PHEOCHROMOCYTOMA

PHEOCHROMOCYTOMA

Pheochromocytoma is a pathological condition in which there are benign tumor developments in or outside adrenal glands either one or both. Even though the condition is rare and asymptomatic at the beginning if left untreated it may produce serious effects including death.

Pathophysiologically the tumors are formed from the chromaffin cells of the adrenal medulla either by mechanical over-stimulation such as frequent stress, anxiety, and tension or due to some pathological conditions.

Pathologically the tumors may stimulate overproduction of catecholamines such as adrenaline and noradrenaline which in turn produce high blood pressure, tachyarrhythmia, stress and other serious cardio and pulmonary vascular effects.

As the produced catecholamines by the tumor are usually metabolised within the chromaffin itself a test for the metabolites may give us a positive result rather than testing for the parent compounds.

Adrenalin is metabolized to metanephrine and noradrenaline to normetanephrine.
Adrenal glands are a pair of small pea-shaped endocrines or ductless glands each one situated at the top of the two kidneys on either sides. They produce important hormones like adrenaline, noradrenaline, and steroid-like hydrocortisone and cortisol.
Adrenal hormones help balance body functions such as
1.Heart Rate
2.Blood Pressure
3.Metabolism
4.Blood Glucose
5.Stress
6.Immunity

Symptoms

1)Skin reactions

2)Elevated heart rate

3.Elevated B.P.

4)Panic and anxiety

5)High sweating

6)Head pain

7) Pallor 

8)Weight Loss

9)Elevated Glucose Level due to lipolysis

The main cause of the disease is genetic.
10.Elevated sweating
11)Tremor
12)Sudden Headaches

Diagnoses

1)By direct measurements of catecholamines in blood plasma or in a 24-hour collection of urine

2)CT or MRI scans of the head, neck, chest, and abdomen. This can help to localize the tumor

Treatments

1. The best treatment is to remove the tumors

this requires a non invasive laparoscopic surgeries with small short recovery incisions.

2. In case if the tumor cannot be removed the doctor may remove the entire affected gland as one gland is sufficient for body control.

3. In rare cases if both the glands are completely affected then complications begin as both the glands are to be removed and the patient should be subjected to have entire hormone replacement therapy.

ERECTILE DYSFUNTIONS(ED)-CAUSES-SYMPTOMS AND TREATMENTS

ERECTILE DYSFUCTION-THERAPIES

Erectile Dysfunction (ED) is a form of sexual impotency that occurs when a man cannot attain a perfect erection sufficiently enough time to perform intercourse to satisfy his partner.

It often ends with depression and an unsatisfied relationship between the couple.

ED cannot be considered to be a disease unless it is not associated with a pathological or physiological defect.

Stress and mental depression can play important roles in affecting a person's sexual performances.

Age is another factor that plays an important role in sexual performance. Men over 75 years are reported more as having erectile disorder according to American Acadamy Of Family Physicians(AAFP). However, men can also have ED at younger ages too.

Nitric oxide produced in the body as a by-product of protein metabolism plays an important role in performing penile erection.

Nitric oxide production from the amino acid L-arginine is a complex process by the group of enzyme nitric oxide synthase.

Nitric oxide has many neuronal functions one of them is vasodilation. Through this effect it dilates the blood vessels of the muscular system of the penis known as corpus cavernosum,to get more blood supply. The corpus cavernosum relaxes leads penile erection.

If the above Nitric Oxide passage disturbed by any means then the penile erection will be disturbed.

There are many prescribed medicines available with some naturally available herbal medicines in the market. Among the natural herbal medicines Red Ginseng occupies an important place.

Red ginseng technically known as Panax ginseng is a Korean herbal remedy for ED.

But this is a traditional older form of remedy practiced in Korea and China. The plant takes at least six years to attain maturity for harvesting.

Red ginseng is available in medical practice in powder, capsule,and syrup formulations.

The main active ingredient in this herb is a glycoside known as Ginsenoside which is responsible for various biological benefits of Ginseng.

