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Fulltext Reticulocyte haemoglobin as a biomarker for the detection of iron deficiency anaemia in haemodialysis patients on recombinant human erythropoietin

Jamian, E., Sanip, Z., Ramli, M., Mohd Daud, K., Mohamad, S., Hassan, R.

Journal of Biomedical and Clinical Sciences, 2018;3(2):29-34.
MyJurnal

Iron deficiency anaemia (IDA) frequently occurs in haemodialysis
(HD) patients undergoing recombinant human erythropoietin (rHuEPO)
therapy and is commonly associated with rHuEPO hypo-responsiveness.
However, the conventional iron indices are inadequate to exhibit the status or
utilisation of iron during erythropoiesis. The aim of this study was to elucidate
the accuracy and usefulness of the reticulocyte haemoglobin (RET-He) test
for diagnosing IDA in HD patients undergoing rHuEPO therapy. Methods: In
this cross-sectional study, fifty-five blood samples of HD patients on rHuEPO
therapy were collected and analysed for haematological and biochemical
parameters. A receiver operating characteristics curve was also plotted for
sensitivity and specificity analysis. IDA detection rates by RET-He, soluble
transferrin receptor (sTfR) and serum ferritin were 63.64%, 3.64% and 0%,
respectively. RET-He level was significantly correlated with sTfR level, mean
cell volume, mean cell haemoglobin level and the transferrin receptor-ferritin
index. The sensitivity and specificity of RET-He in detecting IDA were 78.3%
and 92.0%, respectively, with an area under the curve of 0.864. IDA was more
frequently detected by RET-He than by ferritin or sTfR in HD patients
undergoing rHuEPO therapy. The RET-He level also showed higher sensitivity
and specificity for the iron status in these patients. Therefore, RET-He is a
useful biomarker for the detection of IDA in HD patients undergoing rHuEPO
therapy.

Matched MeSH terms: Anemia, Iron-Deficiency
Fulltext The prevalence of anaemia and associated factors among pregnant women in Tongod and Kinabatangan districts

Glen Wendell Sibadogil, Aza Sherin Mohamad Yusuff, Shahrezza Suhaimi Rinin

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):27-27.
MyJurnal

Introduction: Anaemia in pregnancy is a major cause of disability worldwide, with a prevalence of more than 20% in >80% countries worldwide. Of those affected, roughly 50% are due to iron-deficiency anaemia, but there is some variation across different populations due to local culture and practices. Anaemia affects 38% of pregnant women worldwide, while in Malaysia the prevalence is 35%. The study aim is to determine the prevalence of anaemia among pregnant women in 2 rural districts in Sabah as well as knowledge, attitude and practices towards anaemia in these women. Methods: This retrospective cross-sectional study was done in Tongod and Kinabatangan Districts involving 217 pregnant women at 35-37 weeks of gestation who attended antenatal check-up at 6 government clin-ics in these districts. An interview using a standardized questionnaire was conducted by community nurses at the respective clinics. Sociodemographic and antenatal details was collected, including information about knowledge, attitude and practices toward anaemia. The Chi-square test was used to compare anaemia at 36 weeks with select-ed sociodemographic and antenatal factors, as well as KAP factors. Results: The mean age of women in the study was 28.4 ± 5.9 years, and the mean haemoglobin level at around 36 weeks age of gestation was 11.0 ± 1.1 g/dL. Prevalence of anaemia in these women was 52%. Most of the answers in the KAP section reflected the relatively high awareness about anaemia in pregnancy and methods to lessen its effects. A significant association was found between anaemia at 36 weeks and monthly family income, defaulting on iron supplements, caffeine beverages taken with meals, and dietary restrictions (p = 0.010, 0.001, 0.001, and 0.017 respectively). Conclusion: The high preva-lence of anaemia among pregnant women in these 2 districts reflects the practices of these women despite high levels of knowledge of anaemia. More effort needs to be done to apply this knowledge to decrease anaemia in pregnant women in rural areas.

