The Effect of Steamed Tempeh on Hemoglobin Levels and Body Weight in Pregnant Women at the Kalar - Kalar Health Center, Aru Islands District

Background: Nutrition of pregnant women is very influential on fetal growth, one of which is iron deficiency anemia. Iron deficiency increases in pregnant women with increasing age in pregnancy. Significantly low intake of nutrients will make pregnant women experience Chronic Energy Deficiency. The nutritional content of tempeh can be used to meet the nutritional needs of pregnant women. Objective: The aim of this study was to analyze the effect of giving steamed tempeh to the increase in hemoglobin and Body Weight levels in pregnant women at the Kalar-kalar Health Center, Aru Islands Regency. Method: This type of research is a quasi-experimental with a pre-posttest control group design. The intervention was given to the respondents as many as 24 people with 12 people in the control group and 12 people in the treatment group. Sampling purposive sampling. Subjects were taken from two villages in the working area of ​​the Kalar-Kalar Public Health Center which have relatively the same geography and socioeconomic status and only pregnant women with Hb <11 G/dL were selected. The form of treatment was giving 100 G of steamed tempeh 2 times a week for 30 days while the control group was given biscuits for pregnant women 2 times per week 100 G. Data analysis used univariate and bivariate analysis with paired T test and Mann Whitney. Results: Mann Whitney test results of the effect of steamed tempeh on weight gain in the treatment group obtained a p-value of 0.050 (p=0.05). Differences in hemoglobin levels in anemic pregnant women with a p-value of 0.018 (<0.05) with a mean difference of 0.42 G/dL in the pre-posttest treatment group and the control group with a p-value of 0.217 (<0.05) with a mean difference of 0.21 G/d dL. Conclusion: There is an effect of giving steamed tempeh to increase hemoglobin and body weight in pregnant women. Keywords: Anemia, Pregnant women, Hemoglobin, Body Weight, Tempeh.

Influence of latent iron deficiency on cognitive abilities in students

The aim of the study is to assess the impact of latent iron deficiency on students' cognitive abilities. Material and methods. The study was conducted during 2018-2021 at the Department of Hygiene and Medical Ecology of Odessa National Medical University. A survey of 188 medical students aged 18-20 was conducted using a screening survey. Estimation of the qualitative content of iron compounds in the diet was performed by a calculation method using the USDA / FDA database. Persons with probable iron deficiency were examined for hemoglobin, erythrocytes, hematocrit (general clinical blood test) and serum ferritin. Additionally, the cognitive abilities of people with latent iron deficiency were assessed using MoSA, TMT, GPB, Schulte tables and TAS-20. As a control, 30 students aged 18-20 years who showed no signs of latent or overt iron deficiency were interviewed. Statistical processing was performed by methods of variance and correlation anamnesis using the software Statistica 13.0 (TIBCO, USA). Results. When evaluating diets, probable iron deficiency was identified in 69 (36.7%) students surveyed. A significant number of students reported signs of iron deficiency, namely general weakness (27 or 14.4%), increased fatigue (30 cases or 15.9%), pale skin and mucous membranes (6 or 3.2%), drowsiness (8 or 4.3%), dry mouth (11 or 5.9%), brittle hair (4 or 2.1%), bleeding gums (3 or 1.6%). In isolated cases, hyposmia, dysgeusia and dysphagia have occurred. Probable iron deficiency was found at the previous stage of the study in 29 (15.4%) patients, they subsequently underwent verifying laboratory tests. In the analysis of the obtained data, the diagnosis of mild iron deficiency anemia was confirmed in 2 (6.9%) girls. Latent iron deficiency was identified in 16 (55.2%) students, among whom girls predominated (10 people or 62.5%). Subsequent studies have shown that a significant number of students with latent iron deficiency showed moderate signs of decreased cognition. Conclusions: 1. The frequency of latent iron deficiency in the surveyed contingent was 8.5%, with an absolute predominance of girls (62.5%). 2. Latent iron deficiency in student youth can be manifested by cognitive impairment, and therefore affect academic performance. 3. The most pronounced correlation was found for ferritin content and severity of alexithymia (r = -0.61).

Quantitative Proteome and Transcriptome Dynamics Analysis Reveals Iron Deficiency Response Networks and Signature in Neuronal Cells

Iron and oxygen deficiencies are common features in pathophysiological conditions, such as ischemia, neurological diseases, and cancer. Cellular adaptive responses to such deficiencies include repression of mitochondrial respiration, promotion of angiogenesis, and cell cycle control. We applied a systematic proteomics analysis to determine the global proteomic changes caused by acute hypoxia and chronic and acute iron deficiency (ID) in hippocampal neuronal cells. Our analysis identified over 8600 proteins, revealing similar and differential effects of each treatment on activation and inhibition of pathways regulating neuronal development. In addition, comparative analysis of ID-induced proteomics changes in cultured cells and transcriptomic changes in the rat hippocampus identified common altered pathways, indicating specific neuronal effects. Transcription factor enrichment and correlation analysis identified key transcription factors that were activated in both cultured cells and tissue by iron deficiency, including those implicated in iron regulation, such as HIF1, NFY, and NRF1. We further identified MEF2 as a novel transcription factor whose activity was induced by ID in both HT22 proteome and rat hippocampal transcriptome, thus linking iron deficiency to MEF2-dependent cellular signaling pathways in neuronal development. Taken together, our study results identified diverse signaling networks that were differentially regulated by hypoxia and ID in neuronal cells.

