Iron deficiency anemia is a common type of anemia — a condition in which blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body's tissues.
As the name implies, iron deficiency anemia is due to insufficient iron. Without enough iron, your body can't produce enough of a substance in red blood cells that enables them to carry oxygen (hemoglobin). As a result, iron deficiency anemia may leave you tired and short of breath.
You can usually correct iron deficiency anemia with iron supplementation. Sometimes additional tests or treatments for iron deficiency anemia are necessary, especially if your doctor suspects that you're bleeding internally.
Initially, iron deficiency anemia can be so mild that it goes unnoticed. But as the body becomes more deficient in iron and anemia worsens, the signs and symptoms intensify.
Iron deficiency anemia signs and symptoms may include:
Chest pain, fast heartbeat or shortness of breath
Headache, dizziness or lightheadedness
Cold hands and feet
Inflammation or soreness of your tongue
Unusual cravings for non-nutritive substances, such as ice, dirt or starch
Poor appetite, especially in infants and children with iron deficiency anemia
When to see a doctor
If you or your child develops signs and symptoms that suggest iron deficiency anemia, see your doctor. Iron deficiency anemia isn't something to self-diagnose or treat. So see your doctor for a diagnosis rather than taking iron supplements on your own. Overloading the body with iron can be dangerous because excess iron accumulation can damage your liver and cause other complications.
Iron deficiency anemia occurs when your body doesn't have enough iron to produce hemoglobin. Hemoglobin is the part of red blood cells that gives blood its red color and enables the red blood cells to carry oxygenated blood throughout your body.
If you aren't consuming enough iron, or if you're losing too much iron, your body can't produce enough hemoglobin, and iron deficiency anemia will eventually develop.
Causes of iron deficiency anemia include:
Blood loss. Blood contains iron within red blood cells. So if you lose blood, you lose some iron. Women with heavy periods are at risk of iron deficiency anemia because they lose blood during menstruation. Slow, chronic blood loss within the body — such as from a peptic ulcer, a hiatal hernia, a colon polyp or colorectal cancer — can cause iron deficiency anemia. Gastrointestinal bleeding can result from regular use of some over-the-counter pain relievers, especially aspirin.
A lack of iron in your diet. Your body regularly gets iron from the foods you eat. If you consume too little iron, over time your body can become iron deficient. Examples of iron-rich foods include meat, eggs, leafy green vegetables and iron-fortified foods. For proper growth and development, infants and children need iron from their diets, too.
An inability to absorb iron. Iron from food is absorbed into your bloodstream in your small intestine. An intestinal disorder, such as celiac disease, which affects your intestine's ability to absorb nutrients from digested food, can lead to iron deficiency anemia. If part of your small intestine has been bypassed or removed surgically, that may affect your ability to absorb iron and other nutrients.
Pregnancy. Without iron supplementation, iron deficiency anemia occurs in many pregnant women because their iron stores need to serve their own increased blood volume as well as be a source of hemoglobin for the growing fetus.
These groups of people may have an increased risk of iron deficiency anemia:
Women. Because women lose blood during menstruation, women in general are at greater risk of iron deficiency anemia.
Infants and children. Infants, especially those who were low birth weight or born prematurely, who don't get enough iron from breast milk or formula may be at risk of iron deficiency. Children need extra iron during growth spurts. If your child isn't eating a healthy, varied diet, he or she may be at risk of anemia.
Vegetarians. People who don't eat meat may have a greater risk of iron deficiency anemia if they don't eat other iron-rich foods.
Frequent blood donors. People who routinely donate blood may have an increased risk of iron deficiency anemia since blood donation can deplete iron stores. Low hemoglobin related to blood donation may be a temporary problem remedied by eating more iron-rich foods. If you're told that you can't donate blood because of low hemoglobin, ask your doctor whether you should be concerned.
Mild iron deficiency anemia usually doesn't cause complications. However, left untreated, iron deficiency anemia can become severe and lead to health problems, including the following:
Heart problems. Iron deficiency anemia may lead to a rapid or irregular heartbeat. Your heart must pump more blood to compensate for the lack of oxygen carried in your blood when you're anemic. This can lead to an enlarged heart or heart failure.
