OBESITY IS A RISK FACTOR FOR IRON DEFICIENCY AND ANEMIA: A CASE CONTROL STUDY

OBESITY IS A RISK FACTOR FOR IRON DEFICIENCY AND ANEMIA: A CASE CONTROL STUDY

Amira S. Nassar*, Mohamed F. Allam, Maysa A. Samy and Mohsen A. Gadallah.

Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University.

* Department of Nutritional Requirement and Growth, National Nutritional Institute.

 

ABSTRACT:

 

Background: Rapid dietary and lifestyle changes produce a double burden of malnutrition. The populations suffer from increasing over consumption of food, but continue to have high rates of micronutrient deficiencies. Adipose tissue of obese persons produces increased amount of pro-inflammatory cytokines contributing to the development of a low-grade systemic inflammation in these persons.

Aim of the work: to determine the relation between body mass index (BMI) and hemoglobin (Hg) level, serum iron, total iron binding capacity (TIBC) and C reactive protein (CRP).

Patient and Methods: study was carried out on 60 women attending the outpatient clinic of the National Nutrition Institute (Egypt). Participants were divided into two groups; 30 obese women (case group) and 30 normal weight women (control group). Diagnosis of obesity was based on BMI >30 [WHO, 2014]. Anemia was diagnosed according to Hg level, serum iron and TIBC.

Results: The mean age of participant women was 32.82 years (SD 6.65) and ranged between 18 and 47 years. The mean Hb level of participant women were 11 gm/dl (SD 1.21) and ranged between 8.7 and 13.8 gm/dl. Hb levels showed no significant difference between obese and normal weight women. Serum iron was higher in normal weight women compared with obese women (P <0.05). No significant correlation was observed between BMI and Hb levels. BMI had a significant negative correlation with serum iron. BMI has significant positive correlations with TIBC and CRP. Linear regression analysis showed a significant association between Hb levels and waist hip ratio.

Conclusion: High BMI affected negatively levels of serum iron and is associated with inflammatory process as indicated by higher levels of CRP. High waist hip ratio is an important risk factor for anemia.

 

Key words: Obesity, overweight, BMI, anemia, iron deficiency anemia

 

Ain Shams Medical Journal 2021;75(4):891-898

 

https://asmj.journals.ekb.eg/article_222707_9a4e8866b53089244c47c02b27af75e8.pdf

Melatonin could be used for Treatment of COVID-19?

Melatonin could be used for Treatment of COVID-19?

 

Rehab Mohamed Ali Mohamed (1), Ghada Essam El-Din Amin (1,2), Salwa Mostafa Mohammad Abdel Rahman (1,3), Mohamed Farouk Allam (1,4)*

 

1. Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

2. Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

3. Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams Univer[1]sity, Cairo, Egypt

4. Department of Preventive Medicine and Public Health, School of Medicine, University of Cordoba, Cordoba 14004, Spain

 

*Correspondence: farouk.allam@med.asu.edu.eg

DOI: https://doi.org/10.31586/gjeid.2022.188

Abstract:

Coronaviruses (CoVs) are a broad family of potentially serious RNA viruses that are now causing an outbreak of respiratory disease known as CoV disease 2019 (COVID-19). Melatonin is a pineal hormone that is predominantly produced and released at night from the amino acid trypto[1]phan. Melatonin and its metabolites are also important in immunomodulation, and they have anti[1]oxidative properties due to their capacity to scavenge reactive oxygen species both directly and in[1]directly. COVID-19 leads to changes of altered consciousness levels in about 15% of hospitalized patients, starting from somnolence to disorientation, delirium, stupor, and coma. Melatonin can de[1]crease the molecules that cause delirium in the elderly and central respiratory depression, such as benzodiazepines and antipsychotics. Melatonin may help alleviate infection-induced acute respira[1]tory distress as well as its diverse effects, which include anti-inflammatory, antioxidative, and im[1]mune-enhancing properties. Its supplemental dose may be able to prevent SARS-COV-2 infections by reversing aerobic glycolysis via suppression of both HIF-1 and mTOR, allowing pyruvate dehy[1]drogenase complex activity to be suppressed and acetyl-coenzyme A to be produced. When mito[1]chondrion-produced and parenteral melatonin are combined, the cytokine storm is reduced, and COVID-19 infection-induced damage is alleviated. In conclusion, melatonin could have an im[1]portant role in the management of COVID-19.

 

Keywords: Coronavirus, COVID-19, Melatonin, Management, Review.

Global Journal of Epidemiology and Infectious Disease, 2022, 2, 19-22

https://www.scipublications.com/journal/index.php/gjeid/article/view/188

 

Role of Colchicine in Management of COVID-19?

Role of Colchicine in Management of COVID-19? 

Kholoud Mohamed Elawady Elhefnawy Elshiwy (1), Ghada Essam El-Din Amin (1,2), Mohamed Nazmy (3), Rasha Samir (3), Mohamed Farouk Allam (1,4)*

 

1. Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

2. Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

3. Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

4. Department of Preventive Medicine and Public Health, School of Medicine, University of Cordoba, Cordoba 14004, Spain

 

*Correspondence: farouk.allam@med.asu.edu.eg

 

DOI: 10.31586/gjeid.2022.177

 

Abstract:

 

