Moderate Anemia Research Articles (Page 1)

Anemia is a common comorbidity among patients with acute heart failure (AHF) and is associated with worse clinical outcomes. However, there is limited data on the effects of anemia in AHF patients in Asian populations. Moreover, the impact of anemia at varying severity levels in patients presenting to the emergency department (ED) is still not well understood. This study aimed to evaluate the prevalence and severity of anemia, together with its association with clinical outcomes in adult patients with AHF. A retrospective analysis was conducted on 890 adult AHF patients extracted from 100,420 ED visits at Srinagarind Hospital between October 2021 and March 2023. Anemia was classified into three categories: mild (hemoglobin 11.0g/dl to normal), moderate (hemoglobin 8.0-10.9g/dl), and severe (hemoglobin < 8.0g/dl). Patient characteristics, laboratory markers, and outcomes were compared among groups. Of the 890 patients, 71% were anemic, with 25% having mild, 51% moderate, and 24% severe anemia. Anemic patients, particularly those with moderate and severe anemia, were older (median age 74 and 71.5 years vs. 64 years for non-anemic, p-value < 0.001) and had higher rates of comorbidities, including chronic kidney disease and diabetes. Severe anemia was associated with worse kidney function (median eGFR 28.9 vs. 62.9 mL/min/1.73m² for non-anemic, p-value < 0.001) and higher initial cardiac troponin T levels (85.8 vs. 39.1 ng/dL, p-value < 0.001). Hospital admission rates increased with anemia severity, with 93% of severely anemic patients being admitted compared to 81% of non-anemic patients. In-hospital mortality was highest in the severe anemia group (8.6%), though this was not statistically significant (p-value = 0.238). Anemia is common in patients with AHF, with many exhibiting moderate or severe levels of anemia. Greater severity of anemia correlates with older age, more comorbidities, and higher hospital admission rates, along with a trend toward higher mortality. Not applicable.

5α-reductase deficiency is a rare autosomal recessive disorder of sex development resulting from mutations in the SRD5A2 gene, which impairs the conversion of testosterone to dihydrotestosterone (DHT). We report a case of a 3-year-old child, firstborn of consanguineous parents, who presented with severe pallor, growth failure, and ambiguous genitalia since birth. He was born preterm with low birth weight and required NICU admission for delayed crying. Initially reared as female due to apparently female genitalia, parental concern arose at 6 months when progressive phallic enlargement and bilateral inguinal swellings were noted. Cytogenetic analysis confirmed a normal 46, XY male karyotype. Bilateral orchidopexy was performed at 1.5 years. Despite three intramuscular testosterone injections, microphallus persisted. Examination revealed moderate anemia, growth retardation, bifid scrotum with pea-sized testes, phallus length 2.5 cm, and penoscrotal hypospadias (EMS 3). Hematological evaluation suggested iron deficiency anemia, necessitating four blood transfusions. The β-hCG stimulation test showed elevated testosterone (250.34 ng/dl) with disproportionately low dihydrotestosterone (2.88 ng/dl) and raised T/DHT ratio(86.92:1), indicating 5α-reductase deficiency as the likely etiology of 46,XY DSD. Molecular genetic testing has been advised. This case highlights the complexity of managing 46,XY DSD with suspected 5α-reductase deficiency, particularly when compounded by systemic comorbidities such as chronic anemia and growth failure. Early diagnosis is crucial for gender assignment decisions, counselling of parents, and planning future surgical and hormonal interventions. [J Assoc Clin Endocrinol Diabetol Bangladesh, 2025;4(Suppl 1): S63]

