MyMedR

Use of red blood cell indices for the identification of iron deficiency among blood donors

Nadarajan V, Sthaneshwar P, Eow GI

Transfus Med, 2008 Jun;18(3):184-9.

PMID: 18598281 DOI: 10.1111/j.1365-3148.2008.00862.x

The objective of this study was to identify haematological parameters useful in screening for iron deficiency among blood donors. Iron deficiency is a common complication of blood donation and often goes unrecognized until anaemia develops. Biochemical markers such as soluble transferrin receptor (TfR), ferritin and log(TfR/F) have been proposed as more valid indicators of body iron status. Red blood cell (RBC) parameters are, however, more easily measured and have also been proposed as indicators of iron depletion. We measured ferritin and TfR in 192 blood donors together with RBC analysis, performed on two haematology analysers. Thirteen donors had parameters suggestive of haemoglobinopathy and were excluded from further analysis. Overall, 10% (18/179) of the remaining donors had iron deficiency, as defined by log(TfR/F) exceeding the 95th percentile of the value in the population of first-time donors. Using receiver operating characteristic analysis, the sensitivity of ferritin was 100%, with a specificity of 90% at a cut-off of 15 mug L(-1). The sensitivity and specificity of RBC-Y at a cut-off of 152 for detecting iron deficiency were 81 and 89%, respectively. Haemoglobin content of reticulocytes, meanwhile, showed sensitivity of 69% and specificity of 93% when a cut-off of 28 pg was used. Both measures compare favourably with haemoglobin which only showed a sensitivity of 50%, although specificity was 91% at a cut-off value of 125 g L(-1). The parameter RBC-Y can be useful as a screening measure for iron deficiency in blood donors.

Matched MeSH terms: Anemia, Iron-Deficiency/diagnosis*

Screening results of anaemia among infants in a village in Okinawa, Japan: a cross-sectional study

Quek KF, Hokama T, Yogi C

Asia Pac J Public Health, 2006;18(1):24-8.

PMID: 16629435

The aim of this study is to highlight the baseline characteristics of the results of a screening test for anaemia among infants in a village in Okinawa, Japan. The groups were classified into two; infants with and without anaemia. A total of 201 infants were screened at 3-4 months, 9-10 months and 18 months. The study showed that gestational age and BMI were predictive of anaemia at 3-4 months of age. At 9-10 months, types of feeding and weight ratio were the only factors that were found to be significantly predictive of anaemia. However, no factor was found to be predictive of anaemia at 18 months. Anaemia cases were found to occur at 3-4 months and 9-10 months. Most of the anaemia cases have successfully undergone treatment.

Matched MeSH terms: Anemia/epidemiology*

Fulltext The use of mycophenolate mofetil in treating patients with non responding aplastic anemia

Gan GG, Leong CF, Sangkar JV, Teh A, Goh KY, Cheong SK

Med J Malaysia, 2005 Aug;60(3):311-3.

PMID: 16379185

Aplastic anemia is a relatively uncommon disease and conventional management options include immunosuppressive drugs and/or haematopoeitic stem cell transplantation. It is now known that the pathogenesis of aplastic anemia is immune mediated. Mycophenolate mofetil is a common immunosuppressive drug now used mainly in prophylaxis of graft rejection in organ transplant and also for prevention/treatment for graft versus host disease in haemtopoeitic stem cell transplantation. It is thought that mycophenolate mofetil may be useful in this group of patients. In this short report, mycophenolate mofetil was tried in 6 patients who had severe aplastic anemia with variable doses for a minimum duration of 9 months. The result has however not been encouraging.

Matched MeSH terms: Anemia, Aplastic/drug therapy*

Fulltext Intestinal parasitic infections and micronutrient deficiency: a review

Hesham MS, Edariah AB, Norhayati M

Med J Malaysia, 2004 Jun;59(2):284-93.

PMID: 15559182

Malnutrition including vitamin A and iron deficiency and parasitic diseases have a strikingly similar geographical distribution with the same people experiencing both insults together for much of their lives. Parasitic infections are thought to contribute to child malnutrition and micronutrient deficiency through subtle reduction in digestion and absorption, chronic inflammation and loss of nutrients. Parasites may affect the intake of food; it's subsequent digestion and absorption, metabolism and the maintenance of nutrient pools. The most important parasites related to nutritional status are intestinal parasites especially soil transmitted helminthes, Giardia duodenalis, Entamoeba histolytica, followed by other parasites such as the coccidia, Schistosoma sp. and malarial parasites.

