Mosquitoes and Malaria

The bites of the common British species of mosquito (Culex pipiens) cause little more than irritation and swelling. In many tropical countries, the Middle East and Southern Asia, species of mosquito in the genus Anopheles transmit the disease malaria. It is estimated that about 280 million people suffer from malaria and over 2 million or more die each year.

The disease is caused by a single-celled parasite (Plasmodium spp.) which enters the blood stream as a result of a 'bite' from an infected mosquito. The parasites enter the red blood cells and reproduce there, feeding on the cytoplasm of the cell. The red cells eventually burst open and release the parasites into the blood stream, where they go on to infect other red cells. When hundreds of red cells burst simultaneously, they cause the patient to suffer from fever. The regular phases of reproduction and release produce regular bouts of fever.

If a mosquito sucks blood from an infected person, the parasites break out of the red cells and enter the mosquito's gut wall where they continue to reproduce. From here they migrate to the salivary glands. The next person to be bitten will receive saliva containing the parasite and will probably develop malaria. The parasites first enter the cells of the liver and reproduce there. When they break out, they go on to invade the red blood cells.

There are three lines of defence against the disease; destroying the malarial parasite in the blood, destroying the mosquitoes which transmit the disease and preventing people from being bitten.

There are drugs such as Chloroquine which destroy the parasites in the blood but not in the liver. The malarial parasite has, in many cases, developed resistance to these drugs and new drugs are constantly being sought.

Insecticides can be used to kill mosquitoes in dwellings but, here again, the mosquitoes have developed resistance to insecticides such as DDT. Other ways of reducing the mosquito population involve draining the swamps when they breed, increasing the flow of sluggish streams to carry away the eggs and larvae, spraying oil and insecticide to kill the larvae in the water, covering all stores of water and preventing water from accumulating in discarded tins, tyres etc.

To avoid being bitten by mosquitoes, screens can be placed over windows and doors and, since most bites occur at night, people can sleep under a tent of fine netting to keep mosquitoes out.

An intensive search for a vaccine has not been successful so far.

More information, and illustrations to accompany this article, can be found on biology-resources.com

D G Mackean is the author of GCSE Biology, IGCSE Biology, and many other Biology text books. He has a site of Biology Teaching Resources at http://www.biology-resources.com which includes a bank of experiments for teachers, sample PowerPoint presentations, and many biological drawings

Healthy Diets For You

Most people these days are desperate to lose weight no matter what the cost, even disregarding sometimes nutritious and healthy diets in the process. It is essential for them to reduce a few inches in their waistline even at the expense of employing supplements with very minimal scientific backing. What's important is they effectively shed a few pounds, which is good for them and they are happy about it. However, although the results can look promising, the underlying potential danger is often set aside, as the body suffers eventually.

To properly lose weight, healthy diets are essentially important, as well as vital natural supplements such as vitamins, minerals, and proteins. You can easily lose weight with some alternative method, but the necessary important elements that keeps the body from functioning well are reduce dramatically leaving the body weak and undernourished. Even though a lot of experts believed that salt, sugar, calories, and fats are the ingredients that make your body gain weight, it is undeniable that the body needs these (in moderation) to keep it functioning well. Excessive intake or consumption of these substances is always unhealthy for your body, but taken in moderation or occasionally, they can be a part of healthy diets.

Having nutritious and healthy diets does not necessarily means total avoidance with unhealthy fat, sugar, cholesterol, and any other things or foods that are considered unhealthy. They only become unhealthy and dangerous to your health if they are utilized excessively, as everything taken or consume in excess is harmful to your body. As even nutrients rich healthy diets like vegetable and fruits when taken or consume excessively is potentially bad for your health, as it can lead to constipation or diarrhea. However, there are still substances that even when utilized moderately or occasionally are still potentially harmful to our health and a good example for this is cigarettes.

