Anaemia

Objective: Vivax malaria is common in Pakistan. We carried out this study to determine the effects of this infection on blood counts and the impact of splenomegaly on these results.
Methods: This was a retrospective observational study carried out at 1 Mountain Medical Battalion, Bagh, Azad Kashmir. Old medical records of all patients admitted with vivax malaria from Jan 2010 to Oct 2012 were scrutinized. The presence or absence of a palpable spleen and the results of complete blood counts and platelet counts measured at the time of admission were noted down. Anaemia was defined as Hb<13g/dl in men, leukopenia as total leukocyte count (TLC)<4000/µl and thrombocytopenia as platelets count <150000/µl. Data was analysed with STATA version 12.1. The results of haematology parameters were compared amongst patients with splenomegaly and the rest.
Results: Anaemia was seen in 22.15%, neutropenia in 23.49% and thrombocytopenia in 90.60% of the 149 male patients having a mean age of 27.54±5.11 years. The differences in mean blood counts and the number of patients with haematological abnormalities in the two groups were statistically insignificant.
Conclusion: Since the blood counts are not affected by presence or absence of splenomegaly, mechanisms other than hypersplenism are important.

Introduction: Growth failure among children and micronutrient deficiency among children and women is one of the major nutritional problems in Bangladesh. According to a 2011 estimate, half of the children and 40% women were anaemic, and the prevalence of stunting and underweight was 40% and 36% among children, while a quarter of non-pregnant adult women were chronically energy deficient. The problem was magnified among the extreme poor population. Previously, standalone initiatives have attempted to tackle undernutrition and micronutrient deficiency separately, but there have been few attempts to integrate these two approaches; and credible evidence from experimental studies was sought from the government and development partners to guide future policy and investment decisions.

Aims & Objectives: This study aimed to determine the effect of an intervention package, containing deworming at six-monthly intervals, daily multiple-micronutrient powder (MNP containing 15 ingredients) supplementation for twelve months, and flip flop (thong) shoes in reducing anaemia among extremely poor women and children under-five, as well as to assess the effect on growth failure.

Methods: The study employed a two-arm cluster randomised trial design involving 537 women and 168 under-five children in 21 clusters within the intervention arm, while the comparison clusters contained a total of 503 women and 139 under-five children in another 21 clusters. The implementation took place between December 2010 and December 2011. Anaemia prevalence was the primary outcome; growth failure (measured by anthropometry), the prevalence of diarrhoea, and passed worms were assessed as secondary outcomes. The analysis was conducted based on cluster-level summaries of mean and prevalence, and the differences between groups were compared using independent sample t-tests.

Results: The study detected a significant effect on anaemia. At endline, the prevalence of anaemia among the women in the intervention clusters was 52% less than the comparison clusters (mean difference 18.1%, 95% CI: 11.1% to 25.1%, P<0.001). Among the under-fives in the intervention clusters, anaemia prevalence was 58% lower (mean difference 18.4%, 95% CI: 7.2% to 29.6%, P=0.002). Mean haemoglobin concentration was also significantly higher among the children (mean difference 7.8 g/l, 95% CI: 5.0 to 10.7, P<0.001) and women (mean difference 4.8 g/l, 95% CI: 3.3 to 6.3, P<0.001) in the intervention clusters. However, there was no detectable effect on child growth failure (stunting, underweight, wasting and thinness), chronic energy deficiency among women, the prevalence of diarrhoea, or passed worms.

Conclusion: The study results suggest that the intervention package is effective in reducing anaemia among women and children under-five. However, the current evidence is insufficient to make a public health recommendation for using the intervention package, containing 15 component MNP, to replace the existing government and WHO recommendation for using 5 component MNP. Further investigation would be necessary to answer this important public health question.

