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Biosynthesis of zerovalent iron nanoparticles for catalytic reduction of 4-nitrophenol and decoloration of textile dyes

Anasdass JR, Kannaiyan P, Gopinath SCB

Biotechnol Appl Biochem, 2022 Dec;69(6):2780-2793.
PMID: 35293654 DOI: 10.1002/bab.2323

We demonstrate a green chemistry approach to synthesize narrow-sized zerovalent iron (nZVI) nanoparticles using Artocarpus heterophyllus Lam. leaf extract as reducing and capping agent. The produced nZVI was characterized by various instrumental methods including ultraviolet-visible spectra, transmission electron microscopy, vibrating sample magnetometer (VSM), X-ray diffraction, and Fourier transform infrared spectroscopy. Based on the electron microscopy observations, the particle size was estimated to be ∼30 nm. In VSM, the saturation point of magnetization was observed to be 0.6 emu g-1 under a magnetic field of 0 ± 30 kOe. The synthesized nZVI was amorphous in nature as per the XRD results. The catalytic activity of the nZVI was employed for the catalytic reduction of 4-nitrophenol (4-NP) and decoloration of textile dyes such as methylene blue, methyl orange, and malachite green, respectively. The proposed nZVI synthesis method exhibited better catalytic performance toward reduction of 4-NP and degradation of dyes within 4 min for 0.1 mg of catalyst. Moreover, the synthesized catalyst nZVI can be recoverable and reutilized in many cycles without loss of its significant catalytic activity. The synthesized nZVI could be a promising material to treat industrial wastewater via profitable, sustainable, and ecofriendly approaches.

Matched MeSH terms: Iron/chemistry
Structural and functional characterisation of HepTH1-5 peptide as a potential hepcidin replacement

Azemin WA, Alias N, Ali AM, Shamsir MS

J Biomol Struct Dyn, 2023 Feb;41(2):681-704.
PMID: 34870559 DOI: 10.1080/07391102.2021.2011415

Hepcidin is a principal regulator of iron homeostasis and its dysregulation has been recognised as a causative factor in cancers and iron disorders. The strategy of manipulating the presence of hepcidin peptide has been used for cancer treatment. However, this has demonstrated poor efficiency and has been short-lived in patients. Many studies reported using minihepcidin therapy as an alternative way to treat hepcidin dysregulation, but this was only applied to non-cancer patients. Highly conserved fish hepcidin protein, HepTH1-5, was investigated to determine its potential use in developing a hepcidin replacement for human hepcidin (Hepc25) and as a therapeutic agent by targeting the tumour suppressor protein, p53, through structure-function analysis. The authors found that HepTH1-5 is stably bound to ferroportin, compared to Hepc25, by triggering the ferroportin internalisation via Lys42 and Lys270 ubiquitination, in a similar manner to the Hepc25 activity. Moreover, the residues Ile24 and Gly24, along with copper and zinc ligands, interacted with similar residues, Lys24 and Asp1 of Hepc25, respectively, showing that those molecules are crucial to the hepcidin replacement strategy. HepTH1-5 interacts with p53 and activates its function through phosphorylation. This finding shows that HepTH1-5 might be involved in the apoptosis signalling pathway upon a DNA damage response. This study will be very helpful for understanding the mechanism of the hepcidin replacement and providing insights into the HepTH1-5 peptide as a new target for hepcidin and cancer therapeutics.Communicated by Ramaswamy H. Sarma.

Matched MeSH terms: Iron/metabolism
Expert consensus on improving iron deficiency anemia management in obstetrics and gynecology in Asia

Leung TW, Damodaran P, Torres R, Chuncharunee S, Chu MY, Gamilla Z, et al.

Int J Gynaecol Obstet, 2023 Nov;163(2):495-509.
PMID: 37096333 DOI: 10.1002/ijgo.14804

Iron deficiency anemia (IDA) is a major health burden among women in Asia. Key issues in IDA management in Asia are under-diagnosis and under-treatment. The lack of Asia-specific guidelines, and suboptimal utilization of treatment compounds the management of IDA. To address these gaps, a panel of 12 experts in obstetrics, gynecology, and hematology from six regions in Asia convened to review current practices and clinical evidence and provide practical guidance on IDA diagnosis and management in Asian women. The Delphi approach was used to obtain objective opinions and attain consensus on statements pertaining to awareness, diagnosis, and management of IDA. In total, 79 statements attained consensus and are summarized to provide guidance on raising awareness of IDA and approaches for improved diagnosis and treatment of IDA among women in various settings: pregnancy, postpartum, heavy menstrual bleeding, gynecologic cancers, and perioperative care. This clinician-led consensus integrates appropriate recommendations based on clinical evidence and best practices and is intended to guide decision making in the management of iron deficiency/IDA in women. The expert panel raises a call for timely diagnosis and utilization of appropriate treatment, including use of high-dose intravenous iron, stringent blood management, and interdisciplinary collaboration, for optimization of IDA management among women in Asia.

