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Kucil 250Mg Injection Tips

Acne scars: Diagnosis and treatment

Acne scars: Diagnosis and treatment
Safe and effective treatment for acne scars begins with a consultation. During the consultation, a dermatologist will examine your skin, playing close attention to your scars. A dermatologist will also ask you some essential questions.

To get the most from your consultation, many people find it helpful to answer the following questions BEFORE meeting with a dermatologist:

Why do I want to treat my acne scars?
Treatment is not for everyone. Some people feel that the scars are not so bad. Others feel that the scars affect their everyday life. Dermatologists often recommend treatment when someone answers “yes” to one or more of the following questions:

Do I often wish that I could get rid of my acne scars?
Do I feel that my scars limit my opportunities to date, get a job, advance my career, or perform well in school?
Am I less social now than before I had acne scars?


How do I want to look after treatment?
Some people want less noticeable scars. Others wish to eliminate wavy skin texture.

What can I afford to spend on treatment?
Medical insurance does not cover the cost.

How much downtime can I afford?
Some treatments require downtime.

How much time will I devote to getting treatment and caring for my skin?

Your answer will help determine which treatments will be best for you.
How do dermatologists treat acne scars?

If you and your dermatologist believe that treatment is right for you, your dermatologist will create a treatment plan tailored to your needs. In creating this plan, your dermatologist will consider many things, including scar types and where the scars appear on your body.

If you have taken isotretinoin to treat acne, be sure to tell your dermatologist BEFORE treatment for acne scars begins.

To obtain the best results, your dermatologist may recommend more than one treatment. For example, if you have a deep boxcar scar (often looks like a large pore), laser therapy and a type of acne scar surgery called “subcision” may be necessary to give you the results you want.

The following tables list the treatments that a dermatologist may use.

Depressed Acne scars: Many effective treatments

Best results often come from using 2 or more treatments. The treatments that a dermatologist may use to treat depressed acne scars include:

Acne scar surgery: This sounds scarier than it is. Dermatologists often perform this minor surgery to treat very noticeable acne scars. The goal is to create a less-noticeable scar. The remaining scar should fade with time.

To perform acne scar surgery, a dermatologist may lift the scar. Bringing a scar closer to the surface of the skin tends to make it less noticeable. Another type of acne scar surgery involves breaking up scar tissue.

A dermatologist or dermatologic surgeon can safely perform acne scar surgery in a medical office. Patients remain awake but numb so that they do not feel pain.

Best for: Treating a few depressed scars.

Resurfacing procedures: When a patient wants to diminish the appearance of widespread acne scarring, a dermatologist may recommend a resurfacing procedure. Resurfacing removes layers of skin, which allows the body to produce new skin cells.

Dermatologists use the following resurfacing procedures to treat depressed acne scars:
Laser skin resurfacing
Chemical peeling
Dermabrasion
Microdermabrasion (differs from kits bought for at-home use)



Resurfacing works well for treating acne scars that are nearly flat (not too deep). Even dermabrasion, which removes the top layers of skin and some of the middle layers, cannot effectively treat deep acne scars.

Best for: Depressed acne scars that are not deep, useful for contouring scar edges to make scars less noticeable. Deep scars often require skin surgery and resurfacing.

Skin fillers: Dermatologists use fillers to safely and effectively plump depressed acne scars. A dermatologist may fill acne scars with collagen, the patient’s own fat, or another substance. Many fillers give us temporary results, which last between 6 and 18 months. Some fillers are permanent.

Both temporary and permanent fillers have unique pros and cons. If this is a treatment option for you, be sure to ask your dermatologist about the pros and cons of the recommended filler.

Best for: Treating a few depressed scars, but not icepick scars.

Skin tightening: This is a newer treatment and tends to be more affordable. This treatment is safe for all skin colors.

Dermatologists often use a technology called radiofrequency to tighten the skin. As the skin tightens, depressed acne scars become less noticeable.

Radiofrequency requires repeat appointments. Most patients return once a month for 4 months. After a radiofrequency treatment, many patients say they feel a burning sensation for about 1 hour and their skin has a pinkish color for 2 to 3 days.

Radiofrequency treatments require some at-home care. For at least one week after each treatment, you will need to apply sunscreen every morning and a moisturizing cream at night. Dermatologists recommend wearing a sunscreen that offers UVA/UVB protection, an SPF of 30 or greater, and water resistance.

Best for: Depressed acne scars. Sometimes, skin tightening effectively treats deep icepick and boxcar scars.

Collagen-induction therapy: Also known as “needling” or “micro-needling,” this treatment encourages your body to make more collagen.

To perform this procedure, a dermatologist moves a sterile, handheld needle-studded roller across the depressed acne scars. This punctures your skin. As your skin heals, it produces collagen.

It takes time to see the results, sometimes as long as 9 months. Most people, however, notice gradual changes before 9 months. Many patients require between 3 and 6 treatments and return every 2 to 6 weeks for a treatment.

After each treatment, you may have some swelling and possibly bruising. These side effects usually clear within 4 to 5 days.

You will need to follow a skin care plan while undergoing treatment.

Research shows that this is a safe treatment for people of all skin colors.

