Reduced Hemoglobin Concentration Research Articles

The Impact of Sleep on Haematological Parameters in Firefighters.

Sleep is a vital process that impacts biological functions such as cell renewal, bone regeneration, and immune system support. Disrupted sleep can interrupt erythropoiesis, leading to fewer red blood cells, reduced haemoglobin concentration, and decreased haematocrit levels, potentially contributing to haematological disorders. This is particularly concerning for shift workers for example firefighters. While previous studies have explored sleep's adverse effects on various professions, research specific to firefighters is limited. This study investigates the relationship between sleep quality and haematological parameters among firefighters in Northeast Portugal. From a sample of 201 firefighters, variations in red blood cells, haemoglobin, and haematocrit values were linked to sleep quality. The study utilised non-parametric tests (Wilcoxon-Mann-Whitney, Spearman's correlation) to explore the connection between sleep quality and haematological profile. The impact of covariates on haematological parameters was assessed using non-parametric ANCOVA (Quade's). A multiple regression analysis was employed to further understand how sleep quality and various confounding variables impact haematological levels. Findings suggest a negative link between sleep quality and haematological levels, meaning that as sleep quality deteriorates, there is a tendency for haematological levels to decrease, as indicated by Spearman's correlation (rRBC = -0.157, pRBC = 0.026; rHb = -0.158, pHb = 0.025; rHCT = -0.175, pHCT = 0.013). As observed in scientific literature, the correlation found suggests a possible inhibition of erythropoiesis, the process responsible for red blood cell production. Despite firefighters presenting a haematological profile within the reference range (RBC: 5.1 × 106/mm3 (SD ± 0.4), Hb: 15.6 g/dL (SD ± 1.3), 47% (SD ± 1.0), there is already an observable trend towards lower levels. The analysis of co-variables did not reveal a significant impact of sleep quality on haematological levels. In conclusion, this study underscores the importance of sleep quality in determining haematological parameters among firefighters. Future research should investigate the underlying mechanisms and long-term implications of poor sleep quality on firefighter health. Exploring interventions to enhance sleep quality is vital for evidence-based strategies promoting firefighter well-being.

Cerebral blood flow regulation in hypobaric hypoxia: role of haemoconcentration.

During acute hypoxic exposure, cerebral blood flow (CBF) increases to compensate for the reduced arterial oxygen content (CaO2). Nevertheless, as exposure extends, both CaO2 and CBF progressively normalize. Haemoconcentration is the primary mechanism underlying the CaO2 restoration and may therefore explain, at least in part, the CBF normalization. Accordingly, we tested the hypothesis that reversing the haemoconcentration associated with extended hypoxic exposure returns CBF towards the values observed in acute hypoxia. Twenty-three healthy lowlanders (12 females) completed two identical 4-day sojourns in a hypobaric chamber, one in normoxia (NX) and one in hypobaric hypoxia (HH, 3500m). CBF was measured by ultrasound after 1, 6, 12, 48 and 96h and compared between sojourns to assess the time course of changes in CBF. In addition, CBF was measured at the end of the HH sojourn after hypervolaemic haemodilution. Compared with NX, CBF was increased in HH after 1h (P=0.001) but similar at all later time points (all P>0.199). Haemoglobin concentration was higher in HH than NX from 12h to 96h (all P<0.001). While haemodilution reduced haemoglobin concentration from 14.8 ± 1.0 to 13.9 ± 1.2g·dl-1 (P<0.001), it did not increase CBF (974 ± 282 to 872 ± 200ml·min-1; P=0.135). We thus conclude that, at least at this moderate altitude, haemoconcentration is not the primary mechanism underlying CBF normalization with acclimatization. These data ostensibly reflect the fact that CBF regulation at high altitude is a complex process that integrates physiological variables beyond CaO2. KEY POINTS: Acute hypoxia causes an increase in cerebral blood flow (CBF). However, as exposure extends, CBF progressively normalizes. We investigated whether hypoxia-induced haemoconcentration contributes to the normalization of CBF during extended hypoxia. Following 4 days of hypobaric hypoxic exposure (corresponding to 3500m altitude), we measured CBF before and after abolishing hypoxia-induced haemoconcentration by hypervolaemic haemodilution. Contrary to our hypothesis, the haemodilution did not increase CBF in hypoxia. Our findings do not support haemoconcentration as a stimulus for the CBF normalization during extended hypoxia.