Matched MeSH terms: Anemia, Iron-Deficiency/etiology*

Fulltext Epidemiology of aplastic anaemia in the state of Sabah, Malaysia

Yong ASM, Goh AS, Rahman M, Menon J, Purushothaman V

Med J Malaysia, 1998 Mar;53(1):59-62.

PMID: 10968139

Aplastic anaemia is a rare disease which is more prevalent in the Far East. In Malaysia, it appears to be unusually common in the state of Sabah. A retrospective analysis of all cases of aplastic anaemia diagnosed between January 1993 and March 1996 was undertaken. The criteria of the International Aplastic Anaemia and Agranulocytosis Study (IAAAS) was used. In this 39 month period, 31 cases were confirmed by marrow trephine biopsy to be aplastic anaemia. The male-to-female ratio was 3.4. Median age of diagnosis was 23 years. There were 24 patients (77%) who were from the Kadazan-Dusun ethnic group, which forms 18% of the population of Sabah. The incidence of aplastic anaemia in Sabah appears to be higher than that reported elsewhere in the Far East, at 4.8 per million population per year. Peak incidence is in the elderly group at 8.6 per million followed by a second peak in young people aged 15 to 24 (7.9 per million). The aplastic anaemia to total acute leukaemia ratio is 0.37. The marked male preponderance and apparent susceptibility of the Kadazan-Dusun people are also notable. A further prospective study to address the true incidence of aplastic anaemia and possible aetiologic factors accounting for these observations is necessary.

Matched MeSH terms: Anemia, Aplastic/epidemiology*

Development of a modified method for sequencing high G:C regions in chicken anemia virus genome

Chowdhury SM, Omar AR, Aini I, Hair-Bejo M, Jamaluddin AA, Wan KL, et al.

J. Biochem. Mol. Biol. Biophys., 2002 Jun;6(3):229-32.

PMID: 12186760

Two areas in the chicken anemia virus (CAV) genome have high G:C content with secondary structures. These two G:C rich areas could not be sequenced with Perkin Elmer's Big Dye Terminator Cycle Sequencing Kit. Several modifications were carried out to solve the problem. Finally, a package of modified method was developed to sequence the high G:C areas. The result showed that the Perkin Elmer's Big Dye Terminator Cycle Sequencing Kit with the normal procedures are not suitable for sequencing the high G:C regions of the CAV genome. The present developed method made the Perkin Elmer's Kit useful for the first time to sequence the G:C rich hairpin structures of the CAV genome. The system may be useful to sequence all other G:C rich DNA templates.

Matched MeSH terms: Chicken anemia virus/genetics*

Predictive factors by multivariate analysis for colorectal cancer in Malaysian patients undergoing colonoscopy

Tan YM, Rosmawati M, Ranjeev P, Goh KL

J Gastroenterol Hepatol, 2002 Mar;17(3):281-4.

PMID: 11982698

BACKGROUND: The majority of colorectal cancers are still diagnosed in patients who present with symptoms especially in countries where colorectal screening programs are not practised. The aim of our study was to determine the predictive factors for colorectal cancer in patients referred for colonoscopy.

METHODS: A prospective study of 485 consecutive patients who underwent colonoscopy during a 22-month period was performed. All patients answered a detailed questionnaire. Indications for colonoscopy and the findings were recorded.

RESULTS: The mean age of the study population was 55.7 +/- 14.7 years. There were 221 (45.6%) males and 264 (54.4%) females. Sixty-five (13.4%) were Malays, 298 (61.4%) were Chinese and 112 (23.1%) were Indians. Multiple backward stepwise regression analysis revealed that independent predictors for colorectal cancer (odds ratio [95% CI]) were the presence of rectal bleeding (4.3 [4.0-8.0]) and iron deficiency anemia (4.0 [3.6-10.2]). In those aged 50 and over, male gender (4.5 [2.2-9.3]) and abdominal pain (3.1 [1.4-6.7]) were also significant positive predictors of cancer.

CONCLUSIONS: With the ever-increasing demand for gastrointestinal endoscopy, the appropriate utilization of colonoscopy is essential to afford prompt patient evaluation. Our study supports the need to prioritize the use of colonoscopy in patients with rectal bleeding and iron deficiency anemia. In the older patient where the background prevalence of colorectal cancer is higher, referral for colonoscopy is also justified.

Matched MeSH terms: Anemia, Iron-Deficiency/epidemiology

Fulltext Positive direct antiglobulin test with Unasyn--a case report

Leong CF, Cheong SK, Fadilah SA

Med J Malaysia, 1999 Dec;54(4):517-9.