Best for: Widespread depressed acne scars. Not a treatment for raised acne scars, which form when the body produces too much collagen.

Electrodesiccation: This treatment uses electric probes to heat the tissue, which causes the tissue to die. This treatment may be part of a treatment plan for boxcar acne scars. Electrodesiccation by itself is not an effective treatment for acne scars.

Best for: Shaping or reducing the edges of boxcar scars.
Raised acne scars: Treatment can ease pain, diminish scars

The treatments that a dermatologist may use to treat raised acne scars are:

Injections: Your dermatologist may recommend injecting medicine directly into the scars. This can soften and flatten raised, thick scars.

Getting the best results often requires repeat visits. These injections are usually given once every few weeks. How often you will need to return for treatment depends on the scar and many other considerations. You may need to return once every 2 to 6 weeks for a while.

Many patients receive injections of corticosteroids. A chemotherapy medicine known as fluorouracil (5-FU) can also be effective in treating raised acne scars. Some scars respond best when injections of both 5-FU and corticosteroids are used.

Interferon, which is also used to treat cancer, can be effective. Our bodies naturally produce interferon.

If the scar does not respond (or stops responding) after you receive the 4th injection, acne scar surgery may be recommended.

Best for: Painful, raised scars.

Acne scar surgery: Dermatologists perform acne scar surgery to reduce raised acne scars. This surgery can be performed in a dermatologist’s office.

To obtain the best results, acne scar surgery is often followed by another treatment.
Acne scar surgery, followed by injections: After surgery, dermatologists often treat raised scars with injections of corticosteroids, 5-FU, or interferon.

Combining acne scar surgery with these shots remains one of the most effective treatments for raised scars. Most patients receive injections once a month for a few months.
Acne scar surgery, followed by radiation: Studies show that radiation can prevent raised scars from returning after acne scar surgery. Due to the potential for radiation treatments to cause problems years or decades later, some doctors do not recommend radiation treatment.



Best for: Raised scars that need more than injections.

Laser therapy: Lasers and other light treatments can treat raised scars safely and effectively. Treatment with a pulsed dye laser (PDL) can help reduce the itch and pain, diminish color, and flatten a raised scar. For people with lighter skin, intense pulsed light (IPL) also may be a treatment option.


Best for: All types of acne scars.

Cryosurgery: This treatment freezes the scar tissue. Freezing the tissue causes it to die and gradually fall off. To improve the results, dermatologists recommend a series of cryotherapy sessions and corticosteroid injections. This combination often produces better results.

The main drawback is that cryotherapy can cause permanent light spots to form on the treated skin.

Best for: It can effectively diminish raised scars in people who have lighter skin. Not recommended for skin of color.

Scar creams and gels, silicone (dressings and bandages): Often available without a prescription, these can be used at home to treat raised scars. These products can help reduce the itch and discomfort as well as shrink, flatten, and fade raised scars.

Silicone dressings and bandages can be especially helpful. Although no one knows for sure how these work, one possibility is that silicone helps hydrate the skin. This may reduce the itch and pain as well as make the skin more flexible.

To be effective, these products must be used continuously. This can be difficult, especially for scars on the face. Many people are willing to do this because these treatments have little risk of side effects. Even so, with continuous use, some people develop itchy, irritated skin. This usually clears when the person stops using the product.

Best for: Reducing scar size and discomfort. None is likely to eliminate a raised scar.

What outcome can a person with acne scars expect?
Most treatments can reduce the size and visibility of acne scars. With time, many of the treated acne scars fade, making them barely noticeable.

Your results depend almost entirely on the knowledge and skill of the person performing the treatment.

Dermatologists and dermatologic surgeons perform these procedures frequently, so they have the skills and experience needed to perform these procedures safely and effectively.

While dermatologists offer safe and effective treatment for acne scars,
there may be better solution: prevention.


References:
Ramesh M et al. “Novel Technology in the Treatment of Acne Scars: The Matrix-tunable Radiofrequency Technology.” J Cutan Aesthet Surg. 2010 May;3(2):97-101. Riveria AE. “Acne scarring: A review and current treatment modalities.” J Am Acad Dermatol 2008;59:659-76.

Sardana K et al. “Which Type of Atrophic Acne Scar (Ice-pick, Boxcar, or Rolling) Responds to Nonablative Fractional Laser Therapy?” Dermatol Surg 2014 Jan 21. doi: 10.1111/dsu.12428. [Epub ahead of print].

Thiboutot, D et al. “New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group.” J Am Acad Dermatol 2009;60:5(sup. 1) S1-S50.

Zurada JM et al. “Topical treatments for hypertrophic scars.” J Am Acad Dermatol 2006;55:1024-31.


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Dengue fever

Dengue fever
Use homeopathic eupatorium 30 thrice a day as specific but for better result detail history is must.
Keep surrounding clean. Avoid stagnancy of water.
Keep hydrating your self with water and liquid diet
Do cbc, esr, h1n1 (dengue profile).
Good rest.
Good mind set no need for panic.
Regular investigation of platelet count.
Tab paracetamol for fever
No use of antibiotics unless prescribed
4 people found this helpful

Epilepsy:
Cause:
1) Neurological Disorder
2) Rest less Mind
3) Un known cause
4) Brain Cell Damage due to Accident or Stroke

In system of Medicine Anti- Convulsion Drug use along with sedative Drug.

