Mild Iron Deficiency Anemia Research Articles

Iron Deficiency Anemia among Sanitation Workers in a Tertiary Care Hospital: A Cross-sectional Study

ABSTRACT Background: Iron deficiency anemia (IDA) has been the main cause of the health burden in India over the past decade. The aim of the present study was to examine the iron status and prevalence of iron deficiency anemia using biochemical markers among sanitation workers working at a tertiary healthcare center. Methodology: This hospital-based cross-sectional observational study was conducted on 80 sanitation workers for a period of 18 months (age 31–40 years). Dietary intake patterns were collected through the structured questionnaires. Blood samples were analyzed for complete blood count, serum iron level and unsaturated iron binding capacity, and ferritin. Total iron binding capacity and percentage transferrin saturation were calculated. Stool samples were screened for intestinal helminthic ova and cysts of intestinal protozoa. Results: Of the 80 sanitation workers, IDA was found in 38.7%; out of this, mild anemia was found in 16 (20%) participants, while 11.3% and 7.5% participants had moderate and severe anemia, respectively. Higher plasma sTfR levels were observed in women with severe iron depletion than in those with iron sufficiency (median 17.6 versus 15.5 nmol/L; P = 0.001). A statistically significant positive correlation between hemoglobin and serum iron, serum ferritin, and transferrin saturation was found. Hemoglobin was positively correlated with white blood cells, red blood cells, hematocrit, and mean corpuscular hemoglobin. Conclusion: This study highlights the presence of mild IDA among sanitary workers and lower levels of iron intake than the recommended dietary allowance.

Iron deficiency anemia in relation to pinch strength and hand dexterity in preschool children: a cross-sectional study

BackgroundIron deficiency anemia (IDA) constitutes a considerable nutritional problem in Egyptian preschool children. Moreover, IDA limits physical activity performance and interferes with children's development. Accordingly, we aim to investigate the correlation between IDA and hand dexterity and pinch grip strength in preschool children.ResultsThis observational cross-sectional study encompassed the participation of 87 children, comprising both genders, with an age range of 5–6 years. The cohort was initially stratified into three distinct groups: Group A comprised 36 non-anemic children, group B included 25 children with mild iron-deficiency anemia (IDA), and group C consisted of 26 children with moderate IDA. After group delineation, comprehensive laboratory analyses were performed on all participants to assess for IDA, involving a thorough examination of their complete blood picture, hemoglobin (Hb) levels, serum iron levels, and serum ferritin levels. The evaluative metrics employed in this study encompassed the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) and the Baseline Mechanical Pinch Gauge. These instruments were utilized to assess manual dexterity and pinch strength, specifically tip-to-tip and tripod strength. This investigation revealed a positive correlation between Hb, serum iron, and serum ferritin levels with both manual dexterity and pinch strength across all three groups.ConclusionThis study highlights that IDA negatively affects hand dexterity and pinch grip strength in preschool children. Managing IDA early is crucial for improving their physical performance and overall development.

Evaluation of reticulocyte indices and mathematical formulas for beta-thalassemia carriers screening among Egyptian beta-thalassemia patients’ families

Background Egypt lies within the global thalassemia belt, where beta-thalassemia presents a notable socioeconomic burden. Patients and methods One hundred fifty-seven relatives of beta-thalassemia patients were included in this cross-sectional study. It aimed to ascertain a cost-efficient and accurate screening approach for identifying beta-thalassemia carriers (BTC) by evaluating some erythrocyte and reticulocyte parameters measured on Advia 2120 analyzer (Siemens) and assessing four mathematical Formulas (Metzner index, Green and King et al., Roth et al., and Vicinanza et al. formulas). Results Participants were stratified into distinct categories: BTC (42%), normal (24.2%), mild iron-deficiency anemia (IDA) (17.2%), severe IDA (3.8%), and a subset with both IDA and BTC (mix group) accounting for 12.7%. Receiver operating characteristic curve analysis identified absolute reticulocyte count as the optimal discriminator (area under a curve=0.837) between BTC and IDA. The Mentzer index and Green and King et al. formula demonstrated superior diagnostic utility among the evaluated formulas. However, none of the formulas effectively distinguished between BTC and the mix group, a frequently overlooked and challenging group for diagnosis. Interestingly, our data highlighted absolute reticulocyte count and percentage as the sole parameters capable of distinguishing BTC from the mix group. Consequently, two algorithms were developed. The first one had a good agreement (κ=0.62) with 77.3% concordance, while the second one demonstrated improved screening performance (κ=0.66) with 79.8% agreement. Conclusion The optimal screening strategy involves distinguishing between various categories of both IDA and BTC. Our algorithms, designed as a low-cost and user-friendly mass screening tool, may serve this purpose effectively.

