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Shilajit in management of iron deficiency anaemia

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Chinnasamy Velmurugan at PGP College of Pharmaceutical Sciences and Research Institute
Chinnasamy Velmurugan
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B. Vivek
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Velmurugan Vivek. et al. / JPBMS, 2010, 1 (01)
1 Journal of Pharmaceutical and Biomedical Sciences (JPBMS), Vol. 01, Issue 01
Available online at www.jpbms.info
JPBMS
JOURNAL OF PHARMACEUTICAL AND BIOMEDICAL SIENCES
SHILAJIT IN MANAGEMENT OF IRON DEFICIENCY ANAEMIA
C.velmurugan
1
, B.Vivek
1
, D.Sheshadri Shekar
1
, SP. Sudha
2
& T. Sundaram
3
1
Department of Pharmacology, Sri K.V College of Pharmacy, M.G.Road, Chickballapur. (KA)-562101
2
Department of Pharmaceutical chemistry, Sri K.V College of Pharmacy, M.G.Road, Chickballapur. (KA)-562101
3
Department of Pharmaceutics, Sri K.V College of Pharmacy, M.G.Road, Chickballapur. (KA)-562101
Abstract
The Shilajit as a dietary supplement was examined for iron deficiency anaemia in experimental animals. In this study diet
induced and bleeding technique were used to evaluate the iron deficiency anaemia. In diet induced, low iron diet from
sigma and in bleeding technique bled 2ml of blood from each animal for 5 alternative days was used to induce iron
deficiency anaemia (IDA), the animals which did not developed anaemia i.e. haemoglobin level < 9g/dl, were rejected and
replaced with new animals. The Shilajit 500 mg/kg shows significant (p<0.01) increase in Hb, RBC & PCV values in both
the model. According to our results Shilajit in doses of 500 mg/kg reveals anti-anaemic activity.
Key words: Shilajit, iron deficiency anaemia, haemoglobin, bleeding technique & low iron diet.
Introduction
Anaemia is a decrease in number of red blood cells (RBCs)
or less than the normal quantity of hemoglobin in the
blood. Anemia is estimated to affect nearly two thirds of
the pregnant women in developing countries[1].Iron
deficiency anemia is responsible for 95% of the anemias
during pregnancy[2-3], [(Breymann C) (Yaqoob N), 2002].
In underdeveloped countries, anemia is a major
contributory factor to maternal morbidity and
mortality[4].Shilajit, a traditional medicine has been used
for cardioprotective, anti-asthmatic, anti-diabetic,
hepatoprotective, anaemic and potent CNS activity for
ages[5].In the Charak Samhita, Shilajit is described as a
product of four minerals: gold, silver, copper and iron,
whereas Susruta Samhita included two more minerals,
lead and zinc in its composition[6].The present study has
been designed to evaluate the anti anaemic activity of
shilajit in bleeding and diet induced IDA model in rats. The
drug has been able to raise the Hb.
to
satisfactory level
when used in severely anemic iron deficient in rats.
Materials and Methods
Shilajit Dose Determination
The dose of shilajit was determined by acute toxicity study.
As per OECD 425 guidelines the acute toxicity study was
studied and it was found that the LD
50
is 5000 mg/kg body
weight. The effective dose calculated from one by tenth of the
LD
50
(500mg/kg).
Animal experiments
The animal experimental protocol was approved by
*Corresponding Author
C.Velmurugan
Department of Pharmacology,Sri K.V College of Pharmacy,
M.G.Road,Chickballapur. KA-562101
Mobile: 09663337129
Email: velu0906@gmail.com
Institutional Animal Ethical Committee as per the guidance of
the Committee for the Purpose of Control and Supervision of
Experiments on Animals (CPCSEA) 117/99/kvcp.
