Thalassemia is a genetic blood disorder caused by mutations in genes responsible for hemoglobin production, resulting in ineffective erythropoiesis and severe anemia. The disease has a worldwide prevalence and is managed through regular blood transfusions to correct anemia, iron chelation therapy to prevent iron overload from transfusions, and potentially curative bone marrow transplantation if a matched donor is available. Nursing care focuses on managing anemia, iron overload, nutritional status, and the psychological impacts of lifelong treatment.
The document discusses the thalassemias, a group of inherited blood disorders caused by defects in hemoglobin synthesis. There are two main types: alpha thalassemia results from reduced alpha globin chain production, while beta thalassemia is caused by reduced beta globin chains. Symptoms range from none to severe anemia requiring blood transfusions, depending on the number of defective genes. Thalassemias are most common in people from Mediterranean, African, and Southeast Asian descent and are diagnosed based on blood tests showing microcytic anemia and abnormalities in hemoglobin electrophoresis and red blood cell indices.
This document discusses thalassemia, an inherited blood disorder caused by mutations affecting hemoglobin production. It provides details on the types of thalassemia (alpha and beta), symptoms, mechanisms, and treatments. The standard treatments discussed are blood transfusions, iron chelation therapy, and folic acid supplements. Blood transfusions help maintain normal hemoglobin levels but require ongoing iron chelation therapy to prevent iron overload damage. Other less common treatments mentioned are splenectomy and bone marrow transplantation.
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1. WHAT IS THALASSEMIA?
2. Molecular Basis of Thalassemia.
3. Types of Thalassemia.
4. - Thalassemia.
5.Types of - Thalassemia.
6. 휷- Thalassemia.
7. Types of 휷- Thalassemia.
8. Thalassemia Syndrome.
9.Treatment
Halima, an 11-year-old girl with consanguineous parents, presented with not growing well, gradual pallor, and abdominal distension for 7 years. On examination, she was severely pale with facial dysmorphism and hepatosplenomegaly. Her history included repeated blood transfusions. She was diagnosed with hereditary hemolytic anemia. The seminar discussed thalassemia, including the types of thalassemia, clinical features, investigations, complications, and management with a focus on blood transfusions and chelation therapy.
The document discusses thalassemia, a group of inherited blood disorders characterized by reduced or absent globin chains. It covers the basics of alpha and beta thalassemia including genetic basis, classification, clinical outcomes, complications, and management approaches like transfusions, chelation therapy, splenectomy, and immunizations. Key points include the varying severity of alpha and beta thalassemia syndromes depending on which globin chains are affected, the risk of iron overload and related organ damage without proper chelation therapy, and the goal of splenectomy to reduce transfusion needs in severe cases.
This document discusses aplastic anemia, a condition characterized by pancytopenia and bone marrow hypocellularity. It defines aplastic anemia, discusses its causes (acquired from things like radiation, drugs, viruses, immune diseases, or inherited genetic syndromes), epidemiology, pathophysiology, clinical features including symptoms and examination findings, diagnostic testing including blood tests and bone marrow biopsy, and treatment options including hematopoietic stem cell transplantation, immunosuppression, supportive care, and prognosis.
1. Thalassemia is a group of inherited blood disorders caused by a defect in the synthesis of the globin chains that make up hemoglobin. There are two main types - alpha and beta thalassemia.
2. Symptoms range from mild anemia to life-threatening conditions depending on the type and severity. Diagnosis involves blood tests and family screening. Treatment involves lifelong blood transfusions and iron chelation therapy for severe cases.
3. Complications include iron overload, organ damage, bone changes and endocrine abnormalities which require monitoring and additional management. While transplantation offers a cure, compliance with treatment and managing complications long-term is important to maximize outcomes for patients.
The document discusses the thalassemias, a group of inherited blood disorders caused by defects in hemoglobin synthesis. There are two main types: alpha thalassemia results from reduced alpha globin chain production, while beta thalassemia is caused by reduced beta globin chains. Symptoms range from none to severe anemia requiring blood transfusions, depending on the number of defective genes. Thalassemias are most common in people from Mediterranean, African, and Southeast Asian descent and are diagnosed based on blood tests showing microcytic anemia and abnormalities in hemoglobin electrophoresis and red blood cell indices.
This document discusses thalassemia, an inherited blood disorder caused by mutations affecting hemoglobin production. It provides details on the types of thalassemia (alpha and beta), symptoms, mechanisms, and treatments. The standard treatments discussed are blood transfusions, iron chelation therapy, and folic acid supplements. Blood transfusions help maintain normal hemoglobin levels but require ongoing iron chelation therapy to prevent iron overload damage. Other less common treatments mentioned are splenectomy and bone marrow transplantation.
Get here,
1. WHAT IS THALASSEMIA?
2. Molecular Basis of Thalassemia.
3. Types of Thalassemia.
4. - Thalassemia.
5.Types of - Thalassemia.
6. 휷- Thalassemia.
7. Types of 휷- Thalassemia.
8. Thalassemia Syndrome.
9.Treatment
Halima, an 11-year-old girl with consanguineous parents, presented with not growing well, gradual pallor, and abdominal distension for 7 years. On examination, she was severely pale with facial dysmorphism and hepatosplenomegaly. Her history included repeated blood transfusions. She was diagnosed with hereditary hemolytic anemia. The seminar discussed thalassemia, including the types of thalassemia, clinical features, investigations, complications, and management with a focus on blood transfusions and chelation therapy.
