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Content available remote Anaemia and heart failure
Anaemia is one of the most frequent co-morbidities in patients with heart failure. Its prevalence increases from 4% to7% in subjects with asymptomatic left ventricular dysfunction to >30% in patients with severe heart failure. Renal insufficiency, activation of inflammatory mediators and treatment with renin-angiotensin antagonists seem to be its main determinants. The results of many studies agree in providing evidence that anaemia is a powerful independent determinant of survival in patients with heart failure. However, the mechanisms of this relation are still not fully understood. Moreover a favourable effect of the correction of anaemia on prognosis has not yet been shown. Also In addition to this, controlled studies assessing its effects on exercise tolerance have yielded controversial results. Further research is needed to assess the effect of correcting anaemia in chronic heart failure (CHF) patients; ongoing reduction of events with RED-HF (Darbepoetin alpha in heart failure) trial will help define the role.
Plummer Vinson syndrome, also known as ‘Paterson Brown-Kelly’ syndrome is a syndrome associated with the triad of symptoms comprising microcytic hypochromic anaemia, oesophageal strictures and dysphagia. PVS (Plummer Vinson Syndrome) is commonly found in women of middle age especially in the fourth and fifth decade of life and is rarely reported in males and young females. Symptoms resulting from anaemia predominate the clinical picture, apart from additional features such as glossitis, angular cheilitis, and dysphagia. Dysphagia, however, is the main clinical feature of PVS. PVS carries an increased risk of development of squamous cell carcinoma of oesophagus and pharynx[1]. A classic case report of PVS associated with swelling of the salivary gland with clinical features, oral manifestations, malignant potential, differential diagnosis, investigation, and treatment is discussed here. This article carries the message that oral and pharyngeal manifestations should be considered to rule out malignancy in PVS, moreover, that PVS increases the risk factor of salivary gland squamous cell carcinoma. Early identification and diagnosis improves the prognosis and better chances of survival. We have to be familiar, therefore, with the oral manifestations of anaemia and be able to suspect PVS to aid in early diagnosis and prompt treatment. This case study was taken from Medcare hospital, Karimnagar, Telangana.
Impact of Rectal Artesunate on haematological parameters was assessed in 905 children below the age of 5 years. Grid systematic method was employed in selecting sixteen study centres from 8 Local Government Areas of Ogun State. Ethical approvals were obtained in addition to interactive sessions with parents of the children and PHCs medical practitioners. Drug was administered at a dose of 5 to 10mg/kg of the body weight per rectum at 0 hour, 24 hours and 48 hours. Data obtained were analyzed using SPSS version 20 to assess association with p-value of < 0.05. Impact of Rectal Artesunate was monitored by analysing blood samples taken at 0 hour, 24 hours and 48 hours for Packed Cells Volume (PCV) and Haemoglobin concentration (Hb). There was a significant (p < 0.05) increase in baseline PCV (L/L) and Hb (g/L) during 48 hours across the LGAs. Parasitaemia (MPC/µl) in children has a significant (p < 0.05) association with anaemia (PCV and Hb) and was positively correlated (r = +0.348 and r =+ 0.201). A significant (p < 0.05) difference observed between MCV (fl), MCH (pg) and MCHC (g/L) at 0 hour and MCV (fl), MCH (pg) and MCHC (g/L) at 48 hours. More awareness on the use of Rectal Artesunate in reducing anaemia due to malaria in children should be created since it is highly effective antimalarial suppository.
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