Trends in iron deficiency anemia research 2010 – 2023: a bibliometric analysis

Anemia is a health disorder marked by a reduction in hemoglobin concentration (Hb), hematocrit (Ht), and erythrocyte count. Iron deficiency anemia is marked by a reduction in hemoglobin synthesis, resulting in the production of hypochromic microcytic erythrocytes. The interest over time in the topic of iron deficiency anemia throughout the world is increasing. Many studies associated with iron deficiency anemia have been conducted by various authors and are increasing from year to year. The aim of the present review was to evaluate the literature on iron deficiency published between 2010 and 2023, with a focus on the trend in number of publications and citations, the trend of the link strength on the topic of iron deficiency anemia, and the low density of articles published from 2010 to 2023, to determine the trend and novelty of the topic of iron deficiency anemia. This review was a systematic study with the stages conforming to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram. The data on scientific publications on the topic of iron deficiency anemia were collected using dimensions.ai from 2010 to 2023. The data were subsequently analyzed with the Vosviewer program. This review resulted in the following findings. First, the number of publications and citations on the topic of iron deficiency anemia increased exponentially from year to year. Second, there were 139 items, 3 clusters, and 5579 links, with a link strength of 18253 for the topic of iron deficiency anemia. Third, the recommended study topics connected with iron deficiency anemia are topics of low density, namely clinician, pathogenesis, and biofortification. The study findings may assist the interested researchers to know the trends and novelties of studies on iron deficiency anemia, and may recommend suggestions for further research.

Effect of intake of probiotics and probiotic fermented foods on clinical outcomes among people living with HIV: A systematic review and meta-analysis.

The objective of the study was to determine the effect of probiotics and of probiotic-fermented foods on CD4 T-cell count, viral load, anaemia and body mass index (BMI) among people living with HIV (PLHIV). In this article, we systematically reviewed the evidence on the influence of probiotic supplementation on CD4 lymphocyte count, viral load and anaemia among PLHIV on highly active antiretroviral therapy (HAART) and those who were HAART-naive. Medical literature databases identified randomised trials and pre-post studies of probiotic supplementation and HIV-related outcomes, and random effects meta-analysis was conducted. The preponderance of the evidence suggests that probiotic supplementation only improved CD4 lymphocyte count modestly, with quantitatively greater impact among individuals who were HAART-naive compared to HAART-experienced individuals. Probiotic supplementation improved CD4 lymphocyte count by 53 cells/mm3 (95% CI: 22 to 85) from 18 studies. Probiotic supplementation however reduced haemoglobin concentration by -2.1 g/L (95% CI: -4.0 to -0.2). Although viral load remain unchanged in HAART-experienced participants following probiotic supplementation, HAART-naïve participants saw a decrease in viral load. There were too few studies on the impact of probiotic supplementation on viral load (N = 1). Probiotic supplementation resulted in a modest increase in CD4 lymphocyte count among HAART-naive individuals with no significant change observed among HAART-experienced ones. Viral load and haemoglobin concentration also remained unchanged following probiotic supplementation. Further rigorous and well-powered studies may evaluate the effect of probiotic supplementation on important clinical outcomes among PLHIV on HAART.

Influence of Two Kinds of Combined Oral Contraceptives on Some Red Blood Cell (RBC) Parameters in Women Attending Family Planning Unit in University of Port Harcourt Teaching Hospital

Background: The use of hormonal contraceptives is on the increase among women of reproductive age in Nigeria. In this study effort was made to examine the influence of combined oral contraceptives on some Red blood cell (RBC) parameters in women attending family planning unit. Materials and Methods: Data for this study were obtained through questionnaire administered on one hundred and twenty (120) respondents who were randomly purposively selected. The subjects blood samples were collected and analysed using appropriate techniques. One way ANOVA was adopted as statistical analysis method for the study. Results and Discussions: It was observed that while combined oral contraceptives therapy caused reduction in MCV value, MCHC was significantly raised. The significant increase in haematocrit value coupled with con-comitant reduction in haemoglobin concentration in circulation as reported by this study is of great advantage in terms of oxygen carrying and delivery capacity of red blood cells and maintenance of normal function in individuals. Conclusion: The combined oral contraceptives does not show the capacity of inducing anaemia in users.

Association of Admission Anaemia with the Severity of Acute Ischemic Stroke: A Study in a Tertiary Care Hospital

