Percentage Of Hemoglobin Research Articles

Effectiveness of Dietary Intervention on Iron Deficiency Anemia among Nursing Students in Selected Nursing Colleges, Mangaluru

Introduction: Anemia is a medical condition characterized by low red blood cell counts, which lead to hypoxia, or insufficient oxygenation of body tissue. Anemia is caused by an inadequate Iron supply in the body. Raising hemoglobin levels is essential in preventing anemia. Anemia is a major nutritional problem in India. The prevalence of anemia is higher among developing nations, because of low socioeconomic status and lack of access to the healthcare services. A study was aimed to evaluate the effectiveness of dietary interventions on Iron deficiency anemia among selected 1st year B.Sc. Nursing and GNM students in Mangaluru. Method s: An evaluative approach with one- group pre test post test design was used for the study. Permission was obtained from the concerned authority for conducting the study. The purposive sampling technique was used to draw 30 female nursing students. On day 1, Students were assessed for signs and symptoms of Iron deficiency anemia using signs and symptoms checklist and classified as mild, moderate, and severe anemia. Level of anemia was assessed by checking the hemoglobin percentage using hemoglobinometer. The samples who were having Hb percentage below 12gmdl were administered dietary intervention which included rice flake balls (125 gms) and a gooseberry (10 gms) for 30 days and on day 31st, samples were checked for Hb percentage and signs and symptoms of Iron deficiency anemia. Result: In the pre test mean Hb percentage was 10.620 0.875 and in the post test mean Hb percentage was 12.003 1.046 Hb values were increased in the post test. In the pretest majority 70 of them had mild anemia and 30 had moderate anemia. Whereas in the post test all had mild anemia. The pre test mean signs and symptoms score was 4.1 0.9 and the post test mean signs and symptoms score was 1.86 0.68. This shows the post test mean signs and symptoms score was reduced from the pre test. Interpretation: The finding of the study proved that the dietary intervention was an effective measure to improve the hemoglobin level of nursing students. Conclusion: It was concluded that dietary intervention of rice flakes balls and gooseberry administered may be effective in improving iron status of nursing students to prevent Iron deficiency anemia.

Role of Unenhanced Computed Tomography of the Chest in the Prediction of Anaemia: A Cross-sectional Study

Introduction: Anaemia is a common clinical condition. The detection of incidental findings on unenhanced Computed Tomography (CT) that predict the presence of anaemia may play a pivotal role in early diagnosis, treatment and prognosis. Aim: To assess the role of unenhanced CT thorax in predicting anaemia by determining the sensitivity and specificity of the Interventricular Septum Sign (IVS) and Aortic Rim Sign (ARS) in the prediction of anaemia. Materials and Methods: This was a cross-sectional study conducted on 300 patients who underwent High-resolution Computed Tomography (HRCT) of the thorax using a 128-slice CT scanner in the Department of Radiology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India, Nizams Institute of Medical Sciences, Hyderabad, from July 2022 to September 2022. An estimation of haemoglobin levels was performed from a peripheral blood sample within 24 hours of the scan and the diagnosis of anaemia was made based on World Health Organisation (WHO) guidelines of haemoglobin values according to age and gender. On imaging, the following parameters were analysed: the variables considered for each patient included age and gender, the presence or absence of ARS, the presence or absence of an IVS and the Hounsfield Units (HU) values of seven selected Regions of Interest (ROI) on each examination. Three ROIs were placed in the Left Ventricular (LV) cavity, three on the IVS and a single ROI was placed in the aorta at the same level. Mean, percentage, frequency and standard deviation were calculated. The Chi-square test was applied for statistical analysis and a p-value of <0.05 was considered significant. Results: Out of the total sample size of 300, 188 were males and 112 were females with the mean age of 47.16±19.77 years. The mean haemoglobin percentage in the study was 11.62±2.25 gm%. Approximately 195 (65%) out of 300 patients were found to be anaemic based on blood reports. Among them, the majority were diagnosed with moderate anaemia 109 (36.3%), followed by mild anaemia 76 (25.3%) and severe anaemia 10 (3.3%), respectively. The sensitivity of the dense IVS was 100% for severe anaemia, 75.6% for moderate anaemia and 55.3% for mild anaemia. In comparison, the aortic rim sign showed a sensitivity of 100% for severe anaemia, 86.5% for moderate anaemia and 67.69% for mild anaemia, with a specificity of 88.57%. Conclusion: The presence of an IVS on an unenhanced CT predicts the likelihood of underlying anaemia and suggests the need for further evaluation and timely management.

