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ANAEMIA

Anaemia can be defined as decreased haemoglobin counts or reduced red blood cell counts or reduced oxygen carrying capacity of blood, due to “loss of” or “abnormality of” red blood cells or haemoglobin.

Normal Heamoglobin Counts

  • 6 months to 5 years of age > 11g/dl
  • 5 years to 12 years of age > 11.5g/dl
  • 12years to 16 years of age > 12g/dl
  • Adult Females (non-pregnant) > 12g/dl
  • Adult Females (pregnant) > 11gm/dl
  • Adult Males > 13g/dl

CAUSES OF ANAEMIA

  • Blood losss
  • Excessive Red Blood Cell destruction
  • Heamoglobinopathies
  • Hypovitaminosis B12
  • Hypoferremia
  • Anaemia of Chronic diseases
  • Autoimmune haemolytic anaemia
  • Inflamatory bowel diseases
  • Hypervolemia or water retention due to sodium or other salts.
  • Genetic hereditary conditions like Thalasemia
  • Certain cancers
  • Kidney diseases
  • Reduced erythropoetin production
  • Excessive RBC destruction
  • Impaired RBC production
  • Certain infections like malaria which causes RBC destruction.
  • Certain drugs which causes RBC destruction eg. Quinine causes chinchonism.
  • Bone Marrow lesions and pathologies
  • Etc.

CLASSIFICATION OF ANAEMIA

There are many types of anaemias. It can be broadly classified into 7 categories depending upon their causes

Anaemia due to

  1. Blood Loss
  2. Hemolysis
  3. Impaired or abnormal Erythropoesis
  4. Hypervolemia
  5. Chronic Diseases
  6. Nutritional deficiency

Based on RBC morphology it can be classified into 3 groups

  • Microcytic
  • Macrocytic
  • Normocytic

FEW COMMON and RARE TYPES OF ANAEMIA

  • Iron Deficiency Anaemia
  • Aplastic Anaemia
  • Megaloblastic Anaemia
  • Pernicious Anaemia
  • Sideroblastic Anaemia
  • Autoimmune Hemolytic Anaemia
  • Myelodysplastic Syndrome
  • Thalasemia
  • Fanconi Anaemia
  • Congenital Dyserythropoetic Anaemia
  • Daimond-Blacfan Anaemia
  • Myelopthisis
  • Anaemia of Prematurity
  • Erythroblastopenia or Pure Red Cell Aplasia
  • Hereditary Spherocytosis
  • Hereditary Elliptocytosis

SYMPTOMS

  • Weakness
  • Lethargy
  • In children it affects growth in general
  • Somnolence, Drowziness in day time
  • Disturbed sleep at night
  • Pallor, general pale appearance of skin, mucous membranes and eyes.
  • Dyspnoea on Exertion.
  • Reduced Immunity, tendency to catch infections and slow recovery and healing.
  • Bodyaches
  • Cyanosis in severe cases
  • Palpitations
  • Tachycardia
  • Low blood pressure
  • Chest pain
  • Depression
  • Craving for indigestible things , PICA
  • Cold clammy extremities
  • Oedematous swelling of extremities, dependent oedema
  • Angina or cardiac failure in severe cases
  • Will impact general growth and repair of all the vital organs and tissue of the body.

HOMEOPATHIC MEDICINES FOR ANAEMIA

Depending upon the cause of anaemia and general constitution of the patient, one of the following medicines may be called for duty by a homeopathic physician.

  • Ferrum Metallicum
  • Ferrum Phosphoricum
  • Cinchonna Officinalis
  • Natrum Muriatic um
  • Arsenicum Album
  • Abrotanum
  • Hamamelis Verginiana
  • Pulsatilla Nigricans
  • Janosia Ashoka
  • Crotalus Horridus
  • Lachesis
  • Acidum Phosphoricum

THALASEMIA

Thalasemia is a genetic disorder where in mutation or deletion in any genes responsible to produce globin chain of haemoglobin results in abnormal haemoglobin production.

Normal adult has Haemoglobin A (HbA). HbA is a hetrotetramer of two α globin chains and two β globin chains. In normal humans there are total 4 genes (2pairs) for production of αglobin chain and 2 genes(1 pair) for production of β globin chain. When there is defect in genes producing α globin or β globin chains of heamoglobin it results into thalasemia.

