• SIDEROBLASTIC ANEMIA- ANEMIA IN WHICH BONE

MARROW PRODUCES RINGED SIDEROBLASTS RATHER

THAN HEALTHY RED BLOOD CELLS.
• MAIN FEATURES OF SIDEROBLASTIC ANEMIA IS- PRESENCE
OF RING SIDEROBLAST
 APLASTIC ANEMIA

• A DISORDER WHERE THE BONE MARROW STOPS PRODUCING BLOOD

CELLS.
• IT CAN BE ACQUIRED OR CONGENITAL
 THALASSEMIA

• THALASSEMIA IS AN INHERITED BLOOD DISORDER IN WHICH THE BODY

PRODUCES AN ABNORMAL FORM OF HEMOGLOBIN WHICH RESULTS IN EXCESSIVE
DESTRUCTION OF RED BLOOD CELLS AND FURTHER LEADS TO ANEMIA.

• TYPES OF THALA- THALASSEMIA MAJOR – IT IS ALSO CALLED AS

ALPHA THALASSEMIA OR COOLEY ANEMIA -
 GENERAL OBJECTIVE

•At the end of my presentation the peer will able to

know about Anemia.
 SPECIFIC OBJECTIVE
• At the end of my presentation the group will be able to-
• Define anemia
• Describe the incidence of anemia
• Tell epidemiology of anemia
• Enlist the types of anemia
• Explain iron deficiency anemia, causes, sign and symptoms
• Explain pernicious anemia, it’s causes and sign and symptoms
• Describe sickle cell anemia, it’s causes and sign and symptoms
• Define diagnosis for all types of anemia
• Enlist lab tests for anemia
• Describe management for anemia
• Describe prevention of anemia
• Enlist the role of community health nursie in management
 INTRODUCTION
• Anemia is a major global health problem, especially in developing countries
like India, despite the fact that this problem is largely preventable and easily
treatable. It is the commonest disease affecting humankind anD is responsible
for morbidity and mortality among general populationto reduction below
normal in the concentration of hemoglobin, Hematocrit or red blood cells in
the blood. Any of the three measures of concentrate (Heamoglobin,
Hematocrit or Number of Red blood cells) may be used to establish the
presence of anemia, but the blood hemoglobin level is preferred, in part
because of its accuracy and reproducibility.
 INCIDENCE

• . ABOUT 30% OR NEARLY ONE THIRD OF WORLD'S POPULATION IS SUFFERING

FROM ANEMIA DUE TO VARIOUS CAUSES.
• IN INDIA PREVALENCE IS VERY HIGH AS COMPARED TO WORLD PREVALENCE.
• IN INDIA PREVALENCE IS APPROXIMATELY 51%. IMPACT OF ANEMIA IS MORE ON
PREGNANT WOMEN AND CHILDREN.
 DEFINITION
•Anemia is a decrease in the number of red blood cells
or less then the normal quantity of haemoglobin in
the blood.
Or,
•Anemia is defined as a decrease in the ability of the
blood to carry oxygen due to-
•Decrease in the total number of erythrocytes, each
having a normal quantity of haemoglobin
•A decrease concentration of haemoglobin per
erythrocytes
• A combination of both.
 TYPES OF ANEMIA

• Iron deficiency anemia

• Pernicious anemia
• Sickle anemia
• Megaloblastic anemia
• Aplastic anemia
• Thalassemia
• Sideroblastic anemia
 IRON DEFICIENCY ANEMIA

•Iron deficiency anemia is a most common type of

anemia which find in community.
•Iron deficiency anemia is a common nutritional problem
in children
•Iron deficiency anemia is also called as nutritional
anemia
 CAUSES OF IRON DEFICIENCY ANEMIA

2) INCREASED DEMAND OF
1) INADEQUATE INTAKE OF IRON 3) EXCESSIVE LOSS OF IRON
IRON
• All women of
• Poor diet
reproductive/child
• Poverty bearing age group
• Ignorance • Pregnancy
• Inadequate folate/ • Periods of rapid growth,
like infancy, childhood,
vitamin c intake. adolescence..
• Normal basal loss
(1mg/day)
• Menstruation(2mg/day)
• Peptic ulcers/bleeding
piles
• Accidents/trauma/surgery
• Rrpeated/frequent
pregnancy.
 CLINICAL FEATURES OF IRON DEFICIENCY
ANEMIA

• Spoon nails
• Smooth tongue
• Fatigue
• Tachycardia
• Weakness
• Cheliosis
 PERNICIOUS ANEMIA
•Pernicious anemia is a condition in
which the body can’t make enough
healthy red blood cells because it
doesn’t have enough vitamin b12.

