Non-anemic Group Research Articles

Anemia Is a Strong Predictor of Wasting, Disease Severity, and Progression, in Clinical Tuberculosis (TB).

A typical trait of chronic tuberculosis (TB) is substantial weight loss that concurs with a drop in blood hemoglobin (Hb) levels, causing anemia. In this observational study, we explored Hb levels in 345 pulmonary TB patients. They were divided into anemic or non-anemic groups which related to clinical symptoms, anthropometric measurements, and immune status. Data was obtained in a randomized controlled trial that we previously conducted using nutritional supplementation of TB patients in Ethiopia. A post hoc analysis demonstrated that anemic patients have a higher composite clinical TB score at baseline than non-anemic patients. Consequently, Hb values were significantly lower in underweight patients with moderate to severe disease and/or cavitary TB compared to normal weight patients with mild disease or non-cavitary TB. Anemia was associated with a low body mass index (BMI), low mid-upper arm circumference (MUAC), lower peripheral CD4 and CD8 T cells counts and IFN-γ levels, and a higher erythrocyte sedimentation rate (ESR). Chronic inflammation and TB disease progression appeared to be driven by elevated systemic levels of pro-inflammatory IL-6 in anemic patients. Multivariable modeling confirmed that a low Hb and a low BMI were key variables related to an unfavorable TB disease status. Although Hb levels increased with successful chemotherapy, anemic TB patients maintained a slower clinical recovery compared to non-anemic patients during the intensive phase treatment (two months). In conclusion, anemia is a strong predictor of wasting, disease severity, inflammation, and slower recovery in patients with pulmonary TB.

Effect of Video Counseling about Prevention of Anemia on Adolescent Girls Behavior in Supporting the First 1000 Days of Life

BACKGROUND: Lack of knowledge, attitudes, and behavior awareness to prevent anemia among adolescent girls in supporting 1000 HPK has resulted in high anemia incidence in Indonesia. Multimedia counseling is a method of learning that involves audio, visual, and discussion to make it more interesting and easy to understand. AIM: This study analyzed the effect of multimedia counseling about prevention of anemia on adolescent girls behavior to prevent anemia. MATERIALS AND METHODS: This study used pre-test–post-test with control group design, with a quasi-experimental design using the case–control method. The study population was 259, the samples were 90 respondents who were assigned to two groups, namely, 45 people in anemia group and 45 in non-anemia group. The samples were selected by simple random sampling. Respondents were given multimedia counseling about anemia prevention, behavioral questionnaire and food frequency questionnaire (FFQ). Capillary blood test was conducted using Quik-Check, an the respondents were followed up every week and evaluated for 5 weeks. Results were tested using t-test and linear regression. RESULTS: Multimedia counseling had an effect on knowledge (t = 3.097; CI = 95%; 2.229–10.215; p = 0.003), attitude (t = 9.56; CI = 95%; 10.055–15.331; p = 0.001), behavior (t = −2.22; CI = 95%; −4.628–−0.260; p = 0.029), FFQ (t = −2.18; CI = 95%; −4.883 – −0.227; p = 0.032), and BMI (t = −10.40; CI = 95%; −5.094 - −3.460; p = 0.001) among adolescent girls in preventing anemia with R-Square of 0.952 (95%). CONCLUSION: There was an effect of multimedia counseling on the increase in knowledge, attitudes, and behavior in preventing adolescent anemia. Provision of ongoing multimedia counseling and monitoring of female careers in preventing adolescent anemia needs to be improved. Therefore, the role of health-care providers for monitoring and evaluation is very necessary.

Ratio of Placenta to Birth Weight in Anemic and Non-Anemic Mothers

Background: The placenta is a uterine organ in pregnancy which facilitates exchange of materials between maternal and fetal circulation. Decreased maternal hemoglobin decreases oxygen supplementation to fetus among anemic mothers which may cause low birth weight. The aim of this study was to compare the ratio of placenta to birth weight among anemic and non-anemic mothers.
 Materials and Methods: A comparative cross-sectional study was conducted in 82 anemic pregnancies and 203 non-anemic pregnancies in Department of Obstetrics & Gynecology, Nobel Medical College Teaching Hospital, Biratnagar. Participants with haemoglobin concentration lower than 11 g/dl were included in anemic group and 11g/dl or more in non-anemic group. The difference of means of placental weight, birth weight and placenta to birth weight ratio in anemic and non-anemic groups was determined by Student’s t-test.
 Results: In anemic group, mean placental weight was 578.78±141.80 g, mean birth weight was 2973.17±680.97 g and mean placenta to birth weight ratio was 0.20±0.05. In non-anemic group, mean placental weight was 575.96±128.88 g, mean birth weight was 3125.91±590.89 g and mean placenta to birth weight ratio was 0.19±0.05. Significant difference was observed in means of placenta to birth ratio in anemic and non-anemic groups (p-value 0.05).
 Conclusion: Mean placental weight and mean ratio of placenta to birth weight was higher in pregnant women with anemia than in non-anemic pregnant women and significant difference was observed in means of placenta to birth ratio between anemic and non-anemic groups.