World Nutrition 10 (4), 43-62
Authors: MM Rana, J Schellenberg

Anaemia is the world's second leading cause of disability and thus one of the most important global public health problems. Iron deficiency is a major cause of anaemia. It is a common nutritional problem among children and adolescent in India. In India, more than 51% of adolescent and women of reproductive age have iron deficiency anaemia. At all levels, the negative effects of anaemia during adolescence justify public health action unfortunately, because initiatives to prevent anaemia commonly target infants, young children and pregnant and lactating women, and not necessarily adolescents. The needs of adolescents may remain unmet & the consequences of anaemia in adolescents continue as a major health problem in all developing countries including India Keywords Anaemia, Adolescent Girls, Knowledge Objectives 1. To assess the level of knowledge among adolescent girls (age 15-18 years) 2. To find out the association between level of knowledge with selected demographic variables such as age, education of mother, social economic status, type of family and area of residence. Methodology The study conducted among adolescent girls aged 15-18 years in higher secondary sections of St.Goretti's Higher Secondary School for Girls, Carmel Girl's Higher Secondary School Thiruvananthapuram A Non experimental descriptive survey design was chosen for the study and total of 60 samples were selected by convenient sampling technique. The tool used for data collection were of two sections; demographic variables and self-administered questionnaire on knowledge of iron deficiency anaemia. The data collected were analysed using descriptive and inferential statistics. Findings of the Study The findings reveal that 80% have average knowledge, 17% have poor knowledge and 3% have good knowledge. the mean value of study was 17.2 and standard deviation was 3.31. There was a significant association between demographic variable: Area of residence (p<0.05) with level of knowledge of adolescent girls on iron deficiency anaemia. There is no significant association between age, education of mother, socio economic status and type of family (p>0.05) with the level of knowledge of adolescent girls on iron deficiency anaemia.

This reference document aims to help Member States and their partners in their efforts to make informed decisions on the appropriate nutrition actions to prevent and control nutritional anaemias. The suggestions, steps and course of actions proposed are intended for health workers covering a wide audience, including policy-makers, economists and technical and programme staff in ministries and organizations involved in the design, implementation and scaling-up of public health actions, to help in the design and implementation of a comprehensive nutrition-based strategy for combating nutritional anaemias.

Edith Ileen Macpherson (1898-1984) was a co-founder of Australia’s original Demeter Farm (c.1934-1954) along with her partner Ernesto Genoni (1885-1974). Ileen was a member of Rudolf Steiner’s Experimental Circle of Anthroposophic Farmers and Gardeners (from 1936). Ernesto was the first Australian member (from 1928). At their Demeter Farm in Dandenong, Victoria, they practiced biodynamic agriculture on over 40 acres (16 ha) through the years of the Great Depression, through World War II, and for the first decade of the post-war years, producing milk, fruit, and vegetables. Ileen was an early Australian Anthroposophist and follower of Rudolf Steiner. It was a blow to their Demeter Farm enterprise when she fell ill. Eventually she was no longer able to manage physical work at all and this fell to Ernesto. Although she is remembered as ‘the woman in the wheelchair’ this paper reveals that she was previously an active, fit and keen sportswoman, participating in basketball, tennis, running, hockey, and dancing. At school she was known as ‘Ikey’, she was a prefect, she was a member of the school sports committee, and she won the prize for “best all-round sport”. Ileen was confined to a wheelchair for the last four decades of her life. The cause has generally been misunderstood and misattributed, and is revealed here to be pernicious anaemia (lack of vitamin B12). This condition is now easily and successfully treatable, but it was then generally fatal. Ileen was a financial supporter of the Anthroposophical movement in Australia during her lifetime. Her benefaction has continued since her death via the Ileen Macpherson Trust which reports having dispensed over $600,000 for Anthroposophic causes in Australia. A portrait of Ileen by Italian/Australian artist Ernesto Genoni and photographs of Ileen are presented.