The document discusses thalassemia, a group of inherited blood disorders characterized by reduced or absent globin chains. It covers the basics of alpha and beta thalassemia including genetic basis, classification, clinical outcomes, complications, and management approaches like transfusions, chelation therapy, splenectomy, and immunizations. Key points include the varying severity of alpha and beta thalassemia syndromes depending on which globin chains are affected, the risk of iron overload and related organ damage without proper chelation therapy, and the goal of splenectomy to reduce transfusion needs in severe cases.
This document discusses aplastic anemia, a condition characterized by pancytopenia and bone marrow hypocellularity. It defines aplastic anemia, discusses its causes (acquired from things like radiation, drugs, viruses, immune diseases, or inherited genetic syndromes), epidemiology, pathophysiology, clinical features including symptoms and examination findings, diagnostic testing including blood tests and bone marrow biopsy, and treatment options including hematopoietic stem cell transplantation, immunosuppression, supportive care, and prognosis.
1. Thalassemia is a group of inherited blood disorders caused by a defect in the synthesis of the globin chains that make up hemoglobin. There are two main types - alpha and beta thalassemia.
2. Symptoms range from mild anemia to life-threatening conditions depending on the type and severity. Diagnosis involves blood tests and family screening. Treatment involves lifelong blood transfusions and iron chelation therapy for severe cases.
3. Complications include iron overload, organ damage, bone changes and endocrine abnormalities which require monitoring and additional management. While transplantation offers a cure, compliance with treatment and managing complications long-term is important to maximize outcomes for patients.
Dr. Neela Ferdoushi presented on thalassemias and hemoglobinopathies. Thalassemias are genetic disorders caused by mutations that decrease the synthesis of the alpha or beta globin chains, resulting in imbalanced globin chain production and anemia. The clinical severity depends on the specific gene mutations inherited. Untreated homozygous forms can be fatal in childhood. Heterozygous carriers may be asymptomatic or have mild anemia. Laboratory tests can help identify abnormalities in hemoglobin type or amounts through hemograms and hemoglobin electrophoresis. Management involves blood transfusions and iron chelation therapy for severe forms.
This document discusses thalassemia, specifically alpha and beta thalassemia. It describes the genetics, pathophysiology, clinical presentations, and laboratory diagnosis of the different types. The main points are:
1) Thalassemia results from inherited abnormalities in globin chain production, causing excess unpaired chains. Alpha thalassemia affects alpha chain production, while beta thalassemia affects beta chain production.
2) There are different clinical syndromes for each type depending on the severity of the genetic mutation, ranging from silent carriers to severe anemia requiring transfusions.
3) Laboratory testing helps diagnose and classify the specific type of thalassemia based on hemoglobin electrophoresis
The document provides information about an upcoming seminar on thalassemia. It includes details about the presenters and two case scenarios that will be discussed. It also provides background information on thalassemia including epidemiology, genetics, clinical presentation, complications, diagnosis, and management. The key topics that will be covered in the seminar are outlined.
This document provides an overview of thalassemia syndromes. It defines thalassemia as a heterogeneous group of quantitative globin chain defects that result in inherited anemia. It describes the different types of thalassemia including β-thalassemia major, β-thalassemia intermedia, α-thalassemias, and other subtypes. It discusses the clinical manifestations, genetic basis, diagnosis, and principles of treatment for the different thalassemia syndromes.
1. Thalassemia is an inherited blood disorder that causes anemia due to reduced hemoglobin and fewer red blood cells.
2. It occurs when genes that code for the alpha or beta globin chains of hemoglobin are missing or abnormal.
3. Symptoms range from none to severe anemia, depending on which genes are affected and how many. The most severe form is called Cooley's anemia.
The document discusses thalassemia, a genetic blood disorder. It defines thalassemia and describes its prevalence worldwide. There are two main types - alpha and beta thalassemia - depending on which globin chain is deficient. Symptoms range from mild to severe anemia. The disorder is diagnosed through blood tests and analysis of red blood cells. Treatment involves blood transfusions and medication.
Thalassemia is an inherited blood disorder where the body makes an abnormal form of hemoglobin, which causes excessive destruction of red blood cells and leads to anemia. There are two main types - beta thalassemia, which occurs when the body can't produce beta globin, and alpha thalassemia, which occurs when the body can't produce alpha globin. Symptoms vary but can include bone deformities, dark urine, delayed growth, and tiredness. Treatment depends on the severity and may include blood transfusions, bone marrow transplants, medications, and surgery to remove the spleen or gallbladder.
This document provides information about aplastic anemia and Fanconi anemia. It discusses the pathophysiology, clinical features, investigations, management, complications, and prognosis of both conditions. Aplastic anemia results from suppression of hematopoietic stem cells, causing low blood cell counts. Fanconi anemia is a rare inherited disorder that also causes bone marrow failure and is associated with physical abnormalities and cancer risk. Treatment options include hematopoietic stem cell transplantation, immunosuppression, and androgen therapy.
This document discusses the pathogenesis of thalassemia. It begins by explaining why studying thalassemia is important, as patients have unknowingly passed on the disease gene to their offspring, increasing cases. It then provides statistics on annual births of different hemoglobin disorders globally. The document notes thalassemia originated in Mediterranean people and was first described in 1925. It describes the mutations that cause alpha and beta thalassemia by disrupting hemoglobin chain production. The classifications and symptoms of both types are explained. The document concludes by covering diagnosis, treatment, complications and prevention of thalassemia.