Type 2 diabetes mellitus remission following laparoscopic sleeve gastrectomy and hindgut-based procedure: a retrospective multicenter study.

Sleeve gastrectomy (SG) is considered the standard bariatric surgery due to its excellent outcomes. However, in patients with obesity and type 2 diabetes mellitus (T2DM), SG alone carries a high risk of metabolic failure. To achieve better metabolic results, SG can be combined with either foregut- or hindgut-based procedures, although a direct comparison between these approaches is lacking. In this retrospective study, we compared the bariatric and metabolic effects of SG (n = 20 patients) with SG associated with duodenal diversion and ileal interposition (SG-DD-II) (n = 20), SG associated with duodenal-ileal anastomosis (SADI-S) (n = 20), and SG associated with single gastro-ileal anastomosis (SASI-S) (n = 20). Patient data, including anthropometric measurements and T2DM characteristics, were extracted from our database. The evaluation criteria included weight loss (% excess weight loss), fasting glycemia (FGL), glycated hemoglobin (HbA1C) percentage, and T2DM remission rates. Our statistical analysis (p < 0.05) revealed that shortly after surgery, all procedures demonstrated acceptable outcomes in terms of weight loss and T2DM remission. However, after 3 and 5years post-surgery, the T2DM relapse rate was significantly higher following SG alone compared to hindgut-based operations. In patients with obesity and T2DM, we recommend combining SG with a hindgut-based procedure to reduce the long-term relapse rate.

A clinical study to evaluate the efficacy of yogaraja rasayana in pandu roga (w.s.r. to iron deficiency anemia)

Objectives: To evaluate the efficacy of Yogaraja rasayana in pandu. Materials and Methods: A non-randomized and open single arm study was conducted on 100 patients suffering from pandu. Results: The trial drug showed encouraging results in the overall health status of selected cases of pandu [with special reference (w.s.r.) iron deficiency anemia (IDA)] with &gt;75% improvement in 61 cases and &gt;50% improvement in 36 patients. Conclusion: Yogaraja rasayana is an unique herbo-mineral combination containing iron rich content ‘mandoor’ along with other herbal drugs helps in increasing the hemoglobin percentage in cases of pandu.

Consuming spicy food and type 2 diabetes incidence in Southwestern Chinese aged 30–79: a prospective cohort study

BackgroundCapsaicin is the main component of chili peppers and is believed to have antidiabetic effects. However, the association between spicy food consumption and the incidence of diabetes remains unclear.MethodsA cohort of 20,490 Han residents aged 30–79 without diabetes at baseline were followed from enrollment to June 2, 2023. The consumption of spicy food was obtained through face-to-face surveys conducted during the baseline survey from October 2018 to February 2019. The definition of type 2 diabetes onset was based on the ICD-10 code of E11 in the diabetes case reporting system and death system; Additionally, self-reported diagnosis of diabetes by a physician in active follow-ups, or a fasting blood glucose level of ≥ 7 mmol/L or a glycated hemoglobin percentage of ≥ 6.5% found on-site during the resurvey. Both Cox proportional hazard regression and competing risk regression were used to calculate hazard ratios (HRs) and confidence intervals (CIs).ResultsDuring the follow-up period (53.5 ± 3.0 months), 182 individuals (1.1%) were newly diagnosed with T2D with an incidence rate of 246.2 per 100,000 person-years. Cox regression analyses revealed that spicy food consumers had a 34% reduced risk of developing type 2 diabetes (HR: 0.66, 95% CI: 0.48, 0.91) compared to non-consumers. The HRs (95% CIs) for participants consuming spicy food 3–5 days/week, 6–7 days/week, and with weak pungency were 0.45 (95% CI: 0.25, 0.81), 0.69 (0.49, 0.98), and 0.64 (0.46, 0.90), respectively. However, little significant protective effect was observed among those who consumed spicy food for 1–2 days/week, with moderate pungency, or with strong pungency (all P > 0.05).ConclusionsConsuming spicy food may lower the risk of developing type 2 diabetes, particularly at a frequency of 3–5 days/week, and with weak pungency. Further multicenter prospective studies or interventional studies are needed to confirm these findings.

Pathogenesis and Biomarkers of Cancer-Related Ischemic Stroke.

