Toxoplasmosis symptoms and treatment

Posted by Muhammad ayaz Friday, March 1, 2013 5 comments




Toxoplasmosis

In this factsheet:
  • The Facts on Toxoplasmosis
  • Causes of Toxoplasmosis
  • Symptoms and Complications of Toxoplasmosis
  • Diagnosing Toxoplasmosis
  • Treating and Preventing Toxoplasmosis

The Facts on Toxoplasmosis

Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. This single-celled parasite is capable of living in a wide range of birds and mammals, but only produces eggs in the lining of the intestines of cats. In humans it usually causes no symptoms. On average, 20% to 40% of the population in North America is infected - the infection rate is even higher in other parts of the world.
Toxoplasmosis usually lies dormant, but occasionally it reactivates to cause disease. Usually this happens when some other disease weakens the immune system. Toxoplasmosis is considered an opportunistic infection, one that shouldn't harm healthy people but can be very serious if your immune defenses are down (e.g., people with AIDS or cancer, or who are taking medications that suppress the immune system). It also threatens the fetus if an expectant mother is infected during pregnancy.

Causes of Toxoplasmosis

The most common way people get toxoplasmosis is by ingesting toxoplasma eggs (oocysts).
 Cats are the primary source of these eggs. While Toxoplasma gondii can reproduce asexually in a variety of animals, only in the intestines of cats does it undergo sexual reproduction to generate eggs, which are then passed out in the cat's feces. The eggs that are passed by the cat can remain viable in moist soil for 18 months or longer. This means it is possible to ingest these eggs by directly contacting the cat or its litter box or by ingesting food (vegetables) from contaminated soil.

Another way in which people get toxoplasmosis is by eating undercooked meat.
 Animals such as cows, pigs, and sheep may ingest soil contaminated with the eggs shed by the cats. In these animals the eggs hatch, and the Toxoplasma penetrate through the intestines and form tiny cysts within their tissues. If we eat meat from these animals that is not thoroughly cooked, the cysts break apart in our stomach and the Toxoplasma inside the cysts are then released to invade our tissues. Pork and lamb are much more likely than beef to contain these cysts.
Only rarely can toxoplasmosis be transmitted by a blood transfusion. Toxoplasmosis is not spread from human to human.
Toxoplasmosis is everywhere, and many of us are infected without knowing it.
The good news is that most infections occur without causing any symptoms and eventually the parasites lie dormant in their cyst form in humans, just as they do in cows and sheep. They do not usually cause harm unless the immune system is not functioning properly.

Symptoms and Complications of Toxoplasmosis

For most of us, the immune system never reaches a state where toxoplasmosis can get enough of a foothold to cause symptoms. However, a few healthy people suffer mild symptoms from toxoplasmosis infection.
About 80% to 90% of people show no symptoms when infected with toxoplasmosis. About 10% to 20% of people will develop swollen glands and some of these people will develop symptoms that are similar to the flu or infectious mononucleosis (e.g., low-grade fever, muscle aches, sore throat, an enlarged spleen and liver, and sometimes mild diarrhea). There may also be a mild anemia. These symptoms can last for weeks or longer, but will go away without treatment.
Of people with AIDS, about 30% to 40% develop disease from toxoplasmosis, usually because of the reactivation of an old infection. Most of these infections involve the central nervous system. Symptoms can include:
  • coma
  • loss of vision or other senses
  • partial paralysis
  • weakness
  • tremors
  • headache
  • confusion
  • difficulty speaking
  • seizures
  • fever
For the majority of people with AIDS who have toxoplasmosis, the onset of symptoms is quite slow and subtle. There may be changes in emotions, behaviour, or cleanliness. Later, there may be numbness or weakness in the arm or leg.
Rarely, areas outside the central nervous system are affected and can lead to inflammation of the brain (encephalitis), its lining (meningitis), the heart (myocarditis), the lungs (pneumonitis), and various other organs. Other symptoms such as high fever, chills, sweating, and rash can occur with these infections.
Women who already have toxoplasmosis infection and become pregnant have little to worry about. But if a woman becomes infected while pregnant, there's a risk the fetus will be infected. The risk is about 15% in the first trimester. Fetuses infected at this stage often miscarry. The risk of infection of the fetus rises to 30% if infection occurs in the second trimester and rises up to 60% if infection occurs in the third trimester.
Babies infected late in pregnancy rarely miscarry but instead have symptoms such as:
  • seizures
  • brain damage
  • enlarged spleen and liver
  • inflammation of the eye
  • jaundice (yellowing of the skin and whites of eyes)
  • poor motor coordination
  • unusually small head
  • rash
  • easy bruising
Less severe infections may not be obvious at birth but can show up months or years later. The baby often grows up into a healthy young adult. But around age 20 or 30, the eyesight starts to degenerate as toxoplasma attacks the retina, the light-sensitive membrane at the back of the eye. Ocular toxoplasmosis can cause pain, blurred vision, and permanent damage, including blindness, and can occasionally occur in adults

Diagnosing Toxoplasmosis

Normally, Toxoplasma infection is easily detected by looking for antibodies to the parasite in a blood sample. The only exception to this rule is people with AIDS who have severe disease, and whose immune systems are too weak to produce detectable antibodies. Usually the disease is in the brain, and the doctor will use a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan to locate small round lesions that are highly suggestive of toxoplasmosis. To diagnose toxoplasmosis during pregnancy, a sample of amniotic fluid may be used to detect the parasite.

Treating and Preventing Toxoplasmosis

People with healthy immune systems usually do not need treatment for toxoplasmosis. For people with symptoms, the treatment most frequently used is a combination of pyrimethamine* and sulfadiazine or clindamycin. There are a few minor variations, but treatment is basically similar for babies, healthy adults, and people with AIDS. People taking pyrimethamine are usually also prescribed leucovorin (also called folinic acid) to prevent toxic effects on the bone marrow.
People with ocular toxoplasmosis are also prescribed a corticosteroid (e.g., prednisone). Even then, eye problems are likely to recur, and it takes constant vigilance to catch new flare-ups early and prevent slow deterioration of eyesight.
Pregnant women who become infected are usually treated with spiramycin as long as the fetus is not infected. If the fetus is infected and the pregnancy is beyond the first trimester (i.e., after the first 3 months), then pyrimethamine and sulfadiazine are used. Pregnant women should avoid cats if possible. If you have a cat and you are pregnant, it is recommended that you not handle cat feces (i.e., change the litter box) for the duration of your pregnancy.

To prevent getting infected with toxoplasmosis:
  • Wear gloves while working in the garden, especially if you're handling soil, and wash your hands well with soap and warm water after touching soil.
  • Cook meat thoroughly, to at least 74°C to 77°C (164°F to 170°F), and wash hands well after touching raw meat.
  • Wash or peel fruits and vegetables.
  • Wash all kitchen tools and utensils and hands thoroughly with hot, soapy water after contact with raw meat, seafood, or unwashed fruits or vegetables.
  • Cover sandboxes to reduce the chance of cat feces getting in the sand.
  • Avoid unpasteurized milk and milk products.
  • Keep cats indoors.


