Increase In Hemoglobin Levels Research Articles

EFFICACY AND SAFETY OF NICORANDIL FOR PERIPROCEDURAL MYOCARDIAL INJURY IN PATIENTS UNDERGOING PCI

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality globally, with percutaneous coronary intervention (PCI) being a typical therapeutic approach. Objectives: In this comparative study, we aimed to investigate the efficacy and safety of nicorandil for periprocedural myocardial injury in patients undergoing PCI. Methods: This comparative study was conducted at Ayub Teaching Hospital from September 2023 to December 2023. Data from 90 patients was recruited for the research using inclusion and exclusion screening standards. Our study was performed on 90 patients treated with percutaneous coronary intervention (PCI). Patients from Group 1 were different from those in Group 2. Group A: the critical study parameters will switch between those patients who received nicorandil and Group B: non-nicorandil patients. Baseline demographic data, past medical history, and relevant laboratory values and clinical characteristics were documented for all patients. In addition, an intraoperative laboratory investigation was conducted, including cardiac biomarkers. Results: Research data were drawn from 90 patients whose gender wasn't a factor based on the research protocol. In Group A, the mean age of the patients was 62 years. Players in group A played for 4 ± 8.5 years. In team B, the players had a slightly longer experience and played for 63. Humans on Earth could do the same, and it could significantly impact future generations: ± 7. 9 years. Of 58 men and 32 women in the control group, there were two persons and persons in the experimental group, respectively. Only one stent differed between the two groups; however, the number was similar. 8 ± 0. 6 mmol/l in the tricorandil group and 1. +9 ± 0 in Case 1. Patients in the Nicorandil group displayed the lowest level of heart problem-causing protein (troponin) at the peak (5. There is a statistically significant 1.8-fold (2 ng/mL versus seven ng/mL) decline in serum lysozyme levels in the group administered rhG-CSF. The treatment group exhibited a substantial increase in haemoglobin levels (t(12) = 3. 74, p-value <0.005) with a mean difference of 0. 5 ± 2 ng/mL. 001, 95% CI: 2. 1 to 3. 5). Conclusion: It is concluded that nicorandil shows positive results for the efficacy (the ability of a drug to bring the desired effect) and safety of the drug in reducing myocardial injury and in maintaining the function of myocardial during percutaneous coronary intervention in patients.

The Effect of Bangun-Bangun Leaf Juice on Hemoglobin Levels for Postpartum Mother in The Working Area of Puskesmas Talun Kenas

During the puerperium, anemia can occurs in mothers who had lower than nor-mal hemoblobin levels. This condition could caused iron loss, onterfere with the lactatio process, anda cause the uterus to fail to contract because not enough blood enters oxygen to the uterus. The strongest factor causing post partum ane-mia was blood loss during delivery, both moderate and large. Events that cause the mother to lose moderate to large amounts of blood, nameli interventions dur-ing labor such as episiotomy, delivery using a vacuum; third or fourth degree perineal laceration; and caesarean section. The provision of non-drug therapy that can be given to increase hemoglobin levels was to provide iron containing nutrients. The research aim to determine the effect of bangun-bangun leaf  juice on hemoglobin levels for postpartum mother in the Working area of Puskesmas Talun Kenas. This research was a type of quantitative research that is quasi-experiment. The population of this study is all postpartummothers in the work area of Puskesmas Talun Kenas. The samples obtained were 25 people with accidental sampling technique. The statistical test used was the paired sample t test, with a 95% confidence level (? = 0,05). The results of this study indicate that there is an effect of bangun-bangun leaf juice on hemoglobin levels in postpartum mothersin the working area of Puskesmas Talun Kenas (p vaue 0,000). So it was expected that the health center could informed the mother about the benefits of bangun-bangun leaf juice in increasing maternal hemoglobin levels during the postpartum period which can informed during antenatal care visits or during home visits for postpartum mother.