To investigate the pathogenesis of cancer-related ischemic stroke (CRIS) and to search for reliable biomarkers of CRIS. Patients with CRIS, only-cancer and only-ischemic stroke who were hospitalized in the First Affiliated Hospital of Guangxi Medical University from May 2022 to January 2024 were recruited, and laboratory and clinical data of the three groups were collected. Peripheral venous blood was collected and enzyme-linked immunosorbent assay (ELISA) was used to detect markers of coagulation (D-dimer) and endothelial integrity (intercellular adhesion molecule-1 (ICAM-1)). The study included 16 patients with CRIS, as well as 16 patients with only-cancer and 16 patients with only-ischemic stroke. Among patients with CRIS, the most common cancer was lung cancer, and the most common pathological type was adenocarcinoma. It was found that compared with patients with only-cancer and only-ischemic stroke, the hemoglobin and lymphocyte percentage in patients with CRIS were decreased (P<0.05), while the neutrophil percentage and neutrophil to lymphocyte ratio (NLR) were increased (P<0.05). Compared with only-ischemic stroke group, the lymphocyte absolute value in patients with CRIS was decreased (P<0.05), and platelet to lymphocyte ratio (PLR), globulin, prothrombin time (PT), international normalized ratio (INR) and ICAM-1 were increased (P<0.05). D-dimer level was higher in patients with CRIS than in only-cancer group (P<0.05). In the present study, the increased NLR, PLR, ICAM-1 and D-dimer were expected to be biomarkers of CRIS, indicating that hypercoagulability mediated by cancer inflammation and endothelial damage may be the pathogenesis of CRIS. The novel findings in the present study will facilitate clinicians to identify the patients at high risk of CRIS. Because of the small sample size, the findings need to be validated by prospective large-sample studies in the future.

Development and validation of a predictive scoring system for hypoglycaemic agents for optimal control of blood glucose during glucocorticoid therapy.

Glucocorticoid (GC) treatments are often used. There is limited information on the prediction of hyperglycaemia after GC administration. This study aimed to identify the risk factors for hyperglycaemia after glucocorticoid (GC) administration and the need for hypoglycaemic agents to correct it and to develop and validate a novel scoring system for predicting GC-induced hyperglycaemia. In a development set, 508 adults receiving prednisolone (PSL) for the first time were divided into two groups based on treatment with or without hypoglycaemic agents. Clinical and laboratory parameters were compared, and risk factors were identified using logistic regression analysis after performing univariate analyses between the two groups. A point-addition scoring system with several categories and coefficients for each risk factor was constructed to predict the need for hypoglycaemic agents. The scoring system was then applied and validated on two validation sets: A and B. Older age, higher glycated haemoglobin percentage, body mass index and initial PSL dosage were identified as risk factors. The sensitivity, specificity and accuracy of the scoring system were 70.6%, 81.9% and 77.1% in the development set; 75.8%, 78.4% and 77.4% in validation set A; and 79.4%, 73.9% and 75.3% in validation set B respectively. By fitting the total score in the development set and the probability of hyperglycaemia to a logistic curve, a figure was created to show the probability of GC-induced hyperglycaemia in patients scheduled to receive GC. This scoring system is a novel, valid and reliable tool for predicting GC-induced hyperglycaemia and the need for hypoglycaemic agents to correct it.

Impact of home-based exercise on residual kidney function in patients initiating peritoneal dialysis: A feasibility multicenter randomized controlled trial.

Although the impact of aerobic exercise (AE) and resistance training (RT) on peritoneal dialysis (PD) patients is well established, the impact of exercise programs on residual kidney function (RKF) has not been elucidated. Patients were randomly assigned to either the exercise (n = 25) or control groups (n = 30). Patients in the exercise group performed AE three times a week and RT twice a week at home for 24 weeks. The control group did not receive any specific intervention. The primary outcome was RKF, assessed by residual glomerular filtration rate (rGFR). Secondary outcomes included urinary protein levels, distance covered in the incremental shuttle walking test (ISWT), and glycated hemoglobin (HbA1c) percentages. Linear mixed-effects models showed no significant changes in mean rGFR between the exercise and control groups at 12 weeks (-0.40; 95% confidence interval (CI): -2.17, 1.36; p = 0.65) and at 24 weeks (0.65; 95% CI: -1.15, 2.45; p = 0.48). There was a trend toward improvement in mean urinary protein level and ISWT results, and a significant decrease in mean HbA1c percentage at 24 weeks in the exercise group (-1.07, 95% CI: -2.29, 0.15, p = 0.09; 37.7, 95% CI: -10.1, 85.5, p = 0.12; -0.57, 95% CI: -0.97, -0.18, p = 0.005, respectively) compared to the control group. The 24-week home-based exercise program did not demonstrate beneficial effects on RKF in incident PD patients. Nonetheless, it may have an impact on reducing urinary protein levels and HbA1c percentages.