Matched MeSH terms: Iron/therapeutic use
PAHs remediation from hazardous waste landfill leachate using fenton, photo - fenton and electro - fenton oxidation processes - performance evaluation under optimized conditions using RSM and ANN

Singa PK, Isa MH, Sivaprakash B, Ho YC, Lim JW, Rajamohan N

Environ Res, 2023 Aug 15;231(Pt 2):116191.
PMID: 37211185 DOI: 10.1016/j.envres.2023.116191

Polycyclic aromatic hydrocharbons (PAHs) are a class of highly toxic pollutants that are highly detrimental to the ecosystem. Landfill leechate emanated from municipal solid waste are reported to constitute significant PAHs. In the present investigation, three Fenton proceses, namely conventional Fenton, photo-fenton and electro-fenton methods have been employed to treat landfill leehcate for removing PAHs from a waste dumpig yard. Response surface methodology (RSM) and artificial neural network (ANN) methodologies were adopted to optimize and validate the conditions for optimum oxidative removal of COD and PAHs. The statistical analysis results showed that all independent variables chosen in the study are reported to have significant influence of the removal effects with P-values <0.05. Sensitivity analysis by the developed ANN model showed that the pH had the highest significance of 1.89 in PAH removal when compared to the other parameters. However for COD removal, H2O2 had the highest relative importance of 1.15, followed by Fe2+ and pH. Under optimal treatment conditions, the photo-fenton and electro-fenton processes showed better removal of COD and PAH compared to the Fenton process. The photo-fenton and electro-fenton treatment processes removed 85.32% and 74.64% of COD and 93.25% and 81.65% of PAHs, respectively. Also the investigations revelaed the presence of 16 distinct PAH compunds and the removal percentage of each of these PAHs are also reported. The PAH treatment research studies are generally limited to the assay of removal of PAH and COD levels. In the present investigation, in addition to the treatment of landfill leachate, particle size distribution analysis and elemental characterization of the resultant iron sludge by FESEM and EDX are reported. It was revealed that elemental oxygen is present in highest percentage, followed by iron, sulphur, sodium, chlorine, carbon and potassium. However, iron percentage can be reduced by treating the Fenton-treated sample with NaOH.

Matched MeSH terms: Iron/chemistry
Ferroptosis as a potential target for cancer therapy

Chen Z, Wang W, Abdul Razak SR, Han T, Ahmad NH, Li X

Cell Death Dis, 2023 Jul 24;14(7):460.
PMID: 37488128 DOI: 10.1038/s41419-023-05930-w

Ferroptosis is a recently discovered essential type of cell death that is mainly characterized by iron overload and lipid peroxidation. Emerging evidence suggests that ferroptosis is a double-edged sword in human cancer. However, the precise underlying molecular mechanisms and their differential roles in tumorigenesis are unclear. Therefore, in this review, we summarize and briefly present the key pathways of ferroptosis, paying special attention to the regulation of ferroptosis as well as its dual role as an oncogenic and as a tumor suppressor event in various human cancers. Moreover, multiple pharmacological ferroptosis activators are summarized, and the prospect of targeting ferroptosis in cancer therapy is further elucidated.

Matched MeSH terms: Iron Overload*
Fulltext Role of Intracellular Iron in Switching Apoptosis to Ferroptosis to Target Therapy-Resistant Cancer Stem Cells

Pandrangi SL, Chittineedi P, Chalumuri SS, Meena AS, Neira Mosquera JA, Sánchez Llaguno SN, et al.