Abstract Background and Aims Granulomatosis with polyangiitis (GPA) is a necrotizing vasculitis affecting predominantly small to medium vessels and produces granulomatous inflammation of the upper and lower respiratory tracts as well as necrotizing, pauci-immune glomerulonephritis. Neurological involvement is a relatively common manifestation of GPA, occurring in up to 50% of patients. The vast majority of them suffer from peripheral neuropathy, whereas central nervous system (CNS) involvement is considered to be extremely rare. The aim of this article was to present a case report of a severe neurological complication in a young woman newly diagnosed with GPA. Method A 22-year-old female from Pakistan, diagnosed with hypertension, presented to the Emergency Department with frequent urination, nocturia, intermittent fever, chills, and a dry cough for 1.5 months. Initial laboratory tests revealed significantly elevated inflammatory markers (C-reactive protein 274 mg/l, N &amp;lt; 5), leukocytosis (20.8 G/l, N 4-10), moderate normocytic anemia (hemoglobin 9.8 g/dl, N 12-15). Urinalysis revealed microscopic hematuria and trace amounts of protein. A chest X-ray showed features of bronchopneumonia and a small shadow (11 mm in diameter) in the upper lobe of the right lung. She received empirical antibiotic therapy and with an initial diagnosis of unspecific infection was referred to our department. Despite receiving intravenous antibiotics, her clinical state did not improve, and she remained febrile. Both urine and blood cultures did not detect any pathogens. A contrast-enhanced chest CT revealed three radiologically ambiguous nodules. Immunological studies showed a markedly increased titer of c-ANCA antibodies (1:1280). Based on the whole clinical picture, lung lesions on imaging studies, and the presence of c-ANCA antibodies, GPA was diagnosed. The patient received high doses of methylprednisolone and the first dose of cyclophosphamide (CP). The BVAS/WG score was 6 points, indicating a severe active course. Results One day after the first CP pulse, she became somnolent and developed left-sided hemiparesis. She was urgently consulted by a neurologist, and a magnetic resonance imaging (MRI) of the brain was performed (Fig. 1). It showed the presence of an intracerebral hematoma in the right hemisphere with puncture into the ventricular system. She was subsequently referred directly to the operating theater, where a hemicraniectomy was performed. After the surgery, the patient was intubated, mechanically ventilated, and transiently supported with a norepinephrine infusion in the Intensive Care Unit (ICU). Once cardiopulmonary stability was achieved, she was transferred to the Neurology Department (ND), primarily for rehabilitation and further treatment. She was evaluated by an endocrinologist due to significant polyuria accompanied by hypernatremia. A diagnosis of central diabetes insipidus was established, and she was started on desmopressin therapy. Ultimately, she was discharged with only mild neurological impairment. Despite left-sided hemiparesis, she was able to walk. During her stay in the ICU and ND, she received an additional four pulses of CP. Subsequently, she was hospitalized again in our department and received the final CP pulse without any complications. Currently, she is on azathioprine (AZA) as maintenance therapy. Conclusion Comprehensive differential diagnosis and effective multidisciplinary collaboration led to the establishment of an accurate diagnosis. CNS involvement should always be considered in patients with severe active course vasculitis.

The prevalence of anemia among pregnant women at the Mandor Community Health Center is quite high, reaching 27.4% of 575 targets, with 147 cases of mild anemia (9-10 g/dl) and 11 cases of moderate anemia (7-8 g/dl). Preventive measures were taken pharmacologically by administering 90 Fe tablets, as well as non-pharmacologically by consuming citrus fruits or dragon fruit combined with Fe tablets. This study aimed to analyze the effectiveness of the combination of citrus fruits and Fe tablets compared to the combination of dragon fruit and Fe tablets in increasing hemoglobin levels in pregnant women with anemia at the Mandor Community Health Center. Using a quasi-experimental design with a pretest-posttest two-group design, this study involved 44 samples from a population of 158, divided into two groups of 22 respondents each for the citrus fruit and dragon fruit interventions. The analysis results showed an increase in hemoglobin levels in both groups, with a median value of 10.750-11.750 for the citrus group and 10.070-11.150 for the dragon fruit group. The Mann Whitney test produced a p-value of 0.019 (&lt;0.05), indicating that the combination of citrus fruit and iron tablets was more effective in increasing hemoglobin levels in pregnant women with anemia than the combination of dragon fruit and iron tablets at the Mandor Community Health Center.

