Moderate Anemia Research Articles

Evaluation of Prevalence and Severity of Anemia among Non-pregnant women of Reproductive Age in Garmian Province, Iraqi Kurdistan Region

Anemia is a major significant public health issue that affects both pregnant and non-pregnant women throughout the world. This study aimed to determine the prevalence and severity of anemia, as well as its classification, based on MCV values in non-pregnant women residing in the Garmian province in the east of Iraq. Blood samples were collected from non-pregnant women between the ages of 16 and 49 years. Anemia is classified as mild, moderate and severe, and as microcytic, normocytic and macrocytic depending on the level of Hb or mean corpuscular volume (MCV) respectively. In this study sociodemographic and hematological characteristics were also evaluated. The results showed that 56% of the study samples were anemic, and of the total anemic patients, 54 (35%), 86 (55%) and 16 (10%) had mild, moderate, and severe anemia respectively. Also, of the total anemic patients, 102 (65%) had microcytic type of anemia, 51 (33%) had normocytic anemia and only 3 (2%) had macrocytic anemia. The majority of anemic women (77.6%) had normal RBC counts but low Hct, MCH and MCHC values of 76.3%, 79.5% and 81.4%, respectively. The results showed also that there was no significant difference between the severity of anemia and age groups, occupation, blood pressure, bleeding, and haemorrhoids. However, diabetics showed a significant difference in anemia severity with <0.0004 P-value. The results showed that anemia had become a major public health issue in the study area.

Gastrointestinal bleeding with direct oral anticoagulants in patients with atrial fibrillation and anaemia

IntroductionA high risk of gastrointestinal bleeding has been reported with the use of some direct oral anticoagulants (DOACs). This risk may be of particular concern in individuals with associated anaemia. The aim of this study is to investigate potential differences in the risks of gastrointestinal bleeding and stroke among the four available DOACs in patients with atrial fibrillation (AF) and moderate or severe anaemia. Materials and methodsAll Danish patients diagnosed with incident AF who had a baseline haemoglobin measurement and subsequently initiated DOAC therapy between 2012 and 2021 were identified through administrative registries. Only patients with moderate or severe anaemia (N = 7269) were included and evaluated regarding the risk of hospitalization for gastrointestinal bleeding and stroke. Standardized absolute 1-year risks of stroke and gastrointestinal bleeding were calculated from multivariable Cox regression analyses. DOACs were compared pairwise ResultsCompared with apixaban, both dabigatran and rivaroxaban were associated with a significantly increased risk of gastrointestinal bleeding with standardized 1-year risk ratios of 1.73 (95 % confidence interval [CI], 1.10–2.35) and 1.56 (95 % CI, 1.18–1.93), respectively, while no significant difference was seen in the comparison of apixaban with edoxaban 1.32 (95 % CI, 0.41–2.32). No significant differences in gastrointestinal bleeding were observed with pairwise comparisons of dabigatran, rivaroxaban and edoxaban. Finally, no significant difference in stroke risk among the four DOACs was observed. ConclusionIn AF patients with moderate or severe anaemia, apixaban was associated with a significantly lower risk of gastrointestinal bleeding than dabigatran and rivaroxaban. No significant difference in stroke risk was observed across all four available DOACs.

’FREQUENCY OF WORM INFESTATION AMONG PREGNANT FEMALES PRESENTING WITH ANEMIA TO DOCTORS TRUST TEACHING HOSPITAL SARGODHA

Background: Anemia is major contributor to maternal deaths as well as to low birth weight in developing countries. Association of anemia with helminthic infestation has been seen in the world and by eliminating it, anemia may be reduced with positive effects on maternal outcome.
 Methods: A cross sectional study done in Doctors trust teaching hospital Sargodha from 1st August 2019 to 31st July 2020 and total 130 patients were enrolled. Hemoglobin estimation and stool examination for parasitic infestation was done for all these women. Data was collected through a structured questionnaire and was entered and analyzed using SPSS version 24.0.
 Results: From 130 patients, it was observed that the minimum age was 18 years and maximum age was 40 years with mean and standard deviation of the age was 29.86 ± 6.61 years. Mild anemia was observed in 45.4% patients, moderate anemia was observed in 26.9% patients and severe anemia was observed in 27.7% patients. The frequency of worm infestation was found as 17.7% in pregnant females presenting with anemia to a tertiary care hospital. Effect modifiers have significant influence except age and monthly income. Significant association was found between BMI and presence of worm infestation having p-value = 0.005.