Molecules, 2022 May 07;27(9).
PMID: 35566360 DOI: 10.3390/molecules27093011

Iron is a crucial element required for the proper functioning of the body. For instance, hemoglobin is the vital component in the blood that delivers oxygen to various parts of the body. The heme protein present in hemoglobin comprises iron in the form of a ferrous state which regulates oxygen delivery. Excess iron in the body is stored as ferritin and would be utilized under iron-deficient conditions. Surprisingly, cancer cells as well as cancer stem cells have elevated ferritin levels suggesting that iron plays a vital role in protecting these cells. However, apart from the cytoprotective role iron also has the potential to induce cell death via ferroptosis which is a non-apoptotic cell death dependent on iron reserves. Apoptosis a caspase-dependent cell death mechanism is effective on cancer cells however little is known about its impact on cancer stem cell death. This paper focuses on the molecular characteristics of apoptosis and ferroptosis and the importance of switching to ferroptosis to target cancer stem cells death thereby preventing cancer relapse. To the best of our knowledge, this is the first review to demonstrate the importance of intracellular iron in regulating the switching of tumor cells and therapy resistant CSCs from apoptosis to ferroptosis.

Matched MeSH terms: Iron/metabolism
EDXRF and the relative presence of K, Ca, Fe and as in amyloidogenic tissues

Mohd Nor Ihsan NS, Abdul Sani SF, Looi LM, Pathmanathan D, Cheah PL, Chiew SF, et al.

Spectrochim Acta A Mol Biomol Spectrosc, 2024 Mar 05;308:123743.
PMID: 38113556 DOI: 10.1016/j.saa.2023.123743

Trace and minor elements play crucial roles in a variety of biological processes, including amyloid fibrils formation. Mechanisms include activation or inhibition of enzymatic reactions, competition between elements and metal proteins for binding positions, also changes to the permeability of cellular membranes. These may influence carcinogenic processes, with trace and minor element concentrations in normal and amyloid tissues potentially aiding in cancer diagnosis and etiology. With the analytical capability of the spectroscopic technique X-ray fluorescence (XRF), this can be used to detect and quantify the presence of elements in amyloid characterization, two of the trace elements known to be associated with amyloid fibrils. In present work, involving samples from a total of 22 subjects, samples of normal and amyloid-containing tissues of heart, kidney, thyroid, and other tissue organs were obtained, analyzed via energy-dispersive X-ray fluorescence (EDXRF). The elemental distribution of potassium (K), calcium (Ca), arsenic (As), and iron (Fe) was examined in both normal and amyloidogenic tissues using perpetual thin slices. In amyloidogenic tissues the levels of K, Ca, and Fe were found to be less than in corresponding normal tissues. Moreover, the presence of As was only observed in amyloidogenic samples; in a few cases in which there was an absence of As, amyloid samples were found to contain Fe. Analysis of arsenic in amyloid plaques has previously been difficult, often producing contradictory results. Using the present EDXRF facility we could distinguish between amyloidogenic and normal samples, with potential correlations in respect of the presence or concentration of specific elements.

Matched MeSH terms: Iron/analysis
Iron overload in anaemia with underlying haemoglobin constant spring in an antenatal mother in primary care

Thew HZ, Ng CH, Loo CY

BMJ Case Rep, 2024 Feb 17;17(2).
PMID: 38367998 DOI: 10.1136/bcr-2023-258526

This is the case of a gravida 3 para 1 woman in her late 20s with underlying haemoglobin constant spring who visited a healthcare clinic for an antenatal check-up. Towards the end of her second trimester, she experienced lethargy. During her antenatal booking, she was diagnosed with mild asymptomatic anaemia, high serum ferritin, T saturation of 88% and abnormal liver function tests. She was referred to a hospital where an MRI scan revealed over 2 g of iron deposits in her liver, leading to a revised diagnosis of iron overload. Treatment included deferoxamine and expectant management throughout her antenatal period, and her delivery was uncomplicated. While iron deficiency anaemia is common in pregnancy, it is crucial not to overlook iron deposition and the distinction from acute fatty liver during pregnancy to prevent treatment delays.

Matched MeSH terms: Iron/therapeutic use
An online open-source tool for automated quantification of liver and myocardial iron concentrations by T2* magnetic resonance imaging

Git KA, Fioravante LA, Fernandes JL

Br J Radiol, 2015 Sep;88(1053):20150269.
PMID: 26118302 DOI: 10.1259/bjr.20150269

To assess whether an online open-source tool would provide accurate calculations of T2(*) values for iron concentrations in the liver and heart compared with a standard reference software.

Matched MeSH terms: Iron/analysis*; Iron Overload/diagnosis*
Fulltext Memorandum on ancylostomiasis or the anaemia of Ceylon

Kynsey WR

Journal of the Straits Medical Association, 1891;2:32-7.