PMID: 11072473

A 56-year-old Chinese lady with valvular heart disease and atrial fibrillation was referred to us from a private hospital for further management of autoimmune haemolytic anaemia. Physical examination and laboratory investigations did not support the diagnosis of haemolytic anaemia. However, direct antiglobulin test (DAT) was strongly positive with anti-IgG and negative with anti-C3d. There was also mild anaemia and reticulocytosis, which was attributable to persistent haematuria. The DAT became positive after commencing Unasyn and cessation was associated with decreasing reactivity of the positive DAT. We believe that the positive DAT in this patient was most likely due to the Unasyn therapy.

Matched MeSH terms: Anemia, Hemolytic/diagnosis

Fulltext Anti-lymphocyte globulin therapy in aplastic anaemia--a university hospital experience

Leong KW, Teh A, Bosco JJ, Jayaranee S, Sadat U

Med J Malaysia, 1995 Jun;50(2):158-61.

PMID: 7565186

Antilymphocyte globulin (ALG) was given every other day for 5 doses with platelet transfusions immediately following ALG administration in 6 patients with aplastic anaemia. Four patients responded and 3 durable remissions were achieved. One patient relapsed and further treatment with anti-thymocyte globulin and cyclosporin also failed. One patient died of Flavobacterium septicaemia 6 days after completion of ALG. Our data suggests that using an alternate day regimen, a response rate similar to a daily regimen can be obtained.

Matched MeSH terms: Anemia, Aplastic/therapy*

Fulltext The clinical use of leucocyte--depleting filters in the multiply transfused patients--a case report

Yap S, Duraisamy G

Med J Malaysia, 1992 Jun;47(2):150-3.

PMID: 1494336

Matched MeSH terms: Anemia, Refractory/therapy

Fulltext Acne fulminans with dapsone induced haemolysis: a case report

Ismail R

Med J Malaysia, 1987 Jun;42(2):124-6.

PMID: 2971861

Acne is one of the most common disorders affecting mankind. Although acne does not cause death, it however produces a lot of discomfort, disfigurement and psychological trauma, particularly in teenagers. Acne vulgaris is a chronic condition involving the pilosebaceous unit of the skin. It is characterised by the presence of comedones, inflammatory papules, pustules or cysts, and eventually by scarring. The end result of acne varies from hyperpigmentation, slight pitting, to extremely disfiguring scars that may develop into keloids. Acne fulminans is a rare disorder and is characterised by sudden explosive appearance of highly inflammatory, tender, crusted, ulcerated lesions involving the back, chest and face. It is one of the most scarring acute dermatologic disorders of young people. A case of acne fulminans in a young female who developed haemolysis due to dapsone is reported here.

Matched MeSH terms: Anemia, Hemolytic/chemically induced*

Effect of laparoscopic sterilization and insertion of Multiload Cu 250 and Progestasert IUDs on serum ferritin levels

Goh TH, Hariharan M

Contraception, 1983 Oct;28(4):329-36.

PMID: 6667621

Blood haemoglobin and serum ferritin levels were measured at the initial visit and 12 months following sterilization and IUD insertion. Ferritin levels were unaltered in Progestasert users after 12 months but haemoglobin values increased though not significantly. Ferritin levels fell in Multiload Cu 250 users and in sterilized women; haemoglobin levels were also observed to fall but significantly only in the latter group. Iron-deficiency anaemia was prevalent at initial contact and there appeared to be an increased risk subsequently in Multiload Cu 250 users and in those who were sterilized. Screening and monitoring for anaemia is indicated. From the viewpoint of iron status, the Progestasert is preferable to the Multiload Cu 250 but it suffers the major disadvantages of needing frequent replacement and of causing menstrual disturbances which might compromise its acceptability. Menstrual blood loss studies may help explain why anaemia develops after sterilization.

Matched MeSH terms: Anemia, Hypochromic/etiology

Evans syndrome: a report on 12 patients

Ng SC

Clin Lab Haematol, 1992;14(3):189-93.

PMID: 1451398

From 1981 to 1989, 12 patients of the University Hospital, Kuala Lumpur, were diagnosed to have Evans syndrome based on direct antiglobulin test (DAT) positive haemolytic anaemia and immune thrombocytopenia occurring either simultaneously (7 patients) or consecutively (5 patients). Their mean age at presentation was 24.8 years with a marked female preponderance. All 12 patients were given high dose steroid after diagnosis. Subsequently, other modalities including intravenous immunoglobulin (1 patient) and high dose methylprednisolone (1 patient) were given. Three patients died of intracranial haemorrhage during the first admission while 1 patient died of pulmonary embolism six months after diagnosis. Three patients had splenectomy because of thrombocytopenia. Six patients tested positive for antinuclear factor and antibodies to double stranded DNA and four of them died. Positive serology appeared to be associated with a poorer prognosis. Follow up observations indicate that patients who survive the acute attacks fare reasonably well.