Healthy diets combined with regular exercise are unquestionably very beneficial to your health and well-being. With proper consumption of nutrients rich foods such as fruits, vegetables, nuts, whole grains, oily fish, and healthy fats, to name a few can greatly enhance and strengthen your body's wellness both physically and mentally. Healthy diets is not all about strict dietary nutrition and depriving yourself of every food that you love, but rather, it's all about being healthy and enjoying it, having more stamina and energy, and staying fit and strong, which can be all acquired by properly learning some nutritional and dietary basics and employing them in a way that suits you best.

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Alternatively check out my blog on how to diet healthily at www.yourawesomediet.com/howtodiet

Quick Healthy Diet Foods For Easy Weight Loss

Fortunately, there are fast ways lose weight, free. One of the most important things that people can do to lose weight is change their diet. The reasons that obesity is such an issue today is because people are eating all of the wrong foods. Chips, sodas, fried foods and cookies are readily available, which makes it even more easy for people to gain weight.

The healthy diet food list:

Below are some of the foods that a healthy diet consists of:

Lean protein (poultry, fish, lean beef)

Fruits

Vegetables

Legumes

Beans

Whole grains

Cereal

Low-fat and fat-free dairy products (milk, yogurt)

Oats

Oatmeal

Those who need a more descriptive example about what they should be eating everyday can check out one of the many free diet plans that are available online.

Another one of the most important things that people can do to lose weight quickly is drink plenty of water. It seems so simple, but it is something that many people neglect. Approximately 65-70 percent of the human body is made up of water, so drinking plenty of it is one of the best things that people can do for their health.

Water helps promote weight loss in three ways. One of the ways that it promotes weight loss is by replacing sugary beverage. A twelve ounce can of coke is about 140 calories. If a person drinks three cokes per day, that is 420 empty calories added to his or her diet. If one replaces those three cups with a bottle of water, he or she will be able to save 420 calories.

Water has also been shown to help promote a feeling of fullness. One of the root causes of weight gain is overindulging. Studies have shown that people who drink a glass of water before a meal eat less than those who do not. Additionally, water also helps rid the body of excess toxins.

People also need to make sure that they are exercising regular. Researchers have found that half of the population does not engage in regular exercise. Exercise is not only effective for promoting weight loss, but it also helps people keep the weight off for the rest of their lives.

Experts recommend being physically active for at least 30 minutes per day. However, those who are trying to lose weight should aim for about an hour most days of the week. Walking is one of the simplest exercises that a person can do because it is something that the body was designed to do naturally. Other forms of aerobic exercise that one may want to consider include: jogging, dancing, skating and playing a sport. Additionally, people should also make sure that they include resistance exercises in their regimen.

One of the most important things that people can do to keep their bodies healthy is maintain a healthy weight. Eating a healthy diet and exercising will help people lose weight fast.

Explore various benefits and features of weight loss detox programs for those looking for a customized solution to achieve a naturally toned body fast.

Reasons to Live a Healthy Lifestyle

The aim of this article is to show just what a range of benefits that you can achieve by losing weight and improving your overall fitness. By consistently following a program of sound nutrition and exercises you will reach your goals but don't expect it to happen overnight.

The first thing you need to do is to stop listening to or buying into the multitude of diet scams that are around these days. Reality is that you are not going to lose weight or get fit with no effort. Permanent weight loss and fitness requires effort and commitment but the end result is worth it.

There is no other way around it...you have to eat properly and you do have to exercise.

Okay...let's look at some of the benefits of exercise.

1. Losing body fat

If you diet without any exercise, you lose some fat but you are also losing lean muscle. Restricting calories actually slows down your metabolism causing you to gain weight as soon as you increase those calories again. Combining an exercise program with your dieting helps to maximize fat loss while minimizing lean muscle loss.

2. Maintaining a healthy body weight

A good routine of healthy eating and exercise keeps your weight stable so that you don't have to turn to dangerous fad diets all the time. These scams may work for a very short time but you will put the weight on again just as quickly. If you make healthy eating choices and exercise a part of your life, a stable weight will be normal for you.

3. Faster metabolism

How many times have you heard someone use the excuse of a slow metabolism? I must admit that I've used it myself. Well, it's a myth. Our metabolism slows down due to our own unhealthy choices not the other way around.