H.Pylori | Helicobacter Pylori and Gastritis

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This unusual name identifies a specific bacteria that can cause infection of the stomach. This infection can contribute to the development of diseases, such as dyspepsia (heartburn, bloating and nausea), gastritis (inflammation of the stomach), and ulcers in the stomach and duodenum. It will be useful to know some things about the upper digestive tract to understand how and where Helicobacter pylori infection can occur.
When food is swallowed it passes through the esophagus (the tube that connects the throat to the stomach) It then enters the larger upper part of the stomach. A strong acid that helps to break down the food is secreted in the stomach. The narrower, lower part of the stomach is called the antrum. The antrum contracts frequently and vigorously, grinding up the food and squirting it into the small intestine. The duodenum is the first part of the small intestine, just beyond the stomach. The stomach, including the antrum, is covered by a layer of mucous that protects it from the strong stomach acid.
It is known that alcohol, aspirin, and arthritis drugs such as ibuprofen, can disrupt the protective mucous layer. This allows the strong stomach acid to injure underlying stomach cells. In some people, corticosteroids, smoking, and stress appear to contribute in some way. Until the mid 1980s, it was felt that one or more of these factors working together led to the development of gastritis and ulcers. Since that time, evidence has been mounting that Helicobacter pylori (H. pylori) has a major role in causing these diseases.

The Infection
H. pylori is a fragile bacteria that has found an ideal home in the protective mucous layer of the stomach. These bacteria have long threads protruding from them that attach to the underlying stomach cells. The mucous layer that protects the stomach cells from acid also protects H. pylori. These bacteria do not actually invade the stomach cells as certain other bacteria can. The infection, however, is very real and it does cause the body to react. Infection-fighting white blood cells move into the area, and the body develops H. pylori antibodies in the blood.
H. pylori infection probably occurs when an individual swallows the bacteria in food, fluid, or perhaps from contaminated utensils. The infection is likely one of the most common worldwide. The rate of infection increases with age, so it occurs more often in older people. It also occurs frequently in young people in the developing countries of the world, since the infection tends to be common where sanitation is poor or living quarters are cramped. In many cases it does not produce symptoms. In other words, the infection can occur without the person knowing it. The infection remains localized to the gastric area, and probably persists unless specific treatment is given.

How is H. pylori Infection Diagnosed?
There are currently four ways to diagnose H. pylori infection. During endoscopy (a visual exam of the stomach through a thin, lighted, flexible tube), the physician can remove small bits of tissue through the tube. The tissue is then tested for the bacteria. A breath test is also available. In this test a substance called urea is given by mouth. A strong enzyme in the bacteria breaks down the urea into carbon dioxide, which is then exhaled and can be measured.  There is a blood test that measures the protein antibodies against these bacteria that are present in the blood. The blood is generally not useful in detecting acute disease and mostly represents a past exposure to the bug.  This antibody can mean the infection is present, or that it was present in the past.  Finally, there is fecal antigen test that is very accurate and inexpensive.

Gastritis and Dyspepsia
The symptoms are discomfort, bloating, nausea and perhaps vomiting. The person may also have symptoms that suggest ulcers - burning or pain in the upper abdomen, usually occurring about an hour or so after meals or even during the night. The symptoms are often relieved temporarily by antacids, milk, or medications that reduce stomach acidity. Yet, the physician does not find an ulcer when the patient is tested by x-ray or endoscopy. When H. pylori is found in the stomach, it is tempting to believe that it is the cause of the symptoms, although this connection is not yet clear cut. The physician will usually prescribe antibiotic therapy to see if clearing the infection relieves symptoms.

Ulcers
Stomach Ulcers: With stomach ulcers, H. pylori infection is found in 60 to 80 percent of the cases. Again, it is still uncertain how the infection acts to cause the ulcer. It probably weakens the protective mucous layer of the stomach. This allows acid to seep in and injure the underlying stomach cells. However, there is still a great deal of research to be done to unravel this relationship.
Duodenal Ulcers: In times past, physicians were taught "no acid, no ulcer." The medical profession felt the single most important factor causing duodenal ulcers to form was strong stomach acid. Research has now shown that over 90% of all patients who develop duodenal ulcers have H. pylori infection in the stomach as well. Medical studies are under way to determine the relationship between the two and how an infection in the stomach can be related to a duodenal ulcer. Acid is still important; patients without acid in the stomach never get duodenal ulcers. However, physicians now accept the fact that the infection is directly related to the development of duodenal ulcers. It is now rather easy to clear duodenal ulcers with the strong acid-reducing medicines available. But, the ulcers will usually recur unless the H. pylori infection is also cleared from the stomach.

Stomach Cancer and Lymphoma
These two types of cancer are now known to be related to H. pylori bacteria. This does not mean that all people with H. pylori infection will develop cancer; in fact, very few do. However, it is likely that if the infection is present for a long time, perhaps from childhood, these cancers may then develop. This is another reason why it is important to treat H. pylori infection.

When is Treatment Necessary?
Since the infection is so common, it is sometimes recommended that no treatment be given when there are no symptoms. However, these recommendations may change as more research develops. Increasingly, physicians are treating the acute ulcer with acid-reducing medicines and treating the infection with antibiotics. Interestingly, one of these antibiotics is a bismuth compound that is available over-the-counter as Pepto-Bismol. It is also available as a generic drug called bismuth subsalicylate. The bismuth part of the medicine actually kills the bacteria. However, do not go to the drugstore and purchase a bottle of Pepto-Bismol, expecting this alone to cure the infection. H. pylori is buried deep in the stomach mucous, so it is difficult to get rid of this infection. Several antibiotic drugs are always used together to prevent the bacteria from developing resistance to any one of them. Current medical studies are being done to develop earlier treatment programs for this difficult infection.

Summary...
H. pylori is a very common infection of the stomach. It may be the most common infection in the world. It is now clear that the infection is directly related to the development of stomach and duodenal ulcers, and it is likely that it may be related to cancers involving the stomach. There are several diagnostic tests available, and effective treatment can prevent the recurrence of ulcers and, perhaps, the development of cancer.

Iron deficiency anemia in pregnancy

Posted by Muhammad ayaz 4 comments









Why does pregnancy make me more likely to become anemic?

Your iron requirements go up significantly when you're pregnant. Iron is essential for making hemoglobin, the protein in red blood cells that carries oxygen to other cells. During pregnancy, the amount of blood in your body increases until you have almost 50 percent more than usual. And you need more iron to make more hemoglobin for all that additional blood. You also need extra iron for your growing baby and placenta.
Unfortunately, most women start pregnancy without sufficient stores of iron to meet their body's increased demands, particularly in the second and third trimesters. If you get to the point where you no longer have enough iron to make the hemoglobin you need, you become anemic.

Your risk is even higher if you have morning sickness severe enough to cause frequent vomiting, if you've had two or more pregnancies close together, if you're pregnant with more than one baby, if you have an iron-poor diet, or if your pre-pregnancy menstrual flow was heavy.

