n = 249). Study outcomes measures were morbidity and mortality during hospitalization and at 3- and 6-month follow-up. Appropriate anemia or iron deficiency management was considered when adherence to PBM policy was higher than 75%. A total of 450 patients (57.6% men, median age: 74 years, interquartile range: 63-82) were included. Overall, 55.1% and 59.3% of patients received transfusion and iron supplementation, respectively. The rates of appropriate transfusion and iron supplementation adherence were 90.9% (range: 86.9-93.5%, P = 0.109) and 81.8% (range: 78.5-85.1%, P = 0.041), depending on Hb level, respectively. No associations were observed between adherence to the PBM strategy and length of stay (P = 0.263) or risk of further bleeding (P = 0.742). Patients who were transfused [hazard ratio (HR): 0.79, 95% confidence interval (CI): 0.27-0.85] and iron supplemented (HR: 0.91, 95% CI: 0.38-1.41), however, appropriately achieved a lower risk of death. Age (HR: 1.12, 95% CI: 1.12-1.25) and further bleeding (HR: 39.08, 95% CI: 4.01-181.24) were poor prognostic factors. No serious adverse events were reported. In this nationwide study, there is a high level of adherence and safety of PBM for the treatment of GI bleeding. Adherence to the PBM strategy improved outcomes in patients with GI bleeding.

Impact of Iron Tablet and Moringa Leaf Capsule Supplementation on Hemoglobin Levels in Anemic Pregnant Women in Pariaman City, 2016

Background: Iron deficiency anemia is a prevalent global nutritional problem, particularly affecting pregnant women in developing countries. This study aimed to evaluate the effects of iron tablet supplementation and Moringa leaf capsules on hemoglobin (Hb) levels in anemic pregnant women in Pariaman City, Indonesia. Method: A total of 60 pregnant women were divided into two groups: one receiving iron tablets and the other Moringa leaf capsules for four weeks. Hemoglobin levels were measured before and after the intervention. Findings: In the iron supplementation group, the average Hb level increased from 9.05 g/dL to 9.46 g/dL, with a significant improvement (p = 0.001). Similarly, the Moringa capsule group showed an Hb increase from 8.99 g/dL to 9.27 g/dL (p = 0.019). While iron tablets resulted in a greater increase in Hb, Moringa capsules, rich in natural iron, also demonstrated significant effectiveness. The study concludes that both iron supplements and Moringa capsules are effective in increasing Hb levels, with Moringa capsules being a potential natural alternative for combating anemia in pregnant women. However, optimizing the dosage of Moringa could further enhance its efficacy. Factors such as adherence, diet, and knowledge of iron absorption enhancers and inhibitors play crucial roles in the success of the interventions.

HUBUNGAN KETERATURAN PEMERIKSAAN ANC TERHADAP KEJADIAN ANEMIA DI WILAYAH KERJA PUSKESMAS TURIKALE KECAMATAN TURIKALE KABUPATEN MAROS

Regular pregnancy checks will determine the mother's health status during pregnancy because basically the cause of Fe deficiency anemia in pregnant women is caused by two factors, namely direct and indirect factors. Meanwhile, factors that do not directly influence a person's Hb levels by influencing the availability of Fe in food include the low economy.The aim of this research is to determine the relationship between the regularity of ANC examinations and the incidence of anemia in the Turikale Community Health Center Working Area, Turikale District, Maros Regency. The type and research method used is the Cross Sectional Study method. In this study, the samples taken were 36 third trimester pregnant women who had their pregnancies checked in the Turikale Community Health Center Working Area, Maros Regency, using purposive sampling. The research results showed that 29 people (80.6%) regularly made ANC visits and 7 people (19.4%) did not regularly. Six respondents (16.7%) experienced anemia and 30 respondents (83.3%) did not experience anemia. There is a relationship between the regularity of ANC visits and the incidence of anemia with a value of ρ=0.004&lt;from α=0.05, this means that Ho is rejected and Ha is accepted. It is hoped that it can increase monitoring and screening of pregnant women who experience high levels of anemia through home visits, making class activities more effective for pregnant women and empowering families, especially husbands or parents, to be motivated to invite pregnant women to have their pregnancies checked regularly. The husband or closest family member can be given an understanding of the dangers and efforts to prevent anemia in pregnant women

