Iron Deficiency Anemia In Patients Research Articles

The frequency of vitamin B12 derangements in females presenting for workup of iron deficiency anemia

Objective: Iron deficiency anemia (IDA) is the most prevalent hematological disorder in women of child-bearing age. IDA poses a threat to feto-maternal wellbeing. It is the leading cause of morbidity and mortality in pregnancy. IDA in young females can coexist with other nutritional deficiencies such as vitamin B12 (Vit B12). An undetected Vit B12 deficiency carries a greater likelihood of development of maternal neuropsychiatric disorders and neural tube defects in the fetus. Materials and methods: Venous blood samples of non-pregnant female population (N=133) from Fauji Foundation Hospital, Rawalpindi were collected and analyzed for complete blood count (CBC), Vit B12 and serum Ferritin. Population was further subdivided into two groups. Group A, included females with low serum Ferritin and low MCV, group B restricted to normal serum Ferritin and low MCV, whereas control group had females with normal serum Ferritin and MCV levels. Results: Demographic data suggested that only height was slightly lower in IDA patients other than reduced serum Ferritin levels. Group A also showed reduced levels of Vit B12 as compared to group B and control group. CBC analysis indicated marked reduction in all hematological parameters except platelet count in group A. Conclusion: Our findings suggest that IDA and Vit B12 deficiency may coexist in young females. Monitoring Vit B12 along with iron deficiency parameters is essential to treat anemia and prevent gynecological complications. Paucity of information on their coexistence in females of childbearing age require further investigation. Keywords: Vitamin B12, Iron deficiency anemia, Microcytosis, Serum Ferritin.

Logistic-Nomogram model based on red blood cell parameters to differentiate thalassemia trait and iron deficiency anemia in southern region of Fujian Province, China.

Differentiation between thalassemia trait (TT) and iron deficiency anemia (IDA) is challenging and costly. This study aimed to construct and evaluate a model based on red blood cell (RBC) parameters to differentiate TT and IDA in the southern region of Fujian Province, China. RBC parameters of 364 TT patients and 316 IDA patients were reviewed. RBC parameter-based Logistic-Nomogram model to differentiate between TT and IDA was constructed by multivariate logistic regression analysis plus nomogram, and then compared with 22 previously reported differential indices. The patients were randomly selected to a training cohort (nTT = 248, nIDA = 223) and a validation cohort (nTT = 116, nIDA = 93). In the training cohort, multivariate logistic regression analysis identified RBC count, mean corpuscular hemoglobin (MCH), and MCH concentration (MCHC) as independent parameters associated with TT susceptibility. A nomogram was plotted based on these parameters, and then the RBC parameter-based Logistic-Nomogram model g (μy ) = 1.92 × RBC count-0.51 × MCH + 0.14 × MCHC-39.2 was devised. The area under the curve (AUC) (95% CI) was 0.95 (0.93-0.97); sensitivity and specificity at the best cutoff score (120.24) were 0.93 and 0.89, respectively; the accuracy was 0.91. In the validation cohort, the RBC parameter-based Logistic-Nomogram model had AUC (95% CI) of 0.95 (0.91-0.98); sensitivity and specificity were 0.92 and 0.87, respectively; accuracy was 0.90. Moreover, compared with 22 reported differential indices, the RBC parameter-based Logistic-Nomogram model showed numerically higher AUC, net reclassification index, and integrated discrimination index (all p < 0.001). The RBC parameter-based Logistic-Nomogram model shows high performance in differentiating patients with TT and IDA from the southern region of Fujian Province.

Assessment of Serum Electrolytes and Glycated Hemoglobin Level in Non-diabetic Iron-Deficient Anaemic Patients.