Perbedaan Parameter Eritrosit Dan Retikulosit Pada Pasien Talasemia Beta Minor Dan Anemia Defisiensi Besi Ringan

Beta thalassemia and iron deficiency anemia (IDA) are most common microcytic hypochromic anemia. It is difficult to distinguish minor β thalassemia from mild iron deficiency anemia only by clinical findings and routine hematology examinations, it requires confirmatory tests which are limited in availability and relatively expensive. The presence of additional erythrocyte and reticulocyte parameters (RDW-CV, RBC-He, %MicroR, %Hypo-He, Ret-He, IRF) in hematology analysers are expected to be screening parameters in differentiating minor β thalassemia from mild IDA. The purpose of this study was to determine the differences in the values ​​of RDW-CV, RBC-He, %MicroR, %Hypo-He, Ret-He, and IRF between minor β thalassemia patients and mild IDA. This study was an observational, analytical, comparative, with a cross sectional design. Research was conducted at RSU Kota Tangerang Selatan from July to October 2020. Subjects were children who went to an outpatient clinic/medical check-up, or with laboratory data of minor β thalassemia or had β thalassemia families. Samples were analysed using Sysmex XN 1000. Statistical analysis was performed by the independent t test for normally distributed data and the Mann Whitney difference test for abnormally distributed data. The RBC-He and Ret-He values ​​were lower in minor β thalassemia than mild IDA and significantly different with p value 0.005 and 0.004, respectively. The %MicroR and %Hypo-He values were higher in minor β thalassemia than mild IDA and significantly different with p values ​ 0.000 and 0.003, respectively. The RDW-CV and IRF values ​​were higher in minor β thalassemia than mild IDA but were not significantly different with the p value 0.076 and 0.528 respectively. Conclusion: RBC-He and Ret-He values which reflect hemoglobin content in erythrocytes and reticulocytes ​​were lower in minor β thalassemia patients compared to mild IDA and were significantly different. The values ​​of %MicroR and %Hypo-He which reflect microcytic and hypochromic in erythrocyte population were higher in patients with minor β thalassemia than mild IDA and were significantly different. RDW-CV which reflects variation size of erythrocytes and IRF which reflects erythropoiesis activity and ineffective erythropoiesis were higher in patients with minor β thalassemia than mild IDA and were not significantly different.

Effectiveness of Lesser Known Homoeopathic Medicines in the Treatment of Iron Deficiency Anaemia

Anaemia is a major public health problem in India as it is estimated that most of the non-pregnant women of reproductive age group are anaemic. It occurs when there is decreased level of haemoglobin in red blood cells. The primary cause of anaemia is iron deficiency. Iron deficiency anaemia (IDA) may be present with other systemic diseases. People with mild and moderate iron deficiency anaemia may not have any sign and symptom. But more severe iron deficiency anaemia may cause fatigue, tiredness, shortness of breath or chest pain. Although Homoeopathy gives importance to the individualisation of the patients, for remedy selection, still then, some medicines are prescribed based on disease diagnostic features. Such medicines are not well proved, so they are known as rare/lesser-known medicines. Of course, their role in the management of certain diseases cannot be ignored. This article aims at showing the effectiveness of some lesser-known medicines in the treatment of iron deficiency anaemia.

Bilateral pulmonary sequestrations: Distinct types sharing a common celiac artery origin, presented with pneumonia and associated findings in a pediatric case.

A 14-year-old boy presented with shortness of breath, cough, and mild chest pain, with a history of intermittent milder symptoms. Physical examination and initial tests showed mild iron deficiency anemia, elevated C-reactive protein, and normal vital signs. Chest radiograph revealed abnormalities in the left lower zone, leading to contrast-enhanced chest CT. The CT scan revealed bilateral intrapulmonary sequestrations, both deriving blood supply from a common trunk originating from the celiac artery. The patient's symptoms initially attributed to a pulmonary infection improved with antibiotic therapy. Pulmonary sequestration is a congenital anomaly characterized by aberrant lung tissue lacking connections to bronchial tree or pulmonary arteries. It can lead to recurrent pulmonary infections and postinfectious sequelae. This case presented a unique bilateral sequestration, both originating from the celiac artery. Radiologists should be aware of sequestration types and associated anomalies, even in atypical locations. Blood supply can originate from various arteries, not just the aorta.