Ομιλία για την ιστορική πορεία της ιατρικής έρευνας για τη Μεσογειακή Αναιμία, κυρίως στην Ελλάδα. Η πρώιμη περίοδος ιατρικών ερευνών για τη διάγνωση και θεραπεία της ασθένειας διαρκεί από το 1925 μέχρι το 1950, η δεύτερη περίδος από το 1950 μέχρι το 1975 και η τελευταία από το 1975 μέχρι σήμερα.

The problem of anemia in most rural communities in Nigeria is enormous especially among children and pregnant women. Therefore, communities tend to explore alternative and cheaper means in treating anaemic disease condition when they occur. The study was carried out to test for the haematoprotective property of ethanol extract of Eremomastax speciosa (Hocht.) Acanthaceae leaves. Phenylhydrazine was used to induce anaemia by intraperitoneal injection. Two doses of the extract (300 and 500 mg/Kg body weight) were administered to the anaemic test groups by oral gavage. The control groups (normal and anaemic) were given normal saline instead of the extract. All the experimental animals had access to distilled water and rat chow ad libitum. The effect of the extract was tested on haematological indices of the experimental animals. Result: the results showed that there were significant (P< 0.05) increases in the haemoglobin, red blood cell count, and haematocrit, when compared with the normal and anaemic control groups. The Mean cell haemoglobin concentration recorded significant (P< 0.05) reduction compared with the negative control. Our findings showed that the leaf extract of Eremomastax speciosa contains some bioactive agents with possible haematoprotective property.

Malaria associated anaemia is a huge problem in Africa responsible for a great morbidity and mortality among children. This study was designed to evaluate the prevalence of malaria and malaria anaemia being the complication of malaria in relation to children epidemiological data and parents/guardians sociodemographic characteristics. This was a prospective study considered Out-Patient children visiting Specialist Hospital Yola from July to November 2015. Thick and Thin blood film was made and stained using standard parasitological procedures. PCV was used to screen for anaemia and classified anaemia using WHO criteria. A total 310 children were recruited into the study. The overall prevalence of malaria infection and malaria anaemia was 50.6% and 41.3% respectively. High malaria infection was recorded among female (54.9%), age-group 5-9 years (58.3%), Children parents/guardians with others profession (60.0%), attended secondary education (53.4%) and children residing in quarters (54.5%). These were statistically insignificant (p˃0.05). Malaria infection in relation to anaemia, children with moderate anaemia (52.2%) recorded highest. Malaria anaemia in relation to children epidemiological data, females (44.4%), 5-9 years (50.0%) had the highest infection rate while in relation to parents/guardians sociodemographic characteristics, children whose parents/guardians had other profession (50.0%), undergo non formal education (47.1%) and resides in quarters (45.5%) their children had the highest prevalence rate. The factors associated with malaria anaemia include children age, occupation and educational qualification of parents/guardians. Efforts need to be undertaken on the control and prevention of mosquito vector and malaria Plasmodium and should be routinely done by the state stakeholders and by encouraging individuals and communities participation.

Anemia causes losses of billions of dollars annually in terms of productivity among working women of the reproductive age; it affects both their cognitive and physical performance. In developing countries where many manual labor jobs exist, an iron supplementation program is the first choice for eradicating anemia. However, this program cannot sufficiently meet reduction targets, and this created a polemic among health experts. The purpose of this study was to explore how iron deficiency anemia may be eradicated in developing countries. The results showed that the main challenges for iron anemia deficiency eradication are as follows: low adherence, infection, hidden symptoms, comorbidities from other non-communicable diseases, micronutrient deficiencies, and lack of program monitoring. In terms of low adherence, the side effects of iron supplements become a major factor in taking medication. Conversely, parasites and worms cause most of the high infection cases. Poor access to facilities of healthcare centers are becoming the main factor for the absence of anemia eradication program evaluation in remote areas of developing countries. Therefore, breakthroughs are expected to be developed to reduce anemia significantly. These include increasing patient visits to a healthcare center, diagnosing anemia accurately and intensively, prioritizing infection control, fortifying food, and monitoring iron side effects.