Association of pre-treatment hemoglobin levels with survival outcomes among Indian women with triple negative breast cancer.

e12549 Background: Prevalence of Triple Negative Breast Cancer (TNBC), which has utterly poor prognosis and higher recurrence rate, is high among Indian women ranging from 20-43% across different regions of India. Previous studies from other countries have shown that pretreatment hemoglobin and hematocrit values influence treatment outcomes among breast cancer patients. Recent 2019-2020 National Family Health Survey (NFHS) of India reported that 66.4% of women suffer from anemia. This study examined the association of pre-treatment hemoglobin levels with survival outcomes among Indian women with TNBC. Methods: We retrospectively analyzed the medical records of 435 women registered at our institute with a diagnosis of TNBC between the years 2013-2021. Pre-treatment hemoglobin levels i.e. either before the start of neoadjuvant chemotherapy (NACT) or prior to surgery among those who received adjuvant chemotherapy were retrieved from the medical records along with clinical and tumor characteristics. Primary outcomes were relapse free survival (RFS) and overall survivals (OS). Cox-regression and Kaplan-Meier survival analysis were used to examine the association of pre-treatment anemia with survival outcomes in these patients. Results: Fifty-one percent (n=221) of the 435 TNBC patients in our study cohort had pretreatment hemoglobin level of <12.0 g/dL (based on the World Health Organization criteria). 278 patients received NACT and pathological complete response (pCR) rates were similar in anemic (31.5%) and non-anemic groups (30.1%). When adjusted for clinical and other hematological parameters, anemia was not associated with pCR. Median follow-up of the study cohort was 22.9 months (Range: 2.6 to 92.7 months). Pre-treatment anemia was significantly associated with poor RFS when adjusted for clinical and hematological parameters [adjusted Hazard ratio (aHR) (95%CI): 1.53 (1.02-2.31)]. Median RFS was 52.5 months among the anemic group and was not reached in non-anemic group. Effect of anemia on RFS did not vary by age category or menopausal status. However, the effect of anemia on OS varied significantly by menopausal status. Menopausal women with anemia at time of diagnosis had significantly higher hazard of death compared to menopausal women without anemia [aHR (95%CI): 5.0 (1.15-21.66)] and this association was not observed in pre-menopausal women [aHR (95%CI): 0.53 (0.19-1.44)]. Conclusions: Pretreatment hemoglobin level of <12g/dL was associated with poor survival outcomes among Indian women with TNBC and the effect of anemia on overall survival of these patients varied by menopausal status. Evaluation of hemoglobin levels during chemotherapy, pre-post surgery, and at various stages of follow-up is needed to determine the independent association of hemoglobin level trajectories with treatment outcomes and long-term survival among these TNBC patients.

Evaluation of the effect of preoperative hemoglobin level and proinflammatory factors on intertrochanteric fracture union.

Intertrochanteric fractures are associated with high mortality and morbidity, so these patients should undergo fracture fixation surgery immediately. Despite surgery, the possibility of fracture fusion may not occur due to the association with various causes. Therefore, our aim is to investigate these factors (TNF‑a, IL‑1, Hb) and their effect on fracture union after fixation. From 2018 to 2020, at our orthopedic trauma center, 163patients older than 50years with intertrochanteric fractures underwent DHS fixation surgery. Patients were divided into anemic and non-anemic groups in terms of preoperative hemoglobin level (standard hemoglobin 11 mg/dl). For 3 months, patients were assessed for union and failure fixation criteria, levels of proinflammation (TNF‑α, IL-1) and level of hemoglobin. The results show that out of 163patients with fractures, at the time of initial admission, 74patients had less than 11hemoglobin g/dl. Patients with union fractures had higher hemoglobin levels than patients with non-union (11.71 ± 1.51 versus 11.24 ± 1.96), which was statistically significant between hemoglobin and union level (p = 0.030). At the end of the third visit (third month), 44 (59.5%) anemic patients received union completly, while among the patients with normal hemoglobin level, 32 (36%) received union bread, which was statistically significant (p = 0.003). There were no statistically significant differences between proinflammatory factors before surgery and 3 months after surgery (p > 0.05). Due to the effect of anemia and proinflammatory factors in the process of healing fractures and bone formation and creating musculoskeletal balance, low hemoglobin level before surgery has asignificant effect on fracture union and failure of fixation. So it is recommended to correct this anemia in these patients before surgery and during follow-up.