Comparison Of The Effectiveness Of Moringa And Spinach Leaf Capsules In Increasing Hemoglobin Levels Among Anemic Pregnant Women In The Third

Background Data from the Bandar Lampung City Health Office in 2022 shows the proportion of anemia in pregnant women is 37.25%, namely pregnant women with Hemoglobin levels < 8 gr%/dl is 2.41%, Hb is 8-11gr%/dl is 36.3%. Anemia occurs in pregnant women due to insufficient production of red blood cells by the consumption of nutrients, especially iron. Iron can be obtained by consuming Moringa leaves. Another vegetable that is believed to contain a lot of iron is spinach, especially green spinach. The Purpose of the study was to find out the comparison of the effectiveness of moringa and spinach leaf capsules in increasing Hb levels in third trimester pregnant women with anemia in the Working Area of the Panjang Community Health Center, Bandar Lampung City, in 2023.Methods This study uses a type of quantitative research, with a quasi-experimental design. The population in this study were all pregnant women with their third trimester of gestation who made ANC visits at the Panjang Community Health Center in Bandar Lampung City and experienced anemia with a total of 47 people. A sample of 36 respondents. The data collection technique uses a questionnaire sheet and the data analysis used is the independent t-test.The results showed that the average hemoglobin level in third trimester pregnant women before consuming moringa leaf capsules was 10.46 gr/dl, and in the spinach leaf group was 10.37 gr/dl. The average hemoglobin level in third trimester pregnant women after consuming moringa leaf capsules was 11.87 gr/dl, and in the spinach leaf group was 11.24 gr/dl. Conclusion There is a difference in the effectiveness of moringa and spinach leaf capsules in increasing Hb levels in TM III pregnant women with anemia in the Working Area of the Panjang Community Health Center, Bandar Lampung City, 2023 (p value 0.000). Suggestion It is hoped that health workers can optimize counseling regarding the consumption of moringa leaf capsules to increase hemoglobin levels in third trimester pregnant women with anemia. Keywords: Moringa leaf capsules, spinach leaves, Hb levels

Hemoglobin scavenger receptor CD163 as a potential biomarker of hemolysis induced hepatobiliary injury in sickle cell disease.

Sickle cell disease (SCD) associated chronic hemolysis promotes oxidative stress, inflammation and thrombosis leading to organ damage, including liver damage. Hemoglobin scavenger receptor CD163 plays a protective role in SCD by scavenging both hemoglobin-haptoglobin complexes and cell free hemoglobin. A limited number of studies in the past have shown a positive correlation of CD163 expression with poor disease outcomes in patients with SCD. However, the role and regulation of CD163 in SCD related hepatobiliary injury has not been fully elucidated yet. Here, we show that chronic liver injury in SCD patients is associated with elevated levels of hepatic membrane bound CD163. Hemolysis and increase in hepatic heme, hemoglobin and iron levels elevate CD163 expression in the SCD mouse liver. Mechanistically we show that HO-1 positively regulates membrane bound CD163 expression independent of NRF2 signaling in SCD liver. We further demonstrate that of the interaction between CD163 and HO-1 is not dependent on CD163-hemoglobin binding. These findings indicate that CD163 is a potential biomarker of SCD associated hepatobiliary injury. Understanding the role of HO-1 in membrane bound CD163 regulation may help identify novel therapeutic targets for hemolysis induced chronic liver injury.

The effect of providing multiple micronutrient supplements and education on increasing hemoglobin levels in adolescent girls

Anemia is a serious global health problem. In Indonesia, anemia is a nutritional problem that must be addressed immediately because its prevalence is quite high. Based on gender, the incidence of anemia in men is 20.3%, and in women, it is 27.2%, so it can be seen from these data that the incidence of anemia is higher in women. The study aimed to assess the effect of providing MMS (Multi Micronutrient Supplement) and video education on increasing Hb (Hemoglobin) levels in adolescent girls. The research was conducted at MA Muhammadiyah Bontorita and MA Babussalam Takalar Regency. With a Quasi-Experimental research design. A total of 70 samples of young women consisted of 35 samples from the intervention group giving MMS and video education and 35 samples from the control group giving MMS without education. Bivariate analysis namely the Wilcoxon test, Man-Whitney test, paired t-test, and independent test. The results analysis of knowledge variables in the intervention group exhibited a significant improvement in knowledge (p=0.000), contrasting with the control group (p=0.060), where the change was not significant. Regarding Hb levels, the intervention group displayed a significant increase (p=0.043), and similarly, the control group also showed a notable rise (p=0.000). However, the increase in Hb levels was more pronounced in the intervention group There were differences in changes in knowledge and changes in hemoglobin levels in female adolescents, where changes in the intervention group were greater than those in the control group.