Background: Acute ischemic stroke imposes substantial disability, economic, and social burdens. Prevention plays a vital role in reducing morbidity and mortality. Reduced hemoglobin concentration in ischemic stroke patients hampers oxygen delivery to neuronal tissue, leading to adverse effects on the ischemic penumbra and increasing the risk of infarct expansion. By addressing anemia and identifying other associated risk factors, we can effectively enhance stroke prevention strategies and mitigate its overall impact on individuals and society. Understanding the multifaceted nature of ischemic stroke and implementing comprehensive prevention measures is key to minimizing its devastating consequences. Objectives: The purpose of this study is to show the association of admission anaemia with the Severity of Acute Ischemic Stroke. Method and Materials: This cross-sectional study was carried out in the Department of Neurology, Dhaka Medical College and Hospital (DMCH), Dhaka for a period of two years. Two hundred and seventy- nine patients with acute ischemic stroke were selected consecutively through screening with a set of inclusion and exclusion criteria. Each patient underwent a CT of the head and/or MRI of the brain and blood tests, including hemoglobin (Hb) concentration on the first day of hospitalization. Demographic and risk factors from all subjects were collected with a structured questionnaire. The neurological state of the patients was assessed on the first day of hospitalization by the National Institute of Health Stroke Scale (NIHSS). After data collection analysis was done by SPSS for Windows version 26. A p-value ≤ 0.05 was considered statistically significant. Results: The frequency of anemia in acute ischemic stroke patients was 39.1%, in males it was 35.8%, and in females 44.7%. Frequency Anemia was observed more among the older patients than younger patients but there was no significant difference. Anemia was found highest in the age group ........

Efficacy of oral Tranexamic Acid in reducing blood loss during primary total hip arthroplasty: A comparative study

Background: Perioperative blood loss is a major concern for patients undergoing total hip arthroplasty. Intravenous Tranexamic acid is commonly used to reduce blood loss and need for blood transfusion following total hip replacement. Recent studies have shown the efficacy of oral tranexamic acid in reducing perioperative blood loss in total hip replacement.&#x0D; Method: A total of 69 patients undergoing primary total hip replacement in National Orthopaedic Hospital, Igbobi, Lagos, were recruited. Patients were randomized to receive 2gram oral tranexamic acid 2hours before incision or 1-gram intravenous tranexamic acid 10minutes before incision. Primary outcome measure was reduction in haemoglobin concentration.&#x0D; Results: There was no significant difference in mean reduction in haemoglobin concentration in the oral tranexamic acid group compared to intravenous tranexamic acid group (3.78g/dl ±1.27 and 3.61g/dl ±0.54 respectively, P- 0.49). There was no significant difference between total blood loss and requirement for blood transfusion in the two groups.&#x0D; Conclusion: Oral and intravenous routes of tranexamic acid administration have comparable efficacy in reducing blood loss and requirement for blood transfusion. Oral tranexamic acid is cheaper, easier to administer and should be considered as a safe and effective alternative to intravenous tranexamic acid.

Evaluation of the proximate and anti-nutrient composition of methanol extract of Mangifera indica (mango) seed kernel and impact of its consumption on haematological parameters

The aim of this study was to evaluate the proximate and anti-nutrient composition of methanol extract of Mangifera indica (mango) seed kernel and impact of its consumption on haematological indices of treated rats. Mango seed kernels were processed into fine powder which was subsequently divided into two parts. While one half of the flour sample was used for proximate analysis, the remaining half was subjected to extraction. Twenty five adult male wistar rats were divided into five groups of five rats each. Group I was the normal control and was fed rat chow and water only, Groups II-V were administered with 200, 400, 600 and 800 mg/kg bw of Mango Seed Kernel Extract (MSKE) respectively. Administration of extract lasted for 21 days after which rats were sacrificed and blood sample collected for analysis of haematological indices which were determined by standard procedures. Proximate analysis revealed the presence of ash, crude fibre, crude protein, fat and total carbohydrate (70.12±1.34%) which was reportedly more abundant. The study also revealed the presence of anti-nutrients such as oxalate, tannins, phytate, alkaloid and saponins and phytate (1.49±0.01 mg/100g) which was most abundant, while alkaloid (0.03±0.02 mg/100 g) was the least abundant. Administration of 200, 400, 600 and 800 mg/kg body weight of MSKE significantly (P&lt;0.05) reduced Haemoglobin concentration (Hb), Red Blood Cell (RBC), Packed Cell Volume (PCV). However, 400, 600 and 800 mg/kg MSKE reduced WBC compared to the control, there was a non-significant (P&gt;0.05) difference between the WBC of the control group and that of the group II administered with 200 mg/kg bw MSKE. In conclusion, the fact that MSKE is an embodiment of nutrients and anti-nutrients has undoubtedly been consolidated further through this research and the alterations observed in the studied blood parameters are direct consequence of the anti-nutrient.