Iron-Deficiency Anemia Related to Ancylostoma duodenale Infection in 67 Years Old Female Patient

Background. Ancylostomiasis is an infection caused by hookworms. It is estimated that hookworms infect 1.2 billion people worldwide and cause higher morbidity than other types, mainly due to iron deficiency anemia. Hookworm infection increases with age. The main clinical manifestations are abdominal pain, features of iron deficiency anemia and hypoproteinemia. Diagnosis is based on the finding of characteristic eggs in the stool. Case presentation. A 67-year-old female patient had been administered into the Internal Medicine Ward of Dr. M. Djamil Padang Hospital with the main complaint of weakness, fatigue, and lethargy which had increased since 3 days before being admitted to the hospital. The patient also had complaints of pale skin, fever, heartburn, decreased appetite and weight loss. The patient was admitted to the hospital with awareness of compost mentis, cooperative, and his general condition appeared to be moderately ill, blood pressure 130/90 mmHg, pulse rate 104 x/minute, regular pulse, adequate filling, respiratory rate 22 x/minute, temperature 37.8 C. On physical examination, the conjunctiva of the pantient’s eyes were anemic. Laboratory examination revealed Hemoglobin 4 g/dl, Hematocrit 16%, MCV/MCH/MCHC 62fl/15pg/25g/dL, Reticulocytes 0.5%, SI/TIBC 22/315 mg/dL, Ferritin 8.5 ng/mL, and peripheral blood smear showing severe hypochromic microcytic anemia and relative eosinofilia. Ancylostoma duodenale worm eggs were found on routine stool examination. Final diagnosis was Severe microcytic hypochromic anemia caused by an iron deficiency and Ancylostomiasis. Severe microcytic hypochromic anemia caused by iron deficiency and ancylostomiasis was established based on the patient’s history, physical examination and laboratory investigations. Conclusions. Hookworms infect many people worldwide and cause high morbidity, mainly due to iron deficiency anemia. The highest prevalence is found in the tropics and subtropics, including Indonesia. The main clinical manifestations are abdominal pain, features of iron deficiency anemia and hypoproteinemia. Diagnosis is based on the finding of characteristic eggs in the stool. Albendazole 400 mg single dose resulted in 80% cure and a dose of 200 mg/day for 3 days gave 100% cure. Treatment of anemia is by administering ferrous sulfate or ferrous gluconate orally 200 mg three times a day and continued for up to 3 months after normal hemoglobin levels are achieved to maintain iron stores.

Changes of Serum Ferritin, Hemoglobin, and Serum Iron (SI) and Treatment Effect of Iron Proteinsuccinylate Oral Solution Combined with Vitamin A and D Drops on Children with Nutritional Iron Deficiency Anemia

Objective. The purpose was to evaluate the treatment effect of iron proteinsuccinylate oral solution combined with vitamin A and D drops on children with nutritional iron deficiency anemia. Methods. 124 children treated in the outpatient department of our hospital from January 2017 to January 2020 were selected as the study subjects. They were randomly divided into control and observation two groups. The control group was treated with iron proteinsuccinylate oral solution (1.5 mL/kg) in the morning and evening, respectively. The observation group received adjuvant treatment with oral vitamin A and D drops based on the treatment of the control group. The treatment effect of proteinsuccinylate oral solution combined with vitamin A and D drops was evaluated by the serum iron (SI), serum ferritin (SF), and transferrin (TRF) levels, the values of CD3+, CD4+, and CD4+/CD8+, and other evaluation indicators. Results. After treatment, the SI and SF levels of children in both groups significantly increased ( P < 0.01 ) while the TRF level significantly decreased ( P < 0.01 ), and the SI and SF levels in the observation group increased more significantly, and the TRF level decreased more significantly compared with those in the control group ( P < 0.01 ). After treatment, the values of CD3+, CD4+, and CD4+/CD8+ of children in both groups significantly increased compared with those before treatment ( P < 0.01 ), and the values of CD3+, CD4+, and CD4+/CD8+ increased more significantly in the observation group compared with those in the control group ( P < 0.01 ). In addition, the evaluation results of treatment effect showed that the markedly effective rate in the observation group was significantly higher than that in the control group ( P < 0.01 ). Conclusion. Iron proteinsuccinylate oral solution combined with vitamin A and D drops can better improve the anemia symptoms in children, with high application value.