Anemia in pregnancy is a major health problem in developing countries. Haemorrhage ranks first in the list of maternal mortality in developing countries. Materials and Methods: A prospective study on all anaemic pregnant patients (according to WHO) admitted to labour room of more than 28 weeks gestational age from May 2015 to May 2017 in Sri Siddhartha Medical College, Tumkur were included in the study and appropriately treated. Demographic factors like age, education, socioeconomic status, parity, birth spacing and intake of iron supplements was studied. Maternal and perinatal outcome was also studied. Results: Among 2982 deliveries, 32 cases were excluded according to exclusion criteria. About 1903 were found to be anemic. In these cases, 61% were in 20-24yrs age group, 35% patients educated upto middle school, 71% belonged to low socioeconomic status, 62.1% had less than 2 years of birth spacing. All these factors were statistically significant. But 38% cases had not received iron supplements. Although mild anemia cases were uneventful, moderate and severe anaemia cases had maternal complications. In moderate anemia, 4% patients had PPH and received blood and blood products, 10 % had puerperial fever and rest uneventful. Severe anemia had significant outcome: preterm labour (38%), preeclampsia (20%), IUGR (10%), intrauterine fetal demise (8%), abruption placenta (7%), placenta previa (1%), puerperal fever (7.2%), cardiac failure (0.8%), PPH (8%). Maternal mortality was noted in 3 patients. About 35 neonates of mild anaemic cases,65 neonates of moderate anaemic cases and nearly 46.5% of severe anaemia cases had complications. Conclusion: Prevalence of anemia is most common in rural population. Demographic factors also play a very important role. Effective management of anemia cases definitely prevents maternal and perinatal mortality.

A multi-centre cross-sectional study was conducted between July 2012 and February 2013 to assess anaemia prevalence and associated factors among pregnant women attending three antenatal clinics in malaria endemic south-western Ebonyi State, Nigeria. Haemoglobin (Hb) levels were determined using the Haemocue haemaglobinometer detecting system for 660 of the 702 eligible women, while their obstetrics and socioeconomic information were obtained using close-ended structured questionnaire. Mean age of the participants was 24.9 ± 6.1 years (range, 18 – 47 years); mean number of previous pregnancies was 4.7 ± 1.2 per woman (range, 1 – 12). Overall prevalence of anaemia during pregnancy (Hb ≤ 11 g per decilitre) was 60.0% (95% confidence interval (CI): 58-62). Prevalence of mild (10 g /dl ≤ Hb < 11 g /dl), moderate (7 g /dl ≤ Hb < 9 g/dl), and severe (Hb < 7 g /dl) anaemia was 56.8%, 37.9% and 5.3% respectively. Over 90% of the total anaemic women had Hb levels below the benchmark for pregnant women (11 g /dl). Multivariate analysis showed that anaemia in pregnancy was significantly and independently associated with low socio-economic status, advanced age of gestation and increasing number of previous pregnancies. The result is discussed in relation to the need for increased awareness campaign of the associated predisposing factors of anaemia in pregnancy at the antenatal clinics levels.

Nutritional status measured by anthropometry has been a reliable indicator of individual as well as population health. It is associated with morbidities, reduced activity and fitness, impaired cognitive development and also early mortality in adults. On the other hand, Iron Deficiency Anaemia, indicated by low haemoglobin level is a considered as a global health hazard, especially in women from the developing countries. States of undernutrition and anaemia were pointed out to be linked at the population level. The present study was conducted to estimate the prevalence of undernutrition and anaemia among the Bengalee adult females in a sub urban municipal locality in West Bengal. The study included 222 adult women aged > 18 years. Height, weight and haemoglobin level were measured; nutritionaland anaemic status were determined as per WHO guidelines. The prevalence of chronic energy deficiency (CED) and anaemia were 25.2% and 58.4%, respectively. Both the prevalence of CED and anaemia were the lowest in the eldest and the youngest age groups. Higher prevalence of CED were associated with lower mean Hb level and higher frequency of anaemia. The women with low BMI had higher chance of being diagnosed with anaemia. The situation indicated towards a serious health problem in respect of CED and moderate in respect of anaemia.

