Thalassemia Trait Research Articles

Detection of Hemoglobinopathies by HPLC in a Referral Clinical Laboratory in Nepal

Introduction: Various hemoglobin variants are prevalent in the Nepalese population owing to the ethnic diversity of our population. Detection of asymptomatic carriers by a reliable laboratory method is the cornerstone of prevention of this serious health problem. The simplicity of the automated system with internal sample preparation, superior resolution, rapid assay time, and accurate quantification of hemoglobin fractions makes ion-exchange high-performance liquid chromatography (IEX- HPLC) an ideal methodology for the routine screening for hemoglobinopathies. We report the clinical laboratory-based prevalence of variant hemoglobin and hemoglobinopathies through IEX- HPLC analysis in a cohort of patients referred for hemoglobin electrophoresis to a referral clinical laboratory in Nepal.
 Materials and Methods: The variant hemoglobin and hemoglobinopathy were diagnosed based on percentage, retention time, and peak characteristics of variant hemoglobin in a chromatogram. Peripheral blood films, reticulocyte count, serum iron profile, and sickling test were done in selected cases along with detailed family history.
 Results: Hemoglobinopathy was detected in all age group but the vast majority was detected between 20 to 40 years of age. Beta thalassemia trait was the most frequently detected hemoglobinopathy in all age groups.
 Conclusions: The present study conducted using IEX-HPLC reflects the magnitude of thalassemia and hemoglobinopathies in a laboratory-based population which helps to increase awareness among both health caregivers and the general population. Routine screening for hemoglobinopathy of individuals at the reproductive age group is recommended and this screening can be done through IEX-HPLC.

Application of HbA2 levels and red cell indices-based new model in the differentiation of thalassemia traits from iron deficiency in hypochromic microcytic anemia Cases.

Thalassemia traits and iron deficiency anemia are the most common types of hypochromic microcytic anemia with similar clinical and laboratory features. It is vital to establish a new screening model based on HbA2 levels and red cell indices for the differentiation of TT from IDA in hypochromic microcytic anemia cases. The data comprised of the red blood cell indices and HbA2 prenatal diagnostic test results of 810 individuals who were identified to conform to the following criteria: MCV<80fl or MCH<26pg. We launched a new model consisting mainly of significative red cell indices and HbA2 levels, as well as proposing cutoff values by using decision trees and logistic regression analyses. Next, we evaluated our new method by comparing the sensitivity, specificity, positive, and negative predictive values with those of the previous formulas. We put forward a new model and compared it with 5 efficient formulas. The new model exhibited the highest accuracy (0.918), with its sensitivity and specificity calculated as 0.917 and 0.921, respectively. Our new model's Youden index was 0.838, which is higher than the other formulas' Youden indices. The new screening model, based on HbA2 levels and red cell indices, is suitable for the screening of thalassemia patients in the hypochromic microcytic anemia group and has the best efficiency in distinguishing TT and IDA.

Verification of 20 Mathematical Formulas for Discriminating Between Iron Deficiency Anemia and Thalassemia Trait in Microcytic Anemia.

Currently, more than 45 mathematical formulas based on simple red blood cell (RBC) parameters have been proposed for differentiating between iron deficiency and thalassemia in microcytic anemia, of which 20 are relatively new and have not been thoroughly independently verified. The study goal was to verify these 20 new formulas and to identify which RBC parameters have a decisive impact on the performance of those formulas. A database containing laboratory and diagnostic data from 2788 subject individuals with microcytic anemia was used for assessing performance by receiver operating characteristic (ROC) analysis. The new Index26 had excellent performance, equivalent to the Green and King, Jayabose, and Janel formulas previously identified in the literature. The discriminant power of nearly all newer formulas was lower in our study than that claimed by the original authors. We discovered that a well-performing formula requires mean cell volume (MCV), RBC distribution width (RDW), and RBC measurements, whereas hemoglobin measurements appeared not to be essential. Only the new Index26 performed at a level comparable to the very strongest established formulas. All other new formulas had lower performance than was claimed in the original publications, underscoring that independent verification of new formulas is indispensable.

Pseudo-Thrombocytosis Caused by Extreme Microcytosis in a Patient with Alpha Thalassemia Trait.

Pseudo-Thrombocytosis Caused by Extreme Microcytosis in a Patient with Alpha Thalassemia Trait.

