ts that where still  at the hospital  when in my opinion where ready to go home 
One day  when I was on call I asked one of the doctors about a particular patient that had a gastrointestinal surgery (don’t remember which) but that he was without pain, no fever, cero indications of infection, tolerating diet, he had already gone to  the bathroom, in general he was doing pretty good,.
The doctor told me that sometimes the doctor of this patient didn’t liked to go to the hospital on Sundays  so he wait until Monday to discharge his patients
I was really upset about this because he was just making the patient stayed at the hospital and spend more money without any reason 
And I was sad to see how doctors  takes advantage of people when they are trusting them with their health

Here are the most clinically relevant haematinics deficiencies : vitamin B12 (cobalamin), vitamin B9 (folate), and iron.

Iron deficient patients can develop microcytic anaemia and may have a range of clinical features.

Most of these symptoms are related to anaemia, such as fatigue, shortness of breath, weakness and reduced exercise tolerance. Other symptoms can include pica (e.g. ice craving) and restless leg syndrome.

Typical clinical findings of iron-deficiency anaemia on examination may include:

If is suspected, initial screening investigations should include:

These tests allow the identification and quantification of anaemia by measuring the haemoglobin (Hb) and haematocrit (Hct) mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC). These may be low in iron deficiency, while red cell distribution width (RDW) may be elevated.

Ferritin is an intracellular protein that is responsible for most iron storage in the body. 

There is a direct correlation between serum ferritin levels and overall iron stores in health. However, serum ferritin is an acute-phase protein, and so increases in inflammatory states, chronic kidney disease, liver disease, and malignancy.

Ferritin level of <15 μg/l is indicative of an iron deficiency in those aged >5 years.

Transferrin is the primary serum iron transporter molecule in the body. In an iron-deficient state, the body produces more transferrin to increase the total iron-binding capacity and so acquire more iron for its cells.

Levels <16% are supportive of a diagnosis of iron deficiency.

A blood film can be helpful if there is diagnostic uncertainty and can show morphological changes, which might support the conclusion that a patient is iron deficient.

Blood film features which make iron deficiency more likely include anisocytosis, microcytosis, hypochromia, pencil cells, target cells, and elliptocytes.

They include mean reticulocyte haemoglobin concentration, percentage of red cells that are hypochromic, and reticulocyte haemoglobin equivalent.

Mean reticulocyte haemoglobin of <29 pg can be supportive of a diagnosis.

These are not usually required to diagnose iron-deficiency anaemia but are available from most laboratories and can support the diagnosis.

Serum iron only measures a fraction of the iron in the blood.

Serum iron levels show diurnal variation and are sensitive to recent iron intake.

The TIBC is calculated by taking a serum sample and adding excess iron to fully saturate the iron carrying molecules.

Transferrin is the main serum iron transporter molecule which can be measured in a patient’s serum.

Like TIBC, transferrin can rise in iron deficiency as the body tries to increase the total iron-binding capacity.

In iron deficiency, these developing cells display an increased number of transferrin receptors as they try to acquire more iron, this increase can be measured in the serum.

Oral iron with vitamin C that improves the absorption of oral iron

Traditional dosing guidelines suggested aiming for 100-200mg of elemental iron a day however, more recent studies shown that dosing of around 45-80mg elemental iron is more effective and avoids gastrointestinal side effects.

 A response in the haemoglobin count should be seen within a few weeks of starting therapy.

In certain scenarios, intravenous iron may be preferred. This includes patients with chronic kidney disease, inflammatory bowel disease, those intolerant of oral iron.