Hemoglobin D and Coinheritance with Hb S, β-thalassemia

Objective: Hb D-Punjab (also known as D-Los Angeles) is a recessively inherited variant of hemoglobin. It is one of the most common hemoglobin variants worldwide. In this study, we aimed to evaluate the hematological features of our homozygous and heterozygous Hb D patients and patients with compound heterozygosity for Hb D and other hemoglobinopathies in terms of clinical and laboratory findings. Methods: In this study, cases with Hb D-Punjab have been identified in both the heterozygous and homozygous states, as well as coinheritance with Hb S or β-thalassemia. We presented the clinical and laboratory characteristics of 18 cases (Hb D/D (n=2), Hb D/β-thalassemia (n=3), and Hb S/D (n=3) and Hb D traits (n=10)). Results: As a result of the study, it was observed that Hb D was asymptomatic in both heterozygous and homozygous forms. Hb D/β thalassemia cases showed mild microcytic and hypochromic anemia, but they were clinically normal. Compound heterozygosity for Hb S/D showed moderate hemolytic anemia, but a severe clinical picture with painful crises, just like sickle cell patients. Conclusion: Hemoglobin D-Punjab, which is asymptomatic even in homozygous conditions, can cause a variety of clinical pictures from mild to severe when inherited in combination with other hemoglobinopathies.

Improving anaemia diagnosis using peripheral blood smear with remote interpretation in adults living with HIV with moderate to severe anaemia: A prospective study nested within the Kilombero and Ulanga antiretroviral cohort.

In low-resource settings, anaemia is a very common condition. Identification of anaemia aetiologies remains challenging due to the lack of diagnostic tools and expertise. We aimed to improve anaemia diagnostics using peripheral blood smear (PBS) with remote interpretation in people living with HIV (PLHIV) with moderate to severe anaemia. We conducted a prospective study nested within the Kilombero and Ulanga Antiretroviral Cohort, including non-pregnant PLHIV aged ≥18 years presenting with moderate (haemoglobin 7.0-9.9 g/dl) or severe (<7.0 g/dl) anaemia at any visit from January 2019 to December 2020. For each participant, ten PBS images, full blood count and clinical details were shared with a haematologist for remote interpretation (enhanced care). Identification of anaemia etiologies and potential impact on treatment was compared between enhanced and standard care. Among 400 PLHIV with moderate to severe anaemia, 349 (87%) were female, median age was 40 years (interquartile range (IQR) 35-46)), 65 (17%) had a body mass index <18.5 kg/m2, 215 (54%) had HIV WHO stage III/IV, 79 (20%) had a CD4 cell count <200 cells/μl and 317 (89%) had HIV viral load <100 copies/ml. Severe anaemia was diagnosed in 84 (21%). Suspected multiple aetiologies were documented more frequently by enhanced care compared to standard care 267 (67%) vs 20 (5%); p<0.001. Suspected iron deficiency was the most frequent aetiology (n = 337; 84%), followed by chronic disease (n = 199; 50%), folate/vitamin B12 deficiency (n = 78; 20%) and haemoglobinopathy (n = 83; 21%). In 272 participants (68%), enhanced care revealed additional clinically relevant findings with impact on the treatment recommendation. Remote interpretation of PBS combined with clinical information and blood cell count results can provide insights to the suspected aetiological diagnosis of moderate and severe anaemia in rural low-resource settings and impact specific treatment.

The burden of anemia among Chinese HIV-infected patients following the initiation of antiretroviral therapy in the treat-all era: a nationwide cohort study