The WHO has recognised iron deficiency anaemia (IDA) as the most common nutritional deficiency in the world, with 30% of the population being affected by this condition. The patient's glycemic status during the past three months is shown by the glycated haemoglobin A1C (HbA1c) test. According to several studies, iron deficiency can increase HbA1C levels without affecting blood sugar levels. HbA1C levels of≥6.5% have been approved by the American Diabetes Association (ADA) as a diagnostic indicator for diabetes mellitus (DM). An imbalance in serum electrolyte levels and anaemia havebeenlinked by several studies. Aim: To analyze the effect of iron deficiency anaemia on HbA1c levels and serum electrolytes in an adult non-diabetic population. This was a descriptive cross-sectional studyconducted in Shri BM Patil Medical College, Hospital and Research Centre, Vijayapura, Karnataka, India from January 2021 to June 2022. A total of 65 moderate to severe normoglycemic iron deficiency anemia patients between 18 to 75 years were enrolled in the studyafter fulfilling inclusion and exclusion criteria. A detailed history, clinical and biochemical examination was performed including HbA1c levels. The results were pooled and statistical analyses were performed using Statistical Package for Social Sciences (SPSS) version 20 (IBM Corp., Armonk, NY, USA). We found elevated HbA1c levels (5.67±1.1%) in non-diabetic iron-deficient anaemia individuals, and elevation was more in women of reproductive age group (30.8%). There was a statistically significant Spearman negative correlation between hemoglobin and HbA1C levels. Also, 16 patients had hyponatremia with a mean haemoglobin (Hb) of 4.8 g/dL and one patient had hyperkalemia with a mean Hb of 3.2 g/dL which was statistically non-significant. In this study haemoglobin and HbA1c had a statistically significant positive correlation with serum sodium and a negative correlation with serum potassium in moderate to severely iron-deficient anaemic patients, especially females of the reproductive age group.

Iron deficiency anemia is associated with increased medical and implant-related complications and length of stay for patients undergoing total shoulder arthroplasty.

Iron deficiency anemia (IDA) is associated with decreased bone mineral density and osteoporosis; however, studies investigating the effects of IDA in patients undergoing primary total shoulder arthroplasty (TSA) have not been well studied. The purpose of this study is to utilize a nationwide administrative claims database to investigate whether patients with diagnosed IDA undergoing primary TSA have higher rates of 1) in-hospital length of stay (LOS); 2) medical complications; and 3) implant-related complications. A retrospective review from 2005 to 2014 was conducted using the Medicare Standard Analytical Files. Patients with IDA undergoing primary TSA were identified and matched to controls without IDA, in a 1:5 ratio by age, sex, and medical comorbidities. Outcomes analyzed included in-hospital LOS and 90-day medical and implant-related complications. Mann-Whitney U tests compared in-hospital LOS, and multivariate logistic regression was used to calculate odds ratios (ORs) on the effects of IDA on postoperative complications after adjusting for age, sex, and Elixhauser Comorbidity Index. A total of 17,689 patients with IDA and 88,445 without IDA participated in the matched-cohort analysis, with no differences in age, gender, and comorbidities (P=.99). IDA patients were found to have significantly longer in-hospital LOS (3-days vs. 2-days, P<.0001). IDA patients were also found to have significantly higher odds of 90-day implant-related complications (OR: 1.65, P<.0001), such as periprosthetic joint infections (OR: 1.80, P<.0001) and 90-day medical complications (OR: 2.87, P<.0001), including blood transfusions (OR: 10.37, P<.0001). Patients with IDA undergoing primary TSA have significantly longer in-hospital LOS, and medical and implant-related complications. Patients were 10 times more likely to undergo a blood transfusion and 2 times more likely to have a periprosthetic fracture.

A randomized controlled trial of thrice-weekly versus thrice-daily oral ferrous fumarate treatment in adult patients with iron-deficiency anemia.