Matched MeSH terms: Anemia, Iron-Deficiency
Fulltext Date palm and goat milk improve haematological parameters and availability of functional iron in iron deficient rats

Nurainna Abd Majid, Zuriani Zainol, Nor Aripin Shamaan, Nazefah Abd Hamid, Nuruliza Roslan, Noor Fadzilah Zulkifli

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):52-59.
MyJurnal

Introduction: Iron deficiency anaemia (IDA) is endemic especially in the under-developed and developing countries and is a major public health concern. Improving nutrition is one of the ways to alleviate this condition. Consumption of locally available and affordable food such as date palm and goat milk which are rich in iron is one of the ways to overcome IDA. This study is aimed at evaluating the effect of date palm and goat milk supplementation on hae- matological parameters and iron bioavailability in IDA rats. Methods: 24 male Wistar rats were randomly divided into normal control and IDA group. The normal control was fed with normal diet and water ad libitum while the IDA group were fed on iron-deficient diet for two weeks to induce iron deficiency. The IDA rats were further divided into subgroups; each being supplemented with date palm, goat milk, a combination of date palm and goat milk, and ferrous fumarate as positive control. Blood were collected after 28 days for haematological parameters and iron profile determination. Iron bioavailability was assessed using the haemoglobin regeneration efficiency (HRE) index. Data was analysed by Student T Test and ANOVA using SPSS 23.0 software with p value < 0.05 considered as sta- tistically significant. Results: Supplementation of date palm and goat milk for 28 days significantly improved Hb, RBC, PCV, MCV, MCH, serum iron and transferrin saturation (p

Matched MeSH terms: Anemia, Iron-Deficiency
Fulltext Anaemia and cognitive function among Chinese elderly in old folks homes

Suzana Shahar, Lee X.K., Siti Balkis Budin, Mokhtar Abu Bakar, Nor Aini Umar, Junara Mohd Halim

Jurnal Sains Kesihatan Malaysia, 2005;3(1):1-15.
MyJurnal

The relationship between anaemia and cognitive function was evaluated among 35 Chinese elderly (24 men and 11 women) aged 60 to 85 years (mean age 70.1 ± 6.7 years) from five old folks homes in Klang Valley. They were interviewed to obtain information on social and health status, habitual dietary intake and cognitive function. Hodkinson's Abbreviated Mental Test was used to measure the cognitive function. Haematological indices which included Full Blood Count (FBC), serum iron, serum ferritin, Total Iron Binding Capacity (TIBC), serum folate and serum cobalamine (vitamin B12) were measured using an automated analyzer. Anthropometric measurements and clinical signs of anaemia were also examined. The findings indicated that the prevalence of anaemia as assessed using haemoglobin alone was 22.9%, while iron deficiency anaemia based on low serum iron, microcytic and hypochromic criterion was detected among 5.7% of the sample. Subclinical folate and vitamin B12 deficiencies were diagnosed among 34.3% and 8.6% of the subjects. However, there was no occurrence of megaloblastic anaemia. There was a positive correlation between cognitive score with mid upper arm circumference (MUAC) (r=0.547, p

Matched MeSH terms: Anemia, Iron-Deficiency
Fulltext Intravenous iron-sucrose complex for treatment of iron deficiency anaemia in pregnancy - experience in an obstetric day care clinic in a tertiary hospital

Tan, AE, Siti, S.A.

Medicine & Health, 2008;3(2):288-293.
MyJurnal

A cross-sectional study was undertaken to evaluate if outpatient administration of in-travenous iron sucrose complex (Venofer) was a sensible option in treating iron defi-ciency anaemia during pregnancy and puerperium. A total of 120 patients with iron deficiency anaemia were recruited from the Obstetric Day Care Clinic at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) over 18 months from March 2003 to August 2004. The main outcome measures were haemoglobin increment, patients’ compliance, adverse effects and saving from hospitalization fees. The pre-treatment haemoglobin (Hb) level was 8.5+0.85g/dl for the antenatal patient and 7.6+0.80 g/dl in the post-partum group. The mean post-treatment haemoglobin increment at day four-teenth was 3.52+0.75g/dl. One patient developed skin rash while another had low-grade pyrexia. Seven patients experienced mild metallic taste. There were no serious side effects or anaphylactic reactions. Ten patients (8.3%) did not complete their ther-apy - eight delivered before completion of treatment; another two defaulted following delivery. The average number of Venofer used was seven ampoules i.e. 700mg per person, most of them required three sessions to complete the course. Outpatient treatment allows each patient to save hospitalization fees of RM45 per day, which to-talled up to RM135 for a 3-days ward stay. An estimation of RM16,200 hospitalization fees for the 120 patients was avoided during the study period. In conclusion, outpatient treatment of anaemia in pregnancy and post-partum period using Venofer was safe and feasible, with high patient compliant and cost-savings from hospitalization fees.
Study site: Obstetric Day Care Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Matched MeSH terms: Anemia, Iron-Deficiency
Prevalence of anaemia and associated risk factors amongst The Malaysian Cohort participants

Abdullah N, Ismail N, Abd Jalal N, Mohd Radin F, Othman R, Kamalul Arifin AS, et al.