Red Blood Cell Transfusion in European Neonatal Intensive Care Units, 2022 to 2023

Red blood cell (RBC) transfusions are frequently administered to preterm infants born before 32 weeks of gestation in the neonatal intensive care unit (NICU). Two randomized clinical trials (Effects of Transfusion Thresholds on Neurocognitive Outcomes of Extremely Low-Birth-Weight Infants [ETTNO] and Transfusion of Prematures [TOP]) found that liberal RBC transfusion thresholds are nonsuperior to restrictive thresholds, but the extent to which these results have been integrated into clinical practice since publication in 2020 is unknown. To describe neonatal RBC transfusion practice in Europe. This international prospective observational cohort study collected data between September 1, 2022, and August 31, 2023, with a 6-week observation period per center, from 64 NICUs in 22 European countries. Participants included 1143 preterm infants born before 32 weeks of gestation. Admission to the NICU. Study outcome measures included RBC transfusion prevalence rates, cumulative incidence, indications, pretransfusion hemoglobin (Hb) levels, volumes, and transfusion rates, Hb increment, and adverse effects of RBC transfusion. A total of 1143 preterm infants were included (641 male [56.1%]; median gestational age at birth, 28 weeks plus 2 days [IQR, 26 weeks plus 2 days to 30 weeks plus 2 days]; median birth weight, 1030 [IQR, 780-1350] g), of whom 396 received 1 or more RBC transfusions, totaling 903 transfusions. Overall RBC transfusion prevalence rate during postnatal days 1 to 28 was 3.4 transfusion days per 100 admission days, with considerable variation across countries, only partly explained by patient mix. By day 28, 36.5% (95% CI, 31.6%-41.5%) of infants had received at least 1 transfusion. Most transfusions were given based on a defined Hb threshold (748 [82.8%]). Hemoglobin levels before transfusions indicated for threshold were below the restrictive thresholds set by ETTNO in 324 of 729 transfusions (44.4%) and TOP in 265 of 729 (36.4%). Conversely, they were between restrictive and liberal thresholds in 352 (48.3%) and 409 (56.1%) transfusions, respectively, and above liberal thresholds in 53 (7.3%) and 55 (7.5%) transfusions, respectively. Most transfusions given based on threshold had volumes of 15 mL/kg (470 of 738 [63.7%]) and were administered over 3 hours (400 of 738 [54.2%]), but there was substantial variation in dose and duration. In this cohort study of very preterm infants, most transfusions indicated for threshold were given for pretransfusion Hb levels above restrictive transfusion thresholds evaluated in recent trials. These results underline the need to optimize practices and for implementation research to support uptake of evidence.

Whole Blood Donor Iron Management Across Europe: Experiences and Challenges in Four Blood Establishments

Whole blood donors lose iron while donating and frequent blood donation is therefore known to induce a risk of iron deficiency and/or anemia. In this review we present, compare and discuss the pros and cons of 4 distinctive donor iron management strategies in England, Finland, the Netherlands, and Denmark. Donor iron management policies in the countries concerned are described for the year 2021, and data on donor and donation numbers, low hemoglobin (Hb) deferral rates and Hb levels are presented. In England Hb levels were only measured in donors failing a copper sulphate test, while in the other 3 countries Hb is measured at every donation. In Finland, donors considered at risk of iron deficiency receive iron supplements, while in the Netherlands, ferritin-guided donation intervals without iron supplementation are in place. In Denmark, iron supplementation is provided to donors with low ferritin levels. Low-Hb deferral rates and average Hb levels are quite similar across the included countries, with the exception of higher deferral rates in England. To conclude, despite significant diversity in donor iron management approaches, low Hb deferral rates and average Hb levels are similar among the included countries except for England, where higher deferral rates were observed that are likely attributed to the absence of iron supplementation or ferritin-guided deferral. Achieving an optimal, more tailored iron management strategy requires further research and a nuanced understanding of both donor demographics and physiological responses to optimize the effectiveness and safety of blood donation practices.

