A large percentage of the population, especially in underdeveloped nations, suffers from anaemia, making it a serious public health issue worldwide. A low haemoglobin (Hb) content or a reduced number of red blood cells (RBCs) in the blood causes this disease, which in turn hinders the body's ability to transfer oxygen to tissues [1-3]. The World Health Organisation (WHO) reports that around 25% of the world's population suffers from anaemia, with the elderly, pregnant women, and small children being the most susceptible. Anaemia is still very common in India, especially among children and women. This leads to more sickness, less successful pregnancies, and less productivity at work [2-4].

Nutritional deficits, chronic diseases, haemolytic disorders, and bone marrow abnormalities are some of the many factors that can lead to anaemia. Iron deficiency anaemia (IDA) is the most frequent kind of this condition, and it can be caused by a lack of iron in the diet, persistent blood loss (from conditions like gastrointestinal bleeding or menstruation issues), or a condition like coeliac disease or inflammatory bowel disease that makes it hard for the body to absorb iron. Vitamin B12 and folate deficiencies are other nutritional reasons; vegetarians and those who are malnourished are more likely to suffer from these conditions [5-7].

Anaemia of chronic disease (ACD) can have dietary origins but is also common in people with autoimmune disorders, chronic kidney disease (CKD), cancer, rheumatoid arthritis, lupus, and TB, among others. Inflammatory mechanisms that disrupt iron metabolism and erythropoiesis are commonly linked to this form of anaemia [7]. There are two types of haemolytic anaemias: inherited (such as sickle cell anaemia, thalassaemia, or hereditary spherocytosis) and acquired (such as autoimmune haemolytic anaemia or drug-induced haemolysis). These anaemias result from the premature death of red blood cells. Extreme forms of deep anaemia necessitating long-term treatment can be caused by bone marrow abnormalities such aplastic anaemia and myelodysplastic syndromes [7-9].

The degree and origin of anaemia determine its clinical manifestation. Weakness, weakness, paleness, vertigo, difficulty breathing, palpitations, and headaches are common symptoms. Cardiomyopathy, low blood pressure, mental fogginess, decreased ability to exercise, and potentially fatal consequences including heart failure are all possible outcomes of severe anaemia. Preterm delivery, low birth weight, and maternal death are among dangers that pregnant women face when anaemia is present. In children, anaemia can lead to growth retardation and impaired cognitive development [8-10].

While many research have shown that anaemia is common, few have looked at the clinical characteristics and causes of anaemia at tertiary healthcare facilities. Improving our understanding of hospitalised patients' anaemia, its prevalence, severity, and causes—will shed light on how to treat and avoid this condition. The purpose of this research is to examine the demographics, clinical manifestations, and degree of anaemia in patients presenting to a tertiary healthcare facility [9-11].

This observational study was conducted at a tertiary healthcare facility over a period of six months. This study was conducted at the department of General Medicine, Sardar Rajas Medical College Hospital and Research Center, Bhawanipatna, Odisha, India from June 2009 to May 2010. A total of 250 individuals diagnosed with anaemia, according to WHO criteria (haemoglobin levels <13 g/dL in males and <12 g/dL in females), were included. Comprehensive demographic information, clinical history, laboratory analyses (including complete blood count, serum ferritin, vitamin B12, and folate levels), and etiological factors of anaemia were recorded. Anaemia severity was classified as mild (Hb 10–12 g/dL), moderate (Hb 7–9.9 g/dL), and severe (Hb <7 g/dL). Statistical analysis was used to ascertain correlations between clinical indicators and the degree of anaemia.

Inclusion Criteria:

• Patients diagnosed with anemia.
• Age ≥18 years (both genders).
• Willing to provide written informed consent.
• Undergoing routine hematological investigations

Exclusion Criteria:

• Age <18 years
• Acute blood loss
• Recent blood transfusion
• Hematological malignancies
• Pregnant women.

The study encompassed 250 individuals who had been diagnosed with anaemia. The results were evaluated according to variables such as demographics, clinical manifestations, anaemia severity, causes, and laboratory values. Of the 250 patients surveyed, 150 were female (or 60%) and 100 were male (or 40%), suggesting that the female gender was more prevalent. The highest percentage of patients (40%), with a mean age of 42.5 ± 15.3 years, was seen in the age group of 31-50 years. Discomfort: 25%

Etiology of Anemia:

150 individuals (60%) — the leading cause, commonly observed in female patients and those with ongoing haemorrhage. autoimmune diseases, diabetes, cancer, and chronic renal disease were present in 50 patients (20%). 25 patients (10%)—mainly as a result of malabsorption syndromes or dietary deficits. Twelve individuals, or 5% of the total, had sickle cell disease, autoimmune haemolytic anaemia, or hereditary spherocytosis complications. Different Reasons: Five percent of cases were due to aplastic anaemia, myelodysplastic syndrome, or other unexplained reasons.

Laboratory Findings:

Severe anaemia cases had lower haemoglobin (Hb) levels than the mean of 9.2 ± 2.1 g/dL. Serum ferritin levels were low in 85% of IDA patients, with an average of 18.5 ± 5.2 ng/mL. A vitamin B12 level of 215 ± 45 pg/mL was found in patients with B12 deficient anaemia. As a result of enhanced RBC destruction, the reticulocyte count was found to be higher in instances of haemolytic anaemia (mean 3.8%).