CoV-2 disease 2019 (COVID-19) pandemic has exerted a great burden on the health and economic systems worldwide. One of the most important factors that affect the severity and prognosis of COVID-19 is the occurrence of hyperstimulation of the immune system resulting in “cytokine storm”. Similar to SARS-CoV, an intracellular complex called nod like receptor family pyrin domain containing 3 (NLRP3) inflammasome was found to be activated by SARS-CoV-2, then in turn stimulates several interleukins and initiates the inflammatory cascade. In addition, other inflammatory mediators such as interferons e.g., IFN-α, and IFN-γ, interleukins e.g., IL-1β, IL-12, IL-18, tumor necrosis factor-α (TNF- α), and chemokines e.g., CCL2, CXCL10 have been reported in severely ill patients. These mediators represent the corner stone in developing cytokine storm that results in uncontrolled systemic inflammatory reaction with subsequent acute respira[1]tory distress syndrome (ARDS), multiple organ failure and eventually death. Based on its an[1]ti-inflammatory effects, colchicine has also gained attention to be utilized in the management of COVID-19 patient. Colchicine exerts its anti-inflammatory effect through inhibition of formation of microtubules which is considered an essential step in several cellular processes such as division, signalling, and migration. Also, colchicine affects the cytokine cascade by inhibiting IL-1β leading to reduction in neutrophils recruitment, free radicles production and inflammasome stimulation. This raises the concerns about the effectiveness of colchicine in COVID-19 treatment and the pos[1]sibility of providing an improvement of the clinical course of the disease.

 

Keywords: Coronavirus, COVID-19, Colchicine, Management, Review

 

Global Journal of Epidemiology and Infectious Disease, 2022, 1, 1-3

 

https://www.scipublications.com/journal/index.php/gjeid/article/view/177

The Link between Vitamin D and SARS-COV-2

The Link between Vitamin D and SARS-COV-2

 

Bahaa El-Din LM (a), Amin GE (a,b), Samir R (c), Nazmy M (c) and Allam MF (a,d*)

a. Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

b. Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

c. Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

d. Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Cordoba, Cordoba 14004, Spain

 

DOI: https://doi.org/10.36266/JPDRM/107

 

Abstract

 

Vitamin D is a fat-soluble vitamin that crosses through membranes and binds to a specific receptor; the Vitamin D receptor (VDR). It is becoming clearer that microbes decelerate immune reactivity by dysregulating the VDR ultimately to increase their chance of survival, and that is why Immune[1]modulatory therapies that enhance VDR expression and activity are considered in the clinic today to a greater extent. Recent studies found that vitamin D supplementation reduced the risk of acute respiratory infection. It has been shown that vitamin D triggers innate cellular immunity, through the production of antimicrobial peptides, such as cathelicidins, IL-37, and defensins. It also hinders the cytokine storm, decreasing the production of pro-inflammatory cytokines such as IFNγ and TNFα. The SARS-COV-2 outbreak rapidly spread across the world and it has spurred a global effort to tackle the disease and to establish risk factors and prognostic markers like for example serum vitamin D. Over the past months, the evidence continued to grow and there’s more publications in peer-reviewed medical journals about the possible connection between vitamin D and SARS-COV-2. Literature about the correlation of vitamin D status in the context of clinical outcomes of SARS-COV-2 infection is limited. Further studies are needed to explore possible associations between Vitamin D status and disease severity and survival in SARS-COV-2 patients.

 

Keywords: Vitamin D; COVID-19; SARS-COV-2; Vitamin D receptor; IFNγ; TNFα.

 

Journal of Pulmonary Disease and Respiratory Medicine 2021;1(2):1-2.

 

https://www.pubtexto.com/journals/journal-of-pulmonary-diseases-and-respiratory-medicine/fulltext/the-link-between-vitamin-d-and-sarscov2

Comparison of hemoglobin level and neutrophil to lymphocyte ratio as prognostic markers in patients with COVID-19

 

Shaimaa Hani Fouad (1), Mohamed Farouk Allam (2), Sara Ibrahim Taha (3), Ahmed Ashraf Okba (4), Amr Hosny (5), Mayada Moneer (1) and Sylvia Wefky Roman (1)

 

1. Departments of Internal Medicine and Allergy and Clinical Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

2. Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

3. Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

4. Department of Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

5. Department of Anesthesiology and Intensive Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

 

Journal of International Medical Research 2021;49(7):1-15.

 

DOI: 10.1177/03000605211030124

 

Abstract

Background. Anemia can negatively affect the outcome of many diseases, including infections and inflammatory conditions.

Aim. To compare the prognostic value of hemoglobin level and the neutrophil/lymphocyte ratio (NLR) for prediction of coronavirus disease 2019 (COVID-19) severity.

Methods. In this retrospective cohort study, clinical data from patients with laboratory-confirmed COVID-19 were collected from hospital records from 10 April 2020 to 30 July 2020.

Results. The proportions of patients with mild, moderate, and severe COVID-19 differed significantly in association with hemoglobin levels, neutrophil counts, lymphocyte counts, NLR, and total leukocyte counts. Patients with severe COVID-19 had significantly lower hemoglobin levels than those with moderate or mild COVID-19. There were statistically significant negative associations between hemoglobin and D-dimer, age, and creatinine. The optimal hemoglobin cut-off value for prediction of disease severity was 11.6 g/dL. Using this cut-off value, hemoglobin had higher negative predictive value and sensitivity than NLR (92.4% and 51.3%, respectively). The specificity of hemoglobin as a prognostic marker was 79.3%.

Conclusion. Both NLR and hemoglobin level are of prognostic value for predicting severity of COVID-19. However, hemoglobin level displayed higher sensitivity than NLR. Hemoglobin level should be assessed upon admission in all patients and closely monitored throughout the disease course.

 

Keywords. Coronavirus disease 2019, hospital, anemia, neutrophil/lymphocyte ratio, patient stratification, hemoglobin, intensive care unit, severity.

 

Journal of International Medical Research 2021;49(7):1-15.

 

https://journals.sagepub.com/doi/full/10.1177/03000605211030124