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Almahdi, R. A., & A. Khalid, S. (2021). An Insight into the Practice of Iron Therapy: Contribution to the On-going Debate with Special Reference to Low- and Middle-income Countries. Sudan Journal of Medical Sciences (SJMS), 16(1), 17-32. https://doi.org/10.18502/sjms.v16i1.8934
https://doi.org/10.18502/sjms.v16i1.8934
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Randa Alsadig Almahdi
Randa Alsadig Almahdi
Vice dean, Faculty of Pharmacy, University of Science & Technology, Sudan
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Sami A. Khalid
Sami A. Khalid
Dean, Faculty of Pharmacy, University of science & Technology Professor of Phytochemistry Faculty of Pharmacy, University of Khartoum, Sudan
Published Date
- Mar 31, 2021
An Insight into the Practice of Iron Therapy: Contribution to the On-going Debate with Special Reference to Low- and Middle-income Countries
Abstract
Background: Iron deficiency anemia is a public health problem of a sizable proportion in developing countries. Recently, emerging biochemical knowledge coupled with the discovery of Hepcidin have greatly advanced our understanding of iron metabolism and offered a better insight into its associated pathophysiology. This knowledge should be applied to iron-deficiency anemia therapy to avoid subsequent sequelae of tissue damage associated with reactive oxygen radicals that are catalyzed by iron, because current practices do not include these advances in the treatment guidelines. In the light of recent progress, the existing iron therapy program in many healthcare settings is controversial. This necessitates adjusting the magnitude of iron dose with respect to the very limited iron bioavailability, as gauged by Hepcidin. The current study was therefore aimed to incorporate newly emerging biochemical knowledge into the current iron-deficiency anemia treatment practice
Methods: Literature relevant to iron-deficiency studies published in English between 1964 and 2020 and available online was covered.
Conclusion: Evidently, the existing iron-therapy schedule is both inefficient and toxic. The intricate metabolism of iron should be translated into a more rational iron intervention program with special bias towards low- and middle-income countries requiring a more individualized approach.
Key words: iron deficiency anemia, hepcidin, oxidative stress, iron therapy
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[9] Clark, S. F. (2008). Iron deficiency anemia. Nutrition in Clinical Practice, vol. 23, no. 2, pp. 128–141.
[10] Ramakrishnan, U. and Imhoff-Kunsch, B. (2008). Anemia and iron deficiency in developing countries. In: C. J. Lammi-Keefe, S. C. Couch, E. H. Philipson (Eds.), Handbook of Nutrition and Pregnancy (pp. 337–354). Humana Press.
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[12] Chaparro, C. M. and Suchdev, P. S. (2019). Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. Annals of the New York Academy of Sciences, vol. 1450, no. 1, pp. 15–31. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697587/
[13] Killip, S., Bennet, J. M., and Chambers, M. D. (2007). Iron deficiency anemia. American Family Physician, vol. 75, no. 5, pp. 671–678. Retrieved from: https://www.aafp.org/afp/2007/0301/p671.html
[14] Qu, X. H., Huang, X. L., Xiong, P., et al. (2010). Does Helicobacter pylori infection play a role in iron deficiency anemia? A meta-analysis. World Journal of Gastroenterology, vol. 16, no. 7, pp. 886–896. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825337/
[15] Yiannikourides, A. and Latunde-Dada, G. O. (2019). A short review on iron metabolism and pathophysiology of iron disorders. Medicines, vol. 6, no. 3, p. 85. Retrieved from: https://www.mdpi.com/2305-6320/6/3/85
[16] Iuchi, Y. (2012). Anemia caused by oxidative stress. In: D. S. Silverberg (Ed.) [Internet]. London: IntechOpen. Retrieved from: https://www.intechopen.com/books/anemia/anemia-caused-by-oxidative-stress. doi: 10.5772/31404
[17] Mishra, K., Ojha, H., and Chaudhary, N. K. (2012). Estimation of antiradical properties of antioxidants using DPPH assay: a critical review and results. Food Chemistry, vol. 130, no. 4, pp. 1036–1043. Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S0308814611011058
[18] Munoz, M., Villar, I., and Garcia-Erce, J. A. (2009). An update on iron physiology. World Journal of Gastroenterology, vol. 15, no. 37, pp. 4617–4626. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754509/
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