Frequency to Non-Compliance to Oral Iron Therapy in Pregnancy and Common Factors Leading to it

OBJECTIVES: The objective of this study was to determine frequency of non-compliance to oral iron therapy in pregnancy and common factors leading to it. METHODOLOGY: It was a cross-sectional study done in the Department of Obstetrics and Gynecology of Lady Willington Hospital Lahore, Pakistan. The duration of this study was six months i.e., 3rd October 2019 to 2nd March 2020. All antenatal patients between ages of 18 to 45 years presented in the obstetrics outdoors or admitted in the ward were included in this study. A total of 245 patients were included in this study by consecutive non-probability sampling. Patients with gynecological problems, patients dependent on others for their medication cost, patients with psychiatric illness or physical disability were excluded. Post stratification Chi-square test was applied keeping P-value ≤0.05 as significant RESULTS: Among 245 patients, mean age was 27±2.16 years. Iron supplement used by 245 patients was analyzed as 159 (65%) patients had used the iron supplement while 86 (35%) patients didn’t use iron supplements (P-value 0.001). Iron supplement used by 245 patients was analyzed and only 93 (38%) patients had used the iron supplement while 152 (62%) patients didn’t use iron supplements. CONCLUSION: The coverage of antenatal iron and folic acid supplements is very low in the surveyed districts of Pakistan due to lack of parental education and older aged women belonging to poor households.

The Efficacy and Safety of Pharmacological Treatments for Restless Legs Syndrome: Systemic Review and Network Meta-Analysis

Although various drugs are currently used for restless legs syndrome (RLS) in clinic, selecting appropriate drugs for patients is difficult. This network meta-analysis (NMA) aimed to compare the efficacy and safety of different drugs. After literature searching and screening, 46 trials, including 10,674 participants are included in this NMA. The pooled results showed that, compared with placebo, only levodopa is inefficient to relieve symptoms of RLS. Cabergoline decreases IRLS scores to the greatest extent among all drugs (MD −11.98, 95% CI −16.19 to −7.78). Additionally, pramipexole is superior to ropinirole in alleviating symptoms of RLS (MD −2.52, 95% CI −4.69 to −0.35). Moreover, iron supplement alleviates RLS symptoms significantly compared with placebo in patient with iron deficiency (MD −5.15, 95% CI −8.99 to −1.31), but not for RLS patients with normal serum ferritin level (MD −2.22, 95% CI −6.99 to 2.56). For primary RLS, these drugs are also effective, while there is insufficient data to analyze drug efficacy in secondary RLS. We analyzed risk of common adverse effects of drugs including nausea, somnolence, fatigue, headache and nasopharyngitis. Alpha-2-delta ligands and DAs are favorable choices for both primary and secondary RLS because of their significant efficacy and good tolerability. Iron supplement can significantly alleviate symptoms of RLS patients with iron deficiency than placebo. We recommend gabapentin, gabapentin enacarbil, and pregabalin for clinicians for first consideration mainly because that they rarely cause augmentation. Oxycodone-naloxone could be considered in patients with severe or very severe RLS who failed in treatment with above drugs.

Role of iron in breath holding spells and effect of iron therapy in children

Background: Breath holding spells (BHS) are paroxysmal events resulting from painful stimulus or emotional event resulting in forceful crying, occur in children’s aged between 6 months to 6 years. To assess the role of iron in breath holding spells (BHS) and to assess the efficiency of iron therapy in reducing frequency of BHS.Methods: This was a prospective, interventional study conducted at GMC baramulla. A total of 70 patients between the ages of 6 months and 5 years with breath holding spells with iron deficiency and iron deficiency anemia were studied. After giving them iron therapy for 6 and 12 weeks, they were assessed for the improvement in their anemia and its impact on the frequency of breath holding spells.Results: Seventy children with breath holding spells were studied prospectively. Forty (57.15%) cases were males and 30 (42.85%) females. There was a statistically significant rise in the hemoglobin level, serum ferritin, serum iron with 6 and12 weeks of iron therapy (p<0.001). This rise in the hemoglobin level serum ferritin and serum iron was associated with a statistically significant fall in the frequency of breath holding spells with 6 and 12 weeks of iron therapy (p<0.001).Conclusions: iron supplement is effective in reducing the frequency of breath holding spells and thus iron has role in BHS.

Comparative Evaluation of Sucrosomial Iron and Iron Oxide Nanoparticles as Oral Supplements in Iron Deficiency Anemia in Piglets

Iron deficiency is the most common mammalian nutritional disorder. However, among mammalian species iron deficiency anemia (IDA), occurs regularly only in pigs. To cure IDA, piglets are routinely injected with high amounts of iron dextran (FeDex), which can lead to perturbations in iron homeostasis. Here, we evaluate the therapeutic efficacy of non-invasive supplementation with Sucrosomial iron (SI), a highly bioavailable iron supplement preventing IDA in humans and mice and various iron oxide nanoparticles (IONPs). Analysis of red blood cell indices and plasma iron parameters shows that not all iron preparations used in the study efficiently counteracted IDA comparable to FeDex-based supplementation. We found no signs of iron toxicity of any tested iron compounds, as evaluated based on the measurement of several toxicological markers that could indicate the occurrence of oxidative stress or inflammation. Neither SI nor IONPs increased hepcidin expression with alterations in ferroportin (FPN) protein level. Finally, the analysis of the piglet gut microbiota indicates the individual pattern of bacterial diversity across taxonomic levels, independent of the type of supplementation. In light of our results, SI but not IONPs used in the experiment emerges as a promising nutritional iron supplement, with a high potential to correct IDA in piglets.