Combination of a TGF-β ligand trap (RAP-GRL) and TMPRSS6-ASO is superior for correcting β-thalassemia.

A recently approved drug that induces erythroid cell maturation (luspatercept) has been shown to improve anemia and reduce the need for blood transfusion in non-transfusion-dependent as well as transfusion-dependent β-thalassemia (BT) patients. Although these results were predominantly positive, not all the patients showed the expected increase in hemoglobin (Hb) levels or transfusion burden reduction. Additional studies indicated that administration of luspatercept in transfusion-dependent BT was associated with increased erythropoietic markers, decreased hepcidin levels, and increased liver iron content. Altogether, these studies suggest that luspatercept may necessitate additional drugs for improved erythroid and iron management. As luspatercept does not appear to directly affect iron metabolism, we hypothesized that TMPRSS6-ASO could improve iron parameters and iron overload when co-administered with luspatercept. We used an agent analogous to murine luspatercept (RAP-GRL) and another novel therapeutic, IONIS TMPRSS6-LRx (TMPRSS6-ASO), a hepcidin inducer, to treat non-transfusion-dependent BT-intermedia mice. Our study shows that RAP-GRL alone improved red blood cell (RBC) production, with no or limited effect on splenomegaly and iron parameters. In contrast, TMPRSS6-ASO improved RBC measurements, ameliorated splenomegaly, and improved iron overload most effectively. Our results provide pre-clinical support for combining TMPRSS6-ASO and luspatercept in treating BT, as these drugs together show potential for simultaneously improving both erythroid and iron parameters in BT patients.

EDUKASI GIZI DAN MINUMAN KACANG HIJAU SEBAGAI PREVENTIF ANEMIA DALAM KEHAMILAN

In developing countries, the most common pregnancy complication in pregnant women is anemia. The prevalence of anemia in pregnancy in Indonesia is still quite high, including in the East Java region. The problem of pregnant women at the Polindes Kaliwining in the Puskesmas Rambipuji Jember is that anemia status is not detected in each trimester of pregnancy. Mung beans contain iron which helps the formation of erythrocytes to increase hemoglobin levels. This community service aims to provide nutritional education and the use of mung beans in preventing anemia in pregnancy. The implementation of this service uses an outreach method using a video media approach. Apart from that, blood hemoglobin levels are also checked in pregnant women as an early detection of anemia. Iron supplementation is given in the form of blood supplement tablets to pregnant women. Furthermore, giving mung beans drinks as a complement to iron supplementation to prevent anemia in pregnancy. The educational approach via video has proven effective in increasing pregnant women's knowledge by 25% regarding anemia and the benefits of mung beans. Based on the results of examinations during this service activity, blood hemoglobin levels showed that 2 respondents experienced anemia in the third trimester of pregnancy. Regular Hb checks are very important during pregnancy. The combination of consuming blood supplement tablets and mung beans can reduce the incidence of anemia in pregnancy.

Concentration of voxelotor in sickle cell disease can be estimated using electrophoresis and high-performance liquid chromatography.

Voxelotor can increase hemoglobin levels in patients living with sickle cell disease (SCD). A clinician who is monitoring voxelotor response may want to know whole-blood voxelotor concentration, but this cannot be measured in most clinical settings. However, voxelotor has been demonstrated to cause "peak splitting" in common methods of hemoglobin measurement such as capillary zone electrophoresis (CZE) and high-performance liquid chromatography (HPLC). We hypothesized that we could use the size of the peak split to estimate the whole-blood concentration. Blood from people with SCD was dosed with known concentrations of voxelotor, and multiparameter regression was used to derive the relationship of voxelotor concentration to the degree of peak splitting observed. To validate these equations, 21 patients started on voxelotor at 1500mg/d had blood samples drawn at days 0, 14, 30, and 60. Samples were sent out for gold standard voxelotor concentration testing. The derived equations were then used to calculate voxelotor concentration. Calculated concentrations correlated strongly with measured concentrations for both CZE (R2 = 0.83, P < .001) and HPLC (R2 = 0.76, P < .001). Voxelotor concentration also had a significant effect on increases in hemoglobin (R2 = 0.40, P < .001). Thus, peak splitting CZE and HPLC can be used to estimate voxelotor concentration.

