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Article
Complications of High Serum Ferritin Level after Splenectomy in β Thalassemic Patients

Author: Zuhair Omran Easa
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2009 Volume: 12 Issue: 1 Pages: 243-250
Publisher: University of Kufa جامعة الكوفة

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Abstract

Objectives: Compare between splenectomized and non splenectomized β -thalassemic patients regarding clinical, biochemical and therapeutic characteristics. Methods: This study was conducted on 140 patients with beta thalassemia major and thalassemia intermedia, expressed as two groups (group I) splenectomized patients and (group II) non splenectomized patients, who were attending Thalassemia Center in Karbala Teaching Hospital for Children from the first of November 2007 through 30th of April 2008. Both groups were studied by physical examination, biochemical analysis, hemoglobin level, serum ferritin, hepatitis C virus antibodies, and hepatitis B surface antigen. Echocardiography was done for most of patients. Results: In group I patients, 82.9% were under transfused and 80% were underchelated, whereas 91.4% of group II patients were under transfused and 74.3% of them were underchelated. Complications including, cardiac complications, diabetes mellitus, bone deformities, and gall stone were higher in group I than group II patients, moreover, only bone deformities was detected in β- thalassemia intermedia patients of both groups. Splenectomy was beneficial in reducing frequency of blood transfusion in 77.1% of group I patients. Conclusions: There is an aggravating effect of splenectomy on hemosiderosis. High serum ferritin level in splenectomized patients is associated with higher incidence of complications.


Article
Assessment of serum ferritin levels in thalassemia and non-thalassemia patients presented with anemia

Authors: Mohammed Mahdi Abdulomohsin AL-Zubaidi --- Khiaria Jaber Tutli Alkhtaua
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2015 Volume: 4 Issue: 1 Pages: 119-125
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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ABSTRACTBackground: Thalassemia is an autosomal genetic disease leading to anemia and remains one ofthe major health problems in Southeast Asia and other parts of the world. Almost 100,000 patientswith major thalassemia need regular transfusion. Human hemoglobin (Hb) is the molecule thatcarries and transports oxygen all through the body. Ferritin is the principal iron storage protein,found in the liver, spleen, bone marrow, and to a small extent in the blood.Objectives: The aim of this study was to assess serum ferritin levels in B-thalassemia patients,and to compare it with non-thalassemic anemia and healthy control.Materials and methods: A prospective cross sectional study conducted at Thalassemia Center inIbn Al- Baladi Hospital for Children and Women during the period from1st February to 30th May2014 during their attendance to out-patient clinic. A total .number of 101 patients complaining ofanemia (51 patients with thalassemia, 50 with non-thalassemia) in addition to 50 healthy subjectsconsidered as control. All patients were tested for Serum ferritin levels and all results wereobtained through automated quantitative test for use Vidas machineResults : The mean serum ferritin levels in cases of thalassemia was 9542 + 782 ng/ml whileserum ferritin levels in control sample was 138 +323 ng/ml in male and 28+ 108 ng/ml in female .in patients with non-thalassemia anemia, the levels of serum ferritin was 1+80 ng/ml. Age of allpatients in this study ranged from 3day-9year .the age of thalassemia patients ranged from 1-6year and p-value was(0.23) while the age of patients with non-thalassemia anemia was 1-5 yearand p-value was (0.11).Conclusion: This study confirm that serum ferritin is high in patients wih thalassemia than nonthalassemia.


Article
Serum Ferritin Concentrations in Adolescents
تراكيز الفرتين في مصل الدم عند المراهقين

Author: Shatha S. Al- Sharbatti د.شذى الشربتي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2006 Volume: 19 Issue: 1 Pages: 26-34
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract:The present study aimed to assess iron stores of Iraqi adolescents by the assessment of their serum ferritin concentration. Collection of data was carried out during the period between the 1st of November 1996 untill the end of April 1997. A sample of 241 adolescents (89 males and 152 females) was included. The study showed that the mean serum ferritin concentration in males was significantly higher than females (24.4 Vs 16.8 microgram /L). Maximum prevalence of severe depletion of iron stores (SF<12 microgram/L) in males and in females was found in the age groups 14-15 and18-19 years respectively. In menstruating females, lowest mean serum ferritin value was found in the first year after menarche. On simple linear regression, in females, significant positive correlations were observed between serum ferritin concentration and dietary intake of calorie, protein and iron and with iron bioavailability of the diet, while significant negative correlation was noticed with the number of pads used during the menstrual period. However, in males, serum ferritin concentration showed significant positive correlations with age, dietary intake of iron and iron bioavailability of the diet. In multiple regression analysis, serum ferritin concentration has significant positive correlations with gender, age-gender interaction and iron bioavailability of the diet, while in females, significant negative correlation was observed with the number of pad used during the menstrual period.Key wards: Iron stores, serum ferritin concentration, adolescents.