Researches still cannot come to a clear understanding of the mechanism of action of these herbal remedies.

In 2008 various study results have been published in the British Journal of Clinical Pharmacology which revealed that six of the studies proved that ginseng consumption improves sexual activities and penile erection by an unknown mechanism on the comparison. But all the studies could never come to a clear conclusion regarding the definite mechanism of action of ginseng to cure ED.

Other generic medication for ED.

There are a number of medications in generic forms have been invented for ED therapy.

They are sildenafil(Viagra by Pfizer), tadalafil(Cialis by Eli Lilly), vardenafil (Levitra by Bayer), and so on. All these drugs work by the route of nitric oxide pathway to improve penile erections

SIDE EFFECTS OF GINSENG

1.Insomnia

2.Headaches

3.Stomach upset

4.Constipation

Other Herbal Remedies For ED

1.Dehydroepiandrosterone (DHEA):-

A supplement of this hormone is available with the dosage forms of 75 mg but should be consulted with the doctor.

It is assumed that DHEA works through the stress hormone Adrenaline which helps the body to produce various hormones to improve the body, sexual abilities.

2.Horney Goat Weed (Epimedium)

Chinese herbal medicine which the doctors believe that can cure various sexual dysfunctions including ED.

3.Ginko

Ginkgo Biloba is herbal medicine is believed to be correcting the ED by dilating the blood vessels of corpus cavernosum.

EYE CARE-CONTACT LENSES

SOME IMPORTANT ASPECTS OF CONTACT LENSES

 

Wearing the contact lenses verily depends on sufficient tear production by the eyes. Dry eye condition makes difficulty and insufficiency in contact lenses wearing.

Indications

1.Protrusion of or extension of the central part of the cornea beyond the limit. (Cornea-the pupil cap).This condition is known as Keratoconus

2.Absence of eye lens. The condition is known as Aphakia

3.Visual blurring

4. Nearsightedness is known as Myopia

5.Distant sightedness known as Hyperopia

6.Improper focus of light rays known as Astigmatism

7.Improper accommodation and no flexibility of lens known as Presbyopia

8. One eye is having near vision while the other is having a far vision. The condition is known as Monovision.

Contra-Indications

1. Work requires high exposure to dust.

2. Exposure to high winds

3.Exposure to high smoke.

4.Chronic conjunctivitis

5.Chronic blepharitis

6.Recurring infections

Precautions

Caution should be exercised by patients who suffers and possibilities of changes in eye conditions as follows:-

1.Epilepsy

2.High B.P. which may damage retina

3.Cardiac diseases.

4.Diabetes Mellitus which causes outgrowth of  vessels in the iris and  the eye's anterior chamber.

5. Taking oral contraceptives as regular consumption may alter the optical physiology. These changes are corneal sensitivity elevation, color changes, decreased visual acuity.

Types of Contact Lenses

1. There are some contact lenses made of polymethylmethacrylate(PMMA). These are rigid and water-resistant. These are Hard Glasses commercially known as Lucite or Plexiglas.

These hard lenses are having major advantages are their cost effects when compared with soft lenses and they can be easily marked to identify for the left or right eye.

The disadvantages also like minimum wettability,and limited oxygen permeability. Because of the hardness which does not permit sufficient oxygen and moisture it is difficult for the individual to adapt with it for a longer time.

2. Soft Lenses are made out of glasses that are flexible, and oxygen and water permeable.

These are easy to use,more comfortable to wear, and more difficult to dislocate from the position.

There are disadvantages like they are prone to absorb harmful chemicals,high costs,very easily deteriorate from storage,and altered visual acuity due to hydration of the lens.

Patients wearing soft lenses can use a few drops of rewetting agents. At the same time they should avoid other ophthalmic agents.

3. There are other types of lenses such as Gas Permeable Lenses. These are soft lenses contains PMMA. Hence they permit only oxygen but resist water.

They have the advantages over the hard lenses by their comfortability,and increased visual acuity.