Daprodustat: A Hypoxia-Inducible Factor-Prolyl Hydroxylase Inhibitor for Anemia of Chronic Kidney Disease.

The objective was to review the safety and efficacy of daprodustat, a hypoxia-inducible factor-prolyl hydroxylase inhibitor (HIF-PHI) in the treatment of anemia of chronic kidney disease (CKD). A literature search was conducted in MEDLINE, EMBASE, and ClinicalTrials.gov using the keywords "daprodustat," "GSK1278863," and "hypoxia-inducible factor-prolyl hydroxylase inhibitors" from January 2010 through November 2023. Literature was included if it evaluated pharmacology, pharmacokinetics, efficacy, and/or safety of daprodustat in human subjects and was reported in English. The manufacturer's product monograph was also utilized. Daprodustat significantly increased hemoglobin levels in CKD patients on dialysis (difference 0.18 g/dL) and not on dialysis (difference 0.08 g/dL) over 52-week treatment periods compared with erythropoiesis stimulating agents (ESA) in Anemia Studies in CKD: Erythropoiesis via a Novel PHI Daprodustat (ASCEND)-D and ASCEND-ND, respectively. First occurrence of major adverse cardiovascular events (MACEs) was similar between daprodustat and ESAs in both trials. Daprodustat can be used in patients with CKD on dialysis and already receiving an ESA for at least 6 weeks to further increase serum hemoglobin levels without increasing the risk of MACE. Adverse effects of daprodustat that may occur more than ESAs include headache, emesis, and thrombosis. Daprodustat is a novel oral, non-iron therapy for treatment of anemia of CKD. It was Food and Drug Administration approved in 2023 in patients already receiving dialysis for at least 4 months but not in non-dialysis patients. Long-term data for safety and additional benefits are pending.

Pathogenesis and therapy of anemia in patients with inflammatory bowel diseases

Background. Anemia represents one of the most frequent complications in inflammatory bowel disease and severely impairs the quality of life of affected patients. The etiology of anemia in inflammatory bowel disease patients can be multifactorial, often involving a combination of iron deficiency anemia and anemia of chronic disease. The choice of therapy, focused on the leading cause of anemia, allows for individualized therapy, minimizing the risk of side effects and the cost of therapy.Aim. A comparative analysis of blood parameters before and after treatment was performed.Materials and methods. For 5 years, 47 patients (15 women, 32 men) with inflammatory bowel disease with a median age of 48 years (from 28 to 65 years) were studied. Two groups were formed: patients with iron deficiency anemia and patients with anemia of chronic disease. Patients with combination of iron deficiency anemia and anemia of chronic disease D (n = 21) were not included. A division was also made according to the type of treatment performed.Results. In the iron deficiency anemia group, a statistically significant increase in hemoglobin level was revealed as a result of the use of intravenous iron. During therapy with oral iron and B vitamin therapy, as well as therapy aimed only at correcting gastrointestinal tract pathology, no reliable dynamics of the studied parameters was observed. In the anemia of chronic disease group, there were no significant changes in red blood cell parameters with any of the treatment options (p &gt;0.05).Conclusion. The effectiveness of various therapeutic approaches to correct anemia is controversial. Further follow-up and an increase in the sample size are needed, which will help individualize therapy and improve the patients’ quality of life.

The association between hemoglobin levels and renal function parameters during normothermic machine perfusion: A retrospective cohort study using porcine kidneys.