الملخص:تهدف الدراسة الىتقيم مخزون الحديد عند المراهقين العراقيين بواسطة تقيم مستوى تركيز الفرتين في مصل الدم. تم جمع المعلومات للفتره من بداية كانون الأول سنة 1996 و حتى نهاية شهر نيسان سنة 1997. شملت الدراسة عينه تتضمن 241 مراهق(89 ذكور و152 اناث ). أظهرت ألدراسة ان متوسط تركيز الفرتين في مصل الدم عند الذكور كان أعلى بدرجه معنويه مما هو عليه عند الأناث(24.4مقابل 16.8مايكروغرام/لتر). وجد أن أعلى أنتشار لنضوب مخزون الحديد عند الذكور و الأناث كان في الفئات العمريه 14-15و18-19سنه على التوالي. عند الأناث اللاتي يحضن , وجد ان اوطأ قيمه لمعدل تركيز الفرتين في مصل الدم كان في السنه الأولى بعد ظهور الحيض لأول مره. عند تطبيق الأرتداد الخطي البسيط, عند الأناث , لوحظ وجود أرتباط معنوي موجب بين تركيز الفرتين في مصل الدم و كل من ؛ كميه السعرات, البروتين و الحديد المتناول في الغذاء و التواجد الحيوي للحديد في الغذاء, كما لوحظ و جود ارتباط معنوي سالب مع عدد الحفاضات المستعمله اثناء فترة الحيض. من ناحيه ثانيه, عند الذكور ظهر وجود علاقه معنويه موجبه بين تركيز الفرتين في مصل الدم و كل من ؛العمر, كمية الحديد المتناول مع الغذاء و التواجد الحيوي للحديد في الغذاء. عند تطبيق الأرتداد الخطي المركب, لوحظ وجود علاقه معنويه موجبه بين تركيز الفرتين في مصل الدم و كل من؛ الجنس, تفاعل العمر مع الجنس و التواجد الحيوي للحديد في الغذاء. كما لوحظ وجود علاقه معنويه سالبه عند الأناث مع عدد الحفاضات المستعمله اثناء فتره الحيض.


Article
Iron Chelator in Patients with SickleCell Anemia, Comparative Study
طوارد الحديد لمرضى فقر الدم المنجلي ,دراسة مقارنة

Author: Talib Abduljaleel Jasim
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2014 Volume: 4 Issue: 3 Pages: 95-100
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background: the two main reasons for blood transfusion in sickle cell disease are to correct anemia so that the oxygen-carrying capacity of the blood is improved, and to treat or prevent painfulvasoocclusiveby lowering the proportion of sickle cell hemoglobin. Iron over load will be evitable.Aim: The aim of this study is to assessafety and efficiency of different chelation therapy.Patients and method:Fifty two patients divided in to two equalgroup, for treatment by combined Deferoxamine-Deferasirox therapy and on Deferasirox alone.Results: both drug regimens proved to have no adverse effect on hepatic or renal function. The degree of descend of serum ferritin is significantly higher with combined Deferoxamine-Deferasirox therapy.Conclusion: combined chelating agents have significant effect on serum ferritin, with acceptable level of safety.Recommendation: combined therapy was safe regime and can be used with good efficacy for patients with iron over load.