Iron deficiency model
Bleeding Induced IDA
This test was followed by the method described by
McCance, R. A., 1937 with some modifications. In the
model a total of 18 rats were divided into three groups of
six each. The Group II &III rats were rendered Anemia by
removing 2ml of blood from retro orbital plexus of each
rat for 5 alternative days. Group III rats were treated with
Shilajit 500mg/kg/day from the11th day after conforming
anemia to 20
th
day from the initial bleeding. The blood
samples were collected on 21
st
day for estimating the
haematological parameters.
Low Iron Diet Induced IDA
Three groups of six rats each were used for study. Group I
was maintained on normal rat diet, whereas Group II & III
were maintained on an iron deficient diet.[7-8], for 13
days before study. The diet was served in porcelain dishes.
The rats were fasted 1 day before study and Shilajit was
administered to Group III rats, 14 days after beginning the
iron-deficient diet upto 20
th
day. The blood samples were
collected at the end of the 20
th
day for estimating the
hematological parameters.
Results
Bleeding induced IDA
Shilajit significantly increased the level of Hb, HCT and
RBC against the anaemia induced by bleeding. The values
are shown in the Table 1
Low iron diet induced IDA
Research
Article
Velmurugan Vivek. et al. / JPBMS, 2010, 1 (01)
2 Journal of Pharmaceutical and Biomedical Sciences (JPBMS), Vol. 01, Issue 01
Results (Table 2) reveled that Shilajit shows the significant (p < 0.01) anti-anaemic activity at dose of 500mg/kg.
Table 1: Effect of Shilajit on bleeding induced IDA Table 2 : Effect of Shilajit on low iron diet induced IDA
Groups Hb g/dl HCT % RBC
x10
6
/mm
3
Normal
control
18.18±0.4453
**
54.65±0.4696
**
8.96±0.3504
**
Induced
control
8.2 ± 0.2460
23.85± 0.2997
5.46 ±0.2305
Shilajit
500mg/kg
15.3± 0.2217
**
45.16± 0.6344
**
8.73±0.3630
**
Values are in mean ±SEM; (n=6), ** p<0.01 vs. induced Values are in mean ±SEM; (n=6), ** p<0.01 vs. induced
control control
Discussion
The Shilajit’s increased the Hb, HCT and RBC when
assessed using the bleeding model and in low iron diet
induced model. About 1 mg of iron is lost each day through
sloughing of cells from skin and mucosal surfaces,
including the lining of the gastrointestinal tract[9].
Menstruation increases the average daily iron loss to
about 2 mg per day in premenopausal female adults[10].
The iron depletion leads to Hb deficiency. Hemoglobin
(found inside RBCs) normally carries oxygen from the
lungs to the tissues, anemia leads to hypoxia (lack of
oxygen) in organs, because all human cells depend
on oxygen for survival. Shilajit containing iron, when taken
as a dietary supplement it increase the haemoglobin level
and it neutralizes the regular loss and during
menstruation. Hence the present study shows that Shilajit
exhibited activities in various degrees against both models
of IDA.
Conclusion
In conclusion, this study has shown that the Shilajit having
significant anti-anaemic activity in both model. Our data
obtained from the present study suggest that the Shilajit
can be taken as a dietary supplement in the management
of iron deficiency anaemia.
References
1.Breymann C. Iron deficiency and anemia in pregnancy:
Modern aspects of diagnosis and therapy. Blood Cells Mol
Dis 2002; 29: 506-16.
2.Breymann C. Anemia working group. Current aspects of
diagnosis and therapy of iron deficiency anemia in
pregnancy. Schweiz Rundsch Med Prax 2001; 90:1283-91.
3.Yaqoob N, Abbasi SM. Nutritional iron deficiency in our
population. J. Coll Physicians Surg Pak 2002; 12: 395-7.
4.Saeed M, Khan TA, Khan SJ. Evaluation of risk factors in
antenatal care. Mother and child 1996; 34: 139-142.
5..Acharya SB, Frotan MH, Goel RK, Tripathi SK, Das PK.
Pharmacological actions of Shilajit. Indian J Exp Biol. 1988;
26(10): 775-7.