Assessment of peripheral nerve conduction in iron deficiency anemia patients in Indian rural adult population attending a tertiary care hospital

Background: Iron deficiency anemia (IDA) is the most common nutritional deficiency anemia in India. Peripheral neuropathy can result due to iron deficiency as it disrupts myelination and neuronal energetics in neuronal functioning. Nerve conduction studies (NCS) can quantitatively detect peripheral nerve dysfunction. This study was conducted to observe effect of IDA on peripheral nerve conduction velocity in adults using neuroelectrophysiological techniques with the aim to recommend Complete Blood Count for serologic evaluation of patients with peripheral neuropathy in Indian population. Objectives: This study aims to compare motor and sensory nerve conduction study parameters between controls and IDA patients and evaluate the effect of various grades of IDA on motor and sensory nerves. Methodology: 30 newly diagnosed patients of IDA in age group of 20-45 yrs and 30 healthy controls in same age group were recruited in this study. NCS was conducted on bilateral motor and sensory median and ulnar nerves in Neurophysiology laboratory using Neurosoft machine. Neuroelectrophysiological data of both the groups was evaluated and analysed using Student’s unpaired t test. Also, patients were categorised as mild, moderate and severe anemia cases and one way ANOVA was used for comparison among patients with various grades of anemia. Results: CMAP (compound muscle action potential), SNAP (sensory nerve action potential) and nerve conduction velocity (NCV) of bilateral median and ulnar nerves was reduced and DL (distal latency) was increased in bilateral median and ulnar nerves in patients with IDA compared to controls. The results were statistically significant (p=0.001). A highly significant difference between motor and sensory nerve conduction values between mild, moderate and severe IDA patients was also observed (p=0.001). Conclusion: The results of the study confirmed peripheral nerves involvement in IDA patients. As severity of anemia increases, peripheral neuropathy worsens. These results can be extrapolated for screening patients with peripheral neuropathy for iron deficiency as a routine part of diagnostic approach for peripheral neuropathy.

Thalassemia and Hemoglobinopathy Screening in Women Attending Antenatal Clinic at a Tertiary Care Center in Uttarakhand, India: A Re-look at the Laboratory Parameters Mandating High-Performance Liquid Chromatography Workup.

Thalassemia and hemoglobinopathies are the most common inherited hematological disorders. Of these, β thalassemia is the commonest disorder reported in India, followed by certain hemoglobinopathies encountered in different regions of the country. The data pertaining to the incidence of these disorders in the Uttarakhand region of India are sparse. To ascertain the prevalence and spectrum of thalassemia/hemoglobinopathies amongst antenatal women in Uttarakhand. The study also aimed to analyze the ability of red cell indices in differentiating beta thalassemia trait (BTT) from mild iron deficiency anemia (IDA). A total of 460 pregnant women in the first trimester of pregnancy were screened by cation exchange high-performance liquid chromatography. Retention time and proportions of normal/abnormal hemoglobin peaks were documented in all cases. Hemoglobin A2 (HbA2) values of ≥4% were taken as a cut-off for diagnosing BTT. Blood samples were also collected for complete blood counts, reticulocyte counts, and serum ferritin. The ability of the various discriminatory indices to differentiate between IDA and BTT was also assessed. The prevalence of BTT and hemoglobin D-Punjab trait amongst pregnant women was found to be 2.6% and 0.2%, respectively. RBC count, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) were found to be moderately strong predictors of BTT, with an area under the curve of 0.860, 0.857, and 0.842, respectively, which were comparable to the discriminatory indices found to be most useful in this study. In view of the 2.6% prevalence of BTT in antenatal women in this region of Uttarakhand, a routine screening will be helpful in detecting carriers early in the antenatal period. Careful interpretation of red cell indices is crucial to the distinction between BTT and IDA. Discriminatory indices are reasonably accurate in differentiating BTT from mild iron deficiency, but for practical purposes, MCV and MCH provide equivalent information to identify cases that require further workup.