A-149 Comparison of Mass Spectrometry to Sickle Solubility for Confirmation of Low Percentages of Hemoglobin S

Abstract Background Hemoglobin S (HbS) causes sickling disorders. In the laboratory, confirmation of HbS in patient samples with varying percentages is essential. Assessment is routinely performed using capillary electrophoresis (CE) and/or high-performance liquid chromatography. Sickle solubility (SS) exploits decreased solubility of HbS under reducing conditions and is a confirmatory test. SS is unreliable with low HbS, elevated HbF, severe anemia, erythrocytosis, hyperglobulinemia, extreme leukocytosis, hyperlipidemia, or increased serum proteins. Infant samples commonly have low percentages of HbS, high HbF, and limited sample volume. Intact globin chain Mass Spectrometry (MS) is used to identify abnormal hemoglobin variants by detecting the mass change (normal α/β/γ mass =15127/15867/15996 amu), respectively). MS has potential advantages in sensitivity and efficiency over SS and requires lower input sample volume. Herein we compare the utility of MS versus SS for confirmation of HbS. Methods Twenty-three EDTA-anticoagulated blood samples containing low percentages of HbS were identified. SS was performed on 30μL washed packed cells (requires 200μL whole blood) per standard methods. Intact Quadrupole Time-of-Flight MS (Accurate-Mass Q-TOF LC/MS 6520, Agilent Technologies, California) was performed using 10μL whole blood sample in acetonitrile solution reagent and results were compared. HbS and HbF levels were assayed by capillary electrophoresis (Sebia, France) per standard methods. Results Select results are summarized in Table 1. SS detected HbS percentages to 4.8% when HbF was low but not 6% HbS when Hb F is high. MS showed no HbF interference and identified HbS peaks (at 15837 amu) down to 3.1%. HbS percentages &amp;lt;3.1 were undetected by both methods. Conclusions Overall, MS was superior to SS for confirming HbS, particularly in samples with low variant percentage and/or elevated HbF. MS is also optimal when sample volume is minimal, such as for infants. Percentages of HbS &amp;lt;3% require methods such as IEF or DNA sequencing for confirmation.

A Study Evaluating Infection with the Parasite Entamoeba Histolytica and Its Relationship to Hemoglobin Level and White Blood Cell Count

This study was conducted to determine the incidence of the histolytic encephalopathy and its relationship to some blood variables (hemoglobin and white blood cells). A number of (120) samples were collected from the general records of Zawia Teaching Hospital from the period (January 2023-December 2023) in the children's department, in addition to examining some samples of shelter cases in the children's department, where we relied on the direct stain method to examine stool samples. The results showed that the most infected age groups are the ages between (6 years - 10 years) at a rate of (19%), in addition to the fact that the most infected gender was females at a rate of (64%), in addition to the fact that it was noted that the infected had a slight deficiency in the hemoglobin percentage, which indicates that the infections were not severe, in addition to the fact that the percentage of white blood cells was (14%), which is considered a high percentage compared to the normal percentage, and the percentage of non-infected indicates that the children's immunity was good and the infection was simple. Keywords: Entamoeba histolytica parasite, infection, relationship, hemoglobin level, white blood cells.

Comparison of the effectiveness of ferrous ascorbate with ferrous sulphate in improving haemoglobin percentage among ante-natal mothers in rural field practice area of a medical college

