Non-suicidal intentional ingestion of iron tablets and severe intoxication: the result of adolescent boy’s impulsive risky behaviour in the school

Acute iron poisoning is a potentially fatal intoxication in children. As the Iron preparations are commonly administered to pregnant women, lactating mothers, toddlers, it is easily available at home. So younger children are prone to consume it accidently. Although iron is a therapeutic drug in recommended dosages, excessive iron in the free state can produce toxicity by affecting multiple cellular processes by catalysing redox reactions with lipid peroxidation and free radical formation. The severity of intoxication depends on the amount of elemental iron ingested. Serious toxicity is usually associated with a dose of >40 mg/kg of elemental iron. Levels more than 100 mg/kg are almost always fatal. We report a case where a 12-year male child intentionally taken 60 tablets of iron (ferrous fumarate) at his school as a part of competition or bet to other schoolmate and presented with acute iron poisoning with hepatic encephalopathy to us. Important initial laboratory parameters were AST-4,879 U/L, Prothrombin time-60 sec and Iron level-213 microgram/dl. With timely specific management i.e., deferoxamine infusion along with all required intensive care supportive management in PICU the patient was discharged successfully. We chose to report this case to highlight the risky behaviour of adolescence who usually grows physically and emotionally earlier but their prefrontal lobes are yet immature to take proper and correct decision. Thus, impulse activity may prove fatal for them.

Investigation of Anaemia in Geriatric patients Admitted to Norfolk & Norwich University teaching Hospital Old People’s Medicine/Geriatric Department

Aims To assess if anaemia detected in geriatric patients admitted to the Old Peoples Medicine Department at Norfolk and Norwich University Teaching Hospital was investigated with appropriate laboratory tests- haematinics and iron level tests. Also increase awareness among doctors of the high prevalence of anaemia in geriatric patients and the need to investigate to start treat if indicated. Target population or scope All patients aged 80 and above admitted under the care of NNUH OPM department on a given day incidentally found to have anaemia. Criteria All over 80 year olds admitted to hospital found incidentally to have low HB (anaemia) should be investigated by having elemental iron level and haematinic checks; Iron level check Vitamin B12 and folate check Ferritin Target population or scope All patients aged 80 and above admitted under the care of NNUH OPM department on a given day incidentally found to have anaemia.

Daily Oral Supplementation with 60 mg of Elemental Iron for 12 Weeks Alters Blood Mitochondrial DNA Content, But Not Leukocyte Telomere Length in Cambodian Women

There is limited evidence regarding the potential risk of untargeted iron supplementation, especially among individuals who are iron-replete or have genetic hemoglobinopathies. Excess iron exposure can increase the production of reactive oxygen species, which can lead to cellular damage. We evaluated the effect of daily oral supplementation on relative leukocyte telomere length (rLTL) and blood mitochondrial DNA (mtDNA) content in non-pregnant Cambodian women (18–45 years) who received 60 mg of elemental iron as ferrous sulfate (n = 190) or a placebo (n = 186) for 12 weeks. Buffy coat rLTL and mtDNA content were quantified by monochrome multiplex quantitative polymerase chain reaction. Generalized linear mixed-effects models were used to predict the absolute and percent change in rLTL and mtDNA content after 12 weeks. Iron supplementation was not associated with an absolute or percent change in rLTL after 12 weeks compared with placebo (ß-coefficient: −0.04 [95% CI: −0.16, 0.08]; p = 0.50 and ß-coefficient: −0.96 [95% CI: −2.69, 0.77]; p = 0.28, respectively). However, iron supplementation was associated with a smaller absolute and percent increase in mtDNA content after 12 weeks compared with placebo (ß-coefficient: −11 [95% CI: −20, −2]; p = 0.02 and ß-coefficient: −11 [95% CI: −20, −1]; p= 0.02, respectively). Thus, daily oral iron supplementation for 12 weeks was associated with altered mitochondrial homeostasis in our study sample. More research is needed to understand the risk of iron exposure and the biological consequences of altered mitochondrial homeostasis in order to inform the safety of the current global supplementation policy.