Distortion product otoacoustic emissions in newborn babies with and without late-term maternal iron deficiency anaemia

BackgroundStudies on animals have demonstrated that maternal iron deficiency anaemia (IDA) could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions (DPOAEs) of young guinea pigs. Thus, it is essential to study the functioning of cochlear hair cells using DPOAEs in human newborn babies with maternal IDA. The current study explores maternal IDA's effect on DPOAEs in newborn babies. MethodA total of 110 newborn babies with gestational age ≥34 weeks were considered and a ‘between-subjects’ design was used. The participants were divided into 3 groups- “Normal” (61 babies without maternal IDA), “Mild” (28 babies with mild maternal IDA) and “Moderate” (21 babies with moderate maternal IDA). The cord blood was collected and the DPOAEs were recorded for each baby for a range of frequencies (1 k – 8 kHz) and a range of intensities (70–40 dB SPL in 10 dB steps). ResultsThe analysis of both DP-gram and DP input-output (I/O) function showed that there was no significant difference (p > 0.05) across the normal, mild, and moderate groups in the overall presence of DPOAEs as well as the amplitude across frequencies or intensities (70–40 dB SPL). Also, the overall correlation of RBC indices with DPOAE amplitude across frequencies as well as the slope of the I/O function showed no relationship. ConclusionThe current study concludes that there is no effect of late-term maternal IDA on the DPOAEs of newborn babies.

Application of Hematologic Indices for Diagnosis of Iron Deficiency Anemia in Pregnancy [ID: 1378030

INTRODUCTION: Prenatal care providers may omit iron studies if the complete blood count is suggestive of mild or moderate iron deficiency anemia (MMIDA). We investigated how sensitive the mean corpuscular volume (MCV) or red blood cell distribution width (RDW) are in identifying MMIDA that is diagnosed by ferritin measurement. METHODS: This IRB-approved retrospective cohort study from October 15, 2007 to October 14, 2021, included singleton pregnancies diagnosed with MMIDA and treated with iron for at least 4 weeks prior to delivery. Patients with comorbidities that predispose to anemia (eg, thalassemia) were excluded. The primary outcome was the percentage of patients whose MMIDA could be identified by low MCV or elevated RDW. Secondary outcomes included changes in hemoglobin, MCV, and RDW, and were assessed by persistence versus correction of MMIDA by delivery. RESULTS: Eight thousand eight hundred thirty-three patients met criteria; 1,141 (12.9%) had MMIDA diagnosed by low ferritin. The MCV or RDW was concordant with MMIDA diagnosis in 259 (22.7%). Hemoglobin significantly improved from 10.6 to 11.8 g/dL in the corrected group and did not change in the persistent group. Treatment with concurrent oral and IV iron resulted in greater hemoglobin increase (persistent, +0.4, versus corrected, +1.9 g/dL) versus oral iron alone (−0.1 versus +1.3 g/dL). The MCV decreased and RDW increased in both persistent (−2.7 fL, +1.0%) and corrected groups (−0.8 fL, +0.7%). CONCLUSION: Thirteen percent of providers ordered iron studies when MMIDA was suspected. Low MCV or elevated RDW are insensitive surrogates of ferritin. Iron studies remain the gold standard for diagnosis. Concurrent IV iron results in superior improvement of hemoglobin versus oral iron alone.

Physiological Responses of Anemic Women to Exercise under Hypoxic Conditions

When combining two conditions of reduced oxygen availability, anemia and hypoxia, human physiological responses are highly challenged to maintain arterial oxygen delivery, especially during whole-body exercise. The aim of this study was to compare the cardiorespiratory responses of mildly anemic women with those of healthy controls, while cycling in normobaric hypoxia. Two groups of young females were matched for age, weight, height, and involvement in physical activity, one with normal hemoglobin, hematocrit, and ferritin levels and another suffering from mild iron deficiency anemia (10 < (Hb) < 12 g/dL, 34 < Hct < 37%, ferritin < 15 μg/L). They cycled to exhaustion under normoxia and hypoxia (FIO2 0.21 and 0.14), and their physiological responses were compared at 40, 80, and 100% VO2max of the specific condition. The two groups differed (p < 0.05) mainly at the higher exercise intensities; the anemic participants exhibited similar heart rate but lower oxygen pulse than their control counterparts, as well as a larger drop in maximal oxygen uptake. However, they sustained maximal effort by employing the anaerobic metabolism to a larger extent, which stimulated a greater ventilatory response. It appears that iron deficiency anemia of mild severity, which is commonly observed in young athletic females, impacts physiological responses during whole-body exercise in the presence of moderate hypoxia.