Matched MeSH terms: Anemia, Iron-Deficiency
Fulltext Iron-based metal-organic framework: Synthesis, structure and current technologies for water reclamation with deep insight into framework integrity

Joseph J, Iftekhar S, Srivastava V, Fallah Z, Zare EN, Sillanpää M

Chemosphere, 2021 Dec;284:131171.
PMID: 34198064 DOI: 10.1016/j.chemosphere.2021.131171

Water is a supreme requirement for the existence of life, the contamination from the point and non-point sources are creating a great threat to the water ecosystem. Advance tools and techniques are required to restore the water quality and metal-organic framework (MOFs) with a tunable porous structure, striking physical and chemical properties are an excellent candidate for it. Fe-based MOFs, which developed rapidly in recent years, are foreseen as most promising to overcome the disadvantages of traditional water depolluting practices. Fe-MOFs with low toxicity and preferable stability possess excellent performance potential for almost all water remedying techniques in contrast to other MOF structures, especially visible light photocatalysis, Fenton, and Fenton-like heterogeneous catalysis. Fe-MOFs become essential tool for water treatment due to their high catalytic activity, abundant active site and pollutant-specific adsorption. However, the structural degradation under external chemical, photolytic, mechanical, and thermal stimuli is impeding Fe-MOFs from further improvement in activity and their commercialization. Understanding the shortcomings of structural integrity is crucial for large-scale synthesis and commercial implementation of Fe-MOFs-based water treatment techniques. Herein we summarize the synthesis, structure and recent advancements in water remediation methods using Fe-MOFs in particular more attention is paid for adsorption, heterogeneous catalysis and photocatalysis with clear insight into the mechanisms involved. For ease of analysis, the pollutants have been classified into two major classes; inorganic pollutants and organic pollutants. In this review, we present for the first time a detailed insight into the challenges in employing Fe-MOFs for water remediation due to structural instability.

Matched MeSH terms: Iron
Fulltext Evaluation of selected metal elements in commercial drinking water and tap water in Peninsular Malaysia

Khoo, Hock-Eng, Azrina Azlan, Mohd Aizat Idris, Amin Ismail, Muhammad Rizal Razman

Jurnal Sains Kesihatan Malaysia, 2011;9(1):5-11.
MyJurnal

The present study was carried out to determine the concentrations of selected metal elements (lead, copper, manganese, zinc and iron) in 51 samples of commercial drinking water and tap water available in Malaysia. The results indicated that low metal elements were found in the studied water samples. Lead, manganese, zinc and iron were not detected in some of the studied samples, except copper. The concentrations of the metal elements in the studied samples were well below the maximum permitted concentrations as recommended. Therefore these drinking water are safe for consumption and do not pose adverse effect to the health of consumers due to metal toxicity.

Matched MeSH terms: Iron
Hyperferritinaemia: An Iron Sword of Autoimmunity

Giemza-Stokłosa J, Islam MA, Kotyla PJ

Curr Pharm Des, 2019;25(27):2909-2918.
PMID: 31686632 DOI: 10.2174/1381612825666190709202804

BACKGROUND: Ferritin is a molecule that plays many roles being the storage for iron, signalling molecule, and modulator of the immune response.
METHODS: Different electronic databases were searched in a non-systematic way to find out the literature of interest.
RESULTS: The level of ferritin rises in many inflammatory conditions including autoimmune disorders. However, in four inflammatory diseases (i.e., adult-onset Still's diseases, macrophage activation syndrome, catastrophic antiphospholipid syndrome, and sepsis), high levels of ferritin are observed suggesting it as a remarkable biomarker and pathological involvement in these diseases. Acting as an acute phase reactant, ferritin is also involved in the cytokine-associated modulator of the immune response as well as a regulator of cytokine synthesis and release which are responsible for the inflammatory storm.
CONCLUSION: This review article presents updated information on the role of ferritin in inflammatory and autoimmune diseases with an emphasis on hyperferritinaemic syndrome.