Iron Status and Dietary Patterns of Collegiate Female Distance Runners

Introduction: Iron is in oxygen transport which is important for athletic performance. Many female distance runners struggle to maintain adequate iron status through diet alone and rely on iron supplementation. Methods: Interviews were conducted with eight members of the Women’s Cross Country team at a Division I university to assess dietary patterns and behaviors related to iron status. This information, along with food records and serum ferritin levels, were analyzed qualitatively for trends with a focus on iron intake, total energy intake, and food components that enhance and inhibit iron absorption. Results: All participants took an iron supplement at the time of the study. All but one had experienced poor iron status currently or in the past. Most participants did not meet dietary iron, Vitamin E, or estimated energy requirements. Half of the participants expressed an attempt to increase iron intake in response to higher training loads. Half attempted to increase intake in response to a low ferritin result or iron deficiency symptoms. Conclusions: Consistently low energy and iron intake among participants indicated the likelihood of a relationship with poor iron status and/or reliance on supplementation. The most common motivation for increasing iron intake was the prevention of symptoms.

Factors Associated With Uptake of Iron Supplement During Pregnancy Among Women of Reproductive Age in Tanzania: an Analysis of Data From the 2015 to 2016 Tanzania Demographic and Health Survey and Malaria Indicators Survey

Background: Pregnant women are vulnerable to iron deficiency due to the fact that more iron is needed primarily to supply the growing fetus and placenta and to increase the maternal red cell mass. Little is known on the factors associated with uptake of iron supplement during pregnancy.Methods: The study used data from the 2015 to 2016 Tanzania Demographic and Health Survey and Malaria Indicators Survey. A total of 6,924 women of active reproductive age from 15 to 49 were included in the analysis. Both univariate and multiple regression analyses were used to determine factors associated with uptake of iron supplement during pregnancy.Results: Majority of the interviewed women 5,648 (81.6%) always took iron supplement during pregnancy, while a total of 1,276 (18.4%) women never took iron supplement during pregnancy. After controlling for confounders, the predictors for uptake of iron supplement during pregnancy were early antenatal booking (adjusted odds ratio, AOR = 1.603 at 95% CI = 1.362–1.887, p &lt; 0.001); rural residence (AOR = 0.711 at 95% CI = 0.159–0.526, p = 0.007); wealth index [rich (AOR = 1.188 at 95% CI = 0.986–1.432, p = 0.07)]—poor was the reference population; level of education [primary education (AOR = 1.187 at 95% CI = 1.013–1.391, p = 0.034)]—no formal education was the reference population; parity [para 2 to 4 (AOR = 0.807 at 95% CI = 0.668–0.974, p = 0.026), para 5 and above (AOR = 0.75 at 95% CI = 0.592–0.95, p = 0.017)], para 1 was the reference population; zones [mainland rural (AOR = 0.593 at 95% CI = 0.389–0.905, p = 0.015) and Unguja Island AOR = 0.63 at 95% CI = 0.431–0.92, p = 0.017]—mainland urban was the reference population; and current working status [working (AOR = 0.807 at 95% CI = 0.687–0.949, p = 0.009)].Conclusion: The study revealed that, despite free access to iron supplement during pregnancy, there are women who fail to access the supplement at least once throughout the pregnancy. The likelihood to fail to access iron supplement during pregnancy was common among pregnant women who initiated antenatal visits late, were from poor families, had no formal education, reside in rural settings, had high parity, were from mainland rural, and were in working status. Interventional studies are recommended in order to come up with effective strategies to increase the uptake of iron supplement during pregnancy.

Pentingnya Pengetahuan Mengenai Anemia Remaja Putri di SMA N 1 Tanjung Jabung Barat

The low khowledge of teenager girl at SMA N 1 Tanjung Jabung Barat was one of the reason for distribution of iron supplemented tablets from Dinas Kesehatan Tanjung Jabung Barat. In addition, knowledge about iron supplemented tablets is also very minimal. So it is not uncommon for many reason that iron supplemented tablets are not consumed and are not properly distributed.one of efforts to overcome this problem is counseling about anemia. This activity was carried out at SMA N 1 Tanjung Jabung Barat. The implementation of this activity is from September 2020 to February 2021. The target of this activity is teenager girl of SMA N 1 Tanjung Jabung Barat. The implementation method are in the form of counseling and discussion. The results obtained in this activity were the goal of understanding the material about anemia. It is recommended that the school be able to work together with Puskesmas and Dinas Kesehatan to provide health education regularly when carry out activities to provide iron supplement tablets in order to understand the importance of knowledge about anemia