Balochistan Plateau of Pakistan, Article Review Example

Evaluation of hemoglobin concentration in pregnancy and correlation with different altitudes: A study from Balochistan Plateau of Pakistan

The purpose of the article is to determine the effects of hemoglobin concentrations on pregnancy outcomes. The researchers found that the altitude at which people live in have an impact on hemoglobin concentrations on the blood. They therefore aimed to determine the prevalence of anemia of individuals living in high altitude and low altitude areas in the Balochistan Plateau of Pakistan. To do so, blood samples were retrieved from 132 pregnant individuals and 110 females that had no history of pregnancy. Chemical analysis of the blood was conducted to determine hemoglobin level and detect possible presence of anemia. It was found that pregnant individuals in high altitude areas were more likely to have higher levels of hemoglobin, while individuals living in low altitudes were more likely to be anemic. In addition, individuals that consumed higher levels of meat were less likely to be anemic. It was concluded that the altitude that an individual lives at can impact the level of hemoglobin their body produces.

The article can be considered internally valid because only individuals living in the Balochistan Plateau of Pakistan were studied. Thus, the difference seen can be specific to individuals living in this area. The strong point of the article is that a statistically significant difference was seen between the hemoglobin concentrations of individuals living in high altitude areas compared to those living in low altitude areas. An additional strength is that the introduction and discussion sections are based on peer-reviewed articles that are considered to be timely and from reliable sources. However, it is apparent that many confounding factors can be present to prevent the true relationship from being seen, which is a major weakness of the article. For example, individuals living at high altitudes and low altitudes may have different diets due to food availability. Thus, individuals that eat less or foods with iron will have a higher likelihood of becoming anemic. In addition, people who live at different altitudes likely live very different lifestyles in general; the job or home life that an individual would have in a valley for example, would be very different from that of an individual living on a mountain. Thus, an additional weak point is that the relationship between hemoglobin levels during pregnancy was not fully examined. A final weak point is that the introduction was short and did not provide a thorough understanding of why hemoglobin levels of individuals living in the Balochistan Plateau of Pakistan were selected specifically. While studies of this region have not been conducted before, the rationale was not thorough.

If I had the ability to ask the authors questions, I would ask what percentage of the population of Pakistan is anemic and do the answered received from this analysis vary from this number. I would also ask whether men tend to be anemic, and whether the authors believe that findings would be different for individuals of different genders.

In my opinion, the next step of this project would be to determine whether men and children have different levels of hemoglobin at varying altitudes. The purpose of the study is to determine the effect in pregnant women, but the amount of hemoglobin does not appear to be heavily impacted by pregnancy. Thus, it would be valuable to determine this effect in this population on a larger scale. It would also be beneficial to repeat the experiment in several different settings. It is possible that the individuals living in this region of Pakistan have certain genetic predispositions that are not true of individuals in other parts of the world. Thus, it would be interesting to determine the prevalence of anemia in individuals living in high altitudes in the United States, specifically in the Rockies and similar areas, compared to those that live at lower altitudes. Doing so will help us gain a better understanding of the distribution of anemia in addition to its relationship with altitude.

References

Umar Z, Rasool M, Asif M, Karim S, Malik A, Mushtaq G, Kamal MA, Mansoor A. (2015). Evaluation of Hemoglobin Concentration in Pregnancy and Correlation with Different Altitude: A Study from Balochistan Plateau of Pakistan.The Open Biochemistry Journal, 9: 7-14.

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