Matched MeSH terms: Iron/blood*; Iron Metabolism Disorders/blood*
Knowledge, attitude and practice towards dietary iron among patients with thalassemia and their caregivers in Peninsular Malaysia

Chin DM, Kader Maideen SF, Rashid A

Med J Malaysia, 2019 Oct;74(5):365-371.
PMID: 31649210

INTRODUCTION: Thalassemias are the most common human monogenic disorders in the world. Regular blood transfusion and increased intestinal absorption of iron among thalassemia patients will lead to iron overload, which will not only markedly decrease their life expectancy but also pose a heavy burden to the healthcare system. The objective of this study was to evaluate the level of knowledge, attitude and practice towards dietary iron among thalassemia patients and their caregivers.
METHODS: An analytical cross-sectional study using purposive sampling method was conducted at eight thalassemia societies in Peninsular Malaysia. 260 respondents comprised of patients and caregivers were assessed with two separate sets of questionnaires.
RESULTS: Knowledge on dietary iron among the respondents was unsatisfactory, despite them having good knowledge on thalassemia disorder. Female patients were found to have better dietary knowledge, attitude and practice compared to males. The percentage of caregivers with good attitude and good practice were significantly higher compared to adult patients. Caregivers with children on iron chelators were noted to have better dietary attitude and practice. Thalassemia knowledge and children on vitamins were found to be the predictors of dietary knowledge among the patients and caregivers respectively.
CONCLUSION: The level of knowledge on dietary iron among the patients and caregivers was unsatisfactory in spite of their attitude and practice towards dietary iron were good. Effective delivery of dietary information to the patients and caregivers is essential to enable them to choose a healthy diet for their condition.

Matched MeSH terms: Iron; Iron Chelating Agents; Iron Overload; Iron, Dietary
Effect of iron buffer layer on the microstructures of giant magnetroresistive multilayers

Kok KY, Ng IK

Sains Malaysiana, 2008;37.

The effects of Fe buffer layer on the microstructures and GMR property of magnetron sputtered Co/Cu multilayers were studied. The main focus was to systematically identify the types of microstructural features present in the multilayers and to determine their characteristic length scales via qualitative and quantitative microstructural characterisation techniques. Both diffraction and imaging techniques were used to extract useful information on layering and crystallographic structures of the materials. This has provided an insight into the structure-property relationship of the materials system. Co/Cu multilayered samples grown with iron buffer layers were found to display better structural coherency and layering quality as compared to those grown without the iron buffer layers. The high GMR effect as demonstrated by these multilayers was associated with highly correlated interface profiles, sharp columnar grain boundaries and high degree of lateral coherency in columnar grain growth.

Matched MeSH terms: Iron
Intramuscular versus oral iron supplementation in patients on renal replacement therapy receiving erythropoietin

Thiruventhiran T, Ang BB, Tan SY

JUMMEC, 1999;4:110-112.

Anaemia in patients on renal replacement therapy is a cornmon problem and response to treatment with erythropoietin may be limited by functiollal iron deficiency. We recently studied prospectively for 22 weeks the effect of iron supplemetltation via intramuscular and oral vs intramuscular vs oral routes in 16 patients on chronic haemodialysis with renal anaenlia treated with erythropoietin injections. The rise in haemoglobin was significant in all patients except those on intramuscular iron only. This study supports unconfirmed observations that oral iron supplementation may be effective in patients with renal anaemia associated with functional iron deficiency. KEYWORDS: Renal, Anaemia, Erythropoietin, Iron deficiency, Oral, Parenteral.

Matched MeSH terms: Iron
New designs of paper based analytical devices (PADs) for completing replication analysis of a sample within a single run by employing smartphone

Kiwfo K, Woi PM, Seanjum C, Grudpan K

Talanta, 2022 Jan 01;236:122848.
PMID: 34635238 DOI: 10.1016/j.talanta.2021.122848

Paper-based analytical devices (PADs) with four new designs could be fabricated using commercially available home-based scan-and-cut printer. They serve for miniaturised platforms for chemical analysis. Replication analysis of a sample together with the calibration (using the analyte standards at different concentrations) can be completed in a single run, by utilising smartphone as the detector. Some new approaches for choosing detection zones were suggested. The four proposed PAD designs here were used as models in microliter scale operation to demonstrate the well-known chemistries of colorimetric determinations of iron, phosphate, and hardness using 1,10-phenanthroline and simple aqueous guava leaf extract; molybdate, and EBT-EDTA complexometric titration, respectively, through calibrations: where Blue (B) value = 88.2log [Fe3+] - 80.8, R2 = 0.989; B value = 1.75 [Fe3+] + 0.198, R2 = 0.999; Grey scale (I) value = 1.77 [Fe3+] - 1.22, R2 = 0.997; Red (R) value = 16.1log [PO43-] + 8.95, R2 = 0.999; Hue (H) value = 43.3log [Ca2+] + 233, R2 = 0.994, respectively. For the hardness, using one of the PAD designs, true titration was also possible. Applications of the proposed devices and procedures were demonstrated for real world samples with validation. Additionally, kinetic study of the molybdenum blue for phosphate was demonstrated using one of the PADs.