Prognostic impact of anemia in acute coronary syndrome patients

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Anemia commonly accompanies acute coronary syndromes (ACS) and is associated with worst outcomes. Over the last decade several trials have investigated the prognostic impact of hemoglobin (Hb) levels in the context of acute coronary syndrome (ACS), both in the short-term, during hospitalization, and in the long-term, albeit mainly up to three months, with only a few trials assessing one-year outcomes. Methods This was a retrospective study of ACS patients admitted to a single center between October/2011 and September/2018, in whom Hb level was evaluated on admission. Anemia was defined as defined as Hb ≤ 13g/dL for males and Hb ≤ 12g/dl for females. Baseline characteristics, management, and outcomes were compared between patients with and without anemia. The primary endpoint, MACE, was a composite of acute coronary syndrome, stroke and global death events. The secondary endpoint was cardiovascular death. Results A total of 578 patients were selected, with a mean age of 66.7±13.1 years, 74.9% were male, 42.6% had a ST-Elevation Myocardial Infarction and 18.9% met criteria for anemia. These patients had more comorbidities: arterial hypertension (78.0% vs 60.6%; p=0.001), diabetes mellitus (25.7% vs 50.5%, p=0.001), peripheral artery disease (3.9% vs 10.1%, p=0.01) and were older (mean age 64.8±13.1 vs 72.1±11.0 years, p<0.001). The non-anemic group had a higher percentage of smokers and, during hospitalization, was more often submitted to percutaneous coronary angioplasty. Antithrombotic therapy given during hospitalization and on discharge was similar in both groups. During a median follow-up of 41 months (IQR: 20-59), 91 patients (15.7%) died and 104 (18%) had a MACE event. In a multivariate regression analysis, after adjusting for possible confounders, anemia was an independent predictor of MACE events (HR 1.64, 95% CI: 1.07-2.50) and cardiovascular death (HR 2.24, 95% CI: 1.26-3.96). Conclusion Anemia is highly prevalent in the ACS setting and the presence of anemia was independently associated with worse outcomes, particularly mortality.

Effects of anemia during the third trimester of pregnancy on postpartum depression and pregnancy outcomes in pregnant women older than 35 years: a retrospective cohort study.

There is no study on the impact of anemia on postpartum depression and outcomes in mothers older than 35 years, which makes the nursing of these pregnant women with anemia more difficult. We retrospectively collected the demographic and clinical characteristics of pregnant women older than 35 years at conception between August 2014 and December 2019. Hemoglobin less than 110 g/L was defined as anemia. Postpartum depression was assessed according to Edinburgh Postnatal Depression Scale. A subgroup analysis was performed by dividing anemia into mild anemia or moderate and severe anemia. All participants were followed up for at least 3 months postpartum and their pregnancy outcomes were recorded. The existence of postpartum depression was evaluated at 4 weeks postpartum. The risk factors of anemia during the third trimester of pregnancy and the impacts of anemia on postpartum depression and pregnancy outcomes were analyzed using multivariable logistic regression analysis. A total of 519 pregnant older than 35 years women were included in this study, including 281 without anemia and 238 with anemia. No significant difference was found in the incidence of postpartum depression between anemia and non-anemia groups (18.9% vs. 12.8%, P=0.057), while the anemia group had significantly higher incidence of preterm delivery, prolonged labor, and caesarean section. The subgroup analysis found that significantly pregnant women with older age in the moderate or severe anemia subgroup had postpartum depression than those in the mild anemia subgroup (23.2% vs. 12.5%, P=0.038). A higher rate of preterm delivery, prolonged labor, and caesarean section was recorded in the moderate or severe anemia subgroup (8.3% vs. 20.4%, P=0.012; 30.2% vs. 43.0%, P<0.001; 20.8% vs. 40.1%, P=0.002). Moderate or severe anemia, the presence of depression during the first trimester of pregnancy, unplanned pregnancy, and fewer parity were identified as risk factors of postpartum depression in pregnant women older than 35 years with anemia. Anemia has significant impacts on pregnancy outcomes in pregnant women older than 35 years. Furthermore, moderate and severe anemia will significantly increase the incidence of postpartum depression, which should be corrected at an early stage to minimize its negative effects.

Maternal first trimester iron status and its association with obstetric and perinatal outcomes.