ABSTRACT Background: Anaemia in pregnancy is defined by the World Health Organisation (WHO) as a haemoglobin concentration of less than 11 g/dl in venous blood. The prevalence of anaemia among ante-natal mothers in India is 50.3%[3]. The government of India supplies ferrous sulphate for prophylaxis and treatment of anaemia among ante-natal mothers for free through the reproductive maternal neonatal and child health + adolescent (RMNCH+A) programme. However, patient compliance is poor due to gastrointestinal disturbances (of all registered pregnancies, less than 1/3 consumed a full course of ferrous sulphate). Previous studies in different settings have shown increased compliance and higher mean haemoglobin levels with ferrous ascorbate, which is more affordable than other commercially available compounds. Objective: Hence, the current study was done to compare the effectiveness of ferrous ascorbate with ferrous sulphate in improving haemoglobin percentage among ante-natal mothers in a rural field practice area of a medical college. Methods: An interventional community-based study was conducted in the rural field practice area of Andhra Medical College. The study was done among 76 registered (registered at Rural Primary Health Centre Simhachalam) ante-natal mothers in gestational age 13–17 weeks with haemoglobin concentration of 7–10.9 g/dl (mild to moderate anaemia) after taking informed consent. The study was performed for two years. Ante-natal mothers who were registered but unavailable during the study period, with a medical history of haematological disorders, chronic cardiac and kidney diseases, known or suspected to have sensitivity to iron compounds, with known thyroid dysfunction or mental illness were excluded from the study. Results: There was a rise in haemoglobin among the entire study population, which was statistically significant (P &lt; 0.0001). There was a higher rise in haemoglobin among the antenatal women who took ferrous ascorbate than among those who took ferrous sulphate (mean difference = 0.344 gm/dl) after 12 weeks of follow-up, which was statistically significant (P = 0.014). Conclusion: The study compared the effectiveness of ferrous ascorbate with ferrous sulphate in improving haemoglobin percentage among antenatal mothers in a medical college’s rural field practice area. There was a significant rise in haemoglobin percentage among the study group, which was on ferrous ascorbate with better compliance and fewer gastrointestinal side effects.

Evaluation of disease activity in systemic lupus erythematosus using standard deviation of lymphocyte volume combined with red blood cell count and lymphocyte percentage

Systemic lupus erythematosus (SLE) commonly damages the blood system and often manifests as blood cell abnormalities. The performance of biomarkers for predicting SLE activity still requires further improvement. This study aimed to analyze blood cell parameters to identify key indicators for a SLE activity prediction model. Clinical data of 138 patients with SLE (high activity, n = 40; moderate activity, n = 44; mild activity, n = 37; low activity, n = 17) and 100 healthy controls (HCs) were retrospectively analyzed. Data from 89 paired admission–discharge patients with SLE were collected. Differences and associations between blood cell parameters and disease indicators, as well as the relationship between the these parameters and organ damage, were examined. Machine-learning methods were employed to develop a prediction model for disease activity evaluation. Most blood cell parameters (22/26, 84.62%) differed significantly between patients with SLE and HCs. Analysis of 89 paired patients with SLE revealed significant changes in most blood cell parameters at discharge. The standard deviation of lymphocyte volume (SD-V-LY), red blood cell (RBC) count, lymphocyte percentage (LY%), hemoglobin(HGB), hematocrit(HCT), and neutrophil percentage(NE%) correlated with disease activity. By employing machine learning, an optimal model was established to predict active SLE using SD-V-LY, RBC count, and LY% (area under the curve [AUC] = 0.908, sensitivity = 0.811). External validation indicated impressive performance (AUC = 0.940, sensitivity = 0.833). Correlation analysis revealed that SD-V-LY was positively correlated with ESR, IgG, IgA, and IgM but was negatively correlated with C3 and C4. The RBC count was linked to renal and hematopoietic system impairments, whereas LY% was associated with joint/muscle involvement. In conclusion, SD-V-LY is associated with SLE disease activity. SD-V-LY combined with RBC count and LY% contributes to a prediction model, which can be utilized as an effective tool for assessing SLE activity.

Retinopathy of Prematurity in Eight Portuguese Neonatal Intensive Care Units: Incidence, Risk Factors, and Progression-A Prospective Multicenter Study.

Retinopathy of prematurity (ROP) is a retinal neovascular disease affecting preterm infants. Identifying risk factors for its development and progression is critical for effective screening and prevention. This study aimed to analyze the incidence of ROP and identify key risk factors for its development and progression. We conducted a prospective, observational cohort study on 455 neonates (gestational age [GA] < 32 weeks or birth weight < 1500 g) across eight Portuguese NICUs. ROP incidence was 37.8%, with 4.6% requiring treatment. Multivariate analysis identified low GA and the number of red blood cell (RBC) transfusions as significant factors for ROP development and progression. After adjusting for these variables, platelet transfusions, high maximum fraction of inspired oxygen (FiO2) in the second week, and surfactant use remained significantly associated with ROP development, while early and late sepsis, maternal chronic hypertension, and delayed enteral nutrition were associated with progression to ROP requiring treatment. These findings underscore the importance of addressing low GAs and adult RBC transfusions in ROP risk management and suggest that maximum FiO2, platelet transfusions, and sepsis also play crucial roles. Larger studies are needed to validate these results and explore preventive interventions, particularly regarding the impact of multiple adult RBC transfusions on fetal hemoglobin percentages.

