World Sickle Cell Day is observed each year on June 19th to raise the public awareness regarding this disease and its treatment methods. Sickle Cell disease is an inherited transmitted deformity/abnormality of haemoglobin. It is an inherited form of anaemia. This abnormality generates changes in the shape of red blood cells from round to crescent, which reduces the oxygen carrying capacity and slows down the flow of blood to various parts of the body. 

Generally, red blood vessels are round and flexible, passing easily through the blood vessels. The red blood cells become sticky and rigid in sickle cell anaemia. Sickle cells last 10 to 20 days, which causes anaemia because of the disorder of red blood cells, while healthy red blood cells could live up to 120 days.

Millions of people around the world are affected by Sickle Cell Anemia. There is no specific cure for this disease as Sickle cell anaemia is not contagious, it is hereditary. Sickle cell anaemia is named so for the reason that red blood cells are crescent-shaped or sickle-shaped, and anaemia signifies lack of blood. There is a difference between iron-deficiency anaemia and sickle cell anaemia.

Symptoms

Sickle Cell Disease (SCD) has many symptoms which includes: serious anemia, episodes of suffering, additionally a range of complications, heart failure, dizziness, chronic kidney disease (CKD), acute chest syndrome (ACS), chest pain, gallstones, pulmonary hypertension, immune deficiency, paralysis or stroke, splenomegaly, joint damage mainly in the hip joint, foot ulcers, delayed puberty, retinopathy, and endocrine disorders.

Diagnosis

Sickle Cell Disease is diagnosed by blood tests.

Treatment

Bone marrow transplant or stem cell transplant in patients usually below the age of sixteen is the only available cure for the disease.

Aim of the World Sickle Cell Day

The aim of the World Sickle Cell Day is to support and promote research for the patients in order to help them upgrade their overall quality of life to the maximum possible extent. It also aspires to increase awareness for sickle cell disease disorder in the general public so that they know how to deal with patients suffering from the disease. Moreover, the World Sickle Cell Day has the objective of raising awareness of the importance among generations of pre-marital screening to lessen the transmission of Sickle Cell Disease.

Target Groups for Awareness Programs

Though it is desirable that everybody knows about Sickle Cell Disease, the target groups for the awareness programs include health decision-makers, sickle cell anaemia sufferers and their families, health organizations and associations, people who are planning to get married, and the health workers including health educators, physicians, and nurses.

On the World Sickle Cell Day, different societies provide advocacy, information, and advice for raising awareness. They also provide educational and welfare grants, support services, annual children s holiday, home help, hospital visits, mentoring and befriending through holding talks, assisting into research and training, lobbying for better service provision, patient education seminars, and campaigning.

World Sickle Cell Day - What Should You Know?

What do we mean by the term Anemia?

It is described as a decrease in the total number of red blood cells, or hemoglobin in the blood, or a decreased oxygen-carrying capacity of blood.

How to know if an individual has Anemia?

An individual with anemia may show one or more of the following signs or symptoms:
Shortness of breath, chest pain, and headache are especially seen with exercise as the oxygen supply decreases
Difficulty in concentration which is mostly seen in children
Easy tiredness, fatigue, and loss of energy
Dizziness because of low blood volume leading to hypotension
Hair loss especially while combing, washing hair. Also, hair becomes brittle and dry due to anemiaInsomnia (lack of sleep)
Cramps in legs especially calf muscle 
Rapid heartbeat with exercise as the demand for oxygen increases during exercise, so your heart beats faster than usual
Craving for indigestible substances, such as pica, paper, mud, ice, dirt, etc.
Koilonychia (spoon-shaped nails or upward curvature of the nails)
Soreness and cracks at the corners of the mouth
Very heavy menstrual periods or irregular bleeding because of low hemoglobin count
Pale skin is especially seen over the palms of your hands and under your nail beds. Also, the conjunctiva looks pale
Anemia due to Deficiency of Vitamin B12 Dementia (loss of memory)
Tingling sensation in the hands or feet
Loss of the sense of touch
Difficulty in walking
Stiffness in the arms and legs
Delayed growth and development in children
Swelling of the hands and feet
Episodes of severe pain in the joints, abdomen, and limbs as the red blood cells obstruct capillaries
Anemia by Chronic Red Blood Cell Destruction/Hemolytic anemia

Jaundice (yellowish or greenish pigmentation of skin and sclera of the eyes)
Brown or red colored urine due to the destruction of red blood cells
Fever due to the destruction of red blood cells
Small bruises under the skin
Abdominal pain because of enlargement of the spleen and liver
Black stools due to the destruction of the red blood cells
Anemia Caused by Chronic Lead Poisoning
Level of lead in blood is higher than 50  g/dLA blue-black line is seen on the gums. It is also known as a lead line
Abdominal pain
Constipation
Vomiting
Investigations 

Complete blood count: This test will help an individual know the percentage of hemoglobin in blood as well as red blood cell count. Also, mean cell volume (MCV) is used to categorize anemia.
Serum Ferritin Test: Ferritin levels below 15 20 micrograms/L in a person confirms iron-deficiency anemia.
Total Iron-Binding Capacity: It measures the blood's capacity to bind iron with transferrin.

