Effect of B12 supplementation on renal anemia among hemodialysis patients at El-Najar hospital, Gaza strip

Introduction: Patients with end-stage renal disease (ESRD) are predisposed to nutritional deficiencies, resulting in vitamin B12 deficiency with negative hematologic consequences. Objective: This study aimed to investigate the impact of intramuscular B12 on renal anemia among ESRD patients receiving hemodialysis (HD) at El-Najar hospital, Gaza Strip. Patients and Methods: A case-control study conducted, which included 110 healthy controls and 110 HD patients who received B12 on a daily, weekly, and monthly basis over two months. Sociodemographics and current diseases were reported. Serum levels of serum B12, white blood cell (WBC), red blood cell (RBC), hemoglobin (Hb), mean corpuscular volume (MCV), and platelet (PLT) were recorded before and after treatment. Data analysis was conducted using SPSS. Results: Baseline serum B12 level was significantly lower in HD patients compared to controls (362.62 ± 166.40 versus 483.36 ± 115.07 ρg/mL, P<0.001), which significantly improved after vitamin B12 treatment (639.08 ± 362.99 ρg/mL, P<0.001). Additionally, mean WBCs, RBCs, Hb, and PLT levels were significantly increased after treatment (P<0.001). Serum B12 level was positively and significantly (P<0.001) correlated with levels of WBC (r = 0.45), RBC (r = 0.43), Hb (r = 0.39) and PLT (r = 0.51), and negatively correlated with MCV (r = -0.46, P<0.001). Conclusion: Administration of vitamin B12 improves serum B12 levels in HD patients, which was associated with increased WBCs, RBCs, Hb, and PLT levels and decreased MCV levels. Treatment by vitamin B12 can improve HD patients’ renal anemia. Future studies with larger sample sizes and prolonged follow-up are advocated

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population