Varying Doses of Rare-Earth-Metal-Based Neodymium Zirconate Zinc Sulfide Nanocomposite Disrupt Blood and Serum Parameters, as well as Markers of Oxidative Stress in the Selected Organs of Albino Mice

Despite extensive industrial use, the biocompatibility of nanocomposites has not been extensively explored. The present study was designed to report the effect of variable doses of a newly synthesized nanocomposite, Neodymium Zirconate Zinc Sulfide, on selective serum and complete blood count parameters and on the oxidative stress markers from the vital organs of albino mice. Albino mice (C57BL/6 strain, 5 weeks old) of both sexes were orally treated for 11 days, either with 10 mg (low dose) or 20 mg/mL saline/kg body weight (high dose) of Neodymium Zirconate Zinc Sulfide nanocomposite. A control group that was not treated with the nanocomposite but with saline solution was also maintained. Data analysis revealed that high-dose nanocomposite-treated male mice had significantly reduced hemoglobin concentration as compared to the control males. Female mice treated with both doses of nanocomposite had higher serum triglyceride levels than controls. High-dose-treated female mice had elevated serum cholesterol concentration compared to their saline-treated controls. Oxidative stress marker analysis from selected organs indicated that concentrations of malonaldehyde (MDA) in the kidney and liver, Superoxide dismutase (SOD) levels in the brain and catalase in the kidney of male mice treated with the nanocomposite were significantly higher than in the control group, whereas SOD in the heart, MDA in the heart and kidney and catalase levels in the kidney were significantly disrupted in female mice compared to their respective controls.

Safety of single-dose primaquine as a Plasmodium falciparum gametocytocide: a systematic review and meta-analysis of individual patient data

BackgroundIn 2012, the World Health Organization (WHO) recommended single low-dose (SLD, 0.25 mg/kg) primaquine to be added as a Plasmodium (P.) falciparum gametocytocide to artemisinin-based combination therapy (ACT) without glucose-6-phosphate dehydrogenase (G6PD) testing, to accelerate malaria elimination efforts and avoid the spread of artemisinin resistance. Uptake of this recommendation has been relatively slow primarily due to safety concerns.MethodsA systematic review and individual patient data (IPD) meta-analysis of single-dose (SD) primaquine studies for P. falciparum malaria were performed. Absolute and fractional changes in haemoglobin concentration within a week and adverse effects within 28 days of treatment initiation were characterised and compared between primaquine and no primaquine arms using random intercept models.ResultsData comprised 20 studies that enrolled 6406 participants, of whom 5129 (80.1%) had received a single target dose of primaquine ranging between 0.0625 and 0.75 mg/kg. There was no effect of primaquine in G6PD-normal participants on haemoglobin concentrations. However, among 194 G6PD-deficient African participants, a 0.25 mg/kg primaquine target dose resulted in an additional 0.53 g/dL (95% CI 0.17–0.89) reduction in haemoglobin concentration by day 7, with a 0.27 (95% CI 0.19–0.34) g/dL haemoglobin drop estimated for every 0.1 mg/kg increase in primaquine dose. Baseline haemoglobin, young age, and hyperparasitaemia were the main determinants of becoming anaemic (Hb < 10 g/dL), with the nadir observed on ACT day 2 or 3, regardless of G6PD status and exposure to primaquine. Time to recovery from anaemia took longer in young children and those with baseline anaemia or hyperparasitaemia. Serious adverse haematological events after primaquine were few (9/3, 113, 0.3%) and transitory. One blood transfusion was reported in the primaquine arms, and there were no primaquine-related deaths. In controlled studies, the proportions with either haematological or any serious adverse event were similar between primaquine and no primaquine arms.ConclusionsOur results support the WHO recommendation to use 0.25 mg/kg of primaquine as a P. falciparum gametocytocide, including in G6PD-deficient individuals. Although primaquine is associated with a transient reduction in haemoglobin levels in G6PD-deficient individuals, haemoglobin levels at clinical presentation are the major determinants of anaemia in these patients.Trial registrationPROSPERO, CRD42019128185

Codeine induced hematological, hepatic alterations, lung and brain damage in mice

Codeine, an opiate derivate, which induces pleasure and euphoria in users, is contained in many OTC cough syrups as dextromethorphan. In 2011, its abuse has been reported in Nigeria from consumption of codeine-based cough syrup such as Benylin containing codeine syrup (BCS). Thereafter, the neurobehavioural alteration was reported with BCS in mice. 45 Swiss male mice (20 g -25 g) were grouped into control, low dose-(10.95 ml/kg BCS) and High dose-(21.90 ml/kg of BCS). BCS was given orally above the therapeutic dose for 4weeks. Blood samples were collected after 7 and 28days under mild ether anesthesia into plain and heparinized bottles to assess hematological indices, serum creatinine level, and activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Thereafter, the brain, lung, and liver were excised and processed for brain protein level and histopathological observation. Data were analyzed using Two-way ANOVA at P &lt; 0.05. At both doses, BCS reduced hemoglobin concentration (10.56; 21.69%), lymphocyte count (10.54; 29.22%) and brain protein level (4.86±0.81; 4.86 ± 0.80 vs 9.20 ± 0.61 g/l) while white blood cell count (20.47; 46.08%), serum creatinine level (5.36; 18.75%), AST (26.31; 32.77%) and ALT (22.90; 36.70%) activities were increased compared to control. Histology shows marked necrosis and chronic infiltration by inflammatory cells in the brain, liver, and lung. Acute and chronic treatment of mice with Benylin with codeine resulted in significant alterations in blood and vital body organs such as kidney, liver, lung, and brain in a dose-dependent manner.