Thalassemia is an inherited blood disorder caused by variants or missing genes that affect hemoglobin production. This results in reduced red blood cells and mild to severe anemia. There are two main types - alpha and beta thalassemia. Symptoms range from none in minor cases to severe anemia requiring transfusions in major cases. Investigations include blood tests to check hemoglobin levels, red blood cell size and count, and hemoglobin electrophoresis to confirm the diagnosis. Management focuses on blood transfusions and iron chelation therapy to prevent organ damage from excess iron.
Thalassemia is a genetic blood disorder caused by mutations in the genes that control globin production. There are two main types - alpha thalassemia affects alpha globin genes, while beta thalassemia affects beta globin genes. Thalassemia severity depends on the number of affected genes, ranging from no symptoms to severe anemia requiring chronic blood transfusions. The thalassemia gene is maintained in populations where malaria is common due to heterozygote resistance to the disease.
Thalassemia Dr.Ahmad Qassm :What is thalassemia ,INTRODUCTION of thalassemia,Types,Signs & Symptoms of thalassemia ,Diagnosis of thalassemia ,Treatment and Food Treatment of thalassemia ,Iron chelation therapy of thalassemia ,Bone Marrow & Stem Cell Transplant of thalassemia ,Possible Future Treatments of Thalassemia
Thalassemia is a genetic blood disorder characterized by reduced or absent hemoglobin production, causing anemia. There are two main forms: alpha thalassemia affects alpha globin gene production, while beta thalassemia affects beta globin genes. Beta thalassemia was first described in 1925 and symptoms include anemia, spleen and liver enlargement, and bone changes. Diagnosis involves blood tests showing microcytic anemia. Treatment for beta thalassemia major includes regular blood transfusions and iron chelation therapy.
1. Thalassemia is caused by a defective production of the globin portion of hemoglobin, resulting in an imbalance between alpha and beta globin chains.
2. There are two main types - alpha thalassemia affects alpha chain production while beta thalassemia affects beta chain production.
3. Beta thalassemia major is the most severe form, characterized by severe anemia starting in early childhood requiring lifelong regular blood transfusions and iron chelation therapy to prevent iron overload.
This document discusses iron deficiency anemia, including its causes, signs and symptoms, diagnostic tests, and differential diagnosis. It notes that iron deficiency anemia is the most common cause of anemia and results from absent or decreased iron stores combined with low serum ferritin levels. The document outlines how iron is absorbed, transported, and stored in the body. It also lists common signs of iron deficiency anemia such as fatigue, angular stomatitis, and nail changes. Diagnostic tests discussed include complete blood count, serum iron, total iron binding capacity, serum ferritin, and bone marrow examination. Thalassemia, lead poisoning, and anemia of chronic disease are mentioned as conditions in the differential diagnosis.
1. Sickle cell anemia is a genetic blood disorder caused by a mutation in the beta-globin gene resulting in abnormal hemoglobin S.
2. Red blood cells with hemoglobin S become sickle shaped and rigid, causing them to clog small blood vessels and obstruct blood flow. This leads to chronic hemolytic anemia, organ damage, and painful sickle cell crises.
3. Treatment involves management of pain, antibiotics to prevent infection, blood transfusions, hydroxyurea therapy, and potentially bone marrow transplantation or gene therapy in severe cases. Regular screening and preventative measures can help reduce complications.
This document provides information on hemoglobinopathies and thalassemias. It begins by defining hemoglobinopathies as genetically determined abnormalities of the hemoglobin molecule, associated with globin chains. It then discusses the different types of globin chains and normal hemoglobin development.
The document classifies hemoglobinopathies into 5 major classes including structural abnormalities, thalassemia syndromes, thalassemic hemoglobin variants, hereditary persistence of fetal hemoglobin, and acquired hemoglobinopathies. It provides detailed information on beta thalassemia syndromes, genetics, clinical features, hematologic findings, bone marrow findings, laboratory tests, and complications/management of thalassemia major. It also briefly discusses
it include nursing management. kindly see this for your reference, your likes and comment will improve the things in future. its very helpful to the nursing students.
Thalassemia is a group of inherited blood disorders caused by reduced or absent globin chains. There are two main types - alpha and beta thalassemia. Alpha thalassemia results from reduced alpha globin production while beta thalassemia results from reduced beta globin production. Thalassemia is characterized by ineffective red blood cell production and increased red blood cell breakdown leading to anemia. Common complications include iron overload, bone and organ damage, and endocrine abnormalities. Treatment involves regular blood transfusions along with iron chelation therapy.
This document discusses polycythemia, which is an increase in red blood cells. It can be primary (polycythemia vera) or secondary to other causes like tissue hypoxia or abnormal erythropoietin production. Polycythemia vera is a clonal disorder associated with a JAK2 mutation and is typically managed through phlebotomy to reduce red blood cell mass and prevent complications like thrombosis. Symptoms can include splenomegaly, aquagenic pruritus, erythromelalgia, and hyperuricemia. Treatment may also include chemotherapy or splenectomy in severe cases.
case presentation on diagnosis of beta thalassemia majorDrShinyKajal
case history of 9 month old infant
Paediatric Clinical Approach to this case
examination
workup at blood centre
HPLC screening
laboratory findings
screening of father mother
prominent facial features
PBF and bone marrow findings
usg abdomen
xray skull
prbc transfusion therapy in thalassemia major
classification of thalassemia
national burden in india
pathogenesis- anemia skull bone iron overload
world thalassemia day
Thalassemia is a genetic blood disorder caused by an imbalance in the alpha and beta globin chains that make up hemoglobin. There are two main types - alpha thalassemia and beta thalassemia. Beta thalassemia major requires lifelong blood transfusions and iron chelation therapy to remove excess iron from the body, while beta thalassemia minor causes only mild anemia. Management of thalassemia major involves regular blood transfusions, monitoring of iron overload, and iron chelation therapy to remove excess iron and prevent organ damage. With proper treatment, patients can survive well into adulthood.