Problems during pregnancy. In pregnant women, severe iron deficiency anemia has been linked to premature births and low birth weight babies. But the condition is preventable in pregnant women who receive iron supplements as part of their prenatal care.
Growth problems. In infants and children, severe iron deficiency can lead to anemia as well as delayed growth and development. Additionally, iron deficiency anemia is associated with an increased susceptibility to infections.
You can reduce your risk of iron deficiency anemia by choosing iron-rich foods.
Choose iron-rich foods
Foods rich in iron include:
Red meat, pork and poultry
Dark green leafy vegetables, such as spinach
Dried fruit, such as raisins and apricots
Iron-fortified cereals, breads and pastas
Your body absorbs more iron from meat than it does from other sources. If you choose to not eat meat, you may need to increase your intake of iron-rich, plant-based foods to absorb the same amount of iron as does someone who eats meat.
Choose foods containing vitamin C to enhance iron absorption
You can enhance your body's absorption of iron by drinking citrus juice or eating other foods rich in vitamin C at the same time that you eat high-iron foods. Vitamin C in citrus juices, like orange juice, helps your body to better absorb dietary iron.
Vitamin C is also found in:
Preventing iron deficiency anemia in infants
To prevent iron deficiency anemia in infants, feed your baby breast milk or iron-fortified formula for the first year. Cow's milk isn't a good source of iron for babies and isn't recommended for infants under 1 year. After age 6 months, start feeding your baby iron-fortified cereals or pureed meats at least twice a day to boost iron intake. After one year, be sure children don't drink more than 20 ounces (591 milliliters) of milk a day. Too much milk often takes the place of other foods, including those that are rich in iron.
Anemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin. Hemoglobin is the main part of red blood cells and binds oxygen. If you have too few or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will not get enough oxygen. Symptoms of anemia -- like fatigue -- occur because organs aren't getting what they need to function properly.
Anemia is the most common blood condition in the U.S. It affects about 5.6% of the people in the U.S. Women, young children, and people with chronic diseases are at increased risk of anemia. Important factors to remember are:
Certain forms of anemia are hereditary and infants may be affected from the time of birth.
Women in the childbearing years are particularly susceptible to iron-deficiency anemia because of the blood loss from menstruation and the increased blood supply demands during pregnancy.
Older adults also may have a greater risk of developing anemia because of poor diet and other medical conditions.
There are many types of anemia. All are very different in their causes and treatments. Iron-deficiency anemia, the most common type, is very treatable with diet changes and iron supplements. Some forms of anemia -- like the mild anemia that develops during pregnancy -- are even considered normal. However, some types of anemia may present lifelong health problems.
What Causes Anemia?
There are more than 400 types of anemia, which are divided into three groups:
Anemia caused by blood loss
Anemia caused by decreased or faulty red blood cell production
Anemia caused by destruction of red blood cells
Anemia Caused by Blood Loss
Red blood cells can be lost through bleeding, which often can occur slowly over a long period of time, and can go undetected. This kind of chronic bleeding commonly results from the following:
Gastrointestinal conditions such as ulcers, hemorrhoids, gastritis (inflammation of the stomach), and cancer
Use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, which can cause ulcers and gastritis
Menstruation, especially if menstrual bleeding is excessive
Anemia Caused by Decreased or Faulty Red Blood Cell Production
With this type of anemia, the body may produce too few blood cells or the blood cells may not function correctly. In either case, anemia can result. Red blood cells may be faulty or decreased due to abnormal red blood cells or a lack of minerals and vitamins needed for red blood cells to work properly. Conditions associated with these causes of anemia include the following:
Sickle cell anemia
Bone marrow and stem cell problems
Other health conditions
Sickle cell anemia is an inherited disorder that, in the U.S. affects mainly African-Americans and Hispanic Americans. Red blood cells become crescent-shaped because of a genetic defect. They break down rapidly, so oxygen does not get to the body's organs, causing anemia. The crescent-shaped red blood cells can also get stuck in tiny blood vessels, causing pain.