In vitro and in vivo evaluation of hypoglycemic potential and acute toxicity of microencapsulated turmeric instant powder

BackgroundCurcuma longa L. (turmeric), traditionally used to treat various ailments including diabetes, has demonstrated beneficial health effects. However, its potential in food formulations requires further investigation. PurposeThis study examined the hypoglycemic effects of an instant powder containing microencapsulated turmeric oleoresin both in vitro and in vivo, alongside an acute toxicity assessment in Holtzman rats. MethodsThis study encompassed both in vitro and in vivo evaluations. In vitro, the α-glucosidase (a digestive enzyme) inhibition assay was employed to determine the powder's effectiveness. In vivo assessments included: (1) evaluation of the hypoglycemic effect in mice; (2) conducted safety testing following international guidelines, administering a 2000 mg/kg dose to rats with subsequent monitoring of biochemical parameters; and (3) histological examination of liver, kidney, and spleen tissues for potential harmful effects. ResultsThe instant powder with turmeric oleoresin microencapsulation demonstrated significant α-glucosidase inhibition in vitro and hypoglycemic effects in vivo. The acute toxicity test at 2000 mg/kg showed no mortality but revealed significant alterations in erythrocyte parameters and hemoglobin percentage. Histological examinations of liver, kidney, and spleen tissues did not differ from those of the control group, though pancreatic tissue was not evaluated in this study. ConclusionAccording to this study, the microencapsulated turmeric oleoresin instant powder exhibited antidiabetic effects without signs of overt toxicity at doses up to 2000 mg/kg in rats.

Effectiveness of Multilevel and Multidomain Interventions to Improve Glycemic Control in U.S. Racial and Ethnic Minority Populations: A Systematic Review and Meta-analysis.

Racial and ethnic disparities in type 2 diabetes outcomes are a major public health concern. Interventions targeting multiple barriers may help address disparities. To conduct a systematic review and meta-analysis of diabetes self-management education (DSME) interventions in minority populations. We hypothesized that interventions addressing multiple levels (individual, interpersonal, community, and societal) and/or domains (biological, behavioral, physical/built environment, sociocultural environment, and health care system) would have the greatest effect on hyperglycemia. We performed an electronic search of research databases PubMed, Scopus, CINAHL, and PsycINFO (1985-2019). We included randomized controlled trials of DSME interventions among U.S. adults with type 2 diabetes from racial and ethnic minority populations. We extracted study parameters on DSME interventions and changes in percent hemoglobin A1c (HbA1c). A total of 106 randomized controlled trials were included. Twenty-five percent (n = 27) of interventions were exclusively individual-behavioral, 51% (n = 54) were multilevel, 66% (n = 70) were multidomain, and 42% (n = 45) were both multilevel and multidomain. Individual-behavioral interventions reduced HbA1c by -0.34 percentage points (95% CI -0.46, -0.22; I2 = 33%) (-3.7 [-5.0, -2.4] mmol/mol). Multilevel interventions reduced HbA1c by -0.40 percentage points (95% CI -0.51, -0.29; I2 = 68%) (-4.4 [-5.6, -3.2] mmol/mol). Multidomain interventions reduced HbA1c by -0.39 percentage points (95% CI -0.49, -0.29; I2 = 68%) (-4.3 [-5.4, -3.2] mmol/mol). Interventions that were both multilevel and multidomain reduced HbA1c by -0.43 percentage points (95% CI -0.55, -0.31; I2 = 69%) (-4.7 [-6.0, -3.4] mmol/mol). The analyses were restricted to RCTs. Multilevel and multidomain DSME interventions had a modest impact on HbA1c. Few DSME trials have targeted the community and society levels or physical environment domain. Future research is needed to evaluate the effects of these interventions on outcomes beyond HbA1c.