Dr. Neela Ferdoushi presented on thalassemias and hemoglobinopathies. Thalassemias are genetic disorders caused by mutations that decrease the synthesis of the alpha or beta globin chains, resulting in imbalanced globin chain production and anemia. The clinical severity depends on the specific gene mutations inherited. Untreated homozygous forms can be fatal in childhood. Heterozygous carriers may be asymptomatic or have mild anemia. Laboratory tests can help identify abnormalities in hemoglobin type or amounts through hemograms and hemoglobin electrophoresis. Management involves blood transfusions and iron chelation therapy for severe forms.
This document discusses thalassemia, specifically alpha and beta thalassemia. It describes the genetics, pathophysiology, clinical presentations, and laboratory diagnosis of the different types. The main points are:
1) Thalassemia results from inherited abnormalities in globin chain production, causing excess unpaired chains. Alpha thalassemia affects alpha chain production, while beta thalassemia affects beta chain production.
2) There are different clinical syndromes for each type depending on the severity of the genetic mutation, ranging from silent carriers to severe anemia requiring transfusions.
3) Laboratory testing helps diagnose and classify the specific type of thalassemia based on hemoglobin electrophoresis
The document provides information about an upcoming seminar on thalassemia. It includes details about the presenters and two case scenarios that will be discussed. It also provides background information on thalassemia including epidemiology, genetics, clinical presentation, complications, diagnosis, and management. The key topics that will be covered in the seminar are outlined.
This document provides an overview of thalassemia syndromes. It defines thalassemia as a heterogeneous group of quantitative globin chain defects that result in inherited anemia. It describes the different types of thalassemia including β-thalassemia major, β-thalassemia intermedia, α-thalassemias, and other subtypes. It discusses the clinical manifestations, genetic basis, diagnosis, and principles of treatment for the different thalassemia syndromes.
1. Thalassemia is an inherited blood disorder that causes anemia due to reduced hemoglobin and fewer red blood cells.
2. It occurs when genes that code for the alpha or beta globin chains of hemoglobin are missing or abnormal.
3. Symptoms range from none to severe anemia, depending on which genes are affected and how many. The most severe form is called Cooley's anemia.
The document discusses thalassemia, a genetic blood disorder. It defines thalassemia and describes its prevalence worldwide. There are two main types - alpha and beta thalassemia - depending on which globin chain is deficient. Symptoms range from mild to severe anemia. The disorder is diagnosed through blood tests and analysis of red blood cells. Treatment involves blood transfusions and medication.
Thalassemia is an inherited blood disorder where the body makes an abnormal form of hemoglobin, which causes excessive destruction of red blood cells and leads to anemia. There are two main types - beta thalassemia, which occurs when the body can't produce beta globin, and alpha thalassemia, which occurs when the body can't produce alpha globin. Symptoms vary but can include bone deformities, dark urine, delayed growth, and tiredness. Treatment depends on the severity and may include blood transfusions, bone marrow transplants, medications, and surgery to remove the spleen or gallbladder.
This document provides information about aplastic anemia and Fanconi anemia. It discusses the pathophysiology, clinical features, investigations, management, complications, and prognosis of both conditions. Aplastic anemia results from suppression of hematopoietic stem cells, causing low blood cell counts. Fanconi anemia is a rare inherited disorder that also causes bone marrow failure and is associated with physical abnormalities and cancer risk. Treatment options include hematopoietic stem cell transplantation, immunosuppression, and androgen therapy.
This document discusses the pathogenesis of thalassemia. It begins by explaining why studying thalassemia is important, as patients have unknowingly passed on the disease gene to their offspring, increasing cases. It then provides statistics on annual births of different hemoglobin disorders globally. The document notes thalassemia originated in Mediterranean people and was first described in 1925. It describes the mutations that cause alpha and beta thalassemia by disrupting hemoglobin chain production. The classifications and symptoms of both types are explained. The document concludes by covering diagnosis, treatment, complications and prevention of thalassemia.
Thalassemia is an inherited blood disorder caused by variants or missing genes that affect hemoglobin production. This results in reduced red blood cells and mild to severe anemia. There are two main types - alpha and beta thalassemia. Symptoms range from none in minor cases to severe anemia requiring transfusions in major cases. Investigations include blood tests to check hemoglobin levels, red blood cell size and count, and hemoglobin electrophoresis to confirm the diagnosis. Management focuses on blood transfusions and iron chelation therapy to prevent organ damage from excess iron.
Thalassemia is a genetic blood disorder caused by mutations in the genes that control globin production. There are two main types - alpha thalassemia affects alpha globin genes, while beta thalassemia affects beta globin genes. Thalassemia severity depends on the number of affected genes, ranging from no symptoms to severe anemia requiring chronic blood transfusions. The thalassemia gene is maintained in populations where malaria is common due to heterozygote resistance to the disease.
Thalassemia Dr.Ahmad Qassm :What is thalassemia ,INTRODUCTION of thalassemia,Types,Signs & Symptoms of thalassemia ,Diagnosis of thalassemia ,Treatment and Food Treatment of thalassemia ,Iron chelation therapy of thalassemia ,Bone Marrow & Stem Cell Transplant of thalassemia ,Possible Future Treatments of Thalassemia
Thalassemia is a genetic blood disorder characterized by reduced or absent hemoglobin production, causing anemia. There are two main forms: alpha thalassemia affects alpha globin gene production, while beta thalassemia affects beta globin genes. Beta thalassemia was first described in 1925 and symptoms include anemia, spleen and liver enlargement, and bone changes. Diagnosis involves blood tests showing microcytic anemia. Treatment for beta thalassemia major includes regular blood transfusions and iron chelation therapy.