Matched MeSH terms: Iron
Fulltext Upgrade Recycling of Cast Iron Scrap Chips towards β-FeSi₂ Thermoelectric Materials

Laila A, Nanko M, Takeda M

Materials (Basel), 2014 Sep 04;7(9):6304-6316.
PMID: 28788193 DOI: 10.3390/ma7096304

The upgrade recycling of cast-iron scrap chips towards β-FeSi₂ thermoelectric materials is proposed as an eco-friendly and cost-effective production process. By using scrap waste from the machining process of cast-iron components, the material cost to fabricate β-FeSi₂ is reduced and the industrial waste is recycled. In this study, β-FeSi₂ specimens obtained from cast iron scrap chips were prepared both in the undoped form and doped with Al and Co elements. The maximum figure of merit (ZT) indicated a thermoelectric performance of approximately 70% in p-type samples and nearly 90% in n-type samples compared to β-FeSi₂ prepared from pure Fe and other published studies. The use of cast iron scrap chips to produce β-FeSi₂ shows promise as an eco-friendly and cost-effective production process for thermoelectric materials.

Matched MeSH terms: Iron
Fulltext Longitudinal clinical study of patients with iron rim lesions in multiple sclerosis

Altokhis AI, Hibbert AM, Allen CM, Mougin O, Alotaibi A, Lim SY, et al.

Mult Scler, 2022 Dec;28(14):2202-2211.
PMID: 36000485 DOI: 10.1177/13524585221114750

BACKGROUND: Iron rims (IRs) surrounding white matter lesions (WMLs) are suggested to predict a more severe disease course. Only small longitudinal cohorts of patients with and without iron rim lesions (IRLs) have been reported so far.
OBJECTIVE: To assess whether the presence and number of IRLs in patients with clinically isolated syndrome (CIS) and multiple sclerosis (MS) are associated with long-term disability or progressive disease.
METHODS: Ninety-one CIS/MS patients were recruited between 2008 and 2013 and scanned with 7 T magnetic resonance imaging (MRI). Expanded Disability Status Scale (EDSS) was used to calculate Age-related Multiple Sclerosis Severity Score (ARMSS) at the time of scan and at the latest clinical follow-up after 9 years. WMLs were assessed for the presence of IRL using Susceptibility weighted imaging (SWI)-filtered phase images.
RESULTS: In all, 132 IRLs were detected in 42 patients (46%); 9% of WMLs had IRs; 54% of the cohort had no rims, 30% had 1-3 rims and 16% had ⩾4. Patients with IRL had a higher EDSS and ARMSS. Presence of IRL was also a predictor of long-term disability, especially in patients with ⩾4 IRLs. IRLs have a greater impact on disability compared to the WML number and volume.
CONCLUSION: The presence and number of perilesional IR on MRI hold prognostic value for long-term clinical disability in MS.

Matched MeSH terms: Iron
Fulltext Getting patient blood management Pillar 1 right in the Asia-Pacific: a call for action

Abdullah HR, Ang AL, Froessler B, Hofmann A, Jang JH, Kim YW, et al.

Singapore Med J, 2020 Jun;61(6):287-296.
PMID: 31044255 DOI: 10.11622/smedj.2019037

Preoperative anaemia is common in the Asia-Pacific. Iron deficiency anaemia (IDA) is a risk factor that can be addressed under patient blood management (PBM) Pillar 1, leading to reduced morbidity and mortality. We examined PBM implementation under four different healthcare systems, identified challenges and proposed several measures: (a) Test for anaemia once patients are scheduled for surgery. (b) Inform patients about risks of preoperative anaemia and benefits of treatment. (c) Treat IDA and replenish iron stores before surgery, using intravenous iron when oral treatment is ineffective, not tolerated or when rapid iron replenishment is needed; transfusion should not be the default management. (d) Harness support from multiple medical disciplines and relevant bodies to promote PBM implementation. (e) Demonstrate better outcomes and cost savings from reduced mortality and morbidity. Although PBM implementation may seem complex and daunting, it is feasible to start small. Implementing PBM Pillar 1, particularly in preoperative patients, is a sensible first step regardless of the healthcare setting.

Matched MeSH terms: Iron/administration & dosage*; Anemia, Iron-Deficiency/drug therapy*

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