This is why the amount of iron you need shoots up during pregnancy from 18 to 27 milligrams (mg) per day. Because it's hard to get enough iron through diet alone, the Centers for Disease Control and Prevention recommend that pregnant women take a daily supplement of 30 mg of elemental iron as a preventive dose. Many prenatal supplements contain that amount.

Iron deficiency is by far the most common cause of anemia in pregnancy, but it's not the only cause. You could also develop anemia from not getting enough folic acid or vitamin B12, by losing a lot of blood, or from certain diseases or inherited blood disorders such as sickle cell disease.
The treatment for anemia depends on the cause. Iron supplements are not always the answer.

How will I know if I'm anemic?

Your practitioner tests your blood for anemia at your first prenatal appointment. One of these tests (hematocrit) measures the percentage of red blood cells in your plasma. The other (hemoglobin) measures the number of grams of hemoglobin in your blood.
Even if you're not anemic at the beginning of pregnancy, it's not uncommon to develop anemia as your pregnancy progresses, so you'll have another blood test in your late second trimester or early third trimester. It's normal for your hemoglobin and hematocrit levels to go down somewhat in the second half of pregnancy, when the amount of blood in your body is expanding dramatically and the amount of plasma (the fluid component of blood) increases faster than the number and size of red blood cells – but you don't want them to dip too low.

If you do become anemic, you might not have any symptoms at all, especially if your condition is mild. Or you might feel tired, weak, and dizzy. (Of course, these are symptoms that many women experience during pregnancy, anemic or not.) You might also notice that you're paler (especially in your fingernails, the underside of your eyelids, and your lips). Other symptoms include a rapid heartbeat, heart palpitations, shortness of breath, headache, dizziness, irritability, and trouble concentrating.
Finally, some studies have found a link between severe iron-deficiency anemia and cravings for non-food substances such as ice, paper, or clay (a condition known as pica). If you do have these cravings, don't give in to them, and be sure to tell your healthcare provider.

How is iron-deficiency anemia treated?

If your test indicates that you have iron-deficiency anemia, your practitioner will prescribe an iron supplement. The dose will depend on the severity of your anemia, but it's likely to be 60 to 120 mg or more of elemental iron daily, in addition to the iron in your prenatal supplement. Follow your practitioner's instructions – never take more iron than prescribed.
Note that these doses refer to the amount of elemental iron, or pure iron, in a supplement. Some labels list the amount of ferrous sulfate (a kind of iron salt) instead of or in addition to the amount of elemental iron. A supplement that contains 325 mg of ferrous sulfate, the most commonly used iron supplement, will give you about 60 mg of elemental iron. Others use ferrous gluconate, 300 mg of which yields about 34 mg of elemental iron, or ferrous fumarate, which contains about 106 mg of elemental iron in a 325 mg tablet.
In order to absorb as much of the iron as possible, it's best to take your iron pills on an empty stomach. Wash them down with water or orange juice (the vitamin C helps with absorption), but not with milk (calcium interferes with absorption). Coffee and tea also hinder absorption.
Within a week or so after starting treatment, you should be producing a lot of new red blood cells and your hemoglobin level will begin to rise. It usually takes just a couple of months for the anemia to resolve, but your caregiver will likely advise you to continue taking iron supplements for several more months so you can replenish your iron stores.
One more important thing to note: Be vigilant about keeping any pills containing iron in childproof containers and away from children. More kids die from iron overdose each year than from any other kind of accidental drug poisoning. In fact, a single adult dose can poison a small child.

Are there any side effects from taking iron supplements?

High levels of iron from supplements can upset your gastrointestinal tract. Most often it leads to constipation, which is already a problem for many pregnant women. If you suffer from constipation, try drinking prune juice. It can help you stay regular ­­– and it's a good source of iron, as well. Taking a stool softener may be helpful, too.
You may also have heartburn, abdominal discomfort, nausea, vomiting, or, less commonly, diarrhea. Try taking your iron at different times of day to see what works best for you. For example, if the iron irritates your stomach or you suffer from heartburn, you'll want to avoid taking it at bedtime because lying down afterward may increase your discomfort. On the other hand, if your only complaint is that the iron makes you a bit queasy right after you take it, try downing it near bedtime – perhaps you can sleep through the nausea.
If side effects continue to plague you, talk to your practitioner. You may be able to lessen stomach problems by cutting back and taking less iron, and then gradually building up to the dose you need. Or you may find that taking the iron in divided doses throughout the day helps minimize your discomfort. If these tactics don't help, you may end up needing to take some or all of your iron with food or trying a time-released formula, which is not ideal in terms of absorption but may be a necessary compromise.

By the way, don't worry if your stools look darker when you start taking iron. That's a normal and harmless side effect. Contact your healthcare provider right away if you notice blood in your stool, though.

How does iron-deficiency anemia affect my baby's health and mine?

Your baby does a good job taking care of his iron needs – he'll get his share before you do. Still, maternal anemia can affect a baby's iron stores at birth, increasing his risk for anemia later in infancy.
Iron-deficiency anemia during pregnancy is linked to an increased risk of preterm delivery and low birth weight. It's also associated with a higher risk of stillbirth or newborn death, so it's something to take seriously.
Iron-deficiency anemia affects your health as well. It can sap your energy and make it harder for your body to fight infection. And if you're anemic later in pregnancy, you're more likely to have problems if you lose a lot of blood when you give birth. You may feel dizzy, have a rapid heart rate, or have other symptoms that require you to stay in the hospital an extra day or two. You're also more likely to need a blood transfusion. And there's research suggesting that anemia may even raise your risk of postpartum depression.

What can I do to prevent iron deficiency?

Take your prenatal vitamin and eat a healthy diet that includes plenty of iron-rich foods. Red meat is your best bet, although poultry (dark meat), other meats, and shellfish are good sources, too. Non-animal iron-rich foods include beans, lentils, tofu, raisins, dates, prunes, figs, apricots, potatoes (leave the skin on), broccoli, beets, leafy green vegetables, whole grain breads, nuts and seeds, blackstrap molasses, oatmeal, and iron-fortified cereals. Keep in mind that your body absorbs the iron from animal sources (heme iron) much more readily than the iron from non-animal sources (non-heme iron).
One note of caution: Don't turn to liver for your iron needs. Liver is best avoided during pregnancy because it contains unsafe amounts of vitamin A, which can cause birth defects.
Nutrients that interfere with your body's ability to absorb iron
If you're taking calcium supplements or an antacid that contains calcium, don't take either one while you're eating iron-rich foods or at the same time as your iron supplement. Calcium hinders your body's ability to absorb iron. For that reason, don't take your supplement with milk. Drink milk between meals, instead.
The same goes for tea and coffee, which contain polyphenols that interfere with the absorption of iron from supplements and plant sources.
Nutrients that help your body absorb iron
Eating or drinking something rich in vitamin C when you take your iron supplement or eat iron-rich plant foods can help your body absorb significantly more non-heme iron. Good vitamin C choices include a glass of orange or tomato juice, a handful of strawberries, sliced bell peppers, or half a grapefruit.
Eating meat and fish (sources of heme iron, which your body absorbs easily) can also improve your absorption of the iron in non-meat foods. For example, a bit of beef in a pot of vegetable chili can help you absorb iron from the vegetables.