Effect of HB Cleanser® Bitters on Haematological Parameters in Wistar Rats

The public advertisement with indiscriminate sale of herbal bitters has led to increase in consumption without adequate information on the safety profile of the product. Thus, this study aimed to investigate the effects of HB cleanser® bitters (a polyherbal mixture composing of Aloe vera, Acinos arvensis, Moringa oleifera, Chenopodium murale and Cinnamomum aromaticum, Allium sativum on haematological parameters in Wistar rats.&#x0D; Twenty-eight animals were randomly allotted into 4 groups comprising 7 animals each. HB cleanser® bitters was administered at doses of 1 ml/kg, 1.03 ml/kg and 1.29 ml/kg according to the manufacturers recommendation while the fourth group was administered with normal saline orally for 28days consecutively. Feed and fluid intake were measured daily. Haematological parameters (PCV, RBC, WBC, HB, platelet, neutrophil, lymphocyte, monocyte, eosinophil, and basophil) were evaluated. Flavonoids, saponins and cardiac glycosides were revealed as the phytoconstituents. The results showed that the HB cleanser bitters at 1.03 ml/kg significantly (P&lt;0.05) increased the WBC (17.00 ± 3.22 x109/L), while there was a non-significant ((P&gt;0.05) decrease in RBC, PCV and Hb (4.88 ± 0.14 ×1012/L, 44.40 ± 1.17%, 14.54 ± 0.55 g/dl) when compared to control. A non-significant increase in platelets occurred at all doses. The findings of this study have shown that HB cleanser® bitters caused an increase in white blood cell count with a reduction in haemoglobin concentration and red blood cell count hence, it should be taken with caution.

Analysis of complete blood count parameters pre and post transfusion of packed red blood: A meta-analytic study in a tertiary care hospital

The clinical condition of anaemia is defined as reduction below normal limits of the total circulating red cell mass. It is measured by the reduction in packed red cell volume or reduction in haemoglobin concentration of blood. Patients with hemoglobin below 6 gm/dl usually require transfusion therapy. In stabilized patients with hemoglobin values between 6 and 10 gm/dl, the decision whether to transfuse is based on an evaluation of clinical status. The present study comprised of 140 Anaemic patients who received packed red cell transfusion. The study was analyzed for a period of one year. Haematological parameters – complete blood counts were collected by running anticoagulated blood in automated haematology analyser before and after transfusing the blood units. Peripheral smear by using Leishman’s stain. Reticulocyte count by using new methylene blue.Of total 140 patients, 45(34.6%) of patients were clinically diagnosed as iron deficiency anaemia followed by 43(33.1%) anaemia of chronic disease patients, 18(13.8%) of anaemia of chronic kidney disease, 20(15%) of anaemia of liver disease, 10(7.7%) of dimorphic anaemia (anaemia of combined deficiency) and 4(3.1%) of anaemia in hypersplenism.Iron deficiency anaemia is the most common disease group in the present study followed by anaemia of chronic disease. Anaemia is more prevalent in the female population with M:F ratio of 4:5. Particularly iron deficiency anaemia is more prevalent among females with M:F ratio of 1:3. After one unit of packed red cell transfusion the mean increase in Hb in IDA was 1.106gm/dl, in anaemia of ACD was 0.922gm/dl, in anaemia of CKD was 1.015gm/dl, in anaemia of liver disease was 0.614gm/dl in anaemia of combined deficiency was 0.925gm/dl and in hypersplenism was 0.367 gm/dl. From this background the present study concludes that before planning transfusion in anaemic patients, accurate clinical assessment and work up for type of anaemia is essential. After transfusion of one unit of packed red cells in chronic anaemia patients,. In all the types of anaemia studied, the mean increase in Hb and PCV values were statistically more significant (Pvalue&amp;#60;0.05) than other parameters. Hence Hb and PCV can be taken as valuable parameters to monitor the post transfusion outcome.