Also they have the advantage over the soft lenses by their impermeability to resist chemicals.

The disadvantage of the gas permeable lenses is the accumulation of proteins and lipid deposits as they are moisture resistant.

Toxic Effects

Corneal edema due to improper oxygenation of the eye.

Medication can affect the eyes and potentiate the problems.

e.g.Oral contraceptives.

      Decongestants

      Antihistamines

      Tricyclic Antidepressants such as amitriptyline,imipramine etc

      Diuretics

Lens Care

Hard lenses are cleaned to remove oil,dust, and debris,followed by soaking in a storage solution,wetting to retain its hydrophilic surface,and rewetting.

Soft lenses are cleaned by surface-active or enzymatic cleaners,followed by disinfectants thermally or chemically. Finally rewet them.

Gas permeable lenses are cared for by cleaning,wetting, and soaking. Some are containing more silicone agents, requiring conditioning solutions that are made especially for rewetting purposes.

Solutions Recipe

Cleaning Products generally contain non ionic or amphoteric surfactants,which remove mucus,lipids,and proteins from the lens. Contact lenses should be rinsed following the cleaning steps to prevent eye irritations

Wetting Solutions are applied directly into the lens before inserting the lens into the eyes. Wetting solutions are intended to lubricate,decrease lens surface tension,and change the lens surface from hydrophobic to hydrophilic.

Wetting and Soaking solutions are meant for creating an aseptic environment and to hydrate the lens.

Preservatives

1.Benzalkonium chloride,

2. Thimerosal,this may produce more irritating episodes.

3.Phenylmercuric nitrate,

4.Sorbic acid,

5.Sodium edetate.

 

 

CONCEPT OF EYE PREPARATION USES

EYE CARE

There are varieties of eye drops for various uses of eye diseases and defects. It is very essential to know how to use them for different purposes.

A BRIEF ANATOMY OF EYE 

                              

Eyelids are protecting the eyes. They are folds of tissues. They distribute tears.
The eyes can be divided into two parts.
The external eye is formed by the tear gland and the conjunctival cul de sac
The internal eye is composed of the followings:
1.The outer coating of the eyeball known as the sclera
2.The colored membrane of the pupil that regulates the light entering through the pupil known as the iris.
3.The fluid-like substance derived from the blood by a process of ultrafiltration and secretion, known as the aqueous humor
4. The transparent tissue hanging at the center balanced by ciliary tissues on either side is known as the lens. The lenses are light refracting, focuses light rays to form an image at the retina.
5. The tissue linings of the eyelids are known as the conjunctiva

6. In between the lens and retina space is filled with a thick viscous gel- fluid known as the vitreous body or humor. The vitreous is very important which keeps the eyeball in shape, keeps retina sufficiently apart from the lens so that the lens can produce a clear image on the retina. Any detachment or shrinkage in vitreous may cause blurred images and sight problems.

Unlike the aqueous humor which is more watery the vitreous is stagnant and more vicious. Any detached cells can float inside the vitreous and can be reflected in the retina as flying bubbles in front of us. A heavy blow in the head, or during faint the vitreous may get disturbed to form many virtual flys in front of us.

At the corner of the conjunctiva there is fine meshwork followed by a downward draining canal known respectively as trabecular meshwork and canal of Schlemm through which the aqueous humor can be drained out.

1.Anti-infective eye preparations 

The concept of anti-infective eye preparations such as 

1.sulpha preparations and antibiotics such as chloramphenicol, gentamicin, tobramycin, and polymixin trimethoprim combinations are used if an infection is found in the eyes.

A stye is a condition in which there are symptoms such as pain, tenderness, redness, and eye swelling may present. The style is a kind of eye infection involving one or more sebaceous(sweat) glands of the eyelid. More often without medication a frequent hot compress is enough to get relief from stye but some times it needs an antibiotic prescribed by a doctor.

Other eyelids inflammatory infectious conditions such as blepharitis whose symptoms are inflammation, redness, and itching of the eyelid certainly need antibiotic eye preparation.

