Brief Answer: Low hemoglobin is due to Beta thalassemia trait. Detailed Answer: Hello XXXX Thanks for writing back Your wife blood picture and low hemoglobin suggests Beta thalassemia trait.This is also confirmed by increased Hb A2 level. Beta thalassemia trait affects hemoglobin in the red blood cells.She doesn't require further investigations. Beta thalassemia trait is inherited from one of the parents.People who have milder forms of thalassemia like trait are usually diagnosed during the investigation of anemia. Because thalassemia are passed from parents to children through genes,family genetic studies is needed to diagnose the disorder.These studies involve taking a family medical history and doing blood tests on family members.The tests will show whether any family members have missing or altered hemoglobin genes. Treatment of thalassemia depend on the type and severity of the disorder. People who are carriers or who have alpha or beta thalassemia trait have mild or no symptoms.They generally need little or no treatment. In moderate and severe forms of thalassemia, patient require blood transfusions, iron chelation therapy and folic acid supplements.This is not applicable in your wife's case. At present she should take iron rich foods like green leaf vegetables,jaggery,dates,meat,chicken,fish etc. She regularly need iron-zinc and folic acid supplementation.She should also take vitamin C rich citrus fruits. Ultrasound of abdomen can be done to see organomegaly. Get well soon. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX

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Brief Answer: Brown urine may be due to lysis of hemoglobin. Detailed Answer: Hello XXXXX Thanks for writing back Brown urine may be due to breakdown of hemoglobin. Bacterial count in urine is not significant. Low protein may be due to many reasons like loss of protein from kidney,decreased protein production form liver etc. Low protein need further investigations like Renal function test,Ultrasound of abdomen.Further investigations can be done if needed. She can take diet as discussed earlier. Get well soon. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX

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