It will take some work on your part to correct iron-deficiency anemia, but take heart – Mother Nature will give you a hand. If you're deficient in iron, you'll actually absorb more iron from your food than someone with adequate stores.


Hepatitis c Virus

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Hepatitis C

Hepatitis C is a viral disease that leads to swelling (inflammation) of the liver.

Causes, incidence, and risk factors

Hepatitis C infection is caused by the hepatitis C virus (HCV). People who may be at risk for hepatitis C are those who:
  • Have been on long-term kidney dialysis
  • Have regular contact with blood at work (for instance, as a health care worker)
  • Have unprotected sexual contact with a person who has hepatitis C (this risk is much less common than hepatitis B, but the risk is higher for those who have many sex partners, already have a sexually transmitted disease, or are infected with HIV)
  • Inject street drugs or share a needle with someone who has hepatitis C
  • Received a blood transfusion before July 1992
  • Received a tattoo or acupuncture with contaminated instruments (the risk is very low with licensed, commercial tattoo facilities)
  • Received blood, blood products, or solid organs from a donor who has hepatitis C
  • Share personal items such as toothbrushes and razors with someone who has hepatitis C (less common)
  • Were born to a hepatitis C-infected mother (this occurs in about 1 out of 20 babies born to mothers with HCV, which is much less common than with hepatitis B)

Symptoms

Most people who were recently infected with hepatitis C do not have symptoms. About 1 in 10 have yellowing of the skin (jaundice) that gets better.
Of people who get infected with hepatitis C, most develop a long-term (chronic) infection. Usually there are no symptoms. If the infection has been present for many years, the liver may be permanently scarred. This is called cirrhosis. In many cases, there may be no symptoms of the disease until cirrhosis has developed.
The following symptoms could occur with hepatitis C infection:
  • Abdominal pain (right upper abdomen)
  • Abdominal swelling (due to fluid called ascites)
  • Clay-colored or pale stools
  • Dark urine
  • Fatigue
  • Fever
  • Itching
  • Jaundice
  • Loss of appetite
  • Nausea
  • Vomiting

Signs and tests

Blood tests are done to check for hepatitis C:
  • MIA assay to detect hepatitis C antibody
  • Hepatitis C RNA assays to measure virus levels (viral load)
Genetic testing is done to check for the hepatitis C genotype. Six genotypes exist. Test results can help your doctor better choose your treatment.
  • Most Americans have genotype 1 infection, which is the hardest to treat.
  • Genotypes 2 and 3 are also common, and respond better to treatment.
The following tests are done to identify and monitor liver damage from hepatitis C:
  • Albumin level
  • Liver function tests
  • Prothrombin time
Liver biopsy can show how much damage has been done to the liver.

Treatment

The goals of HCV treatment are to remove the virus from the blood and reduce the risk of cirrhosis and liver cancer that can result from long-term HCV infection.
Many patients with hepatitis C benefit from treatment with medications. The most common medications are a combination of pegylated interferon alfa and riboflavin, an antiviral medication.
  • Most patients receive weekly injections of pegylated interferon alfa.
  • Ribavirin is a capsule taken twice daily. Ribavirin can cause birth defects. Women should avoid getting pregnant during, and for 6 months after treatment.
  • Treatment is given for 24 - 48 weeks.
  • Telaprevir and boceprevir are newer drugs which may be used for patients with genotype 1.
These medications have a number of side effects, and patients must be watched closely. See: Cirrhosis for information about treating more severe liver damage caused by hepatitis C.
Patients who develop cirrhosis or liver cancer may be candidates for a liver transplant.
People with hepatitis C should also:
  • Be careful not to take vitamins, nutritional supplements, or new over-the-counter medications without first discussing it with their health care provider.
  • Avoid any substances that are toxic to the liver, including alcohol. Even moderate amounts of alcohol speed up the progression of hepatitis C, and alcohol reduces the effectiveness of treatment.
  • Get vaccinated against hepatitis A and B.

Support Groups

You can often ease the stress of illness by joining a support group of people who share common experiences and problems. See liver disease - resources.

Expectations (prognosis)

Most people with hepatitis C infection have the chronic form.
Patients with genotypes 2 or 3 are more likely to respond to treatment than patients with genotype 1. Newer drugs may improve the response of those with genotype 1.
Many doctors use the term "sustained virologic response" rather than "cure" when the virus is removed from the blood, because it is not known whether this will last a person's entire life. Even if treatment does not remove the virus, it can reduce the chance of severe liver disease.
Hepatitis C is one of the most common causes of chronic liver disease in the United States today. People with this condition may have:
  • Cirrhosis of the liver
  • Liver cancer (also called hepatocellular cancer) -- may develop in a small number of people with liver cirrhosis
Hepatitis C usually comes back after a liver transplant, which can lead to cirrhosis of the new liver.

Calling your health care provider

Call your health care provider if:
  • You develop symptoms of hepatitis
  • You believe you have been exposed to the hepatitis C virus

Prevention

Avoid contact with blood or blood products whenever possible. Health care workers should follow precautions when handling blood and bodily fluids.
Do not inject illicit drugs, and especially do not share needles with anyone. Be careful when getting tattoos and body piercings.
Sexual transmission is very low among stable, monogamous couples. A partner should be screened for hepatitis C. If the partner is negative, the current recommendations are to make no changes in sexual practices.
People who have sex outside of a monogamous relationship should practice safer sex behaviors to avoid hepatitis C as well as sexually transmitted diseases, including HIV and hepatitis B.
Currently there is no vaccine for hepatitis C.

Hepatitis A

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Hepatitis A

Hepatitis A is inflammation (irritation and swelling) of the liver from the hepatitis A virus.
See also:
  • Hepatitis
  • Hepatitis A vaccine
  • Hepatitis B
  • Hepatitis C

Causes, incidence, and risk factors

The hepatitis A virus is found mostly in the stools and blood of an infected person about 15 - 45 days before symptoms occur and during the first week of illness.
You can catch hepatitis A if:
  • You eat or drink food or water that has been contaminated by stools (feces) containing the hepatitis A virus (fruits, vegetables, shellfish, ice, and water are common sources of the hepatitis A virus)
  • You come in contact with the stool or blood of a person who currently has the disease
  • A person with hepatitis A does not wash his or her hands properly after going to the bathroom and touches other objects or food
  • You participate in sexual practices that involve oral-anal contact
About 3,600 cases of hepatitis A are reported each year. Because not everyone has symptoms with hepatitis A infection, many more people are infected than are diagnosed or reported.
Risk factors include:
  • International travel, especially to Asia or South or Central America
  • IV drug use
  • Living in a nursing home or rehabilitation center
  • Working in a health care, food, or sewage industry
Other common hepatitis virus infections include hepatitis B and hepatitis C. Hepatitis A is the least serious and mildest of these diseases. The other hepatitis infections may become chronic illnesses, but hepatitis A does not become chronic.