1. Thalassemia is caused by a defective production of the globin portion of hemoglobin, resulting in an imbalance between alpha and beta globin chains.
2. There are two main types - alpha thalassemia affects alpha chain production while beta thalassemia affects beta chain production.
3. Beta thalassemia major is the most severe form, characterized by severe anemia starting in early childhood requiring lifelong regular blood transfusions and iron chelation therapy to prevent iron overload.
This document discusses iron deficiency anemia, including its causes, signs and symptoms, diagnostic tests, and differential diagnosis. It notes that iron deficiency anemia is the most common cause of anemia and results from absent or decreased iron stores combined with low serum ferritin levels. The document outlines how iron is absorbed, transported, and stored in the body. It also lists common signs of iron deficiency anemia such as fatigue, angular stomatitis, and nail changes. Diagnostic tests discussed include complete blood count, serum iron, total iron binding capacity, serum ferritin, and bone marrow examination. Thalassemia, lead poisoning, and anemia of chronic disease are mentioned as conditions in the differential diagnosis.
1. Sickle cell anemia is a genetic blood disorder caused by a mutation in the beta-globin gene resulting in abnormal hemoglobin S.
2. Red blood cells with hemoglobin S become sickle shaped and rigid, causing them to clog small blood vessels and obstruct blood flow. This leads to chronic hemolytic anemia, organ damage, and painful sickle cell crises.
3. Treatment involves management of pain, antibiotics to prevent infection, blood transfusions, hydroxyurea therapy, and potentially bone marrow transplantation or gene therapy in severe cases. Regular screening and preventative measures can help reduce complications.
This document provides information on hemoglobinopathies and thalassemias. It begins by defining hemoglobinopathies as genetically determined abnormalities of the hemoglobin molecule, associated with globin chains. It then discusses the different types of globin chains and normal hemoglobin development.
The document classifies hemoglobinopathies into 5 major classes including structural abnormalities, thalassemia syndromes, thalassemic hemoglobin variants, hereditary persistence of fetal hemoglobin, and acquired hemoglobinopathies. It provides detailed information on beta thalassemia syndromes, genetics, clinical features, hematologic findings, bone marrow findings, laboratory tests, and complications/management of thalassemia major. It also briefly discusses
it include nursing management. kindly see this for your reference, your likes and comment will improve the things in future. its very helpful to the nursing students.
Thalassemia is a group of inherited blood disorders caused by reduced or absent globin chains. There are two main types - alpha and beta thalassemia. Alpha thalassemia results from reduced alpha globin production while beta thalassemia results from reduced beta globin production. Thalassemia is characterized by ineffective red blood cell production and increased red blood cell breakdown leading to anemia. Common complications include iron overload, bone and organ damage, and endocrine abnormalities. Treatment involves regular blood transfusions along with iron chelation therapy.
This document discusses polycythemia, which is an increase in red blood cells. It can be primary (polycythemia vera) or secondary to other causes like tissue hypoxia or abnormal erythropoietin production. Polycythemia vera is a clonal disorder associated with a JAK2 mutation and is typically managed through phlebotomy to reduce red blood cell mass and prevent complications like thrombosis. Symptoms can include splenomegaly, aquagenic pruritus, erythromelalgia, and hyperuricemia. Treatment may also include chemotherapy or splenectomy in severe cases.
case presentation on diagnosis of beta thalassemia majorDrShinyKajal
case history of 9 month old infant
Paediatric Clinical Approach to this case
examination
workup at blood centre
HPLC screening
laboratory findings
screening of father mother
prominent facial features
PBF and bone marrow findings
usg abdomen
xray skull
prbc transfusion therapy in thalassemia major
classification of thalassemia
national burden in india
pathogenesis- anemia skull bone iron overload
world thalassemia day
Thalassemia is a genetic blood disorder caused by an imbalance in the alpha and beta globin chains that make up hemoglobin. There are two main types - alpha thalassemia and beta thalassemia. Beta thalassemia major requires lifelong blood transfusions and iron chelation therapy to remove excess iron from the body, while beta thalassemia minor causes only mild anemia. Management of thalassemia major involves regular blood transfusions, monitoring of iron overload, and iron chelation therapy to remove excess iron and prevent organ damage. With proper treatment, patients can survive well into adulthood.
Current Component Therapy by Diane Eklund, MDbloodbankhawaii
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This document provides guidelines for blood transfusion in clinical practice. It discusses the principles of transfusion medicine including avoiding unnecessary transfusions and using alternatives when possible. It provides triggers for transfusing red blood cells, fresh frozen plasma, cryoprecipitate and platelets based on hemoglobin, coagulation factor and platelet count levels. It also gives specific guidelines for transfusing patients with sickle cell disease, thalassemia, neonates and in emergency situations. The risks of transfusion are weighed against the benefits of maintaining adequate oxygen-carrying capacity and hemostasis.
This document discusses various blood components used in transfusion therapy, including their properties, collection, storage, and clinical indications. It covers red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. Key points include how each component is prepared from whole blood, typical volumes and contents, storage guidelines, dosage recommendations, and common clinical scenarios where their use is appropriate or contraindicated.