In Neurological Disorder many time suggested for Operation.

What Is Definition of Restless Mind?
When Many uncalled n Called thought conflict with each other & if same was not Resolved in timely then Its lead a stress in mind , and when many stress condition again conflict with each other lead Restless Mind . Its Very serious Disorder of mind Condition & Handle with appropriate Remedy along with Family support to come out from this situation
Treatment:
1) C T Scan / MRI / EEG / CBC with other test
2) Along with Medicine and Family support Its need for Meditation n Use complimentary system of Remedy to fast come out from this cause Like Homeopathy / Aroma / Bio – Chemic / Bach Flower / acupressure etc…
3) Proper Balanced Diet with Exercise & Meditation



7 people found this helpful

Ayurveda Can Cure Ulcerative Colitis ?

Ulcerative colitis is an inflammatory bowel disease (IBD) that causes long-lasting inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum. Symptoms usually develop over time, rather than suddenly.

Causes

  • Heredity
  • Overactive immune response in the intestine

Diagnosis

A flare-up may be sudden and severe

A flare-up may begin gradually

  • Urgency to defecate
  • Mild cramps in lower abdomen
  • Blood and mucous found in stool

Investigations

Treatment

Chikitsa Siddhant (Principle)

  • Vata –Pitta Samana Chikitsa
  • Vranaropana
  • Sita Virya Durgs
  • Sodhan, Saman & Stambhan Chikitsa

Re-search medicine by (Vaidyaratnam Sandip Patel)

  • Tablet  Diex   1 or 2 Two Times / Three Times a Day
  • Tablet  Diex-B    1 or 2 Two Times / Three Times a Day
  • Tablet Coag  1 or 2 Two Times / Three Times a Day
  • Tablet Tindukvati   1 or 2 Two Times / Three Times a Day
  • Tablet Paxid  1 or 2 Two Times / Three Times a Day
  • Paxid Syrup  1 Teaspoon Two Times / Three Times a Day

Home remedies

Fried Methi (Fenugreek)   100gm

Haldi (Turmeric)   100gm

Ganthoda (Granthik)  10gm

Mix  it properly

Dose: one teaspoon Morning & Evening

Castrol oil –one teaspoon with warm water/milk/tea at bedtime once or twice in weak

Fried Lahsun- with ghee and take one to two pieces everyday morning.

4 people found this helpful

Care To Be Taken By Dengue Fever Patients!

Care To Be Taken By Dengue Fever Patients!

Dengue is a mosquito-borne disease that causes severe body pain, fever, rash, dehydration, and weakness in the body. The major cause of dengue is Flaviviridae. It is generally called DENV (Dengue Virus). It generally occurs in tropical parts of the world.

Dengue is a fairly new disease in the world, and not many people understand how to care for a patient going through dengue fever. This article will present the steps that should be taken by someone who is suffering from Dengue.

Initial Steps One Should Take

The first step of caring when contacted with this disease is to go to a doctor and get checked. Doctor will get some tests done to verify that the condition is indeed Dengue. After the doctor prescribes medication, self-care begins. Here are some.

Do’s and Don’ts one should follow which help to cure from Dengue Fever.

Do’s

● The rise of Hematocrit (PCV) should be checked every day and informed by the physician.
● A thermometer should be present at all times to check the temperature of the patient.
● If the patient has a high fever, then dip a sponge in cool water and slowly wash the body with it.
● Upon high fever, one should only take Paracetamol and Acetaminophen. Doctor should be consulted before taking any medication.
● The patient should also check the number of trips taken to the bathroom, in order to keep a track of the urination cycle.
● Check if the patient has a dry mouth and lips. Dehydration is very common with people contacted with dengue and needs to have water and electrolytes supplements every now and then.
● It is very important to check the CBC (complete blood count) of the patient daily as directed by physician. Call a pathology technician evenryday to get a blood test as recommended by the doctor to keep the platelet and the haematocrits in check.

Don’ts

● Do not take antibiotics, Ibuprofen or Aspirin.
● Do not take artificial fruit juice for hydration purposes.
● Do not agitate.
● Do not take unsupervised supplements to increase platelet counts.
● Do not use alternative medications like herbs as they can cause an allergic reaction.
● Do not stay without food for too long.
● Do not take any kind of sleeping pills if the patient is having difficulty sleeping.

Conclusion:

Dengue is a troublesome disease which can be disastrous if not taken care of properly. That is why it is very important to know the do’s and don’ts for caring about this disease. However, consulting a doctor or getting hospitalised in the worst cases will always be a good idea.

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What Is Anemia ?

What Is Anemia ?

WHAT IS ANEMIA :

Anemia is a condition in which you don't have enough healthy red blood cells to carry adequate oxygen to the body's tissues. Having anemia may make you feel tired and weak.
There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe. See your doctor if you suspect you have anemia because it can be a warning sign of serious illness.


