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The lack of response could be attributable to reasons including limited compliance or presence of
other factors that limit the response such as vitamin A deficiency (3, 18). Delhi: UNICEF Regional
Office for South Asia, 1997:75-124. - - 51 Page 61. In a subset of women with initial haemoglobin -
- 2 Page 139. The women were provided with a plastic container to collect a sample of faeces. This
study was nested into an iron supplementation trial in pregnant women in Bangladesh, where the
response in haemoglobin concentration was compared between daily and weekly iron
supplementation and in this process differentiating between biologically and behaviourally induced
differences such as compliance (3). Women of all SES groups are affected by anaemia irrespective of
age and parity. A full-time field supervisor, who had several years of experience in organising surveys
on health and nutrition, directly supervised the daily activities. This number of weeks rather than the
number corresponding to the hemoglobin assessment was better associated with hemoglobin
response. Results from an iron supplementation study in pregnant women in Tanzania indicated
maximum response at a similar amount of iron (29). The women were aged 15-45 years, married,
apparently healthy and reportedly non-pregnant at the time of the survey. In the context of this
thesis, the term compliance has been used to refer the extent to which women follow daily and
weekly regimens of iron supplementation, respectively. The number of globin subunits in the
hemoglobin quaternary structure differs between species. Number of iron tablets actually consumed
was, thus, not randomised and there was a potential risk for confounding. Dhaka: Bangladesh
Bureau of Statistics, Ministry of Planning, 2000. 105. FAO. The State of Food Insecurity in the
World 2001. However, in the thesis, data on iron status at baseline during pregnancy and at 6 weeks
post partum are presented. This sampling method has been recommended in health studies in low
income countries15. Am J Clin Nutr 1996;64:386-374. 30. Galloway R, McGuire J. Washington,
D.C.: International Nutritional Anemia Conssultative Group, World Health Organization, United
Nations Children's Fund, 1998. 8. Yip R. Iron deficiencies: contemporary scientific issue and
international programmatic approaches. Iron Deficiency: Pathogenesis, Clinical Aspects, and
Therapy. Hemoglobin concentration (Hb) at week 4, 8 and 12 as functions of number of tablets taken
at week 3, 7 and 11, respectively. It was hypothesized that a first dose of iron would load the mucosa
with iron and block subsequent doses from absorption (1, 2). What proportion of anaemia is due to
iron deficiency. To detect difference between two independent groups, student’s t-test was used.
Considering the potential negative effects of larger than necessary amounts of iron there is an urgent
need for further research establishing what is required, in particular in populations where parasite
infestation aggravate the severity of iron deficiency. In the catchment area of these ANCCs a total of
611 pregnant women with fundal height - - 4 Page 79. As indicated in the model, compliance is
hypothesised to be affected by the dose frequency of iron supplementation and also by the side
effects that are experienced due to ingestion of iron compounds. The results from the analyses using
tablet intake as an independent variable are robust and the estimated effects were not affected by
confounding factors. All analyses were tested for potential confounding effect of maternal age,
parity, initial hemoglobin concentration, fundal height and SES. It plays a role in cellular redox
reactions and in the transport of oxygen. Daily iron supplementation is more effective than twice
weekly iron supplementation in pregnant women in Pakistan in a randomized double-blind clinical
trial.
Although pregnant women are most frequently affected, it is also prevalent in non-pregnant women
and other population groups including children (6). Surprisingly, in an era of high technology
precision medicine, many pregnant women are iron deficient, anemic, and not receiving adequate
iron supplementation. About 20% of women, 50% of pregnant women and 3% of men do not have
enough iron in their body. An SES score was constructed using a combination of the previously
mentioned three SES indicators. Statistics Make data-driven decisions to drive reader engagement,
subscriptions, and campaigns. However, the theory has so far not been supported by human studies.