Risk Factors For Anemia In Pregnant Women In The Third Trimester

Anemia is a condition in which the percentage of erythrocytes and hemoglobin (Hb) levels of pregnant women fall below normal. Ponorogo Regency Health Profile Data in 2022, there were 1,746 anemic pregnant women out of 10,878 (16.50%). This study aims to provide an overview of risk variables and initiatives aiming to decrease the proportion of anemia cases among pregnant women. Method: Analytical observational research was used to conduct the study, which was conducted retrospectively from quantitative data. All 62 pregnant women with anemia in the third trimester formed the study sample for the case population. Two independent (free) factors were used in this study: parity, education, nutritional status, maternal age, and gestational age. The prevalence of anemia in third trimester pregnant women is the dependent variable. The instrument used by researchers is an observation sheet. Data analysis to test the truth of the hypothesis uses Regression Logistic Analysis. Result: The findings of the study revealed that maternal age (p-value 0.009) and gestational age (p-value 0.027) were risk factors that had an impact on the incidence of anemia at the North Ponorogo Health Center, indicating that gestational age affects the incidence of anemia. Maternal age has a significant risk impact on the occurrence of anemia. The data showed that the incidence of anemia with a risk of 0.884 times was not affected by nutritional status (p-value = 0.727), parity (p-value = 0.043), education (p-value = 0.043), while the incidence of anemia with a risk of 8.483 times was influenced by parity. Discussion: The findings of this study lead to the conclusion that influencing risk factors were gestational age, maternal age and parity, while nutritional status and education were risk factors that had no effect on anemia in pregnant women. Suggestion: It is expected to provide advice or reference to health centers in order to conduct early detection or further improve comprehensive examinations in order to reduce the prevalence of anemia in the third trimester of pregnancy among several parameters that have been examined by researchers.

Insulin-induced Lipohypertrophy in a Patient with Type 2 Diabetes

Abstract Lipohypertrophy (LH) is a common side effect of insulin treatment in patients with diabetes, characterized by soft, benign nodules in the subcutaneous tissue. This case report describes the management of insulin-induced LH in a 66-year-old male with type 2 diabetes. The patient had been on a combination of oral antidiabetic agents (ODAs) and biphasic human insulin for 5 years, experiencing the symptoms of numbness, leg swelling, fatigue, and frequent hypoglycemic episodes. Upon examination, LH with skin pigmentation was observed at the insulin injection sites on both calves. The patient’s laboratory investigations revealed poor glycemic control with high glycated hemoglobin percentage. To address the condition, the patient was advised to change the injection site, use proper site rotation, and change the insulin needle daily. The insulin therapy was modified by switching to biphasic premixed analog insulin injected 5 min before meals using the insulin pen. In addition, ODAs were adjusted for better glycemic control. Following these interventions, the patient reported improved glucose levels and stable kidney function. This case report emphasizes the importance of early detection and appropriate management of insulin-induced LH through patient education and insulin therapy adjustments. Health-care providers should remain vigilant for LH and educate patients on proper injection practices to optimize diabetes management and prevent complications.

Prediction of acute coronary syndrome in patients with myeloproliferative neoplasms.

Patients with myeloproliferative neoplasms (MPN) are exposed to a higher risk of cardiovascular disease, especially cardiovascular calcification. The present research aimed to analyze the clinical features and coronary artery calcium score (CACS) in MPN patients, and construct an effective model to predict acute coronary syndrome (ACS) in MPN patients. A total of 175 MPN patients and 175 controls were recruited from the First Affiliated Hospital of Ningbo University. Based on cardiovascular events, the MPN patients were divided into the ACS group and the non-ACS group. Multivariate Cox analysis was completed to explore ACS-related factors. Furthermore, ROC curves were plotted to assess the predictive effect of CACS combined with white blood cells (WBC) and platelet for ACS in MPN patients. The MPN group exhibited a higher CACS than the control group (133 vs. 55, P < 0.001). A total of 16 patients developed ACS in 175 MPN patients. Compared with non-ACS groups, significant differences in age, diabetes, smoking history, WBC, percentage of neutrophil, percentage of lymphocyte, neutrophil count, hemoglobin, hematocrit, platelet, lactate dehydrogenase, β 2-microglobulin, and JAK2V617F mutation were observed in the ACS groups. In addition, the CACS in the ACS group was also significantly higher than that in the non-ACS group (374.5 vs. 121, P < 0.001). The multivariable Cox regression analysis identified WBC, platelet, and CACS as independent risk factors for ACS in MPN patients. Finally, ROC curves indicated that WBC, platelet, and CACS have a high predictive value for ACS in MPN patients (AUC = 0.890). CACS combined with WBC and platelet might be a promising model for predicting ACS occurrence in MPN patients.