TYPES OF ANEMIA :

Iron deficiency anemia
Thalassaemia
Aplastic anemia
Haemolytic anemia
Sickle cell anemia
Pernicious anemia
Fanconi anemia

Symptoms :

Anemia signs and symptoms vary depending on the cause of your anemia. They may include:
Fatigue
Weakness
Pale or yellowish skin
Irregular heartbeats
Shortness of breath
Dizziness or lightheadedness
Chest pain
Cold hands and feet
Headache
At first anemia can be so mild that it goes unnoticed. But symptoms worsen as anemia worsens.

Causes :

Anemia occurs when your blood doesn't have enough red blood cells. This can happen if:
Your body doesn't make enough red blood cells
Bleeding causes you to lose red blood cells more quickly than they can be replaced
Your body destroys red blood cells

Diagnosis :

To diagnose anemia, your doctor may ask you about your medical and family history, perform a physical exam, and run the following tests:
Complete blood count (CBC). A CBC is used to count the number of blood cells in a sample of your blood. For anemia your doctor will be interested in the levels of the red blood cells contained in the blood (hematocrit) and the hemoglobin in your blood.
Normal adult hematocrit values vary from one medical practice to another but are generally between 40 and 52 percent for men and 35 and 47 percent for women. Normal adult hemoglobin values are generally 14 to 18 grams per deciliter for men and 12 to 16 grams per deciliter for women.
A test to determine the size and shape of your red blood cells. Some of your red blood cells may also be examined for unusual size, shape and color.
Additional diagnostic tests
If you receive a diagnosis of anemia, your doctor may order additional tests to determine the underlying cause. For example, iron deficiency anemia can result from chronic bleeding of ulcers, benign polyps in the colon, colon cancer, tumors or kidney problems.
Occasionally, it may be necessary to study a sample of your bone marrow to diagnose anemia.

Eating the right foods :

1. Increase Iron Rich Food:
It is seen that those who suffer from iron deficiency usually exhibit the symptoms of anemia. You could take up:
Food that is rich in iron content
Vitamin supplements 
These steps will ensure that you step up the iron content in the body which is the main element needed to produce hemoglobin

2. Fruits:
Apples are rich in micro nutrients including iron. Thus, if you are anemic you need to intake:
Fruits of different kinds
Consume more than one apple a day
Consume Citrus Fruits. It is necessary to have citrus fruits which increase the iron content in the body and the absorption of the micro nutrient.
Have at least more than one citrus fruit a day
Choose between limes, lemons and other fruits
Try Figs
Figs are seen to be excellent remedy for anemia
One should consume three to four figs daily in order to combat anemia
Try Bananas It is important to incorporate bananas in one’s diet.
It is known to be a good source of magnesium
Banana combined with honey will surely help one to step up the necessary salt content for increasing hemoglobin in the blood.

3. Honey:
Honey is known to be an excellent source of cure for anemia.
A concoction of honey, lemon juice and apple cider vinegar will prove to be ideal to combat the anemic conditions
Such a mixture is known to be a powerful antioxidant and will help to address general health issues as well. It is necessary to increase honey intake as it is beneficial for an anemic person. It is rich in iron, manganese and copper. These micro nutrients are known for their necessity to step up the hemoglobin content in the bloodstream

4. Beetroot Juice:
It is imperative that one know the vegetables that are rich in iron content.• Beetroot is one such vegetable which is beneficial for those who have low iron content and suffer from anemia• Beetroot can be had as a cooked vegetable or in the form of beetroot juice which is more effective

5. Currants In The Morning:
One could soak currant and consume them to feel the benefits. About ten currants should be soaked overnight. The seeds should be removed. They should be eaten first thing in the morning. 
This should be done for a period of three to four weeks

6. Increase Red Colored Fruits And Veggies In Your Diet:
The red colored fruits as well as vegetables contain the necessary vitamins which will enrich the blood of hemoglobin and reduce anemia.
Have apples
Use tomatoes in your diet
Consume beetroot as vegetable or in juice form

7. Consume Green And Leafy Vegetables:
One should consume green and leafy vegetables as that helps to step up the level of micro nutrients in the body. 
Increase iron content
Increase salt content

8. Vitamin B12:
It is seen that anemic patients are usually low on their vitamin B12 content. This can be increased by:
Consuming fruits and food items rich in such a micro nutrient
Taking up supplements rich in this complex micro nutrient

9. Avoid Caffeinated Drinks:
It is best to avoid coffee as the caffeine increases the heart rate and might not be ideal for anemic patients. Try and consume decaf version. Limit the number of cups of coffee consumed.
10. Stay Active:
The more active one stays the more the capability of the blood to circulate and keep one healthy. Regular exercises should be done. Strength training will increase muscle mass and help keep up strength and keep away fatigue.