Table 1: Clinical and Laboratory Findings of Anemic Patients

Sixty percent of cases, mostly in women, were of the Iron Deficiency Anaemia (IDA) variety. Half of the patients had moderate anaemia, defined as haemoglobin levels between 7 and 9.9 g/dL, highlighting the importance of prompt treatment. It is important to manage underlying disorders, as they are responsible for 20% of anaemia cases. Chronic diseases include CKD, diabetes, and cancers. Cases of megaloblastic anaemia and IDA were associated with low serum ferritin and vitamin B12 levels, which points to dietary inadequacies as a key contributor. Typically, chronic diseases, haemolysis, and bone marrow problems were linked to severe anaemia (Hb <7 g/dL), necessitating specialised methods of therapy. In order to decrease anemia-related morbidity in tertiary healthcare settings, these results highlight the necessity of early screening, nutritional interventions, and effective management techniques.

Women and others with long-term health conditions bear a disproportionate share of the burden of anaemia, which remains a major public health concern worldwide but especially in underdeveloped areas. The purpose of this research was to examine anaemic individuals who sought treatment at a tertiary healthcare facility from every angle: clinical profile, severity, aetiology, and laboratory results [12-14].

Consistent with worldwide trends, our results show that anaemia afflicted 60% of females and 40% of males. Periodic blood loss, pregnancy, and nutritional inadequacies put women, especially those of childbearing age, at a higher risk. The average age of the participants in the study was 42.5 ± 15.3 years, and 40% of the cases were found in the 31-50 year old age bracket. This provides more evidence that people of working age are at increased risk of anaemia, and that the health problems experienced by this group may lead to a decline in productivity, highlighting the social and economic consequences of this condition [13-15].

Moderate anaemia (Hb 7-9.9 g/dL) was the most common kind of anaemia, affecting 50% of the study group. The severity of the anaemia varied among the participants. This highlights the significance of identifying cases of mild anaemia early and intervening promptly to stop them from becoming severe. A higher percentage of patients with chronic conditions such as chronic kidney disease (CKD), cancer, and infections experience severe anaemia, with a haemoglobin level below 7 g/dL, which affects 20% of the patients. A more complicated presentation of anaemia can be caused by several diseases, which often necessitate specialised treatment. Consistent with the limiting impacts of anaemia on everyday functioning, symptoms like dizziness (65%), pallor (78%), and exhaustion (85%) were the most commonly mentioned [16-18].

This investigation revealed a wide variety of causes for anaemia. Iron deficiency anaemia (IDA) was the leading cause, representing 60% of all cases. Consistent with worldwide data, this discovery confirms that iron deficiency is the primary cause of anaemia, particularly in females and those experiencing chronic blood loss from gastrointestinal or menstrual-related causes. Twenty percent of patients had chronic disease anaemia (ACD), which was most common in those with chronic kidney disease (CKD), diabetes, or cancer [19, 20]. In such cases, anaemia develops as a result of persistent inflammation and impaired iron metabolism. In addition, 10% of patients had vitamin B12 insufficiency, which highlights the importance of addressing nutritional inadequacies through therapies that focus on food consumption and malabsorption syndromes. Hereditary spherocytosis, sickle cell disease, and autoimmune haemolytic anaemia were the most common causes of haemolytic anaemia, which affected 5% of the participants in the study. Expert diagnostic and treatment measures are necessary in these instances [21, 21].

The test results supported the patient's symptoms, since the average haemoglobin level of 9.2 ± 2.1 g/dL indicated that most of the participants in the research had moderate anaemia. Consistent with iron depletion, the average serum ferritin level in cases of Iron Deficiency Anaemia was 18.5 ± 5.2 ng/mL. Important techniques for controlling anaemia, especially in populations at risk, include iron supplementation and dietary modifications. Furthermore, in instances of B12 shortage, vitamin B12 levels were found to be 215 ± 45 pg/mL, emphasising the necessity of B12 supplementation in these instances. Cases of haemolytic anaemia were associated with enhanced red blood cell destruction, as shown by elevated reticulocyte counts, a hallmark of haemolytic processes [21-23].

This study's results are in line with those of other studies that have looked at the causes and prevalence of anaemia around the world. While iron deficiency is still the leading cause of anaemia, anaemia caused by chronic disorders such as CKD and inflammatory conditions is becoming increasingly problematic. The need of early screening and diagnosis is highlighted by the findings, especially for high-risk populations including women and those with chronic conditions. Programs to control anaemia should centre on nutritional interventions that address B12 deficiencies, dietary counselling, and iron supplementation. Furthermore, a multidisciplinary approach is crucial for treating patients with anaemia since better management of chronic diseases is necessary to avoid or lessen the severity of anaemia [24-26].

The study's single-center design is a major caveat that might make the results underrepresentative of community-wide anaemia rates, especially in less developed or rural areas. In addition, the potential impact of particular dietary habits and deficits on the development of anaemia may have been better understood with the use of a comprehensive dietary evaluation. The long-term treatment results and recurrence of anaemia should be better assessed with a longitudinal trial that includes follow-up [27, 28].

Finally, this study's results highlight the high frequency of anaemia, particularly in women and people with long-term health conditions. Anaemia due to chronic disease or a lack of vitamin B12 was the second most common cause, after iron deficiency anaemia. In order to lessen the impact of anaemia, the study stresses the importance of regular screenings, nutritional interventions, and the proper treatment of underlying diseases. It also implies that patients could benefit greatly from interdisciplinary treatment plans that address dietary deficiencies as well as chronic illness management. To provide more all-encompassing methods for avoiding and controlling anaemia, additional research is necessary, particularly studies conducted in the community.

Funding: 

None

Conflict of Interest:

None

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