The document summarizes key aspects of blood component therapy. It discusses how whole blood can be separated into components like red blood cells, platelets, and plasma through centrifugation or apheresis techniques. It provides indications and dosing guidelines for administering various blood components to treat conditions like anemia, bleeding disorders, and liver disease. It also outlines some hazards of blood transfusion like acute hemolytic reactions, bacterial contamination, and transfusion-related acute lung injury.
This document provides an overview of thalassemia, including its introduction, epidemiology, types, pathogenesis, clinical presentation, screening tests, treatment, monitoring of patients, and prevention. Some key points:
- Thalassemia refers to genetic disorders involving imbalanced production of alpha and beta globin chains in hemoglobin. The most common types are alpha and beta thalassemia.
- It is endemic in areas around the Mediterranean Sea, Middle East, tropical Africa, Indian subcontinent and Asia.
- Clinical presentations range from asymptomatic (thalassemia minor) to severe anemia requiring regular blood transfusions (thalassemia major).
- Treatment of thalassemia
Disorders of Blood can include conditions like anemia, thalassemia, hemophilia, and leukemia. Anemia is defined as a reduction in red blood cells or hemoglobin. It can be classified based on cell morphology (size) or etiology (cause). Common types include iron deficiency anemia and thalassemia. Thalassemia is an inherited disorder of hemoglobin synthesis causing anemia. Hemophilia is an inherited bleeding disorder caused by a deficiency in clotting factors, most commonly factor VIII or IX.
1. The document provides guidelines for the management of transfusion dependent thalassemia, including recommendations for who to transfuse, compatibility testing, target pre-transfusion and post-transfusion hemoglobin levels, use of vitamin C during chelation, cardiac and liver complications, indications for splenectomy, risks of infection, endocrine diseases, fertility and pregnancy considerations, and osteoporosis management.
2. Major topics covered include appropriate transfusion thresholds, testing to avoid alloimmunization, chelation therapy protocols, monitoring and treatment of iron overload complications in major organs, and preventing infections that are leading causes of death.
3. Guidelines aim to optimize transfusion regimens and chelation
Anemia is common in pregnancy due to increased iron and nutrient demands. This document defines anemia in pregnancy and classifies it as physiological or pathological. Iron deficiency anemia is the most common type due to high iron demands, inadequate intake, and diminished absorption. Signs include fatigue, palpitations, and pallor. Treatment involves oral iron supplementation, parenteral iron or blood transfusions, and ensuring adequate nutrient intake. Megaloblastic anemia from B12 or folate deficiency requires B12 injections or high dose oral folic acid. Nursing care focuses on managing fatigue, preventing infections, and promoting balanced nutrition and activity tolerance.
This document summarizes the current state of anemia treatment in chronic kidney disease (CKD) patients. It discusses the magnitude of the problem, clinical management including use of erythropoiesis-stimulating agents (ESAs), and future therapies. ESAs are currently the mainstay of treatment but have limitations like requiring high doses and increased risks at higher hemoglobin levels. Newer approaches being researched include stabilizing hypoxia-inducible factor to stimulate endogenous erythropoietin production, modulating the iron-regulating hormone hepcidin, and gene therapy to introduce the erythropoietin gene directly.
This document provides guidelines for perioperative care in elective colorectal surgery as part of an Enhanced Recovery After Surgery (ERAS) protocol. It makes recommendations for several preadmission items including preadmission counselling and education, preoperative optimization of medical conditions, prehabilitation, preoperative nutrition, management of anemia, and prevention of postoperative nausea and vomiting. The recommendations are based on reviews of the available evidence and are intended to reduce complications and facilitate early recovery after colorectal surgery.
This audit of over 9,000 medical transfusions found that:
1. 78% were given for anaemia, with 53% considered potentially avoidable.
2. The most common reasons for avoidable transfusions were reversible causes of anemia in 20% of cases and transfusing above pre-set hemoglobin triggers in 29% of cases.
3. Further review identified opportunities to reduce unnecessary transfusions through earlier anemia management, stricter adherence to transfusion guidelines, and individualized approaches for chronic anemia patients.
Blood transfusion involves receiving blood products intravenously from donors. The history of blood transfusion began in the 17th century with animal-human transfusions. Key developments included the discovery of blood groups in 1901 and identification of the Rhesus system in 1939. Indications for transfusion include acute blood loss, perioperative anemia, and symptomatic chronic anemia. Complications can include hemolytic reactions, febrile reactions, allergic reactions, infections, and transfusion-related lung injury. Proper blood typing and cross-matching is essential to prevent hemolytic transfusion reactions from incompatible blood groups.
This document provides guidelines for blood transfusion, including:
1. It discusses the selection and preparation of blood products such as whole blood, platelet concentrates, fresh frozen plasma, and packed red blood cells. Proper donor requirements, collection procedures, and storage conditions are outlined.
2. Indications, dosing, and expected responses to transfusions of various blood components are covered. Red blood cell and platelet transfusion thresholds and dosing are provided.
3. Safety procedures for blood typing, cross-matching, and transfusion monitoring are described. Special considerations for patients with conditions like autoimmune hemolytic anemia that could cause transfusion reactions are highlighted.