Iron deficiency anemia (IDA) is a common health problem in developing countries. Many studies have shown that low-dose oral iron could have similar efficacy and less gastrointestinal effects in iron deficiency without anemia. This prospective open-labeled randomized controlled study was designed to compare the response of 200 mg ferrous fumarate thrice-weekly (TIW) as not inferior to the thrice-daily (TID) regimen and to assess the incidence of adverse events (AEs) between two regimens in treating adult patients with IDA. The primary endpoint was either an increase in Hb ≥ 3 g/dL, having Hb of 12 g/dL in females or 13 g/dL in males at the 12th week of treatment. Secondary outcomes included adverse events (AEs), red blood cell indices, iron profiles, and patient compliance. Sixty-four patients were randomized: 32 in the TIW arm and the other 32 in the TID arm. The response rates were not different between two arms either with intention to treat analysis (72.0%, 95%CI 56.6-88.5 vs. 71.9%, 95%CI 53.3-86.3, p = 0.777); or per-protocol analysis (88.9%, 95%CI 70.8-97.6 vs. 88.5%, 95%CI 69.8-97.6, p = 1.0), respectively. The trial demonstrated non-inferiority at a margin of 23%. Although the iron profile response of the TID arm was earlier than the TIW arm, almost all patients recovered from anemic symptoms at week 4, and hematologic responses were not different at week 12. There were more gastrointestinal AEs in the TID arm. In conclusion, this study showed that the TIW was non-inferior to the TID iron treatment of IDA patients but less AEs and costs.

Serum and Salivary Vitamin B12 Levels among Iron Deficiency Anemia Patient with Recurrent Aphthous Stomatitis

Introduction: We aimed to evaluate serum and salivary vitamin B12 levels in patients with iron deficiency anemia (IDA) with and without recurring aphthous ulcers (RAS). Methods: Study participants were divided into three groups, clinically healthy control group (n = 25), an IDA patient with RAS (n = 25), and an IDA without RAS (n = 25). The enzyme-linked immunosorbent assay (ELISA) method was used to assess the serum and salivary B-12 levels blindly. Data analyses were performed using one-way ANOVA and the Tukey’s post hoc test using R software. Result: There were statistically significant differences regarding serum and salivary B12 levels among study groups (P&lt;0.001). All pairwise comparisons showed significant differences regarding serum (P&lt;0.001) and salivary (P ≤ 0.002) B12 levels. Conclusion: The Control group (396 ± 18.2 pg/mL) was within the normal serum level of vitamin B12 (200-900 pg/mL), while in IDA with RAS (111 ± 15.4 pg/mL) and IDA without RAS (145 ± 57.2 pg/mL) serum level of vitamin B12 is lower than the normal range and significantly lower than the control group.

Cerebral iron deficiency may induce depression through downregulation of the hippocampal glucocorticoid-glucocorticoid receptor signaling pathway

BackgroundIron is a trace essential element to sustain the normal neurological function of human. Many researches had reported the involvement of iron deficiency (ID) in neural development and cognitive functions. However, the role of ID in pathogenesis of depression and its underlying mechanism are still unclear. MethodsIn this study, we first used chronic unpredicted mild stress (CUMS) and iron deprivation mouse models to clarify the pathogenesis role of cerebral ID in depression. Then the role of hippocampal glucocorticoid (GC)-glucocorticoid receptor (GR) pathway in cerebral ID induced depression were elucidated in iron deprivation mice and iron deficiency anemia patients. ResultsOur results revealed that both CUMS and iron deprivation could induce cerebral ID in mice, and combination of iron deprivation and CUMS could accelerate the onset and aggravate the symptoms of depression in mice. In hippocampus, ID led to neuronal injury and neurogenesis decrease, which might be related to downregulation of GC-GR signaling pathway caused GR dysfunction, thereby inhibiting the negative feedback regulation function of hippocampus on hypothalamic-pituitary-adrenal (HPA) axis. Moreover, the overactivity of HPA axis in iron deprivation mice and iron deficiency anemia patients also confirmed GR dysfunction. LimitationsIron deprivation led to food and water intake decrease of mice, which may affect the behavioral test. In addition, we mainly evaluated the role of hippocampal ID in depression, and the number of iron deficiency anemia patients was limited. ConclusionsOur results identified that cerebral iron homeostasis was a key factor for maintaining mental stability.