6.Ghosal S, Singh SK, Kumar Y, Srivatsava R.
Antiulcerogenic activity of fulvic acids and 4-metoxy-6-
carbomethyl biphenyl isolated from shilajit. Phytother Res.
1988;2:187-91.
7.McCance RA, Widdowson EM. Absorption and excretion
of iron. Lancet 1937; 2, 680.
8.Pollack S R, Kaufman M, Crosby WH.Iron absorption: the
effect of an iron-deficient diet. Science 1964; 144, 1015
9.Cook JD, Skikne BS, Estimates of iron sufficiency in the
US population. Blood. 1986; 68, 726.
10.Bothwell T H. and Charlton, R. W. (). A general
approach of the problems of iron deficiency and iron
overload in the population at large. Seminars in
Hematology. 1982; (19) 54.
.
Group
s
Hb g/dl
HCT %
RBC
x10
6
/mm
3
Normal
control
15.78±0.353
**
45.95±0.84
**
8.85±0.28
**
Induced
control
7.90 ± 0.12
23.91± 0.60
5.33 ±0.23
Shilajit
500mg/kg
12.81± 0.45
**
45.95± 0.84
**
7.16±0.14
**
... Iron deficiency anemia remains quite prevalent despite the widespread ability to diagnose the disease and availability of medicinal iron preparations [2]. Anemia is caused by poor iron absorption from the diet, where several dietary factors can influence this absorption; these absorption enhancing factors include ascorbic acid, meat, fish and poultry; inhibiting factors are plant components in vegetables, tea and coffee (e.g., polyphenols, phytates), and calcium [3,4]. After identifying these factors, specific attention was paid to the effects of tea on iron absorption [3,4]. ...
... Anemia is caused by poor iron absorption from the diet, where several dietary factors can influence this absorption; these absorption enhancing factors include ascorbic acid, meat, fish and poultry; inhibiting factors are plant components in vegetables, tea and coffee (e.g., polyphenols, phytates), and calcium [3,4]. After identifying these factors, specific attention was paid to the effects of tea on iron absorption [3,4]. Over the past few decades so much knowledge has been gained about iron needs, dietary iron availability and adequacy that is now one of the bestdefined nutrients in these respects [3,4]. ...
... After identifying these factors, specific attention was paid to the effects of tea on iron absorption [3,4]. Over the past few decades so much knowledge has been gained about iron needs, dietary iron availability and adequacy that is now one of the bestdefined nutrients in these respects [3,4]. Development of new and accurate methods for the measurement of both the iron loss from the body and the absorption of iron from the diet has significantly contributed to this situation [5]. ...
Overcoming tea-drinking limitation by Fortification of Iron Bio- absorption
Preprint
Full-text available
  • Sep 2023
Tea is a popular drink with beneficial health properties, and a rich source of specific flavanols. The tea extract has high antioxidant activities, evidenced by its ability to chelate ferrous ions. There is a clear indication that tea drinking limits the absorption of iron through complex formation with the phenolic compounds in the gastro-intestinal lumen. There are some iron absorption enhancing factors such as pH, ascorbic acid, albumin egg and sucrose. The aim of this study is to investigate the effect of adding these different beneficial compounds to tea components that inhibits the formation of iron complex with the phenolic compounds to enhance iron bio-absorption and prevent iron deficiency anemia. This study recommends that, acidity is favored at pH less than 4.5 and sucrose increases the bio-absorption of iron and fortifies green tea than black tea. Also, addition of ascorbic acid before drinking fortifies the iron bio-absorption with green and black teas.
View
... This substance contains fulvic and humic acids, free and conjugated dibenzo-α-pyrones, proteins, and numerous minerals (10). A growing body of data points to the prophylactic and therapeutic uses of shilajit in treating different diseases and disorders (10,11); however, it is plausible to also count anticancer activity among the functions of this substance (12,13). Ghosal et al. showed the possible effect of shilajit as an anti-ulcerogenic and anti-inflammatory agent. ...