Background: Micronutrients, including vitamins and minerals, are required by the body in small quantities but play vital roles in various biochemical processes such as enzymatic reactions, gene transcription, and protection against oxidative stress (Brown et al., 2021). Deficiencies in these essential nutrients can lead to life-threatening conditions (Camaschella, 2019). Micronutrient deficiencies, often termed “hidden hunger,” continue to pose significant public health challenges, particularly in low- and middle-income countries like India. Despite growing awareness, deficiencies in iron, vitamin D, calcium, and vitamin B12 remain prevalent across various age groups, especially among women and adolescents. Many of these deficiency-related conditions are preventable through dietary awareness, the promotion of a healthy and balanced diet, education, and early detection—facilitated by the use of technological and scientific advancements (World Health Organization). Methods: This was an explorative study, used evaluative approach and conducted at Buldhanarural district of Maharashtra amongst 30 Women byusing simple random samplingmethod during the period of June 2025 to July 2025. Demographic characteristics, anthropometric measurements, blood cossllected for Hemoglobin, Calcium, Vitamin B12, Vitamin D, folate. Pretest and posttest knowledge regarding micronutrients were assessed through 30 questions. Structured teaching programme was provided after pretest data collection. Results: Majority of the women 22 (73.33%) had Hemoglobin &gt;12gm%, 7 (23.33%) had Mild anemia, 01(3.33%) had moderate anemia.1 (3.33%) had Vitamin D deficiency, 21(70%) had insufficient level of Vitamin D, and 2(6.66%) had folate deficiency.Majority (36.67%) of the womenwere between 36-45 years were, 56.66% were graduate and 53.14%, 50% of them were working in private sector and had 5 to 10 thousand income per month. All of them were from Buldhana-a rural district of the Maharashtra,80% are married 63.33% belong to joint family having 3 to 6 members in their family. Many of them were vegetarian, taking 2 home cook meals in the day, 46.67% of women consuming micronutrients rich food regularly.Majority of them don’t have past medical history, history of anaemia or taking medication. In pre-test, women had 15.93 knowledge score and in post-test it was 23.73 knowledge score, so the mean difference was 7.80 score, which was large and statistically significant, knowledge score. Conclusion: This study concluded that Prevalence of Micronutrient deficiency was low. Waist circumference and BMI of women is more than normal and Vitamin B12 is less in women who had inadequate knowledge regarding micronutrients, also structured teaching program was significantly effective in improving their knowledge regarding micronutrients. Statically significant was found association between vegetarian diet, income, private job and the prevalence of micronutrient deficiencies.

BackgroundMalnutrition and anemia are major concerns that significantly impact quality of life and disease activity in patients with Crohn’s disease (CD) following surgical resection. However, comprehensive data on nutritional status and anemia in post-surgical CD patients remain limited. This study aims to evaluate the prevalence of malnutrition and anemia in a multi-center cohort of CD patients after surgery.MethodsIn this cross-sectional study, patients with CD who underwent bowel resection across 20 provinces in China were evaluated for nutritional status and anemia. Biochemical parameters were collected and analyzed to explore their associations with nutritional status and anemia.ResultsA total of 160 patients, with a mean age of 37.6 years and 63.8% male, were enrolled. Malnutrition was observed in 47.5% of patients, with 56.3% at risk of malnutrition post-surgery. Malnourished patients exhibited lower nutritional indicators and more severe disease activity. Anemia was detected in 60.6% of patients, with 79.4% having mild anemia and 20.6% moderate anemia. Patients with post-surgical anemia showed elevated inflammatory markers and increased disease activity. Both malnutrition and anemia were significantly associated with reduced quality of life (p < 0.05).ConclusionMalnutrition and anemia were highly prevalent and negatively impacted patients with CD following surgery. Screening and early preventive management of malnutrition and anemia were critical components of postoperative care in CD.

Background: Anemia is a preventable medical condition that Pakistan has been facing for decades, particularly among children. It is a primary risk factor contributing to the disease burden in this population. Methods: This analytical cross-sectional study aimed to evaluate anemia and its determinants in children at the Children’s Hospital and the Institute of Child Health, Lahore. Blood samples were collected from children aged 1–11 years (n = 271) who visited the outpatient department and nutrition clinic of the hospital. Hemoglobin (Hb) levels were tested in the hospital’s pathology laboratory to determine the occurrence of anemia (defined as Hb levels &lt;11.5 g/dL) and to categorize the severity of the condition as follows: mild anemia (11.0–11.4 g/dL), moderate anemia (7.0–10.99 g/dL), and severe anemia (&lt;7.0 g/dL). Data on potential risk factors associated with anemia, as well as anthropometric measurements, were also collected. Results: The median Hb level was 10.1 g/dL (interquartile range: 8.6–11.4 g/dL) with levels ranging from 4.2 to 14.5 g/dL. A high proportion of children (66.8%, 181/271) were anemic, with severity classified as mild (54.1%, 98/181), moderate (32.6%, 59/181), and severe (13.3%, 24/181). The most prevalent type of anemia was microcytic (94.4%, 171/181), followed by normocytic (3.9%, 7/181) and macrocytic (1.7%, 3/181) cases. Additionally, malnutrition was observed in a significant number of children (51.7%, 140/271). In multivariable regression analysis, age was identified as a significant contributor to anemia. Children aged two years or younger had nearly three times the odds (2.97 times) of developing anemia compared to older age groups. Conclusion: The high prevalence of anemia and malnutrition compromises the quality of life for children, negatively affecting their long-term productivity, intellectual capacity, social interactions, and emotional well-being.