Calorie restrictive diets create havoc with the metabolism whereas an effective nutrition and exercise plan can definitely speed up your metabolism, allowing it to burn off those excess kilos.

4. More sustained endurance and muscular strength

You don't need to be a bodybuilder or an elite sportsperson to benefit from increased strength and endurance. Whatever you do, it allows you to perform more efficiently. Some women are concerned that increased muscular strength means huge, bulky biceps and so forth but that isn't what you need to become.

5. Better cardio respiratory function

A properly designed exercise program can improve your endurance in a short time. As the cardio respiratory system responds positively to exercise, you will find you can climb the stairs without any trouble.

6. More strength in the bones, ligaments, and tendons

Weight bearing exercises and a sensible regimen of resistance training will not only strengthen the muscles but will benefit the entire skeletal system and connective tissues, greatly reducing risk of injury.

7. Greater muscle mass

An increase in muscle mass equals an increase in the number of calories burned throughout the day, meaning a faster metabolism. It also makes you more physically attractive.

8. Lower blood pressure

High blood pressure can lead to strokes or heart attacks. While medication can help, lifestyle changes in diet and exercise are the vital elements in blood pressure control.

9. Lower cholesterol

Cholesterol is necessary for some of our bodily functions but many people have led a lifestyle that has left them with a dangerously high level of cholesterol. This can lead to cardiovascular disease, particularly if you are also overweight or obese. Losing fat through nutrition and exercise is the key to the overall improvement in cholesterol levels.

10. Reduced risk of type 2 diabetes

In type 2 diabetes, the pancreas doesn't produce enough insulin to maintain the bodys blood glucose levels. Maintaining a healthy weight and leading an active lifestyle decrease the risk of this disease.

11. Lower risk of osteoporosis

This condition is a very painful disease characterized by decreased bone mass as well as 'chalky' bones. Because they are so fragile, fractures can occur from something as simple as bumping into something. Resistance training and weight bearing exercises can assist in increasing bone density.

12. Higher self-esteem

Participating in structured exercise leads to an improvement in appearance. This makes you feel good about yourself and you find an increase in energy, vitality, and confidence.

So, as you can see, the benefits to your overall health are numerous and too important to leave to chance. As the saying goes, "use it or lose it" and this is very applicable to the use of your muscles and your body in general.

Anne has worked primarily within health and welfare for around 35 years. She has always loved to write and has a wide range of interests. She is the owner of http://www.ozebizwiz.com and http://www.ourkidzbiz.com

Tips On How to Live a Healthy Lifestyle

The world today is a very stressful, fast-paced place to live. Many people have a very hard time making it through life without having problems at times. The best way to make it through life without major problems is to live a healthy lifestyle. Living a healthy lifestyle makes everything much easier to deal with, because you are in a good frame of mind, and you feel well physically. A healthy lifestyle is not just about eating a healthy diet, or exercising regularly. I think the most important thing in living a healthy lifestyle is everything in moderation. You need to eat healthy, exercise, and find a healthy balance between work and play.

Eating healthy is very important to living a healthy lifestyle, because your diet is what fuels your life. If you are constantly eating junk food and drinking alcohol, then you are causing physical damage to your body. This damage will cause you to have a lack of energy and you will not be able to do the things that you want to do.

Exercise is also very important to live a healthy lifestyle, because if you are out of shape you will not feel well or be able to do the things that you want to do. When you exercise you release different chemicals into your bloodstream that make you feel better. Exercising can be a big help getting you through a tough day, because it can give you a good head start to the day, or a pick me up after a bad day.

I think the most important way to live a healthy lifestyle is to find and maintain a balance between work and play. If you work too much then your stress level will be very high, and your health and happiness will decline very quickly. However if you play too much, your stress will also be very high, because you are going to have to worry about how you are going to pay your bills. If you strike a balance between the two then you can make enough money to pay your bills, but still have enough fun that you are able to relieve your stress. If you pay attention to these things in your life, then you will be able to live a healthy lifestyle.