خلفية البحث :إنّ السببين الرئيسيين لنقلِ الدَم في مرضِ خليةِ الدم المنجلي لتُصحّح فقر الَدم لكي تحسن قابلية نقل الأوكسجين ولمنع حدوث الانسداد الوعائي بتقليل نسبة خضاب الدم المنجلي.االحمل الحديدي سيكون وارد الحصول. الهدف : إنّ هدف هذه الدراسةِ لمقارنة الأمان وكفاءةِ علاجِ مختلف طوارد الحديد.المنهجية ؛اثنان و خمسون مريض قسّموا إلى مجموعتين متساويتين، للمعالجةِ بعلاجِDeferoxamineالمشترك مع عقارDeferasiro و على Deferasiroxلوحده.أجريت الدراسةللفترة من اذار 2012 لغاية نهاية شباط 2013.عملت فحوص الفرتين و وظائف الكبد والكلى كوسائل للمتابعة والمقارنة.النَتائِج : أثبتت كلتا أنظمة العلاج أنلا تأثير مضادَّ على الوظيفةِ الكبديةِ أَو الكلويةِ .إن درجةَ هبوط الفريتين في مصلِ الدم أعلى جدا بعلاجِ Deferoxamine_ Deferasiroxالمشترك.الاستنتاج: العلاج المشترك Deferoxamine__Deferasiroxله تأثير هام على نسبة الفريتين في المصلِ بالمستوى المقبولِ مِن الأمانِ.التوصيات :العلاج المشترك كَان نظاماً آمنا ممكن استعماله بكفاءة جيدةِ لمرضى فقر الدم المنجلي ذوي الحملِ الحديدي الزائد.


Article
Iron Status in Patients with Chronic Renal Failure on Haemodialysis

Author: Safa Ez-Aldeen Al-Mukhtar
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2006 Volume: 5 Issue: 3 Pages: 318-324
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Anaemia is common in renal failure. Serum iron (SI), and the percentage of transferrin saturation(TSAT) reflect the amount of iron immediately available for haemoglobin (Hb) synthesis. Serumferritin level reflects total body iron stores. Adequate iron stores are essential for achieving maximumbenefit from recombinant human erythropoietin (Epo). A low level of either of these indices mayindicate the need for supplement iron to support erythropoiesis.METHODS:Seventy Patients with end stage renal disease (ESRD) on regular haemodialysis (HD) were included inthis study from three dialysis centers in Baghdad: We have collected data on, serum iron, total ironbinding capacity (TIBC), TSAT, Serum ferritin, and blood film, was done. Fifty subjects were includedin the control group.RESULTS:A44 patients (62.9%) were receiving regular parenteral Iron Dextran with Epo, and 26 patients (37.1%)were receiving irregular oral or intramuscular iron Dextran with Epo. According to the serum ferritin,41 patients (58.6%) involved have serum ferritin level >300ng/ml, of them; the TSAT was > 20% in27 patients while TSAT ≤ 20% in 14 patients in this group, and Hb was > 11 g/dl in 11 patients whereas ≤ 11 g/dl in 30 patients in this group. Serum ferritin in 29 patients (41.4%) was ≤ 300 ng/ml, of them, the TSAT was ≤ 20% in 26 patients and > 20% in three patients only, the Hb level was ≤ 11 g/dlin all patients in this group. There was significant correlation with anaemia. (Hb ≤ 11 g/dl) and lowserum ferritin (P<0.005), patients with TSAT ≤ 20%, all were anaemic (Hb≤11 g/dl) and there was asignificant association between these two markers (P<0.005). In patients receiving regular parenteraliron and Epo (44 patients) (62.9%), the TSAT was > 20% in 21 patients (30%), while those who takingno or irregular iron therapy with Epo (26 patients) (37.1%), the STAT was >20% in 9 (12.9%) the difference was not statically significant.CONCLUSION:The serum ferritin in our study group was higher than that reported in other studies. Serum ferritin of ≤300 ng/ml, and TSAT of≤ 20% in our study group was significantly correlated with anaemia. Serumferritin of ≤ 300 ng/ml and a TSAT of≤ 20% were significantly associated.


Article
Prevalence of Iron Deficiency in Patients with Heart Failure

Author: Dersim Muslih Hussein
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2018 Volume: 15 Issue: 4 Pages: 306-309
Publisher: Babylon University جامعة بابل

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Abstract

Background: Heart failure (HF) is a common health issue with the prevalence between 1% and 2% in public; in addition, it is a major riskfactor for mortality, morbidity, and low quality of life. The prevalence of iron deficiency (ID) in patients with chronic HF (CHF) was examinedin the present study. Materials and Methods: In the present cross‑sectional, iron parameters of patients hospitalized for CHF decompensationwere prospectively assessed within the 72 h following admission to hospital. ID was established as serum ferritin <100 μg/ml (absolute ID)and serum ferritin between 100 and 299 μg/ml with transferrin saturation <20% (functional ID) in accordance with the European Society ofCardiology HF Guidelines 2012. Results: The present study showed that the prevalence of absolute and functional iron deficiencies in patientswith CHF was 44.9% and 18.8%, respectively, and 36.2% did not have the ID. The study did not find a significant difference in ID betweenmale and female patients and between the patients with and without comorbidities. Conclusions: The present study suggests that ID is verycommon in patients admitted for CHF.


