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OBJECTIVE@#To observe the variability of hemoglobin (HB) level in patients with renal anemia, and to analyze its relationship with effect of repeated blood transfusion therapeutic in patients.@*METHODS@#A retrospective cohort study and propensity score matching method were used, 60 patients with renal anemia who had effective treatment with repeated blood transfusion in Changzhou No.2 People's Hospital from May 2018 to May 2021 were retrospectively analyzed and set as the effective group; 153 patients with renal anemia who had ineffective treatment with repeated blood transfusion in the hospital in the same period were collected and set as the ineffective group, the propensity score matching method was used, the patients who were effective and ineffective in repeated blood transfusion were matched 1∶1 for analysis; the medical records and laboratory indexes of the two groups were checked; the Hb level of patients within 6 months (1/month) were recorded, the residual standard deviation (Res-SD) of Hb of patients was calculated according to the Hb level and evaluated the variability of Hb level; the relationship between HB variability level and therapeutic effect of repeated blood transfusion in patients with renal anemia was analyzed.@*RESULTS@#After propensity score matching, there was no statistical significant difference between the two groups in terms of baseline data such as age, sex, dialysis age and BMI (P>0.05). The levels of serum albumin and transferrin of patients in the ineffective group were significantly lower than those of patients in the effective group (P<0.05); at 1 and 2 months of the observation period, there was no statistical significant difference in Hb levels of patients in both groups (P>0.05); the Hb level of patients in the ineffective group was significantly lower than that of patients in the effective group at 3, 5 and 6 months, and significantly higher than that of patients in the effective group at 4 months (P<0.05); the Res-SD of male patients and female patients in the ineffective group were respectively significantly higher than that of male patients and female patients in the effective group (P<0.05). Logistic regression analysis results showed that high variability of Hb level (Res-SD) was a risk factor for the ineffective treatment of repeated blood transfusion in patients with renal anemia (OR>1, P<0.05); the decision curve results showed that, when the high-risk threshold was 0.0-1.0, Res-SD predicted the net benefit rates of male and female patients with renal anemia were greater than 0, which was clinically significant, the smaller the high-risk threshold in the above range, the greater the net benefit rate.@*CONCLUSION@#The therapeutic effect of repeated blood transfusion in patients with renal anemia may be related to the variability of Hb level.
Subject(s)
Humans , Male , Female , Retrospective Studies , Hemoglobins/therapeutic use , Anemia/therapy , Chronic Disease , Blood Transfusion , Kidney DiseasesABSTRACT
Background: In developing countries the prevalence of anemia among pregnant women averages 60% resulting in varying levels of adverse pregnancy outcomes. Iron, Vitamin B12 and folic acid deficiencies, malaria, intestinal parasitic infections and hemoglobinopathies are the principal causes of anemia in pregnancy. Above nutritional requirements increase during pregnancy and if it is not maintained, may result in adverse maternal and fetal outcomes. The aim of this study was to study the prevalence of anemia in pregnant mothers, study the clinical patterns of anemia in pregnancy and to study the histopathological patterns of anemia during pregnancy.Methods: This is a prospective study done on 60 pregnant women whose hemoglobin level is less than 10.9 gm/dL. Blood samples were taken, and peripheral blood smears were examined along with their complete clinical and obstetric history.Results: Out of 60 cases of anemia, 40% were found to have dimorphic anemia, 30% with microscopic hypochromic anemia, 20% of patients have normocytic hypochromic anemia, 1.7% had sickle-cell anemia and 8.3% of patients were thalassemia cases. The risk factors for anemia in this study is noted to be low social economic status, occurrence of complications during previous pregnancy and multiparty. In this study anemia was more commonly found in the multigravida women and in the third trimester of pregnancy.Conclusions: With improved social economic conditions, early detection, good antenatal care, awareness regarding available treatment, a healthy diet, routine antenatal counselling and adequate iron supplementation, anemia in pregnancy can be avoided.
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Background: Anaemia, which is defined as a low oxygen carrying capacity of blood, is a major public health problem. It is a condition in which there is a decrease in the total number of red blood cells in the blood, either due to decreased production or increased destruction or both. Anaemia, one of the most prevailing nutritional disorders, has a worldwide prevalence of approximately 52%. The burden of anaemia is high especially among females of reproductive age group where India ranks the top. The study is aimed to establish the prevalence of anaemia among female patients of reproductive age group (15-49 years).Methods: A cross sectional study was conducted among 254 females of reproductive age group, attending Anakaputhur, an urban field practice area of Sree Balaji Medical College. Convenient sampling method was used. Data was collected by discussion using a pretested semi-structured questionnare and haemoglobin estimation was done by venous sampling method.Results: The mean age of the study participants were 34.6±12.4 years with 9.05% uneducated and 8.6% graduate females. 26% gave history of symptoms of anaemia and prevalence of anaemia was reported to be 42.12% with 24.4%, 12.2% and 5.5% of mild, moderate and severe anaemia, respectively.Conclusions: Prevention and its treatment in women is much essential at this point, hence programmes and policies should be implemented based on the needs of the community, and health education should be imparted with respect to measures that can prevent and help in early diagnosis of anaemia.