This bias may have decreased the estimated efficacy of daily supplementation. However, for the first
4 weeks of supplementation, it has been shown that there is a considerable overlap in tablet intake
(14) as many of the women in the daily group took fewer tablets and weekly women took more
tablets than prescribed. Low serum iron and ferritin levels with an elevated TIBC are diagnostic of
iron deficiency; while low serum ferritin is virtually diagnostic of iron deficiency, normal serum
ferritin can be seen in patients who are deficient in iron and have coexistent diseases (eg, hepatitis or
anemia of chronic disorders); these test findings are useful in distinguishing iron deficiency anemia
from other microcytic anemias. Therefore, it does not quantify the number of tablets taken. Thus, the
trial effectiveness analysis could not be confounded by these factors. GIFs Highlight your latest
work via email or social media with custom GIFs. Structures range from monomeric to a variety of
multimeric arrangements. Women of reproductive age in low income countries who are currently not
pregnant are also affected by anaemia8. Lastly, the model assesses the effect of iron supplementation
during pregnancy by comparing the two dose frequencies, i.e., daily and weekly, and examines the
occurrence of side effects as a potential determinant of compliance. The same cause of insufficient
plasma volume expansion might also have resulted in low sFt. Low impact of side effects on
compliance was also found in a study in Tanzania where only a third of non-compliance was
explained by occurrence of side effects and, therefore, a large part of non-compliance remained
unexplained (29). While these losses did not result in a difference in baseline characteristics between
daily and weekly regimens, there was a difference in sFt between the groups. Poor compliance limits
the programme effectiveness (28, 80-82). The study indicated that the efficacy of a 12-week daily
regimen during pregnancy was higher as compared to weekly, but also suggested that in a longer
supplementation period the effect of a weekly regimen could approach that of daily. In chronic iron
deficiency anemia, the cellular indices show microcytic and hypochromic erythropoiesis—that is,
both the mean corpuscular volume (MCV) and the mean corpuscular hemoglobin concentration
(MCHC) have values below the normal range for the laboratory performing the test. Differences in
baseline characteristics between groups were tested by Student’s t-test. In Bangladesh, 50 antenatal
care centres were randomly assigned to prescribe either a weekly or daily supplementation regimen
(86 women in each group). In the rural setting of Bangladesh, most women are present around their
houses and the cultural practice is for men to be responsible for most of the outside activities
including food purchase. Add Links Send readers directly to specific items or pages with shopping
and web links. The system has been shown to have an accuracy and precision similar to the standard
cyanmethaemoglobin method (112). In pregnant women IV iron has fewer gastrointestinal side
effects than oral iron. 16 Many severely iron deficient patients need 1,000 mg of iron to resolve their
deficit. Each of the antenatal care centers was randomly assigned to prescribe one of the
interventions: one supplement daily or two supplements each Friday. The procedures to control for
confounding were rigorous, as described in the methods section. Absorption of non-heme iron is
reduced by consumption of dairy products, coffee, tea, and chocolate.
New York: Taylor and Francis, 1987. 51. Hershko C. Iron and infection. New York: Raven Press,
1992. 52. Brabin B, Ginny M, Sapua J, Galme K, Paino J. Weekly staff meetings were held with all
members including the field co-ordinator to review the study progress and to discuss activities - - 23
Page 33. The comparison of trial effectiveness of supplementation regimens showed the actual
difference in hematological effect over a 12 weeks period including the effect of differential
compliance. Confounding factors The main outcome variable in most of the analyses presented in the
thesis is haemoglobin concentration. It is, therefore, possible that not only anaemic women but also
women with high haemoglobin can be iron deficient and in need of iron supplementation.
Consequently, treatment with IV iron may be especially appropriate for women with iron deficiency
anemia in the third trimester of pregnancy. It plays a role in cellular redox reactions and in the
transport of oxygen. Structures range from monomeric to a variety of multimeric arrangements. A
possibility is that women from higher SES had a better understanding of the importance of iron
supplementation and were more motivated to continue the supplementation despite the felt
symptoms of side effects. KavyasriPuttamreddy Seminario Biologia Molecular - Susana Cano V.pdf
Seminario Biologia Molecular - Susana Cano V.pdf susiedapp 1. GP Chi tren hay l? kho c?n xem
nhi?u.pdf 1. GP Chi tren hay l? kho c?n xem nhi?u.pdf HongBiThi1 GERIATRIC
PHARMACOLOGY Geriatric pharmacology is a specialized field focusing. While an increased
compliance was found in the study, this was not due to a less frequent occurrence of side effects.
