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Global Scenario
• 60 – 80% of world population i.e. 4 – 5 billion people are
anemic
• 20% maternal deaths contributes due to anemia
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Anemia Prevalence in pregnant
women
0%
10%
20%
30%
40%
50%
60%
70%
80%
Developed
Countries
Developing
Countries
India
14%
51%
75%
Source: WHO
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India Senario
• According to WHO estimates, India is one of the countries in
the world that has highest prevalence of anaemia.
• India is high prevalence of anaemia in world
• 74.3% population with severe anaemia (Haemoglobin < 11
g/dl)
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Remedies
BLOOD
• Blood is a body fluid in humans and other animals that
delivers necessary substances such as nutrients and oxygen to
the cells and transports metabolic waste products away from
those same cells.
• The Blood cells are mainly,
• Red Blood Cells/ RBCs/ Erythrocytes
• White Blood Cells/ WBCs/ Leukocytes
• Platelets/ Thrombocytes
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Red blood cell
• cytoplasm is rich in Hb
• mature red blood cells are flexible biconcave disks that lack a
cell nucleus
• 2.4 million new erythrocytes are produced per second.
• develop in the bone marrow and circulate for about 100–120
days in the body before their components are recycled by
macrophages.
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RBC
• women have about 4 to 5 million erythrocytes per microliter
(cubic millimeter) of blood and
• men about 5 to 6 million;
• people living at high altitudes with low oxygen tension will
have more
• Each RBC contains approx. 270 million of Hb biomolecules,
each carrying 4 heme groups.
• RBCs of an average adult human male store collectively
about 2.5 grams of iron, representing about 65% of the total
iron contained in the body
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Why Adolescents?
• 58% of women are married before 18 years
• 16% of women are pregnant in age group 15 – 19 years
Early
Marriage
Early
Pregnancy
Under
Nutrition
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Remedies
Reasons for Anemia
• Poor dietary intake of Iron
• Worm infestation and high rate of infection
• Growth support leading to increased demand of iron in the
body
• Onset of menstruation
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WHO Grading of Anaemia
• Grade 1 (Mild Anemia): 10 g/dl
• Grade 2 (ModerateAnemia): 7-10 g/dl
• Grade 3 (Severe Anemia): below 7 g/dl
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Remedies
Iron deficiency anemia
• Iron is an essential part of Hb
• low iron levels result in decreased incorporation of hemoglobin
into red blood cells
• hypochromic (paler than usual) and microcytic (smaller than
usual)
• Causes
ü insufficient dietary intake
üabsorption of Iron
ülosses due to diseases.
übleeding lesions of the gastrointestinal tract
üparasitic infestation
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Remedies
Ferrous Ascorbate
• Ferrous Ascorbate is a synthetic molecule of
ascorbic acid and iron
• It is indicated in the treatment of iron deficiency
anemia.
• Ascorbic acid enhances absorption of iron.
• All dietary iron has to be reduced to ferrous form to enter the
mucosal cells
• Ferrous sulphate (20% elemental Iron) is commonly used for
tablet preparations.
• These salts have good bioavailability but it markedly
decreased in presence of dietary inhibitors like phytates,
tannic acid
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Remedies
FOLIC ACID
• Folic acid also known as folate, vitamin B9 and it is
essential for numerous bodily functions.
• Folate has to be supplied through the diet to meet their
daily requirements.
• The human body needs folate to synthesize DNA, repair
DNA, and methylate DNA as well as to act as a cofactor
in certain biological reactions. It is especially important in
aiding rapid cell division and growth, such as in infancy
and pregnancy. Children and adults both require folic acid
to produce healthy red blood cells and prevent anemia
19. INDICATIONS
•Iron deficiency anemia (anemia is a condition in
which the body does not have enough healthy red
blood cells. Red blood cells provide oxygen to body
tissues).
•It help to prevent neural tube defects.
•Some people use folic acid to prevent colon cancer
or cervical cancer. It is also used to prevent heart
disease and stroke
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Remedies
HOW FOLIC ACID WORK ??
• The basic mechanism of action underlying folic acid is its
role in cellular division and DNA synthesis. Without folic
acid cells do not divide properly.
• Folic acid is critical in the nervous system development of
the foetus and for healthy red blood cell production. Folate is
also required for the regeneration of methionine from
homocysteine and plays a key role as a 'methyl-donor'.
• In the CNS folate is involved with methylation and
hydroxylation, and both reactions are important in
neurotransmitter synthesis and metabolism. Folate is
concentrated in the synaptic regions of CNS neurons
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Remedies
WHAT ARE THE ADVANTAGES OF
TAKING FERROUS ASCORBATE
FOLIC ACID?
• Most of the doctors would recommend every pregnant
woman to take folic acid during conception stage and even
before the conception stage because it causes numerous
advantages for the baby.
• When the pregnant woman has an adequate amount of
ferrous ascorbate folate in the body, it is guaranteed that the
baby will achieve the complete development of the brain and
spinal column. There is an assurance that the baby will not
have any neural tube defects and other inborn defects like
harelip and others
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Remedies
• On the side of the mother, taking a ferrous ascorbate folic
acid would help her to avoid having an anemia sickness
during pregnancy and in addition to that it also boosts the
immune system of the mother and the baby. This is the
reason why, it is highly recommended that every pregnant
woman should start taking ferrous ascorbate folate especially
during the early stages of pregnancy and even before
pregnancy.
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Remedies
Dosage
Adolescents 10 – 19 Years
• Weekly dosages of 100 mg
elemental iron & 500 mcg folic
acid with biannual de-worming
Pregnant & Lactating Women
• 100 mg of elemental iron & 500
mcg of folic acid daily during
pregnancy. Followed by same
dosages for 100 days in the post
partum period
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Remedies
Anaemia is actually a
sign of a disease
process rather than a
disease itself
Anaemia ( from Greek word anaimia, meaning lack of blood) is a decrease in
number of red blood cells (RBCs) or less than the normal quantity of haemoglobin
in the blood.