Ex vivo normothermic machine perfusion (NMP) is a promising tool for assessing an isolated kidney prior to transplantation. However, there is no consensus on the perfusate's optimal oxygen-carrying capacity to support renal function. To investigate the association of hemoglobin levels with renal function parameters, a retrospective analysis of isolated, normothermically, perfused porcine kidneys was performed. Between 2015 and 2021, a total of 228 kidneys underwent 4 h of NMP with perfusates that varied in hemoglobin levels. A generalized linear model was used to determine the association of hemoglobin levels with time-weighted means of renal function markers, such as fractional sodium excretion (FENa) and creatinine clearance (CrCl). Stratified by baseline hemoglobin level (<4.5, 4.5-6, or >6 mmol/L), these markers were modeled over time using a generalized linear mixed-effects model. All models were adjusted for potential confounders. Until a hemoglobin level of around 5 mmol/L was reached, increasing hemoglobin levels were associated with superior FENa and CrCl. Thereafter, this association plateaued. When hemoglobin levels were categorized, hemoglobin <4.5 mmol/L was associated with worse renal function. Hemoglobin levels were neither significantly associated with proteinuria during NMP nor with ATP levels at the end of NMP. Hemoglobin levels >6 mmol/L showed no additional benefits in renal function. In conclusion, we found an association between baseline hemoglobin levels and superior renal function parameters, but not injury, during NMP of porcine kidneys. Furthermore, we show that performing a retrospective cohort study of preclinical data is feasible and able to answer additional questions, reducing the potential use of laboratory animals.

A survey on perioperative red blood cell transfusion trigger strategies for pediatric patients in the Nordic countries.

Transfusion of red blood cells (RBC) to rapidly increase hemoglobin levels have been associated with increased risks and worse outcomes in critically ill children. The international TAXI consensus from 2018 (pediatric critical care transfusion and anemia expertise initiative) recommended restrictive RBC transfusion strategies in pediatric patients. To elucidate physicians perioperative RBC transfusion trigger strategies for pediatric patients in the Nordic countries and to investigate what factors influence the decision to transfuse this group of patients. An electronic web-based survey designed by the TransfUsion triggers in Pediatric perioperAtive Care (TUPAC) initiative including six different clinical scenarios was sent to anesthesiologist treating pediatric patients at university hospitals in the Nordic countries on February 1, 2023 and closed May 1, 2023. The study had a response rate of 67.7% (180 responders out of 266 contacted). Median hemoglobin thresholds triggering RBC transfusions were 7.0 [IQR, 7.0-7.3] g/dL in a stable young child (1-year-old), 7.0 [IQR, 7.0-7.0] g/dL in the stable older child (5-year-old), 8.5 [IQR, 8.0-9.0] g/dL in the older child with cardiac disease, 9.0 [IQR, 8.0-10.0] g/dL the older child with traumatic brain injury, 8.0 [IQR, 7.3-9.0] g/dL in stabilized older child with septic shock and 8.0 [IQR, 7.0-9.0] g/dL in the older child with active but non-life-threatening bleeding. Apart from specific hemoglobin level, RBC transfusions were mostly triggered by high lactate level (74.2%), increasing heart rate (68.0%), prolonged capillary refill time (48.3%), and lowered blood pressure (47.8%). No statistical difference was found between the Nordic countries, work experience, or enrollment in a pediatric anesthesia fellowship program regarding RBC transfusion strategies. Anesthesiologists in the Nordic countries report restrictive perioperative RBC transfusion strategies for children that are mostly in agreement with the international TAXI recommendations. However, RBC transfusions strategies were modified to be guided by more liberal trigger levels when pediatric patients presented with severe comorbidity such as severe sepsis, septic shock, and non-life-threatening bleeding.

The Efficacy of Mung Bean Drink with Inulin and Iron Tablets in the Erythropoiesis Response of Adolescent Girls with Iron Deficiency Anemia: A Randomized Controlled Trial

This study aims to determine the effectiveness of mung bean drink with inulin and iron tablets on the erythropoiesis response as characterized by changes in reticulocyte count of adolescent girls with iron deficiency anemia. This is a non-blinding, randomized controlled trial with pre-test-post-test with control groups research design which was conducted in Sleman Regency, Yogyakarta, Indonesia. Sixty-one adolescent girls with iron deficiency anemia were recruited from junior and senior high schools and then randomized into two groups. The treatment group (n=30) received iron tablets and a mung bean drink with inulin, whereas the control group (n=31) received iron tablets and a palm sugar drink. The intervention was carried out for 12 weeks. Data collection involved interviews, monitoring adherence to drinking, and blood tests. Data were analyzed using Chi-Square Tests, paired T-Tests, and Mann-Whitney Tests. The results showed that there was a significant increase in reticulocyte count after two weeks of intervention in the treatment group (p-value 0.0001) and the control group (p-value 0.001). After four and 12 weeks of intervention, reticulocyte counts of both groups decreased along with increasing hemoglobin levels. In conclusion, the mung bean drink with inulin and iron tablets is effective in the erythropoiesis response.