An Isolated Intestinal Juvenile Polyp Diagnosed by Abdominal Ultrasonography and Resected by Double-Balloon Endoscopy: A Case Report and Literature Review.

Juvenile polyps, typically localized in the rectum and sigmoid colon, are a common cause of pediatric bloody stool. An isolated small intestinal juvenile polyp is uncommon and generally difficult to diagnose. The first case of an isolated juvenile polyp diagnosed by abdominal ultrasonography before acute abdomen had developed and resected by double-balloon endoscopy is presented along with a review of previous reports including this case. A two-year-old Japanese boy was referred to our institute for further evaluation of anemia persisting from one year of age. Laboratory findings showed mild iron deficiency anemia and elevated fecal human hemoglobin (Hb) and fecal calprotectin values. Upper and lower endoscopic findings showed no abnormalities. Because the abdominal ultrasonography performed one year later demonstrated a 15 mm jejunal polyp, combined with a similar finding on small intestinal capsule endoscopy, this was diagnosed as an isolated lesion. The lesion was resected by cautery with double-balloon endoscopy and diagnosed as a juvenile polyp pathologically. All clinical symptoms disappeared, and all laboratory data improved after treatment, without recurrence for more than one year after the procedure. Abdominal ultrasonographic screening and the fecal calprotectin value led to the diagnosis and non-surgical invasive treatment of an isolated small intestinal juvenile polyp.

Correlation of Erythroferrone and Hepcidin Hormones with Iron Status Levels in Patients with Iron Deficiency

INTRODUCTION: Iron-deficiency anemia (IDA) can be grouped under low hepcidin and high erythroferrone (ERFE) anemia. There is a negative correlation between ERFE and hepcidin, irrespective of the type of anemia. ERFE is a mediator of the response to erythropoietic stress, suppressing hepcidin to promote the mobilization of stored iron and the absorption of dietary iron. OBJECTIVE: The objective was to determine the effect of ERFE hormone on hepcidin level as iron metabolism regulator in patients with iron deficiency (ID). METHODS: The study included 50 female patients with ID who were investigated for complete blood count, serum levels of ferritin, and serum levels of iron using automated hematology, immunology, and chemistry analyzer. ERFE and hepcidin were measured by a specific enzyme-linked immunosorbent assay kit. RESULTS: The serum ERFE levels were higher than normal in all cases and were negatively correlated with serum hepcidin (r = −0.023). In IDA, serum ERFE concentration had a nonsignificant negative correlation with hemoglobin (Hb) concentration. Serum hepcidin concentration had a nonsignificant negative correlation with Hb concentration. Serum ERFE had a nonsignificant negative correlation with Hb% in severe IDA (r = −0.679; P = 0.094) and mild IDA (r = −0.068; P = 0.789). ERFE had a nonsignificant positive correlation with Hb% in moderate IDA (r = 0.069; P = 0.793). Serum hepcidin had a nonsignificant positive correlation with Hb% in severe IDA (r = 0.036; P = 0.939). Serum hepcidin had a nonsignificant negative correlation with Hb% in mild IDA (r = −0.079; P = 0.764) and moderate IDA (r = −0.179; P = 0.491). CONCLUSIONS: The potential of ERFE and hepcidin in diagnosing and categorizing ID disorders is promising. Understanding the mechanism of ERFE/hepcidin interaction will help in developing ERFE-/hepcidin-targeted therapies.

Ferric Carboxymaltose in the Management of Iron Deficiency Anemia in Pregnancy: A Subgroup Analysis of a Multicenter Real-World Study Involving 1191 Pregnant Women.

