ObjectivesThis study aimed to understand the impact of iron deficiency anemia in female users of a hematology service in a developing country.DesignRetrospective cross-sectional study of adult and adolescent women with iron deficiency anemia who presented to a hospital department of hematology.SettingA tertiary university hospital inpatient and outpatient hematology service.ParticipantsAll female patients who were ≥13 years of age with confirmed iron deficiency anemia and received hospital hematology services.ResultsA total of 208 patients were enrolled and analyzed in the registry. The mean age of the patients was 41.4 years (range, 14–82). A total of 195 patients had anemia that was moderate or severe according to the World Health Organization anemia classification with 13 patients having mild anemia. A total of 108 patients had comorbidities, which were primarily endocrine and cardiovascular. Iron deficiency anemia was associated with very heavy (n = 56, 30%) or heavy menses (n = 84, 45%) in 140 patients and was associated with poor (<200 g/week of red meat) (n = 101, 54%) or very poor (vegan, strict vegetarian) nutrition (n = 34, 18%) in 135 patients. A total of 101 patients had a previous pregnancy history with a mean of six previous pregnancies (range, 1–11 pregnancy episodes per patient). Blood film was performed on all patients; only four had a picture consistent with thalassemia minor.ConclusionIron deficiency anemia is caused by multiple factors. Heavy menses and low consumption of red meat were found to be associated with the severity of anemia. Our findings may be useful for healthcare planners and policy makers in increasing efforts to reduce the prevalence and severity of iron deficiency anemia among women in Jordan.
Unusual clinical course Background:Spinal cord injuries (SCI) resulting from various types of accidents have a known onset, unlike other progressive neurological diseases. Nonetheless, in most cases, the resulting disability permanently affects the individual's quality of life due to the limited outcome of available treatment options. The neurological deficit associated with SCI results from primary injury induced by the physical trauma and secondary injury involving inflammation, spinal tissue degeneration, and scar formation. Stem cells of different origins and using different treatment protocols have been tried to minimize aspects of secondary injury in the spinal cord. Case Report:In this case report, we evaluated the safety and efficacy of intrathecal injections of Wharton's Jelly-derived mesenchymal stem cells (WJ-MSCs) in a patient with chronic traumatic complete SCI. The findings indicated that the treatment was safe with no serious adverse events related to the procedure or administration of stem cells. The long-term follow-up period showed sustained sensory and motor function improvements with enhanced quality of life scores. Conclusions:The results imply a potential role of WJ-MSC in the treatment of chronic and severe SCI. As indicated by previous studies, the mechanism of action points mainly to the ability of MSCs to protect the neural elements that survived the initial mechanical insult by modulating the immune response and promoting neuronal regeneration.
Reticulocyte hemoglobin (CHr) is a measure of the amount of hemoglobin in reticulocytes and a marker of cell hemoglobinization. In this study, we aimed to find the optimal cut-off point for reticulocyte hemoglobin to diagnose iron deficiency anemia using multiple methods. A total of 309 patients were included. The median age at diagnosis was 54 years. Most were females (71.2%). 68% had iron deficiency anemia. Patients with IDA had significantly lower levels of CHr compared to those who had non-IDA (p < 0.0001). The optimal cut-off value of CHr for detecting IDA, determined using various methods, was 30.15 pg. This cut-off point had a sensitivity of 87.8% and a specificity of 77.7%. CHr showed a significant positive correlation with hemoglobin, mean corpuscular volume, serum iron, serum ferritin, and transferrin saturation and a significant negative correlation with total iron-binding capacity. CHr levels correlate with most established laboratory tests for IDA. It reliably detects IDA. Our results indicate the importance of CHr in diagnosing IDA, and that CHr should be used more widely in suspected cases of IDA since it is a cheap, fast, and reliable test.
About 12% of all lymphoid tumors worldwide are peripheral t cell lymphomas, which are uncommon subtypes of non-hodgkin lymphoma. they have a poor prognosis and are more common in populations and countries in asia. T cell lymphomas with gamma delta t cell receptors expressed in them are very rare (less than 1% of lymphoid neoplasms) and extremely aggressive; they originate from gamma delta t cells; a small subset of peripheral t cells with direct antigen recognition capability acting at the interface between innate and adaptive immunity . Lymphoid tissue, skin, gastrointestinal tract, and the red pulp of the spleen are where gamma delta t lymphocytes tend to cocentrate, representing only 1-5% of the total circulating lymphocytes, but accounting for up to 30% of the entire t cell population. In contrast to alpha beta t cells, gamma delta t lymphocytes develop from cd4/cd8 thymic precursors in the bone marrow and usually lack the major histocompatibility complex restriction. These lymphocytes conduct as cytotoxic cells similar to natural killer cells in their activity as early effectors of innate, non-specific immune response and are capable of t cell receptor rearrangement as well as phagocytosis. Hepatosplenic t cell lymphoma and primary cutanous gamma delta cell lymphoma are recognized as two different gamma delta t cell lymphoma entities. A well characterized extranodal lymphoma, hepatosplenic t cell lymphoma has a disguised onset, secondary to intrasinusoidal infiltrationn of the spleen, liver, and bone marrow, has a rapidly progressive course, is poorly responsive to chemotherapy. A panniculitis-like clinical picture with prominent epidermal involvement can be a presentation of primary cutaneous gamma delta t cell lymphoma. In this case study , the authors will discuss a case of 19 year old male patient present with a lupus like malar rash and hepatosplenomegaly and who had been diagnosed with gamma delta t cell lymphoma.
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