Anaemia is present in 31.3% of male and 73.6% of female subjects heterogenous for beta thalassaemia. In males, none had serum ferritin (SF) levels less than 10 ng/ml. In contrast, female subjects with haemoglobins less than 12 gm/dl, had SF levels less than 20 ng/ml. Statistical differences in the Hb, RBC, MCV, MCH, MCHC abd HBA were found with the normal groups (p<0.001). Comparison of the SF levels in both the males and females show no difference from those in the normal groups (p<0.10). Iron loading was not a significant feature in both the males and females. Correlation of the SF with age shows a weak negative correlation. Married females with children showed that the SF levels fell significantly with increasing age, suggesting the possibility that repeated pregnancies may deplete iron stores as reflected by the SF levels. In countries where iron deficiency and thalassaemia are highly prevalent, assays of serum ferittin will indicate if there is a need for supplemental iron in subjects hetergenous for beta thalassaemia.
Haemoglobin Bart's hydrops fetalis syndrome is totally lethal. Globin chain electrophoresis on mylar backed cellulose acetate strips, by a method modified from Ueda and Schneider has been established to demonstrate total absence of alpha chains in this syndrome. This simple test can identify fetuses, stillbirths and newborns with homozygous αo-thalassaemia. In this region where DNA studies are limited, and prenatal diagnosis is unavailable, this test which describes the phenotypic expression of Hb Bart's syndrome will improve genetic counselling of women at risk of homozygous αo-thalassaemia.
Clinically, Hb H disease presents as alpha thalassaemia intermedia. The majority have a clinical course of well compensated chronic haemolytic anaemia with exacerbations caused by oxidant haemopoietic stress. Haematological and DNA studies have identified the common molecular defects associated with Hb H disease in West Malaysia. Patients were shown to have α0 - thalassaemia of the South-East Asian type (--/SEA) in association with α+ thalassaemia or with Hb Constant Spring. In a study of 32 patients with Hb H disease, 50% were shown to have α+ thalassaemia (-α 3.7, 87.5%; -α 4.2, 12.5%). Growth and development were normal in all patients, and cholelithiasis was seen in 50% of the patients with the non-deletional type of Hb H disease. Comparisons of the clinical parameters (the necessity of blood transfusion, thalassaemia facies), haemoglobin and bilirubin levels show that the non-deletional type of Hb H disease in West Malaysia is associated with a more severe clinical state than the deletional type.
Caring for an elderly person is not an easy job and it requires understanding, patience, tolerance, full attention and dedication on the part of the caregiver. The effects on the caregiver in terms of his mental, emotional, physical and financial aspects are tremendous. Due to all these stresses, the caregiver's mental health would possibly be affected. This study explored the relationship between the mental and physical health of the elderly person and the caregiver, in forty-three elderly persons and their caregivers. Analyses of the results indicated that the caregivers' burden was related to their mental health status. In addition, the elderly persons' depressive symptoms, memory and behavior problems were the two main causes of these caregivers' burden.