Iron-deficiency anemia occurs because of a lack of the mineral iron in the body. Bone marrow in the center of the bone needs iron to make hemoglobin, the part of the red blood cell that transports oxygen to the body's organs. Without adequate iron, the body cannot produce enough hemoglobin for red blood cells. The result is iron-deficiency anemia. This type of anemia can be caused by:
An iron-poor diet, especially in infants, children, teens, vegans, and vegetarians
The metabolic demands of pregnancy and breastfeeding that deplete a woman's iron stores
Frequent blood donation
Digestive conditions such as Crohn's disease or surgical removal of part of the stomach or small intestine
Certain drugs, foods, and caffeinated drinks
Vitamin-deficiency anemia may occur when vitamin B12 and folate are deficient. These two vitamins are needed to make red blood cells. Conditions leading to anemia caused by vitamin deficiency include:
Megaloblastic anemia: Vitamin B12 or folate or both are deficient
Pernicious anemia: Poor vitamin B12 absorption
Dietary deficiency: Eating little or no meat may cause a lack of vitamin B12, while overcooking or eating too few vegetables may cause a folate deficiency.
Other causes of vitamin deficiency: pregnancy, certain medications, alcohol abuse, intestinal diseases such as tropical sprue and celiac disease
During early pregnancy, sufficient folic acid can help prevent the fetus from developing neural tube defects such as spina bifida.
Bone marrow and stem cell problems may prevent the body from producing enough red blood cells. Some of the stem cells found in bone marrow develop into red blood cells. If stem cells are too few, defective, or replaced by other cells such as metastatic cancer cells, anemia may result. Anemia resulting from bone marrow or stem cell problems include:
Aplastic anemia occurs when there's a marked reduction in the number of stem cells or absence of these cells. Aplastic anemia can be inherited, can occur without apparent cause, or can occur when the bone marrow is injured by medications, radiation, chemotherapy, or infection.
Thalassemia occurs when the red cells can't mature and grow properly. Thalassemia is an inherited condition that typically affects people of Mediterranean, African, Middle Eastern, and Southeast Asian descent. This condition can range in severity from mild to life-threatening; the most severe form is called Cooley's anemia.
Lead exposure is toxic to the bone marrow, leading to fewer red blood cells. Lead poisoning occurs in adults from work-related exposure and in children who eat paint chips, for example. Improperly glazed pottery can also taint food and liquids with lead.
Anemia associated with other conditions usually occurs when there are too few hormones necessary for red blood cell production. Conditions causing this type of anemia include the following:
Anemia happens when there is a decreased number of circulating red blood cells in the body. It is the most common blood disorder in the general population. Symptoms can include headaches, chest pains, and pale skin.
It often results when other diseases interfere with the body's ability to produce healthy red blood cells or abnormally increase red blood cell breakdown or loss.
Fast facts on Bohemian
Here are some key points about anemia:
Anemia affects an estimated 24.8 percent of the world's population.
Pre-school children have the highest risk, with an estimated 47 percent developing anemia, globally.
More than 400 types of Anemia have been identified.
Anemia is not restricted to humans and can affect pets also.
Symptoms for Anemia:
The most common symptom of all types of Anemia is a feeling of fatigue and a lack of energy.
Other common symptoms may include:
Paleness of skin
Fast or irregular heartbeat
Shortness of breath
In mild cases, there may be few or no symptoms.
Some forms of anemia can have specific symptoms:
Aplastic anemia: Fever, frequent infections, and skin rashes
Folic acid deficiency anemia: Irritability, diarrhea, and a smooth tongue
Hemolytic anemia: Jaundice, dark colored urine, fever, and abdominal pains
Sickle cell anemia: painful swelling of the feet and hands, fatigue, and jaundice
What causes Anemia?
The body needs red blood cells to survive. They carry hemoglobin, a complex protein that contains iron molecules. These molecules carry oxygen from the lungs to the rest of the body.
Some diseases and conditions can result in a low level of red blood cells.
There are many types of anemia, and there is no single cause. It can sometimes be difficult to pinpoint the exact cause.
Below is a general overview of the common causes of the three main groups of anemia:
Anemia caused by blood loss:
The most common type of anemia—iron deficiency anemia—often falls into this category. It is caused by a shortage of iron, most often through blood loss. When the body loses blood, it reacts by pulling in water from tissues outside the bloodstream in an attempt to keep the blood vessels filled. This additional water dilutes the blood. As a result, the red blood cells are diluted.