B12 deficiency: a silent epidemic with serious consequences
================================================

B12 deficiency and unsteadiness

Timothy c. Hain, md page last modified: december 19, 2014

Vitamin b12 deficiency is common in the population over 80 (about 10%). It can be a cause of unsteady gait (ataxia), sometimes accompanied by anemia (macrocytic), and loss of position sense. When associated with spinal cord disease, it is sometimes termed" subacute combined degeneration. The ataxia is called a" sensory ataxia, because it appears to be related to loss of position sensation from the feet. A list of diseases that can present with a similar picture is given below:

Subacute combined degeneration (b12 deficiency)
Tabes dorsalis (neurosyphilis)
Fredreich' ataxia (a cerebellar disorder), with damage with sensory input to the cerebellum.
Peripheral neuropathy (common)
Thoracic spinal cord lesions (very rare)
Subacute sensory loss (a rare paraneoplastic syndrome).
The term subacute combined degeneration was coined by russell, batten and collier in 1900 to describe pathological changes in the spinal cord. While changes in the posterior columns are emphasized in clinical accounts, pathologically the lateral and anterior columns are also often affected. The peripheral nerves are generally unaffected. B12 deficiency is a risk factor for cognitive decline (i. E. Dementia)

Causes of b12 deficiency

Decreased intake (e. G. Vegetarians)
Malabsorption
Autoimmune (pernicious anemia)
Stomach and small bowel disorders (e. G. Gastritis, surgery)
Medication interaction (e. G. Metformin, medications that reduce stomach acidity)
Over consumption (blind loop)
B12 is available only from animal sources and thus strict vegetarians are at a risk of deficiency. B12 is bound to animal protein and released by gastric acid. When taken as part of food, b12 is released from food by a combination of gastric acid and pepsin (an enzyme).

A medication for diabetes, metformin, reduces absorption of b12.

Gastric conditions contributing to b12 deficiency include various stomach diseases that impair release of b12 from food

Pernicious anemia (pa) accounts for 15-70% of b12 deficiency. This an autoimmune disorder where antibodies are made to intrinsic factor. Oral supplements are less effective in pa than other modes of administration.

Diagnosis of b12 deficiency

B12 deficiency is usually detected through a b12 blood level. Typical lower limits of normal are 200 pg/ml. A cbc test may show macrocytic anemia.

Because b12 is stored in the liver, it takes about 2 years following a sudden cessation of intake for signs of deficiency to arise.

Treatment of b12 deficiency

There are presently a variety of options.

Oral therapy involves giving 1 to 2 mg (1000 mcg) of b12 daily. Oral therapy is usually as effective as the others noted below
Monthly injections of b12 are traditional. The first injection is generally 1000ug, and subsequent ones are 100.
Nasal b12 is also now available as an alternative to injection in persons who do not respond to oral therapy.
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The Theory Behind Complete Blood Count!

The Theory Behind Complete Blood Count!

Complete blood count (CBC):

CBC provides information of the circulating blood & Screen for a wide range of conditions and diseases

  • Help diagnose various conditions, such as anaemia, infection, inflammation, bleeding disorder or leukaemia
  • Monitor the condition and/or effectiveness of treatment after a diagnosis has been established
  • Monitor treatment that is known to affect blood cells, such as chemotherapy or radiation therapy

 Human body is made up of cells and water. Many of the cells group together and form the skin, muscle, bones and organs like Heart, Lungs & Kidney.

Some very special and important cells move throughout the body by circulating in the blood which provides Oxygen to all these stationary cells in the body. These help them to fight against the infection, stop bleeding after an injury.

EVALUATION:  Three types of cells circulate in our body.

  1. WHITE BLOOD CELLS
  2. REDBLOOD CELLS.
  3. PLATLETS.

A. WHITE BLOOD CELLS (WBC):

These cells represent the defence system of body i.e. fight infection and cancer. It also plays role in allergies and inflammation. 

Types of WBC:

  1. NEUTROPHIL: Neutrophils are cells that protect the body from bacterial infections. They move toward bacteria and then swallow them up so the bacteria cannot harm the body.
  2. LYMPHOCYTE: Lymphocytes are cells that protect the body against viruses, bacteria, and fungi. One type of lymphocyte (B-cell) produces antibodies that attack and destroy the bacteria and viruses. Another type of lymphocyte (T-cell) can directly attack viruses and bacteria and can stimulate the B-cells to produce antibodies
  3. MONOCYTES: Monocytes are cells that consume dead or damaged cells. They are the “clean-up crew”.
  4. EOSINOPHIL: Eosinophils are cells that kill parasites and contribute to allergic reactions.
  5. BASOPHIL: Basophils are cells that release histamines during allergic reactions.
  6. OTHERS: Promyelocytes, Metamyelocytes, Blasts, etc. are not normally appear in the blood. In the presence of any of these cells indicates a need for follow-up .

EVALUATION OF WBC:

Low count of WBC is called Leukopenia. The causes of low count are -

  1. Dietary deficiency.
  2. Autoimmune condition.
  3. Sever infection
  4. Lymphoma or other cancer that spread in bone marrow
  5. Bone marrow disorders or damage
  6. Disease of immune system

High count of WBC called Leucocytosis. The causes of high count are-

  1. Infection most commonly bacterial or viral
  2. Inflammation
  3. Leukaemia
  4. Allergy
  5. Tissue death
  6. Intense exercise or sever stress.

 

B. RED BLOOD CELLS (RBC)

These cells transport oxygen from the lungs to the rest of body. These oval shaped cells contain haemoglobin, the protein that binds oxygen while it is carried to all stationary cells in the body i.e., cells in the skin, muscle, bone and organ. The chemical process converts the nutrients found in food into energy requires oxygen. All stationary cells require energy to function; thus, they need oxygen and dependent on the RBCs to transport it.