Reticulocyte Hemoglobin as a Screening Test for Iron Deficiency Anemia: A New Cut-Off.

Latent iron deficiency (LID), in which iron stores in the body are depleted without incidental anemia, poses a key diagnostic challenge. Reticulocyte hemoglobin content (Ret-Hb) is directly correlated with the functionally available iron for heme synthesis in erythroblasts. Consequently, Ret-Hb has been proposed as an efficient iron status marker. To assess the importance of Ret-Hb in detecting latent iron deficiency as well as its use in screening for iron deficiency anemia. A study involving 108 individuals was conducted at Najran University Hospital, 64 of whom had iron deficiency anemia (IDA) and 44 of whom had normal hemoglobin levels. All patients were subjected to complete blood count (CBC), reticulocyte percentage, Ret-Hb, serum iron, total iron binding capacity (TIBC), and serum ferritin measurements. A significant decrease in Ret-Hb level was observed in IDA patients compared to non-anemic individuals, with a cut-off value of 21.2 pg (a value below which indicates IDA). The measurement of Ret-Hb, in addition to CBC parameters and indices, provides an accessible predictive marker for both iron deficiency (ID) and IDA. Lowering the Ret-Hb cut-off could better allow for its use as a screening parameter for IDA.

PREVALENCE OF THROMBOCYTOSIS IN ANEMIC PATIENTS OF AKHTAR SAEED TRUST HOSPITAL LAHORE, PAKISTAN

Introduction and objective: Anemia is the one of the most widespread disorder all across the world characterized by low haemoglobin levels in blood causing reduced oxygenation of red blood cells and consequently producing symptoms such as lethargy, malaise and shortness of breath according to its severity. Thrombocytosis is a condition in which the number of platelets is increased and it can be identified by same methods which we use for the diagnosis of anemia. In previous studies, it has been found that thrombocytosis is associated with mild, moderate and severe forms of anemia. The objective of the study is to assess the prevalence of throbocytosis in anemic patients of different ages. Methods: In this cross-sectional study, the patients with anemia who were less than 18 years old were included. Samples were collected from the outdoor and indoor patients of Akhter Saeed Trust Hospital Lahore, who were not treated with any therapy to cure anaemia. About 2-3 ml of venous blood was drawn and sent to laboratory for CBC. Data regarding the MCV, MCH, and platelet count was collected on structured performa. Results: From total 224 patients, 64.73% were males, and 35.27% were females. Statistically, the p-value showed a significant association between all age groups [first (p =0.001), second (p =0.001), third (p =0.001), and fourth (p =0.001)], and genders [males (p =0.001), and females (p =0.001)] with all (mild, moderate and severe) anemias. The prevalence of thrombocytosis in iron deficiency anemia patients was 23.57%. Conclusion: The present study concluded that the patients having anemia can also be affected with thrombocytosis.

Clinical Significance of Serum Iron in the Diagnosis of Iron Deficiency Anemia in Patients from Local Population of Punjab-Lahore

Background: The main cause of anemia in one-third of the world's population is a lack of iron (ID). Anemia affects between 700 and 800 million individuals globally. Methodology: Only the patients diagnosed with iron deficiency anemia was selected from Ali Fatima Hospital Lahore and Jinnah Hospital Lahore for determination of serum iron concentration in comparison with healthy controls. Results: In our study male patients were 67% and females were 33%. Frequency of children with beta thalassemia major under 5 year of age is 19%, 5-9 year is 24%, 9-15 years is 31% and above 15 years is 26% Practical implications: The current study aims to spread the awareness among community about clinical significance of serum iron in the diagnosis of iron deficiency anemia in patients and ways to control the iron deficiency. This investigation will assist in determining the severity of the condition in our community as well as the status of serum iron levels in individuals with iron deficiency anemia. The evaluation of serum iron levels in anemic individuals will be helpful to medical experts in determining the best course of treatment. Conclusion: We concluded that renal tubular damage and hepatocellular injury may be secondary to oxidative lipid peroxidation mediated by the iron overload. However further investigations are extremely necessary for this interpretation. A better evaluation of iron toxicity and regular monitoring of renal functions, liver functions, accompanied by an improvement in chelation therapy along with the administration of selective antioxidants (vitamins E and C), may protect different organs against oxidative stress and its consequences, specifically endocrine problems. Keywords: Anemia, Iron deficiency, Ferritin, Hemoglobin, Thalassemia, hepatocellular injury.