Symptoms

Symptoms will usually show up 2 - 6 weeks after being exposed to the hepatitis A virus. They are usually mild, but may last for up to several months, especially in adults.
Symptoms include:
  • Dark urine
  • Fatigue
  • Itching
  • Loss of appetite
  • Low-grade fever
  • Nausea and vomiting
  • Pale or clay-colored stools
  • Yellow skin (jaundice)

Signs and tests

The doctor will perform a physical examination and may discover that you have an enlarged and tender liver.
Blood tests may show:
  • Raised IgM and IgG antibodies to hepatitis A (IgM is usually positive before IgG)
  • Elevated liver enzymes (liver function tests), especially transaminase enzyme levels

Treatment

There is no specific treatment for hepatitis A. Rest is recommended when the symptoms are most severe. People with acute hepatitis should avoid alcohol and any substances that are toxic to the liver, including acetaminophen (Tylenol).
Fatty foods may cause vomiting, because substances from the liver are needed to digest fats. Fatty foods are best avoided during the acute phase.

Expectations (prognosis)

The virus does not remain in the body after the infection has gone away.
Over 85% of people with hepatitis A recover within 3 months. Nearly all patients get better within 6 months.
There is a low risk of death, usually among the elderly and persons with chronic liver disease.

Complications

There are usually no complications. One in a thousand cases becomes fulminant hepatitis, which can be life threatening.

Calling your health care provider

Call for an appointment with your health care provider if you have symptoms of hepatitis.

Prevention

The following tips can help reduce your risk of spreading or catching the virus:
  • Always wash your hands thoroughly after using the restroom and when you come in contact with an infected person's blood, stools, or other bodily fluid.
  • Avoid unclean food and water.
The virus may spread more rapidly through day care centers and other places where people are in close contact. Thorough hand washing before and after each diaper change, before serving food, and after using the restroom may help prevent such outbreaks.
If you have recently been exposed to hepatitis A and have not had hepatitis A before or have not received the hepatitis A vaccine series, ask your doctor or nurse about receiving either immune globulin or the hepatitis A vaccine. Common reasons why you may need to receive one or both of these include:
  • You live with someone who has hepatitis A
  • You recently had sexual contact with someone who has hepatitis A
  • You recently shared illegal drugs, either injected or noninjected, with someone who has hepatitis A
  • You have had close personal contact over a period of time with someone who has hepatitis A
  • You have eaten in a restaurant where food or food handlers were found to be infected or contaminated with hepatitis A
Vaccines that protect against hepatitis A infection are available. The vaccine begins to protect 4 weeks after receiving the first dose. The 6- to 12-month booster is required for long-term protection. See: Hepatitis A vaccine
Travelers should take the following precautions:
  • Avoid dairy products.
  • Avoid raw or undercooked meat and fish.
  • Beware of sliced fruit that may have been washed in contaminated water. Travelers should peel all fresh fruits and vegetables themselves.
  • Do not buy food from street vendors.
  • Get vaccinated against hepatitis A (and possibly hepatitis B) if traveling to countries where outbreaks of the disease occur.
  • Use only carbonated bottled water for brushing teeth and drinking. (Remember that ice cubes can carry infection.)
  • If no water is available, boiling water is the best method for eliminating hepatitis A. Bringing the water to a full boil for at least 1 minute generally makes it safe to drink.
  • Heated food should be hot to the touch and eaten right away.

Hepatitis B

Posted by Muhammad ayaz 15 comments









Hepatitis B

Hepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV).
Other types of viral hepatitis include:
  • Hepatitis A
  • Hepatitis C
  • Hepatitis D
See also:
  • Autoimmune hepatitis
  • Chronic persistent hepatitis
  • Drug-induced hepatitis

Causes, incidence, and risk factors

Hepatitis B infection can be spread through having contact with the blood, semen, vaginal fluids, and other body fluids of someone who already has a hepatitis B infection.
Infection can be spread through:
  • Blood transfusions (not common in the United States)
  • Direct contact with blood in health care settings
  • Sexual contact with an infected person
  • Tattoo or acupuncture with unclean needles or instruments
  • Shared needles during drug use
  • Shared personal items (such as toothbrushes, razors, and nail clippers) with an infected person
The hepatitis B virus can be passed to an infant during childbirth if the mother is infected.
Risk factors for hepatitis B infection include:
  • Being born, or having parents who were born in regions with high infection rates (including Asia, Africa, and the Caribbean)
  • Being infected with HIV
  • Being on hemodialysis
  • Having multiple sex partners
  • Men having sex with men
Most of the damage from the hepatitis B virus occurs because of the way the body responds to the infection. When the body's immune system detects the infection, it sends out special cells to fight it off. However, these disease-fighting cells can lead to liver inflammation.

Symptoms

After you first become infected with the hepatitis B virus:
  • You may have no symptoms
  • You may feel sick for a period of days or weeks
  • You may become very ill (called fulminant hepatitis)
If your body is able to fight off the hepatitis B infection, any symptoms that you had should go away over a period of weeks to months.
Some people's bodies are not able to completely get rid of the hepatitis B infection. This is called chronic hepatitis B.
Many people who have chronic hepatitis B have few or no symptoms. They may not even look sick. As a result, they may not know they are infected. However, they can still spread the virus to other people.
Symptoms may not appear for up to 6 months after the time of infection. Early symptoms may include:
  • Appetite loss
  • Fatigue
  • Fever, low-grade
  • Muscle and joint aches
  • Nausea and vomiting
  • Yellow skin and dark urine due to jaundice
People with chronic hepatitis may have no symptoms, even though gradual liver damage may be occurring. Over time, some people may develop symptoms of chronic liver damage and cirrhosis of the liver.

Signs and tests

The following tests are done to identify and monitor liver damage from hepatitis B:
  • Albumin level
  • Liver function tests
  • Prothrombin time
The following tests are done to help diagnose and monitor people with hepatitis B:
  • Antibody to HBsAg (Anti-HBs) -- a positive result means you have either had hepatitis B in the past, or have received a hepatitis B vaccine
  • Antibody to hepatitis B core antigen (Anti-HBc) -- a positive result means you had a recent infection or an infection in the past
  • Hepatitis B surface antigen (HBsAg) -- a positive result means you have an active infection
  • Hepatitis E surface antigen (HBeAg) -- a positive result means you have a hepatitis B infection and are more likely to spread the infection to others through sexual contact or sharing needles
Patients with chronic hepatitis will need ongoing blood tests to monitor their status.

