To evaluate the effect of tea drinking on the occurrence of microcytic anemia in infants, we studied 122 healthy infants who underwent routine blood counts at the age of 6-12 months. An overall high frequency of anemia (Hb less than 11 gm/dl-48.4%), microcytosis (MCV less than 70 Mm3-21.3%) and microcytic anemia (19%) was found in the whole group. The percentage of tea drinking infants with microcytic anemia (32.6%) was significantly higher than that of the non-tea drinkers (3.5%). The daily amount of tea drinking was 50-750 ml (median 250 ml). The tea drinkers had significantly lower mean levels of hemoglobin than that of the non-tea drinkers (10.5 +/- 1.2 gm/dl vs 11.2 +/- 0.8 gm/dl, respectively) and significantly lower mean levels of mean corpuscular volume than that of the non-tea drinkers (71.5 +/- 7.1 micron 3 vs 76.1 +/- 4.6 micron 3). There were no significant differences between the two groups in their sex distribution and in the duration of breast feeding. The two groups differed with regard to their ages and social class but a multivariate analysis had excluded the possible confounding effect of these differences on the hematological results. Based on our finding we do not recommend giving tea to infants whose main source of iron is from milk, grains, vegetables or medicinal sources.
Aggressive surgical resection, achieving complete resection, can lead to prolongation of life and may be a potential cure for patients with gastrointestinal stromal sarcoma.
Kidney transplantation at the time of the COVID-19 pandemic is challenging. Modifying the immunosuppression protocols is controversial and not evidence based. In this study, we aim to review the published literature of kidney transplant recipients who encountered COVID-19.
A literature review was performed using PubMed, ScienceDirect, and World Health Organization databases to identify relevant English-language articles published up to May 7, 2020.
There were 24 articles that reported 129 kidney transplant recipients who encountered COVID-19. The age mean was 54.2 years with 73.7% as males. The most commonly reported presentations in order were fever (82.3%), cough (58%), shortness of breath (33.2%), and fatigue (30.7%). Acute kidney injury was observed in 34.1% of patients. Kidney transplant patients encountered COVID-19 were maintained on tacrolimus (Tac, 92%), mycophenolate mofetil (MMF, 78.8%), and prednisone (Pred, 77%) and were manage by holding MMF in 79.1% of patients and holding Tac in 34.4% of patients. In all, 20% of patients needed Intensive Care Unit (ICU) admission and 24.6% of patients required mechanical ventilation. In all, 18.8% of patients had died compared to the reported general population COVID-19 mortality of 3.4%.
The clinical presentation of COVID-19 in kidney transplant recipients may be different from the general population with a higher rate of severe disease, complications including renal failure, and mortality.
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