TYPES

  • Alpha Thalasemia – Abnormal or dhieficient α globin chain production
  • Beta Thalasemia – Abnormal or deficient β globin chain production.
  • Delta Thalasemia – Abnormal or defective delta chain production.
  • Thalasemia in combimation with other haemoglobinopathies like – Haemoglobin S , Haemoglobin E, Haemoglobin C, Haemoglobin D.

Of the above all types the most common types alpha and beta are discussed below.

ALPHA THALASEMIA

Alpha Thalasemia has defective α globulin chain production. Genes responsible to produce α globin chain are situated on chromosome 16. HBA1 and HBA2 genes are responsible for production of α globin chain. Both the genes are acquired from both the parents so total two HBA1 and two HBA2 genes. So, there are two genes acquired from each parent making total 4 genes or two pairs(αα/αα) responsible to produce α globin chain.

Depending upon number of gene deleted the condition is classified into 4 categories

  • α Thalasemia Silent (1 gene deletion)
  • α Thalasemia Trait (2 gene deletion)
  • HbH disease (3 gene deletion)
  • Hb Bart Syndrome (all 4 gene deletion)

Alpha Thalasemia Silent

Any one gene deletion (-α/αα), one of the two allele not received from one parent. Usually there are no sign of anaemia as the remaining three genes produce sufficient alpha globin chains. Althought they dont show symptoms they are the silent carrier and if married to person with one or more α globin making gene deletion then some of their offsprings will have symptoms, probability and severity of the disease in the offsprings will depend on number of gene deletion in the partner.

Alpha Thalasemia Trait

Any two gene deletion, it can be of two genotypes as descussed below, this type shows mild anaemia symptoms.

  1. Two gene deletion – homologous; one of the two allele not received from each parent(-α/-α).
  2. Two gene deletion- heterologous; both the alleles not received from one parent (–/αα).

HbH Disease

Three gene deletion (–/-α) No copy of gene received from one parent and only one of the two copy received from another parent. These causes very low α chain production resulting into excess proportion of β chains causing formation of unstable haemoglobin tetramer made up of 4 β globin chains, instead of two α and two β. This type of haemoglobin with all 4 globin chain of β globin is called HbH which is very unstable. These individuals shows moderate to severe anaemia and other thalasemia related symptoms.

Hb Bart Syndrome

All four gene deletion (–/– )No copy of α chain producing gene received from either of the parent. It is a fatal condition where in there are no α chains produced and results into severe fetal condition called hydrops fetalis. Death ensues soon after birth.

BETA THALASEMIA

Beta thalasemia has defective β globin chain production. For production of β globin chain there is only one gene acquired from each parent makin it total one pair(β/β) i.e total 2 genes responsible to produce β globin chain. Gene Responsible for production of β globin chain is called HBB and is located on chromosome 11.

Beta Thalasemia Minor

  1. (b/β) One gene received from a parent is altered and the one from other parent is normal.
  2. (-/β) No gene received from a parent and the gene received from another parent is normal.

Beta Thalasemia Intermedia

  1. (b/-) One copy of gene received from a parent altered and one from another parent is absent.
  2. (b/b) Genes received from both the parent are altered.

Beta Thalasemia Major

  • (-/-) No genes producing β globin chain received from either parent.

SIGNS AND SYMPTOMS

Symptoms and its severity depends upon the above mentioned severity of genotype the individual has few complaints which patient with this disease condition show are mentioned below.

  • Anaemia
  • Iron Overload
  • Bone deformities
  • Enlarged spleen
  • General growth is slow
  • Ferquent Infections
  • Cardiac complaints

DIAGNOSIS

  • Complete blood count
  • Hb Electrophoresis
  • DNA analysis.

HOMEOPATHIC TREATMENT AND INDICATED HOMEOPATHIC MEDICINES FOR THALASEMIA

  • Cinchonna Officinalis
  • Abrotanum
  • Natrum Muriaticum
  • Phosphorus
  • Calcarea Phosphorica
  • Calcarea Carbonica
  • Calcarea flourica
  • Ruta Graveolens

Neurons, Base Camp of life energy?

Neurons – Base Camp Of Life Energy?

We will make a big mistake in understanding and treating the person if we ignore how all the subtle impressions can influence our body.

By the time you complete reading this article you will have a major change in your philosophy of perceiving your body and you will start having a more broader view and acceptance towards many other aspects of nature and its implications on health and Life.