BackgroundThe purpose of this study was to evaluate the effect of third-trimester maternal iron deficiency and iron deficiency anemia on neonatal cord-blood hemoglobin (Hgb), and serum ferritin levels.MethodsPregnant women who gave birth between 370/7 and 406/7 weeks of gestation, and their neonates were included. Maternal hemoglobin and ferritin levels were assessed. They were divided into two groups based on Hgb values as anemic and non-anemic. Furthermore, the anemic group was classified as mild, moderate, and severe anemia. Maternal and cord Hgb, hematocrit and ferritin levels were compared between groups. The study population was stratified into two groups according to iron supplementation status.ResultsAmong 627 women included, 226(36%) were diagnosed as anemic, of which 130(57.5%) had mild, 94(41.6%) moderate, and 2(0.9%) severe anemia. Mean maternal Hb levels were 9.9±0.9 g/dl and 12.1±0.9 g/dl in the anemic and non-anemic groups, respectively. The mean maternal serum ferritin of anemic and non-anemic mothers were 11.7 ng/ml and 15.8 ng/ml, respectively (p < 0.001). The mean cord-blood serum ferritin of neonates born from anemic and non-anemic mothers was 113±68.8 ng/ml and 134±95.0 ng/ml, respectively (p = 0.012). Cord-blood Hb levels of neonates born from anemic and non-anemic mothers were 15.1±1.8 g/dl and 15.5±2.0 g/dl, respectively (p = 0.006). The 5th, 25th, 50th, 75th, and 95th percentiles of cord blood serum ferritin concentrations were 32.6, 72.2, 107.5, 154.1, and 272.6 ng/ml, respectively. Among neonates born from mild, moderate, and severe anemic mothers, there was no significant difference regarding cord-blood serum ferritin and blood count parameters (p > 0.05). Cord-blood serum ferritin concentrations were found to be 119 ± 85.7 ng/ml and 136.4 ± 87.9 ng/ml in the low and normal maternal serum ferritin groups, respectively (p = 0.015).ConclusionMaternal anemia is common and associated with lower neonatal cord blood hemoglobin and ferritin levels. However, lack of iron supplementation during pregnancy, rather than anemia itself, was the strongest independent predictor of neonatal anemia. These findings highlight the importance of routine antenatal iron supplementation to support fetal iron status and improve perinatal outcomes. Further randomized controlled trials are needed to evaluate the effects of maternal iron supplementation on fetal iron stores and long-term outcomes.

Anemia continues to be a major public health challenge worldwide, particularly among adolescent girls who are biologically and socio-culturally vulnerable during their developmental years. In India, the prevalence remains critically high, affecting not only physical health but also emotional well-being, cognitive functioning and academic performance. This qualitative study aimed to explore the lived-in experiences of adolescent girls diagnosed with anemia who underwent a structured 12 week multi-intervention program. The program included nutritional support, cognitive training and health education designed to enhance awareness and promote self-care practices. Adopting a phenomenological design, in-depth interviews were conducted with 15 adolescent girls aged 12 to 18 years from government schools in the Raigarh district of Chhattisgarh. Participants were selected through purposive sampling and had been clinically diagnosed with mild to moderate anemia (hemoglobin levels between 7.0 and 11.9 g/dL). Interviews, lasting between 30 to 45 minutes, were conducted in a private setting to ensure confidentiality and comfort. Audio recordings were transcribed verbatim and analyzed thematically using Braun and Clarke’s six-phase framework. Analysis of the narratives revealed six interconnected themes: functional limitations, physiological burnout, cognitive symptom clusters, academic impairments, social stigma and self-directed care. These themes reflected the interconnected challenges faced by the participants and highlighted both the debilitating impact of anemia and their evolving resilience. This study emphasizes the significance of understanding anemia not merely as a clinical condition but as a deeply personal and complex experience that shapes various domains of adolescent life. Beyond general observations, qualitative inquiry uncovers the nuanced emotional, social and psychological impacts often overlooked in routine health assessments. The insights gained underscore the need for adolescent-centered, integrative health strategies that address the lived realities of anemia, particularly in resource-constrained settings.