The black eye is a condition there is a black stain surrounding the eye resulted in a blow that can often be treated with cold compresses for 24 hours followed by warm compresses. If eyelids are damaged a physician should be inferred.

Conjunctivitis, an infection of the conjunctiva(the white part of the eye).Symptoms are redness, burning, and pain needs antibiotic treatments.

Dacryoadenitis

It is the swelling of the tear glands due to infection. Symptoms include red burning eyes, and the sensation of a foreign body in the eye.
The following antibiotics alone or with some combinations are available as additional pieces of information:
1. Ofloxacin (Antibiotic) eye drops-This preparation can be used if an infection is present.
2. Gatifloxacin (Antibiotic) with Dexamethasone (Corticosteroid) Combination can be used if there are reddening and inflammation along with infection.
3.Hypromellose (Tears Naturale): Can be used in dry eyes.

2.Astringents

Astringents are substances that are chemical compounds that make body tissues tend to shrink and thereby relieve irritations and pain.

The only FDA approved astringent in the USA is 0.25% zinc sulfate in eye drops to be used to relieve eye irritations.Of course zinc sulfate is a mild astringent it is safe and widely used in medicine.

3..Demulcents

Demulcents are used to protect and lubricate the dry eyes give relief from light irritations. They are relatively free from side effects and can act as artificial tears.

The best examples are sodium carboxymethylcellulose,dextran-70,gelatin,glycerin,hydroxyethylcellulose,hydroxypropyl methylcellulose,methylcellulose,polyethylene glycol-300,polyethylene glycol-400,polysorbate-80,polyvinyl alcohol,povidone and propylene glycol.Whenever you tend to use demulcents check any of the above ingredients on the label.

4.Decongestants and Vasoconstrictors

These agents work by producing a temporary constriction of the blood vessels present in the conjunctiva and thereby relieve eye redness and pain.
Examples are naphazoline hydrochloride (e.g.Clear Eyes), phenylephrine hydrochloride (e.g.Isopto Frin),
tetrahydrozoline (Murine Plus) and oxymetazoline hydrochloride (OcuClear)
Combination decongestant and antihistamine products include Naphazoline Plus Solution, Naphcon-A, and Opcon-A.
Keep in your mind that continue the use of any of the above product may cause a rebound of the condition.
Decongestants and vasoconstrictors are contraindicated in angle-closure glaucoma patients.

5.Hypertonic Eye Drops

It is known that a 2 to 5% sodium chloride solution can be conveniently hypertonic to the lacrimal fluid. Hypertonic solutions are used to relieve corneal swelling.

Even though hypertonic solutions are available on the counter as nonprescription medicine it is advisable to use it under doctor's supervision because of its hypertonicity which may cause rupture of the cornea.

6.Artificial Tears

These are a combination of a hypertonic agent, buffering agent, an agent that causes viscosity, and a preservative.

In general OTC nonprescription eye products should not be used for more than three days.Any abnormal symptoms persists immediately the patient should be referred to a physician.

The followings are the usual contents of artificial tears:-

1.Carboxymethylcellulose or any methylcellulose compound as demulcents

2.Polyvinyl alcohol (A lubricating agent)

3.Hyaluronic acid (A viscosity agent)

4.Sodium chloride solution below 0.9%(as a hypertonic agent)

5.Sodium perborate (as an oxidative preservative)

It is advisable to use those eye lubricants without preservatives in mono-dose-vials to prevent harmful side effects.

Artificial tears are prescribed for dry eyes,keratoconjunctivitis sicca

PRESCRIPTION MEDICINES

1.Atropine 

First of all you must keep in your mind that in general atropine is an anti cholinergic antimuscarinic drug. It will block all acetylcholine muscarinic receptors and to pave the for adrenergic overactivity.

Hence using atropine in eyes causes dilation of the pupil and causes a decrease in eye sensitivity towards light. It is usually used during eye examinations.

The drug may relieve pain but should be dangerous if use without medical consent.