... The cells were seeded into two cell culture flasks at a density of 5 × 10 4 cells/flask, and 72 h after shilajit treatment (IC 50 concentration), the cells were extracted. Next, the washed cells were suspended in a binding buffer and stained using propidium iodide (PI) and Annexin V, based on the manufacturer's instructions (11). After incubation time (15 minutes), the apoptotic cell% was quantified using BD FACSCalibur flow cytometry (BD Biosciences Co.). ...
Modulation of IKK/NF-κB Signaling: A Therapeutic Mechanism of Shilajit in Breast Cancer Cells
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Background: Shilajit is a natural pale-brown to blackish-brown phytocomplex that exudes from mountain rocks in various parts of the world. In recent years, numerous pharmacological effects of shilajit have been explored through extensive experiments. Shilajit is known as an antioxidant and anti-inflammatory agent. Activation of the nuclear factor kappa B (NF-κB) signaling pathway could be an important player in inflammation-driven tumor progression. Therefore, the current study evaluated the anti-inflammatory effect of shilajit on a breast cancer cell line (MCF7). Methods: In this experimental study, the MCF7 cell line was treated with shilajit, and an MTT assay was applied to analyze the half-maximal inhibitory concentration (IC50) after 72 hours of treatment. Following this, the apoptotic rate was assessed using flow cytometry, and p50, RelB, and IKKα/β gene expression were evaluated using real-time PCR assay. Results: Shilajit had potent cytotoxic activity in a dose- and time-dependent manner with an IC50 of 280 μg/mL. Based on the Annexin-PI analysis, the IC50 concentration of this compound induced significant apoptosis in the cells, possibly through suppression of NF-κB (p50, RelB, and IKKα/β)-regulated genes. The real-time PCR results indicated that treating MCF7 cells at the IC50 dose of shilajit for 72 hours could reduce the mRNA expression levels of p50, RelB, and IKKα/β in the cells. Conclusion: The findings of the present experiment showed that shilajit may have promising anti-breast-tumor and anti-inflammatory activity through inhibition of the NF-κB signaling pathway. Therefore, shilajit can help treat breast cancer in combination with other standard treatments.
View
... Prevalence of anemia in medical students (Senthilkumar, et al.) Hb and in hypochromic and microcytic RBCs [8]. Iron deficiency could result from decreased nutritional supply and blood loss for any reason. ...
Prevalence of Anemia, Iron Level, Total Iron Binding Capacity Level, and Body Mass Index of Medical Students Living in Hostels in South India
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Studies have evidenced that hostel-staying medical students are at increased risk for anemia due to improper diet and long periods of studies that ultimately affect their performance. The nature of medical education, student efforts, and stress also raise the risk of anemia. The objective of this study is to find out the prevalence of anemia in medical students and iron levels, total iron binding capacity (TIBC) levels, and body mass index (BMI) in residing medical students in the hostel. This study is a descriptive cross-sectional study conducted at the Swamy Vivekanandha Medical College Hospital and Research Institute (SVMCHRI). The Institutional Ethical Committee (IEC) was obtained from IEC-SVMCHRI. The total number of students who participated in this study was 115 first-year medicine students (female = 76, male = 39) aged 18-24 years and were boarded in the hostel. Samples were collected after obtaining informed consent from students. Demographic parameters such as name, age, sex, and anthropometric parameters including weight, height, and BMI were recorded. Haemoglobin (Hb) was analyzed by a cell counter analyzer, iron levels, and TIBC levels were measured by a semi-autoanalyzer, and a blood smear study was performed. Anemia prevalence was higher in females than males; therefore, statistical analysis for male and female associations was observed through the Chi-squared test. The Hb cut-off followed the anemia classification per the World Health Organization (WHO). Overall, students had severe anemia (0.9%), moderate (8.7%), and mild (26.1%) anemia in hostels studying medicine. Females had a higher prevalence of anemia than males. The comparison of Hb, iron levels, and TIBC levels between men and women was highly significant: Hb 14.93 and 11.85 g.dL-1 in men vs. women (P<0.001); iron levels 122.07 and 77.5289 µg.dL-1 in men vs. women (P<0.001); and TIBC levels 323.02 and 349.92 µg.dL-1 in men vs. women (P<0.008), consecutively. BMI was not significant between male and female associations. Overall, 18 participants had microcytic and hypochromic anemia in the blood smear study. This research finding concludes that the anemia prevalence is more common in female medical students with a tendency to microcytic and hypochromic anemia. Therefore, they may suffer from anemia due to nutritional deficiencies and benefit from iron supplementation. Keywords: Anemia, Iron, Hemoglobin, Microcytic and Hypochromic, Total Ion Binding Capacity.