The association of anaemia with maternal and perinatal mortality poses a significant public health threat. This challenge is often exacerbated among adolescent pregnant women in low and middle-income countries. However, the prevalence of this devastating condition and its causes among pregnant teenagers in Ghana remain unclear. This study aimed to address the knowledge gap about the causes of anaemia among adolescent pregnant women attending antenatal care services at Ussher Hospital in Accra. About 329 pregnant adolescents aged 13–19 receiving antenatal care services at Ussher Hospital within the period of June, 2023 to August, 2023 were recruited. Questionnaires were administered to the participants after informed consent had been taken to collect socio-demographic information. The laboratory result for the participants with respect to Haemoglobin (Hb) level and sickling status were recorded from their ANC book between the study period; June, 2023 to August, 2023. Data was presented in percentage in a tabular format. The findings revealed that 72% of pregnant adolescents were anaemic. About 5.8% had severe anaemia, while 43.1% and 23.1% had moderate and mild anaemia, respectively. Non-compliance with intake of iron and folate supplements and poor dietary practices due to financial constraints as well as genetic factors such as sickle cell disease were the primary causes of the high prevalence of anaemia recorded in this study. This study recommends nutritional education and counselling as well as interventions that promote access to healthcare and utilization of iron-folate supplements that promote nutritional balance and help to prevent anaemia especially during pregnancy.

Background: Anemia is a major global public health concern, particularly affecting women of reproductive age. Occupational settings like garment factories may pose additional risks due to poor working conditions, nutritional inadequacies, and workplace-related health hazards. India has the highest burden of anemic women globally, with over half of reproductive-age women affected. Methods: A cross-sectional analytical study was conducted among women aged 15-49 years working in garment factories in Bengaluru Urban. Multi-stage cluster sampling was used to select participants. Data was collected through structured interviews, anthropometric measurements, and hemoglobin estimation using the digital hemoglobinometer method. Anemia was defined as hemoglobin levels &lt;12.0 gm/dl according to WHO criteria. Statistical analysis included descriptive statistics and multivariable logistic regression to identify associated factors. Results: The overall prevalence of anemia was found to be 71.3%, with 37.2% having mild anemia, 52.9% moderate anemia, and 9.8% severe anemia. Significant risk factors included low socioeconomic status, inadequate dietary intake, long working hours, and poor workplace conditions. Conclusions: Anemia prevalence among female garment workers in Bengaluru urban area was substantial, indicating an urgent need for targeted interventions focusing on nutritional supplementation, improved workplace conditions, and comprehensive occupational health programs.

Stunting can begin as early as adolescence, particularly through anemia in young girls. Anemia occurs due to a lack of hemoglobin, especially during menstruation. If not properly addressed, it can lead to stunting. In Indonesia, the anemia rate among adolescents remains high, reaching 32% in 2018 and declining to 15.5% in 2023. According to the WHO, this figure is still considered high, as it remains above 10%. The purpose of this community service activity is to increase adolescent knowledge and skills regarding anemia prevention. The community outreach activities included pre-test and post-tests, giving health education, and hemoglobin level checks. Results showed that knowledge before the health education was less of knowledge (84.3%), but after the health education increased to 86.8% in good knowledge. Furthermore, hemoglobin level checks revealed that 37% of students had anemia, with half of these having moderate anemia. This community service activity can be a way to prevent anemia through health education and hemoglobin level checks, thereby increasing knowledge about anemia prevention and stunting prevention.