Mutation in thalassemia syndrome and clinical manifestation

Introduction: Thalassemia intermedia is a term used to define a group of patients with β thalassemia in whom the clinical severity of the disease is somewhere between the mild symptoms of the β thalassemia trait and the severe manifestations of β thalassemia major. Thalassemia intermedia shows considerable heterogeneity in phenotype and molecular basis. Objectives: The aim of this study was to identify the common mutations of beta globin gene and the relationship between genotypes and phenotypes in thalassemia intermedia patients in Mazandaran province, in the north of Iran. Patients and Methods: Fifty unrelated thalassemia intermedia patients, based on clinical and hematological characteristics including age of diagnosis, age of first blood transfusion, history of blood transfusion, mean corpuscular volume (MCV), mean cell hemoglobin (MCH), hemoglobin values, and liver and spleen status were selected. DNA of peripheral blood was extracted and common mutations in beta globin gene were analyzed by reverse dot blot (RDB) method. Results: Our study showed that 30 patients (60%) had blood transfusion. There was no obvious hepatomegaly in any of the subjects, however 40 patients (80%) showed splenomegaly among which 34 cases (68%) underwent splenectomy. Mutations analysis indicated that HBB:c.315+1G&gt;A [IVS II-1 (G&gt;A)] mutation was the dominant mutation and has been widely associated with the phenotypic manifestations of thalassemia intermedia patients. Conclusion: It is important to comprehend the molecular basis of thalassemia intermedia and the association between genotype and phenotype in different ethnic groups. Therefore a careful evaluation of genetic, molecular, hematological and clinical aspects is necessary to differentiate thalassemia intermedia in patients at presentation.

Update in Laboratory Diagnosis of Thalassemia.

Alpha- and β-thalassemias and abnormal hemoglobin (Hb) are common in tropical countries. These abnormal globin genes in different combinations lead to many thalassemic diseases including three severe thalassemia diseases, i.e., homozygous β-thalassemia, β-thalassemia/Hb E, and Hb Bart’s hydrops fetalis. Laboratory diagnosis of thalassemia requires a number of tests including red blood cell indices and Hb and DNA analyses. Thalassemic red blood cell analysis with an automated hematology analyzer is a primary screening for thalassemia since microcytosis and decreased Hb content of red blood cells are hallmarks of all thalassemic red blood cells. However, these two red blood cell indices cannot discriminate between thalassemia trait and iron deficiency or between α- and β-thalassemic conditions. Today, Hb analysis may be carried out by either automatic high-performance liquid chromatography (HPLC) or capillary zone electrophoresis (CE) system. These two systems give both qualitative and quantitative analysis of Hb components and help to do thalassemia prenatal and postnatal diagnoses within a short period. Both systems have a good correlation, but the interpretation under the CE system should be done with caution because Hb A2 is clearly separated from Hb E. In case of α-thalassemia gene interaction, it can affect the amount of Hb A2/E. Thalassemia genotypes can be characterized by the intensities between alpha-/beta-globin chains or alpha-/beta-mRNA ratios. However, those are presumptive diagnoses. Only DNA analysis can be made for specific thalassemia mutation diagnosis. Various molecular techniques have been used for point mutation detection in β-thalassemia and large-deletion detection in α-thalassemia. All of these techniques have some advantages and disadvantages. Recently, screening for both α- and β-thalassemia genes by next-generation sequencing (NGS) has been introduced. This technique gives an accurate diagnosis of thalassemia that may be misdiagnosed by other conventional techniques. The major limitation for using NGS in the screening of thalassemia is its cost which is still expensive. All service labs highly recommend to select the technique(s) they are most familiar and most economic one for their routine use.

Haematological Disease Pattern at Specialized HOPD - A study in Bangabandhu Sheikh Mujib Medical University

The aim of this retrospective observational study was to observe the pattern and frequency of haematological disorders among the patients attending in the specialized Haematology outpatient Department (HOPD) in Bangabandhu Sheikh Mujib Medical University. Consecutive 201 patients over the period of one year were enrolled. Their age ranged from 01 to 72 years with a mean age of 36.76 years. Most of the patients (34.3%) were in between the ages of 31 to 45 years followed by 16 to 30 years (27.9%). Male to female ratio was 0.65. Iron deficiency anaemia is the most common (24.9%) followed by chronic myeloid leukaemia (11.9%), Hb E beta thalassaemia (9.5%), idiopathic thrombocytopenic purpura (9.5%), beta thalassaemia trait (7.0%), Hb E trait (5.5 %), aplastic anaemia (5.0%), multiple myeloma (3.5%), acute lymphoblastic leukaemia (3.0%). Acute myeloid leukaemia, autoimmune haemolytic anaemia, chronic lymphocytic leukaemia, anaemia of chronic disease, non-Hodgkin lymphoma, polycythaemia, beta thalassemia major and alpha thalassemia was 2.5%, 2.5%, 2.0%, 1.5%, 1.5%, 1.5%, 1.0% and 1.0%, respectively. In the present study, we observed that iron deficiency anaemia the most common non-malignant disease and chronic myeloid leukaemia is the common haematological malignancy.