To assess the following in singleton pregnant women: (1) associations between first trimester iron deficiency and obstetric and perinatal outcomes, (2) overall first trimester iron status and (3) post-treatment iron status after intensified iron supplementation. A prospective cohort study was conducted with linkage of first trimester hemoglobin and plasma ferritin with obstetric and perinatal data from a hospital database. Blood sample data were obtained from a Danish University Hospital. The cohort was divided into groups according to ferritin and hemoglobin: (1) iron-deficient anemic (ferritin < 30ng/mL and Hb < 110g/L), (2) iron-deficient non-anemic (ferritin < 30ng/mL and Hb ≥ 110g/L), and (3) iron-replete non-anemic (ferritin 30-200ng/mL and Hb ≥ 110g/L). Obstetric and perinatal outcomes in each iron-deficient group were compared to the iron-replete non-anemic group using multivariable logistic regression. The effect of 4weeks intensified iron supplementation on hemoglobin and ferritin was assessed by groupwise comparisons. The cohort comprised 5763 singleton pregnant women, of which 14.2% had non-anemic iron deficiency, and 1.2% had iron-deficiency anemia. Compared to iron-replete non-anemic women, iron-deficient anemic women had a higher risk of gestational diabetes (aOR 3.8, 95% CI 1.4-9.0), and iron-deficient non-anemic women had a higher risk of stillbirth (aOR 4.0, 95% CI 1.0-14.3). In group 1 and 2, 81.5% and 67.7% remained iron-deficient after intensified iron supplementation. Iron-deficiency anemia was associated with gestational diabetes, and non-anemic iron deficiency with stillbirth, although risk estimates were imprecise due to few events. Iron deficiency was present in 15.4% and often persisted despite 4weeks intensified iron supplementation.

Characterisation of anaemia amongst school going adolescent girls in rural Haryana, India.

High burden of anaemia exists amongst rural adolescent girls in India. The objective of this study was to characterise anaemia in school going adolescent girls in rural Haryana, India. Linear and multiple logistic regression analysis of data collected prior to an intervention trial was conducted. Participants were classified into anaemic (haemoglobin <12 g/dl) and non-anaemic group and were further classified into deficiencies of Fe, folate or vitamin B12, mixed, anaemia of other causes and inflammation. Three schools in Ballabgarh block of Faridabad District, Haryana, India. One hundered and ninety-eight non-anaemic and 202 anaemic adolescent girls (12-19 years). Anaemic girls had 29·6 % Fe deficiency, 28·1 % folate or vitamin B12 deficiency, 15·8 % mixed deficiency and 9·7 % acute inflammation. Anaemia of other causes was found in 16·8 % of the anaemic participants. Girls with Fe and isolated folate deficiency had 2·5 times and four times higher odds of developing anaemia, respectively, as compared with non-anaemic girls. Fe deficiency with no anaemia was found amongst 11 % non-anaemic girls. Non-anaemic girls had a high prevalence of combined deficiency of folate or vitamin B12 (29·5 %) and acute inflammation (14·4 %). The current strategy of Fe and folic acid supplementation alone will not suffice for achieving the desired reduction in the prevalence of anaemia as unknown causes and anaemia of inflammation contribute to a substantial proportion of anaemia. Integrating other nutrition-specific components like improving water, sanitation and hygiene practices with the ongoing micronutrient supplementation program will comprehensively tackle anaemia. Unknown causes of anaemia warrant further research.

Diagnosis and treatment status of perioperative anemia in patients with gastrointestinal neoplasms: a multi-center study in Hubei Province

Objective: To investigate the incidence and treatment of perioperative anemia in patients with gastrointestinal neoplasms in Hubei Province. Methods: The clinicopathological data of 7 474 patients with gastrointestinal neoplasms in 62 hospitals in 15 cities (state) of Hubei Province in 2019 were collected in the form of network database. There were 4 749 males and 2 725 females. The median age of the patients was 62 years (range: 17 to 96 years). The hemoglobin value of the first time in hospital and the first day after operation was used as the criterion of preoperative anemia and postoperative anemia. Anemia was defined as male hemoglobin <120 g/L and female hemoglobin <110.0 g/L, mild anemia as 90 to normal, moderate anemia as 60 to <90 g/L, severe anemia as <60 g/L. The t test and χ2 test were used for inter-group comparison. Results: The overall incidence of preoperative anemia was 38.60%(2 885/7 474), and the incidences of mild anemia, moderate anemia and severe anemia were 25.09%(1 875/7 474), 11.37%(850/7 474) and 2.14%(160/7 474), respectively. The overall incidence of postoperative anemia was 61.40%(4 589/7 474). The incidence of mild anemia, moderate anemia and severe anemia were 48.73%(3 642/7 474), 12.20%(912/7 474) and 0.47%(35/7 474), respectively. The proportion of preoperative anemia patients receiving treatment was 26.86% (775/2 885), and the proportion of postoperative anemia patients receiving treatment was 14.93% (685/4 589). The proportions of preoperative anemia patients in grade ⅢA, grade ⅢB, and grade ⅡA hospitals receiving treatment were 26.12% (649/2 485), 32.32% (85/263), and 29.93% (41/137), and the proportions of postoperative anemia patients receiving treatment were 14.61% (592/4 052), 22.05% (73/331), and 9.71% (20/206). The proportion of intraoperative blood transfusion (16.74% (483/2 885) vs. 3.05% (140/4 589), χ²=434.555, P<0.01) and the incidence of postoperative complications (17.78% (513/2 885) vs. 14.08% (646/4 589), χ²=18.553, P<0.01) in the preoperative anemia group were higher than those in the non-anemia group, and the postoperative hospital stay in the preoperative anemia group was longer than that in the non-anemia group ((14.1±7.3) days vs. (13.3±6.2) days, t=5.202, P<0.01). Conclusions: The incidence of perioperative anemia in patients with gastrointestinal neoplasms is high. Preoperative anemia can increase the demand for intraoperative blood transfusion and affect the short-term prognosis of patients. At present, the concept of standardized treatment of perioperative anemia among gastrointestinal surgeons in Hubei Province needs to be improved.