How Can Anaemia Be Diagnosed?

A healthy kidney produces a hormone known as the erythropoietin. The latter assists the bone marrow to produce an adequate amount of RBC that carries oxygen to every nook and corner of the body. A damaged kidney results in less RBC production, thereby, creating a condition known as anemia. The hemoglobin count in the blood reduces significantly in this condition.

Anemia is characterized by shortness of breath, weakness and tiredness. It can affect sleep and a loss of appetite. A patient suffering from anemia reports of frequent headaches and a faster heart rate. These symptoms also surface when a person suffers from chronic kidney diseases (CKD). The condition gets worse as the disease progresses.

Treating anemia:
A patient suffering from anemia should be treated on time as there are many pitfalls of a lower hemoglobin level. The treatment will give instant relief from other symptoms that might have arrived with CKD. Doctors frequently prescribe Erythropoiesis Stimulating Agent (ESA) for patients suffering from CKD and suffering from anemia due to the shortage of erythropoietin. ESAs can be injected through an injection or intravenously. These injections stimulate the bone marrow to produce more RBCs. However, studies have revealed that ESAs increase the chance of strokes, heart attacks and blood clots. Furthermore, they aggravate tumor growth and shorten life expectancy for cancer patients. People undergoing ESA treatment should have periodic check-ups to ensure that the hemoglobin count is normal and under control.

Iron
Iron count in the body has an important role in treating patients suffering from anemia and CKD. In case the level of iron is too low in the body, ESAs fail to improve the condition of an anemic patient. The ferritin count of a patient should be in the range of 100-800 mcg/L. One more test known as TSAT reveals the number of iron required to produce RBCs in the body. In case the iron count is less, doctors often suggest iron pills to bring the count to a more accepted level.

Other causes
There could be other reasons for anemia as well. A doctor might further investigate the level of B12 and folic acid present in the body. Even an inflammatory condition can lead to anemia. A decreased count of any of the above-mentioned ingredients can cause anemia to a patient suffering from EKD.

Food items necessary to improve the condition
A healthy diet helps in improving the condition of an anemic patient. Iron deficiency is best addressed by fish and beef. Food rich in vitamin C helps the body to absorb more iron in the body. Certain food items that block the entry of iron in the body include tea, milk, albumen (egg white) etc. Therefore, you should be strictly avoid these items from your diet.

Kidney Disease - How It Is Related With Anaemia?

Anemia is a condition where the red blood cell count is reduced due to deficiencies within the system. This is usually caused by a lack of iron, folate and other related nutrients in the diet. Anemia is a major public health concern in India as over 50 percent of women are known to be anemic. This pushes up the mortality rate of young mothers and even children.

Some symptoms of Iron deficiency anemia
Anemia has a wide range of symptoms which varies from person to person. However there are some generic symptoms which can be noticed in most people. Some of these are
1. Pale appearance of skin - Many people exhibit this symptom where their skin appears to be pale as there is a reduced amount of oxy - hemoglobin in the skin.
2. Physical weakness, light headedness and fatigue - This is a general symptom, which many tend to suffer from and complain about. Fatigue and weakness may come in very quickly even with the slightest effort.
3. Hair loss - Many women may complain about hair loss due to Iron deficiency  anemia.

Some other symptoms are -
a. Breathlessness
b. Constipation
c. Missed or irregular periods
d. Numbness or burning sensations
e. Depression
f. Tinnitus among others

Causes of Iron deficiency anemia
The primary cause of Iron deficiency anemia is the lack of iron in the diet which causes the hemoglobin in the blood to be reduced. Some of the patients may still have Iron deficiencyanemia as they have developed gastrointestinal disorders which prevents the absorption of nutrients like iron within the body.