Atropine after application shall cause blurred vision for some times and do not rub the eyes. Since atropine causes high pressure due its anticholinergic effects and adrenergic overactivity in the eyes it should not be used by diabetics especially those who suffers glaucoma (both open-angle or close angle).

2.Cosopt eye drops:

This is a combination of two medicines a beta-adrenergic blocker(Timolol) and a carbonic anhydrase inhibitor (Dorzolamide).
The concept of using this eye drops is to reduce the elevated eye pressure and to relieve open-angle glaucoma. Untreated glaucoma and elevated will cause blindness.
The preparation should be used as per the medical advice.

Corticosteroid Eye Drops & ointments

Corticosteroids are immunity sparing drugs and should be used with caution.
Corticosteroids are used in eye preparation to get relief from inflammations, injuries in post-operative conditions, and in some other allergic conditions which need immunity compromises such as pain and swellings.
1.Dexamethasone (Maxidex)
2.Fluocinolone
3.Difluprednate
4.Fluorometholone (FML forte)
5.Loteprednol
6.prednisolone
7.prednisone
Whenever using eye preparations the following concepts are to be kept in the mind.
1. Thoroughly wash your hands and wipe them to dry.
2. Take the vial in your hand and open the lid.
3.Sit in a chair or sofa in a relaxed position and tilt the head up sufficiently supported by the sofa head at the back.
4. Pull the lower eyelid a little and without touching the eye get the vial nozzle sufficiently closer to the eye and direct it towards the corner of the eye just above the nose and press the vial to instill the medicine in drops and close the eye immediately.
5. To apply ointment no need of seat arrangements. Stand in front of a mirror and pull the eyelid little and apply for the medicine by slowly pressing the tube. Direct the tube nozzle towards the corner of the eye just above the nose and get it closer without touching the eye. Put the medicine started from the corner followed by the lower lid lining and blink the eyes.

 

NEWS UPDATE:BENEFITS OF CASHEW NUTS

THE INCREDIBLE BENEFITS OF CASHEW NUTS

Cashew trees came to India from their homeland Brazil. The wonderful shrubs may some times called as trees can grow a maximum height of 14 meters in an extraordinary growth.

It belongs to the botanical family Anacardium accidental. It is indigenous to South America especially to Brazil. It looks very greenery.

It is very common on the east and west coast of southern India.

The tree yields cashew apple which is attached with the nut at its bottom tip. According to a botanist the nut is originally the fruit and the fruit like upper part is originally the pearl millet or a swollen stem attachment of the fruit to the tree.

The apple and the nuts are having huge benefits for our health.

1. National Center for Biotechnology Information (NCBI), in a case study revealed that eating cashew nuts on a daily basis has many cardiovascular benefits by their rich omega-3 unsaturated fatty acids. Cashew eating can lower LDL and increase HDL.IN 2003 the FDA also confirmed that cashews help lower LDL and decrease cardiovascular defects.
The Heart Association recommends a fist full of cashew nuts per week can be beneficial for heart diseases but warns against taking too much cashew nut as they are heavy in calories.
A study published in the New England Journal of Medicine (NEJM) has also confirmed the association of eating cashew nuts with a lower incidence of death due to heart diseases, cancer, and respiratory diseases due to their rich content of omega-3 fatty acids, antioxidants, and anti-carcinogenic agents.
The study stated that cashews are rich in unsaturated fatty acids, fibers, protein, vitamins, minerals, and antioxidants.
2. Cashew nuts are preventing iron deficiency anemias by their rich in copper content. Copper facilitates the absorption of iron and its metabolism.
3. Cashew contains a powerful antioxidants pigment known as Zeaxanthin. This pigment is directly absorbed by our retina. Zeaxanthin is one of the major retinal components mostly present in the central macular retina.
4. Cashewnut oil is rich in zinc, selenium, magnesium, iron, and phosphorous. Because of these elements along with protein and antioxidants cashew oil is good for the skin.
5. Since cashew nuts are rich in omega-3 unsaturated fatty acids they are good for weight reduction. The rich unsaturated fatty acids help excess fats to burn fast. They improve excess fat metabolism. Many studies have proved that those who consume cashew nuts on a regular basis have reduced and healthy BMI.
6. According to many studies cashews are rich in dietary fiber carbohydrates. The two important dietary fibers are oleic acid and palmitic acid which the body cannot be produced by the body. Cashewnuts are found rich in oleic acid and palmitic acid which helps digestion and absorption.
7. Cashew oil which is rich in zinc, copper, and selenium using this oil on a regular basis is good for hair growth and their health.