BackgroundTo assess the prevalence of anemia before and after antiretroviral therapy (ART) initiation and to identify impact of anemia on mortality among HIV-infected patients in China during the Treat-All era.MethodsAll HIV-infected patients who newly initiated ART between January 1, 2017 and December 31, 2020 were enrolled and followed up to December 31, 2021 in China. We analyzed the prevalence of anemia before and after ART initiation. Generalized estimating equations were fitted to determine factors associated with anemia after ART. Time-dependent cox proportional hazards models were performed to estimate the effect of anemia on death.ResultsOf 436,658 patients at the baseline of ART initiation, the overall prevalence of anemia was 28.6%. During a median 2.65 (IQR: 1.80–3.51) years of follow-up after ART initiation, 376,325 (86.2%) patients had at least one Hb measurement (a total of 955,300 hemoglobin measurements). The annual prevalence of anemia after ART was 17.0%, 14.1%, 13.4%, 12.6% and 12.7%, respectively. Being anemic at the baseline of ART initiation (adjusted odds ratio, aOR = 6.80, 95% confidence interval (CI): 6.67–6.92) was the strongest factor associated with anemia after ART. Anemia status after ART showed a strong association with death after multivariable adjustment (mild anemia: adjusted hazard ratio (aHR) = 2.65, 95% CI: 2.55–2.76; moderate anemia: aHR = 4.60; 95% CI:4.40–4.81; severe anemia: aHR = 6.41; 95% CI:5.94–6.91).ConclusionsIn the era of ART universal access, pre-ART anemia was common among HIV-infected patients. Notably, a certain proportion of anemia still persisted after ART, and was significantly associated with death. We recommend strengthening the monitoring of patients at risk of anemia, especially in patients with baseline anemia or during the first year of ART, and timely treatment for correcting anemia.

Prevalence of Iron Deficiency Anemia among Under Five Years Children in a Tertiary Health Care Center of Nepal

BackgroundGlobally 39.8% children under five years old are anemic, with prevalence of childhood anemia in Nepal reported to be 52.7% by 2016. The aim of this study is to analyze the prevalence of anemia among pediatric age group between 2 months to 60 months to provide some insight for prevention of anemia among children. MethodsThis is a prospective observational cross-sectional study conducted over the period of 15st March 2019 to 14th August 2019 at Nobel Medical College Teaching Hospital which included children presenting to pediatric department between ages 2 to 60 months. Children with known history of hemolytic disorders, malignancies and chronic diseases were excluded from the study. Hemoglobin level and Mean Corpuscular Volume (MCV) was obtained. Descriptive statistics such as mean, percentage and standard deviation were calculated. ResultsTotal 500 children selected randomly for the study, 234 (46.8%) children were non-anemic while mild anemia was seen in 86 (17.2%), moderate anemia in 155 (31.0%) and severe anemia in 25(5.0%) children. Mean hemoglobin was 10.2 gm/dl with standard deviation of 1.847. Among male 45.6% were anemic whereas 42.7%female were anemic. Children of age group 2 to 12 months had higher percentage of anemia with 76.2% being anemic. Among 266 anemic children 219 (82.3%) had MCV below the normal range. ConclusionOur study shows the higher prevalence of anemia in children between 2 to 60 months of age. Microcytic anemia was more common which represents higher prevalence of iron deficiency anemia among anemic children.

Preoperative hematocrit levels and postoperative mortality in patients undergoing craniotomy for brain tumors.

Abnormal hematocrit values, including anemia and polycythemia, are common in patients undergoing craniotomy, but the extent to which preoperative anemia or polycythemia independently increases the risk of mortality is unclear. This retrospective cohort study aimed to examine the association between preoperative anemia and polycythemia and postoperative mortality in patients who underwent craniotomy for brain tumor resection. We retrospectively analyzed data from 12,170 patients diagnosed with a brain tumor who underwent cranial surgery at West China Hospital between January 2011 and March 2021. The preoperative hematocrit value was defined as the last hematocrit value within 7 days before the operation, and patients were grouped according to the severity of their anemia or polycythemia. We assessed the primary outcome of 30-day postoperative mortality using logistic regression analysis adjusted for potential confounding factors. Multivariable logistic regression analysis reported that the 30-day mortality risk was raised with increasing severity of both anemia and polycythemia. Odds ratios for mild, moderate, and severe anemia were 1.12 (95% CI: 0.79-1.60), 1.66 (95% CI: 1.06-2.58), and 2.24 (95% CI: 0.99-5.06), respectively. Odds ratios for mild, moderate, and severe polycythemia were 1.40 (95% CI: 0.95-2.07), 2.81 (95% CI: 1.32-5.99), and 14.32 (95% CI: 3.84-53.44), respectively. This study demonstrated that moderate to severe anemia and polycythemia are independently associated with increased postoperative mortality in patients undergoing craniotomy for brain tumor resection. These findings underscore the importance of identifying and managing abnormal hematocrit values before craniotomy surgery.

Etiology of Mild and Moderate Anaemia Among Rural Adolescent Girls in India.

