Hemophilia Essay Research Paper 1 common app essay help Nursing assignment help

Hemophilia Essay, Research Paper

( 1 )

In the human organic structure, each cell contains 23 braces of chromosomes,

one of each brace inherited through the egg from the female parent, and the

other inherited through the sperm of the male parent. Of these

chromosomes, those that determine sex are X and Y. Females have XX

and males have XY. In add-on to the information on sex, & # 8216 ; the Ten

chromosomes carry determiners for a figure of other characteristics of

the organic structure including the degrees of factor VIII and factor IX. & # 8217 ; 1 If

the familial information finding the factor VIII and IX degree is

faulty, haemophilia consequences. When this happens, the protein

factors needed for normal blood curdling are effected. In males,

the individual X chromosome that is effected can non counterbalance for the

deficiency, and therefore will demo the defect. In females, nevertheless, merely one

of the two chromosomes will be unnatural. ( unless she is luckless

plenty to inherit hemophilia from both sides of the household, which

is rare. ) 2 The other chromosome is likely to be normal and she can

hence compensate for this defect.

There are two types of hemophilia, haemophilia A and B.

Haemophilia A is a familial upset in which hemorrhage is due to

lack of the curdling factor VIII ( VIII: C ) 3. In most of the

instances, this coagulant protein is reduced but in a rare sum of

instances, this protein is present by immunochemical assay but defective.4

Haemophilia A is the most common terrible shed blooding upset and

about 1 in 10,000 males is effected. The most common types

of shed blooding are into the articulations and musculuss. Haemophilia is terrible

if the factor VIII: Degree centigrade degrees are less that 1 % , they are moderate if

the degrees are 1-5 % and they are mild if they degrees become 5+ % .5

( 2 )

Those with mild hemophilias bleed merely in response to major injury

or surgery. As for the patients with terrible hemophilias, they can

bleed in response to comparatively mild injury and will shed blood

spontaneously.

In hemophiliac, the degrees of the factor VIII: Degree centigrade are reduced.

If the plasma from a haemophiliac individual mixes with that of a

normal individual, the Partial thrombokinase clip ( PTT ) should go

normal. Failure of the PTT to go normal is automatically

diagnostic of the presence of a factor VIII inhibitor. The criterion

intervention of the hemophiliac is chiefly the extract of factor

VIII dressed ores, now heat-treated to cut down the opportunities of

transmittal of AIDS.6 In the instance of minor hemorrhage, the factor

Eight: C degrees should merely be raised to 25 % with one extract. For

moderate hemorrhage, & # 8216 ; it is equal to raise the degree ab initio to

50 % and maintain the degree at greater that 25 % with repeated

extract for 2-3 yearss. When major surgery is to be performed, one

raises the factor VIII: C degree to 100 % and so maintains the

factor degree at greater than 50 % continuously for 10-14 days. & # 8217 ; 7

Haemophilia B, the other type of hemophilia, is a consequence of

the lack of the curdling factor IX & # 8211 ; besides known as

Christmas disease. This sex-linked disease is caused by the decreased

sum of the factor IX. Unlike haemophilia A, the per centum of

it & # 8217 ; s occupance due to an abnormally functioning molecule is larger.

The factor IX lack is 1/7 every bit common as factor VIII lack

and it is managed with factor VIII concentrates. Unlike factor VIII

dressed ores which have a half life of 12 hours, the half life of

factor IX concentrates is 18 hours. In add-on, factor IX

P >

( 3 )

dressed ores contain a figure of other proteins, including

activated cloting factors that contribute to a hazard of

thrombosis. Therefore, more attention is needed in hemophilia B to

make up one’s mind on how much concentration should be used.

The forecast of the hemophiliac patients has been

transformed by the handiness of factor VIII and factor IX

replacing. The confining factors that consequence include disablement

from perennial articulation hemorrhage and viral infections such as

hepatitis B from recurrent transfusion.8

Since most hemophiliacs are male and merely their female parent can

base on balls to them the deficient cistron, a really of import issue for the

households of hemophiliac now is placing which females are

bearers. One manner to find this is to gauge the sum of

factor VIII and IX nowadays in the adult female. However, while a low degree

confirms the bearer position, a normal degree does non except it. In

add-on, the factor VIII and IX blood degrees are known to

fluctuate in people and will increase with emphasis and gestation. As

a consequence, merely a anticipation of the bearer position can be given with

this method.

Another method to find the bearer position in a adult female is

to look straight at the Deoxyribonucleic acid from a little blood sample of several

members of the household including the hemophiliac. In Canada,

modern operations include Chorionic Villous Sampling ( CVS ) and it

helps analyse the Deoxyribonucleic acid for markers of hemophilia at 9-11 hebdomads of

gestation. ( Fig. 1 ) 9 A little investigation is inserted through the cervix of

the female parent uterus or through the venters under local anesthetics. A

bantam sample from the placenta is removed and sent for Deoxyribonucleic acid analysis.

( 4 )

Since this procedure can be done at 9-11 hebdomads after gestation, the

gestation is in it & # 8217 ; s comparatively early phases and a determination by the

female parent ( and father ) to end the gestation will non be as

physically or emotionally demanding on the female parent than if she had

it performed in the late phases of the gestation.

Traveling back to the hemophiliac, many have become seropositive

for HIV infections transmitted through factor VIII and IX

dressed ores and many have developed AIDS. In Canada, the two drugs

presently undergoing clinical proving for intervention of HIV disease

are AZT and DDI. For the usage of AZT, the major complication is

suppression of normal bone marrow activity. This consequences in low ruddy

and white blood cell counts.The former can take to terrible weariness

and the latter to susceptibleness to infections.10 DDI is provided

as a pulverization, which must be reconstructed with H2O instantly

prior to utilize. The most common inauspicious consequence so far is the failing

in the custodies and legs. However, it appears that DDI is free of the

bone marrow.11 AZT and DDI both represent the first coevals of

anti-retroviral drug and it is the hope of many people that they

will be followed by less toxic and more effectual drugs.

As it can be seen, haemophilia is one of those sex-linked

diseases that must affect the heritage of both recessionary and

deficient chromosomes. It is largely found in males and since every

male has a Y chromosome, it is a general regulation that the male will

non go through it to his male progenies. Haemophiliacs can hold either

inherited the disease or they could hold had a mutant. In either

instance, these people must seek to populate a normal life and must avoid

any activities that can ensue in injury.

& # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ; & # 8212 ;