Anemia in pregnancy presents a critical public health concern in developing countries, including India, as it is associated with increased risks of maternal complications and adverse fetal outcomes. This study investigates the socio-economic and demographic variables associated with anemia during pregnancy in Gajapati district, Odisha, an aspirational district with a significant tribal population. A cross-sectional survey was carried out at the community level involving 151 pregnant women. Data were collected through semi-structured interviews, and hemoglobin levels were recorded from ‘Mother and Child Protection’ (MCP) cards issued under the National Health Mission. Statistical analysis using SPSS (v20) included descriptive statistics, bivariate analysis, and binary logistic regression. The results revealed a 37.75% prevalence of anemia, with 12.58% experiencing moderate anemia. Significant associations were found between anemia and educational level (p = 0.004), maternal age (p = 0.001), and rural residence (p = 0.007), while factors such as income and family size showed no significant impact. These findings highlight the importance of focused health education, improved access to antenatal care, and enhanced outreach through SHGs and ASHA workers in tribal and underserved areas. The study contributes to the evidence base for designing context-specific interventions aligned with national nutrition and maternal health strategies.

α-thalassemia is a hereditary hemolytic anemia, in which the clinical manifestations vary greatly depending on the degree of α-globin gene deletion. -α3.7/--SEA thalassemia is an intermediate type of α-thalassemia, with three α-globin genes deletion. The clinical symptoms of -α3.7/--SEA thalassemia vary from mild to moderate anemia [1]. However, little studies had reported the diagnosis and clinical symptoms of -α3.7/--SEA thalassemia. Here we reported two cases of -α3.7/--SEA thalassemia, one inpatient for chronic headache and one outpatient for elevated bilirubin. Two patients were first subjected to blood test, and the laboratory data showed the decreased hemoglobin concentration and mean corpuscular volume. Peripheral blood cells smear displayed that the mature red blood cells were markedly different in size, with enlarged central pale area, occasional oval red blood cells, suggesting the potential microcytic hypochromic anemia. Hemoglobin electrophoresis displayed the low level of HbA2, indicating the α-thalassemia or δ-thalassemia. Reverse dot blot hybridization assay detected the deletion of α-globin genes in the two cases. After ameliorative treatment for anemia, the inpatient's headache was significantly relieved and stable. Comprehensive judgment of clinical symptoms and laboratory test results is applicative for -α3.7/--SEA thalassemia diagnosis. -α3.7/--SEA thalassemia may lead to individual differences in clinical symptoms and complications, which requires more attention and early treatment.

Background:Anemia during pregnancy is a global public health concern that can negatively impact maternal and fetal outcomes. It is a major health concern among antenatal mothers in India, and there is substantial variation in the prevalence of anemia in different parts of India. Understanding the problems in the regions of the country can help devise locally viable plans to mitigate the problem, and this study aimed to assess the prevalence of anemia among antenatal women in north-western India.Materials and Methods:A cross-sectional study involving convenient selection of antenatal women was conducted in selected hospitals in Punjab, India, between July 2022 and December 2022. The data were collected using structured questionnaires. The prevalence of anemia and its contributing factors were ascertained using descriptive statistics as well as bivariate and multivariate statistical analyses.Results:Out Of 300 pregnant women evaluated for anemia, 70.7% had anemia; 35.71%, 27.33%, and 7.75% had mild, moderate, and severe anemia, respectively. Educational level (χ2 = 21.90, df = 299, p = 0.01) and family income level (χ2 = 12.46, df = 299, p = 0.006) were associated with anemia among antenatal women. Parity (χ2 = 15.58, df = 299, p = 0.01), gestational age (χ2 = 14.95, df = 299, p = 0.02), and consumption of iron and folic acid tablets (t299 = 60.56, p < 0.001) were pregnancy-related factors significantly associated with anemia.Conclusions:According to this study, anemia in pregnant women is highly prevalent in north-western India and has a number of modifiable contributing factors. These factors should be considered for the prevention and control of anemia in pregnant women during antenatal care and visits.

This study aimed to determine the prevalence of anaemia and associated factors among type 2 diabetic patients. This research utilised a hospital-based cross-sectional study design. The research was conducted at the Diabetic Clinic of Ho Municipal Hospital. The study involved 180 type 2 diabetic patients, aged 20 years or older, who had been on anti-diabetic medications for a minimum of three months before the study. Premenopausal women who had not menstruated in the two weeks before recruitment were also included in the study. Participants were excluded if they were receiving haematinics, had undergone a blood transfusion in the preceding month, were undergoing treatment for malaria or helminthiasis, or had any other chronic complications such as renal failure, liver disease, or stroke. Individuals with type 1 diabetes and pregnant women were excluded from the study. Approximately a quarter [44 (24.4%)] of the study population had anaemia, with a slight male preponderance [15(25.0%)]. Mild and moderate anaemia were 31 (70.5%) and 13(29.5%), respectively. Microcytic hypochromic anaemia [16 (36.4%)] was the most frequent morphological type of anaemia, followed by normocytic normochromic anaemia [12(27.3%)]. High BMI and low platelet counts were independently associated with reduced odds of developing anaemia in patients with type 2 diabetes mellitus. Anaemia is a common finding in patients with type 2 diabetes mellitus in the Ho municipality. Mild anaemia and microcytic hypochromic anaemia were predominant among the anaemic patients. High BMI and low platelet count were significant predictors of reduced probability of anaemia. None declared.