A cluster randomized control trial study was conducted in Ballabgarh block of Faridabad District, Haryana, India. Baseline data of a total of 198 non-anemic and 202 anemic adolescent girls (12-19 years) was analyzed for hemoglobin and serum level of hepcidin, ferritin, folate acid, soluble transferrin receptor, vitamin B12 and CRP. Deficiency of iron (p < 0.001), folate (p < 0.01) and their mixed deficiency (p < 0.001) significantly increased with increasing severity of anaemia and contributed to 48.7% mild anaemia and 66.9% moderate anaemia. Anaemia of inflammation contributed to 16.2% of mild anaemia and 11.7% of moderate anaemia. More than one third of mild anaemia is caused by other causes. Current iron and folic acid program can alleviate around more than 2/3rd moderate anaemia and aroundhalf of mild anaemia among adolescent girls. Unknown causes of anaemia need further investigation.

Characteristics of Anemic Pregnant Women Receiving SMS Intervention on Iron Supplement Consumption

The case of maternal deaths due to anemia is increasing. The high level of anemia is caused by a lack of compliance in taking iron supplements. SMS (Short Message Service) features on mobile phones can be used as reminders for patients to take iron supplements. This research aims to describe the characteristics of anemic pregnant women who receive SMS interventions regarding iron supplement consumption. This study uses a descriptive research design conducted in 7 community health centers in the city of Makassar. The sampling technique uses purposive sampling and a total of 68 pregnant women were included (33 received SMS intervention and 35 did not receive SMS intervention). The research involving 33 anemic pregnant women shows that 48.5% are between 17 and 25 years old, and 51.5% have completed high school. Most are unemployed (81.8%), with sufficient husband support (45.5%). Most of them are in the second trimester (57.6%), with the highest parity being multiparous (45.5%) with only one ANC visit (42.4%), and have moderate anemia (51.5%). This study concludes that the respondents are classified as having moderate anemia, multipara, and having only one ANC visit. Regarding socioeconomic status, most of them have completed high school, unemployed, and receive sufficient support from their husbands.&#x0D; Keywords: Anemia, Iron Supplement, SMS Intervention

Prevalence of, association with, severity of, and prognostic role of serum hemoglobin level in acutely decompensated heart failure patients

BackgroundThe role of hemoglobin (Hb) level in the short-term prognosis of patients with acute decompensated heart failure (ADHF) remains a matter of debate. We aimed to declare the prevalence of, association with, severity of, and prognostic role of SHL with ADHF.MethodsUsing the data from the Persian Registry Of Cardiovascular Disease/ Heart Failure (PROVE-HF) study, we assessed the association between anemia and polycythemia (Hb < 13 g/dLit, > 16.5 g/dLit in males and < 12 g/dLit, and > 16 g/dLit in females, respectively) and short-term mortality using Cox proportional hazard modeling, with adjustment of clinically relevant variables.ResultsOf 3652 ADHF patients, anemia was seen in 1673 patients (48.40%). The prevalence of mild, moderate, and severe anemia was 42.33% (n = 1546), 3.23% (n = 118), and 0.24% (n = 9), respectively. Also, 422 patients (11.55%) had polycythemia. Compared to non-anemic patients, anemic patients were mainly male, older, and were more likely to have diabetes mellitus (DM), renal dysfunction, hypertension (HTN), and thyroid disease. Significant predictors of short-term mortality were lower systolic and diastolic blood pressure, lower Hb level, and higher blood urea nitrogen (BUN). Anemic patients had higher all-cause mortality [adjusted hazard ratio (aHR) 1.213, 95% confidence interval [CI] 1.054–1.396]. Moderate anemia increased mortality by approximately 80% in males (aHR 1.793, 95% CI 1.308–2.458) and females (aHR 1.790, 95% CI 1.312–2.442), respectively. Polycythemia had no association with short-term mortality in both genders (P-value > 0.05).ConclusionsThis study revealed that anemia is an adverse prognostic factor for short-term mortality in ADHF patients, with higher mortality in moderately anemic patients.

Accidental cardiac puncture during pericardiocentesis in a dog

AbstractA 12‐year‐old, male, neutered, crossbreed dog, with a bodyweight of 7.6 kg, was diagnosed with a moderate volume of pericardial effusion with cardiac tamponade using point‐of‐care ultrasound. Initial bloodwork revealed moderate anaemia (packed cell volume 23%) and hyperlactataemia (2.3 mmol/L). During pericardiocentesis, accidental cardiocentesis and drainage of 16.5 mL/kg of blood occurred, resulting in an increased heart rate, hypotension and alterations in the electrocardiogram trace amplitude. The patient received 25 mL/kg of packed red blood cells, and was discharged from hospital the next day. Unfortunately, the pericardial effusion reoccurred 7 days later. The patient was diagnosed with an epicardial mass, and euthanased 48 hours later.