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Anemia in Cancer Patients

Anemia

Anemia literally means lack of blood. It actually designates a condition in which body lacks healthy red blood cells. In human body, red blood cells are developed in bone marrow. Principle function of red blood cells is to carry oxygen to body tissues; so red blood cells are the ones who keep our body cells oxygenated, alive, and healthy. Hemoglobin is the main component of red blood cells. It binds with the oxygen and helps in transferring the oxygen to body cells. Hemoglobhn is an iron-containing molecule which is responsible for red color of our blood. Normal hemoglobin level varies from 12 g/dL to 15 g/dL.

Anemia can occur due to several reasons. In cancer patients, anemia is a common condition. In most of the cases cancer itself causes anemia. If the cancer affected regions include liver, lung, bone marrow, heart, kidney etc then red blood cell production is decreased severely causing anemia. If the patient is having tumor or ulcer in the internal body organs such as intestine, bladder, or stomach etc then severe bleeding can occur which can in turn cause anemia. Chemotherapy and radiotherapy can also be responsible for anemia in cancer affected patients. Though radiotherapy regions do not include organs like liver but if the radiotherapy is being delivered to any adjacent body structure then liver functionality can be affected causing anemia. Same thing happens if radiotherapy is delivered in the spinal region.

Most dominant symptoms of anemia are shortness of breath, severe tiredness, dizziness and swelling of hands and feet, as well as chest pain.

Techniques that helps

- Blood transfusion: Blood transfusion is the emergency method of treating anemia. Blood transfusion is a process in which blood components such as red blood cells, white blood cells, plasma etc is transfused intravenously into the circulatory system of patient body. Blood transfusion is used only in case of severe anemia when the blood hemoglobin level is less than 8 g/dL. Blood transfusion can give relief quickly than any medication or supplement but it also has a few risks involved such as lung injury, transfusion reaction and congestive heart failure. If the blood is transfused too quickly before the heart can handle it can lead to congestive heart failure. Transfusion reaction occurs when body immunity system rejects foreign blood cells. It is almost like an allergic reaction.

Supportive Supplements and herbs

- Folic Acid: Folic acid is essential to generate healthy red blood cells in people of all ages. Folic acid is available as a supplement. There are natural sources rich in folic acid such as spinach, beans, peas, egg yolk, Baker's yeast, and fish liver oil.

- Vitamin B12: Vitamin B12 is needed in every single cell for normal cellular function, deficiency of which can lead to anemia which is called pernicious anemia and it is basically an autoimmune disease. Pernicious anemia is commonly seen in people with gastric cancer. It can be treated orally with B12 supplement. Usually such a high dose of vitamin B12 is given orally the amount absorbed in intestine through passive diffusion is enough for body functionality.

- Vitamin A: Other than the above two components, excessive vitamin A intake can lead to cancer. It can be clinically determined with associated symptoms such as insomnia, diarrhea etc but for proper diagnosis blood test is necessary.

- Vitamin B6: According to Journal of American Medical Association vitamin B6 itself can reduce the risk of colorectal cancer. Vitamin B6 is an essential component for producing hemoglobin inside the body. Vitamin B6 enhances oxygen binding of hemoglobin. So vitamin B6 deficiency can lead to severe anemia. Natural sources include whole grain foods, bananas, and meat.

- Vitamin C: Vitamin C enhances iron absorption in body. Deficiency of vitamin C can lead to hemolytic anemia in which red blood cells break down abnormally. Natural sources of vitamin C include citrus fruits like lemon, orange as well as papaya, strawberry, guava, and green chili pepper etc.

- Iron: Iron is the main component of hemoglobin. Deficiency of iron can result in impaired red blood cells formation successively resulting in anemia. Iron supplement can be taken orally as tablet, capsule, or syrup. Natural sources include red meat, poultry, leafy vegetables etc. Marsh barbel is also an efficient dietary supplement for iron deficiency but unfortunately it is available in the Indian continent only.