How to treat Iron deficiency anemia
Diet related anemia can be easily cured or controlled with changing diets. Inclusion of certain foods within the diet can easily reverse the Iron deficiencies. Some of the food items that help with deficiencies are:
1. Fortified cereals
2. Green dark leafy vegetables
3. Poultry items
4. Eggs
5. Meat
You may also require certain iron supplements if you have certain underlying conditions which is causing issues with iron absorption.

How to prevent Iron deficiency anemia
It is important, especially for women to go for regular checkups to your doctor and also a hemoglobin check up. Your doctor or dietician can tell you to include certain foods in your diet that include folate, iron and vitamin B 12 so that the level of hemoglobin in your blood can be maintained at healthy levels.

All About Iron Deficiency - Anemia

Thalassemia is a genetic (which is passed from parents to children through genes) blood disorder. People with Thalassemia disease are not able to make enough hemoglobin, which causes severe anemia. Hemoglobin is found in red blood cells and carries oxygen to all parts of the body. When there is not enough hemoglobin in the red blood cells, oxygen cannot get to all parts of the body. Organs then become starved for oxygen and are unable to function properly.

Symptoms

The symptoms depend on the type of thalassemia:

Thalassemia Minor: Thalassemia minor usually doesn t cause any symptoms. If it does, it causes minor anemia.
Beta-thalassemia: Beta-thalassemia comes in two serious types, which are thalassemia major, or Cooley s anemia, and thalassemia intermedia. The symptoms of thalassemia major generally appear before a child s second birthday. The severe anemia related to this condition can be life-threatening. Other signs and symptoms include:
fussiness
paleness
frequent infections
a poor appetite
failure to thrive
jaundice, which is a yellowing of the skin or the whites of the eyes
enlarged organs
This form of thalassemia is usually so severe that it requires regular blood transfusions.

Alpha-thalassemia: Alpha-thalassemia also has two serious types, which are hemoglobin H disease and hydrops fetalis. Hemoglobin H disease can cause bone issues. The cheeks, forehead, and jaw may all overgrow. Hemoglobin H disease can cause:
jaundice, which is a yellowing of the skin or the whites of the eyes
an extremely enlarged spleen
malnourishment
Hydrops fetalis is an extremely severe form of thalassemia. It occurs before birth. Most individuals with this condition are either stillborn or die shortly after being born.

Thalassemia - Symptoms Based on Types of Thalassemia 

The lack of red blood cells or hemoglobin in the blood is termed as anemia. You may also be diagnosed as anemic is your red blood cells do not have a high enough hemoglobin count. Since hemoglobin is responsible for the amount of oxygen in our blood, being anemic results in a decreased flow of oxygen in the blood. 

There are 5 different types of anemia. These are:
1. Iron deficiency anemia: when the iron levels of the blood are lower than normal. 
2. Sickle cell anemia: when the red blood cells are shaped like a'sickle' and hence more fragile. This is an inherited condition. 
3. Thalassemia - when the body does not produce enough red blood cells or hemoglobin. This is also an inherited condition.
4. Megaloblastic anemia - when the blood does not have enough vitamin b12 and hence cannot transport hemoglobin through the body. 
5. Hemolytic anemia - when the red blood cells are rapidly removed from the blood due to an infection, medication or disease. 

Lack of oxygen can have a serious effect on the organs of the body. Hence the symptoms of anemia are also the effects of the disease. 
Some of these are: 
Lack of energy
Fatigue
Dizziness
Chest pain
Difficulty breathing
Abnormal heartbeat
Reduced attention span
Numbness of the hands and feet. 

Anemia can also lead to a number of major health problems such as:
1. Heart disease: anemia is directly linked to heart disease. When the blood carries less oxygen, the heart needs to work harder to pump it to the rest of the body. Thus, people who are anemic are at a higher risk of having a heart attack than a non anemic person. Anemia can also lead to arrhythmia or a condition where the person suffers from an irregular heartbeat. 

2. Pregnancy complications: one of the first and most vital supplements prescribed to a pregnant woman is iron. Iron is essential not only for a healthy baby, but also for your own body. Anemia caused by a lack of iron can result in premature birth and a number of other complications at the time of pregnancy. 

3. Increased risk of infections: lack of oxygen in the blood can affect your immune system by lowering its ability to fight infections. This makes the body vulnerable to diseases. 

4. Cognitive damage: anemia in children can result in a greatly reduced attention span and weaken their memory. Sometimes, even when treated, this can result in permanent scarring and reduced iq levels. 

Fighting anemia is not hard. Consult your doctor instantly if you recognize any of its symptoms and start eating food rich in iron to fight this disease.

Anaemia and How It Can Affect Your Health

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