BackgroundVitamin B12 is an essential micronutrient for optimal hematopoietic and neurocognitive function. Vitamin B12 deficiency is associated with a wide spectrum of diseases affecting various systems of the body. This study aimed to investigate the clinico-hematological parameters in patients with vitamin B12 deficiency and analyze their correlation with severity.MethodologyThis hospital-based, prospective observational study was conducted at the Department of Pathology, Tata Main Hospital, Jamshedpur, over 12 months (June 2022-May 2023). Vitamin B12 testing was not routinely performed for all OPD and IPD patients but was ordered based on clinical discretion; therefore, patients with serum vitamin B12 <180 pg/mL were included, regardless of anemia status. During the study period, a total of 420 adult patients were classified as deficient (100-179 pg/mL) or severely deficient (<100 pg/mL). Sociodemographic, clinical, and hematological parameters were collected and analyzed for correlation with the severity of vitamin B12 deficiency.ResultsAmong 9,596 patients tested for vitamin B12, 2,193 had levels <180 pg/mL, giving a prevalence of 22.9% among tested individuals. Out of 420 patients who met our eligibility criteria, 268 participants (63.8%) were classified as vitamin B12 deficient, while 152 participants (36.2%) were severely deficient. The most common clinical features were pallor (236, 56.2%), fatigue (160, 38.10%), anorexia (156, 37.14%), and tingling sensations (135, 32.14%). Anemia was present in 315 participants (75%), with higher rates of moderate and severe anemia in the severely deficient group (P < 0.001). Contrary to expectations, normocytic normochromic blood picture (176, 41.90%) and normocytic normochromic anemia (126, 30.00%) were more common than macrocytic anemia (9, 2.14%). The proportion of patients with irritability, numbness, and glossitis was significantly higher in severely deficient patients (P < 0.05). Mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW) values were significantly higher in the severely deficient group (P < 0.05). Bicytopenia and pancytopenia were observed in 11 patients (2.6%) and 10 patients (2.38%), respectively, and occurred exclusively in those with severe vitamin B12 deficiency.ConclusionsVitamin B12 deficiency has a significant prevalence with distinct clinico-hematological correlations to severity. The correlation between the severity of deficiency and clinical manifestations, particularly neurological symptoms and the degree of anemia, underscores the importance of early detection and treatment. The predominance of normocytic rather than macrocytic anemia challenges traditional diagnostic paradigms and suggests clinicians should not rely solely on macrocytosis when suspecting vitamin B12 deficiency.

AimsHypertensive disorders of pregnancy (HDPs) are characterized by adverse or inadequate maternal cardiovascular adaptations and are associated with poor perinatal outcomes. Iron deficiency (ID) is a common pregnancy complication that elicits numerous cardiovascular adaptations. Though generally considered deleterious in pregnancy, whether ID mitigates or exacerbates maternal cardiovascular dysfunction in HDP has not been investigated.Methods and resultsPregnant spontaneously hypertensive rats (SHRs) and normotensive Wistar Kyoto rats were fed either an iron-replete or an iron-restricted diet prior to and throughout pregnancy. Pregnant dams underwent tail-cuff plethysmography and echocardiography throughout pregnancy, as well as pressure–volume loop assessments and in vivo blood pressure (BP) measurements on GD21 (term = GD22). Data were analysed by two-way ANOVA with Holm–Šídák’s post hoc test. Dietary iron restriction caused progressive BP lowering throughout gestation that was most apparent in SHR dams. By GD21, all ID dams had moderate anaemia, whereas ID foetuses of both strains exhibited signs of severe anaemia, asymmetric growth restriction, and placentomegaly. Maternal ID was associated with left ventricular remodeling in both strains, albeit circulating N-terminal pro-B-type natriuretic peptide levels—a marker of pathological stretch—were reduced in ID-SHR dams. Maternal ID hearts exhibited enhanced ventricular performance reflected by increased stroke volume and cardiac output relative to their iron-replete counterparts. ID also improved cardiac efficiency and ventriculo-arterial coupling, and these latter effects were most pronounced in SHR dams.ConclusionID in pregnancy was associated with greater BP lowering and improved cardiac performance in SHR dams compared to normotensive WKY dams, albeit ID foetuses from both strains exhibited growth restriction and placentomegaly. These findings highlight a complex interaction between ID anaemia in pre-existing hypertension in pregnancy and, if translated to humans, could have important implications for the identification and management of both prevalent health conditions.