Senses like Vision, Hearing, Smell, Touch, Taste generates feelings which generates desires and thoughts. Can thought generate itself in absence of all these senses?

Thought gives rise to emotions  like Love, Hatered, Anger, Fear, Sadness, Happiness etc.

Many neurotransmitters like acetylecholine, Dopamine, Serotonine, GABA(Gama Amino Butric Acid), Glutamate, Norepinephrine and there are 60 more such neurotransmitters discovered by scientists who’s secretion is triggered by thought and vice-a-versa.

Senses, Thoughts and Emotions triggers neurotrasnsmitters that determines functioning of our brain  which has hypothalamus and a pitutary glands adjoined below which is called master of orchestra of hormonal interplay in the body as it determines the level of each hormone in the body that we call Hypothalamo-pitutary-Hormonal axis. And you all know how important the hormones are seeing their profound effect on body’s functioning in general. Slightest disturbance in Hypothalamo-Pitutary-Hormonal axis results into grave, acute and chronic complaints.

As we all know that the body parts or organs that are being used more, develops better and those which are not used goes into disuse atrophy and later becomes dormant. Similarly certain functions of body change as per their necessity. We know that most of the body processes are triggered directly or indirectly by brain and our thoughts and emotions.

Certain examples of physiological impact of senses, thoughts, feelings, emotions and other abstract dynamic influences.

  • Sadness causes weeping, it activates tear glands.
  • Fear causes activation of sweat glands , shivering, piloerections, palpitations
  • Fun causes smile and Laughter.
  • Psychological stress causes Hyperacidity, Hypertension, reduced insulin production, reduced Growth hormone secretion.
  • Sight of yawning causes yawning
  • Certain thought Sound and Vision causes stimilation of sexual organs
  • Stimulation of salivary glands on sight of food
  • Nausea on certain sight and odour
  • Depression causes severe appetite and eating disorders, Hypothalamus directly controls our hunger and satiety centers slightest disturbance in this physical psychological or other may cause eating disorders leading to obesity and or alarming weightloss.
  • Depression is thought to be one of the cause of hypothyroidism and vice-a-versa.
  • Now after years of reasearch and experience modern science has accepted the fact that most of the autoimmune conditions are triggered or caused due to psychological stress as one of the major reason.

All these examples shows us that how abstract dynamic influences external or internal has impact on brain and subsequently on our body’s physiology, the prolonged changes in physiology has a wider implication on body’s each and every cells and thus changing the gene environment and epigenome thus influencing gene and finally its structure.

We know the processes of adaptation, our body gradually adapts itself to the type of stimulus we are subjected to for a longer period of time. Similarly our thoughts emotions and other psychological factors influences our body’s physiology and its profound effect for a longer period acts as an effect of a stressor and body has to adapt itself accordingly. Now adaptation initially seemingly to be phenotypic may gradually change genotype as well. Now a change at one locus in gene will have compensatory and/or counter regulatory change at other locus as the harmony is spoiled and body tries to re-harmonize or may be due to one bad sector in gene damaging other sectors(locus) due to their abnormal protein products in gene itself factoring in  new  changes. Now this leads to accumulation of many changes in the character of genome giving rise to positive or negative or mixed physiological or anatomical variations or disturbances leading to diseases.

Majority of endogenous diseases are caused due to genetic imbalance that we got it as hereditary germ line change or are acquired by external impressions and influences that has profound impact on our body.

 

to be continued…

IBD INFLAMATORY BOWEL DISEASE

IBD Inflammatory Bowel Disease is a functional Gastrointestinal disease that mainly affects the bowel-large or small intestine.
It is the chronic relapsing inflammation of intestine.
Certain genetic and environmental factors are known to be associated with IBD.
The disturbances of immune system and impaired action of microbes leads to development of IBD.
Chrons disease and ulcerative colitis are two different entities of IBD.

Chrons disease

It is a type of IBD that may affect the GI tract from mouth to anus.
Most probably it involves sharply demarcated single or multiple areas of large intestine, terminal ileum or ileocecal region.

Risk factors and cause

Age- chrons disease can occur at any age but most commonly develops at young age.
Hereditary-About 15%of patients with chrons disease have one or more family members either with chrons disease or ulcerative colitis.
Cigratte smoking-smokers are most likely to develop chrons disease than non smokers.
Diet-high intake of refined sugars and low intake of fibre can mainly contribute to chrons disease.
Certain medications like NSAID’s.