A Retrospective Study on the Prevalence of Iron Deficiency Anemia Frequency in Rural Areas of Disrict Faisalabad

Objective: To evaluate the prevalence of different anemic grades in patients to give better treatment and to improve quality of life of patients. Material and Methods: This retrospective study was conducted to analyze the immensity of Deficiency of Iron Anemia in DHQ Hospital Faisalabad, and the duration of this study was from February 2021 to January 2022 to evaluate the prevalence and different stages of anemic patients. Two hundred patients were included in this study who met all the criteria needed to this study. In this study we examined blood tests, CBC reports of all patients in the laboratory. Moreover, including detailed patient’s history, previous diseases, current diseases, anemia history in family, gynecological history of women were examined. Results: In all two hundred anemic patients, we found one hundred and seventy (85%) patients had deficiency of iron and 30 (15%) patients had inadequacy of non-iron (lack of other minerals) anemia. Most of the patients (58.8%) who had less volume of iron were aged of 21 to 32 Years. On basis of serum ferritin level (SFL), We observed the intensity of deficiency of iron and classify into modest, mildest and acute groups. We found 120 (70.6%) patients had modest IDA (iron deficiency anemia), 20 (11.8%) patients had acute and rest (17.6%) had mildest deficiency of iron anemia. In 160 IDA patient’s women were 95 (55.9%), 40 (23.5%) were men &gt; 19 years and 35 (20.6%) were growing children had an aged &lt; 14 years. Practical implication: This study was conducted to evaluate the frequency of IDA to maintain a better treatment and to reduce the death ratio and to improve quality of life of patients affected by anemia. Conclusion: In this study, we observed deficiency of iron is the most frequent cause in patients of anemia, especially in females. Keywords: blood, Anemia, oxygen, Deficiency of Iron, hemoglobin level,

Iron supplementation for iron-deficiency anaemia

Background: In recent years, iron supplementation has increased significantly because of the damaging systemic effects of iron deficiency anaemia (IDA) being reported. The standard first-line therapy is oral iron tablets, with over 70% of recipients experiencing gastrointestinal adverse effects. Methods: This recent review of high-quality literature compares the effectiveness and adverse effects of tablet and liquid forms of iron supplementation in patients with IDA. Findings: The evidence to date indicates that both forms of iron supplementation are equally effective. However, the literature consistently and strongly supports the use of the liquid form of iron supplementation (ferrous sulfate) over the tablet form (ferrous sulphate or ferrous fumarate) in terms of adverse effects. Conclusions: Healthcare professionals should consider recommending the use of liquid iron formulation for the management of IDA and switch patients to this form if they experience gastrointestinal adverse effects. This may help to effectively manage IDA.

Etiology of severe anemia in Kashmiri children aged 6 months to 6 years

Background: Anemia is said to be present when the hemoglobin level is more than two standard deviations below the mean for the child’s age and sex. Anemia is the most common global nutritional disorder and may lead to psychomotor retardation, low intelligence, decreased learning capability, weakening of immune system and predisposes to serious infections in children. Methods: The study was an observational study. Physical signs of severe anemia were looked in patients attending outpatient department or admitted in hospital. Children with hemoglobin levels &lt;7 gm/dl and in the age group 6 months to 6 years were recruited in study. Results: The study included 192 patients with a male, female ratio of around 1:1. The mean age of the study subjects was 2.2±1.6 years. Most of the patients around 54% belonged to age group of 6 months to 1½ years. Fever was most common presentation in 86 cases (44.77%), followed by diarrhea and easy fatigability in 38 (19.79%) and 21 (10.93%) patients respectively. A total of 76.56% of patients were having nutritional and 23.44% non-nutritional causes. Iron deficiency anemia is most common etiology 115 (59.90%) with 14 patients having celiac disease, 19 cases (9.90%) were diagnosed as megaloblastic anemia, 13 cases (6.77%) were diagnosed as dual deficiency anemia, 30 cases (15.63%) were diagnosed as hemolytic anemia. Conclusions: Nutritional anemia is major cause of anemia in children. Celiac disease, trichuriasis, cow milk protein allergy should be ruled out in iron deficiency anemia patients.