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... In-spite of increased iron needs, many adolescents, particularly females, may have iron intake of only 10-11 mg per day, out of which 1mg will be absorbed approximately. [6][7][8] Iron deficiency causes great morbidity in all age groups and adversely affects immune status, physical capacity and work performance of adolescents. [9][10][11] Until today, IDA is still the most prevalent and common type of micronutrient deficiency in the developing countries, which results from long-term negative iron imbalance. ...
Prevalence of iron deficiency anaemia among school going adolescent girls: a cross sectional study
Article
Full-text available
  • Jan 2023
Background: The field of nutrition of women in India that has been sadly neglected pertains to the adolescent girls. The adolescent girls, the young women, the mothers to be, represent an age group which experience a crucial phase of growth. Iron deficiency anaemia is a highly prevalent and seemingly intractable problem, particularly among females of reproductive age group in developing countries. Following early childhood, during the adolescent growth spurts, the risk of iron deficiency and anaemia reappears for both boys and girls, after which it subsides for boys but remains for girls because of menstrual loss. Aim of the study was to find the prevalence of iron deficiency anaemia among school going adolescent girls in the field area of National Institute of Unani Medicine, Bangalore. Methods: The present study is an observational, cross-sectional, school health survey undertaken to know the prevalence of iron deficiency anaemia among adolescent girls in the field area of NIUM. The present study was completed within a period of 6 months from August 2008 to January 2008. Prevalence of IDA was determined on the basis of RBC indices (MCV, MCHC) and erythrocyte morphology, evaluated from the points of anisocytosis, poikilocytosis, hypochromia and microcytosis on peripheral blood smear examination. Results: In the study population (240 girls), 25% (60) subjects were affected with various grades of anaemia, i.e., 20.4% (49) were mildly anaemic and 4.6% (11) moderately anaemic. There was no case of severe anaemia. The prevalence of IDA was seen in 11.6% of study population. Conclusions: The present study provides an indication to initiate the anaemia prophylaxis measures for adolescent girls in India including nutrition education in schools. Adolescent girls should be a target group in any programme that builds demand for sustaining iron supplementation or higher dietary intake.
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... Besides, fulvic acid facilitates importing minerals into the target cells, protecting the electrical potential and preventing cell death [21,22]. The safety and healing efficacy of Shilajit has been studied in humans and animals [18].The Shilajit compounds exhibit a great potential for healing the different diseases such as bone fractures, osteoarthritis [23,24], anemia [25], diabetes [26] and Alzheimer [27]. A clinical trial conducted in Iran revealed that oral administration of Shilajit after tibia fracture surgery accelerated bone repair [28]. ...