Pathogenesis

Chrons disease is believed to be result of an imbalance between proinflammatory and anti-inflammatory cells.
There are some mutations in NOD2 gene that disrupts the mucosal defence mechanism.
NOD2 earlier known as CARD15 helps protect body against foreign Invader like bacteria and viruses through immune system cells like macrophages, monocyte and dendritic cells.
When triggered by some bacteria they become active and regulate activity of multiple genes that controls inflammatory response.
ATG16L1 is also involved in pathogenesis.it provides information for making a protein that is required for autophagy (destruction of cells in body).
It’s mutations impaires autophagy process and allows worn our cells to persist in body.
Depressed defence mechanism can stimulate microbial proliferation in body.
Under microscope biopsies of affected colon shows mucosal inflammation characteristed by inflitration of neutrophilis.
Neutrophils along with mono nuclear cells infiltrate crypt’s leading to inflammation and abscess.

Signs and symptoms

Intestinal manifestation-
-Ileum- abdominal pain and cramps
Diarrhoea
Obstructive symptoms
Mass in right iliac fossa
Acute ileitis
-colon- rectal bleeding
Intestinal stenosis
Perianal disease
-rectum-proctitis
Extraintestinal manifestation-
Eyes-it causes uveitis causing blurred vision and eye pain.Photophobia
Oral cavity-it causes apthous stomatitis, geographic tongue,chelitis granulomatosa.
Skin-erythema nodusum, ulcerative nodules.
Chrons disease can also cause osteoporosis and thinning of bones
Clubbing of fingers
Deep vein thrombosis
Fatigue

Diagnosis

Blood test-Anaemia is noted in PT with chrons disease.there are low blood cell count.

Stool test-For presence of any occult blood.

Colonoscopy-it is more accurate test that detects the ulcers and areas of inflammation.It can also be used to take biopsies.

Ultrasonography can be useful in patients with palpable abdominal mass and in order to differentiate from abscess

CT scan-this test is used to diagnose entire bowel as well as tissue outside the bowel.it has replaced barium x-rays.

MRI is useful for investigating complex perianal disease

Upper GI endoscopy- A flexible tube containing a camera is inserted in stomach and upper part of small intestine.it can also be done using a capsule.

Air Purifying Indoor Plants

AIR PURIFYING INDOOR PLANTS

We cant survive few minutes without Breathing, And the very basic and most essential substance of our survival Air is now not breathable due to air pollution created by population explosion, deforestation, industrialisation and civic development.

Recently in past decade with global surge in pollution levels as much as 20-40 times beyond acceptable limits; for certain extremely toxic pollutants in most cities; with Delhi as worlds most polluted megacity , with visibility not more than few feets, this is not only causing road accident pile-ups but also we have seen surge in deaths due to pollution, reduced life-span and poor quality of life due to ill health caused due to surge in Allergic Respiratory diseases , Allergic Skin diseases , Various Autoimmune diseases, Cancers , Hormonal Imbalances, PCOD and the list goes on.

But as we know trees are our best friends, so here they come for our rescue, luckily there are certain indoor plants which can efficiently takle situation and can bring down pollution and increase oxygen in the air thus making air more breathable effectively at our home.

According to study done at IIT-Kanpur, following 3 plants that require low and occasional sunlight and can efficiently absorb pollutants and release sufficient oxygen are and can grow almost in any region are easily availabe in India as well.

Money Plant, botanical name Epipremnum Aureum, its a creeper that can survive in low sunlight. Check the link for details of plant and its image  https://en.m.wikipedia.org/wiki/Epipremnum_aureum

Areca Palm also called Butterfly Palm, Botanical name Dypsis Lutes, it can survive indoor in low and required sunlight once in couple of months.Check the link for details of plant and its image  https://en.m.wikipedia.org/wiki/Dypsis_lutescens

Mother In Law Tug Plant also called Snake Plant, Botanical name Sansevieria Trifasciata, it can survive indoor in low and required sunlight once in couple of months. Check the link for details of plant and its image  https://en.m.wikipedia.org/wiki/Sansevieria_trifasciata

If 3 Erica Palm and 3 Snake Plant each 3 feet tall are planted in house supplimented with couple of short 3-6feet Money Plant creepers releases good quantity of oxygen and efficiently absorbs pollutants for a house of around 600 sqft with 4-5 members.