Clinical features and risk factors associated with bacteremia of nontyphoidal salmonellosis in pediatric patients, 2010–2018

This study aimed to investigate clinical features and antimicrobial susceptibility of inpatient children with nontyphoidal salmonellosis from 2010 to 2018. We retrospectively collected pediatric patients with nontyphoidal Salmonella infection confirmed by positive cultures in a tertiary medical center in Taiwan from 2010 to 2018. Patients' characteristics, clinical manifestations, and laboratory data were collected. Serogroup category and antimicrobial susceptibility were also analyzed. Of total 569 isolates, ampicillin resistant rate was 53% in average, third-generation cephalosporin resistant rate was 6.7%, ciprofloxacin resistant rate was 9% and trimethoprim-sulfamethoxazole resistant rate was 30%. Compared to the resistant rates in 2010, the resistance rate of third generation cephalosporin was significantly higher (3.4% vs. 11%, p=0.003) but that of ciprofloxacin was significantly lower (20% vs. 11%, p<0.001) in 2018. Among 297 inpatients with nontyphoidal salmonellosis, Group D (38%) was the most common in the bacteremia patients whereas Group B (48%) was the most common in the non-bacteremia patients. Among 244 immunocompetent inpatients with community-acquired salmonellosis, the bacteremia patients had significantly longer fever duration and diarrhea duration before hospitalization (p<0.001), and significant higher rate of anemia (p=0.028) due to either thalassemia trait or prolonged disease course than the non-bacteremia patients. Third-generation cephalosporin was still the drug of choice for nontyphoidal Salmonella infection in children though the resistant rate increased progressively. Significant risk factors associated with bacteremia were longer fever and diarrhea duration and anemia due to either thalassemia trait or prolonged disease course in immunocompetent children.

Role of Hematological Indices as a Screening Tool of Beta Thalassemia Trait in Eastern Uttar Pradesh: An Institutional Study.

A large majority of microcytic hypochromic anemia have defects in cellular hemoglobin synthesis due to either iron deficiency or thalassemia trait; both differing in management and prognosis. HPLC and serum iron profile as confirmatory tests are unavailable at health care centers. Blanket therapy of iron supplements is therefore given in all such cases which may cause iron overload in thalassemia cases. Easy to use and cost effective screening methods are desirable. The present study was undertaken to evaluate the diagnostic accuracy of twelve indices to effectively screen cases of thalassemia trait and differentiate them from iron deficiency anemia. Routine samples from the hematology lab with Hb < 13 gm/dl, MCV < 80fl and MCH < 27pg were screened. Taking HPLC and serum ferritin as gold standard, out of total 1353 cases, 98 cases of thalassemia trait (HbA2 > 3.5 on HPLC) and 1102 cases of iron deficiency anemia (serum ferritin < 12g/ml) were evaluated using discrimination indices. Diagnostic accuracy for each index was calculated. While few indices showed a sensitivity of 100%, their specificity was low which meant more number of false positive cases. Based on Youden's Index, which measures the diagnostic tests ability to balance sensitivity and specificity, the best three indices in the decreasing order of their efficacy in our study were Ricerca Index (RI), Green and King Index (GKI) and Mentzer Index (MI). MI is considered a reliable index by many clinicians since a long time, however RI and GKI were found to have a better diagnostic accuracy based on our study.

Prevalence of Congenital Hemolytic Disorders in Denmark, 2000-2016.