The Clinical Significance of the Expression of the Serum BMP 6 in the Patients with Tumor-related Anemia with Lower Levels of CRP and Hepcidin

<i>Objective:</i> To research the expression characteristic and clinical significance of the serum bone morphogenetic protein 6 (BMP6) at the lower expression condition of serum C-reactive protein (CRP) and Hepcidin (Hepc) in patients with tumor-related anemia. <i>Methods:</i> 113 hospitalized tumor patients from October 2019 to June 2020 and 20 healthy volunteers (control group) were recruited. We used enzyme-linked immunosorbent assay (ELISA) to determine the levels of BMP6, soluble-hemojuvelin (s-HJV) and Hepc, Electrochemiluminescence method to determine SF level, and particle-enhanced immune transmission turbidity method to determine CRP level, then analyzed their expression characteristics, correlations and clinical significance. <i>Results:</i> (1) The levels of BMP6, Hepc and CRP of anemia group were respectively 426.18±202.83mg/mL, 6.58±5.41ug/L and 19.10±18.24mg/L, which were all higher than 334.37±171.32mg/mL, 4.60±2.28ug/L and 3.62±3.46mg/L of non-anemia group (<i>t</i>=2.5804, 2.4750 and 3.4144, <I>P</I><0.01, <I>P</I><0.05 and <I>P</I><0.01, respectively). (2) The level of s-HJV was 0.71±0.28ng/mL, which was obviously lower than 1.07±1.01ng/mL (<i>t</i>=2.6529, <I>P</I><0.01) in non-anemia group. (3) There were negative correlations between BMP6 and both Hb and s-HJV (respectively <i>r</i>=-0.2807, <i>t</i>=3.0812 and <i>r</i>=-0.2497, <i>t</i>=2.7230, respectively, <I>P</I> both <0.01), but there were no correlations between BMP6 and CRP, Hepc and SF. (4) Hepc was positively correlated with both CRP and SF (<i>r</i>=0.2004, <i>t</i>=2.0660 and <i>r</i>=0.3089, <i>t</i>=3.1045, <I>P</I><0.05 and <I>P</I><0.01, respectively). Hepc was negatively correlated with Hb (<i>r</i>=-0.2524, <i>t</i>=2.7525, <I>P</I><0.01). Hepc had no correlation with s-HJV (<I>P</I>>0.05). (5) The BMP6 in the normal CRP group was 461.86±142.91 mg/mL, which was significantly higher than 364.51± 129.84 mg/mL in elevated CRP group (<I>F</I>=11.35, <I>P</I><0.01). (6) Hepc, s-HJV and SF in the normal CRP group were 5.17±3.49ug/L, 0.69±0.26ng/mL and 149.89±142.34ng/mL, respectively, which were all significantly lower than 9.02±7.14ug/L, 0.76±0.33ng/mL and 288.36±254.51ng/mL in the elevated CRP group (<I>F</I>=9.56, 4.67 and 2.84, <I>P</I>=0.000, 0.09, 0.046, respectively). <i>Conclusions:</i> When tumor patients with anemia is in a low-level condition of CRP and Hepc, the high expression of BMP6 is an important cause for the occurrence and development of anemia.