Am J Obstet Gynecol 1951;62:947. 16. Grover V, Usha R, Kalra S, Sachdeva S. Greater doses do
not result in more iron absorption and are associated with more side effects. 14,15 (See “Start using
alternate-day oral iron dosing, and stop using daily iron dosing.”) Start using alternate-day oral iron
dosing, and stop using daily iron dosing Recent research reports alternate-day oral iron dosing
compared with daily oral iron dosing results in higher absorption of iron. Am J Clin Nutr
1992;55:985-988. 15. Murphy J, O'Riordan J, Newcombe R, Coles E, Pearson J. It has been
calculated that severe anaemia is associated with a 4.5-fold risk of maternal death in low income
countries21. Am Clin Prod Rev 1987;6:22-25. 113. BRAC. Socio-economic development and health:
a baseline survey in Matlab, 1992. At 6 weeks post partum, there was a dose-dependent effect of iron
supplementation that did not differ between the two regimens. Malaria is not endemic and no case of
HIV has been reported in the region. Underestimation as the increment in hemoglobin concentration
may have been lower due to loss of more responsive women. Lotta, you have taught me to think
hard, be analytical and critical in research. Subjects and methods Study area The study was
conducted May-November 1997 in rural Mymensingh, Northern Bangladesh.
Haemoglobinconcentration was measured on a capillary blood sample by
cyanmethaemoglobinmethod. Predicted efficacy of a 12-week daily and weekly regimens from
scatter plot fitting of Lowess curve. Around 38% of the women suffer from chronic energy
deficiency (BMI - - 14 Page 24. This might have biased the impact on final sFt when compared
between groups. Am J Obstet Gynecol 1991;164:59-63. - - 21 Page 114. Am J Clin Nutr
1994;60:286-292. 120. Olukoya A, Abidoye R. Mean hemoglobin concentration for each antenatal
care center was calculated and compared between the regimens. Capillary blood samples were,
however, used to assess haemoglobin concentration at 4 and 8 weeks of the supplementation. In
order to design an effective intervention for the prevention and control, the aetiology of anaemia
should be clearly investigated to design a package of community-specific intervention programme
including iron supplementation to effectively address the problem of anaemia as well as iron
deficiency. - - 44 Page 54.
Dhaka: Helen Keller International and Institute of Public Health Nutrition. GIFs Highlight your
latest work via email or social media with custom GIFs. Average number of tablets taken was 52 in
daily and 23 in weekly, corresponding to mean compliance of 68% and 104%, respectively. The
sampling and handling of blood were routinely checked for safety. Therefore, an indicator of iron
deficiency is required that identifies who would respond to iron supplementation and, thus, receive
the potential health benefits. A study of intestinal parasites in antenatal clinic patients in Lagos. At 6
weeks post partum, there was a dose-dependent effect of iron supplementation that did not differ
between the two regimens. Nutr Rev 1996;54:318. 3. Ekstrom E-C, Hyder S, Chowdhury A,
Chowdhury S, Lonnerdal B, Habicht J-P, et al. Make volume up to 100ml with iron free distilled
water. As described earlier in the thesis, there was a steep response for the first 20 tablets consumed
and a maximum effect on haemoglobin concentration was observed after the intake of a total of 40
tablets. Inflammations, which are common in countries like Bangladesh, can elevate sFt
concentration and lead to underestimation of the proportion with low iron stores (Baynes et al,
1994; Olivares et al, 1995; Lipschitz, 1990). After a pregnant woman was identified, she was visited
at her house by one of the interviewers to confirm the pregnancy and to control the inclusion criteria
of fundal height - - 36 Page 46. It is known that haemoglobin concentration can be associated with
age, parity, gestational age, SES and parasitic infestations. In the comparison of efficacy between the
daily and weekly regimens, the main determinant tested was the amount of iron supplements
consumed (Paper III). For example, a woman who reported that she had formal schooling, was
economically non- deficit and had more than 0.5 acre of land, was given an SES score of 3. The
microscopic examination was performed using a semi-quantitative technique (115). A weekly
supplementation schedule has been suggested to produce fewer side effects and consequently
increase compliance (1). Br Med J 1969;1:218-222. 84. Schultink W. Iron supplementation
programmes: Compliance of target groups and frequency of tablet intake. Seorang pasien wanita
berusia 46 tahun mengeluh sakit dalam mulut yang berulang terutama di lidahnya selama hampir 5
tahun. Measurements were taken in cm with a standard plastic tape. The comparisons are those
between allocation of daily and weekly regimens respectively, disregarding level of compliance.