Real-world evidence of the efficacy and safety of ferric carboxymaltose (FCM) infusion in Indian pregnant women with iron deficiency anemia (IDA) is lacking. To assess the efficacy and safety of intravenous (IV) FCM in Indian pregnant women with IDA in 4 weeks in a real-life scenario. This is a subgroup analysis of our previously conducted retrospective, multicenter, observational, real-world PROMISE study. Data on demographic and hematological parameters, patient-reported adverse events, and physicians' clinical impressions of efficacy and safety were analysed at 4 ± 1 week. This subgroup analysis included 1191 pregnant women in whom IV FCM resulted in a significant increase in hemoglobin (Hb) by 2.8 g/dL and serum ferritin by 30.03 μg/L at 4 weeks (P < 0.001 for both). In 103 pregnant women with severe IDA, there was a significant increase in Hb by 3.6 g/dL (P < 0.001), and serum ferritin by 16.96 μg/L (P=0.12). In 978 pregnant women with moderate IDA, significant improvement in Hb by 2.74 g/dL and serum ferritin by 33 μg/L (P < 0.001 for both) was noted. Similarly, there was a significant increase in red blood cell count, hematocrit, mean corpuscular volume, and mean corpuscular hemoglobin (P < 0.001 for all). In pregnant women with mild IDA (n = 26), Hb increased significantly by 1.99 g/dL (P < 0.001). Adverse effects were reported in 8.6% of pregnant women. No new safety signals or serious adverse effects were observed. Based on physicians' global assessment, good to very good efficacy and safety of IV FCM was noted in 99.2% and 98.6% of pregnant women, respectively. IV FCM rapidly corrected anemia in a short period of 4 weeks with favorable safety in the second and third trimester of pregnancy with all severities of IDA (severe, moderate, and mild). The physicians' favorable global assessment of FCM's efficacy and safety in pregnant women with IDA supports its use in daily clinical practice. This trial is registered with CTRI/2021/12/039065.

S2473 A Case of Familial Mediterranean Fever Diagnosed by Abdominal CT Scan in a Patient Previously Diagnosed With Functional Abdominal Pain

Introduction: Familial Mediterranean fever (FMF) is a hereditary autoimmune disease in which patients present with periodic, self-limited episodes of fever and serositis. It is prevalent in individuals of Middle Eastern origin. Since no definitive diagnostic test is available, FMF is suspected based on clinical symptoms; there are major and minor criteria to aid in making the diagnosis. Imaging modalities are not included in these criteria. We present a patient whose only symptom was recurrent abdominal with no family history of FMF. At the time he was diagnosed with Functional Abdominal Pain. FMF was suspected based on unexplained focal peritonitis on computerized tomography (CT). Case Description/Methods: A 45-year-old male of Middle Eastern descent was seen in clinic complaining of episodic right upper quadrant (RUQ) abdominal pain since he was 17 years old. The pain occurred once or twice per month. Over the years he had multiple visits to the emergency department and extensive work up including endoscopic evaluation and imaging studies. He underwent cholecystectomy, and bilateral inguinal hernia repair without benefit. He was diagnosed with Functional Abdominal Pain then. When evaluated in our clinic, lab work showed mild iron deficiency anemia; otherwise, unremarkable. Upper endoscopy, colonoscopy, small bowel series and capsule endoscopy were normal. 3 months later he presented to our ER with an acute episode of severe RUQ pain. He was afebrile; abdominal exam was remarkable for localized tenderness in the RUQ. Lab work was remarkable for an elevated erythrocyte sedimentation rate of 31. Abdominal CT was only remarkable for fat stranding around the hepatic flexure and the proximal half of the transverse colon. Colonoscopy was normal with no evidence for segmental colitis to explain the inflammatory changes. Given the history of recurrent abdominal pain, ethnicity, and focal unexplained peritonitis on CT scan, FMF was suspected, and treatment with colchicine was initiated without recurrence of symptoms for now several years since the diagnosis, meeting diagnostic criteria for FMF. Discussion: If not considered, FMF can remain misdiagnosed for many years leading to unnecessary procedures and surgeries. This was an unusual presentation with afebrile episodes of intermittent RUQ pain with the diagnosis ultimately suspected by CT imaging and confirmed by response to colchicine. Clinicians should consider FMF in patients of high-risk ethnic origin presenting with unexplained focal peritonitis on CT scan.