Ann Hematol, 2020 Nov;99(11):2521-2527.
PMID: 32975589 DOI: 10.1007/s00277-020-04279-w

This study was aimed at determining the prevalence of anaemia amongst the Malaysian Cohort participants and the associated risk factors. This was a cross-sectional study that involved 102,388 participants from The Malaysian Cohort (TMC) aged between 35 and 70 years old recruited from April 2006 to September 2012. Venous blood was taken for the full blood count. The prevalence of anaemia was 13.8% with majority having the microcytic-hypochromic type (59.7%). Comparison between the ethnic groups showed that Indians have the highest prevalence of anaemia (19.9%), followed by Malays (13.1%), and Chinese (12.0%). The prevalence of anaemia was substantially higher in females (20.1%) compared to males (4.9%). Amongst the female participants, the prevalence of anaemia was highest amongst those who were younger than 49 years old and decreased as the age increased. In contrast, the prevalence of anaemia in males increased with age. Gender, ethnicity, age, marital status, presence of platelet disorders and kidney disease were significant risk factors associated with anaemia and contributed to 14.9% of the risk of developing anaemia in this population. The prevalence of anaemia amongst the Malaysian Cohort participants is 13.8% with the majority having the microcytic and hypochromic type implying iron deficiency as the main cause. It is important that those who have anaemia be further investigated and treated.
Study name: The Malaysian Cohort (TMC) project

Matched MeSH terms: Anemia, Iron-Deficiency
Fulltext Assessment of Toxicity and Beneficiary Effects of Garcinia pedunculata on the Hematological, Biochemical, and Histological Homeostasis in Rats

Paul S, Ali MY, Rumpa NE, Tanvir EM, Hossen MS, Saha M, et al.

Evid Based Complement Alternat Med, 2017;2017:4686104.
PMID: 28243309 DOI: 10.1155/2017/4686104

This study was undertaken to investigate the toxicological profile of a methanolic extract of Garcinia pedunculata fruit in rats by conducting hematological, biochemical, and histopathological examinations. Long Evans rats were divided into four groups, each with 6 animals, and were treated with three oral doses (250, 500, and 1000 mg/kg) once daily for 21 days. The extract did not cause significant changes in body and relative organ weight, percent water content, or hematological parameters at any administered doses. However, a significant dose-dependent positive effect in serum lipid profile and all atherogenic indices including the cardiac risk ratio, Castelli's risk index-2, and the atherogenic coefficient were observed. Significant increases in the levels of iron and decreases in serum alkaline phosphatase, alanine transaminase, and lactate dehydrogenase activities and the levels of serum glucose were noted when the extract was administered at the highest dose (1000 mg/kg). Histopathological examination of the target tissues further confirmed that the extract was safe and had no observed toxicological features. Our study indicates that G. pedunculata fruit is nontoxic, has the potential to be effective against atherosclerosis, and may be used as a hepatoprotectant. The fruit extract is also beneficial to those with iron deficiency and hyperglycemia.

Matched MeSH terms: Anemia, Iron-Deficiency
Fulltext Clinical nutrition in East Asia and the Pacific

Darnton-Hill I, Cavalli-Sforza LT, Volmanen PV

Asia Pac J Clin Nutr, 1992 Mar;1(1):27-36.
PMID: 24323002

Identifying the nutrition problems of Asia and the Pacific is made difficult by the enormous geographic, socioeconomic and cultural diversity that exists in these areas. With increasing longevity and reduced infant mortality, the more chronic diseases are becoming increasingly important. For almost 90% of the countries that keep such data in the Western Pacific Region of WHO, at least three of the five leading causes of death are noncommunicable diseases. Nevertheless undernutrition is still the most important nutritional problem in the Region. Even though there have been some encouraging declines in the proportion of malnourished under 5-year-olds, increasing populations have meant the actual numbers have not declined. Vitamin A deficiency, iodine deficiency disorders and iron deficiency anaemia remain major public health problems in many countries. There is evidence that vitamin A deficiency is appearing in countries in which it has not previously been a problem. New challenges are occurring, such as childhood obesity, the susceptibility of undernourished populations to the human immunodeficiency virus and the increase in noncommunicable diseases. The three arms of clinical nutrition: therapeutic, research and public health will need to work closely to meet the considerable and continuing threat posed by the nutrition-related diseases.