BackgroundCongenital red blood cell (RBC) disorders, such as hemoglobinopathies, are frequent worldwide but with large geographical variation. Growing migration has increased the number of patients with RBC disorders in formerly low prevalence countries, eg, Denmark. However, accurate prevalences are unknown.MethodsPatients with a registered diagnosis of congenital hemolysis in the Danish National Patient Register between 1977 and 2016 were linked to a national laboratory database of RBC disorders and the Danish civil registration system. We calculate annual age- and sex-specific prevalences of the congenital hemolytic disorders from 2000 to 2016.ResultsPrevalences of all subtypes of congenital hemolytic disorders increased during the study period. The prevalence of hereditary spherocytosis increased 1.73 times between 2000 and 2015, from 10.2/105 persons to 17.7/105 persons. Alpha thalassemia trait had a prevalence of 0.5/105 persons in 2000, but increased 41 times to 19.2/105 persons in 2015. Beta thalassemia minor increased eightfold from 4.5/105 persons in 2000 to 34.9/105 persons in 2015. Likewise, sickle cell trait increased 11 times from 0.7/105 persons in 2000 to 8.1/105 persons in 2015, whereas sickle cell disease increased from 0.5/105 persons to 2.7/105 persons in 2015, a fivefold increase.ConclusionThe prevalence of congenital RBC disorders in Denmark is increasing. The hemoglobinopathy traits now have prevalences as high as hereditary spherocytosis. These estimates of congenital hemolytic disorders in Denmark emphasize that inborn hemoglobin disorders are a public health concern, even in some formerly low prevalence countries.

Role of Red Cell Distribution Width Index for Differentiation of Iron Deficiency Anaemia and Beta Thalassemia Trait

Role of Red Cell Distribution Width Index for Differentiation of Iron Deficiency Anaemia and Beta Thalassemia Trait

Unexpected Genotype in a Non-Transfusion Dependent Thalassemia Family

Non-transfusion dependent thalassemia (NTDT) is an inherited hemoglobin disorder characterized by an ?/non-? globin chain imbalance of variable severity, resulting in a wide spectrum of clinical manifestations. The coinheritance of additional ? genes with a beta-thalassemia heterozygous mutation has a well-known negative effect. Triplication or quadruplication alone are mostly found by chance, but the coinheritance with ? mutations can worsen the very mild anemia to a more severe hematological and clinical phenotype causing NTDT, depending on the severity of beta mutations. We describe a case of a 38-year-old ?-thalassemia trait, pregnant woman at 33 weeks of gestation with supernumerary ?-globin genes and two ?-globin defects. J Med Cases. 2020;11(4):90-93 doi: https://doi.org/10.14740/jmc3335

New haematologic score to discriminate beta thalassemia trait from iron deficiency anaemia in a Spanish Mediterranean region

Several studies have stablished discriminant formulas (DF) from red blood cell (RBC) data as simple, low time-consuming and inexpensive tools to differentiate β-thalassemia trait (β-TT) from iron deficiency anaemia (IDA). The aim of this work is to introduce new formulas and evaluate them in the differentiation of microcytic anaemia (MA) into either β-TT or IDA in the Mediterranean region of Tarragona. A total of 200 anonymized haematological determinations with MA were collected, 100 diagnosed of β-TT and 100 diagnosed of IDA. The cut-off values of new formulas were designed to differentiate β-TT from IDA groups and their diagnostic performance were compared with other published indices. Specifically, Martín-Sánchez index (MSI-I) = (%Micro-R/MCV) * MCHC * Hb and MSI-II = Hb * (MCHC + %Micro-R)/10. In addition, a new score: MSI-score = MCHC + MSI-I + MSI-II was proposed and evaluated in a transversal study with 200 patients. In our region, MSI-II index and MSI-score have demonstrated the best AUC and Youden’s index (YI) (AUC = 0.956, YI = 81%; AUC = 0.971, YI = 87%, respectively) to discriminate β-TT from IDA groups. In summary, the new MSI-score with the highest AUC, the highest YI and the best percentage (93.5%) of correctly identified patients could be used as an efficient and robust tool in microcytic anaemia mass-screening programs in this region.

Deletional Alpha-Thalassemia Alleles in Amazon Blood Donors.