Introduction: Growth failure among children and micronutrient deficiency among children and women is one of the major nutritional problems in Bangladesh. According to a 2011 estimate, half of children and 40% women were anaemic, and the prevalence of stunting and underweight was 40% and 36% among children, while a quarter of non-pregnant adult women were chronically energy deficient. The problem is magnified among the extreme poor population. Previously, standalone initiatives have attempted to tackle undernutrition and micronutrient deficiency separately, but there have been few attempts to integrate these two approaches. However, there was interest among the donors and government in integrating these two approaches, through the integration of direct nutrition interventions into ongoing livelihood or poverty reduction initiatives, in order to tackle undernutrition both by tackling the direct cause (micronutrient deficiency) and the underlying cause (poverty). As there was a lack of evidence from randomised controlled trials, a cluster randomised trial was designed as part of the "Improvement of nutrient intake through crop varieties and supplements" project under the UKaid-funded EEP/shiree programme, to test the effectiveness of an intervention package, containing deworming at 6 monthly intervals, daily micronutrient supplementation (using new sprinkles with 15 ingredients) and flip flops, in reducing anaemia among extremely poor women and children under five, as well as to see the effect on growth failure.

Methods: Data were analysed from a cluster randomised trial involving 2 groups of women and under 5 children: (i) an intervention group, and (ii) a comparison group receiving no nutrition intervention during the study period. After the baseline survey in September 2010, a total of 42 mother groups (considered as 42 clusters) were randomly assigned to either intervention or comparison groups, with each group containing 21 clusters each. At baseline, the intervention clusters had a total of 537 women and 168 under 5 children, while the comparison clusters had a total of 503 women and 139 under 5 children. The intervention started in December 2010, led by a local NGO called National Development Programme (NDP), and ended in December 2011. Following the baseline, data were obtained from the midline survey in June 2011 and endline survey in December 2011. In the final analysis, both trial arms had 21 clusters, while 470 women and 151 children from the intervention and 414 women and 126 children from the comparison group were included. Analysis was conducted based on cluster level summaries of mean and prevalence and difference between groups were compared using independent sample t-test.

Results: There was a significant reduction in anaemia prevalence among both children and women. At endline, the prevalence of anaemia among under 5 children in the intervention group was 58% lower (mean difference 18.4%, 95% CI: 7.2% to 29.6%, P=0.002) than among those in the control group and women in the intervention group displayed a prevalence of anaemia that was 52% less (mean difference18.1%, 95% CI: 11.1% to 25.1%, P<0.001) than those in the control group. Mean haemoglobin concentration was also 7.8 g/l (95% CI: 5.0 to 10.7, P<0.001) higher among the children and 4.8 g/l (95% CI: 3.3 to 6.3, P<0.001) higher among the women in the intervention clusters. However, no significant difference was found with respect to child growth failure (stunting, underweight, wasting and thinness) or chronic energy deficiency among women. Over the trial period there were a significant reduction in the prevalence of diarrhoea and passed worm across both groups, with no statistically significant difference between the treatment and comparison arm.

Conclusion: The study results suggest that daily supplementation of multiple micronutrient powder (MMP), coupled with deworming and provision of flip-flops, was effective in reducing anaemia among non-pregnant women and children. However, the current evidence is insufficient to make a public health recommendation for using the intervention package, containing 15 component MNP, to replace the current government and WHO recommendation for using 5 component MNP. Further investigation would be necessary to answer these important public health questions.