Pregnancy anemia is a condition where the hemoglobin level in the blood falls below normal due to a decrease in the number of erythrocytes or hemoglobin, thereby reducing the blood's ability to carry oxygen to the vital organs of the mother and fetus. The aim of this study is to determine the effectiveness of a combination of iron (Fe) tablets and dates in addressing anemia. This research uses a case study approach, which aims to explore a phenomenon in depth within clearly defined boundaries. Data were comprehensively collected from various sources and documented using the SOAP method (Subjective, Objective, Assessment, Plan), providing a complete understanding of the case involving the respondent. The main focus of this study is on the phenomena arising from complaints and examination results during the period of midwifery care. The study was conducted on Mrs. DN at 38 weeks of gestation with moderate anemia, and the intervention provided consisted of the consumption of Fe tablets and 7 dates per day for 14 days. The results of the 2-week intervention showed successful outcomes for moderate pregnancy anemia, with an increase in hemoglobin levels from 9.2 g% to 9.9 g%. The case analysis established is Mrs. DN at 38 weeks of gestation with moderate anemia. The conclusion of this study is that the combination of Fe tablets and 7 dates per day for 14 days is effective as an intervention for managing moderate pregnancy anemia.

Babesia canis infections are of rising importance in Germany. This retrospective study aimed to correlate hematological and biochemical parameters with acute-phase proteins, levels of parasitemia and antibodies, as well as stays abroad in dogs with acute B. canis infection. Dogs in Germany tested PCR-positive for B. canis and negative for Anaplasma phagocytophilum from January 2018 to December 2024 were included if data on hematocrit, leukocytes, and platelets were available. Hematological scoring (HES) was performed by addition of points for mild (+ 1), moderate (+ 2), and marked (+ 3) anemia, thrombocytopenia, and leukopenia, as well as for the presence of pancytopenia (+ 3) and leukocytosis (+ 1). Results of biochemical and CRP analysis, Babesia antibody determination, and pathogen quantification were included, if available. P ≤ 0.05 in Spearman's rank correlation was considered statistically significant. 342 dogs were included. History of stays abroad was known for 191/342 dogs (55.8%; no stays abroad 113/191 (59.2%), imported 55/191 (28.8%), travel 23/191 (12.0%)). The most common clinicopathologic findings were increased CRP (87.4%), thrombocytopenia (85.1%), anemia (78.7%), hyperbilirubinemia (74.2%), decreased iron levels (51.1%), and leukopenia (49.7%). Dogs without stays abroad showed significantly higher HES (n= 113, median: 6), CRP (n= 60, median: 116.2mg/l), and levels of parasitemia (n= 92, median: 2916 × 103parasites/ml), but lower serum antibody levels (n= 59, median: 1.5 TE) compared with imported dogs (HES: n= 55, median: 2; CRP: n= 23, median: 40.0mg/l; levels of parasitemia: n= 29, median: 23 × 103 parasites/ml; antibodies: n= 37, median: 60.6 TE) (P < 0.001 each). Positive correlations were found between CRP and levels of parasitemia (ρ = 0.444), CRP and HES (ρ = 0.406), as well as levels of parasitemia and HES (ρ = 0.348), while negative correlations were observed between levels of antibodies and parasitemia (ρ = -0.666), as well as antibody levels and HES (ρ = -0.652) (P < 0.001 each). About 60% of dogs with acute B. canis infection had no history of stays abroad, thus representing autochthonous infections. Most dogs without stays abroad were immunologically naive, in contrast to most imported dogs showing positive and high antibody levels. Dogs with high antibody levels showed less severe clinicopathological alterations and lower levels of parasitemia in the peripheral blood, explained by protective antibody activity.