Effects of maternal iron deficiency anemia on placenta and cord blood iron status with specific reference to the iron transport protein ferroportin 1

Introduction: Iron deficiency anemia is the most prevalent nutritional deficiency disorder in pregnant women. During pregnancy, nutrients, including iron, are transferred from the mother to the fetus through the placenta, in which the placental transport protein Ferroportin1 (FPN1) plays a crucial role. It has been frequently observed that developing fetus is immune to anemia despite the presence of anemia in the mother, the mechanisms underlying which have not been identified. We, therefore, planned the present study to explore the effect of maternal iron deficiency anemia on the expression of FPN1 in the placenta. Material and Methods: Two hundred pregnant women recruited were divided into anemic and nonanemic groups based on their predelivery hemoglobin levels (<11 g/dl and ≥11 g/dl, respectively). After delivery, placental expression of FPN1 was studied by immunohistochemistry and mRNA analysis, and neonatal anthropometry was performed. Results: Of the 200 women, 59% were anemic. FPN1 protein immunohistochemical staining in placenta showed a statistically significant increase with increasing severity of anemia. Similarly, placental mRNA expression levels of the FPN1 gene were observed to be higher in anemic mothers when compared with nonanemic mothers. Discussion and Conclusion: Thus, our study for the first time shows that maternal iron deficiency increases placental FPN1 protein and mRNA expression, thereby probably facilitating increased transport of iron from the mother to the fetus.

Predictive value of hemoglobin, platelets, and D-dimer for the survival of patients with stage IA1 to IIA2 cervical cancer: a retrospective study.

ObjectiveCoagulation indexes may be useful survival biomarkers for cervical cancer. This study evaluated the ability of hemoglobin, red blood cells (RBCs), platelets, and D-dimer levels to predict post-hysterectomy survival outcomes in patients with stage IA1 to IIA2 cervical cancer.MethodsIn this retrospective study, coagulation-related indexes were compared between the anemia and non-anemia groups. Independent variables were analyzed by the Cox proportional hazards model. Survival was assessed by the Kaplan–Meier method with the log-rank test. Mortality predictions were evaluated by receiver operating characteristic curves.ResultsAmong this study’s 1088 enrolled patients, 152 had anemia. The 10-year overall survival and recurrence-free survival rates were 90.8% and 86.5%, respectively. Hemoglobin, RBC, and the rate of abnormal platelet counts were significantly lower in the anemia group. Abnormal preoperative D-dimer was an independent factor for recurrence-free survival. Receiver operating characteristic curves showed that D-dimer had area under the curve of 0.734 (cut-off value: 0.685, sensitivity: 85.7%, and specificity: 64.0%). Hemoglobin and platelets had areas under the curves of 0.487 and 0.462, respectively.ConclusionPreoperative D-dimer was the most effective prognostic predictor for patients with cervical cancer. The prognosis of patients with cervical cancer was poorer if their D-dimer levels were >0.685 mg/L.

Assessment of Cytokine (α-TNF) with Erythropoietin and their Correlation in Pulmonary Tuberculosis with Anaemia

Globally tuberculosis is the 9th leading cause of death worldwide. As pulmonary tuberculosis (PTB) is a chronic disease, anaemia of inflammation due to bacterial burden play a vital role in pathophysiology of anaemia. Inflammation interferes with erythropoietin (EPO) function.&#x0D; Methods: The present study was an analytical type of case control study. The study included 100 newly diagnosed anaemic PTB cases and 50 newly diagnosed non anaemic PTB controls. The PTB was confirmed by microscopic examination of sputum specimen for the detection of Acid-Fast Bacilli (AFB). Both cases and controls were subjected to hematological analysis by automated cell counter and serum α-TNF and EPO by ELISA method.&#x0D; Results: Statistically significant difference was observed in levels of both α-TNF and EPO in anemic and non-anemic PTB groups (p&lt;0.001). α-TNF (214.56±82.30) levels were found to be significantly higher in anaemic PTB group while EPO level (58.44 ±14.97) were found to be significantly higher in non anaemic PTB group. Significant inverse correlation (r1=cases, r2=controls) was observed between α-TNF and EPO (r=-0.257, p&lt;0.05) and α-TNF and Hb (r=-0.202, p&lt;0.05) in both the groups.&#x0D; Conclusion: Increased α-TNF with decreased EPO and hemoglobin infers that inflammation interferes with normal functioning of EPO and probably contributes in induction of anemia in tuberculosis patients.

Association between Serum Magnesium and Hemoglobin in Patients with Primary Hyperparathyroidism.