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Background: In modern era, endoscopic methods are commonly used in evaluation of female infertility. Hysterolaparoscopy is such a real time theranostic modality for anatomical causes of the infertility. The objective of this study was to evaluate the effect of accessory parameters (Age, Body mass index, duration of infertility, Rhesus factor, menstruation history and hemoglobin) on success rate of endoscopic procedures in terms of achieving pregnancy.Methods: A total 157 female infertile patients (Mean± standard deviation 27.72±3.82 years) were recruited in present study. During initial assessment detailed history was taken and hysterolaparoscopy was performed. The observed structural abnormalities on hysterolaparoscopy during diagnostic work up were tackled at same time if possible. After procedure, patients were counselled for regular sexual activity. The follow-up of all patients was done for 12 months.Results: A total 157 female infertile patients were recruited and divided into primary 93 (59.2%) and secondary infertile 64 (41.74%) patients on basis of obstetric history. The average age, BMI, hemoglobin and duration of infertility were 27.7years, 21.8 kg/m2, 12.3 gm and 3.9 years respectively. Out of 157 patients, anatomical abnormalities were detected in 125 patients during Hysterolaparoscopy and distributed in 77/93 (82.8%) primary and 48/64 (75%) secondary infertile patients. Of 125 patients with abnormal hysterolaparoscopic findings, 121 underwent active intervention and on follow up, 43 patients were conceived. We found that age; BMI, Rhesus factor, menstruation history and duration of the infertility were not correlated with fertility outcome while hemoglobin level was significantly correlated with conception rate.Conclusions: Authors concluded that outcome of the hysterolaparoscopy in female infertile patients is significantly depends upon hemoglobin levels, however outcome is irrelevant to age, duration of infertility, Rhesus factor and body mass index.
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Background: Hypertension is the most common cardiovascular disease and a major cardiovascular risk factor that causes significant morbidity and mortality worldwide. Most common type is primary (essential) hypertension and is genetically determined. It affects many systems of the body and can also alter various hematological parameters. The study was undertaken to check the effect of atenolol on hemoglobin (Hb) level in mild to moderate hypertension. Methods: The study was prospective and non-randomized. Thirty newly diagnosed hypertensives selected for atenolol therapy by medicine personnel were enrolled in the study based on inclusion and exclusion criteria. Patients were divided into pre-treatment (before starting atenolol therapy) and post-treatment group. Red blood cell (RBC) count, Hb, packed cell volume (PCV) and red cell indices were measured at the time of enrolment and then monthly after starting atenolol for next 3 months. Result: Results were analyzed by repeated measure analysis of variance. Atenolol treatment was found to increase Hb and PCV significantly, whereas no significant change in RBC count and red cell indices. Conclusions: Treatment with atenolol for mild to moderate hypertension has shown a significant increase in Hb and PCV level. This positive effect may be because of the decrease in sodium and water reabsorption by decrease in sympathetic overactivity and excretion of sodium and water by improvement in kidney functions. Atenolol has no any direct effect on Hb synthesis and erythropoiesis.
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Hemangioblastomas are histologically benign tumors but their clinical course is often unfavorable because of the high frequency of recurrence and it presents itself in multicentric forms with involvement of other organs. The tumor sometimes presents as a solid lesions, and is often extremely difficult to manage in contrast to the cystic hemangiolastoma. We present a retrospective analysis of 13 cases of posterior fossa hemangioblastoma diagnosed between 986 and 1993 at our institution, and the clinical characteristics, radiological and histological findings, treatment and outcome is discussed. There were nine males and four females with the mean age of 36.7 years(range 14 to 59) at the time of their first neurosurgical presentation Two patients were compatible with von-Hippel-Lindau complex, one of which was associated with retinal angioma and the other with multiple cysts in the pancreas and the kidney. Six patients had elevated hemoglobin levels which normalized postoperatively. In three out of 4 patients with recurrence of the tumor, the hemoglobin level remained elevated above 16gm/dl. The most common type of tumor in descending order was type II(simple cyst) and type IV(microcystic form) in one case each. The cerebellar hemisphere was the most common location of the tumor(76.9%), followed by the vermis and the brainstem. One case had a multiple location of the tumor. Angiographic studies demonstrate that the most common feeding artery of the mural nodule was the PICA(66.7%). In 4 patients who had a subtotal removal of the tumor mass at their initial operation, there was a recurrence between 2 and 9 years postoperatively. It is concluded from these studies that although hemangioblastomas may be histologically benign, its wide spectrum of clinical presentations, occurrence in multiple locations, and its tendency to recur if surgically excised subtotally renders the tumor a clinical challenge to manage surgically.