Types of Anemia

Anemia

Anemia may be defined as qualitative or quantitative deficiency of hemoglobin in the blood for the age and sex of the individual. The Normal Hemoglobin level in an adult male is 14 to 18 mg/dl and 12 to 16 for female. When the hemoglobin concentration is below of this level then the person can be called anemic theoretically. Normally the hemoglobin concentration in female body is less than a male body. This is due to the activity of estrogen hormone.

Nail change in Anemia

Classification of Anemia

Morphological classification:

Microcytic hypo chromic anemia:

Causes:

1.       Iron deficiency anemia

2.       Thalassaemia

3.       Sideroblastic anemia

4.       Anemia in chronic disease.

Normocytic normochromic anemia:

Causes:

1.       Aplastic anemia

Causes of Iron Deficiency Anemia

Iron Deficiency Anemia

This is a condition when the loss of iron or the physiological demand for iron is more than the intake or absorption. In Iron deficiency anemia, the red blood cells become small and hypo chromatic. The major causes of Iron deficiency anemia are the followings:

Iron Deficiency Anemia

Blood loss:

1.       Gastriris

2.       Peptic Ulceration

3.       Gastric malignancy

4.       Carcinoma colon

5.       Inflammatory bowel disease

6.       Diverticulitis

7.       Polyps

8.       Hook worm infestation

9.       Schistosomiasis

10.   Chronic use of NSAIDs or Aspirin

Common Causes of Anemia in Bangladesh

Anemia

Bangladesh is a poor country. Most of the people here are deprived of basic needs of life. The number of doctors and the health care centers are insufficient. They cannot take nutritious food for their illiteracy and poverty. For these reasons most of the people in Bangladesh are anemic. More over the chronic disease such as Tuberculosis, SLE, Peptic Ulcer Disease, hook worm infestation are very common. These diseases also play a vital role in the development of anemia. A short example can give you a clear idea about the hematological condition of Bangladeshi people. In Bangladesh a lady with a hemoglobin level of 10mg/dl is considered as free from anemia, where the normal international level is 12 to 16 mg/dl.

Clinical Feature and the Treatment of Perforated Peptic Ulcer Diseases

Peptic Ulcer disease is a condition when excessive acid pepsin condition makes a foramen (perforation) in the gas containing hollow viscous of the abdomen.

Clinical feature of perforated peptic ulcer disease

1.       History of previous peptic ulcer disease and non steroidal anti inflammatory drug (NSAIDs) intake.

PUD perforation

2.       Abdominal pain; which is sudden in onset, severe in intensity. The distribution of the pain follows the spread of the gastric contents over the peritoneum. Pain initially develops on the upper abdomen and rapidly become generalized. Pain is also being felt on the tip of the shoulder due to the irritation of the diaphragm. The pain is accompanied by shallow respiration due to limitation of the diaphragmatic movement and by shock.

3.       The muscle of the abdomen become board like rigid.

4.       Bowel sounds are not audible.

Indications of Bone Marrow Transplantation

Indications of Bone Marrow Transplantation

Allogeneic bone marrow transplantation is the last line of treatment in some systemic and some Hematological diseases. The indications of allogeneic bone marrow transplantation are the following;

General indications for allogeneic bone marrow

Bone Marrow Transplantation

transplantation:

1.       Neoplastic disorders affecting the totipotent or pluripotent cell component (Such as Leukemia )

2.       Those with a failure of haematopoiesis

3.       A major inherited defect in blood cell production

4.       Inborn errors of metabolism with missing enzymes or cell lines.

Hematological indications for allogeneic bone marrow transplantation:

1.       AML high risk CR1 and CR2

2.       Adult ALL CR1 and CR2

What is Hydatid cyst? Investigations and treatment.

Hydatid cyst

Hydatid cyst is a very common cystic disease of liver, in the people of the subcontinent. This disease is most common among the people of India, Bangladesh, Nepal and Myanmar. This is a parasitic disease. And the causative organism is Echinococcus granulosus.

Hydatid cyst

Structure of Hydatid cyst:

The cyst is composed of three layers. They are;

1.       An outer layer derived from the host.

2.       An intermediate laminated layer.

3.       An inner germinal layer.

Feature of the cyst:

1.       They can be single or multiple.

2.       Chronic cysts become calcified.

3.       The cyst may be asymptomatic but may present with abdominal pain or mass.

4.       Rupture or secondary infection of the cyst can occur and a communication with the intrahepatic biliary tree can then result with associated biliary obstruction.

Causes of Dry Tap

Dry Tap

Bone marrow study is an essential investigation to diagnose the blood disease mainly. But this investigation can help to diagnose many other systemic and neurological diseases. To do the bone marrow study first of all the aspiration of the bone marrow is required from the medulary cavity of the bone. In most of the cases wide bore needle is used for this aspiration. But in complicated cases another method named trephine can be used as well. Dry tap is one of the complicated cases where the trephine method is required.

Failure to aspirate any material in the bone marrow aspiration needle is referred as dry tap.

Acute pancreatitis can bringa muti systemic complication

Acute pancreatitis

Pancreas 

Acute pancreatitis can be defined as an acute inflammation of the tissue of the pancreas. The most common causes of acute pancreatitis are, stone in the common bile duct and excessive alcohol intake. In most of the cases the patient presents with a severe upper abdominal pain which radiates to the back. Skin color change in the flank of the abdomen can also be seen. The mortality rate in severe attack of acute pancreatitis is very high. And the risk of long term complication or other disabilities are very high as well.

Some Common Complications of Acute Pancreatitis:

Systemic complications:

1.       Systemic inflammatory response syndrome (SIRS)

2.       Hypoxia