Prevalence and associated risk factors of iron deficiency without anemia among school adolescents in Mbouda, Western Cameroon

Background: Adolescents are a particularly vulnerable age group to iron deficiency without anemia (IDWA). This study aimed at determining the prevalence and associated risks factors of IDWA among apparently healthy school teenagers in Mbouda, West-Cameroon.Methods: The 778 blood samples were randomly collected from adolescents aged 10-19 years of four schools in Mbouda. Appropriate indicators including haemoglobin and haematocrit, serum iron, ferritin, transferrin, and total iron binding capacity, transferrin saturation were determined using standard methods.Results: The overall prevalence of IDWA was 40.4%. High significant difference in the mean values of serum iron (p≤0.001), serum ferritin (p≤0.001), TIBC (p=0.007), CST (p≤0.001) were observed in participants with IDWA compared to those without IDWA. The sociodemographic risk factors of IDWA in school adolescents were school site (p=0.022; 0.14 (0.90-1.43) and period of menstruation (p=0.015; 1.48 (1.083-2.03). Consumption of roots-tubers [OR: 0.92 (0.48-1.77)] legumes [OR: 2.65 (1.91-3.67)], cereals [OR: 0.90 (0.67-1.22)], increased the risk of IDWA while consumption of vegetables [OR: 0.29 (0.22-0.39)], eggs [OR: 0.66 (0.49-0.90)], and fish-shrimp [OR: 0.172 (0.10-0.295)] decreased the risk of IDWA. Meal consumption frequency had a statistically significant association with IDWA (p≤0.001).Conclusions: This study identified that IDWA was a major public health in adolescents. This study will help in planning and implementation of the policy for prevention of IDWA in adolescents.

Developmental iron deficiency dysregulates TET activity and DNA hydroxymethylation in the rat hippocampus and cerebellum

Iron deficiency (ID) during neurodevelopment is associated with lasting cognitive and socioemotional deficits, and increased risk for neuropsychiatric disease throughout the lifespan. These neurophenotypical changes are underlain by gene dysregulation in the brain that outlasts the period of ID; however, the mechanisms by which ID establishes and maintains gene expression changes are incompletely understood. The epigenetic modification 5-hydroxymethylcytosine (5hmC), or DNA hydroxymethylation, is one candidate mechanism because of its dependence on iron-containing TET enzymes. The aim of the present study was to determine the effect of fetal-neonatal ID on regional brain TET activity, Tet expression, and 5hmC in the developing rat hippocampus and cerebellum, and to determine whether changes are reversible with dietary iron treatment. Timed pregnant Sprague-Dawley rats were fed iron deficient diet (ID; 4 mg/kg Fe) from gestational day (G)2 to generate iron deficient anemic (IDA) offspring. Control dams were fed iron sufficient diet (IS; 200 mg/kg Fe). At postnatal day (P)7, a subset of ID-fed litters was randomized to IS diet, generating treated IDA (TIDA) offspring. At P15, hippocampus and cerebellum were isolated for subsequent analysis. TET activity was quantified by ELISA from nuclear proteins. Expression of Tet1, Tet2, and Tet3 was quantified by qPCR from total RNA. Global %5hmC was quantified by ELISA from genomic DNA. ID increased DNA hydroxymethylation (p=0.0105), with a corresponding increase in TET activity (p<0.0001) and Tet3 expression (p<0.0001) in the P15 hippocampus. In contrast, ID reduced TET activity (p=0.0016) in the P15 cerebellum, with minimal effect on DNA hydroxymethylation. Neonatal dietary iron treatment resulted in partial normalization of these changes in both brain regions. These results demonstrate that the TET/DNA hydroxymethylation system is disrupted by developmental ID in a brain region-specific manner. Differential regional disruption of this epigenetic system may contribute to the lasting neural circuit dysfunction and neurobehavioral dysfunction associated with developmental ID.

A Life Course Approach to the Prevention of Iron Deficiency Anemia in Indonesia

Iron deficiency anemia (IDA) has a long-term impact on each life stage and remains worldwide a major public health problem. Eleven experts were invited to participate in a virtual meeting to discuss the present situation and the available intervention to prevent iron deficiency anemia in Indonesia. The experts consisted of obstetric gynecologists, pediatricians, nutritionists, midwives, a clinical psychologist, and an education expert. Existing interventions focus attention on preconception and early childhood stages. Considering the inter-generational effects of IDA, we call attention to expanding strategies to all life stages through integrating political, educational, and nutritional interventions. The experts agreed that health education and nutritional intervention should be started since adolescence. Further research to explore the effectiveness of these interventions would be important for many regions in the world. The outcome of this Indonesian consensus is applicable worldwide.