1. BLOOD Indus Pharma

2. Blood Blood is a liquid tissue. zAdult contained blood5 – 6 Liters zpH of blood (alkaline)7.35 – 7.45

3. Function of Blood Blood performs two major functions: zTransport through the body of o Carry oxygen from the lungs & carbon dioxide to the lungs o Carry food molecules (glucose, lipids, amino acids) to tissue o Acts as a vehicle for hormones, vitamins & others chemicals o Maintains ions balance (e.g., Na+, Ca2+, HCO3-) o Drainage of wastes products like urea o Regulate the body temperature o Regulates blood pressure by changing in volume & viscosity zDefense of the body against infections and other foreign materials through WBCs.

4. Composition of Blood

5. Red Blood Cells ( Erythrocytes) These are the most numerous cells in the blood and contain a substance called Hemoglobin, which give them red color and makes up about 35% of its weight. zRBC’s has diameter7.5 µm zWomen contain RBC’s4.8 million/mm 3 zMen contain RBC’s5.4 million/mm 3 zAverage life of RBC’s120 days zThey are flexible and able to pass through the capillaries zRed blood cells are responsible for the transport of oxygen and carbon dioxid e

6. Haemoglobin

7. Quantity of Haemoglobin zMale13-18 gm/100ml of blood zFemale11.5-16.5gm/100mlblood zChildren (1 y)11-13 gm/100ml of blood zChildren 11.5-14.5 gm/100ml of blood (10-12yrs)

9. Anemia? Anemia means either Red Blood Cells are low or the amount of Hemoglobin in the RBC’s is low.” Anemia is also defined as hemoglobin concentration < 10 g/dl

10. What causes anemia

11. Other Causes are? Multifetal pregnancy Deficient absorption e.g. achlorhydria Gastrointestinal hemorrhage Bleeding in pregnancy Folic acid deficiency Use of antifolate drugs Certain pathologies like malignant disease with z increased cell turnover, hemolysis, inflammatory z disease etc

13. Prevalence of Anemia

14. Types of Anaemia There are several different types of anaemia, each with a specific cause and treatment, including the following: Iron-Deficiency Anaemia: Anaemia caused by lack of iron in red blood cells Megaloblastic (Pernicious) Anaemia: Where an inability to absorb vitamin B12 prevents the production of red blood cells and damages the spinal cord Anaemia Of Folate Deficiency: Lack of folic acid can cause anaemia, and it can be caused by alcoholism Hemolytic Anaemia: Anaemia caused by the destruction of red blood cells

15. Iron Deficiency & Anaemia  Iron deficiency is defined as a decreased total iron body content.  Iron deficiency anemia occurs when iron deficiency is sufficiently severe to diminish erythropoiesis and cause the development of anemia.

16. Impact of Anemia  Negative effects on work capacity and Qol.  Negative effects on motor and mental development in infants, children, and adolescents.  Maternal iron deficiency anemia might cause 3 fold risk of low birth weight and preterm delivery  Five fold greater risk of maternal death.  * CDC: October 2002

17. Causes of Iron Deficiency (a) Decreased iron intake, (b) Increased iron loss from the body (c) Increased iron requirements.

18. Iron Daily Loss  Each day 0.5 to 1.0mg of iron is lost in the faeces, urine and sweat.

19. Daily Requirements:10- 20mg  Adult male absorbs and loses about 1 mg of iron daily.  Childbearing female loses an average of 2 mg of iron daily.  A woman loses about 500 mg of iron with each pregnancy.  Menstrual losses are highly variable, ranging from 10-250 mL (4-100 mg of iron) per period.

20. Iron Daily Requirement Children4 to 10 mg Adolescence10 to 20 mg Menstruating women7 to 20 mg Pregnancy & Lactation20 to 48 mg Men & Menopausal women 5 to 10 mg

21. Iron Polymaltose complex The iron Polymaltose complex is a water soluble macromolecular complex of iron. Size: molecular mass of 52300 Daltons.. ÜThis molecule is so large that diffusion through the membrane of the mucosal cells is about 40 times smaller than the one for the Ferrous salts. ÜThe complex is stable and does not release ionic iron under physiologic conditions.

22. Structure of IPC molecule

25. Folic Acid zThe minimal daily requirement is about 100mcg. The need for this is vitamin more than double during pregnancy. zFolic acid may prevent certain birth defects if taken before conception and in the early months of pregnancy Prophylactic folic acid (400mcg daily) is recommended for all women planning a pregnancy.

26. Folic Acid zPrevents Birth Defects Research has shown that by maintaining an adequate intake of Folic acid, a women in her childbearing years may reduce z the risk of conceiving a baby with the birth defects. That’s why, “U.S public Health Service is recommending a daily intake of z Folic acid for all women capable of becoming pregnant, regardless of when they plan to do so”

27. Munawar Shah Sahimunawar@yahoo.com KPK Pakistan

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