Correction of iron deficiency in patients with abnormal uterine bleeding

INTRODUCTION: Iron deficiency (ID) occurring latently or as iron deficiency anemia (IDA) is common in gynecology, particularly in patients with abnormal uterine bleeding (AUB).&#x0D; AIM: We aimed at exploring the efficiency of a medication containing ferrous sulfate and multivitamins for the correction of latent ID and treatment of mild IDA in AUB patients.&#x0D; MATERIALS AND METHODS: We performed a comprehensive clinical, laboratory, and instrumental examination of 60 women aged 35 to 50 years with AUB, revealing many gynecological pathologies (endometrial polyps or hyperplasia, ade nomyosis, and uterine myoma). The examined patients with AUB were divided into two groups: women with latent ID (group 1, n=38) and women with IDA (group 2, n=22). Moreover, all the patients had extragenital pathology in addition to gynecological diseases. As a treatment, ferrous sulfate with multivitamins was prescribed for 13 months.&#x0D; RESULTS: Before treatment, the hemoglobin level in the examined patients ranged from 95 to 130 g/L, with an average of 127.11.8 g/L in group 1 and 100.32.1 g/L in group 2. Serum iron concentrations in the examined groups were 9.80.2 and 6.91.3 mol/L, respectively. After treatment, the average levels of hemoglobin and serum iron increased significantly and reached normal levels in all those examined. Hemoglobin was 143.31.8 g/L in group 1 and 122.51.5 g/L in group 2, whereas serum iron was 14.90.2 mol/L in group 1 and 13.51.0 mol/L in group 2. Furthermore, a significant increase to normal values was observed in other indicators of complete blood count and biochemical analysis.&#x0D; CONCLUSIONS: The results of the study reveal a high clinical efficiency of ferrous sulfate and multivitamins in the treatment of ID in patients with AUB.

Health-related quality of life in iron deficient young women

BACKGROUND: The most important cause of anemia in the world is iron deficiency. Young women are more susceptible to the formation of latent iron deficiency and iron deficiency anemia in comparison with other population groups. Iron deficiency conditions can lead to a deterioration in exercise tolerance and adaptation to them, however, the effect of latent iron deficiency and iron deficiency anemia on cognitive functions, emotional status and quality of life is still a subject of discussion, which may be due to the small number of studies in which iron deficiency conditions are studied in the absence of concomitant chronic diseases.&#x0D; AIM: Evaluate the effect of latent iron deficiency and iron deficiency anemia on the quality of life in young women.&#x0D; MATERIALS AND METHODS: a cross-sectional simultaneous study was conducted in women aged 1821 years. The occurrence of iron deficiency conditions was assessed, a study of the quality of life was conducted using the SF-36 questionnaire. In the statistical processing of the results obtained, the assessment of normality within each group was carried out using Shapiro-Wilk test. For an intergroup comparison of the results obtained between two independent groups, MannWhitney test was used, and Wilcoxon test was used when comparing the results of two dependent groups. The intergroup comparison between the three groups was carried out using KruskalWallis test. When detecting deviations from the null hypothesis, a posteriori analysis was carried out using MannWhitney test with Bonferroni correction.&#x0D; RESULTS: 68 subjects aged 1821 took part in the study. The median age was 18 years [18; 21]. 25 (36.7%) women were diagnosed with ID, 16 (23.5%) with IDA. The level of C-reactive protein in all subjects was 5 mg/l, median 2.4 [1.2; 3.1] mg/l. During a posteriori analysis, comparable indicators of the total blood count between the groups of healthy women and those with ID were revealed. At the same time, there were no differences in ferritin levels between the ID and IDA groups. In the study of quality of life, statistically significant intergroup differences between the study groups were obtained in the scales of general health, vital activity, role functioning due to emotional state, mental health and general mental well-being. When conducting a posteriori analysis, the number of points in the questionnaire scales turned out to be comparable between groups of healthy women and those with ID.&#x0D; CONCLUSIONS: data on the high incidence of latent iron deficiency and iron deficiency anemia in young women have been obtained. The presence of latent iron deficiency does not independently affect the quality of life associated with health. Mild iron deficiency anemia moderately reduces the quality of life due to the emotional component.

Efficacy and Safety of Ferric Carboxymaltose in the Management of Iron Deficiency Anemia: A Multi-Center Real-World Study from India.

BackgroundParenteral iron preparations, like ferric carboxymaltose (FCM), are commonly used to manage moderate-to-severe iron deficiency anemia (IDA). Real-world data on efficacy and safety of FCM is limited in India.MethodsA retrospective, observational and real-world study was conducted to assess the efficacy and safety of FCM in adolescents and adults with IDA across 269 centers in India. Data was retrieved from medical records of patients who received FCM for management of IDA. Physicians’ clinical assessment of efficacy and safety of FCM was also assessed. Data were analyzed for hematological parameters at baseline and at 4 ± 1 week for study population, and for severity of anemia.ResultsIn 1800 patients with IDA, intravenous FCM resulted in a significant increase in hemoglobin (Hb) of 2.76 g/dL, serum ferritin of 35.85 µg/L, red blood cell (RBC) count, hematocrit, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) (P < 0.001 for all) at 4 ± 1 week as compared to baseline. In subjects with severe IDA, an increase in Hb was of 3.31 g/dL, serum ferritin increased of 35.84 µg/L, RBC count, hematocrit and MCH improved significantly (P < 0.001 for all). In subjects with moderate IDA, Hb (increase of 2.63 g/dL), serum ferritin (increase of 35.92 µg/L), RBC count, hematocrit, MCV, and MCH improved significantly (P < 0.001 for all). In subjects with mild IDA, only the mean Hb values at 4 weeks were significantly higher (P < 0.001; increased by 1.89 g/dL). Physicians rated efficacy of FCM as very good to good in 97.5% of patients. Similarly, safety of FCM was rated very good to good in 97.2% subjects.ConclusionFCM efficiently, safely and quickly corrects moderate-to-severe anemia in Indian patients in a short span of 4 weeks. Physicians’ positive clinical impression of efficacy and safety supports clinical usage of FCM in real-world scenario.