Treatment

Acute hepatitis needs no treatment other than careful monitoring of liver and other body functions with blood tests. You should get plenty of bed rest, drink plenty of fluids, and eat healthy foods.
In the rare case that you develop liver failure, you may need a liver transplant. A liver transplant is the only cure in some cases of liver failure.
Some patients with chronic hepatitis may be treated with antiviral medications or a medication called peginterferon. These medications can decrease or remove hepatitis B from the blood and reduce the risk of cirrhosis and liver cancer.
Liver transplantation is used to treat severe, chronic hepatitis B liver disease.
Patients with chronic hepatitis should avoid alcohol and should always check with their doctor or nurse before taking any over-the-counter medications or herbal supplements. This even includes medications such as acetaminophen, aspirin, or ibuprofen.
See: Cirrhosis for information about treating more severe liver damage caused by hepatitis B.

Support Groups

See: Liver disease support group

Expectations (prognosis)

The acute illness usually goes away after 2 - 3 weeks. The liver usually returns to normal within 4 - 6 months in almost all patients who are infected.
Some people develop chronic hepatitis.
  • Almost all newborns and about 50% of children who become infected with hepatitis B develop chronic hepatitis. Less than 5% of adults who are infected with the hepatitis B virus develop the chronic condition.
  • Chronic hepatitis B infection increases the risk for liver damage, including cirrhosis and liver cancer.
  • People who have chronic hepatitis B can transmit the infection. They are considered carriers of the disease, even if they do not have any symptoms.
Hepatitis B is fatal in about 1% of cases.

Complications

There is a much higher rate of hepatocellular carcinoma in people who have chronic hepatitis B than in the general population.
Other complications may include:
  • Chronic persistent hepatitis
  • Cirrhosis
  • Fulminant hepatitis, which can lead to liver failure and possibly death

Calling your health care provider

Call your health care provider if:
  • You develop symptoms of hepatitis B
  • Hepatitis B symptoms do not go away in 2 or 3 weeks, or new symptoms develop
  • You belong to a high-risk group for hepatitis B and have not yet received the HBV vaccine.

Prevention

All children should receive their first dose of the hepatitis B vaccine at birth, and complete the series of three shots by age 6 months. Children younger than age 19 who have not been vaccinated should receive "catch-up" doses.
People who are at high risk, including health care workers and those who live with someone who has hepatitis B should get the hepatitis B vaccine.
Infants born to mothers who either currently have acute hepatitis B, or who have had the infection should receive a special vaccination that includes hepatitis B immune globulin and a hepatitis B immunization within 12 hours of birth.
Screening of all donated blood has reduced the chance of getting hepatitis B from a blood transfusion. Mandatory reporting of the disease allows state health care workers to track people who have been exposed to the virus. The vaccine is given to those who have not yet developed the disease.
The hepatitis B vaccine or a hepatitis B immune globulin (HBIG) shot may help prevent hepatitis B infection if it is given within 24 hours of exposure.
Lifestyle measures for preventing transmission of hepatitis B:
  • Avoid sexual contact with a person who has acute or chronic hepatitis B.
  • Use a condom and practice safe sex.
  • Avoid sharing personal items, such as razors or toothbrushes.
  • Do not share drug needles or other drug equipment (such as straws for snorting drugs).
  • Clean blood spills with a solution containing 1 part household bleach to 10 parts water.
Hepatitis B (and hepatitis C) viruses cannot be spread by casual contact, such as holding hands, sharing eating utensils or drinking glasses, breast-feeding, kissing, hugging, coughing, or sneezing.

What is Hepatitis ?

Posted by Muhammad ayaz 3 comments








Hepatitis

Hepatitis is swelling and inflammation of the liver. The term is often used to refer to a viral infection of the liver.

Causes, incidence, and risk factors

Hepatitis can be caused by:
  • Immune cells in the body attacking the liver and causing autoimmune hepatitis
  • Infections from viruses (such as hepatitis A, hepatitis B, or hepatitis C), bacteria, or parasites
  • Liver damage from alcohol, poisonous mushrooms, or other poisons
  • Medications, such as an overdose of acetaminophen, which can be deadly
Liver disease can also be caused by inherited disorders such as cystic fibrosis or hemochromatosis, a condition that involves having too much iron in your body (the excess iron deposits in the liver).
Other causes include Wilson's disease (excess copper deposits in the body).

Symptoms

Hepatitis may start and get better quickly (acute hepatitis), or cause long-term disease (chronic hepatitis). In some instances, it may lead to liver damage, liver failure, or even liver cancer.
How severe hepatitis is depends on many factors, including the cause of the liver damage and any illnesses you have. Hepatitis A, for example, is usually short-term and does not lead to chronic liver problems.
The symptoms of hepatitis include:
  • Abdominal pain or distention
  • Breast development in males
  • Dark urine and pale or clay-colored stools
  • Fatigue
  • Fever, usually low-grade
  • General itching
  • Jaundice (yellowing of the skin or eyes)
  • Loss of appetite
  • Nausea and vomiting
  • Weight loss
You may not have symptoms when first infected with hepatitis B or C. You can still develop liver failure later. If you have any risk factors for either type of hepatitis, you should be tested regularly.

Signs and tests

You will have a physical exam to look for:
  • Enlarged and tender liver
  • Fluid in the abdomen (ascites)
  • Yellowing of the skin
Your doctor may order laboratory tests to diagnose and monitor the hepatitis, including:
  • Abdominal ultrasound
  • Autoimmune blood markers
  • Hepatitis virus serologies
  • Liver function tests
  • Liver biopsy to check for liver damage
  • Paracentesis if fluid is in your abdomen

Treatment

Your doctor will talk to you about treatment options. Treatments will vary depending on the cause of your liver disease. Your doctor may recommend a high-calorie diet if you are losing weight.

Support Groups

There are support groups for people with all types of hepatitis. These groups can help you learn about the latest treatments and how to cope with having the disease.

Expectations (prognosis)

The outlook for hepatitis will depend on what is causing the liver damage. 

Complications

  • Liver cancer
  • Liver failure
  • Permanent liver damage, called cirrhosis
Other complications include:
  • Esophageal varices that can bleed
  • Spontaneous bacterial peritonitis (fluid in the abdomen that becomes infected)

Calling your health care provider

Seek care immediately if you:
  • Have symptoms from too much acetaminophen or other medicines -- you may need to have your stomach pumped
  • Vomit blood
  • Have bloody or tarry stools
  • Are confused or delirious
Call your doctor if:
  • You have any symptoms of hepatitis or believe that you have been exposed to hepatitis A, B, or C.
  • You cannot keep food down due to excessive vomiting. You may need to receive nutrition through a vein (intravenously).
  • You feel sick and have travelled to Asia, Africa, South America, or Central America.

Prevention

Talk to your doctor about vaccination for hepatitis A and hepatitis B.
Lifestyle measures for preventing spread of hepatitis B and C from one person to another include:
 •Avoid sharing personal items, such as razors or toothbrushes.
•Do not share drug needles or other drug equipment (such as straws for snorting drugs).
 •Clean blood spills with a solution containing 1 part household bleach to 9 parts water. 
 •Be careful when getting tattoos and body piercings.
To reduce your risk of spreading or catching hepatitis A:
 •Always wash your hands thoroughly after using the restroom and when you come in contact with aninfected person's blood, stools, or other bodily fluid.
 •Avoid unclean food and water.