Bilateral Nephrectomy Impairs Cerebral Oxygen Delivery After Acute Hemodilution Anemia in Rats

HypothesisWe hypothesize that renal sensing of hypoxia is essential for activation of cardiovascular responses needed to maintain cerebral oxygen delivery during acute anemia and that bilateral nephrectomy will negatively affect brain oxygen delivery during acute hemodilutional anemia.MethodsAll experiments were approved by the Animal Care and Use Committee at St. Michael’s Hospital and conducted in accordance with ARRIVE‐2 guidelines. Sham or bilateral nephrectomy (n=5) were performed on isoflurane anesthetized Sprague‐Dawley rats prior to performing acute hemodilution (50% estimated blood volume) 1:1 with 6% hydroxyethyl starch. Heart rate (HR), mean arterial pressure (MAP) and rectal temperature were monitored continuously. Arterial blood gases and cooximetry samples were measured before and after hemodilution. Continuous measurements of brain microvascular oxygen tension (PbrO2) were measured via a phosphorescence quenching method using an intravascular oxygen probe, Oxyphor PdG4, and an OxyLED phosphorometer. Data were tested for normality and analysis performed by two‐way ANOVA with p&lt;0.05 taken to be significant.ResultsBilateral nephrectomy resulted in a reduction in baseline HR (p&lt;0.004). Hemodilution resulted in a comparable reduction in hemoglobin concentration in both groups (Sham: 5.1±0.3 g/dL; Nephrectomy: 4.2±0.4 g/dL) with no differences in arterial PaO2 or PaCO2. After hemodilution, HR increased significantly in both groups (p&lt;0.05). MAP tended to be lower in the bilateral nephrectomy group and decreased transiently in both groups following hemodilution (p&lt;0.01). Brain microvascular pO2 (PbrO2)was not significantly different between nephrectomy and sham at baseline. Post‐hemodilution the PbrO2 was significantly lower in nephrectomised rats (11.5±5.1 mmHg) compared to sham operated rats (25.4±11.3 mmHg) (p=0.031).ConclusionsWe observed that bilateral nephrectomy resulted in changes in baseline physiology, including a lower HR. Hemodilution resulted in a comparable reduction in hemoglobin concentration, without difference in PaO2 or PaCO2. MAP decreased more profoundly immediately after hemodilution in nephrectomised animals, and recovered with time. Nephrectomy resulted in a significant drop in brain microvascular pO2 (PbrO2) immediately after hemodilution. This was not observed in sham controls. These data suggest that the kidney serves an important sensing role during acute anemia which supports cardiovascular responses and preserves the adequacy of brain tissue oxygen delivery. Hypoxia sensing by the kidney, and other integrative systemic mechanisms, may be central to these findings.

Evaluation of the potential benefits of iron supplementation in organic pig farming.

Background: Iron from the stock acquired during foetal life and the ingestion of milk is not sufficient to cover the needs of the piglets during their first weeks of life. In organic farming, systematic supplementation with iron is problematic due to a strong limitation in pharmaceutic treatments. Methods: Erythroid parameters around weaning were measured in piglets from organic outdoor and indoor farms, and related to indicators of the inflammatory status. Blood samples were collected from 28.9±2.6 piglets/herd at 42.0±3.2 days of age and 11.9±3.0 kg live weight (mean±SD) in 21 farms from the west part of France. Among the 11 outdoor farms, only one had supplemented piglets with 200 mg iron while among the 10 indoor farms, only one had not supplemented piglets, one had supplemented them with 100 mg, 8 with 200 mg and one with 400 mg. Results: Compared to outdoor piglets without supplementation, piglets kept indoors and receiving 200 mg iron had lower haemoglobin concentration (105 vs 118±2 g/l, mean±SE) and red blood cell volume (56 vs 60±1 fl) (P<0.005). The reduction in haemoglobin concentration and red blood cell volume was more pronounced in indoor piglets supplemented with 100 mg of iron and even more when they had not received iron. The plasma concentration of haptoglobin was lower in outdoor than in indoor piglets (0.51±0.06 vs 0.78±0.09 g/l) whereas no effect of housing was observed for markers of oxidative stress (dROM, BAP). In the 14 farms where sow parity was known, the haemoglobin concentration was lower in piglets from primiparous than from multiparous sows (109 versus 114±2 g/l, P < 0.001). Conclusion: With the exception of soils where the content of bioavailable iron is very low, piglets from outdoor farms do not require iron supplementation, unlike those raised indoors.