AUTOIMMUNE AND HEMATOLOGICAL STATUS OF GRAVES’ DISEASE PATIENTS

Purpose of the study: comparative assessment of hematological and autoimmune status of patients with Graves’ disease (GD). Materials and methods. 43 GD patients aged between 19 and 64 years, 26 of which were women and 17 were men, have been examined. Assessment of hemograms of examined patients helped to reveal anemia in 28(65.1%) examined patients (group I). In 15 (34.9%) patients (group II) anemia was not detected. Mild anemia was diagnosed in 25 (89.3%), moderate anemia – in 3 (10.7%) patients. Hemoglobin, hematocrit, erythrocyte count and erythrocyte indices MCV, MCH, MCHC, serum Fe and ferritin status was chaecked in clinical analysis. The immune status was assessed by the level of CD3+, CD4+, CD8+, CD19+, CD4+/CD8+, CEC, Ef, TSHRAb and hormonal status by the level of TSH, T4 free. Results. Microcytic anemia was determined in 15 (53.6%) patients, normocytic - in 12 (42.8%), macrocytic - in 1 (3.5%) patient due to volume of erythrocytes’ MCV. According to morphological criteria of МСН (mean content of hemoglobin in erythrocyte) anemia hypochromic type of anemia was noted in 15 (53.6%) patients, normochromic - in 12 (42.8%), hyperchromic - in 1 (3.5%) patient. In 15 (53.6%%) patients in the group I microcytic - hypochromic anemia was diagnosed, which is characteristic for iron-deficient anemia; in 12 (42.8%) patients was verified normocyticnormochromic anemia, which has morphological parameters of anemia of chronic diseases and in 1 (3.5%) patient macrocytic-hyperchromic anemia. Comparative assessment of HGB level and indicators of iron metabolism in GD patients with anemia detected decreasing of HGB by 20%, serum Fe by 20%, ferritin by 29% compared to the corresponding control values. More pronounced depletion of the iron depot (ferritin) due to the fact that the development of anemia is preceded by a “latent iron deficiency”, an indicator of which is ferritin. Conclusions. GD is characterized by high frequency of anemia (65.1%), mostly mild form (89.3%), microcytichypochromic (53.6%), characteristic of iron deficiency anemia. The severe hematological disorders, detected among GD patients with anemia are accompanied by deep autoimmune changes and hyperfunction of the thyroid gland.

Prevalence of non-communicable diseases and risk factors of pre-eclampsia/eclampsia in four local government areas in Nigeria: a cross-sectional study

ObjectivesTo assess the prevalence of non-communicable diseases (NCDs) and risk factors associated with pre-eclampsia and eclampsia (PE/E) in women of reproductive age (WRA) in Nigeria.DesignA cross-sectional survey was administered to...

Iron Deficiency Anemia in Cancer Patients in Palliative Care

In this study, we aimed to investigate the effects of anemia on the prognosis by comparing the severity of anemia with several prognostic factors including metastases, functional performance, and the feeding status of cancer patients.This study included 189 cancer patients, who received treatment in the palliative care unit (PCU). Demographic characteristics of the patients, anemia test panel results, chemotherapy, the status of metastases, functional performance, the length of hospital stay, and the status at discharge were recorded and compared between the study groups. Of the cancer patients in PCU, 85.7% had anemia and 88.4% had metastases. In patients with severe anemia, the Eastern Cooperative Oncology Group Scale (ECOG) performance scores were lower and C-reactive protein (CRP) levels were significantly higher compared to the other patients in other groups (p=0.045, p=0.000). Glasgow Coma Scales (GCS) were found to be significantly lower in patients with moderate anemia than those without anemia. (p=0.049) We have shown that there is a correlation between the severity of anemia and poor prognostic criteria including low ECOG, GCS scores and high CRP levels in advanced cancer patients we treated in PCU. The early assessment of anemia and the adequate intake of nutrients along with iron supplements should be ensured in cancer patients during the disease course.