Article
Glucose Tolerance Test in Beta-Thalassemia Major in Al-Sader City

Authors: Qais Abdullah Ali Al-Salahe --- Mohammed Shaker Al-Awady --- Abas Abdalsaheb Al-Gharbawy
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 4 Pages: 550-559
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:β-thalassemia are inherited defects in the synthesis of B-globin portion of hemoglobin. The combination of transfusion and chelating therapy has dramatically extended the life expectancy of thalassemic patients.OBJECTIVE: This study is to determine the prevalence of diabetes mellitus and association of some factors with impaired glucose tolerance test in transfusion dependent β- thalassemia major.PATIENTS AND METHODS: A case-control study done on patients attending blood disease center in Ibn-Al-Balady hospital from 1st of July to 31st of October 2011. Data collected from 287 thalassemic patients (being attended the hospital for regular follow up and blood transfusion) and their relatives which included age, sex, height, weight, history of splenectomy, family history of DM, hepatitis B or C infection, serum ferritin level and an oral glucose tolerance test.RESULTS: It was found that 9.7% of β- thalassemic patients had impaired glucose tolerance test and 1.1% were diagnosed with diabetes, 32.7% were splenectomized, 38.3% had viral hepatitis infection, mean serum ferritin in those older than 20 years was 5923±1033µg/l and 16.8% had family history of diabetes. CONCLUSION: Increased serum ferritin concentration, splenectomy and viral hepatitis infection are associated with abnormal glucose tolerance in patients with blood transfused b-thalassemia. Aggressive iron-chelating therapy and prevention and treatment of viral hepatitis infection were warranted.


Article
The effect of Iron overload on PCV, hemoglobin & serum ferritin of thalassaemia major male patients
تأثير الحديد الزائد على PCV، الهيموغلوبين ومصل الفيريتين من الثلاسيميا المرضى الذكور كبير

Authors: Sara Mossa M. Marbut سارة موسى مطلك --- Moafaq Mutlak Zeidan موفق مطلك
Journal: Al-Kufa University Journal for Biology مجلة جامعة الكوفة لعلوم الحياة ISSN: 20738854 23116544 Year: 2016 Volume: 8 Issue: 3 Pages: 444-448
Publisher: University of Kufa جامعة الكوفة

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Abstract

Red blood Corpuscle transfusion therapy as supportive care for Thalassemic patients is the principal cause of iron overload in patients with especially in β-thalassaemia. As each unit of transfused packed red Corpuscles contains approximately 200-250 mg of iron, patients who are administered regular transfusions can receive a daily iron excess of up to 0.5mg/kg. The complications that occur with β-thalassaemia major are Hypogonadotrophic hypogonadism. Complication of β-thalassaemia major include: Delayed Puberty, arrested puberty and hypogonadism. Delayed puberty is defined as the absence of any pubertal sign in boys (testicular enlargement) by the age of 13 years. The aims of this study are to find out the serum concentration of hemoglobin & PCV, also to see the effect of iron overload as reflected by serum ferritin on blood parameters of male thalassaemia major. Patients & methods: A cross sectional study was conducted on β-thalassaemia major patients whom attended the thalassaemia center in Azadi Teaching Hospital from December 2013 to March 2014. Sixty six male aged (12-16 years) patients were attending thalassaemia center for routine blood transfusion. Twenty nine male subjects apparently healthy, with no family history of hereditary blood disease attendants to out-patient pediatric clinic. All thalassaemic patients included in this study were previously diagnosed as β-thalassaemia major based on the usual hematological criteria (peripheral blood evaluation and haemoglobin electrophoresis) in addition to the family history and transfusion dependence. Venous blood samples were taken from all patients & controls males for hematological & biochemical analysis. Result: There was a significant decrease (p < 0.001) in body weight & body height of thalassaemic male patients as compare with control male subjects. There were a highly significant decrease (p <0.001) in PCV & the concentration of heamoglobin (Hb) of thalassaemic male patients as compared with control male subjects. Moreover, there is significant increase in serum ferritin in male Thalassemic patients as compare with normal healthy males of same age.