•People who have pernicious anemia

can’t absorb enough vitamin b12 due
to lack of intrinsic factor ( a protein
made in the stomach).
 CAUSES OF PERNICIOUS
ANEMIA
• A lack of intrinsic factor is a common cause of pernicious anemia as the
body can’t absorb enough vitamin b12.
• Some pernicious anemia occurs because the body’s small intestine can’t
properly absorb vitamin b12 which may be due to bacterial infection
certain disease conditions, certain medication,surgical removal of part of
the small intestine.
• Sometimes people develop pernicious anemia because they don’t get
enough vitamin b12 in their diets.
CLINICAL FEATURES PERNICIOUS
ANEMIA
 SICKLE CELL ANEMIA
• Sickle cell anemia is a serious disease in which the body makes sickle shaped(c shaped) red blood
cells.
• Sickle cell contain abnormal haemoglobin that causes the cells to have a sickle shape, which don’t
move easily through the blood vessels- they are stiff and sticky and tend to form clumps and get
stuck in the blood vessels.
• The clumps of sickle cells block blood flow in the blood vessels that lead to the limbs and organ
damage.
In sickle cell anemia, a lower than normal number of red blood
cells occurs because sickle cell doesn’t last very long.

Sickle cells usually die about 10 -20 days and the body can’t
reproduce red blood cells fast enough to replace the dying ones,
which causes anemia.
 CAUSES OF SICKLE CELL ANEMIA
Mutation of HBB gene ( haemoglobin,beta,located on
chromosome number 11) cause sickle cell disease.
• The hbb gene provides instructions for making beta
hemoglobin.
• Heamoglobin consist of four protein subunits:
• - two subunits called alpha globin and two subunits called
beta globin.
• Various versions of beta globin result from different
mutations in hbb gene causing different types of sickle cell
disease.
CLINICAL FEATURES OF SICKLE
CELL ANEMIA
 DIAGNOSIS OF ANEMIA
• Anemia can be detected by the simple measurement of the haemoglobin
in the blood.
• A who group expert group proposed that anemia should be considered to
exist, when hb is below the following levels.
• Mchc (mean corpuscular haemoglobin concentration) is an indicator of
iron deficiency anemia. Normal deficiency should be 34% For all age
groups.
• Through evaluation of the client.
• Physical examination and medical history.
LAB TESTS FOR ANEMIA
 PREVENTION OF ANEMIA

• Primary prevention- dietary improvement through

education to encourage selection of iron rich foods to
improve iron content and bioavailability.
• It is important for adolescent girls, pregnant women
and lactating mothers to consume iron folic acid tablets
to prevent anemia as they are at high risk.
• It is important to include citrus fruits (such as lemon,
orange, alla, guava etc) to increase the absorption of
iron in the body.
• Excessive consumption of tea or coffee prevents
absorption of iron in the body and should be avoided.
• Linking intervention strategies to related health and
nutrition programs.
• When these preventive measures fail, routine screening
helps prevent the development of severe anemia.
 MANAGEMENT
• Management of anemia is directed towards correcting or controlling the
- Causes
Nutritional supplement use of nutritional supplements should be
appropriately taught to the client and the family because too much intake
cannot improve anemia.
• Iron therapy- oral ferrous oral salts are most economical and effective
medication for the treatment of iron deficiency anemia.
• Intravenous fluids- intravenous fluids replace the lost volume of blood or
electrolytes to restore them to normal level.
 ROLE OF COMMUNITY HEALTH NURSES
• The overall goal of a community health nurse is to help the individual, family and community in
attaining highest standard of health by means of prevention of illness and promotion of health.
• To collect information about the community.
• To create awareness about their own health problems.
• To increase life expectancy.
• Providing health education in schools, villages, clinic etc.
• By amending and improving the plans of programmes carried out government like anemia mukt
bharat, weekly iron folic acid supplementation programme, national iron plus initiative.
 CONCLUSION

• Anemia is a condition resulting in a decreases in the ability of blood

to transport oxygen.
• There are various types of anemia like iron deficiency anemia, sickle
cell anemia, Megalobstic anemia, pernicious anemia, Thalassemia.
• Iron deficiency anemia is a common type of anemia.
• Anemia is the commonest causes of maternal morbidity and
mortality in spite of easy diagnosis and treatment.
• Anemia is a preventable global disease.
 BIBLIOGRAPHY

• COMMUNITY HEALTH NURSING BY KESHAV SWARNKAR 4TH EDITION, PAGE NUMBERS

373 , 390.
• HUMAN BIOLOGY BY DANIEL D CHIRAS, 4TH EDITION , PAGE NO. 160
• TEXTBOOK OF PHYSIOLOGY BY A. K JAIN VOLUME 1 , 6TH EDITION, PAGE NO. 70-74.