An incidental finding of a hemoglobin E variant in a diabetic patient with an abnormal glycated hemoglobin level: a case report

BackgroundGlycated hemoglobin is a well-known marker for evaluating long-term glycemic control. However, the accuracy of glycated hemoglobin measurement can be affected by the presence of hemoglobin variants, which makes the determination and interpretation of glycated hemoglobin values in terms of glycemic control not only difficult but also misleading. Here we present the first ever case of a patient with type 2 diabetes with hemoglobin E from Nepal, diagnosed incidentally because of spurious glycated hemoglobin levels.Case presentationA 45-year-old Hindu Mongolian female with a history of type 2 diabetes for around 9 years but not very compliant with follow-ups was referred to our facility for plasma fasting and postprandial blood glucose levels and glycated hemoglobin. Fasting and postprandial blood sugars were found to be high. A consistent very low glycated hemoglobin by two different high-performance liquid chromatography (HPLC) methods compelled us to call the patient for a detailed clinical history and for the records of investigations done in the past. The patient has been a known case of type 2 diabetes for around 9 years and presented irregularly for follow-up visits. Around 4 years ago, she presented to a healthcare facility with fatigue, severe headaches, pain in the abdomen, discomfort, and dizziness for a couple of months, where she was shown to have high blood glucose. She was referred to a tertiary-level hospital in Kathmandu, where she was prescribed metformin 500 mg once daily (OD). Due to her abnormal hemoglobin A1c reports, she was then sent to the National Public Health Laboratory for repeat investigations. Her blood and urine investigations were sent. Complete blood count findings revealed high red blood cell and white blood cell counts, a low mean corpuscular volume, and a high red cell distribution width-coefficient of variation. Other parameters, including serum electrolytes, renal function tests, liver function tests, and urine routine examinations, were within normal limits. A peripheral blood smear revealed microcytic hypochromic red cells with some target cells. Hemoglobin electrophoresis showed a very high percentage of hemoglobin E, a very low percentage of hemoglobin A2, and normal proportions of hemoglobin A and hemoglobin F. A diagnosis of homozygous hemoglobin E was made, and family screening was advised.ConclusionsClinicians should be aware of the limitations of glycated hemoglobin estimation by ion exchange high-performance liquid chromatography in patients with hemoglobin E and other hemoglobin variants. If the clinical impression and glycated hemoglobin test results do not match, glycated hemoglobin values should be determined with a second method based on a different principle, and glycemic status should be confirmed through alternative investigations, preferably those that are not influenced by the presence of hemoglobin variants (for example, boronate affinity chromatography, fructosamine test, glycated albumin test, the oral glucose tolerance test, continuous glucose monitoring, etc.). Consistent or even doubtful results should also raise the suspicion of a hemoglobin variant, which should be confirmed through further evaluation and investigations.

Carbohydrate-Binding Properties and Antimicrobial and Anticancer Potential of a New Lectin from the Phloem Sap of Cucurbita pepo.

A Cucurbita phloem exudate lectin (CPL) from summer squash (Cucurbita pepo) fruits was isolated and its sugar-binding properties and biological activities were studied. The lectin was purified by affinity chromatography and the hemagglutination assay method was used to determine its pH, heat stability, metal-dependency and sugar specificity. Antimicrobial and anticancer activities were also studied by disc diffusion assays and in vivo and in vitro methods. The molecular weight of CPL was 30 ± 1 KDa and it was stable at different pH (5.0 to 9.0) and temperatures (30 to 60 °C). CPL recovered its hemagglutination activity in the presence of Ca2+. 4-nitrophenyl-α-D-glucopyranoside, lactose, rhamnose and N-acetyl-D-glucosamine strongly inhibited the activity. With an LC50 value of 265 µg/mL, CPL was moderately toxic and exhibited bacteriostatic, bactericidal and antibiofilm activities against different pathogenic bacteria. It also exhibited marked antifungal activity against Aspergillus niger and agglutinated A. flavus spores. In vivo antiproliferative activity against Ehrlich ascites carcinoma (EAC) cells in Swiss albino mice was observed when CPL exerted 36.44% and 66.66% growth inhibition at doses of 3.0 mg/kg/day and 6.0 mg/kg/day, respectively. A 12-day treatment by CPL could reverse their RBC and WBC counts as well as restore the hemoglobin percentage to normal levels. The MTT assay of CPL performed against human breast (MCF-7) and lung (A-549) cancer cell lines showed 29.53% and 18.30% of inhibitory activity at concentrations of 128 and 256 µg/mL, respectively.