Abstract 2221: Reducing cancer disparity among indigenous people by locally prepared Whey protein isolates having selective cytoprotective ability against chemotherapy induced bone marrow stem cell toxicity

Abstract Background: Cancer disparity is a major problem for the indigenous people living in the rural area of Kamrup district of Assam, a remote north eastern state of India. Often, rural people are prescribed with expensive dietary supplements during chemotherapy by urban for profit medical centers, increasing disparity, as per a study conducted by KaviKrishna Telemedicine Care (KTC) (1). We seek to reduce cancer disparity by using locally available diet/nutrition of Sualkuchi-Hajo cultural complex, including the whey protein prepared by indigenous healers practicing Vedic Jiva Upakara Cikitsha Tantra (Vejiupacita) (2,3). However, the efficacy of the indigenous Vejiupacita Whey protein is not clearly known. Here we have performed pre-clinical and clinical studies to evaluate the therapeutic efficacy of Vejiupacita Chena Pani (VCP) whey protein in reducing cancer chemotherapy induced bone marrow stem cell niche toxicity. Methods: Using a previously described pre-clinical model of cisplatin and busalphan induced BM stem cell niche toxicities (4), the cytoprotective activity of VCP Whey protein was evaluated. Commercially available whey proteins Ensure plus, and Immunocal were used for comparisons. Next, the indigenous cancer patients (n=55) of KaviKrishna Telemedicine Care taking the whey protein (20 gm twice daily for three months of chemo and or radiation) were monitored for hemoglobin, total blood count as well as Glasgow prognostic score (ratio of serum albumin and CRP) and ECOG performance score. Third, using a Vejiupacita based Sahasa-ojash scale of well being (3) patient's quality of life was evaluated. Results: In the pre-clinical model of cisplatin-induced BM toxicity in black 6 mice (n=10 in each group), the VCP whey protein exerted cytoprotection of BM stem cells similar to Immunocal but 2-fold higher protection compared to Ensure plus. Serum glutathione and squalene level was significantly increased only in the VCP whey protein group. The hypoxic niche of CD271+ MSCs showed enhanced stem cell niche protection. Notably, VCP and Immunocal whey protein treatment increased the hypoxic BM stem cell niche defense against cisplatin-induced toxicity. Next, 34/55 patients taking the VCP whey protein (20 gm/twice daily for three months) showed increased hemoglobin level, increased total blood count, and increased weight gain. The Sahasa-ojash scale showed significant improvement in quality of life compared to the period when they did not take whey proteins in a manner similar to Glasgow prognostic score, and ECOG performance score. Conclusion: The Vejiupcita based whey protein concentrate therapy exerts cytoprotection against chemotherapy induced toxicity.

The Potency of Typical Plants of Central Sulawesi Province to Prevent Iron Deficiency Anemia: Experimental Study

Background: Central Sulawesi falls within the Wallacea region, making it home to various endemic flora and fauna. One distinctive plant in Central Sulawesi is the Moringa tree. The Moringa tree, especially its leaves, was often used as a culinary ingredient known as sayurkelor in the traditional cuisine of the Kaili ethnic group in Central Sulawesi Province. Objective: This research aimed to determine the effectiveness of moringa leaf extract in increasing hemoglobin levels and erythrocyte count. Method: Twenty-four male Wistar rats strain (Rattusnorvegicus) 9−10 weeks old and 200−250 grams were divided into four groups (n=6), normal as a no treatment, negative control, ethanol extract, and positive control during the 15thday. Blood samples on the 15thday were administered to determine blood count. Result: The resultsof this study showed differences in hemoglobin and erythrocyte levels in the four experimental groups.The significant difference in average hemoglobin levels between Group 2 and Group 3 with a P-value &lt;0.05 (P value 0.00). The difference between Group 2 and Group 4 is significant with a P-value &lt;0.05 (P value 0.00), and the difference between Group 3 and Group 4 is significant with a P-value &lt;0.05 (P value 0.03). the significant difference in the average erythrocyte counts between Group 2 and Group 3 with a P-value &lt;0.05 (P value 0.00). The difference between Group 2 and Group 4 is not significant with a P-value &gt;0.05 (P value 0.07). The difference between Group 3 and Group 4 has a P-value &gt;0.05 (P value 0.63). Conclusion: The research results indicate that pregnant Wistar rats experienced hemodilution characterized by a decrease in hemoglobin and erythrocyte levels during pregnancy. However, after being given ethanol extract from moringa leaves, there was an increase in hemoglobin and erythrocyte levels. Keywords: Extract; ethanol; moringa; oleifera; hemoglobin

[Construction and validation of an in-hospital mortality risk prediction model for patients receiving VA-ECMO: a retrospective multi-center case-control study].