Iron Deficiency in Anemic Patients: Study in a Tertiary Care Centre

Introduction Anemia is a clinical abnormality characterized by a reduction in hemoglobin concentration below the normal for age and sex. It can be of different types, the most common being iron deficiency anemia which affects mostly pregnant and lactating females and growing children in the developing world. Materials and Methods This was a hospital-based observational study conducted at National Medical College and Teaching Hospital, Pathology Department, Birgunj, Nepal. Patients above the age of 10 years of both sexes (male and females) having anemia ( males having hemoglobin level &lt; 13 gm/dl and females having hemoglobin level &lt; 12 gm/dl ) were included. After a detailed history, preliminary blood tests including complete blood counts, peripheral smear, and reticulocytes count were done. In patients suspected (microcytic hypochromic blood picture and normal reticulocytes count ) to have iron deficiency anemia, serum ferritin was done to confirm the diagnosis. Patients under the age of 10 years and those patients having blood malignancies (acute or chronic leukemia) were excluded from the study. Results Sixty anemic patients were found to have iron deficiency. Females were affected more (66%) with iron deficiency anemia than males (34%). There were two peaks (30% and 21%) in age groups 10 – 20 years and 61 – 70 years. Complete blood counts revealed a significant decrease in the value of red cell indices like mean corpuscular volume in 70% patients (Normal MCV 80 to 100 fl) and mean corpuscular hemoglobin in 72% patients (Normal MCH 27 to 33 pg ). On peripheral smear, it was seen that most of the patients (72%) had microcytic hypochromic blood pictures. Iron deficiency anemia was more common in rural areas. Conclusion Iron deficiency anemia was the most common type of anemia. It is more common in females and the prevalence is more in rural areas.

Oral and intravenous tranexamic acid are equivalent at reducing blood loss following shoulder arthroplasty—A multicenter, double-blinded, randomized, placebo-controlled trial

BackgroundTranexamic acid (TXA) has been shown to reduce blood loss significantly in shoulder arthroplasty. Oral TXA is significantly cheaper than intravenous TXA, but there has been no published literature comparing oral and intravenous TXA in shoulder arthroplasty. The purpose of this study was to compare the efficacy and safety of oral versus intravenous TXA in shoulder arthroplasty. We hypothesized that oral and intravenous TXA are equivalent at reducing blood loss following shoulder arthroplasty. MethodsThis study was approved by the New Zealand Health and Disability Ethics Committee (HDEC) and registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR). Patients undergoing elective shoulder arthroplasties were prospectively randomized into one of two groups. In the oral TXA group, 2g of TXA was administered two hours prior to induction of anesthesia, and in the intravenous TXA group, 1.5g of TXA was administered as a bolus following induction of anesthesia. The primary outcome was a reduction in hemoglobin concentration. The secondary outcomes included drain output, number of blood units transfused, length of hospital stay, and complications. ResultsA total of 80 consecutive patients were randomized. The baseline demographics were comparable between the two groups. There was no difference in the primary outcome measure or any of the secondary outcome measures. With regards to the primary outcome measure, using a two one-sided test (TOST) for equivalence, with a P value of < 0.05 demonstrating equivalence, the mean reduction of hemoglobin was 23.30g/L (± 1.62) versus 22.45g/L (± 1.30) for the oral and the intravenous groups, respectively (P < .001). Postoperative drain output was 74.58mLs (± 11.27) versus 90.03mLs (± 14.53) for the oral and the intravenous groups, respectively (P = .41). Furthermore, there was no difference in the number of blood units transfused, length of hospital stay, and complications. DiscussionTo the best of our knowledge, this is the first study in the literature comparing oral and intravenous tranexamic in shoulder arthroplasty, and we found no difference in the efficacy of the two routes of administration. Surgeons should be encouraged to use the less expensive oral form of the medication as a means to minimize overall healthcare expenditure.

Features of sinus rhythm restoration in patients with paroxysmal and persistent non-valvular atrial fibrillation and previous COVID-19 infection in iron-deficiency anaemia

Background. Currently, there are conclusive data in the literature on the effect of reduced haemoglobin concentration on sinus rhythm restoration in patients with nonvalvular atrial fibrillation. It is relevant to study the features of rhythm restoration in patients with anaemia and atrial fibrillation in COVID-19 infection.&#x0D; Aim. To study the effects of iron-deficiency anaemia on sinus rhythm restoration rate and the dose of amiodarone required for this in patients with paroxysmal and persistent non-valvular atrial fibrillation and previous COVID-19 infection.&#x0D; Material and methods. The study included 63 patients aged between 53 and 94 years (mean age 60.810.9 years): 26 men (41.3%) and 37 women (58.7%). The patients were divided into groups according to the presence of anaemia and computed tomography staging (CT severity score) of lung damage. Criteria for inclusion: paroxysmal or persistent non-valvular atrial fibrillation; previous COVID-infection (according to the documents, medical records). We took into account medical histories, laboratory and instrumental findings, as well as treatment. The statistical analysis was performed by using the Statistica 13.3 software. The obtained data were presented as M or Me [Q1; Q3]. The differences between the indicators were assessed using Students t test, the MannWhitney U test and the KruskalWallis H test. Nominal variables were compared by using Pearsons 2 test with Yates correction or Fishers criterion. The relationship between the parameters was assessed using the Pearsons or Spearmans correlation coefficient. A p 0.05 was considered statistically significant.&#x0D; Results. The patients with normal haemoglobin concentration restored sinus rhythm for 10 [4; 13] hours and the patients with iron-deficiency anaemia for 5.5 [2; 10] hours (p=0.044). In patients with COVID-19 pneumonia, we found a direct correlation between the degree of lung damage and the dose of amiodarone (r=0.33, p 0.05), as well as the time of sinus rhythm restoration (r=0.48, p 0.05).&#x0D; Conclusion. The presence of iron-deficiency anaemia in patients with previous COVID-19 infection and paroxysmal and persistent non-valvular atrial fibrillation is associated with a shorter time and a lower dose of amiodarone required for successful sinus rhythm restoration in comparison to patients with normal haemoglobin concentration; in patients with more severe lung damage caused by COVID-19 pneumonia, it takes more time and a large dose of amiodarone for sinus rhythm restoration.