Anemia | Samptom | treatment

Posted by Muhammad ayaz 3 comments



Anemia

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues.
Other types of anemia include:
  • Anemia due to B12 deficiency
  • Anemia due to folate deficiency
  • Anemia due to iron deficiency
  • Anemia of chronic disease
  • Hemolytic anemia
  • Idiopathic aplastic anemia
  • Megaloblastic anemia
  • Pernicious anemia  
  • Sickle cell anemia
  • Thalassemia

Causes, incidence, and risk factors

Although many parts of the body help make red blood cells, most of the work is done in the bone marrow. Bone marrow is the soft tissue in the center of bones that helps form blood cells.
Healthy red blood cells last between 90 and 120 days. Parts of your body then remove old blood cells. A hormone called erythropoietin made in your kidneys signals your bone marrow to make more red blood cells.
Hemoglobin is the oxygen-carrying protein inside red blood cells. It gives red blood cells their red color. People with anemia do not have enough hemoglobin.
The body needs certain vitamins, minerals, and nutrients to make enough red blood cells. Iron, vitamin B12, and folic acid are three of the most important ones. The body may not have enough of these nutrients because:
  • Changes in the lining of the stomach or intestines affect how well nutrients are absorbed (for example, celiac disease)
  • Poor diet
  • Slow blood loss (for example, from heavy menstrual periods or stomach ulcers)
  • Surgery that removes part of the stomach or intestines
Possible causes of anemia include:
  • Certain medications
  • Destruction of red blood cells earlier than normal (which may be caused by immune system problems)
  • Long-term (chronic) diseases such as chronic kidney disease, cancer, ulcerative colitis, or rheumatoid arthritis
  • Some forms of anemia, such as thalassemia or sickle cell anemia, which can be inherited
  • Pregnancy
  • Problems with bone marrow such as lymphoma, leukemia, multiple myeloma, or aplastic anemia

Symptoms

You may have no symptoms if the anemia is mild. If the problem develops slowly, symptoms that may occur first include:
  • Feeling grumpy
  • Feeling weak or tired more often than usual, or with exercise
  • Headaches
  • Problems concentrating or thinking
If the anemia gets worse, symptoms may include:
  • Blue color to the whites of the eyes
  • Brittle nails
  • Light-headedness when you stand up
  • Pale skin color
  • Shortness of breath
  • Sore tongue
Some types of anemia may have other symptoms.

Signs and tests

The doctor will perform a physical examination, and may find:
  • Heart murmur
  • Low blood pressure, especially when you stand up
  • Pale skin
  • Rapid heart rate
Some types of anemia may cause other findings on a physical exam.
Blood tests used to diagnose some common types of anemia may include:
  • Blood levels of iron, vitamin B12, folic acid, and other vitamins and minerals
  • Red blood count and hemoglobin level
  • Reticulocyte count
Other tests may be done to find medical problems that can cause anemia.

Treatment

Treatment should be directed at the cause of the anemia, and may include:
  • Blood transfusions
  • Corticosteroids or other medicines that suppress the immune system
  • Erythropoietin, a medicine that helps your bone marrow make more blood cells
  • Supplements of iron, vitamin B12, folic acid, or other vitamins and minerals

Complications

Severe anemia can cause low oxygen levels in vital organs such as the heart, and can lead to a heart attack.

Lipid Blood Tests | Lipid Profile Tests

Posted by Muhammad ayaz 1 comment









Objective qualities:

75-169 mg/dL for those age 20 and more youthful

100-199 mg/dL for those over age 21

Arrangement:

This test may be measured whenever of the day without fasting. Be that as it may, if the test is drawn as a feature of an aggregate lipid profile, it needs a 12-hour quick (no sustenance or drink, excluding water). For the most correct comes about, hold up no less than two months after a heart strike, surgery, contamination, damage or pregnancy to check cholesterol levels.

Cholesterol is a sort of oversized, recognized in your blood. It is processed by your form and moreover originates from the sustenances you consume (creature items). Cholesterol is required by your figure to uphold the strength of your cells. A lot of cholesterol expedites coronary course sickness. Your blood cholesterol level is identified with the nourishments you consume or to hereditary conditions (passed down from different eras of relatives).

Heightened Density Lipoprotein (HDL) “Good cholesterol”

Abnormal amounts interfaced to a decreased danger of heart and vein infection. The higher your HDL level, the better.

Objective quality:

More terrific than 40 mg/dL

Planning:

This test may be measured at whatever time of the day without fasting. Nonetheless, if the test is drawn as a feature of an aggregate lipid profile, it needs a 12-hour speedy (no sustenance or drink, with the exception of water). For the most correct comes about, hold up no less than two months after a heart ambush, surgery, contamination, harm or pregnancy to check HDL levels.

HDL is a lipoprotein (a synthesis of large and protein) recognized in the blood. It is called "exceptional" cholesterol for the reason that it uproots overabundance cholesterol from the blood and takes it to the liver. A heightened HDL level is identified with easier danger of heart and vein ailment.

Level Density Lipoprotein (LDL) “Bad cholesterol”

Elevated amounts are joined to an expanded danger of heart and vein malady, inlcuding coronary conduit illness, heart assault and expiration. Lessening LDL levels is a major medication focus for cholesterol-bringing down solutions.

Objective qualities:

Less than 70 mg/dL for the previously mentioned with heart or vein malady and for different patients at extremely towering danger of coronary illness (those with metabolic syndrome)

Less than 100 mg/dL for towering danger patients (e.g., certain patients who have numerous coronary illness hazard components)

Less than 130 mg/dL for people who are at flat chance for coronary conduit infection

Readiness:

Blood ought to be gathered after a 12-hour quick (no nourishment or drink, excluding water). For the most exact comes about, hold up no less than 2 months after a heart strike, surgery, tainting, harm or pregnancy to check LDL levels.

LDL is a lipoprotein (a combo of hefty and protein) discovered in the blood. It is called "terrible" cholesterol for the reason that it grabs cholesterol from the blood and takes it to the phones. An elevated LDL level is identified with a higher danger of heart and vein infection.

Triglycerides (TG)

Raised in fat or diabetic patients. Level expands from consuming basic sugars or drinking booze. Connected with heart and vein illness.

Objective quality:

Less than 150 mg/dl

Planning:

Blood ought to be gathered after a 12-hour snappy (no nourishment or drink, aside from water). For the most exact comes about, hold up no less than 2 months after a heart ambush, surgery, tainting, damage or pregnancy to check triglyceride levels.

Triglycerides are a sort of oversized discovered in the blood. The blood level of this sort of hefty is by and large influenced by the nourishments you consume (for example sugar, hefty or booze) however can likewise be towering because of being overweight, having thyroid or liver sickness and hereditary conditions. Large amounts of triglycerides are identified with a higher danger of heart and vein malady.