Haemoglobin: It is an iron rich protein.

  • It carries oxygen.
  • It makes the blood red.
  • Normal range in Male: 13.5 to 17.5 grams per decilitre
  • Normal range in Female: 12.0 to 15.5 gram per decilitre

Low Haemoglobin: This can occur due to

  • Body produces fewer RBC’s than usual
  • Body destroys RBC’s faster than they can produce
  • Blood loss.

Following conditions produce fewer RBC’s -

  1. Aplastic anaemia
  2. Cancer
  3. Drugs like Anti-retroviral used in HIV infection, Chemotherapy of cancer
  4. Chronic kidney disease
  5. Cirrhosis of liver
  6. Hodgkin’s lymphoma
  7. Hypothyroidism
  8. Iron deficiency anaemia
  9. Leukaemia
  10. 10. lead poisoning
  11. 11.Multiple myeloma
  12. 12. Myelodysplastic syndrome
  13. 13.Non-Hodgkin’s lymphoma
  14. 14. Vitamin deficiency anaemia
  15. Following conditions destroy RBC’s faster
  16. Splenomegaly
  17. Haemolysis
  18. Porphyria
  19. Sickle cell anaemia
  20. Thalassemia
  21. Vasculitis (Blood vessels inflammation)

Other cause of low Haemoglobin count

Bleeding from a wound, digestive tract, ulcers, cancer, Haemorrhoids and menorrhagia (heavy menstrual bleeding)

High Haemoglobin count: It occurs when your body requires increased oxygen -carrying capacity

  • Smoking
  • High altitude
  • Poor heart and lung function ( low blood oxygen levels increase RBC’s production)
  • Bone marrow produces too many RBC’s
  • Consumption of drugs or Hormones e.g. Erythropoietin (EPO) stimulates RBC’s production; injection used for athletic performance

Other cause of high hemoglobin in which the body requires an increased oxygen-carrying capacity.

  • Congenital heart disease in adults
  • COPD (chronic obstructive pulmonary disease)
  • Dehydration
  • Emphysema
  • Heart failure
  • Kidney cancer
  • Liver cancer
  • Polycythemia vera

 

HAEMATOCRIT / Packed cell volume (PCV): It is the measurement by centrifugation of blood. It reflects the ratio of the volume of red blood cells to the total volume of blood or Space occupied by the RBCs.

Normal range in Male: 40 .7% to 50.3%

Normal range in Female: 36.1% to 44.3%

Cause of Low PCV/ Haematocrit or anaemia

  • Bleeding (Ulcers, Trauma, Colon Cancer, Internal bleeding)
  • Destruction of RBCs (Sickle Cell Anaemia, Splenomegaly)
  • Decreased Production of RBCs (Bone marrow suppression, Cancer, Drugs)
  • Nutritional Problems (Low Iron, B12, Folate and Malnutrition)
  • Overhydration (Polydypsia, Intravenous overhydration)

           Cause of High PCV/ Haematocrit or anaemia

  • Dehydration (Heat exhaustion, No available source of fluids)
  • Low availability of Oxygen (Smoking, High altitude , Pulmonary fibrosis)
  • Genetic (Congenital Heart disease)
  • Erythrocytosis (Overproduction of RBCs by bone marrow or Polycythemia vera)

 

  • MEAN CORPUSCLE VOLUME (MCV): It reflects the average size of RBCs.

Low MCV reflect small sized RBCs

High MCV reflect Large sized RBCs

  • MEAN CORPUSCULAR HAEMOGLOBIN (MCH): It reflects the average concentration of haemoglobin in a single red blood cell.

Low MCH reflect low haemoglobin concentration

High MCV reflect high haemoglobin concentration

  • MEAN CORPUSCULAR HAEMOGLOBIN CONCENTRATION (MCHC): It reflects the ratio of MCH AND MCV

Low MCHC shows the Thalassemia (Inherited Blood Disorder) microcytic hypochromic anaemia i.e. RBCs are smaller than usual and have decreased level of haemoglobin. It can be caused by

  • Lack of iron
  • Poor absorption of iron due to disease like CELIAC DISEASE, CHRON’S DISEASE AND GASTRIC BYPASS SURGERY
  • CHRONIC LOW-GRADE BLOOD LOSS LIKE IN PEPTIC ULCER OR LONG MENSTURAL CYCLE.
  • HAEMOLYSIS OR PREMATURE DESTRUCTION OF RBCs OVER TIME
  • CANCER CAUSING INTERNAL BLOOD LOSS.
  • HOOKWORM INFECTIONS
  • LEAD POISOINING.

High MCHC reflects more concentrated haemoglobin in red blood cells. It can occur in conditions where red blood cells are fragile or destroyed leading to haemoglobin being present outside te red blood cells. it can be caused by

  • Autoimmune haemolytic anaemia. In which body develops an antibody that attack your red blood cells. It can be idiopathic autoimmune haemolytic anaemia / Lupus lymphoma/ penicillin reaction.
  • Hereditary spherocytosis. It is a genetic disease in which mutation affects the red blood cell membrane and make it more fragile and prone to destruction.
  • Severe burns often have haemolytic anaemia.