Blood loss can be acute and rapid or chronic. Rapid blood loss can include surgery, childbirth, trauma, or a ruptured blood vessel. Chronic blood loss is more common in cases of anemia. It can result from a stomach ulcer, cancer, or tumor.
Causes of anemia due to blood loss include:
Gastrointestinal conditions, such as ulcers, hemorrhoids, cancer, or gastritis
Use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen
Anemia caused by decreased or faulty red blood cell production:
Bone marrow is a soft, spongy tissue found in the center of bones. It is essential for the creation of red blood cells. Bone marrow produces stem cells, which develop into red blood cells, white blood cells, and platelets.
A number of diseases can affect bone marrow, including leukemia, where too many abnormal white blood cells are produced. This disrupts normal production of red blood cells.
Other Anemia caused by decreased or faulty red blood cells includes:
Sickle cell Anemia: Red blood cells are misshapen and break down abnormally quickly. The crescent-shaped blood cells can also get stuck in smaller blood vessels, causing pain.
Iron-deficiency Anemia: Too few red blood cells are produced because not enough iron is present in the body. This can be because of a poor diet, menstruation, frequent blood donation, endurance training, certain digestive conditions, such as Crohn's disease, surgical removal of part of the gut, and some foods.
Bone marrow and stem cell problems: Aplastic anemia, for example, occurs when few or no stem cells are present. Thalassemia occurs when red blood cells cannot grow and mature properly.
Vitamin deficiency Anemia: Vitamin B-12 and folate are both essential for the production of red blood cells. If either is deficient, red blood cell production will be too low. Examples include megaloblastic anemia and pernicious anemia.
Anemia caused by the destruction of red blood cells:
Red blood cells typically have a life span of 120 days in the bloodstream, but they can be destroyed or removed beforehand.
One type of anemia that falls into this category is autoimmune hemolytic anemia, where the body's immune system mistakenly identifies its own red blood cells as a foreign substance and attacks them.
Excessive haemolysis (red blood cell breakdown) can occur for many reasons, including:
Certain drugs, for example, some antibiotics
Snake or spider venom
Toxins produced through advanced kidney or liver disease
An autoimmune attack, for instance, because of hemolytic disease
Vascular grafts and prosthetic heart valves
Enlargement of the spleen
Leukemia is a #cancer of the blood or bone marrow. Bone marrow produces blood cells. Leukemia can happen when there is a problem with the production of blood cells. It usually affects the leukocytes, or white blood cells.
>> Here are some symptoms of Leukemia you shouldn't ignore:
- Infections or fevers
Since blood cells are an important component of the immune system, having unhealthy cells due to leukemia makes you more prone to falling sick more frequently.
- Shortness of breath
Another symptom you should keep an eye on is shortness of breath.
- Pale skin
The skin turns pale in Leukaemia , as the new cells that are damaged by cancer can overtake #BoneMarrow, making it difficult for healthy cells to grow. Since you are short of healthy cells, you’re more likely to develop #anaemia which can make your skin look pale. In addition, your hands may feel cold all the time due to anaemia.
Just like several other conditions, fatigue is a common symptom of Leukaemia too. So, if you feel tired all the time, may be, your anaemia is to be blamed.
- Slow healing
If it takes forever for cuts and scrapes you get to heal or you are more susceptible to getting bruised easily, all of these symptoms can hint at the kinds of blood cell shifts associated with leukemia.
शरीरात लाल रक्तपेशी वाहून कमी झालेल्या संख्येत ऍनिमिया होतो. सामान्य जनतेमध्ये हा सर्वात सामान्य रक्त विकार आहे. लक्षणे, डोकेदुखी, छातीत दुखणे आणि निरुपयोगी त्वचा यांचा समावेश असू शकतो. बर्याचदा असे परिणाम होतात जेव्हा इतर रोग निरोगी लाल रक्त पेशी तयार करण्यास शरीराच्या क्षमतेमध्ये हस्तक्षेप करतात किंवा लाल रक्तपेशी खंडित होणे किंवा तोटा कमी करतात.
येथे अशक्तपणा बद्दल काही महत्वाचे मुद्दे आहेत.
अनीमिया जगातील लोकसंख्येच्या अंदाजे 24.8 टक्के प्रभावित करते.