Ferric carboxymaltose infusion versus oral iron supplementation for preoperative iron deficiency anaemia in patients with colorectal cancer (FIT): a multicentre, open-label, randomised, controlled trial

A third of patients with colorectal cancer who are eligible for surgery in high-income countries have concomitant anaemia associated with adverse outcomes. We aimed to compare the efficacy of preoperative intravenous and oral iron supplementation in patients with colorectal cancer and iron deficiency anaemia. In the FIT multicentre, open-label, randomised, controlled trial, adult patients (aged 18 years or older) with M0 stage colorectal cancer scheduled for elective curative resection and iron deficiency anaemia (defined as haemoglobin level of less than 7·5 mmol/L (12 g/dL) for women and less than 8 mmol/L (13 g/dL) for men, and a transferrin saturation of less than 20%) were randomly assigned to either 1-2 g of ferric carboxymaltose intravenously or three tablets of 200 mg of oral ferrous fumarate daily. The primary endpoint was the proportion of patients with normalised haemoglobin levels before surgery (≥12 g/dL for women and ≥13 g/dL for men). An intention-to-treat analysis was done for the primary analysis. Safety was analysed in all patients who received treatment. The trial was registered at ClincalTrials.gov, NCT02243735, and has completed recruitment. Between Oct 31, 2014, and Feb 23, 2021, 202 patients were included and assigned to intravenous (n=96) or oral (n=106) iron treatment. Treatment began a median of 14 days (IQR 11-22) before surgery for intravenous iron and 19 days (IQR 13-27) for oral iron. Normalisation of haemoglobin at day of admission was reached in 14 (17%) of 84 patients treated intravenously and 15 (16%) of 97 patients treated orally (relative risk [RR] 1·08 [95% CI 0·55-2·10]; p=0·83), but the proportion of patients with normalised haemoglobin significantly increased for the intravenous treatment group at later timepoints (49 [60%] of 82 vs 18 [21%] of 88 at 30 days; RR 2·92 [95% CI 1·87-4·58]; p<0·0001). The most prevalent treatment-related adverse event was discoloured faeces (grade 1) after oral iron treatment (14 [13%] of 105), and no treatment-related serious adverse events or deaths were observed in either group. No differences in other safety outcomes were seen, and the most common serious adverse events were anastomotic leakage (11 [5%] of 202), aspiration pneumonia (5 [2%] of 202), and intra-abdominal abscess (5 [2%] 202). Normalisation of haemoglobin before surgery was infrequent with both treatment regimens, but significantly improved at all other timepoints following intravenous iron treatment. Restoration of iron stores was feasible only with intravenous iron. In selected patients, surgery might be delayed to augment the effect of intravenous iron on haemoglobin normalisation. Vifor Pharma.

Intake of Acetylsalicylic Acid and High Age Are Risk Factors for Iron Deficiency Anemia in Patients with Large Diaphragmatic Hernias