Background There is a positive association between serum magnesium and hemoglobin levels in the general population. However, no studies have evaluated the association between serum magnesium and hemoglobin levels in patients with primary hyperparathyroidism (PHPT). We aimed to investigate whether there is a relationship between serum magnesium and hemoglobin levels in the patient population with PHPT. Methods This retrospective study included 307 hospitalized PHPT patients who were continuously admitted to the Second Xiangya Hospital of Central South University, from January 2010 to August 2020. Laboratory and demographic data of patients were collected. Hypomagnesemia was defined as serum magnesium <0.75 mmol/L. Patients with a hemoglobin level below 130 g/L in males and below 120 g/L in females were accepted as the anemic group. Results Among the 307 patients with PHPT included in our study, 77 (25.1%) patients (33 (32.4%) males and 44 (21.5%) females) had hypomagnesemia. A total of 138 (45.0%) patients (49 males (48.0%) and 89 females (43.4%)) had anemia. Compared with the nonanemic group, the anemic group had lower average albumin, eGFR, and serum magnesium levels in both males and females. In contrast, average creatinine, PTH, and corrected calcium were significantly higher in the anemic group than in the nonanemic group in both males and females. Lower serum magnesium levels were associated with lower hemoglobin levels independent of serum calcium, albumin, eGFR, and PTH in PHPT patients. Conclusions Hypomagnesemia is a common electrolyte disorder in PHPT patients. Hypomagnesemia is independently associated with lower hemoglobin levels in patients with PHPT.

Consumption of Sinlek Rice Drink Improved Red Cell Indices in Anemic Elderly Subjects.

Iron fortifications are used for the treatment of iron-deficiency anemia; however, iron dosing may cause oxidative damage to the gut lumen. Thai Sinlek rice is abundant in iron and contains phytochemicals. We aimed at evaluating the effect of an iron-rice (IR) hydrolysate drink (100 mL/serving) on neurological function, red cell indices and iron status in elders. Healthy elderly subjects were divided into three non-anemic groups and one anemic group. The non-anemic groups consumed one WR (2 mg iron/serving) and two IR drinks (15 and 27 mg iron/serving) (groups A, B and D, respectively), while the anemic group consumed one IR drink (15 mg iron serving) (group C) every day for 30 days. There were no significant differences in the MMSE Thai 2002 and PHQ9 test scores for members of all groups, while the nutrition scores and body weight values of group D subjects were significantly increased. Hemoglobin (Hb) and mean corpuscular hemoglobin concentrations increased significantly only in group C. Serum iron and transferrin saturation levels tended to increase in group A, while these levels were decreased in members of group C. Serum antioxidant activity levels were increased in all groups, and were highest in group C. Thus, consumption of an IR drink for 15 days functioned to increase Hb and antioxidant capacity levels in anemic elders.

Association of the premature immunosenescence with the presence and severity of anemia among patients with systemic lupus erythematosus.

One of the possible mechanisms that contribute to the development of anemia in systemic lupus erythematosus (SLE) is the presence of premature immunosenescence in SLE. This study aimed to observe the correlation between immunosenescence with anemia in SLE. This research was a cross-sectional study with the subject was 60 women with SLE aged 16-45years old. Subjects were recorded for the demographic and clinical data, complete blood counts, iron status (iron serum, total iron-binding capacity, and transferrin saturation), ferritin, inflammatory markers (erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP]), and anti-dsDNA levels. Immunosenescence was observed by measuring the senescent T cells from peripheral blood mononuclear cells (PBMC) by flow cytometry, counted as CD4+CD57+ and CD8+CD57+ T cells. Serum IL-2 and IFNγ as the cytokines associated with immunosenescence were also measured from all subjects. Subjects were divided into anemic and non-anemic groups according to the classification of anemia from WHO (Hb < 12gr/dl). Anemic SLE patients had higher CD4+CD57+, CD8+CD57+, and IFNγ, while IL-2 was lower in SLE patients with anemia. Multivariate linear regression revealed that the decreasing levels of Hb were associated with the increase of CD8+CD57+ percentages and IFNγ levels. Anti-dsDNA, ESR, CRP, ferritin, iron serum, and transferrin saturation were correlated with CD8+CD57+. IFNγ level also correlated with the anti-dsDNA, iron serum, and ferritin levels. No correlation was found between the iron status and inflammatory markers with CD4+CD57+ percentages and IL-2 levels. Multivariate regression analysis showed that IFNγ was positively associated with anti-dsDNA and negatively associated with iron serum and transferrin saturation, while CD8+CD57+ percentages were positively associated with the ferritin levels. Immunosenescence is associated with anemia by modulating the inflammatory response and causing iron dysregulation in SLE.