Background: Crucial gaps persist in knowledge, attitude, and practice (KAP) of adolescent girls that affect anemia and linear growth failure. Objective: To understand the role of KAP as a risk factor of anemia and linear growth problem in adolescent girls. Methods: We conducted a cross-sectional survey of 335 adolescent girls selected by clustered random sampling. The KAP questionnaire had 18 variables consisting of 9 knowledge, 3 attitude, and 6 practice components. Twelve variables addressed nutrition, dietary diversity, and health environments related to both anemia and stunting. The questionnaire was adapted from the 2014 Food and Agriculture Organization nutrition-related KAP guidelines for anemia. Dietary practice was evaluated from 2-day 24-hour recalls and a semi-quantitative food-frequency questionnaire. Associations between KAP and anemia, and height-forage z-score (HAZ), were analyzed using multivariate logistic and linear regression models, respectively.

BACKGROUND: Postoperative nosocomial infection (PNI) is a severe complication in surgical patients. Known risk factors of PNI such as allogeneic blood transfusions (ABTs), anemia, and iron deficiency are manageable with perioperative intravenous (IV) iron therapy. To address potential concerns about IV iron and the risk of PNI, we studied a large series of ortho-pedic surgical patients for possible relations between IV iron, ABT, and PNI. STUDY DESIGN AND METHODS: Pooled data on ABT, PNI, 30-day mortality, and length of hospital stay (LHS) from 2547 patients undergoing elective lower-limb arthroplasty (n = 1186) or hip fracture repair (n = 1361) were compared between patients who received either very-short-term perioperative IV iron (200-600 mg; n = 1538), with or without recombinant human erythropoietin (rHuEPO; 40,000 IU), or standard treatment (n = 1009). RESULTS: Compared to standard therapy, periopera-tive IV iron reduced rates of ABT (32.4% vs. 48.8%; p = 0.001), PNI (10.7% vs. 26.9%; p = 0.001), and 30-day mortality (4.8% vs. 9.4%; p = 0.003) and the LHS (11.9 days vs. 13.4 days; p = 0.001) in hip fracture patients. These benefits were observed in both trans-fused and nontransfused patients. Also in elective arthroplasty, IV iron reduced ABT rates (8.9% vs. 30.1%; p = 0.001) and LHS (8.4 days vs.10.7 days; p = 0.001), without differences in PNI rates (2.8% vs. 3.7%; p = 0.417), and there was no 30-day mortality. CONCLUSION: Despite known limitations of pooled observational analyses, these results suggest that very-short-term perioperative administration of IV iron, with or without rHuEPO, in major lower limb orthopedic procedures is associated with reduced ABT rates and LHS, without increasing postoperative morbidity or mortality.

The problem of anemia in most rural communities in Nigeria is enormous especially among children and pregnant women. Therefore, communities tend to explore alternative and cheaper means in treating anaemic disease condition when they occur. The study was carried out to test for the haematoprotective property of ethanol extract of Eremomastax speciosa (Hocht.) Acanthaceae leaves. Phenylhydrazine was used to induce anaemia by intraperitoneal injection. Two doses of the extract (300 and 500 mg/Kg body weight) were administered to the anaemic test groups by oral gavage. The control groups (normal and anaemic) were given normal saline instead of the extract. All the experimental animals had access to distilled water and rat chow ad libitum. The effect of the extract was tested on haematological indices of the experimental animals. Result: the results showed that there were significant (P&lt; 0.05) increases in the haemoglobin, red blood cell count, and haematocrit, when compared with the...

The effects of oral administration of aqueous extract of Spinacia oleracea leaf on some haematological indices and body weight changes in phenylhydrazine-treated rats as well as its phytochemical constituents were investigated. Extract was administered to anaemic and normal rats at 100 mg/kg bwt. once daily for 28 days. Extract was found to be rich in phytochemicals and improved the body weight of anaemic and normal treated rats. No significant (p>0.05) change was observed in PCV of anaemia treated group and normal treated group compared with control. However, there was a significant (p<0.05) increase in level of Hb of the normal treated group. The PCV, Hb and RBC level of the anaemia treated group increased (p<0.05) significantly when compared with that of the anaemia untreated group. Aqueous extract of S. oleracea leaves reversed anaemic conditions in the phenylhydrazine-treated rats; these may be attributed to its rich phytochemical, nutrient and vitamin contents.