Health Zone Reply Delete Replies Reply Micheal Alexander 29 May 2021 at 07:09 I have found that
this site is very informative, interesting and very well written. Weekly staff meetings were held with
all members including the field co-ordinator to review the study progress and to discuss activities - -
23 Page 33. However, community-based trials have repeatedly shown that weekly regimen is as
effective as daily. Washington, D.C.: International Nutritional Anemia Consultative Group, 1988. 74.
Kim I, Hungerford D, Yip R, Zyrkowski C, Trowbridge F. In a survey of 179 rural non-pregnant
women (15-45 years), anaemia (Hb An iron supplementation trial was conducted in 50 antenatal care
centres randomly assigned to provide women with either 60 mg iron daily or 2 x 60 mg once weekly
from second trimester to 6 weeks post partum. Geneva: Administrative Committee on Coordination:
Subcommittee on nutrition. Subtypes are classified by the size of RBCs, chronicity, and etiology.
Adherence to iron supplementation during pregnancy in Tanzania: Determinants and heamtologic
consequences. Postgraduate Diploma in Hospital Management and Operational Excellence - Broc.
Bo Lonnerdal of Department of Nutrition, University of California, Davis for assisting in the
laboratory analysis and valuable comments on a number of manuscripts. A small proportion of
women (13%) had both high sTfR and high sFt. The result can be compared with “intent-to-treat”
analyses in the studies done in Indonesia (95), Malawi (94) and in Pakistan (93). Regression model of
hemoglobin concentration (Hb) at 4 wk as a function of initial Hb, tablet intake the first 3 wk and
supplementation group and the interaction between tablet intake and group; subset with initial Hb
Covariate. The blood supply of the tongue originates from the external carotid artery, and the
innervation is through cranial nerves. Although the plan was to treat them according to the WHO
recommendation during pregnancy, the drug was provided after childbirth as per the suggestion of
the local medical authorities. It plays a role in cellular redox reactions and in the transport of oxygen.
The women were provided with a plastic container to collect a sample of faeces. J Nutr
2000;130:2697-2702. 94. Young MW, Lupafya E, Kapenda E, Bobrow EA. The deficiency may also
be overestimated as sFt normally decreases after the first trimester (Taylor et al, 1982). Effect of iron
supplementation on the iron status of pregnant women: consequences for newborns. They have a
high population density and are located on the plain of agricultural land. Anemia of iron deficiency
represent the problem of serious society health because affecting at physical growth and psychical,
behavior and work. Altered fetal growth: antenatal diagnosis by symphysis-fundal height in India in
comparison with western charts. Firstly, the population may have responded to a limited extent due
to low intake of supplements, lower contribution of iron deficiency than what was expected or
presence of causal factors other than iron deficiency such as deficiency of vitamin A (46). The lack
of response could be attributable to reasons including limited compliance or presence of other factors
that limit the response such as vitamin A deficiency (3, 18). International Council for Standardization
in Haematology (ICSH) and is. Efficacy and trial effectiveness of weekly and daily iron
supplementation among pregnant women in rural Bangladesh: disentangling the issues. Bottle-
opening events that occurred on the first and last day were discarded as they did not provide
information on a full day. Based on an experiment in rats (32), it was hypothesised that a first dose
of iron would load the mucosa and block subsequent doses from absorption. Kata kunci: Anemia,
anemia defisiensi besi, produktivitas Abstrack: Iron deficiency anemia is a decrease in the number of
red blood cells caused by too little iron. There was no difference in anaemia prevalence in daily and
weekly regimens neither after 12 weeks supplementation nor at 6 weeks post partum (Table 5). It
was hypothesized that a first dose of iron would load the mucosa with iron and block subsequent
doses from absorption (1, 2). Among these, haemoglobin is involved in the delivery of oxygen from
the lungs to the tissues and transfer of carbon dioxide from the tissues to the lungs. It plays a role in
cellular redox reactions and in the transport of oxygen. J Gen Intern Med. 1992;7(2):145-153.