Evaluation of the potential benefits of iron supplementation in organic pig farming

Background: Iron from the stock acquired during foetal life and the ingestion of milk is not sufficient to cover the needs of the piglets during their first weeks of life. In organic farming, systematic supplementation with iron is problematic due to a strong limitation in pharmaceutic treatments. Methods: Erythroid parameters around weaning were measured in piglets from organic outdoor and indoor farms, and related to indicators of the inflammatory status. Blood samples were collected from 28.9±2.6 piglets/herd at 42.0±3.2 days of age and 11.9±3.0 kg live weight (mean ± SD) in 21 farms from the west part of France. Among the 11 outdoor farms, only one had supplemented piglets with 200 mg iron while among the 10 indoor farms, only one had not supplemented piglets, one had supplemented them with 100 mg, 8 with 200 mg and one with 400 mg. Results: Compared to outdoor piglets without supplementation, piglets kept indoors and receiving 200 mg iron had lower haemoglobin concentration (105 vs 118±2 g/l, mean ± SE) and red blood cell volume (56 vs 60±1 fl) (P&lt;0.005). The reduction in haemoglobin concentration and red blood cell volume was more pronounced in indoor piglets supplemented with 100 mg of iron and even more when they had not received iron. The plasma concentration of haptoglobin was lower in outdoor than in indoor piglets (0.51±0.06 vs 0.78±0.09 g/l) whereas no effect of housing was observed for markers of oxidative stress (dROM, BAP). In the 14 farms where sow parity was known, the haemoglobin concentration was lower in piglets from primiparous than from multiparous sows (109 versus 114±2 g/l, P &lt; 0.001). Conclusion: With the exception of soils where the content of bioavailable iron is very low, piglets from outdoor farms do not require iron supplementation, unlike those raised indoors.

Effets du sulfonate de sodium carbazochrome combiné à l’acide tranexamique sur l’hémostase et l’inflammation pendant la période périopératoire de l’arthroplastie totale de la hanche: un essai contrôlé randomisé

BackgroundThe hemostatic effect of tranexamic acid (TXA) combined with carbazochrome sodium sulfonate (CSS) in total hip arthroplasty (THA) has not been determined. Therefore we performed a randomized study aiming to evaluate the effects of CSS combined with TXA on perioperative blood loss and inflammatory response of THA. HypothesisCSS combined with TXA can effectively reduce perioperative blood loss and immune response compared to TXA. Material and methodsThis randomized placebo-controlled trial assigned 150 patients undergoing unilateral primary total hip arthroplasty who underwent direct anterior approach surgery to 3 groups: group A received TXA plus topical CSS; group B received TXA only; and group C received placebo. The main outcome was total blood loss. Secondary outcomes included reduction in hemoglobin concentration, coagulation parameters, inflammatory marker levels, perioperative visual analog scale (VAS) pain score, transfusion rates, postoperative hospital stay, and incidence of thromboembolic events. ResultsTotal blood loss in group A (668.84±230.95mL) was lower than in group B (940.96±359.22mL) and C (1166.52±342.85mL, p<0.05). We also found that compared with group B, postoperative hip pain, biomarker level of inflammation, visual analogue score (VAS) pain score in group A were significantly improved. The transfusion rate and unit of group A were significantly lower than group C (8 patients; 17.5 units), but there was no statistical difference between group A (no transfusion) and group B (2 patients; 4 units). No differences were observed in thromboembolic and other outcomes among the groups. DiscussionThe combined application of topic CSS and TXA is more effective than TXA alone following THA in regard of reducing total blood loss. In addition, CSS combined with TXA is better than TXA alone in terms of improving postoperative hip pain and reducing the level of inflammatory factors. Level of evidenceI; randomized controlled study.