Cava Smoothie As An Adjuvant in Iron Supplementation Can Increase Hemoglobin Levels and Erythrocyte Indices in Anemic Adolescent Girls

Uncontrolled anemia leads to a decline in hemoglobin levels and erythrocyte blood indices, posing various health risks. To address this, a study aimed to assess the effectiveness of cava smoothies and iron supplementation in boosting hemoglobin levels and erythrocyte indices among anemic adolescent girls. The study involved 87 adolescent girls with moderate anemia, divided into three groups. The control group (C) received weekly iron tablets (60 mg), while two intervention groups (I1 and I2) were given the same iron tablets along with cava smoothies in increasing doses over 28 days. The results revealed significant improvements in hemoglobin levels. Group C showed an increase of 0.27 g/dL, while I1 and I2 demonstrated remarkable gains of 1.46 g/dL and 2.54 g/dL, respectively. Furthermore, erythrocyte indices (MCV, MCH, MCHC) exhibited positive changes. Group C saw increases of 0.35 fl, 0.34 pg, and 0.27 g/dL, I1 showed improvements of 0.69 fl, 0.61 pg, and 0.64 g/dL, and I2 experienced substantial enhancements of 1.97 fl, 1.61 pg, and 1.60 g/dL. In conclusion, the study confirmed that cava smoothies and iron supplementation effectively raise hemoglobin levels and improve erythrocyte indices in anemic adolescent girls, highlighting the potential benefits of this intervention for combating anemia.

Prevalence of anemia among school going adolescents in Thiruvallur district, Tamil Nadu

Background: Nutritional anemia, with iron-deficiency anemia as the most prevalent type, is a pressing global health concern, impacting two billion people worldwide. Among vulnerable groups, school-going adolescents aged 10 to 17 years require special attention due to the critical phase of growth and development during this period. This study aims to assess the prevalence of anemia and its association with sociodemographic factors among adolescents in Thiruvallur district, Tamil Nadu. Methods: A cross-sectional study was conducted among 900 adolescent girls, utilizing a multistage sampling technique. Hemoglobin levels were measured using one-touch blood sampling, and physical examinations were performed by trained healthcare professionals. A structured questionnaire collected sociodemographic information, dietary habits, and lifestyle factors. Results: The study revealed a concerning prevalence of anemia, with 60% of the participants affected. Among these, 41.3% experienced moderate anemia, while 18.4% had mild anemia, and 0.4% had severe anemia. A significant correlation was observed between anemia prevalence and low socio-economic status among the participants. Conclusions: The high prevalence of anemia among adolescent girls in Thiruvallur district underscores the urgency of targeted interventions and public health initiatives to address this critical health issue. Improving nutrition, healthcare access, and socio-economic conditions are crucial steps in combating anemia's impact on school-going adolescents. Collaborative efforts from policymakers, healthcare providers, and community organizations are essential in eradicating nutritional anemia and enhancing the health and prospects of adolescents in the studied region.

Effect of Anemia on Tumor Response to Preoperative Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer

Preoperative neoadjuvant chemoradiotherapy (nCRT) and total rectal mesenteric resection (TME) are the primary treatment options for locally advanced rectal cancer (LARC), but their efficacy varies. This study aimed to investigate the impact of anemia on the tumor response of patients with LARC receiving preoperative neoadjuvant chemoradiotherapy. This study was a retrospective analysis of clinical and pathological data from patients with LARC who underwent nCRT and TME from January 2019 to May 2022 at a single institution. The tumor response was evaluated based on the tumor regression grade (TRG) and T-stage change of the primary tumor. Hemoglobin concentration was measured and graded to determine the presence of anemia. Anemia was categorized into four groups based on the hemoglobin levels: mild anemia (90-120 g/L), moderate anemia (60-90 g/L), severe anemia (30-60 g/L), and extreme anemia (less than 30 g/L). Finally, tumor response was quantified histologically using the AJCC 8th edition tumor regression grading system for rectal cancer and pre- and post-treatment T-grading. A total of 88 patients with LARC who received nCRT and TME were included in the study, with 17 females and 71 males. Of these patients, 9 were moderately anemic and 37 were mildly anemic. The radiation therapy regimen was administered at a dose of 1.8-2 Gy per fraction, five times a week, for a total dose of 45-50.4 Gy. Capecitabine chemotherapy was also administered orally (825 mg/m2, twice a day) on the days of radiation therapy. Other chemotherapy regimens included XELOX and mFOLFOX6. The TRG was significantly different in anemic patients compared to non-anemic patients (P = 0.039). Only 2 out of 46 anemic patients (4%) showed an excellent response (TRG0), while 8 out of 42 non-anemic patients (19%) showed an excellent response (p = 0.043). There was also a significant difference in the incidence of anemia between cT3 and cT4 stages (p = 0.048), with 44% of cT3 patients and 67% of cT4 patients being anemic. The number of patients with poor response (TRG2-3) decreased as the degree of anemia decreased, but no significant difference was found. The incidence of TRG3 was 11% in patients with moderate anemia and 7% in non-anemic patients (P = 0.863). There was no significant difference in postoperative pathological T-stage between anemic and non-anemic patients. 89% of anemic patients had a pathological stage of ypT3 or less after chemoradiotherapy, while 95% of non-anemic patients did (P = 0.167). The pre- and post-treatment pathological staging did not significantly differ between anemic and non-anemic patients. 67% of anemic patients had descending tumors, while 59.5% of non-anemic patients had descending tumors (p = 0.509). Patients with LARC who have normal hemoglobin concentrations during nCRT have better tumor regression compared to patients with anemia. Additionally, the incidence of anemia was higher among patients with advanced T-stage prior to treatment.