Dietary iron Iron in food is present in heme (meat, poultry, fish) and non-heme forms (grains, plant
food, supplements). The study reveals that: 1.While analyzing the heights (cm) for adolescent girls
both in normal and anaemic group it was found that there is statistically significant difference
between the adolescent girls of particular age group (15 years) and recommended values. The
prevalence of iron deficiency anaemia during pregnancy ranged from 10% to 33% depending on the
indicator used to define iron deficiency. However, the theory has so far not been supported by
human studies. An analysis of anemia and pregnancy-related maternal mortality.
Of five gastro-intestinal side effects assessed, vomiting occurred more frequently in weekly (21%)
than in daily (11%, p supplementa-tion, Pregnant woman, Bangladesh - - 2 Page 125. To browse
Academia.edu and the wider internet faster and more securely, please take a few seconds to upgrade
your browser. Lars-Ake, my studies in Sweden would not have been possible without you making the
necessary funds available. It is differentiated from prevalence, which refers to all cases in the
population at a given time. Subjects Through household visits, all reproductive aged women serviced
by 50 ANCCs were screened for pregnancy. It is divided into 3 segments: the duodenum, the
jejunum, and the ileum. Gastrointestinal side effects include nausea, flatulence, constipation,
diarrhea, epigastric distress, and vomiting. It plays a role in cellular redox reactions and in the
transport of oxygen. Reduction of anaemia is dependent on the actual number of iron tablets
consumed rather than on supplementation regimen. The weekly regimen provided a large part of this
amount, explaining the limited difference in effect. The prevalence of iron deficiency increased at
lower Hb concentration. However, while some of the community-based trials testing the mucosal
block theory in practice have demonstrated a larger effect of daily supplementation (6) the difference
has been less than could be expected from differences in amounts of iron between the regimens. A
study in Tanzania showed that women experiencing side effects reduced their iron supplement
intake by one-third, but a large part of the non-compliance remained unexplained when the impact of
side effects had been taken into account (12). Dhaka: Research and Evaluation Division,BRAC,
1994. 18 BBS. Report of the Poverty Monitoring Survey. Seminario Biologia Molecular - Susana
Cano V.pdf Seminario Biologia Molecular - Susana Cano V.pdf 1. GP Chi tren hay l? kho c?n xem
nhi?u.pdf 1. GP Chi tren hay l? kho c?n xem nhi?u.pdf GERIATRIC PHARMACOLOGY Geriatric
pharmacology is a specialized field focusing. The clinical measurement of serum transferrin receptor.
Anemia berkembang perlahan setelah toko besi normal dalam tubuh dan sumsum tulang sudah
kehabisan. The estimation of effect per tablet between the groups was thus based on different mean
number of tablets taken. As there was no severe anaemia in our study population, and if this is the
situation in a larger part of Bangladesh, such screening does not remain an option to improve
effectiveness of anaemia control programs. For programs aimed at treating and preventing anaemia
during pregnancy in Bangladesh, there appears to be no shortcuts. Indian J Pathol Microbiol
1995;38:273-279. 19. Steer PJ. Maternal hemoglobin concentration and birth weight. Iron intake was
assessed by a food frequency questionnaire. Information of socio-economic status and reproductive
history were obtained through home-visits and blood samples were collected at health centres. A
galactic microquasar mimicking winged radio galaxies A galactic microquasar mimicking winged
radio galaxies Case Study - Iron Deficiency Anemia 1. CASE STUDY. Dhaka: BRAC, 2001. 109.