أحمر كرية الدم العلاج نقل عن الرعاية الداعمة لمرضى Thalassemic هو السبب الرئيسي لزيادة تركيز الحديد في المرضى الذين يعانون خصوصا في β-الثلاسيميا. حيث أن كل وحدة من المنقول كريات حمراء معبأة يحتوي على ما يقرب من 200-250 ملغ من الحديد، يمكن للمرضى الذين يخضعون لإدارة عمليات نقل منتظمة الحصول على فائض الحديد يوميا لمدة تصل إلى 0.5mg / كغ. المضاعفات التي تحدث مع β-الثلاسيميا الكبرى هي قصور الغدد التناسلية ناقص موجهة الغدد التناسلية. مضاعفات-β التلاسيمية الرئيسية وتشمل: تأخر سن البلوغ، اعتقلت البلوغ وقصور الغدد التناسلية. ويعرف البلوغ المتأخر عن عدم وجود أي علامة البلوغ في الأولاد (الخصية توسيع) في سن 13 عاما. وتهدف هذه الدراسة إلى معرفة تركيز مصل الدم الهيموغلوبين وPCV، أيضا أن نرى تأثير الحديد الزائد كما يتضح من فيريتين المصل على مكونات الدم من الذكور رائد الثلاسيميا. المرضى والطرق: أجريت دراسة مقطعية على المرضى β التلاسيمية كبيرا منهم حضر مركز الثلاسيميا في مستشفى آزادي التعليمي في الفترة من ديسمبر 2013 إلى مارس 2014. وستين ستة من الذكور الذين تتراوح أعمارهم بين (12-16 سنة) من المرضى كانوا يحضرون مركز الثلاسيميا للدم الروتيني نقل الدم. تسعة وعشرون المواضيع الذكور اصحاء، مع عدم وجود تاريخ عائلي للمرض الحاضرين الدم الوراثية إلى عيادة طب الأطفال المرضى الخارجيين. شملت جميع المرضى thalassaemic في هذه الدراسة تم تشخيص سابقا الميجر β التلاسيمية على أساس المعايير الدموية المعتادة (التقييم الدم المحيطي والكهربائي الهيموجلوبين)، بالإضافة إلى تاريخ العائلة والتبعية نقل الدم. وتم أخذ عينات الدم الوريدي من جميع المرضى والضوابط الذكور الدموية وتحليل الكيمياء الحيوية. النتيجة: كان هناك انخفاض معنوي (p <0.001) في وزن الجسم وارتفاع الجسم من المرضى الذكور thalassaemic كما قارن مع الضابطة الذكور. كان هناك انخفاض كبير للغاية (ع <0.001) في PCV وتركيز heamoglobin (الهيموغلوبين) من المرضى الذكور thalassaemic بالمقارنة مع الضابطة الذكور. وعلاوة على ذلك، هناك زيادة كبيرة في فيريتين المصل في المرضى الذين يعانون Thalassemic الذكور كما مقارنة مع الذكور صحية طبيعية من نفس الفئة العمرية.


Article
Study of Thyroid gland function and serum circulating ferritin in Beta- thalassemia Major female patients in Tikrit city

Author: Mossa M. Marbut, Huda S. Armeet, Dr. Raja S. Najim
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2016 Volume: 2 Issue: 2 Pages: 144-153
Publisher: Tikrit University جامعة تكريت

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Article
The Association of Gestational Diabetes with Serum Ferritin

Author: Dina Akeel Salman *,Thanaa Jameel Al-Khishali **, Nada Salih Ameen ***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 1 Pages: 47-56
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND: Serum ferritin is the standard measurement for the body iron stores, and is the most reliable marker for iron status. During pregnancy, there is a gradual decline in serum ferritin level. However, elevated maternal serum ferritin was notified in women with gestational diabetes mellitus (GDM).OBJECTIVE: To investigate the association between maternal serum ferritin level and gestational diabetes. METHODS: A prospective case control study of 50 women with singleton pregnancy that had gestational diabetes compared to 50 healthy pregnant women. The study was performed in Baghdad teaching hospital for one year period from June 2010 through June 2011. Serum iron, total iron binding capacity, and serum ferritin level were assayed. Mean serum ferritin was elevated (95.6027±99 ng/ml) in women with gestational diabetes, compared to that in the control group (31.7213±42ng/ml). RESULTS: There was a statistically significant elevation of serum ferritin in women with gestational diabetes. CONCLUSION:We concluded that there is a positive association between the elevated serum ferritin and gestational diabetes.

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