Accelerating effect of Shilajit on osteogenic property of adipose-derived mesenchymal stem cells (ASCs)
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Full-text available
  • Sep 2022
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Background Shilajit has been widely used remedy for treating a numerous of illness such as bone defects in Iran traditional folk medicine since hundreds of years ago. The aim of the present study was to explore the effect of Shilajit on the osteogenic differentiation of human adipose-derived mesenchymal stem cells (ASCs) in two- (2D) and three-dimensional (3D) cultures. Materials and methods ASCs were seeded in 3D 1% alginate (Alg) hydrogel with or without Shilajit (500 µg/mL) and compared with 2D cultures. Then, characterization was done using electron microscopy (SEM)/energy-dispersive X-ray spectroscopy (EDX), alkaline phosphatase (ALP) activity, alizarin red staining and Raman confocal microscopy. Results Adding Shilajit had no impact on the Alg scaffold degradability. In the 3D hydrogel and in the presence of osteogenic medium (OM), Shilajit acted as enhancer to increase ALP activity and also showed osteoinductive property in the absence of OM compared to the 2D matched groups at all time points (days 7 and 21 both P = 0.0006, for 14 days P = 0.0006 and P = 0.002, respectively). In addition, calcium deposition was significantly increased in the cultures exposed to Shilajit compared to 2D matched groups on days 14 ( P < 0.0001) and 21 ( P = 0.0003 and P = 0.003, respectively). In both 3D and 2D conditions, Shilajit induced osteogenic differentiation, but Shilajit/Alg combination starts osteogenic differentiation in a short period of time. Conclusion As Shilajit accelerates the differentiation of ASCs into the osteoblasts, without changing the physical properties of the Alg hydrogel, this combination may pave the way for more promising remedies considering bone defects.
View
... Besides, fulvic acid facilitates importing minerals into the target cells, protecting the electrical potential and preventing cell death [21,22]. The safety and healing efficacy of Shilajit has been studied in humans and animals [18].The Shilajit compounds exhibit a great potential for healing the different diseases such as bone fractures, osteoarthritis [23,24], anemia [25], diabetes [26] and Alzheimer [27]. A clinical trial conducted in Iran revealed that oral administration of Shilajit after tibia fracture surgery accelerated bone repair [28]. ...
Accelerating effect of Shilajit on osteogenic property of adipose derived mesenchymal stem cells (ASCs)
Preprint
Full-text available
  • Jun 2022
Background Shilajit, as a herbomineral natural substance, has been most widely used remedy for treating a numerous of illness such as bone defects in Iran traditional folk medicine since hundreds of years ago. The aim of the present study was to explore the effect of Shilajit on the osteogenic differentiation of human adipose-derived mesenchymal stem cells (ASCs) in two- and three-dimensional cultures. Materials and methods ASCs were isolated and seeded in three-dimensional (3D) 1% alginate (Alg) hydrogel with or without Shilajit at a density of 3 × 10⁵ cell/mL. For two-dimensional (2D) cultures, 3 × 10⁴ ASCs /mL were seeded into culture plates and treated with 500µg/mL Shilajit. Then, characterization was done using electron microscopy (SEM)/energy dispersive X-ray spectroscopy (EDX), alkaline phosphatase (ALP) activity, Alizarin red staining, and Raman confocal microscopy. Results Adding Shilajit had no impact on the Alg scaffold degradability. In the 3D Alg hydrogel and in the present of osteogenic medium (OM), Shilajit acted as enhancer to increase ALP activity, also showed osteoinductive property in the absence of OM compared to the 2D matched groups at all time points (days 7 and 21 both P < 0.001, for 14 days P < 0.001 and P < 0.05, respectively). In addition, calcium deposition was significantly increased in the cultures exposed to Shilajit compared to 2D matched groups on days 14 (P < 0.0001), and 21 (P < 0.001and P < 0.01, respectively). In both 3D and 2D conditions, Shilajit induced osteogenic differentiation, but Shilajit/Alg combination starts osteogenic differentiation in a short period of time. Conclusion As Shilajit accelerates the differentiation of ASCs into the osteoblasts, without changing the physical properties of the Alg hydrogel, this combination may pave the way for more promising remedies considering bone defects.
View
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... In adequate iron intake, or lack of dietary iron in a form that can be absorbed, as well as chronic iron loss by excess volume of mestrual fluid or other chronic bleeding, causes irondeficiency anemia, with decreased rates of erythrocyte formation and haemoglobin synthesis (3) . ...