 

1. RED CELL DISTRIBUTION WIDTH (RDW): It reflects the degree of variation in size of the RBCs. Normal red blood cells maintain a standard size of 6-8 micrometres. If cells are larger RDW values will have higher numbers. This test is indicated if one has following problem.

  • Anaemia
  • Iron and vitamin deficiency
  • Family history of blood disorder such as sickle cell anaemia
  • Significant blood loss
  • Disease that affects the red blood cells
  • Chronic illness such as HIV / AIDS.

                RDW test diagnose

  • Types of anaemia
  • Thalassemia
  • Diabetes mellitus
  • Heart disease
  • Liver disease
  • Cancer

Normal Range of RDW: 10.2% - 14.5% (39.0 – 46.0)

Low RDW: Body is not producing enough RBC  It indicate

  • Macrocytic Anaemia: Red blood cells are larger than average. Indicate deficiency of folate or vitamin B12.
  • Microcytic Anaemia: Red Blood Cells are smaller than average. It indicates deficiency of Iron. It also suggests Thalassemia.

High RDW:

The possible cause can be asses by comparison with MCV

  1. High RDW and MCV: Haemolytic anaemia, Megaloblastic anaemia, Lack of vitamin B12. Indicate chronic Liver Disease
  2. High RDW and low MCV: Iron deficiency anaemia or Microcytic anaemia, Thalassemia intermedia.
  3. High RDW and Normal MCV: Beginning stages of Vitamin B12 or Folate Deficiency, Beginning stage of Iron deficiency Anaemia. Indicate Chronic Liver Disease.

 

2. Platelets: Platelet is vital for the normal clotting.

EVALUATION OF Platelet:

Low count of Platelet is called Thrombocytopenia. The causes of low count are –

  1. Viral infection including Dengue.
  2. Platelet autoantibody
  3. Drugs
  4. Cirrhosis
  5. Autoimmune disease
  6. Sepsis
  7. Leukaemia
  8. Myelodysplasia (production of blood cells disturbs)

High count of Platelet is called Thrombocytosis. The causes of high count are-

  1. Cancer
  2. Rheumatoid arthritis
  3. Iron deficiency anaemia
  4. Myeloproliferative disorder (Disease of bone marrow and blood)

Mean Platelet Width (MPV): It is calculation of average size of Platelets. Platelets are produced in the Bone marrow and released into the blood stream. Larger Platelets are usually young and more recently released from the bone marrow. smaller platelets are more likely to have been in circulation for few days. Low Platelet count and high MPV level suggests that that the bone marrow is rapidly producing platelets this is because older platelets are being destroyed so the bone marrow compensate.

High MPV may be associated (Depends on other CBC result):

Cancer

Several types of cancer e.g. Lung, ovarian, endometrial, colon, kidney, stomach, pancreatic, and breast cancer

Warning signs of cancer are:

  1. Skin changes
  2. Breast changes
  3. Thickening skin or lump on or under your skin
  4. Hoarseness or cough that doesn’t go away
  5. Changes in bowel habit
  6. Trouble swallowing
  7. Weight gain or loss for no reason
  8. Abdominal pain
  9. Unexplained night sweats
  10. Unusual bleeding or discharge in urine or stool
  11. Feeling weak or tired
  12. Hyperthyroidism
  13. Heart disease
  14. Diabetes
  15. Vitamin D deficiency
  16. High blood pressure
  17. Stroke
  18. Atrial fibrillation

Low MPV may be associated (Depends on other CBC result):

  • Inflammatory bowel disease, Crohn’s disease or ulcerative colitis
  • Cytotoxic medication
  • Aplastic anaemia.

Platelet Distribution Width (PDW): It reflects how uniform platelets ars in size.

  • Reference range of platelet distribution width is: 10%-18%

Low value of PDW:

A low value indicates uniformity in size of platelets. This may also be an indication that there is a disorder present which is affecting the bone marrow and how it is able to produce platelets. Viral infections will typically produce this result, such as measles, hepatitis, or mononucleosis. Certain drugs and cancers can also cause this result.

High value of PDW:

  • A high value indicates increased variation in the size of the platelets, which may mean that a condition is present that is affecting platelets. There are numerous younger platelets and numerous older platelets in the same sample. This may be an indication that some sort of disorder has affected the bone marrow or the platelets and further testing may be required. Certain cancers, anaemia, and inflammatory conditions typically cause this result, as will some infectious diseases or the use of birth control pills.
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Jaundice - The Right Way It Can Be Treated!

Jaundice - The Right Way It Can Be Treated!

Jaundice is a medical condition where the bilirubin level shoots up in the blood of the affected person. Also referred to as icterus, the condition may affect adults as well as newborn babies (Neonatal Jaundice), whereby the skin and the white part of the eye (sclera) appears yellowish in color (due to the accumulation of bilirubin).