Analysis of Erythrocyte Parameters in Multiple and Long-Term Blood Donors from Northern Pomerania (Poland)

Background/Aims: Assessment of the levels of vital blood parameters in donors is essential to evaluate their health status, ensure their suitability for donation, preserve the integrity of the circulatory system, and facilitate comprehensive health monitoring. The aim of our study was to analyse the levels of haemoglobin, haematocrit, erythrocyte count, MCV, MCH, and MCHC in 12 groups of first-time donors and experienced donors of both sexes at the John Paul II Regional Blood Donation and Treatment Centre in Słupsk, northern Poland. The donors were divided into three age groups (18-30 years, 31-45 years, and 46-65 years). Methods: Using MANOVA multivariate significance tests, we examined the main effects of donor-related factors (age, sex, donor stage) on morphological blood parameters to evaluate different haematological parameters, such as Hb, Ht, RBC, MCV, MCH, and MCHC, and identified statistically significant relationships between all variables. Results: The multivariate analysis of these three main factors showed that the variation in haemoglobin (Hb) levels accounted for 46% of the explained dependence in this statistical model. In particular, approximately half of the variability in the multivariate statistical analysis was attributed to the role of Hb and haematocrit (Ht). In addition, the β-coefficient values for Hb and Ht were statistically higher in relation to donor sex and donor type (single versus repeat). These β-coefficient values from our data represent the strength and direction of the relationship between the haematological parameters (Hb and Ht) and the specific donor characteristics. A higher β-coefficient indicates a stronger influence of donor sex and donor type on these parameters, suggesting that these factors contribute significantly to the variation in the Hb and Ht levels. Based on our results, the comprehensive analysis of the entire statistical model of metabolic biomarkers revealed the following hierarchy: Hb &gt; Ht &gt; MCHC &gt; MCV &gt; RBC &gt; MCH. The results obtained showed strong statistical relationships, as indicated by the high values of the key statistical indicators in our analysis. The coefficient of determination (R²) showed that the model explained a significant proportion of the variance in the data, while the F-test statistic confirmed the significance of the predictors. Conclusion: These strong statistical dependencies provided a clear justification for selecting this model over others, as it effectively represented the underlying relationships within the data. These statistics help to assess how well the model matches the actual data, thereby helping to reduce the risks associated with blood donation, optimise donor safety, and maintain the quality and efficiency of blood transfusion services.

Rising Cases of Hb H Disease in Iraq Highlight the Urgent Need for Pre-Pregnancy Screening

General background: Hemoglobin H (Hb H) disease results from mutations in three of the four α-globin genes, leading to α-thalassemia. Specific background: In Iraq, this condition is rare among alpha-thalassemia cases. The disease presents significant hematological abnormalities, impacting quality of life. Knowledge gap: Despite its rarity, few studies have characterized the hematopathological features and prevalence of Hb H disease in specific Iraqi regions. Aims: This study aimed to assess the hematological parameters and prevalence of Hb H disease among patients in Diyala province, Iraq. Results: A total of 81 patients with Hb H disease (53.18% male, 46.91% female) were registered at the Baqubah Teaching Hospital in 2023. Median patient age was 21.8 years (range 4-48). Hematological analysis revealed consistently low levels of hemoglobin (Hb) and hematocrit (HCT) compared to standard values. Mean corpuscular volume (MCV) was also significantly reduced, with 58.02% of patients presenting Hb levels below 10 g/dL. The 21-40 age group had the highest incidence (46.91%). Novelty: This study is among the few to investigate Hb H disease prevalence and hematopathological characteristics in Diyala province, revealing an unexpectedly high incidence in the 21-40 age group. Implications: These findings suggest that hematological parameters, including MCV and Hb levels, should be considered in thalassemia screening programs, particularly in pre-pregnancy assessments, to prevent the birth of children with severe forms of alpha-thalassemia and reduce Hb H disease prevalence. Highlights: Hb H disease shows low hemoglobin and MCV abnormalities. Highest incidence occurs in patients aged 21-40 years. Pre-pregnancy screening reduces severe alpha-thalassemia risk. Keywords: Hb H disease, alpha-thalassemia, hematological parameters, Diyala province, prevalence

Analysis of Influencing Factors of Moderate to Severe Malnutrition in Elderly Patients with Lung Cancer during Chemotherapy

