ANAEMIA FREE INIDIA

• Group photo

Our TeamPRESENTED At GYNAECON 10/10/2015

Our MISSION: SAY No TO ANAEMIA

DR. JYOTI BHASKAR

DR. SHARDA JAIN Dr.Jyoti Aggarwal

SOARING HIGH !! THROUGH

IRON LIBERATION

Embarrassing !!

Indian Scenario

MAGNITUDE

• 49.7% of Indian pregnant women suffer from anemia (WHO Global database, 2006)

20 % maternal deaths contributed by anemia

• Iron deficiency anemia (IDA) commonest cause of anemia in pregnancy

Most Common deficiency state in the worldPreventable and correctable cause of anemia.

Dr. Sharda Jain – An activist and protagonist of Anaemia Free India –

80% pregnant women are Anaemic

Every Parent Aspires That There Child will

Become anotherAPJ ABDUL KALAM

HARD FACT

HAEMOGLOBIN LEVELS AFFECTS

• INTELLIGENCE

• PERFORMACE• Diminished concentration• Disturbance in perception• Poor learning ability

Reduced Performance and Productivity

Decreased Work OutputDecreased Work Capacity

Anaemic Mother gives birth to an Anaemic Baby

• Irregular Heavy menstruation• Low pre-pregnancy iron stores• LBW babies and preterm delivery

Hemorrhage30%

Anemia19%

Sepsis16%

Abortion9%

Obst. Lab10%

Toxemia8%

Others8%

CAUSES OF MATERNAL MORTALITY SRS-1998

- Direct cause of 20% of maternal deaths Indirect cause for another 20% of maternal deathsNothing is more expensive than a missed

opportunity!

UNCHANGED FOR 5 DECADES

Anaemia

Death

In India, over 300 maternal deaths EVERYDAY,

about 200 due to anemia: FOGSI Beyond numbers!

For every maternal death, there are 30 more who ‘almost died’.

Definition

WHO defines Anemia as

•Hb< 12 gm/dl in women •Hb< 13gm/dl in Men

•Anemia in pregnancy refer Hb < 11gm/dl.

MANAGEMENT

DIET --- IRON AND PROTEINS

WHO

• Anthelminthic medication in pregnant women with anaemia after 12 weeks of pregnancy

• Drug of choice is Mebendazole 100mg BD for 3 days OR Albendazole 400mg

FERROUS SULPHATE

FERROUS GLUCOMATE

FERROUS FUMARATE

Ferrous Succinate

PARENTERAL IRON THERAPY

INDICATIONS

• Non compliance with, or intolerance to, oral iron therapy

• Proven malabsorption

• No Hemoglobinopathy

• Advanced gestation/post partum with moderate to severe

anemia

FORMULATIONS

• Low molecular weight Iron Dextran

• Iron Sucrose

• Ferric Carboxymaltose

Problems With Existing Parenteral Iron Preparations

• The main disadvantage of Iron sucrose is the need for multiple infusions as the maximum weekly dose should not exceed 600 mg (200 mg IV, 1-3 times/week)

• Risk of anaphylaxis and allergic reactions

• Requirement of test dose administration

Cancado RD et al. Rev Bras Hematol Hemoter. 2011; 33(6): 461–469.

NEWER PREPARATIONS

Iron III carboxymaltose (ferric hydroxide carbohydrate complex)

• Controlled delivery of iron within cells of reticuloendothelial

system (primarily bone marrow) • Subsequent delivery to iron binding proteins ferritin and

transferrin.• Rapid incorporation into RBCS

Dosage

• Single intravenous dose of 1000 mg over 15 minutes (maximum 15 mg/kg by injection or 20 mg/kg by infusion)

• Dilution: • 500mg ferric carboxymaltose in 100mL sodium

chloride 0.9%. • 1000mg ferric carboxymaltose in 250mL sodium

chloride 0.9%

• Flush with 50mL sodium chloride 0.9% before and after iron infusion to minimise risk of extravasation.

• Maximum of 1000mg that can be given in one sitting.

• No test dose required

Indications

Were Parenteral iron is Indicated:

• Adolescents and All Women• Pregnant women in 2nd – 3rd trimester• Post-Partum Women• Before Surgeries

Take Home Message

• We Need to Build an Anaemia free India

• Be Obsessed – Detection and Treatment

• Switch Over Early – to Parenteral Iron

• FCM – is Safe, Patient Friendly and Effective

Iron strengthens!

Gold glittersSilver shines

But…

ISO 14001:2004 (EMS)

ISO 9001:2008

HELPLINE-9650588339/22414049

HELPLINE-9599044257

HELPLINE-9910081484ISO 9001:2008

HELPLINE9599044357

…..Caring hearts, healing hands