Blood Groups, Blood Typing and Blood Transfusions

Posted by Muhammad ayaz Thursday, February 28, 2013 4 comments










The discovery of blood groups





Experiments with blood transfusions, the transfer of blood or blood components into a person's blood stream, have been carried out for hundreds of years. Many patients have died and it was not until 1901, when the Austrian Karl Landsteiner discovered human blood groups, that blood transfusions became safer.
Mixing blood from two individuals can lead to blood clumping or agglutination. The clumped red cells can crack and cause toxic reactions. This can have fatal consequences. Karl Landsteiner discovered that blood clumping was an immunological reaction which occurs when the receiver of a blood transfusion has antibodies against the donor blood cells.

Karl Landsteiner's work made it possible to determine blood groups and thus paved the way for blood transfusions to be carried out safely. For this discovery he was awarded the Nobel Prize in Physiology or Medicine in 1930.

What is blood made up of?

An adult human has about 4–6 liters of blood circulating in the body. Among other things, blood transports oxygen to various parts of the body.
Blood consists of several types of cells floating around in a fluid called plasma.

The red blood cells contain hemoglobin, a protein that binds oxygen. Red blood cells transport oxygen to, and remove carbon dioxide from, the body tissues.

The white blood cells fight infection.

The platelets help the blood to clot, if you get a wound for example.

The plasma contains salts and various kinds of proteins.


 

What are the different blood groups?

The differences in human blood are due to the presence or absence of certain protein molecules called antigens and antibodies. The antigens are located on the surface of the red blood cells and the antibodies are in the blood plasma. Individuals have different types and combinations of these molecules. The blood group you belong to depends on what you have inherited from your parents.
There are more than 20 genetically determined blood group systems known today, but the AB0 and Rh systems are the most important ones used for blood transfusions. Not all blood groups are compatible with each other. Mixing incompatible blood groups leads to blood clumping or agglutination, which is dangerous for individuals.
Nobel Laureate Karl Landsteiner was involved in the discovery of both the AB0 blood group (in 1901) and Rh blood group (in 1937).

AB0 blood grouping system

According to the AB0 blood group system there are four different kinds of blood groups: A, B, AB or 0 (null).
Blood group A
If you belong to the blood group A, you have A antigens on the surface of your red blood cells and B antibodies in your blood plasma.
Blood group B
If you belong to the blood group B, you have B antigens on the surface of your red blood cells and A antibodies in your blood plasma.
Blood group AB
If you belong to the blood group AB, you have both A and B antigens on the surface of your red blood cells and no A or B antibodies at all in your blood plasma.
Blood group 0
If you belong to the blood group 0 (null), you have neither A or B antigens on the surface of your red blood cells but you have both A and B antibodies in your blood plasma.

Rh factor blood grouping system



Many people also have a so called Rh factor on the red blood cell's surface. This is also an antigen and those who have it are called Rh+. Those who haven't are called Rh-. A person with Rh- blood does not have Rh antibodies naturally in the blood plasma (as one can have A or B antibodies, for instance). But a person with Rh- blood can develop Rh antibodies in the blood plasma if he or she receives blood from a person with Rh+ blood, whose Rh antigens can trigger the production of Rh antibodies. A person with Rh+ blood can receive blood from a person with Rh- blood without any problems.


Blood group notation

According to above blood grouping systems, you can belong to either of following 8 blood groups:
A Rh+ B Rh+ AB Rh+ 0 Rh+
A Rh- B Rh- AB Rh- 0 Rh-
Do you know which blood group you belong to?

Blood typing – how do you find out to which blood group someone belongs?


1.
You mix the blood with three different reagents including either of the three different antibodies, A, B or Rh antibodies.
2.
Then you take a look at what has happened. In which mixtures has agglutination occurred? The agglutination indicates that the blood has reacted with a certain antibody and therefore is not compatible with blood containing that kind of antibody. If the blood does not agglutinate, it indicates that the blood does not have the antigens binding the special antibody in the reagent.

3.
If you know which antigens are in the person's blood, it's easy to figure out which blood group he or she belongs to!
A person with A+ blood receives B+ blood. The B antibodies (yellow) in the A+ blood attack the foreign red blood cells by binding to them. The B antibodies in the A+ blood bind the antigens in the B+ blood and agglutination occurs. This is dangerous because the agglutinated red blood cells break after a while and their contents leak out and become toxic.

What happens when blood clumps or agglutinates?

For a blood transfusion to be successful, AB0 and Rh blood groups must be compatible between the donor blood and the patient blood. If they are not, the red blood cells from the donated blood will clump or agglutinate. The agglutinated red cells can clog blood vessels and stop the circulation of the blood to various parts of the body. The agglutinated red blood cells also crack and its contents leak out in the body. The red blood cells contain hemoglobin which becomes toxic when outside the cell. This can have fatal consequences for the patient.

The A antigen and the A antibodies can bind to each other in the same way that the B antigens can bind to the B antibodies. This is what would happen if, for instance, a B blood person receives blood from an A blood person. The red blood cells will be linked together, like bunches of grapes, by the antibodies. As mentioned earlier, this clumping could lead to death.

Blood transfusions – who can receive blood from whom?

Of course you can always give A blood to persons with blood group A, B blood to a person with blood group B and so on. But in some cases you can receive blood with another type of blood group, or donate blood to a person with another kind of blood group.

The transfusion will work if a person who is going to receive blood has a blood group that doesn't have any antibodies against the donor blood's antigens. But if a person who is going to receive blood has antibodies matching the donor blood's antigens, the red blood cells in the donated blood will clump.
People with blood group 0 Rh - are called "universal donors" and people with blood group AB Rh+ are called "universal receivers."
Rh+ blood can never be given to someone with Rh - blood, but the other way around works. For example, 0 Rh+ blood can not be given to someone with the blood type AB Rh -.

Blood Group
Antigens
Antibodies
Can give blood to
Can receive blood from
AB Rh+ A, B and Rh None AB Rh+ AB Rh+
AB Rh -
A Rh+
A Rh -
B Rh+
B Rh -
0 Rh+
0 Rh -
AB Rh - A and B None
(Can develop Rh antibodies)		 AB Rh -
AB Rh+		 AB Rh -
A Rh -
B Rh -
0 Rh -
A Rh+ A and Rh B A Rh+
AB Rh+
 A Rh+
A Rh -
0 Rh+
0 Rh -
A Rh - A B
(Can develop Rh antibodies)		 A Rh -
A Rh+
AB Rh -
AB Rh+		 A Rh -
0 Rh -
B Rh+ B and Rh A B Rh+
AB Rh+		 B Rh+
B Rh -
0 Rh+
0 Rh-
B Rh - B A
(Can develop Rh antibodies)		 B Rh-
B Rh+
AB Rh-
AB Rh+		 B Rh -
0 Rh -
0 Rh+ Rh A and B 0 Rh+
A Rh+
B Rh+
AB Rh+






 0 Rh+
0 Rh -
0 Rh - None A and B (Can develop Rh antibodies) AB Rh+
AB Rh -
A Rh+
A Rh -
B Rh+
B Rh -
0 Rh+
0 Rh - 		0 Rh -

 

 

 








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