Prevalence and Role of Anemia in Mortalities of Dogs with Babesiosis

Anemia is a decrease in red blood cells (RBC), packed cell volume (PCV), and hemoglobin in the blood due to hemolysis, hemorrhage, or decreased production of RBC. This research determined the prevalence, characteristics, and role of anemia in association with babesiosis in dogs for one year. A total of 103 dogs positive for babesiosis presented at the Veterinary Teaching Hospital, Federal University of Agriculture, Abeokuta, Nigeria, were screened for anemia. Among these, 80 dogs displaying anemia were selected. A thin blood smear was used to identify Babesia spp. The PCV and hemoglobin concentration (Hb) were determined using an automatic hemoglobinometer (Acon Laboratories, Inc., San Diego, USA). Temperature, pulse, PCV, Hb, and RBC assessed were correlated with mortalities. The findings indicated that 32 anemic babesiosis were male. The percentage of severe anemia was higher, compared to mild or moderate anemia. The age-specific prevalence of anemia was highest among dogs above 3 years but lowest in the age range of 1-3 years. Small breeds of dogs had a higher prevalence of anemia compared with larger breeds. The mortality rate was 18 (22.5%), with severe or microcytic hypochromic anemia being the highest. The temperature and pulse rates of the dogs that died were higher than those of survivors, while the PCV, Hb, and total RBC counts were significantly lower than those of survivors. In conclusion, the prevalence of anemia in dogs with babesiosis in this study was very high. Most of the mortalities recorded in the present study can be attributed to severe anemia and microcytic hypochromic anemia, with mortality rates of 61.% and 38.9%, respectively.

Prevalence and Factors Associated with the Severity of Anaemia among Patients on Chronic Haemodialysis in Lagos, Nigeria

Background: Anaemia is a global public health problem with high mortality and morbidity. It is also a common consequence of chronic kidney disease (CKD). There is a paucity of data on the actual burden of anaemia among patients on chronic haemodialysis (CHD) in Lagos, Nigeria. Objectives: To determine the prevalence and factors associated with the severity of anaemia among Nigerian patients undergoing chronic haemodialysis. Methods: This was a retrospective analysis of adult patients with end-stage renal disease (ESRD) on maintenance haemodialysis at the Lagos State University Teaching Hospital, Ikeja, Lagos. The data extracted from the clinical case files included the bio-demographic and clinical parameters, including the treatment modalities. Results: A total of 92 patients comprising 69 (75%) males and 23 (25.0%) females with the overall mean age of 48.2±14.0 years were included. Hypertension was the commonest aetiology of CKD and the average duration of haemodialysis was 16.6 months. The commonest access route for haemodialysis was a central line while 96.7% and 81.5% received erythropoietin and intravenous iron sucrose respectively. Seventy-three (79.3%) patients have had intra-dialysis blood transfusions in the past. Mild, moderate, and severe anaemia were recorded in 17%, 67%, and 16% respectively. The use of erythropoietin, iron sucrose, and increased frequency of blood transfusions correlated with the severity of anaemia. Conclusion: Anaemia is highly prevalent among patients with CKD on chronic haemodialysis. Increased frequency of blood transfusions, inadequate utilization of erythropoietin, and iron sucrose administration are predictors of anaemia severity.