In the surgical setting, anemia is a common feature and an independent risk factor for blood transfusion, inpatient complications, delayed hospital discharge and poorer functional recovery. Despite adverse side effects and the increasing costs to health systems, allogeneic blood transfusion is the standard of care for anemia. Within this context, NATA (Network for the Advancement of Transfusion Alternatives) guidelines advocate steps towards prevention, diagnosis of anemia and stimulation of erythropoiesis in surgical patients. These include iron – p.o. and i.v. formulations – and recombinant human erythropoietin (rHuEPO) as viable alternatives pre-, peri-and/or postoperatively. The combination of these methods with restrictive transfusion triggers, tranexamic acid and blood salvage techniques may reduce perioperative transfusion rates. The main objective of this article is to briefly review the use of iron in surgical patients, with special focus on orthopedic surgery. From the analyzed information, it can be concluded that, despite the lack of large randomized controlled trials, results indicate that because of the low incidence of serious side effects and the rapid increase of hemoglobin levels, i.v. iron emerges as a safe and effective drug for treating and preventing perioperative anemia. In addition, i.v. iron administration reduces rHuEPO dose requirements. The use of new i.v. iron formulations will allow the administration of large doses in a single session, thus facilitating a more widespread use of this therapeutic option.

Introduction: Intestinal parasitic infections associated with anemia have direct negative impact on the health of human beings. Objectives: To find the association between anaemia and intestinal parasitic infestation among the tea garden workers in Ilam district of Nepal. Materials and Methods: A Community based cross-sectional study was conducted among tea garden workers in Ilam district of Nepal. Out of 4 tea estates in Ilam District, 2 tea estates were selected randomly. Semi-structured questionnaire was administered to the study subjects and Microscopic Examination of Stool was done. Haemoglobin level was determined by cyanmethemoglobin method. The Chisquare test was used to find the association between anaemia and intestinal parasitic infestation. Results: The prevalence of anaemia was seen lower among the study population infected with parasite (37.5%) than parasite negative (48.3%) (P>0.05). Mild anaemia was seen significantly higher among parasite positive (60%) in comparison to moderate anemia (40%) (P<0.05). The prevalence of anaemia was seen significantly higher those infected with hookworm (90%) than Ascaris lumbricoides (40%), Entamoeba histolytica (20%) and Giardia lamblia (16.7%) (P<0.05). Conclusions: This study did not show the association between anemia and intestinal parasitic infestations.The prevalence of anemia was seen higher those infected with hookworm than other intestinal parasites.

In this paper, Sickle cell anaemia a blood disorder resulting from the abnormalities of red blood cells characterized by presence of abnormal cells like sickle cells, ovalocyte, anisopoikilocyte. Patients suffering from this disease experience acute pain and infection in addition to other chronic conditions like anaemia, cardiac, pulmonary and brain complication. Different digital IMAGE PROCESSING techniques for identification of shape and size of cells present in blood. It has been shown that using MATLAB the image can be processed into different stages as edge detection, segmentation, classification and sickle detection finally leading to a successful outcome.