Mechanochemical Reduction of Synthetic Sulphidic Copper-Bearing Minerals in an Industrial Scale

In this paper the mechanochemical reduction of binary sulphides chalcocite (Cu2S) and covellite (CuS) by elemental iron wereinvestigated. The composition and properties of nano-powders prepared by high-energy milling were analyzed by X-ray diffraction,X-ray photoelectron spectroscopy and magnetic measurements. The XRD results showed that in case of chalcocite Cu2S the reactiontakes place until 360 minutes, as no elemental iron, could be identified afterwards. In case of covellite CuS, after 480 minutes of mechanochemicalreduction, a significant amount of non-reacted elemental iron could still be observed. The investigation of magneticproperties reveals significant decrease of saturation magnetization as a result of milling. XPS results showed a significant surfaceoxidation in both systems. Unlike the conventional high-temperature reduction of chalcocite and covellite, the mechanochemicalreduction is fast and ambient temperature and atmospheric pressure are sufficient for its propagation.

Iron Protein Succinylate in the Management of Iron Deficiency Anemia: A Comparative Study with Ferrous Sulphate at Low and High Therapeutic Doses

Oral iron supplementation constitutes the first line treatment for iron deficiency anemia (IDA), with daily doses between 80 mg and 200 mg of elemental iron. Ferrous salts, such as ferrous sulphate (FeSO4), while efficacious, frequently give rise to gastrointestinal side effects. In the present paper we attempted to directly compare the efficacy of an alternative to the FeSO4 formulation, which presents a better tolerability profile, iron protein succinylate (Ferplex®). In a diet-induced anemia model, rats were treated by oral gavage with vehicle, FeSO4, or Ferplex® at a human-dose equivalent of 80 mg and 200 mg of elemental iron. We evaluated the change in anemia-related hematological and biochemical parameters, conducting a histological examination of the intestine at sacrifice. Results indicate that both types of iron supplementation are equally effective in the treatment of IDA, restoring hemoglobin, hematocrit, erythrocytes, free iron and transferrin levels in 15 days, with no statistical differences between treated groups and control. The impact of anemia on body weight was also attenuated following treatment with both iron supplements. Thrombocyte and reticulocyte levels, altered by the anemic condition, returned to homeostasis after 15 days of either FeSO4 or Ferplex® treatment. Importantly, the lower and higher doses of iron were equally effective, thus supporting the current school of thought which states that lower therapeutic doses are sufficient for management of IDA. In addition, the study shows for the first time that oral treatment with Ferplex® does not increase serum hepcidin. Finally, Ferplex® induced minimal iron depositions in the intestinal tissue compared to FeSO4.

Elemental iron: reduction of pertechnetate in the presence of silica and periodicity of precipitated nano-structures

Enhanced TcO4− reduction by metallic Fe0 in the presence of particulate and structural Si. Rhythmical precipitation of dissolved iron leads to formation of layered structures related to geological phenomena such as orbicular rocks and Liesegang rings.

Mackinawite formation from elemental iron and sulfur

Nanoparticulate mackinawite was synthesized from elemental iron and sulfur in a convenient and reliable reaction. The structure and composition of the products were characterized and a new model describing the particle characteristics is established.

Comparative evaluation of efficacy of ferrous ascorbate and ferrous calcium citrate prepared in multidrug delivery system on haemoglobin status in anaemic pregnant women

Iron deficiency anaemia (IDA), the most prevalent nutritional deficiency leading to mortality globally. Oral ferrous salts are effectively used to treat iron deficiency in pregnancy. For the present study, no direct comparison demonstrating the efficacy of ferrous ascorbate and ferrous calcium citrate was considered. An open-label, observational study was designed and conducted for two months. Subjects were randomly allocated to two groups (Group A and Group B). The medication followed in Group A was, ferrous calcium citrate with elemental iron 50 mg; In Group B ferrous ascorbate containing elemental iron 100 mg orally for two months at bedtime. Haemoglobin levels, other hematological parameters, weight changes, side effects, conjunctival colour and general wellbeing were assessed in every visit (i.e. 0, 30th and 60th day) for clinical efficacy assessment. There was an increase in the mean serum haemoglobin and ferritin levels (p<0.05). In Group A and Group B, the mean values of all the assessment parameters increased significantly (p<0.05) in follow-up visits (i.e. 1st month and 2nd month) when compared to baseline values. Out of 69 adverse drug events, 29 (42%) were reported from Group A and 40 (58%) from Group B. Ferrous calcium citrate showed considerable efficacy and safety profiles. Keywords: Iron deficiency; anaemia; haemoglobin; ferrous calcium citrate; ferrous ascorbate