Bilirubin is the bile pigment that results from the breakdown of hemoglobin (when the RBC cells breakdown). The bilirubin thus produced is released into the plasma. The liver then filters the released bilirubin for further metabolism. In the case of a diseased condition, injury or infection to the liver, it fails to remove the bilirubin from the bloodstream. As a result, there is an abnormal rise in the bilirubin level in the blood (Hyperbilirubinemia), resulting in jaundice. In jaundice, Bilirubin can go upto much higher levels. At 2.5-3 it just starts to get manifest as yellow eyes. Obstructive jaundice may require an endoscopic procedure or surgery.

Types of jaundice:
Jaundice may be of the following types:

  • Hepatocellular jaundice: In Hepatocellular jaundice, the elevated bilirubin level in the blood is an outcome of a liver disease or an injury (altering the normal functioning of the liver).
  • Hemolytic jaundice: Here, the increased level of bilirubin in the blood results from an increased breakdown of the RBCs (Hemolysis).
  • Obstructive jaundice: As the name suggests, Obstructive jaundice results from an obstruction in the bile duct. As a result, the bilirubin does not get filtered and remains in the liver.


Factors contributing to jaundice:
The increased buildup of bilirubin may be an outcome of

  • Obstruction and inflammation of the bile duct.
  • Chronic liver disease including liver cirrhosis and hepatitis.
  • Pancreatic Cancer.
  • Hemolytic anemia: It is a condition resulting from increased breakdown of RBCs.
  • Gilbert's syndrome.
  • Certain medications may also interfere and alter the normal functioning of the liver (steroids, birth control pills, and acetaminophen, to name a few).
  • In cholestasis, the bile (conjugated bilirubin), instead of getting eliminated, remains in the liver.

Symptoms:
The symptoms associated with jaundice include

  • The skin (particularly, the face, hands, nails, and feet) and the sclera appear yellowish.
  • The urine appears dark in color.
  • Fever, vomiting, tiredness, and loss of body weight.
  • Abdominal pain (mild to severe).
  • The stool appears pale in color.
  • Itchiness or Pruritus.

Diagnosis and treatment:
The earlier the diagnosis, more effective is the treatment.

  • Jaundice can be diagnosed by
  • Physical examination.
  • Bilirubin tests to determine the total bilirubin level.
  • CBC is used to determine the levels of RBCs, WBCs, and platelets.
  • Liver function tests.

The treatment for jaundice involves identifying the underlying factor responsible for the condition and treating it.

  • In the case of obstructive jaundice, operation helps to improve the condition.
  • Patients with hepatitis may benefit from antiviral medicines as well as steroids.
  • In hemolytic anemia, use of iron supplements helps to improve the condition.
  • Avoid oily and spicy foods, smoking and drinking.
  • Rest as much as possible.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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Thalassemia - What Exactly Is It?

Thalassemia - What Exactly Is It?

Thalassemia is a genetically inherited blood disorder in which the body starts producing an abnormal form of hemoglobin. This hemoglobin gets destroyed by natural immunity, and ultimately leads to anemia.

What is the prevalence of Thalassemia?

Beta thalassemia is particularly prevalent among Mediterranean peoples, and due to this geographical association, it is also known as Mediterranean anemia. It is also commonly seen in Greece, Turkey, and Italy. In India, it is more commonly seen in Jain and Gujarati community.

Why does it occur?

Genetic mutation of the gene which is concerned with hemoglobin production is the major cause of it. This mutant gene is generally inherited from the parents. If both the parents transmit mutated gene to the offspring, then the offering will surely develop thalassemia, and if only one parent transmits mutant gene, then the offspring will become only carrier of the disease. He/she will not get the symptoms of the disease or very rarely he may get symptoms but in minor form.

Types of Thalassemia-

The globin part of hemoglobin includes alpha and beta globin. There are two main types of thalassemia, and they are as follows:

  1. Beta thalassemia: Beta thalassemia occurs when there is a defect in the production of beta globin. Beta thalassemia major is caused when there is no functional beta chain production. This is the most severe form. In beta thalassemia intermedia, some amount of hemoglobin A is produced. Beta thalassemia minor is caused when only one of the two beta globin alleles contains a mutation, so beta chain production is not terribly compromised.
  2. Alpha thalassemia: Alpha thalassemia occurs when the body cannot make alpha globin. It has two subtypes and they are as follows:
  3. Hemoglobin H: It develops when a person is missing three alpha globin genes.
  4. Hydrops fetalis: It develops when all the four alpha globin genes are altered or missing.

Symptoms of Thalassemia-

  • Enlarged organs, such as spleen and liver
  • Chest pain, cold hands and feet, shortness of breath, leg cramps, and rapid heartbeat
  • Delayed growth
  • Headaches, dizziness, and faintness
  • Failure to thrive in newborn
  • Pale or jaundiced skin
  • Frequent infections
  • A poor appetite

How to diagnose it?

Diagnosis can be made by following test:

  1. A complete blood count (CBC): To check hemoglobin level and size of red blood cells
  2. A reticulocyte count: To assist the pace at which reticulocytes are produced
  3. Genetic testing: To find out the faulty gene

What is the treatment available for it?

It includes:

  • Blood transfusions and bone marrow transplant
  • Medications, vitamin supplements, and iron supplements
  • Surgery to remove the spleen and gallbladder
  • Chelation therapy to remove excess of iron and other heavy metals

In case you have a concern or query you can always consult an expert & get answers to your questions!

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