Objective: This study aims to identify the factors influencing moderate to severe malnutrition in elderly lung cancer patients undergoing chemotherapy and to provide a basis for developing clinical prevention and intervention strategies. Methods: The clinical data of 150 elderly lung cancer patients who received chemotherapy were retrospectively analyzed. Demographic data, clinical characteristics, laboratory indicators, treatment plans, and other relevant information were collected. Independent risk factors for moderate to severe malnutrition during chemotherapy were identified. Results: During chemotherapy, 50 patients (33.33%) developed moderate to severe malnutrition. The BMI of patients with moderate to severe malnutrition was significantly lower than that of patients with no or mild malnutrition (21.20 ± 1.60 vs. 26.14 ± 2.31, P &lt; 0.001), and the proportion of patients with stage IV tumors was significantly higher (60.00% vs. 27.00%, P &lt; 0.001). Serum pre-albumin (pre-ALB) and hemoglobin (Hb) levels in patients with moderate to severe malnutrition were significantly lower than those in patients with no or mild malnutrition (152.67 ± 30.41 g/L vs. 252.47 ± 51.24 g/L and 102.44 ± 10.09 g/L vs. 154.21 ± 15.18 g/L, respectively, P &lt; 0.001 for all). Conclusion: Low BMI, decreased serum pre-ALB levels, and decreased serum Hb levels before chemotherapy are independent risk factors for moderate to severe malnutrition in elderly lung cancer patients during chemotherapy. Close clinical attention should be given to these patients, with early intervention measures such as nutritional support to reduce the incidence of malnutrition and improve patients’ quality of life and prognosis.

The Effect of Moringa (Moringa Oleifera L.) Leaf Extract Capsules in Increasing Hemoglobin Levels in Adolescent Girls

Moringa leaves can be an alternative to increase hemoglobin (hb) levels because they contain high iron, protein, and vitamin C. Adolescent girls have a higher risk of experiencing anemia due to increased iron requirements resulting from menstruation. Objective: To determine the effect of moringa leaf extract capsules (Moringa Oleifera L) on increasing hemoglobin levels in teenage girls at SMKN 1 Takokak, Cianjur Regency. Method: The research design employed in this study is a pre-experimental approach, utilizing a one-group pretest-posttest design. The sample size consists of 30 adolescent girls selected through purposive sampling technique. Data collection involves measuring hemoglobin levels. Data analysis is conducted through univariate and bivariate analyses using the Wilcoxon Signed Rank Test. Results: The research findings indicate that there was an increase in hemoglobin levels before (10.69) and after (12.78) the intervention, with an average difference of -2.09. Furthermore, there was a significant p-value of 0.001 (&lt;0.05). Conclusions: The moringa leaf extract capsules have shown an influence in increasing the hemoglobin levels of adolescent girls. Moringa Leaf Extract can be recommended as a non-pharmacological alternative to enhance hemoglobin levels.

Improving Blood Transfusion Request Form Documentation: A Quality Improvement Project.

The transfusion quality improvement project (QIP) serves as a valuable toolfor assessing and educating individuals who request blood components.The World Health Organization (WHO) recommends that each institution utilize a blood transfusion request form to ensure the effective conveyance of patient information to the hospital's blood bank. This QIPaimed to implement a transfusion request form and measure compliance with its use. A prospective study was conducted at Al Managil Teaching Hospital, Sudan, from May 1 to August 3, 2024, to address the lack of standardized transfusion request forms. The study included three cycles involving pre-intervention analysis, two phases of intervention with training sessions, and post-intervention evaluations. The interventions focused on developing and implementing a new transfusion request form, training clinical physicians, and reinforcing the form's use. Data from 100 randomly selected transfusion request forms were analyzed for completeness and adherence. The study showed significant improvements in the completeness of transfusion request forms across three cycles. In the first cycle, no data were collected, highlighting the absence of standardized forms. During the second cycle, with the introduction of the new form, the completion rates varied: some fields, such as patient information and clinical details, were fully completed in 50 cases (100%), while critical clinical parameters, such as current hemoglobin (Hb) and platelet (PLT) levels, were completed in only four requests (8%). By the third cycle, there was a substantial increase in completion rates across all domains. For example, patient information fields achieved 100% completion in 50 cases, and clinical parameters saw significant improvement, with current Hb and PLT levels documented in 48 cases (96%). The mean percentage completion increased from 68.1% in the second cycle to 97.9% in the third cycle, demonstrating the effectiveness of the interventions and training sessions. Minor decreases were observed in health insurance documentation and certain clinical details, indicating areas for further improvement. The systematic implementation and iterative evaluation of transfusion request forms significantly enhanced documentation completeness.