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Full-text available
  • Oct 1986
Traditionally the iron status of a population is assessed by estimating the prevalence of iron deficiency anemia. This approach is inadequate in countries where the diet is heavily fortified with iron because it conveys no information about the iron-replete segment of the population. In the present study iron status of a US adult population was evaluated using data collected in the second National Health and Nutrition Examination Survey (NHANES II). Body iron was estimated in each of 2,829 individuals from measurements of hemoglobin concentration, serum ferritin, transferrin saturation, and erythrocyte protoporphyrin. When individuals between 18 and 64 years of age were divided on the basis of sex and menstrual status, body iron reserves were normally distributed and averaged 309 mg in women 18 to 44 years, 608 mg in women 45 to 64 years, and 776 mg in men 18 to 64 years. The dispersion of storage iron in these groups was similar, with standard deviations of 346, 372, and 313 mg, respectively. The prevalence of iron deficiency anemia was surprisingly low, ranging from only 0.2% in adult men to 2.6% and 1.9% in pre- and postmenopausal women, respectively. Epidemiologic methods that examine iron status in the entire population assume importance in light of evidence that in certain segments of the US population, iron deficiency anemia is now less common than the homozygous state for hereditary hemochromatosis.
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Nutritional iron deficiency in our population
Article
  • Jul 2002
Objective: To document the most common cause of anemia in a rural population. Design: Prospective, case series. Place and Duration of Study: The study was conducted from June, 1999 to June, 2001 at the department of Medicine, Fauji Foundation Hospital, Rawalpindi, (Pakistan). Material and Methods: The subjects were mainly young adults, middle aged men and non-pregnant women presenting with symptoms and signs of anemia. Main outcome of study were types of anaemia, prevalence and causes of iron deficiency anemia. Results: A total of 205 patients presented with findings consistent with the presence of anaemia. The predominant type of anemia was hypochromic microcytic in 93 (43.36%) cases, followed by hematological malignancies in 46 (22.43%) cases. Iron deficiency was noted in all 93 cases. The main cause of iron deficiency was nutritional deficiency in 86 (41.95%) patients. The mean ferritin levels in these iron deficient patients were 5.6 hg/ml. The mean age was 32 years. Conclusion: The iron deficiency is still the commonest cause of anemia. The main cause of high prevalence of iron deficiency is nutritional inadequacy owing to low socioeconomic conditions. Women bear the main brunt of iron deficiency. Iron deficiency can be overcome by directing the financial resources to the vulnerable segments of population and enhancing their access to iron-rich foods.
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Anti-ulcerogenic activity of fulvic acids and 4'-methoxy-6-carbomethoxybiphenyl isolated from Shilajit
Article
  • Dec 1988
  • PHYTOTHER RES
Fulvic acids (FA) and 4′-methoxy-6-carbomethoxybiphenyl (MCB, 1), two major organic compounds isolated from Shilajit (a humus product), were screened for anti-ulcerogenic activity in albino rats. Both FA and MCB showed significant anti-ulerogenic effects in the battery of tests accepted for this purpose. The mechanism of anti-ulcerogenic action was studied with MCB on the basis of its effects on mucin content (gastric juice carbohydrates and carbohydrate/protein ratio) and on the concentration of DNA and protein in the gastric juice. The MCB-induced changes in the mucosa provided resistance against the effect of ulcerogens and also against shedding of mucosal cells. A preliminary acute toxicity study indicated that both FA and MCB had a low order of toxicity.