- Copper: Copper is an essential trace element which means it is needed in a very small amount but its absence can lead to severe disorders. Copper is concerned with formation of hemoglobin from iron. Copper deficiency can lead to less iron absorption leading to anemia. Natural sources of copper include sea foods, animal liver, whole grain, and chocolate etc.

- Blackstrap molasses: Blackstrap molasses, also known as blackstrap is the remaining raw sugar cane after maximum extraction of sugar. It is rich in vitamin B6, iron, calcium, magnesium, and potassium. One tablespoon a day of blackstrap can provide almost one fifth of daily dose of those nutrients in the body. For these reasons it is also known as pregnancy tea.

- Spirulina: Spirulina is a well-known nutritional supplement. It is made from two species of cyanobacteria. It is proved to be beneficial in treating anemia, liver toxicity, as well as cancer. Spirulina contains essential amino acids, vitamin B12, and beneficial lipids like DHA. It is well available in tablet, flake, or power form worldwide.

- Alfalfa: Alfalfa is a flowering plant found worldwide. It has been known to doctors for more than 1500 years. Alfalfa is high in vitamins like vitamin B, vitamin C, vitamin D, vitamin E as well as protein and calcium. It helps in treating anemia.

- Gentian: Gentiana lutea mostly known as bitter root is mainly found in central and southern Europe. It is a herb that is effective in digestive system disorder. It does not contain nutrients that directly help in anemia but as it is effective in digestive system, it helps in absorption of iron, vitamin B12 etc in human body. It also helps to prevent heavy bleeding.

Cytoplasm and Cell Nucleus Functions

Human and animal cells are composed of a wide variety of items. These items within the cell membrane are known as organelles. They carry out vital roles in cell functions. The cytoplasm makes up the vast majority of the cell, but one of the most important parts, if not the most important, is the cell nucleus.

The cytoplasm is the fluid material and organelles within the cell, not including the nucleus. A small amount of energy for use by the cell can be produced by chemical processes that occur in the cytoplasm. This contributes to our survival, as it is the key process in red blood cell energy metabolism; it is called anaerobic metabolism be­cause it doesn't require oxygen.

The cell nucleus is bounded by its own double membrane. The nucleus controls ac­tions that occur in the cell, using hereditary material called deoxyribonucleic acid (DNA). DNA is the "code book" that contains directions for making substances the cell needs. It consists of genes on chromosomes.

This "code book" remains in the nu­cleus of the cell, but conveys its information to other cell organelles by way of a simi­lar molecule called ribonucleic acid (RNA). The RNA has the responsibility of transcribing the information of the DNA and moving out through pores in the nuclear membrane to the cytoplasm. The RNA then carries the code to protein-synthesizing sites called ribosomes. There, the RNA code is translated into a specific protein. With the exception of the red blood cell, all cells have one or more nuclei.

DNA has the secondary task of cell replication. DNA is a double-stranded mole­cule, and when the cell begins to divide, each strand is separated and an identical copy of each is made. Thus, each new DNA contains one new strand of DNA and one strand from the original DNA. In this way, the genetic code is preserved from one cell generation to the next. The mitochondria contain their own DNA, so they reproduce themselves independent of action in the nucleus.

The transport of proteins, vitamins, and other material from the cytoplasm to the nucleus also occurs through pores in the nuclear membrane as just mentioned. These small molecules serve a variety of functions, including the activation (or inactivation) of certain parts of the DNA chain.

DNA is an important part of any living organism as it is what both separates and unites different organisms. Genetic mutations give rise to new forms of life, and evolution favors the organisms which have the DNA that allow them to survive in their respective environments.

Written by, Barbara Johnson For more great information on enrolling in CNA Training or obtaining your RN license visit http://cna-training.info/.

Blood Cells - The Basics

About half of your blood is liquid and the other half is made up of cells. The liquid is 90% water and is called "PLASMA."

There are three types of blood cells - RED BLOOD CELLS, WHITE BLOOD CELLS, and PLATELETS.

RED BLOOD CELLS

There are about 4 million RED BLOOD CELLS per microliter of your blood. Men have a little bit more than women usually do. These have hemoglobin in them, which binds to oxygen. These cells then carry the oxygen throughout your body in your bloodstream, reaching all your tissues.