Efficacy of intermittent iron supplementation in children with mild iron-deficiency anemia.

To study the efficacy of intermittent iron supplementation in children with mild iron-deficiency anemia. A total of 147 children with mild iron-deficiency anemia were enrolled in this prospective study. They were divided into an intermittent iron supplementation group (n=83) and a conventional iron supplementation group (n=64). The levels of hemoglobin were measured before treatment and after 1 and 3 months of treatment. The treat response rate and the incidence rate of adverse drug reactions were compared between the two groups. Both groups had a significant increase in the level of hemoglobin after iron supplementation (P<0.05). After 1 month of treatment, the conventional iron supplementation group had a significantly higher treatment response rate than the intermittent iron supplementation group (61% vs 42%, P<0.05). After 3 months of treatment, there was no significant difference in the treatment response between the two groups (86% vs 78%, P>0.05). The incidence rate of adverse drug reactions in the conventional iron supplementation group was significantly higher than that in the intermittent iron supplementation group (25% vs 8%, P<0.05). For children with mild iron-deficiency anemia, although intermittent iron supplementation is inferior to conventional iron supplementation in the short-term efficacy, there is no significant difference in the long-term efficacy between the two methods, and compared with conventional iron supplementation, intermittent iron supplementation can reduce the incidence of adverse drug reactions, alleviate family financial burdens, and improve treatment compliance of children, thus holding promise for clinical application.

Influence of latent iron deficiency on cognitive abilities in students

The aim of the study is to assess the impact of latent iron deficiency on students' cognitive abilities. Material and methods. The study was conducted during 2018-2021 at the Department of Hygiene and Medical Ecology of Odessa National Medical University. A survey of 188 medical students aged 18-20 was conducted using a screening survey. Estimation of the qualitative content of iron compounds in the diet was performed by a calculation method using the USDA / FDA database. Persons with probable iron deficiency were examined for hemoglobin, erythrocytes, hematocrit (general clinical blood test) and serum ferritin. Additionally, the cognitive abilities of people with latent iron deficiency were assessed using MoSA, TMT, GPB, Schulte tables and TAS-20. As a control, 30 students aged 18-20 years who showed no signs of latent or overt iron deficiency were interviewed. Statistical processing was performed by methods of variance and correlation anamnesis using the software Statistica 13.0 (TIBCO, USA). Results. When evaluating diets, probable iron deficiency was identified in 69 (36.7%) students surveyed. A significant number of students reported signs of iron deficiency, namely general weakness (27 or 14.4%), increased fatigue (30 cases or 15.9%), pale skin and mucous membranes (6 or 3.2%), drowsiness (8 or 4.3%), dry mouth (11 or 5.9%), brittle hair (4 or 2.1%), bleeding gums (3 or 1.6%). In isolated cases, hyposmia, dysgeusia and dysphagia have occurred. Probable iron deficiency was found at the previous stage of the study in 29 (15.4%) patients, they subsequently underwent verifying laboratory tests. In the analysis of the obtained data, the diagnosis of mild iron deficiency anemia was confirmed in 2 (6.9%) girls. Latent iron deficiency was identified in 16 (55.2%) students, among whom girls predominated (10 people or 62.5%). Subsequent studies have shown that a significant number of students with latent iron deficiency showed moderate signs of decreased cognition. Conclusions: 1. The frequency of latent iron deficiency in the surveyed contingent was 8.5%, with an absolute predominance of girls (62.5%). 2. Latent iron deficiency in student youth can be manifested by cognitive impairment, and therefore affect academic performance. 3. The most pronounced correlation was found for ferritin content and severity of alexithymia (r = -0.61).