PERNICOUS ANAEMIA- TYPE OF MEGALOBLASTIC ANAEMIA

                                            PERNICIOUS ANAEMIA


Pernicious anaemia is a type of megaloblastic anaemia due inablity to secrete intrinsic factor that helps in absorption of vitamin B12.

                                                        PERNICIOUS ANAEMIA 
                                                        BLOOD PICTURE


      a.) WHAT CAUSES PERNICIOUS ANAEMIA ?
      ans:->Pernicious anaemia occurs as a complication of rheumatoid gastritis.

                                                    GROSS: RHEUMATOID GASTRITIS

Rheumatoid gastritis leads to damage of parietal  cell of fundic mucousa which is responsible for     secretion of intrinsic factor. Therefore depletion of parietal cells leads to lack of intrinsic factor.           Intrinsic factor is responsible for absorption of vitamin B12 . So lack of intrinsic factor leads to             anaemia.
   
     

  b.) WHAT DOES THE WORD PERNICIOUS MEAN ? 
      ans:-> The word 'PERNICIOUS' means 'DESTRUCTIVE'. In medical term it is used to denote               diseaseof severe charracter and usually fatal without appropriate treatment.  

since there is no treatment or cure for pernicious anaemia after it's clinical signs are seen and
since it is a very severe type of megaloblastic anaemia the term pernicious is appropriate.



  c.) CAN ALL CASES OF VITAMIN B12 DEFICIENCY BE                              CALLED PERNICIOUS ANAEMIA ? 
    ans:-> NO. 
Only the vitamin B12 deficiency due to deficieny of intrinsic factor can be called as pernicious anaemia.


  d.) WHY DOES VITAMIN B12 DEFICIENCY LEAD TO                                  ANAEMIA ?
     ans:-> Vitamin B12 is important factor for DNA synthesis during erythropoesis. Deficiency of vitamin B12 leads to impairment of DNA synthesis that leads to distinctive morphologicchanges and abnormally large erythroid precursors and red cells which are inappropriate for normal RBC function and there fore leads to anaemia.
The large erythroid precusrsors are called megaloblasts and therefore the anaemia is called           megaloblastic anaemia. 

                                    MEGALOBLASTS SURROUNDED BY GAINT BANDS
      
     


       e.) ARE ALL MEGALOBLASTIC ANAEMIA CAUSED                                  ONLY DUE TO FOLATE DEFICIENCY ?    
         ans:-> NO. Megaloblastic naaemia can be either due to folate deficiency or vitamin B12                          deficiency.

 PERNICIOUS ANAEMIA IS DUE TO FOLATE DEFICIENCY.          


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PAST AND FUTURE OF MEDICINE

MEDS TMIELINE

1500 BC         HERE TAKE THIS HERB
1000 BC         THAT HERB IS HEATHEN, DRINK THIS POTION
100   AD         THAT POTION IS SMOKE OIL, SAY THIS PRAYER
2000 AD         PRAYER DON'T WORK,TAKE THIS PILL
2015 AD         PILLS DON'T WORK, EAT THIS HERB
2050 AD         ANTIBIOTICS HAVE SIDE EFFECTS, TAKE THIS HERB

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STROKE - A MEDICAL EMERGENCY

Stroke,previously known as cardiovascular accident, is the rapidly developing loss of brain function due to disturbance in blood supply in the brain. This can be due to ischemia caused by blockage hemorrage.
It is a medical emergency  and can lead to permanent neurological damage, complication and lead to death.

Two types of stroke
1.)Ischemic stroke
-80% cases
-due to cerebral infracts
2.)Hemorragic stroke
-due to rupture of artery within brain(intra cerebral hemorrage)
-due to rupture of an aneurysm(eg. subarachnoid hemorrage)

KNOWING STROKES

-first cause of asquired disablity worldwide.
-second cause of death worldwide.


Risk factors
High BP, overweight, high cholesterole, diabetes, lack of exercise

CONSEQUENCES
Brain cell die resulting in damage or loss of neurons.
Physical disablites such as partial loss of movement , hemiplegia, sensory loss, language disorders, visual disorders and even memory loss.

SIGNS AND SYMPTOMS

 

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TASTE THE MEDICINAL VALUES OF GINGER

Traditionally ginger is used to relive cold and stomach pain .
It is rich in inflamation fighting compound such as gingerols,which some experts belive  may hold some promise in fighting some cancer and reducing arthritis pain.
  
People who took ginger capsule daily for 11 days reported 25% less muscle pain when they perform exercises designed to stress muscle(compared to a similiar group of placebo capsules)(recent studies)

Another studies  found that helped to relive pain in the knee.

Acts as stomach soother.

Ginger extracts can help reduce nausea caused by morning sickness or following surgery or chemotherapy.
 But it is less effective for morning sickness.

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KUPFFER CELLS

                                           MICROSCOPIC SLIDE SHOWING KUPFFER CELLS



1.) WHERE ARE KUPFFER CELLS FOUND?
ANS:- THESE CELLS ARE FOUND IN LVER SPLEEN AND BONE MARROW.


2.) WHAT ARE KUPFFER CELLS?
ANS:- KUPFFER CELLS ARE SPECIALIZED MACROPHAGES LOCATED IN LIVER LINNING WALL OF SINUSOIDS THAT FORM PART OF RETICULO ENDOTHILIAL SYSTEM.

3.) WHAT IS THE FUNCION OF KUPFFER CELLS?
ANS:-

1.) AFTER RUPTURE OF OLD RBC IN SPLEEN KUPFFER CELLS PHAGOCYTOZES THE HEMO GLOBIN.

2.)KUPFFER CELL ACTIVATION IS RESPOSIBLE FOR ALCOHOL INDUCED LIVER DISEASE IN CHRONIC ALCOHOLICS.



HISTORY:
The cells were first observed by Karl Wilhelm von Kupffer in 1876. The scientist called them "sternzellen" (star cells or stellate cells) but thought, falsely, that they were an integral part of the endothelium of the liver blood vessels and that they originated from it. In 1898, after several years of research, Tadeusz Browicz, a Polish scientist, identified them, correctly, as macrophages. 

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