To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO). We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January, 2015 and January, 2022 using a convenience sampling method. The patients were divided into a derivation cohort (201 cases) and a validation cohort (101 cases). Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients, based on which a risk prediction model was established in the form of a nomogram. The receiver operator characteristic (ROC) curve, calibration curve and clinical decision curve were used to evaluate the discrimination ability, calibration and clinical validity of this model. The in-hospital mortality risk prediction model was established based the risk factors including hypertension (OR=3.694, 95% CI: 1.582-8.621), continuous renal replacement therapy (OR=9.661, 95%CI: 4.103-22.745), elevated Na2 + level (OR=1.048, 95% CI: 1.003-1.095) and increased hemoglobin level (OR=0.987, 95% CI: 0.977-0.998). In the derivation cohort, the area under the ROC curve (AUC) of this model was 0.829 (95% CI: 0.770-0.889), greater than those of the 4 single factors (all AUC < 0.800), APACHE II Score (AUC=0.777, 95% CI: 0.714-0.840) and the SOFA Score (AUC=0.721, 95% CI: 0.647-0.796). The results of internal validation showed that the AUC of the model was 0.774 (95% CI: 0.679-0.869), and the goodness of fit test showed a good fitting of this model (χ2=4.629, P>0.05). The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation, calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system, and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

Oral Iptacopan Monotherapy in Paroxysmal Nocturnal Hemoglobinuria

BackgroundPersistent hemolytic anemia and a lack of oral treatments are challenges for patients with paroxysmal nocturnal hemoglobinuria who have received anti-C5 therapy or have not received complement inhibitors. Iptacopan, a first-in-class oral factor B inhibitor, has been shown to improve hemoglobin levels in these patients.MethodsIn two phase 3 trials, we assessed iptacopan monotherapy over a 24-week period in patients with hemoglobin levels of less than 10 g per deciliter. In the first, anti-C5–treated patients were randomly assigned to switch to iptacopan or to continue anti-C5 therapy. In the second, single-group trial, patients who had not received complement inhibitors and who had lactate dehydrogenase (LDH) levels more than 1.5 times the upper limit of the normal range received iptacopan. The two primary end points in the first trial were an increase in the hemoglobin level of at least 2 g per deciliter from baseline and a hemoglobin level of at least 12 g per deciliter, each without red-cell transfusion; the primary end point for the second trial was an increase in hemoglobin level of at least 2 g per deciliter from baseline without red-cell transfusion.ResultsIn the first trial, 51 of the 60 patients who received iptacopan had an increase in the hemoglobin level of at least 2 g per deciliter from baseline, and 42 had a hemoglobin level of at least 12 g per deciliter, each without transfusion; none of the 35 anti-C5–treated patients attained the end-point levels. In the second trial, 31 of 33 patients had an increase in the hemoglobin level of at least 2 g per deciliter from baseline without red-cell transfusion. In the first trial, 59 of the 62 patients who received iptacopan and 14 of the 35 anti-C5–treated patients did not require or receive transfusion; in the second trial, no patients required or received transfusion. Treatment with iptacopan increased hemoglobin levels, reduced fatigue, reduced reticulocyte and bilirubin levels, and resulted in mean LDH levels that were less than 1.5 times the upper limit of the normal range. Headache was the most frequent adverse event with iptacopan.ConclusionsIptacopan treatment improved hematologic and clinical outcomes in anti-C5–treated patients with persistent anemia — in whom iptacopan showed superiority to anti-C5 therapy — and in patients who had not received complement inhibitors. (Funded by Novartis; APPLY-PNH ClinicalTrials.gov number, NCT04558918; APPOINT-PNH ClinicalTrials.gov number, NCT04820530.)