Decrease of haemoconcentration reliably detects hydrostatic pulmonary oedema in dyspnoeic patients in the emergency department – a machine learning approach

BackgroundHaemoglobin variation (ΔHb) induced by fluid transfer through the intestitium has been proposed as a useful tool for detecting hydrostatic pulmonary oedema (HPO). However, its use in the emergency department (ED) setting still needs to be determined.MethodsIn this observational retrospective monocentric study, ED patients admitted for acute dyspnoea were enrolled. Hb values were recorded both at ED presentation (T0) and after 4 to 8 h (T1). ΔHb between T1 and T0 (ΔHbT1-T0) was calculated as absolute and relative value. Two investigators, unaware of Hb values, defined the cause of dyspnoea as HPO and non-HPO. ΔHbT1-T0 ability to detect HPO was evaluated. A machine learning approach was used to develop a predictive tool for HPO, by considering the ability of ΔHb as covariate, together with baseline patient characteristics.ResultsSeven-hundred-and-six dyspnoeic patients (203 HPO and 503 non-HPO) were enrolled over 19 months. Hb levels were significantly different between HPO and non-HPO patients both at T0 and T1 (p < 0.001). ΔHbT1-T0 were more pronounced in HPO than non-HPO patients, both as relative (-8.2 [-11.2 to -5.6] vs. 0.6 [-2.1 to 3.3] %) and absolute (-1.0 [-1.4 to -0.8] vs. 0.1 [-0.3 to 0.4] g/dL) values (p < 0.001). A relative ΔHbT1-T0 of -5% detected HPO with an area under the receiver operating characteristic curve (AUROC) of 0.901 [0.896–0.906]. Among the considered models, Gradient Boosting Machine showed excellent predictive ability in identifying HPO patients and was used to create a web-based application. ΔHbT1-T0 was confirmed as the most important covariate for HPO prediction.ConclusionsΔHbT1-T0 in patients admitted for acute dyspnoea reliably identifies HPO in the ED setting. The machine learning predictive tool may represent a performing and clinically handy tool for confirming HPO.

Comparison of the efficacy and adverse effects of oral ferrous succinate tablets and intravenous iron sucrose: a retrospective study

ObjectiveTo analyse the clinical efficacy and adverse drug reactions (ADRs) of iron preparations.MethodsA total of 374 patients with iron deficiency anaemia admitted to our hospital between 1 January and 31 December 2020 were included in this study. They were divided into 2 groups based on their medication regimens: Group A (n = 187) took oral ferrous succinate tablets, and Group B (n = 187) received intravenous iron sucrose. The remission of major symptoms, laboratory test results, ADRs and other related data were collected after 4 weeks of treatment.ResultsCompared with the pre-treatment baseline, haemoglobin (Hb), serum iron (SI), serum ferritin (SF) and the mean corpuscular volume (MCV) increased in both groups at 4 weeks of treatment (P < 0.05). After treatment, Group A had lower levels of Hb (108.41 ± 8.39 vs. 122.31 ± 6.04 g/L, t = 6.293, P < 0.001), SI (9.72 ± 4.24 vs. 15.62 ± 5.41 µmol/L, t = 5.482, P < 0.001) and SF (27.1 ± 10.82 vs. 39.82 ± 10.44 ug/L, t = 6.793, P < 0.001) compared with Group B. In contrast, there was no significant difference in the post‐treatment level of MCV (P > 0.05). The overall response rate significantly differed between the 2 groups (78.61% vs. 90.91%, χ2 = 10.949, P < 0.001). The incidence of ADRs of both groups were similar, and the difference was not statistically significant (χ2 = 0.035, P = 0.851).ConclusionIron sucrose demonstrates favourable efficacy and safety in treating iron deficiency anaemia.