Concept Of Comprehensive Care In Hemophilia

Optimal management of these patients, especially those with severe forms of the disease, requires more than the treatment and prevention of acute bleeding.

Keys to improvement of health and quality of life include:

  • Prevention of bleeding
  • Long-term management of joint and muscle damage and other sequelae of bleeding
  • Management of complications from treatment including
  • Inhibitor development
  • Eliminating viral infection(s) transmitted through blood products requiring long-term management.

[Read more...]

How To Prevent A Bleed In Hemophilia Patient

Following measures help to control bleeding in hemophilia patient.

Treat Acute Bleeds

Acute bleeds in hemophilia should be treated early. Whenever possible they should be treated within two hours. [Read more...]

What Is Autism Spectrum Disorder

The autism spectrum disorders  is a spectrum of psychological conditions characterized by widespread abnormalities of social interactions and communication, as well as severely restricted interests and highly repetitive behavior.

Incidence is expected to be around 6 per thousand [Read more...]

Prescribing the Treatment In Tuberculosis – Points To Remember

  • Meticulously take a history of any previous ATT, that the patient may have received prior. This is the single, most vital parameter
  • Write the regime and date of starting ATT on each prescription slip so that precise durations are clearly recorded and not left to vagaries of memory.
  • Always calculate the drug doses according to the weight of the patient before prescribing a particular ‘kit’ or fixed drug.
  • Patients should be forcefully instructed to meticulously take the prescribed drugs daily in adequate doses for the complete duration. This is most vital in ensuring compliance and treatment completion.
  • Antitubercular drugs are most effective when given once, in full doses in the morning.
  • The patient has to take 4 drugs in the initial intensive phase.
  • Warm all patients that rifampicin colours the urine, sweat and tears reddish orange.
  • Reduce doses of anticonvulsants during treatment with isoniazid.
  • Oral contraceptives become unreliable when taken with rifampicin. Advise the patient to change the method of contraception.
  • Rifampicin is a potent inducer of liver enzymes. Hence the doses of corticosteroids, oral anticoagulants, oral antidiabetic agents, digoxin, phenobarbitone, morphine, dapsone and ketoconazole may need to be increased when taken concomitantly with rifampicin and reviewed once rifampicin is discontinued.
  • The dose of rifampicin should be reduced in patients with cirrhosis.
  • Streptomycin may cause vestibular damage especially with high doses and in the elderly. This results in giddiness, nystagmus and rarely, deafness. Stop streptomycin when these symptoms occur.
  • Ethambutol rarely causes retrobulbar neuritis which results in progressive loss of vision. It is best to tell patients that ethambutol may affect vision. Wherever possible, they should be told to check visual acuity by reading fine print regularly. They should be instructed to stop taking ethambutol and report, should the vision deteriorate. Always assure the patients that the risk is very small. This will check possible non-compliance.
  • Ethambutol should not be given to patients with very weak eyesight as they may not notice a minor diminution of vision early enough.
  • Rest and nutritious food are not important in the treatment of TB. Adequate, regular chemotherapy, taken for the prescribed period results in cure and prevention of relapse.

What is Short Course Chemotherapy For Tuberculosis?

Short course chemotherapy is the treatment of TB using a combination of new antitubercular drugs in a fixed regime for a set duration. These regimes have shortened the duration of treatment of TB from the 12-18 months of old regimes using streptomycin, isoniazid, thiacetazone or PAS to 6-9 months.

These new regimes with nearly 100 percent cure rates are much more potent than the older regimes and fewer relapses are reported with them. Their potency, shorter duration of treatment and fewer relapse rates make them a very cost effective treatment of choice for TB.

The regimes essentially consist of treating TB in two phases.

Initial intensive phase (for rapid killing)

Several drugs are given in the initial intensive phase to rapidly reduce the bacillary population in the tubercular lesion. This results in the destruction of drug resistant mutants in the bacterial population and prevents their selective proliferation. In addition, the rapid killing also results in very early sputum conversion, which dramatically reduces the risk of transmission of infection.

A tubercular lesion has four different types of bacilli:

Group 1: Rapidly growing, active bacilli (most bacilli in the lesion belong to this group)

Group 2: Those in the acidic environment inside cells and in cavitary walls.

Group 3: Semidormant bacilli which show occasional spurts in growth (mostly responsible for relapses)

Group 4: Few dormant bacilli. (no drug is yet available against this group)

Each of the 4 drugs used in the initial intensive phase acts on different populations in the tubercular lesion. [Read more...]

University of Montpellier Experts Relate Depression To Cholesterol Level and Gender

Do you know the Institute of Health and Medical Research (INSERM) and School of Montpellier financed experts indicated that regulating ‘good’ and ‘bad’ levels of cholesterol can help prevent mood problems among seniors?

In a newly released issue of the journal Biological Psychiatry (http://www.biologicalpsychiatryjournal.com) written in July 2010, leading researcher Dr. Marie-Laure Ancelin of INSERM (Institut National de la Santé et de la Recherche Médicale http://www.inserm.fr) announced that gender specific regulation of cholesterol levels can help stop depressive disorder in the aging seniors. [Read more...]

The Concept Of Comprehensive Care In Hemophilia

Hemophilia is manifested by bleeding disorder. But it is more than a bleeding disorder and is complex disorder in terms of diagnosis and management.

Therefore the management of these patients requires a lot more than the treatment and prevention of acute bleeding.

Objectives of Care of Hemophilia are [Read more...]

What Is Hemophilia?

Hemophilia is an X-linked congenital bleeding disorder  caused by a deficiency of coagulation factor VIII (hemophilia A) or factor IX (hemophilia B).  Hemophilia A is more common (85% of the total) than hemophilia B.
When To Suspect Hemophilia?

  • Easy bruising in early childhood
  • Spontaneous bleeding particularly into the joints and soft tissue
  • Excessive bleeding following trauma or surgery.

[Read more...]

What Are Symptoms of Addison Disease?

Addison’s disease is also called as chronic adrenal insufficiency, hypocortisolism or hypocorticism. It is a rare disorder where the adrenal glands are not able to produce glucocorticoids and less often mineralocorticoids in sufficient quantity. The condition was first described by Dr Thomas Addison, the British physician who first described the condition.

Causes of Addison disease

Adrenal dysgenesis

This means adrenal glands which produce glucocorticoid are absent. [Read more...]

Routine Investigation of Polymerase Chain Reaction & ELISA in Tuberculosis

Polymerase chain reaction

polymerase_chain_reactionWith the help of PCR, millions of identical copies of any specific DNA or RNA sequence can be made. This sequence may be a gene, or a part of gene, or simply a stretch of nucleotides.

This is done by using highly specific oligonucleotide primers to amplify the target nucleic acid by repeated rounds of denaturation, primer annealing and amplification. The target DNA is amplified a billion fold within 2-4 hours, and becomes quantitatively enough to be detected by a variety of detecting system. [Read more...]