RBC's are made up of iron. You need iron in your diet to make RED BLOOD CELLS.

Another term for RED BLOOD CELL is ERYTHROCYTE (cyte means cell.)

WHITE BLOOD CELLS

WBC's fight infection. Normally, you have between 5,000 and 10,000 WHITE BLOOD CELLS per microliter of your blood. WHITE BLOOD CELLS are categorized into two categories-granulocytes and non-granulocytes.

Granulocytes have granules in them that contain chemicals which attack and sometimes kill foreign substances. There are three types of granulocytes-neutrophils, eosinophils, and basophils.

Neutrophils are the most common granulocyte. They fight bacteria. The Neutrophil will surround a group of bacteria and engulf them, then dump the contents of its granules into the bacteria, killing the bacteria and the neutrophil both. Pus is made up of dead neutrophils and dead bacteria.

Eosinophils fight parasites and attack foreign substances. If your body sees bee pollen, for instance, as a foreign body, it will produce extra Eosinophils to fight the bee pollen. If your blood test shows a high percentage of Eosinophils, the doctor will know that there's a good probability that you have either a parasite, or an allergy.

Basophils help fight foreign substances also. Normally, there are zero to one percent Basophils in your blood. But if your body sees a foreign substance, it will produce extra Basophils which will dump the contents of their granules into the foreign substance in an attempt to kill it. The contents contain histamine. Histamine causes sneezing or itching. That's why you take an anti-histamine to counter-affect these symptoms.

The other category of WHITE BLOOD CELLS is non-granulocytes. There are two kinds of them--lymphocytes and monocytes. They usually fight viruses as opposed to bacteria.

PLATELETS

PLATELETS are very small and sticky. If you're bleeding, they rush to the site, stick together, and form a platelet plug, sealing the capillary wall to help stop the bleeding.

The normal count is 150,000 to 450,000 per microliter in your blood.

Another name for PLATELET is thrombocyte.

All these blood cells are manufactured in your bone marrow. Lymphocytes are also produced in the lymph nodes.

After working 20 years as an ASCP certified Med Tech, I switched careers to teach science in an inner-city high school. I've written a memoir about the joys of teaching and the obstacles I fought. No Child Left Behind? The True Story of a Teacher's Quest by Elizabeth Blake on Barnes and Noble and also Amazon at http://tiny.cc/Amazon465 Drugs, gangs, a riot, shootings, murdered students, abusive principals - all contributed to the stress which eventually drove me from the students I loved. The book celebrates triumph over adversity. To read the first page, visit http://www.elizabethblakeonline.com

Complement Fixation Test

There are three diagnostic methods used to identify viruses; the direct, the indirect and serological techniques. Complement fixation test is one of the serological tests used in virology to identify the presence of specific antibodies or antigens. In this context, complements are proteins in series form within the patient's serum which act in response to an antibody antigen complex. In case the reaction takes place on a membrane, pores are produced causing damage to the cell.

Requirements:
• Commercially produced complements from guinea pig
• Patient's serum
• Red blood cells preferably from sheep

Procedure:
1. In complement fixation test, venous blood is collected from the patient and serum isolated.

2. It is natural for individuals to differ in the quantity of complement in serum. With the purpose of eliminating any negative effects these complements might have on the test results, the serum complements are substituted with standardized complement proteins. The complements are destroyed through heating, but care is taken to preserve the antibodies. This can be achieved because complements are vulnerable to heat than antibodies. Thereafter, the standard complements area added into the serum.

3. Into the serum, the antigens of concern are added and the preparation incubated.

4. Red blood cells are added into the preparation

Results:
In complement fixation test, incubation is necessary as it gives complements a period to fix itself onto antibody antigen complex, that is, if it is present. If this happens, complements will not be available to act on the red blood cells and cause hemolysis. As a result, a positive test is designated by the presence of the red blood cells. The cells are observed at the bottom of the beaker. On the contrary, a negative complement fixation test is indicated by the lysis of the red blood cells. The red color of hemoglobin is observed as it spreads in the beaker due to lysis.