Grover V, Usha R, Kalra S, Sachdeva S. Guidelines for the use of iron supplements to prevent and
treat iron deficiency anemia. In the mid eighties, data on global prevalence of anaemia were
compiled for the first time (34). Iron absorption from oral iron supplements given on consecutive
versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted
women: two open-label, randomised controlled trials. The menstrual history of adolescent girls
showed 57.1% of the subjects were of the age of 12 years or more. 57.8% of the adolescent girls
belonged to the category that had duration of flow for 3-4 days. 59.1% of the subjects had
menstrual cycle duration of 28 days where as 55.6% had less than 28 days. Assessing the problem
Anaemia The results confirm the earlier findings that anaemia is highly prevalent in both non-
pregnant and pregnant women in rural Bangladesh (37, 107). Professor Abdullah Akhter and Dr
Akram Hossain, Department of Microbiology, Mymensingh Medical College, Bangladesh
collaborated in the laboratory activities.
The prevalence of low sFt increased among pregnant women in the highest haemoglobin category.
Surgical treatment consists of stopping hemorrhage and correcting the underlying defect so that it
does not recur; this may involve surgery for treatment of either neoplastic or nonneoplastic disease of
the gastrointestinal (GI) tract, the genitourinary (GU) tract, the uterus, and the lungs. The tablets
were produced in Norway and provided by UNICEF. However, only women in the lower socio-
economic stratum had a lower compliance when reporting side effects. It plays a central role in the
transport of iron throughout the circulation. Use of this Web site is subject to the medical disclaimer.
It plays a role in cellular redox reactions and in the transport of oxygen. Efficacy and trial
effectiveness of weekly and daily iron supplementation among pregnant women in rural Bangladesh:
disentangling the issue. Am Clin Prod Rev 1987(6):22-5. 15. Lund CJ. Studies on the iron deficiency
anemia of pregnancy including plasma volume, total hemoglobin, erythrocyte protoporphyrin in
treated and untreated normal and anemic women. Acknowledgement This study was funded by
BRAC, Bangladesh, SAREC (The Swedish Agency for Research Collaboration with Developing
Countries) and the Swedish Society of Medicine. Thrombopoiesis takes place primarily in the bone
marrow through a series of cell differentiation and is influenced by several cytokines. The weekly
dose of 60 mg iron Friday morning and evening that was used in this study resulted in a slightly
elevated frequency of reported side effects in comparison with a daily dose of 60 mg. Dhaka:
Institute of Epidemiology and DiseaseControl Research, 1997 (mimeograph). 24 Islam AIM,
Siddaqua R, Rahman A, Rahman A, Ara I. Antenatal care services to rural mothers are provided
through the community-based ANCCs. Am J Trop Med Hyg 1996;55:66-70. 14. Scholl TO, Hediger
ML, Fischer RL, Shearer JW. The prospectively collected data make causal interpretations of side
effects and subsequent compliance plausible. Guidelines for the use of iron supplements to prevent
and treat iron deficiency anemia. Iron folate supplementation Fifty antenatal care centres were
randomly assigned to prescribe either daily (current program) or weekly dosages of iron
supplementation. A full-time field supervisor, who had several years of experience in organising
surveys on health and nutrition, directly supervised the daily activities. The procedures to control for
confounding were rigorous, as described in the methods section. The number of globin subunits in
the hemoglobin quaternary structure differs between species. It plays a role in cellular redox reactions
and in the transport of oxygen. This may partly explain the low prevalence of severe anaemia in the
study. Thus, women with less than 1 year of schooling, who were landless or who were economically
deficit showed higher prevalence of anaemia. A SES score was constructed using the accumulation
of these three indicators, ranging from 0 to 3. Thank you Mushtaque Bhai, you have introduced me
to the very exiting world of “public health and nutrition research”. Ottawa: The Micronutrient
Initiative, 1999. 14. Ekstrom E-C, Hyder S, Chowdhury A, et al. As hypothesised (127), compliance
was found to be higher in weekly group. Information was provided as listings of date and time of
individual bottle opening and closing events and the time in hours since the last dose of an iron
tablet taken in calendar plots. A proportion of anemia thus persisted in both regimens.