4. Two case illustrations demonstrate the
This document provides information about thalassemia and pregnancy. It defines thalassemia as a genetic blood disorder characterized by reduced or absent globin chain synthesis. It discusses the types and incidence of thalassemia worldwide and in India. It outlines the approach to diagnosis including various blood tests. It covers the management of thalassemia during pregnancy including preconception care, antenatal care, intrapartum care, postpartum care and complications. The goal is to prevent the birth of children with thalassemia major through genetic counseling and screening of potential parents.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
2. Epidemiology:
Worldwide, 15 million people have clinically
apparent thalassemia disorders. Reportedly,
there are about 240 million carriers of β-
thalassemia worldwide, and in India alone, the
number is approximately 30 million with a
mean prevalence of 3.3%(2,3). They are
encountered among all ethnic groups and in
almost every country around the world.
5. Types of Thalassemia
There are 2 main types of thalassemia:
Alpha thalassemia occurs when a gene or genes related to the alpha globin
protein are missing or changed (mutated).
Beta thalassemia occurs when similar gene defects affect production of the
beta globin protein.
There are many forms of thalassemia. Each type has many different subtypes.
Both alpha and beta thalassemia include the following 2 forms:
Beta-Thalassemia major
Thalassemia major characterized by growth retardation, pallor, jaundice, poor
musculature, hepatosplenomegaly, leg ulcers, skeletal changes resulting
from expansion of bone marrow.
Beta thalassemia intermediate
Present with intermediate severity of anemia and do not required blood
transfusion on regular basis.
Beta-Thalassemia minor
Characterized by mild anemia with elevated level of HbA2 or HbF
8. Clinical Appearance
• Severe anaemia, with an Hb level of 3-7g/dL.
• Massive hepatosplenomegaly.
• Severe growth retardation.
• Bony deformities
• In most patients with thalassemia traits, no unusual
signs or symptoms are encountered.
• Some patients, especially those with somewhat more
severe forms of the disease, manifest some pallor and
slight icteric discoloration of the sclerae with
Splenomegally, leading to slight enlargement of the
abdomen.
13. Diagnostive Procedure:
• Physical Examination- History taking and clinical assessment of symptoms
Blood tests may also be used to:
• Measure the amount of iron
• Evaluate hemoglobin level
• Perform DNA analysis to diagnose thalassemia or to determine if a person is
carrying mutated hemoglobin genes
• Radiology:
• X ray of skull and hand
• Prenatal testing
• Testing can be done before a baby is born to find out if he or she has
thalassemia and determine how severe it may be. Tests used to diagnose
thalassemia in fetuses include:
• Chorionic villus sampling. This test is usually done around the 11th week
of pregnancy and involves removing a tiny piece of the placenta for
evaluation.
• Amniocentesis. This test is usually done around the 16th week of
pregnancy and involves taking a sample of the fluid that surrounds the fetus.
14. Diagnostive Procedure:
Assisted reproductive technology
A form of assisted reproductive technology that
combines preimplantation genetic diagnosis with
in vitro fertilization may help parents who have
thalassemia or who are carriers of a defective
haemoglobin gene give birth to healthy babies.
The procedure involves retrieving mature eggs
and fertilizing them with sperm in a dish in a
laboratory. The embryos are tested for the
defective genes, and only those without genetic
defects are implanted into the uterus.
16. Curative
Management
• Rest
• Diet:
Patients/ children are encouraged to avoid high-iron and iron-supplemented
foods, and encouraged to drink tea with meals, which decreases iron
absorption.
Proteins that should be avoided or eliminated from the diet:
Liver
Pork
Beans
Beef
Peanut butter
tofu
Grains that should be avoided or eliminated from the diet:
Infant cereal
Cream of wheat
17. Fruits/Vegetables that should be avoided or eliminated from the diet:
• Prune juice
• Prunes
• Watermelon
• Spinach
• Leafy green vegetables
• Dates
• Raisins
• Broccoli
• Peas
18. Treatments for moderate to severe thalassemia
• Treatments for moderate to severe
thalassemia may include:
• Blood transfusions
• People with severe thalassemia require
medical treatment. A blood transfusion
regimen was the first measure effective in
prolonging life.
19. Outline for transfusion of Blood
• Goals of transfusion
• Basic requirements
– Blood products for transfusion
– Blood storage
– Donor selection and sample testing
– Compatibility testing
• Adverse reactions
– other adverse reactions
– Minimising infection and non-infection risks
– Future approaches to reducing infection risk
• Recommended transfusion regime
– Optimise
• Oxygen carriage
• Supression of IE
– Minimise - Iron loading
20. When to start transfusion
• Should be based on a definitive diagnosis of severe
thalassemia
• Diagnosis should take into account the molecular defect,
the severity of anaemia on repeated measurement
• The level of ineffective erythropoietin, and clinical criteria
such as failure to thrive or bone changes
• Regular transfusion therapy for severe thalassemia usually
occurs in the first two years of life
• Some patients with milder forms of thalassemia who only
need sporadic transfusions in the first two decades of life
may later need regular transfusions because of a falling
haemoglobin level or the development of serious
complications
21. Standard Transfusion Regimen for Thalassemia Major
Regular blood transfusions administered every 2-5 weeks
Maintain the pre-transfusion Hb > 9-10.5g/dl
• Rationale
– promotes normal growth
– allows normal physical activities
– adequately suppresses bone marrow activity in most patients
– minimises transfusional iron accumulation [Cazzola 1995,1997]
• Modifications
– A higher target 11-12 g/dl may be appropriate for patients with heart
disease or other medical conditions and for those patients who do not
achieve adequate suppression of bone marrow activity at the lower
haemoglobin level.
– Although shorter intervals between transfusions may reduce overall blood
requirements, the choice of interval must take into account other factors
such as the patient’s work or school schedule
22. Compatibility Testing
• Before embarking on transfusion therapy
– patients should have extended red cell antigen typing
– at least C, c, E, e.