Alpha-thalassemia is highly prevalent in the plural society of Brazil and is a public health problem. There is limited knowledge on its accurate frequency and distribution in the Amazon region. Knowing the frequency of thalassemia and the prevalence of responsible mutations is, therefore, an important step in the understanding and control program. Hematological and molecular data, in addition to serum iron and serum ferritin, from 989 unrelated first-time blood donors from Amazonas Hemotherapy and Hematology Foundation (FHEMOAM) were collected. In this study, the subjects were screened for −α3.7/4.2/20.5, −SEA, −FIL, and −MED deletions. Alpha-thalassemia screening was carried out between 2016 and 2017 among 714 (72.1%) male and 275 (27.9%) female donors. The aims of this analysis were to describe the distribution of various alpha-thalassemia alleles by gender, along with their genotypic interactions, and to illustrate the hematological changes associated with each phenotype. Amongst the patients, 5.35% (n = 53) were diagnosed with deletion –α−3.7 and only one donor with α−4.2 deletion. From the individuals with –α−3.7, 85.8% (n = 46) were heterozygous and 14.20% (n = 7) were homozygous. The frequency of the –α−3.7 deletion was higher in male (5.89%) than in female (4.0%). There is no significant difference in the distribution of –α−3.7 by gender (p = 0.217). The –α20.5, −SEA, and −MED deletions were not found. All subjects were analyzed for serum iron and serum ferritin, with 1.04% being iron deficient (n = 5) and none with very high levels of stored iron (>220 µg/dL). Alpha-thalassemia-23.7kb deletion was the most common allele detected in Manaus blood donors, which is a consistent result, once it is the most common type of α-thalassemia found throughout the world. As expected, the mean of hematological data was significantly lower in alpha-thalassemia carriers (p < 0.001), mainly homozygous genotype. Leukocytes and platelet count did not differ significantly. Due to the small number of individuals with iron deficiency found among blood donors, the differential diagnosis between the two types of anemia was not possible, even because minor changes were found among hematological parameters with iron deficiency and α-thalassemia. Despite this, the study showed the values of hematological parameters, especially MCV and MCH, are lower in donors with iron deficiency, especially when associated with α-thalassemia, and therefore, it may be useful to discriminate different types of microcytic anaemia. In conclusion, we believed screening for thalassemia trait should be included as part of a standard blood testing before blood donation. It should be noted that this was the first study to perform the screening for alpha deletions in blood donors from the Manaus region, and further studies are required to look at the effects of donated thalassemic blood.

Impact of Iron deficiency on diagnosis of Beta Thalassemia Trait.

Objectives: We aimed to evaluate the effect of low serum ferritin levels on HbA2 values in BTT patients. Study Design: Cross-sectional study. Setting: Pathology department of University Medical &amp; Dental College Faisalabad. Period: August, 2018 to July, 2019. Materials &amp; Methods: One hundred and thirty seven subjects were included in the study after written informed consent. Those with serum ferritin &lt; 10µg/L were taken as iron deficient. Based on serum ferritin levels, we divided our study participants into two groups (Group A Vs Group B). As ferritin is considered an acute-phase protein, 25/137 participants with leukocytosis were excluded from statistical analysis. We measured serum Ferritin on Cobas 6000 e611 and we assessed the red cell parameters on Sysmex (seven part differential XN 1000). Hb variants were analysed through High performance liquid chromatography (HPLC) based technique of BioRad D10. Results: After excluding 25 subjects with high Total leukocyte count (TLC), we are left with 112 subjects. We observed 26 participants in group A with Iron deficiency and 38 in group B with no Iron deficiency. Mean±SD serum ferritin in iron deficient group was 7.25±1.95 as compared to non-iron deficient group (87.63±7.35). Mean HbA2 value in group A was 4.56±0.04 and in group B it was 5.80±1.06 with significant statistical difference of P=0.0188. We also observed significant difference in the mean values of other Red cell indices (MCV, HCT MCHC, MCH) except for RBC count and RDW. Conclusion: This study shows that ID may reduce HbA2 levels. Overall, it does not essentially preclude the identification of BTT. It is recommended that Iron deficiency should be considered before measuring HbA2 levels in BTT.

Patterns of Haemoglobinopathies Diagnosed by High Performance Liquid Chromatography in Karbala Population and Correlations between Different Hematological Parameters