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[Current aspects of diagnosis and therapy of iron deficiency anemia in pregnancy]
Article
  • Sep 2001
Anaemia is one of the most common risk factors in the area of obstetrics and perinatal medicine. During pregnancy and in the puerperium it is associated with an increased incidence of both maternal and fetal morbidity and mortality, the extent of which is dependent upon the severity of anaemia and the resulting complications. In order to correctly diagnose the type and degree of anaemia, a prerequisite for selection of the proper therapy, one must first of all correctly differentiate between the relative, i.e., the physiological anaemia of pregnancy due to the normal plasma volume increase during pregnancy, and "real anaemias" with various different pathophysiological causes. When defining the Hb cutoff value for anaemia in pregnancy, the extent of the plasma volume changes with respect to the gestational age must be taken into consideration. It has been found that haemoglobin values < 11.0 g/dl in the first and third trimesters, and < 10.5 g/dl in the second trimester may point to an anaemic situation which should be further clarified. The first important steps for diagnosing anaemia in a pregnant patient include a thorough check of her medical history and a medical examination. This procedure often lays the basis for a correct diagnosis. The current gold standard to detect iron deficiency remains the serum ferritin value. To be reliable, this requires the ruling out of an infection (chronic or acute) as a cause of the anaemia. We recommend a complete laboratory test for the exact haematological status as well as the assessment of specific chemical laboratory parameters. These should include a palette of additional, promising new parameters such as hypochromic red cells and transferrin receptors which allow more accurate detection of iron deficiency and differential diagnosis of iron deficiency anaemia. After correct diagnosis, major emphasis should be put on safe and effective treatment of anaemia which again depends on severity of anaemia, time for restoration and patients characteristics. Today effective alternatives to oral iron only or blood transfusion such as parenteral iron sucrose complex and in selected cases also recombinant erythropoietin have been investigated and show promising results concerning effective treatment of anaemia during pregnancy and postpartum.
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Iron Deficiency and Anaemia in Pregnancy: Modern Aspects of Diagnosis and Therapy
Article
  • Dec 2005
The prevalence of iron-deficiency anemia in different regions of the world ranges from 12 to 43%. The increased iron requirement in pregnancy and the puerperium carry with it an increased susceptibility to iron deficiency and iron-deficiency anemia and perioperative or peripartal blood transfusion. Prevention and correction presuppose reliable laboratory parameters and a thorough understanding of the mechanisms of iron therapy. The Hb level alone is insufficient to guide management. A complete work-up (ferritin, transferrin saturation) is essential, preferably with hematological indices such as hypochromic and microcytic red cells and reticulocytes, classified by degree of maturity, in particular, before parenteral therapy is given. Since ferritin acts as both an iron-storage and acute-phase protein, it cannot be used to evaluate iron status in the presence of inflammation. A high ferritin level thus requires the presence of an inflammatory process to be eliminated before it can be taken at face value. If the C-reactive protein level is also raised, the soluble TfR concentration can be used, since it is unaffected by inflammation. Inadequate understanding of the complex chemistry of parenteral iron administration was previously responsible for serious side effects, such as toxic and allergic reactions, and even anaphylactic shock, in particular with dextran preparations. However, the current type II iron complexes that release iron to the endogenous iron-binding proteins with a half-life of about 6 hours are not only effective but carry a minimal risk of allergic accident and overload, especially after a comprehensive pretreatment work-up. Our departmental data collected over 8 years and backed by postmarketing experience in 25 countries indicate that iron sucrose complex therapy is a valid first-line option for the safe and rapid reversal of iron-deficiency anemia.
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Iron Absorption: The Effect of an Iron-Deficient Diet
Article
  • Jun 1964
A diet deficient in iron causes a rapid, marked increase in iron absorption in rats. The increased absorption occurs in the absence of a significant change in iron stores as judged by the effect of an equivalent change in stores produced by phlebotomy, and in the absence of increased erythropoietic activity as judged by the rate of removal of iron-59 from the plasma.
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Evaluation of risk factors in antenatal care
  • Jan 1996
  • 139-142
  • M Saeed
  • T A Khan
  • S J Khan
Saeed M, Khan TA, Khan SJ. Evaluation of risk factors in antenatal care. Mother and child 1996; 34: 139-142.