प्री स्कूल मुलांमध्ये जागतिक पातळीवर अंदाजे 47 टक्के अॅनिमिया सर्वाधिक धोका आहे.
400 पेक्षा जास्त प्रकारचे अॅनिमिया ओळखले गेले आहेत.
अॅनिमिया मनुष्यांसाठीच मर्यादित नाही आणि मांजरींनापण होऊ शकतो
सर्व प्रकारच्या अॅनिमियाचा सर्वात सामान्य लक्षण थकवा आणि ऊर्जाची कमतरता आहे.
इतर सामान्य लक्षणांमध्ये हे समाविष्ट असू शकतेः
- त्वचेची चमक
- जलद किंवा अनियमित हृदयाचा ठोका
- धाप लागणे
- छाती दुखणे
सौम्य प्रकरणात, काही लक्षणे दिसू शकतात.
ऍनिमियाच्या काही प्रकारांमध्ये विशिष्ट लक्षणे असू शकतात:
- ऍप्लास्टिक अॅनिमिया: ताप, वारंवार संक्रमण आणि त्वचेच्या चकत्या
- फॉलिक ऍसिडची कमतरता अॅनिमिया: चिडचिडपणा, अतिसार आणि मऊ जीभ
- हेमोलाइटिक अॅनिमिया: जांभळा, गडद रंगीत मूत्र, ताप आणि उदर दुखणे
- सिकल सेल अॅनिमिया: पाय आणि हात दुखणे, थकवा
जिवंत राहण्यासाठी शरीराला लाल रक्तपेशींची आवश्यकता असते. ते हेमोग्लोबिन, एक जटिल प्रथिने असतात ज्यात लोह अणू असतात. हे रेणू फुफ्फुसांमधून ऑक्सिजन घेऊन शरीराच्या उर्वरित भागात जातात. काही रोग आणि परिस्थितीमुळे लाल रक्तपेशींची निम्न पातळी होऊ शकते. अनेक प्रकारचे अॅनिमिया आहेत आणि तेथे एकच कारण नाही. कधीकधी अचूक कारण ओळखणे कठीण होऊ शकते.
खाली अॅनिमियाच्या तीन मुख्य गटांच्या सामान्य कारणाचा आढावा आहे:
1) रक्तवाहिन्यामुळे अॅनिमिया होतो
अॅनिमिया-लोह कमतरता ऍनिमियाचा सर्वात सामान्य प्रकार-बर्याचदा या श्रेणीमध्ये येतो. लोहाची कमतरता यामुळे बहुतेकदा रक्त तोटा येतो.
जेव्हा शरीराचे रक्त हरवले जाते तेव्हा रक्तवाहिन्या भरल्याच्या प्रयत्नात रक्तप्रवाहाच्या बाहेर ऊतकांमधून पाणी आणून ते प्रतिक्रिया देते. हे अतिरिक्त पाणी रक्त पातळ करते. परिणामी, लाल रक्तपेशी पातळ केल्या जातात.
रक्तदाब तीव्र असू शकतो. रक्ताच्या रक्तसंक्रमणात सर्जरी, प्रसव, आघात किंवा खंडित रक्तवाहिन्या समाविष्ट असू शकतात.
अॅनिमियाच्या बाबतीत दीर्घकाळापर्यंत रक्तसंक्रमण अधिक सामान्य होते. हे पोटातील अल्सर, कर्करोग किंवा ट्यूमरमुळे होऊ शकते.