Aim: To know the patterns of hemoglobinopathies and their prevalence in Kerbala society by using high performance liquid chromatography and to conclude if there is any correlations between different hematological parameters in Hemoglobinopathic patients. A total of 70 cases studied from 16th of February 2018 to 20th of June 2018 for hemoglobin variant analysis at the teaching labrotarioes of Al- Hussseini Teaching hospital which were studied for patterns of hemoglobinopathies. When the samples were received, Complete Blood Counts including: Hemoglobin concentration, Total White blood cells count (WBC), Mean Cell Volume (MCV), Mean Cell Haemoglobin (MCH), Mean Cell Hemoglobin Concentration (MCHC), Serum ferritin, Total Iron Binding Capacity ( TIBC), Hemoglobin H (HbH) preparation were done. Out of total 70 patients screened for patterns of hemoglobinopathies the result of the study revealed that 48 Patients which represent(68.57 %) of total patients had B-thalassemia trait which form the predominant percentage of patients with haemoglobinopathy, 11.85% of patients had sickle cell trait, 5.71% of them had B-Thalassemia Major, 4.29% had Hb S/B+Thalassemia Trait, 2.86% had HbS/Alpha thalassemia trait, 1.43% of them had Hb S homozygosity, 1.43% Alpha thalassemia trait, 1.43% had D-Los Anglos, 1.43% had HbS/B+ Thalassemia trait and 1.43% had HbC/B-Thalassemia trait.

Eradication Of Thalassemia By X-ray Photoelectronspectroscopy&amp;DNA Spectral Analysis.

Chromosome no 11 &amp; 16 of human embryo consist of the defective genetic sequence of alpha &amp; beta thalassemia trait respectively.Here we want to eradicate the thalassemia by systematic method of analysing the defective genetic sequence of the chromosome no 11 &amp; 16 if the conceiving couple are found to be carriers. This is further done amniocentesis by X-rayphotoelectronspectroscopy&amp;D.N.A spectral analysis(that is done by decoding of the graph obtained from spectral analysis using computer algorithms, digital signal processing).

Correlative study of various discrimination indices for screening of beta thalassaemia trait

Anaemia affects about 800 million people worldwide. Major contributors are iron deficiency anaemia (IDA) and thalassaemia trait. Thalassaemia (Greek for ‘sea blood’) is so called because it was first discovered around the Mediterranean coast and usually affects people originating from this area

Pattern of hemoglobinopathies and thalassemia in Manipur, India

Background: Hemoglobinopathies are the commonest genetic disorders worldwide. Thalassemia Major, Thalassemia Intermedia and Sickle Cell Disease are the major disorders that require lifelong management and are to be considered for prevention. In India, Beta-Thalassemia is prevalent across the country, with an average frequency of carriers being 3-4%.Methods: This is a cross sectional study conducted between June 2016 - May 2017 in the Department of Medicine, RIMS Imphal in 453 patients as a workup for anemia and clinically suspected cases of Hemoglobinopathy or beta thalassemia. Blood samples were collected and sent for Haemoglobin Electrophoresis using cellulose alkaline technique.Results: Among the 453 cases of the population surveyed, 35% showed the presence of abnormal hemoglobin. 16% were found to be beta thalassemia carrier, 11.69% HbE trait, 6.62% Homozygous HbE, 0.4% beta thalassemia and 0.7% had Hereditary persistence of HbF.Conclusions: High prevalence of Beta Thalassemia trait occurred more frequently than other Hemoglobinopathies. The study concludes that it is immensely important epidemiologically to explore the haemoglobin variants in Manipur so that the carriers can be detected for prevention of more serious disorder in the future generations.

Evaluation of the diagnostic reliability of Mentzer index for Beta thalassemia trait followed by HPLC

Introduction: The individuals having thalassemia trait usually have an asymptomatic course and have mild microcytic hypochromic anemia. Since the other cause of microcytic anemia is iron deficiency, it is important to differentiate it from ???? thalassemia trait. Though the definitive diagnosis of thalassemia trait is possible only by HPLC, the Mentzer index is such an index that can differentiate between thalassemia trait and iron deficiency anemia. Objectives: This study aims at figuring out the diagnostic value and reliability of the Mentzer index in the differentiation of iron deficiency anemia and thalassemia carrier compared with the results of HPLC. Methods: This was a hospital-based retrospective observational study done on 1236 patients of all age groups. Mentzer index of all the patients was calculated and the results were analyzed and further compared with HPLC. Results: Out of 1236 patients, 741 (59.9%) patients are of iron deficiency anemia and 495 (40.1%) patients are of β thalassemia trait. Mentzer index was found to be more reliable to detect true positive cases for β thalassemia trait with a sensitivity of 89.0%, specificity of 87.9%. Positive predictive value for β thalassemia trait is 83.2% and Negative predictive value is 92.3% with Youden’s Index 76.9. Conclusion: Iron deficiency anemia and thalassemia have different effects on blood indices. In resource-poor and developing countries like that of India, it can be used as a screening tool. In doubtful cases, the diagnosis can be confirmed by HPLC.