Introduction: In 15% of patients with iron deficiency anemia, large diaphragmatic hernias are found as the cause of chronic iron loss. Conversely, iron deficiency anemia is present in 10–40% of diaphragmatic hernia patients. However, it is unclear why some patients with large diaphragmatic hernias develop anemia and others do not. Methods: We retrospectively analyzed 116 patients with diaphragmatic hernias larger than 5 cm for the presence of anemia and the effect of surgery on this anemia, dividing these patients into 4 groups (group A: 21 patients with anemia/surgery, group B: 27 patients without anemia but with surgery, group C: 34 patients with anemia but without surgery, and group D: 34 patients without anemia/surgery). Results: Women significantly predominated in the patient population (76%). Patients with iron deficiency anemia tended to be significantly older than patients without iron deficiency anemia (74.7 ± 12.2 vs. 69.6 ± 14.8 years, p = 0.08). The proportion of patients taking ASA was significantly higher in the anemia collective (41.8% vs. 9.8%, p < 0.001). Regression analysis further confirmed that higher age and ASA intake correlated significantly with lower hemoglobin in anemic patients. Performing hernia repair significantly decreased anemia rates and PPI use in the anemia patients, while both remained almost the same in the non-operated anemia patients. Conclusion: ASA use and advanced age are risk factors for the presence of iron deficiency anemia in patients with large diaphragmatic hernias. Surgical hernia repair is suitable to reduce anemia.

Frequency of Anemia and Iron Deficiency Anemia in Patients with Helicobacter Pylori Infection: A Cross-Sectional Study

Objective: To determine the frequency of anemia and iron deficiency anemia in patients with Helicobacter pylori infection. Study design: Cross-sectional study Place and Duration: Department of Medicine, Liaquat University Hospital, Hyderabad from May to November 2019 Methodology: We included a total of 140 patients with anemia, either inpatients or outpatients at Liaquat University Hospital in Hyderabad's department of medicine. We acquired demographic information, such as name, gender, and age. The study involved everyone who meets the inclusion requirement. Anemia's brief history, its duration, the colour of the stools (melena black faeces), and the ferritin level were all noted. The cubital vein of either upper arm was used to collect 10 ml of blood, which was then sent to the lab for analysis of anaemia, ID, and H. Pylori detection. A multiparameter cell counter Sysmex k 1000 hematology analyzer was used to determine the amounts of haemoglobin (Hb) and hematocrit (Hct) in the CBC (Tao electronics, Japan). Serum iron levels were evaluated using a Hitachi 917 biochemistry automated analyzer, and ferritin concentrations were determined using a Cobas e411 hormones auto-analyzer from Roche Diagnostics GmbH in Mannheim, Germany (Roche Diagnostics GmbH, Mannheim, Germany). The researcher himself entered all the data on a proforma that had been previously created. Results: Patients' average ages ranged from 40.44± 14.268 years, and their haemoglobin levels were 8.77 ± 3.14. Patients' serum ferritin levels were 10.5 ±63.21 and their BMI was 24.5 ±3.21 respectively. Of the H. pylori patients, there were 70 (50%) anaemic patients and 70 (50%) with normal Hb levels. In this study, 102 individuals (72.9%) had normal serum profiles while 38 patients (27.1%) had iron deficiency anemia. Conclusion: According to our research, treating H. pylori infection may help IDA patients who are infected with the parasite especially those who have moderate to severe anaemia. Individuals with H. pylori infection had a significant prevalence of anaemia and IDA, and both conditions were linked to patients' ages and several behavioural traits Keywords: H. pylori infection, anemia, iron deficiency anemia

Dynamic Thiol-Disulfide Homeostasis in Children with Newly Diagnosed Iron Deficiency Anemia