रक्ताच्या नुकसानीमुळे अॅनिमियाच्या कारणांमध्ये हे समाविष्ट होते:
अल्सर, बवासीर, कर्करोग, किंवा जठरांसा यासारखी गॅस्ट्रोइंटेस्टाइनल स्थिती
गैर-स्टेरॉइडल अँटी-इंफ्लॅमेटरी ड्रग्स (NSAIDs), जसे एस्पिरिन आणि मासिक पाळी
2) अॅनिमिया कमी किंवा खराब लाल रक्तपेशी निर्मितीमुळे होतो
हाडांच्या मध्यभागी आढळणारा मऊ, स्पॉन्टी टिशू आहे. लाल रक्तपेशी तयार करणे आवश्यक आहे. अस्थिमज्जा स्टेम सेल्स तयार करतात, जे लाल रक्तपेशी, पांढर्या रक्त पेशी आणि प्लेटलेट्समध्ये विकसित होतात. अनेक रोग अस्थि मज्जा प्रभावित करतात ज्यात ल्यूकेमियाचा समावेश आहे, जेथे बरेच असामान्य पांढर्या रक्त पेशी तयार होतात. हे लाल रक्तपेशींचे सामान्य उत्पादन व्यत्यय आणते. कमी झालेल्या किंवा दोषपूर्ण लाल रक्तपेशीमुळे उद्भवलेल्या इतर अॅनिमियामध्ये हे समाविष्ट होते:
- सिकल सेल अॅनिमियाः लाल रक्तपेशी मिसॅपेन होतात आणि वेगाने तोडतात. अर्ध-आकाराचे रक्त पेशी देखील लहान रक्तवाहिन्यांत अडकतात, ज्यामुळे वेदना होतात.
- लोहाची कमतरता: अशक्तपणा: शरीरातील पुरेसे लोह नसल्यामुळे लाल रक्तपेशी तयार होतात. हे कमी आहार, मासिक पाळी, रक्तदान, सहनशक्ती प्रशिक्षण, काही पाचनविषयक शस्त्रे, जसे की क्रॉन्स रोग, आंतचा भाग काढून टाकणे आणि काही पदार्थांमुळे होऊ शकते.
- अस्थिमज्जा आणि स्टेम सेल समस्या: उदाहरणार्थ ऍप्लास्टिक अॅनिमिया, जेव्हा काही स्टेम सेल असतात तेव्हा येते. जेव्हा लाल रक्तपेशी वाढू शकत नाहीत आणि योग्यरित्या परिपक्व होऊ शकत नाहीत तेव्हा थॅलेसेमिया होतो.
- व्हिटॅमिनची कमतरता अनीमिया: लाल रक्तपेशींच्या निर्मितीसाठी व्हिटॅमिन बी -12 आणि फोलेट दोन्ही आवश्यक असतात. जर कमी असेल तर लाल रक्तपेशी उत्पादन खूपच कमी असेल. मेगाब्लॉल्स्टिक अॅनिमिया आणि हानिकारक ऍनिमिया या उदाहरणात समाविष्ट आहेत.
3) लाल रक्तपेशी नष्ट झाल्यामुळे अॅनिमिया होतो
लाल रक्तपेशींमध्ये रक्तप्रवाहात 120 दिवसांचे आयुष्य असते परंतु ते आधीच नष्ट केले जाऊ शकतात किंवा काढून टाकले जाऊ शकतात. या श्रेणीमध्ये आढळणारा एक प्रकारचा अशक्तपणा ऑटोममुने हेमोलाइटिक अॅनिमिया आहे, जेथे शरीराच्या रोगप्रतिकार यंत्रणेने स्वत: च्या लाल रक्त पेशींना चुकीचे ओळखले आहे. एक विदेशी पदार्थ म्हणून त्यांच्यावर हल्ला करतो. अत्यधिक रक्तवाहिन्या (लाल रक्तपेशी खंडित होणे) अनेक कारणांमुळे होऊ शकते, यासह:
- काही औषधे, उदाहरणार्थ, काही अँटीबायोटिक्स
- साप किंवा कोळी विष
- विषारी मूत्रपिंड किंवा यकृत रोगाद्वारे उत्पादित विषारी पदार्थ
- उदाहरणार्थ, हेमोलाइटिक रोगामुळे ऑटोम्यून्यून आक्रमण
- गंभीर उच्च रक्तदाब
- संवहनी grafts आणि कृत्रिम हृदय वाल्व
- गळती विकार
- स्पिलीन वाढवणे
HelloDox is one-stop solution for all your health care needs. In here, you can connect to your doctor, consult online audio/video/chat consultations, do near by clinic visit. You can get preventive health check-up from top NABL accredited labs pan India at lowest price. You can also upload prescriptions which is reviewed by our doctor panel and get it done in-time at minimum price. At HelloDox our mission is to provide best healthcare services at lowest price to all our citizens.
- Survey No. 152-4/1A, Behind Krishna Petrol Pump, Near
Hinjewadi Hospital, Hinjewadi Pune - 411057, India.
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