 

SATURATED FATS INCREASE HEALTH?

ARE MEAT,EGGS,BUTTER,CHEESE-HARMLESS?

The answer is yes, says a recent study at the KG Jabsen Center For Diabetes Research at the University of Bergen
The saturated fats intake rather increases the good cholesterol and not increases the risk of heart attack, the researchers say.
The above concept is totally against the old concept of the intake of saturated fats such as red meat, butter and cheese increase the risk of heart attack and stroke.
In the new Norwegian Fat Intervention study (FATFUNC) published in The American Journal of Clinical Nutrition study leader asst prof. Simon Nitter Dankel et al have overturned and questioned the older dietary concept that taking saturated fat is unhealthy for the population which dominated the medical literature for more than 50 years.
The notion of reducing saturated fat intake to keep the body weight in control and to prevent many chronic illnesses such as heart attack, blood pressure, and many diseases. But the scientists and many health organizations however contrasted with this theory with recent studies.
The American Heart Association (AHA) goes with the government warnings and echo that consuming too much-saturated fat may cause heart attack and other problems.
But The Academy of Nutrition and Dietetics however recommend de-emphasizing the role of saturated fat in causing heart problems as there is no established link between the two.
The majority of the foods containing saturated fat comes from animal sources and dairy products.
The AHA recommends reducing the intake of these foods based on the strong science they believe behind the old concept.
Daniel and his colleges tested the harmful effects of saturated fat on 38 men with abdominal obesity. The participants were divided into two groups. Group A was given a diet rich of high fat with low carbohydrate and group B was given a diet rich of low fat and high carbohydrate for 12 weeks.
The researchers measured the fat mass in the abdomen and also assessed cardiovascular risk factors.
They found the result was negative towards the current theory of the group which was with the diet of high fat and low carbohydrate diet should be at higher risk of getting cardiovascular problems than the other group.
However that was not the case, there was no difference between the groups. 
"The very high intake of total and saturated fat did not increase the calculated risk of cardiovascular disease", the researchers said.
On contrary the participants under high saturated fat diet shown substantial improvements in several cardiometabolic risk factors such as ectopic fat storage (Fat deposits around the organs in the abdominal cavity such as liver and pancreas, skeletal muscle, heart and mainly as triglycerides with very little adipocytes), blood pressure, blood lipids, insulin, and blood sugar.

The Overriding Principle

Finally from the study, we could understand it is not the quantity of saturated fat but it is the quality of the saturated fat that may affect our health.

 

 

ERYTHROBLASTOSIS OR HEMOLYTIC ANEMIA

ERYTHROBLASTOSIS FETALIS

 

This is a condition in which the red blood cells are destroyed by an autoimmune system of our body and thereby cause oxygen depletion and tissue death. The condition is very serious and fatal.

Rh factor is a kind of an inherited protein usually present on the surface of the red cells(RBC). People whose RBC contains Rh factor are considered to be Rh-positive. On the contrary those whose RBC not contains Rh factor are considered to be Rh-negative.

If the mother is Rh-negative and the father is Rh-positive then the child would be mostly Rh-positive. If this is the case then the pregnancy will be risky for both mother and child. During such pregnancy if any opportunity occurred for mixing the mother and baby's blood on either side then it is fatal and risky of getting erythroblastosis by any of them or both.