Maternal Anemia during Pregnancy and Its Association with Preterm Birth

Objective: To determine the association of preterm delivery with maternal anemia in Tertiary Care Hospital, Karachi. Study Design: Prospective cohort study. Study Setting: Study was conducted at Department of Obstetrics and Gynecology of Aga Khan University Hospital Karachi, Pakistan. Duration of Study: Six months from 3rd September, 2018 to 3rd March, 2019. Subjects and Methods: Data was prospectively collected from 90 patients. 45 patients were in the anemic group and 45 patients were in the non anemic group. Quantitative data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables were presented as frequency and percentages. Effect modifiers were controlled through stratification. Post stratification chi square was applied and p-value of ≤0.05 was considered significant. RR &gt; 1 was considered significant. Results: In the anemic group, mean age of the patient was 28.82±3.65 years, gestational age at delivery was 36.97±2.58 weeks, booking hemoglobin was 9.79±0.84 g/dl, and delivery hemoglobin was found to be 9.73±1.19 g/dl. In the non-anemic group mean age of the patient was 29.57±5.83 years, gestational age at delivery 37.08±1.91 weeks, booking hemoglobin was 10.76±0.99 g/dl and delivery hemoglobin was found to be 10.75±1.12 g/dl. Moreover, frequency distribution of preterm status showed that out of 45 patients in anemic and non-anemic group, 35.6% and 46.7% had preterm status respectively. RR was 0.76. Conclusion: Prematurity is major cause of perinatal mortality. The findings of this study although shows prevalence of preterm delivery in both anemic and non-anemic pregnant women however results were not significant to support our hypothesis. Further research is needed with strategies to address the anemia status of expecting mothers. Key Words: Maternal anemia, preterm, anemia and non-anemic group.

Gestational Anemia and its effects on neonatal outcome, in the population of Hyderabad, Sindh, Pakistan

BackgroundAnemia in pregnancy is a globally health-related issue, that affects both mothers and their newborn. Anemia during pregnancy across the world involves approximately 38% of the world population. To evaluate the effect of gestational anemia on perinatal outcome in the population. The aim of present study is to evaluate the effect of gestational anemia on perinatal outcome in the population of Hyderabad, Sindh, Pakistan.MethodsA cross-sectional comparative analysis was conducted among pregnant mothers who were listed to give birth at Liaquat University of medical and health sciences Jamshoro/Hyderabad during the period of September 2018 to September 2019. The study population 400 were selected by convenient random sampling, and grouped into 2 on the basis of their Hb levels, with Hb < 11 gm% they were classified as anemic mothers, Hb ≥ 11 gm% were termed as non-anemic mothers, data was collected on the preformed questionnaire, and was analyzed on SPSS 21.ResultsThe prevalence of anemia was 51.5% in in total population out of which, the incidence of normocytic normochromic anemia was highest 52.4 %microcytic hypochromic anemia was found in 19.4%, Overall, extremely low Apgar was found in 53 anemics, and 8 non. anemic mother’s infants, LBW incidence was 47.5 %; in anemic mothers, and 15.4 % in non-anemic group, the term, small for gestational age infants were 14.5% in anemic mothers, and 3.6% in non-anemic mothers, there were 36 preterm births to anemic mothers and 10 in non-anemic mothers. The incidence of caesarian section is 53.3% in anemic mothers compared to 30.9% in non-anemic mothers.ConclusionsAnemia in pregnancy significantly increases risks of low Apgar, LBW, term SGA, preterm birth, and an increase incidence of caesarian section.

Burden of Mild (

The prognostic impact of anemia, especially mild anemia, in atrial fibrillation (AF) remains unclear. We examined clinical burdens of mild anemia on the quality of life (QoL) and clinical outcomes of 1,677 AF patients. Patients were divided into a non-anemia (hemoglobin [Hb] ≥13 g/dl for men and Hb ≥12 g/dl for women) and a mild anemia group (10≤ Hb <13 g/dl for men and 10≤ Hb <12 g/dl for women). At baseline, 22.5% of patients (n=378) had anemia; patients in the mild anemia group had higher CHA2DS2-VASc scores (3.7 vs 2.7; p <0.01) and brain natriuretic peptide levels (253.5 vs 159.6 pg/ml; p <0.01) and were more likely to develop chronic kidney disease (64.2 vs 42.9%; p <0.01) than those in the non-anemia group. During follow-up (mean 1.7 ± 0.4 years), patients with mild anemia had a higher risk of heart failure hospitalization and major bleeding events than those without (12.2 vs 3.8%; p <0.01 and 5.6 vs 2.5%; p <0.01, respectively). Mild anemia was an independent risk factor for heart failure hospitalization (adjusted hazard ratio: 1.67, 95% confidence interval 1.06 to 2.62, p=0.03) but not for major bleeding (adjusted hazard ratio: 1.44, 95% confidence interval 0.80 to 2.62, p=0.23). QoL improvement was less likely in the mild anemia group during follow-up, despite the lack of significant differences at baseline. In conclusion, the presence of even mild anemia was associated with increased risks of heart failure hospitalization and poor QoL improvement.