Matched MeSH terms: Anemia, Iron-Deficiency
Fulltext Spectrum of hematological disorders in children diagnosed by bone marrow aspiration/biopsy: a retrospective study in a tertiary care center

Khan, Humayun Iqbal, Amir Rashid, Shabbir, A.S., Warriach, Israr B., Tariq, Rabia, Sarfraz, A., et al.

Malaysian Journal of Paediatrics and Child Health, 2011;17(1):0-0.
MyJurnal

Objective: This study assessed the pattern of clinical course of hematological disorders in children diagnosed by bone marrow aspiration/biopsy in a tertiary care centre. Setting: The study was conducted at the Department of Pediatrics, Lahore General Hospital, Pakistan. Design: A retrospective descriptive study. Duration of study: Jan 2006 to Dec 2010. Methods: The clinical and laboratory data of 250 patients including complete history, physical examination, investigations and bone marrow examination reports were collected and then analyzed retrospectively. On the basis of these data, relative frequency of different hematological disorders was determined. Results: A total of 250 patients were selected during this study period where their bone marrow was sent for the investigations. Out of these cases, double deficiency anemia was the commonest diagnosis (22%) followed by aplastic anemia (13.6%), megaloblastic anemia (13.2%) and iron deficiency anemia (5.6%). For hematological malignancies, acute lymphoblastic leukemia (ALL) was observed in 27 cases (10.8%) followed by acute myeloid leukemia (AML) in 12 cases (4.8%), lymphoma in 8 cases (3.2%) and chronic myeloid leukemia (CML) in only two cases. Idiopathic thrombocytopenic purpura (ITP) was reported as frequent as 13.2% (33 cases). Conclusion: The pattern of non malignant hematological disorders in children diagnosed by bone marrow aspiration/biopsy was more common than malignant conditions. Double deficiency anemia was the commonest non malignant condition followed by aplastic anemia, idiopathic thrombocytopenic purpura and megaloblastic anemia. ALL was the most common presentation of the hematological malignancy.

Matched MeSH terms: Anemia, Iron-Deficiency
Fulltext Effects of iron supplementation and nutrition education on haemoglobin, ferritin and oxidative stress in iron-deficient female adolescents in Palestine: randomized control trial

Jalambo M, Karim N, Naser I, Sharif R

East Mediterr Health J, 2018 Jul 29;24(6):560-568.
PMID: 30079951 DOI: 10.26719/2018.24.6.560

Background: Iron deficiency and iron-deficiency anaemia are associated with oxidative stress, but their role is largely unclear. Information is scarce on the effects of iron supplementation on biomarkers of oxidative stress in humans.
Aims: This study evaluated the effectiveness of iron supplementation and nutrition education on improving the levels of haemoglobin and ferritin, and decreasing oxidative stress among iron-deficient female adolescents in Gaza, Palestine.
Methods: A total 131 iron-deficient female adolescents were recruited and allocated randomly into 3 different groups. The iron supplementation group (A) received 200 mg of ferrous fumarate weekly during the 3-month intervention, the iron supplementation with nutrition education group (B) received iron supplements with nutrition education sessions, and the control group (C) did not receive any intervention. The levels of haemoglobin, ferritin and malonyl dialdehyde were measured at baseline, after 3 months (at which point the intervention was stopped), and then 3 months later. Trial registration number: ACTRN12618000960257.
Results: Haemoglobin levels increased significantly after supplementation in both groups A and B. At the follow-up stage (3 months after stopping the intervention), iron and haemoglobin levels in group B continued to increase and malonyl dialdehyde decreased. In Group A, haemoglobin, ferritin and malonyl dialdehyde levels decreased after 3 months of stopping the intervention. No changes were seen in Group C.
Conclusions: A nutrition programme should be adopted and integrated into comprehensive intervention programmes to target iron-deficiency anaemia among female adolescents in Palestine.

Matched MeSH terms: Iron/deficiency

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