Objectives: Different forms of anemia are considered as the most frequent complication of the gestational period. By its etiology, pathogenesis, and clinical hematology, it is not a single disease. Among all forms of anemia occurring during pregnancy, iron deficiency anemia (IDA) is the most common, accounting for 80-95% of all cases. Design: The article describes a theoretical basis for the diagnosis of the anemic syndrome among pregnant women, the determining factors of its development, and the diagnostic methods at different gestational periods. Participants/Materials, Setting, and Methods: Diagnostic and prognostic values of iron balance indicators in the body were established for IDA during pregnancy to improve the outcome of childbirth. A total of 140 anemic patients were examined. The control group consisted of 50 pregnant women without anemia and other significant health problems, 48 IDA pregnant women, and 42 pregnant women with anemia caused by various chronic diseases, including rheumatoid arthritis. All patients of the main and control groups were registered on clinical records at the Family Planning Center in Aktobe city, Kazakhstan. Results: Ferrokinetic indicators were suggested for diagnosing IDA and anemia of chronic diseases. It was established that IDA is characterized by low ferritin levels during gestation, while increased ferritin and C-reactive protein are typical for anemia of chronic diseases. Limitations: Differential diagnostics was applied for pregnant women with IDA and anemia of chronic diseases to observe the dynamics of serum ferritin and C-reactive protein (CRP) levels at different gestational periods. The article presents the results of a study on ferrokinetics in pregnant women with IDA and anemia caused by inflammation or chronic diseases. Other causes of anemia leading to a decrease in hemoglobin (Hb) levels to <90 g/L include hemoglobinopathies, which were not considered in this study. Conclusions: Determination of iron deficiency in pregnant women at different gestational periods will allow for identifying the risk group of anemic patients and deciding on the treatment. IDA (Hb <100 g/L) can be effectively measured by ferritin level <15 ng/mL, iron level of <11.5 μmol/L, and transferrin level >2.6 mg/L at p < 0.001. Anemia due to chronic diseases (Hb <100 g/L) can be effectively diagnosed with ferritin above 15 μg/L and CRP above 10 mg/L at p < 0.001.
Objective: About 90% of cardiovascular diseases can be prevented. In recent years, the role of vitamin D in the prevention of cardiovascular disease and components of metabolic syndrome has been actively discussed. The study aimed to investigate the possible influence of vitamin D3 on the emergence risk of metabolic syndrome and adverse cardiovascular events. Materials and methods: The study enrolled a total of 336 people (170 males and 166 females) aged 50-60 years. For comparative analysis, two groups were formed: Group 1 group involved 150 people treated with placebo, and Group 2 group included 186 people who received vitamin D3 orally in a dose of 2000 IU/day. The duration of treatment and observation was four years. Participants in the study completed a questionnaire developed by the authors of this paper, in which they answered questions about the presence of factors contributing to the development of cardiovascular pathology. Results and Discussion: Daily oral intake of vitamin D3 in a dose of 2000 IU/day for four years did not improve laboratory indicators, which are components of MS, namely, the content in the blood of TC, TG, LDL, HDL, AI, fasting and postprandial glycemia, insulin, and insulin resistance index HOMA2-IR (p>0.05). Prolonged use of vitamin D3 did not reduce the risk of cardiovascular diseases (myocardial infarcts (RR=0.93, 95% CI [0.21-4.09], p=0.92), strokes (RR=1.24, 95% CI [0.18-8.70], p=0.83), stenting (RR=1,23, 95% CI [0.32-4.88], p=0.76), arterial hypertension (RR=1.12, 95% CI [0.47-2.68], p=0.81), as well as cardiovascular death rates (RR=0.83, 95% CI [0.14-4.88], p=0.83) and death from any other causes (RR=0.93, 95% CI [0.21- 4.09], p=0.92). Conclusion: Thus, daily prolonged oral administration of vitamin D3 in a dose of 2000 IU/day does not contribute to the improvement of blood lipid spectrum, glycemia, and insulin resistance in metabolic syndrome and does not reduce the risk of adverse (fatal and non-fatal) cardiovascular events. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.431-438
Background. One of the most prevalent illnesses in the world is anemia. Anemia in pregnant women has been a pressing obstetric issue for many years and is one of the most common complications of pregnancy in the world, particularly in developing countries. Aim. To study the condition of neonates born to women with anemia during pregnancy. Methods. A retrospective analysis of 230 patients' medical records in maternity and pregnancy pathology departments. The patients were divided into 2 groups: Group 1 consisted of patients suffering from iron deficiency anemia, Group 2 comprised patients without iron deficiency anemia. Results. The height-to-weight ratio in the group of neonates born to mothers with anemia statistically was significantly lower compared to the control group. The proportion of neonates with hypotrophy in the group born to mothers with anemia statistically was significantly higher. Body length and birth condition indices assessed according to the APGAR scale were virtually identical across the groups. Conclusions. Anemia during pregnancy affects the trophism of a fetus, which is largely reflected in the health of neonates. Treating maternal anemia is important to prevent or decrease the incidence of underweight in infants at birth.
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Relevance: Metabolic disorders often take on a systemic character. It affects carbohydrate, lipid, and hormonal metabolism. Moreover, these changes promote the development and aggravation of several pathologies. The prevalence of metabolic disorders, including obesity, is increasing world-wide and in Kazakhstan. The study focused on the clinical characteristics of metabolic syndrome (MS) components in pa-tients with cancer comorbidities. Methods: The materials included medical records of cancer patients with MS – 35 people (main group) and non-cancerous patients with MS – 35 people (control group). MS was diagnosed with a combination of three symptoms: abdominal obesity, high blood pressure, and increased high-density lipoprotein cholesterol (HDL-C) levels. The data were analyzed and processed using the STATIS-TICA 10 software package. The significance criterion was p<0.05. Results: All studied patients were diagnosed with abdominal obesity. Indicators analysis showed a significant difference in HDL-C concentration in the main and control groups: 3.8 mmol/l in cancer patients and 5.7 mmol/l in the controls. No significant difference in blood pressure was found. Conclusion: The age of patients with MS evidences a threatening tendency to develop metabolic disorders in young and middle ages. A significantly lower concentration of LDL-C in cancer patients compared with the controls allows using this parameter to predict cancer ]development in patients diagnosed with MS. Thus, HDL-C concentration could be used as a metabolic marker for pre-symptomatic diagnostics.
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