This study examined the perceived causes of anemia and strategies of prevention among pregnant women attending antenatal clinic at Olabisi Onabanjo University Teaching Hospital, Sagamu. A descriptive survey design was used for the study and a simple random sampling method was used to select 120 participants for the study. Data was collected using selfdeveloped questionnaire. The result showed that 65.8% of the respondents have heard about anemia in pregnancy. 55.8% understood that anemia in pregnancy is referred to as shortage of blood during pregnancy. 72.5% of the respondents knew that anemia is a lifethreatening situation and can lead to the death of the mother and fetus and 20% of the respondents agreed that poor knowledge of good nutrition and malnutrition can make them have anemia in pregnancy. The result of the analysis also showed that 68.3% of the respondents strongly agreed that adequate nutritious diet reduces the occurrence of anemia in pregnancy and 63.3% strongly agreed that adequate iron supplements can reduce anemia in pregnancy. The test of hypothesis revealed that, there is significant relationship between knowledge and preventive strategies among pregnant women attending OOUTH r=0.421, df=119, p<0.05. It was recommended that at all levels of health care, health care givers should make iron supplements and foods fortified with iron available to pregnant women.

Since June 2020, there has been discussions and observations by the scientific community about effect of SARS-CoV 2 on haemoglobin levels. Haemoglobin which is the oxygen transporter for the body needs to be maintained in order to compensate for the decreased oxygenation in the lungs. With this hypothesis, anaemic patients might be exposed to increased risk of disease progression which can be easily prevented. The final data set consisted of haemoglobin values of 506 patients. Out of them, 54.34% were non-anaemic. 26.28% of the patients were mildly anaemic. 12.64% of the patients were moderately anaemic and 6.72% were severely anaemic. Low haemoglobin concentration can easily be tackled by dietary requirements which can be supplemented with the current management protocol. Larger data-based studies like this where detailed clinical and pathological findings are incorporated must be conducted.

Introduction: Abruptio placentae (AP) is a significant obstetrical emergency and as per WHO 2009 maternal mortality rates reported due to AP worldwide was 2.1% and fetal perinatal mortality rate was 15%. AP cannot be prevented but maternal and perinatal morbidity and mortality due to AP can be reduced significantly by aggressive management. Methods: The present prospective study was conducted to evaluate the outcome of treatment on the perinatal and maternal outcome in Abruptio Placentae patients in a tertiary care hospital from January 2015 to January 2016 amongst 54 pregnant women diagnosed to have abruptio placentae from 28 weeks of gestation and above and all babies delivered. Face to face interviews were conducted. Results: Maximum no. of abruptio placentae were unbooked-37 (69%) and 85% of patients belonged to less than 30 years of age group. An abruptio placenta was more common in multipara. Anaemia was seen in 21 patients (38%). Anaemia and PIH was seen in 12 patients (23%). 7 patients had fetal distress at the time of admission (13%). Regarding mode of delivery 50% of patients delivered vaginally by artificial rupture of membrane (ARM) and oxytocin augmentation and 50% underwent caesarean section. Conclusion: It was concluded that abruptio placentae is still a leading cause of maternal morbidity and mortality that can be reduced with modern management of abruptio placentae, but timely diagnosis and intervention is necessary.

Anemia is defined as blood hemoglobin concentration of less than 120 g/l in women and less than 130 g/l in men. The main cause of the development of anemia in patients treated with regular hemodialysis is the lack of endogenous erythropoietin, and its main clinical consequences are: progressive decline in residual renal function, development of cardiovascular disorders, disorders of cognitive functions and a decrease in the quality of life of these patients. Despite the administration of an appropriate dose of erythropoietin, in 5-10% of patients treated with regular hemodialysis, there is resistance to erythropoietin activity. The main risk factors for the development of resistance to the effects of erythropoietin are: iron deficiency, microinflammation, deficiency of vitamin D, secondary hyperparathyroidism, deficiency of vitamin C, and inadequate hemodialysis. The main side effects of erythropoietin are: hypertension, thrombosis of the vascular approach to hemodialysis, and the red blood cell precursor aplasia in the bone marrow. Early detection and elimination of risk factors, optimization and indi-vidualization of hemodialysis prescription prevent the development of resistance to erythropoietin activity, enable the achievement of target blood hemoglobin, reduce the development of cardiovascular morbidity, and improve the quality of life of these patients.