Objective: Iron is an element, which is found in the structure of antioxidant enzymes and has an important role in the inactivation of reactive oxygen species. Disruption of oxidant-antioxidant balance may be playing a role in the pathogenesis of iron deficiency anemia (IDA). Dynamic thiol-disulfide homeostasis (DTDH) and serum ischemia-modified albumin (IMA) levels are important indicators of pro-oxidant/antioxidant status. In this study, we aimed to evaluate DTDH parameters and serum IMA levels in children with newly diagnosed IDA, who did not receive iron therapy. Material and Methods: Fifty patients diagnosed with IDA and 33 healthy age- and sex-matched control patients were included in the study. DTDH parameters and IMA levels of the patients and control groups were measured. The same parameters were also compared in patients with Hb&amp;lt;7 g/dl (profound IDA) (n:14/50, 28%) and Hb≥7 g/dl (mild-moderate IDA) (n: 36/50, 72%) in the IDA group. The relationship between DTDH parameters in these groups were investigated. Results: Native thiol, total thiol, native thiol/total thiol levels, constituting antioxidant capacity indicators, were found to be significantly lower in IDA patients; while oxidant disulfide, disulfide/native thiol, disulfide/total thiol, and IMA levels were found to be statistically higher compared to those in the control group (p&amp;lt;0.050). When DTDH parameters and IMA levels were examined; there was a positive correlation between antioxidant parameters and a negative correlation between oxidative parameters with hemoglobin and ferritin levels (p&amp;lt;0.050). Also, oxidative parameters were found to be much higher in profound IDA group than in the group with Hb&amp;gt;7 g/dl (p&amp;lt;0.050). Conclusion: In this study, increase in serum disulfide and IMA levels with the decrease in serum native thiol and total thiol levels indicated oxidative stress in IDA patients before treatment, compared to the control group. Evaluation of these indicators in children is important in predicting the toxicity due to IDA.

The Effects of Iron Deficiency on the Gut Microbiota in Women of Childbearing Age.

Iron deficiency anemia (IDA) is the most prevalent and common nutritional deficiency worldwide and is a global health problem with significant risk, particularly among women of reproductive age. Oral iron supplementation is the most widely used and cost-effective treatment for iron deficiency and IDA. However, there are limitations regarding side effects such as enteritis, treatment compliance, and bioavailability. Intestinal microbiome characteristic research has been recently conducted to overcome these issues, but more is needed. Against this background, a metagenomics study on the 16S gene in the feces of young women vulnerable to IDA was conducted. As a result of analyzing 16 normal subjects and 15 IDA patients, significant differences in bacterial community distribution were identified. In particular, a significant decrease in Faecalibacterium was characteristic in IDA patients compared with normal subjects. Furthermore, in the case of patients who recovered from IDA following iron supplementation treatment, it was confirmed that Faecalibacterium significantly recovered to normal levels. However, no significance in beta diversity was seen compared with before treatment. There were also no differences in the beta diversity results between the recovered and normal subjects. Therefore, intestinal dysbiosis during the disease state was considered to be restored as IDA improved. Although the results were derived from a limited number of subjects and additional research is needed, the results of this study are expected to be the basis for developing treatment and prevention strategies based on host-microbiome crosstalk in IDA.

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

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

Assessment of iron status and iron deficiency anemia in patients with celiac, a single center experience.

This study aimed to assess the status of iron stores and the frequency of iron deficiency anemia in Celiac disease (CD) patients referred to the Golestan Research Center of Gastroenterology and Hepatology, Gorgan, Iran. Studies have shown that nutritional deficiencies affect 20-38% of patients with CD due to malabsorption and as a result of a gluten-free diet. In this study, 59 out of 100 CD patients were assessed. The presence and severity of anemia were determined using the concentration of serum hemoglobin according to WHO criteria. The status of body iron stores was also assessed based on serum ferritin levels. Mean and SD of age, duration of disease, serum hemoglobin, ferritin, TIBC, and serum iron were 39.9±11.9 years, 69.8±45.4 months, 12.6±1.99 g/dl, 54.3±55.3 mg/dL, 365.9±49.1 μg/dL, and 84.1±37.1 μg/dL, respectively. 68.42% had no anemia, 19.3% had mild anemia, 8.77% had moderate anemia, and 3.51% had severe anemia. 25.42% of patients had depleted iron stores, 71.19% had normal iron stores, and 3.39% were exposed to iron overload. There was a statistically significant correlation between serum hemoglobin and the duration of disease diagnosis (P=0.037, r=0.302). In this study, 31.58% of CD patients on a gluten-free diet had some degree of anemia. In addition, 25.42% of patients had depleted iron stores. These results suggest that CD patients should be evaluated for iron status, even with a gluten-free diet.