Efficacy of Giving Iron Tablets on the Incidence of Anemia in Senior High School Students in Klaten, Indonesia

Introduction: Iron deficiency anemia (IDA) is a common public health problem in adolescent girls. In Indonesia, the prevalence of IDA in adolescent girls reaches 37%. Iron tablets are an effective intervention to prevent and treat IDA.&#x0D; Methods: This research was a randomized controlled trial conducted on female senior high school students in Klaten, Indonesia. A total of 200 female students who met the criteria for anemia (hemoglobin levels &lt; 12 g/dL) were randomized to receive iron tablets or placebo for 12 weeks.&#x0D; Results: At the end of the study, hemoglobin levels in the iron tablet group were significantly higher than those in the placebo group (mean difference 1.2 g/dL, 95% CI 0.8-1.6 g/dL). The prevalence of anemia in the iron tablet group was also significantly lower compared to the placebo group (20% vs 40%, p = 0.02).&#x0D; Conclusion: Giving iron tablets is effective in increasing hemoglobin levels and reducing the incidence of anemia in female senior high school students in Klaten, Indonesia.

Prevalence And Factors Associated with Anemia Among Adolescent in Jambi City Indonesia

The prevalence of anemia in developing countries varies between 20-70% of which about 30% affects adolescent and women of childbearing age. Supplementation of iron tablets at school, however the program is not always successful in increasing hemoglobin levels. The aim of this study was to determine the prevalence and factors associated with anemia in adolescent in Jambi, Indonesia. This study had a descriptive analytic design with a cross sectional approach. The respondents had received 52 iron tablets, according to the National Program. After 52 tablet, anemia was measured using finger prick test. Factors associated with anemia were explored, including physical activity, menstrual patterns, adherence to iron tablet consumption, teacher support, side effects, knowledge, consumption of protein sources of iron, consumption of enhancers and consumption of inhibitors using validated questionnaire, including The physical activity instrument used the Questionnaire of Baecke and the measurement of adherence to consuming iron tablets used the Morisky Medication Adherence Scale (MMAS) and Food Frequency Questionnaire (FFQ). Data was analysed using x2-test. In total, 260 students were included with the average age was 16-17 years SD±0.904) and the anemia was occurred in 78 (30 %) students. Only menstrual pattern was significantly associated with anemia (p 0.000, CI=2.825-8.798). There is a relationship between menstrual patterns with anemia in adolescents in Jambi, therefore, it is recommended to have regularly iron supplement during menstruation, as a consideration for iron supplement programs. Keywords: Iron Deficiency Anemia, Iron Supplementation, Menstruation, Medication Adherence

Enhancing Maternal Health: IT Solutions for Monitoring Anemia in Pregnancy

Background: Anemia is a condition in which a deficiencyof red blood cells (erythrocytes) in the blood cycle or mass of hemoglobin is so unable to fulfill its function as a carrier of oxygen in the entire tissue. Handling to increase hemoglobin levels by using pharmacological and non-pharmacological management, one of the non-pharmacological management is by giving vitamin C so that the process of absorption and formation of hemoglobin is faster such as consuming red guava juice every day 2 x 1 together with Fe. the study was to determine the effect of giving Fe tablets and red guava juice on increasing hemoglobin levels in third trimester pregnant women. This pre-post experimental research design uses a design pretest-posttest whit control group design. The sampel in this study 36 respondents consisting of 18 experimental respondents and 18 control respondents with purposive sampling technique. The research instrument used the measuremets tool HB Family Dr. Test Strip and observation for 2 weeks. Data were analyzed using paired t-test to determine changes before and after and independent T-Test to determine the difference between the experimental group and the control group. The results of the pre-post study in the experimental group were p values of 0,000(p &lt;0.05) and in the control group were 0.01(p &lt;0,05). The results of the pre-post study in the experimental and control group p value 0,000. There is an effect of giving red guava juice and Fe tablets to increase hemoglobin levels of pregnant women in the third trimester who have mild anemia. Therefore, it is hoped that PMB (Praktek Mandiri Midwives) can pay attention to the handling of anemia in pregnant women in Kedaung, Pamulang, Tangerang. South with outreach programs and supplementation such as giving red guava juice.