Topics: Hemoglobin, Anemia, Red blood cell Pages: 15 (3907 words) Published: November 29, 2012
بسم الله الرحمن
Background: Anaemia is common worldwide specially in developing countries where nutrient deficiencies are prevalent. It is a common problem in the outpatient set but it’s always neglected and taken lightly which can cause hyperdynamic circulation disturbances and raise the rate of morbidity and mortality. Aim: To determine the prevalence of microcytic Hypochromic anaemia in medicine emergency room casualty in academy teaching hospital. Method: This is a descriptive cross-sectional study which was done in the Academy Teaching Hospital in which 75 of the emergency room patients participated in the study. The state of nutrition of the patients was evaluated by a questionnaire answered by the patients.

Chapter One

Introduction and Literature Review

1.1 Introduction
Anaemia is defined as the reduction in the oxygen-transporting capacity of blood, which usually stems from a reduction of the total circulating red cell mass to below normal amounts. Blood haemoglobin level is below 13.5 g/dl in an adult male and below 11.5 g/dl in an adult female. (1) Classification:

Classified according to:
1. Causes:
a. Inadequate production of RBC.
b. Blood loss anaemia:
* Acute: due to acute hemorrhage.
* Chronic: due to GIT bleeding, menorrhagia.
c. Excessive destruction of RBC (haemolysis).
2. Morphology:
a. Microcytic:
* Iron deficiency.
* Thalassemia.
* Sideroblastic.
b. Microcytic:
* Folate deficiency.
* B12 deficiency.
c. Normocytic:
* Aplastic anaemia.
* Myelodysplastic anaemia.
There are many undiagnosed cases of anaemia that if left undetected can lead to several complications, those include: (2) 1. Infections: people with the anaemia are more susceptible to getting infections from viruses and bacteria. 2. Severe bleeding: if bleeding is severe, internal and excessive then death can ensue if a blood transfusion is not given and the cause of the bleeding is not treated. 3. Stroke: if haemoglobin is defective, it can damage the walls of the red blood vessels and this can result in narrowing or even blockages in the brain, which can lead to serious, life threatening strokes. (2) Microcytic Hypochromic Anaemia

Microcytic anemia is a blood disorder characterized by small red blood cells (erythrocytes) which have insufficient haemoglobin and hence have a reduced ability to carry oxygen through the body. The red blood cells are small due to a failure of haemoglobin synthesis or insufficient quantities of haemoglobin available. (3) Classification:

1. Iron deficiency anaemia
2. Sideroblastic anaemia.
3. Thalassemia.
Iron deficiency anaemia
It’s estimated to be the main cause of anaemia affecting about 10% of the population in developed countries and 25-50% in developing countries. The prevalence of iron deficiency anemia in the United States was 2 percent in adult men, but was found to be more common in child-bearing women age. (4) Total body iron content is about 2gm for females, and 6gm for males. Most of the iron within the body is found in hemoglobin within erythrocytes (80%), with the remainder being found in myoglobin and iron containing enzymes. Iron is stored in liver, spleen, bone marrow and skeletal muscle. This iron storage pool contains on average 15-20% of total body iron. (4) Iron is transported in the plasma by an iron binding protein called transferrin. In normal individuals, transferrin is about 33% saturated with iron. Dietary iron is obtained either from inorganic sources or animal sources. Dietary iron enters intestinal cells via specific transporters. The iron is then used by the cell, stored as ferritin or transferred to the plasma. (4) Erythropoiesis is the development process in which new erythrocytes are produced, through which each cell matures in about 7 days. Through this process erythrocytes are continuously produced in the red bone marrow of large bones, at a rate of...

References: 1. Mohammad Inam Danish. Medical diagnosis and management. Karachi institute of heart diseases, 2010.
4. Vinay Kummar, Abul K. Abbas, Nelson Fausto. Basic pathology. 8th edition, 2007.
5. Laura Dean. Blood Groups and Red Cell Antigens. National Center for Biotechnology Information (NCBI), National Library of Medicine, National Institutes of Health, 2005.
6. Kabanova S, Kleinbongard P, Volkmer J, Andrée B, Kelm M, Jax TW .Gene expression analysis of human red blood cells. International Journal of Medical Sciences 6, 2009 (4): 156–9.
9. Rochester, Minn. Laboratory reference values. Hematology group. Mayo Foundation for Medical Education and Research, 2011 January.
14. .mayo clinic staff, thalassemia. Mayo Foundation for Medical Education and Research (MFMER)., 1998-2012.
15. Mauro Tettamanti, Ugo Lucca, Francesca Gandini. Prevalence, incidence and types of mild anemia in the elderly. Haematol, 2010 November 1.
33. Tatala S, Svanberg U, Mduma B. Low dietary iron availability is a major cause of anemia: a nutrition survey in the Lindi District of Tanzania. Am J Clin Nutr, 1998; 68(1): 171-178.
36. Anne C. Looker, Peter R. Dallman, Margaret D. Carroll, Elaine W. Gunter, Clifford L. Johnson. Prevalence of Iron Deficiency in the United States. JAMA, 1997;277(12):973-976.
Chapter Ten
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