• Blood selection
– transfused with ABO and Rh(D) compatible blood.
– Some clinicians recommend the use of blood that is also matched for at
least the C, E and antigens in order to avoid alloimmunisation against
these antigens.
– Some centres use even more extended antigen matching.
• Before each transfusion
– it is necessary to perform a full crossmatch and screen for new
antibodies
• If new antibodies appear, they must be identified so that blood missing the
corresponding antigen(s) can be used
• A complete record of
– antigen typing,
– red cell antibodies and transfusion reactions
– should be readily available if the patient is transfused at a different
centre.
• Transfusion of blood from first-degree relatives should be avoided because
of the risk of developing antibodies that might adversely affect the outcome
of a later bone marrow transplant
24. Minimising infection risk
Donor Selection & Product screening
• Blood should be obtained from carefully selected
healthy voluntary donors who have undergone
extensive questioning and laboratory screening for:
• Hepatitis B, hepatitis C, HIV, syphilis and other
infectious diseases.
• Specific strategies for donor selection and product
screening will be influenced by the prevalence of
infectious agents in the donor population.
25. Iron loading from transfusion
• 200mg iron in 1 blood unit (from 420ml of donor)
– 0.47mg iron/ml of whole blood
– 1.08mg iron/ml of ‘pure’ red cells
• In Thal Major (spelenctomised) if mean Hb 12g/dl
– 300mls blood/kg body wt per annum
– More if not splenectomised
= average 0.4 mg iron / kg body wt/ day from transfusion
– Add 1-4 mg/day from gut absorption
– In practice wide range 0.3 to 0.7 mg/kg/day
– 4 to 10 g of iron per year
26. Medications/ Chelation therapy:
Multiple blood transfusions can result in iron overload.
The iron overload related to thalassemia may be
treated by chelation therapy with the medications
deferoxamine, deferiprone, or deferasirox. These
treatments have resulted in improving life expectancy
in those with thalassemia major.
Indication:
• After 20-25 RBC transfusion over
• And specially when serum iron level is 1000 ng/dl.
• A liver iron concentration (LIC) of greater than 3 mg
iron/g dry weight as measured by liver biopsy or by
hepatic T2 on magnetic resonance imaging
27. Deferoxamine :is only effective via daily injections which makes its
long-term use more difficult.
Approximately 8 mg of iron is bound by 100 mg of deferoxamine. This
agent is excreted in bile and urine, resulting in red discoloration. It
readily chelates iron from ferritin and hemosiderin, but not from
transferrin.
Deferoxamine is most effective when it is administered as a continuous
infusion.
28. Doses :
Acute Iron Poisoning
• IM administration is indicated for all patients NOT in shock;
administer 1g IM initially and then 500mg Q4hr for 2 doses.
• Depending upon clinical response, subsequent doses of 500mg Q4-
12hr can be administered
• Maximum dose: 6g in 24 hours
• IV administration should be reserved for patients in a state of
cardiovascular collapse or shock; 1g slow IV infusion.
• Rate of infusion should not exceed 15mg/kg/hr for the first dose;
subsequent doses should not be infused at a faster rate than
125mg/hr
Chronic Iron Overload
• SC administration: 1-2g (20-40mg/kg/day) SC over 8-24 hours using
a small portable pump capable of providing continuous mini-
infusion; individualize infusion duration
• IV administration in patients with IV access: 40-50mg/kg/day over
8-12 hours for 5-7 days/ week (maximum of < 60mg/kg/day and an
IV infusion rate of <15mg/kg/hr)
• IM administration: 0.5-1g QD (maximum of 1g QD)
Adverse effects- are primary skin reactions around the injection site
and hearing loss
29. Deferasirox has the benefit of being an oral
medication. Deferasirox is available as a tablet for
oral suspension.
Doses :
• 20 mg/kg PO QDS; may increase by 5-10 mg
increments based on serum ferritin; if not
controlled on 30 mg/kg/day (ie, serum ferritin
persistently >2500 mcg/L), may increase up to 40
mg/kg QDS.
• Common side effects include: nausea, vomiting
and diarrhea.
30. Bone marrow transplant
• Bone marrow transplantation may offer the
possibility of a cure in young people who have an
HLA-matched donor. Success rates have been in the
80–90% range. Mortality from the procedure is about
3% .
• If the person does not have an HLA-matched
compatible donor, another method called bone
marrow transplantation (BMT) from haploidentical
mother to child (mismatched donor) may be used.
• mortality 7%.
31. Nursing Management:
Rest:
Diet:
• Physical Examination:
• On clinical assessment children will show gross clinical features
Subjective data:
• There should always inquire about the patient's ethnic background, family history
of hematologic disorders, and dietary history as this is a heterogenous group of
heritable disease.
• An affected child's parents or caregivers may report history of pallor, abdominal
distension of child, anorexia, activity intolerance.
Objective data:
• Assessment for following:
• Severe anemia, with an Hb level of 3-7g/dL., pallor, fatigue.
• Massive hepatosplenomegaly, distended abdomen.
• Severe growth retardation.
• Bony deformities
• Observation for sign of hemosidarosis.
32. Nursing Diagnosis:
• Ineffective tissue perfusion related to haemoglobin
abnormality.
• Activity intolarence related to anemia as evidence by
easy fatigability.
• Imbalance nutrition less than body requirement related
to inadequate intake of essential nutrient due to disease
process as evidence by growth failure.
• Disturb body image related to disease process as
evidence by abdominal pain.
• Anxiety related to repeated blood transfusion as
evidence by repeated questioning.