OPPORTUNITIES

1. During delivery when the placenta detaches from the uterus wall.

2.Pregnancy with heavy bleeding

3.Manual rotation of a breech baby

4.Miscarriage (premature delivery or spontaneous abortion)

5.Ectopic pregnancy(PREGNANCY OUTSIDE WOMB)

6.Abortion

7.Traumas, or a sudden fall.

8.Invasive prenatal tests such as amniocentesis or chorionic villus sampling.

Dangerous Rh sensitization occurs in the mother during chorionic villus sampling. The Rh-negative mother is at risk by mixing her baby's potentially Rh-positive blood with her own.

As a result the mother's body immune system will recognize in future any blood entry of the Rh-positive factor as a foreign body and will attack them. The antibodies produced by the mother may pass into the fetus also and causes the destruction of its RBCs.The result is the death of a fetus or illness due to erythroblastosis and abortion.

The Rh-positive contamination can occur due to careless uses of contaminated injection needles, and blood transfusion.

Erythroblastosis may not occur due to the difference in blood groups.

The fetus may be born with defective blood or illness. The RBCs of the fetal blood are destroyed. They lost their oxygen-carrying function. Severe anemia will stimulate the liver, spleen, and bone marrow to produce more RBC. This may cause organ damage. Excess formation of bilirubin as a byproduct of RBC damage may cause jaundice and the baby will look yellow in color.

Symptoms

1.Yellowish amniotic fluid (The fluid-filled in the pregnant womb) due to excess bilirubin seen on an amniocentesis test

2.An enlarged liver, spleen or heart

3. Fluid builds up in the abdomen, lungs, and scalp can be recognized by an ultrasound scan test.

Newborns may bear with the following symptoms

1.Pale skin

2.Yellow amniotic fluid, umbilical cord, skin, or eyes either at birth or within 24 to 36 hours after delivery.

3.Organs such as liver or spleen enlargement

4.Breathing difficulties due to full body fluid build-ups.Heart failure. The condition is known as Hydrops Fatalis

Complications

1.Mild to severe anemia

2.Jaundice

3.Organ enlargement

4. Kernicterus:-Excess bilirubin build up in the brain causes deafness, seizures, brain damages, and death.

Diagnosis and Treatments

1. A test for Rhesus or Rh factor may be helpful to diagnose and treat the problem.

An antibody screening test in the first semester, followed by a repeat test after 28 weeks of gestation.

This may reveal a clear knowledge about the presence of Rh incompatibility during pregnancy.

2. Testing the fetus include ultrasound test, amniocentesis, fetal middle cerebral artery blood flow measurement, and fetal umbilical cord blood testing.

After birth in the newborn tests for hemolytic anemia must be carried out.

1.Test for blood group and Rh factor

2.RBC count

3.Test for antibodies and bilirubin levels.

The treatments include fetal blood transfusion and delivery of the baby between 32 to 37th week of gestation.

Treatments of the newborn should be carried out with the following conditions:-

1.Blood transfusion

2.Intravenous fluids

3.Management of breathing difficulties

4.Use of Intra Venous Immuno Globin. The use of IVIG antibody treatment is to reduce the RBC destruction and to control bilirubin raise.

Some times exchange transfusions are carried out by replacing a portion of the newborn's blood in order to increase RBC count and to minimize the bilirubin level.

Prevention

The Rh sensitization can be prevented by giving the medication  Rh immunoglobin (RhIg) also known as RhoGAM before women become sensitized.

This is medication helps the mother not develop destructive antibodies.

But this medicine may not helpful to those women who have been already sensitized

Hence this medicine can be helpful only to those women who are not yet sensitized but at the risk of sensitization.RhoGAM can be given as follows:

1.After 28th week of gestation

2.72 hours following delivery

3. Within 72 hours of miscarriage, abortion, or ectopic pregnancy.

4.Following an invasive prenatal test such as amniocentesis, and chorionic villus sampling.

5. Following vaginal bleeding, if any 

If a woman carries beyond 40 weeks of gestation an additional dose of RhoGAM is recommended.