Matched MeSH terms: Anemia, Hemolytic, Autoimmune/blood*

Fulltext Malnutrition among Semai children

Khor GL

Med J Malaysia, 1988 Dec;43(4):318-26.

PMID: 3241597

Matched MeSH terms: Anemia, Hypochromic/epidemiology*

Malnutrition in malaria endemic villages of Bengkoka Peninsula, Sabah

Kandiah M, Lee M, Ng TK, Chong YH

J Trop Pediatr, 1984 02;30(1):23-9.

PMID: 6429349 DOI: 10.1093/tropej/30.1.23

Matched MeSH terms: Anemia, Hypochromic/epidemiology

Nutrition of Iban children of the Sut and Mujong Rivers

Anderson AJ

J Trop Pediatr, 1981 02;27(1):26-35.

PMID: 7218412 DOI: 10.1093/tropej/27.1.26

Matched MeSH terms: Anemia/epidemiology

Fulltext Homozygous haemoglobin E in association with hereditary ovalocytosis

George E, Kudva MV

Med J Malaysia, 1989 Sep;44(3):255-8.

PMID: 2626141

Hereditary stomatocytic ovalocytosis and haemoglobin E are two genes present in 3-5% of Malays. This is a report of a 22 year old Malay college student with homozygous haemoglobin E and hereditary stomatocytic ovalocytosis where the clinical effects seen were the result of the summation of these genes: he was asymptomatic, presenting with moderate jaundice, moderate hepatosplenomegaly, and a mild haemolytic anaemia.

Matched MeSH terms: Anemia, Hemolytic/genetics

Fulltext Population & social indicators of food and nutrition in Peninsular Malaysia

Chong YH

Med J Malaysia, 1982 Jun;37(2):134-40.

PMID: 6813659

Health, including nuirition is not independent but is closely associated with the social and economic environment. Malnutrition itself can cause death, but more commonly, it can cause considerable ill-health, physical retardation, impaired mental performance, loss in productivity and a decline in the quality of life. The effects of malnutrition as obstacles to socio-economic development are now well recognised. In a rapidly developing country like Malaysia, the nutritional and nutritionally-related problems present themselves with contrasting features. While population indicators such as toddler mortality, incidence of low birthweight and food balance sheet studies suggest an improving nutritional situation, methods of direct assessment have shown that chronic protein-energy malnutrition and anaemia are sWI common amongst pre-school children in both the rural and urban disadvantaged sectors. Moderate anaemia also affects a significant proportion of older children and women of childbearing age. Intestinal parasites, another indicator of under development at the local level, are ubiquitous in the rural setting and urban slums owing to unsatisfactory waste disposal. In striking contrast, diseases associated with dietary excesses and increasing affluence have now emerged as the major killers. This changing pattern of mortality and morbidity along the lines encountered by the industrialised societies is now dramatised by the fact that road accidents are now claiming a large number of victims. It is clear that while continued efforts should be given to the improvement of the nutritional health of both rural and urban poverty communities, little time should be wasted in considering the adoption of public health measures aimed at stemming the rising number of deaths associated with our increasing affluence, particularly those diseases that are nutritionally linked, such as coronary heart disease, hypertension and diabetes mellitus, not forgetting the increasing road toll afflicted by the motor vehicle.

Matched MeSH terms: Anemia/epidemiology

Haemoglobin S in Malays and Indians: association of Hb CoSp and Hb S in a Malay family

Saidi HT, Duraisamy G

Trop Geogr Med, 1978 Mar;30(1):103-8.

PMID: 675819

Four cases of Hb S were seen between Jan. 1976 and June 1976; three of them were newly discovered while the fourth was previously diagnosed. Out of the four cases, two were Malays and the other Indians. The family members of one Malay case were investigated. Six members had Hb S and three had Hb CoSp. Association of Hb CoSp and Hb S was seen in two of the members. Clinically they were healthy.

Matched MeSH terms: Anemia, Sickle Cell/genetics*

Gum Hypertrophy from Cyclosporine

Menon BS, Teh KH

N Engl J Med, 2021 Feb 25;384(8):744.

PMID: 33626603 DOI: 10.1056/NEJMicm2026082

Matched MeSH terms: Anemia, Aplastic/drug therapy

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