Testing for antigens:
It is a common practice in serology to test for antibodies in complement fixation test. Nevertheless, it is feasible to test for antigens. In this case, the test serum is supplemented with antibodies which must be specific in nature. This induces the formation of complement.

Advantages and disadvantages:
The test is cheap as it does not call for expensive equipments and reagents. Again, a large number of viral infections can be screened using complement fixation test. However, it should be noted that the test is labor intensive and frequently non specific.

Constance is a professional article writer. She has written many health articles detailing different approaches to health related issues.

Anemia: A Red Blood Cell Disorder

Anemia is a clinical condition in which total number of red blood cells or the quantity of hemoglobin in blood declines than the normal level so the oxygen binding ability of hemoglobin is decreased. The word anemia is taken from a Greek word meaning lack of blood as hemoglobin deficiency prevails in the blood. Hemoglobin present inside the red blood cells normally carries oxygen from lungs to the tissues and anemia causes hypoxia in organs. As all human cells are dependent upon oxygen for survival, anemia can lead to a wide variety of symptoms depending upon degree of destruction caused. Anemia is the most common disorder of blood and different types of anemia are known depending upon the underlying causes. Anemia can be classified in a variety of ways for example, on the basis of morphology of the RBCs, underlying etiologic mechanisms and discernible clinical spectra.

There are three main classes of anemia for example, hemorrhage characterized by excessive blood loss followed by hemolysis where excessive destruction of the blood cells take place and ineffective hematopoiesis identified by deficient production of red blood cells. There are two major approaches for anemia. The first one is kinetic approach which involves evaluation and production, destruction and loss of the red blood cells. The second approach is the morphologic approach which involves characterization of anemia on the basis of size of red blood cells. The morphologic approach involves use of easily available and low cost laboratory tests to identify anemia. The normal level of hemoglobin is typically different in males and females. Males suffer from anemia when the total hemoglobin levels become less than 13.5 gram/100ml while for females it must be less than 12.0 gram/100ml.

Classification

Anemia can be classified into following types:

1. Production versus destruction or loss
The kinetic approach gives the most relevant classification of anemia. This approach focuses on the evaluation of several hematological parameters for example, the blood reticulocyte count. This then classifies the defects concerned with decreased RBC production as well as its increased destruction and loss. Clinical signs of destruction of RBCs show hemolysis in the blood smear. Increased level of LDH suggests increased loss of blood cells.

2. Red blood cell size
The morphological approach classifies anemia on the basis of size of RBCs. This can be done either automatically or by analyzing the peripheral blood smear. The size of red blood cells is reflected in terms of mean corpuscular volume (MCV). If the size of cell is less than 80 fl then anemia is said to be microcytic and if it is 80-100 fl then anemia is normocytic. If the size of cell is more than 100 fl then anemia is classified as macrocytic. This approach quickly gives some idea about the cause of anemia for example microcytic anemia is the result of iron deficiency. The peripheral blood smear often gives an idea about the white blood cells. Abnormal picture of white blood cells projects towards a defect in the bone marrow.

a. Microcytic anemia
Microcytic anemia is primarily the result of failure of synthesis or insufficient production of hemoglobin in blood and a number of etiologies are also responsible for it. Iron deficiency anemia is the most common type of anemia which may arise due a number of factors. In this type of clinical condition RBCs appear hypochromic and microcytic when viewed under microscope. Iron deficiency anemia is caused due to insufficient intake or absorption of iron in the body. Iron is very important for hemoglobin production and any insufficiency may result in decreased incorporation of hemoglobin in the red blood cells. In United States about 20% females of childbearing age suffer from iron deficiency anemia while only 2% of males of same age group suffer from this clinical condition.

The prime cause of this form of anemia in the premenopausal women is excessive blood loss during menstrual cycle. Studies have shown that iron deficiency without anemia results in poor performance as well as low IQ in girls, although some socioeconomic factors may also be marked responsible for it. Iron deficiency sometimes also causes abnormal fissuring of angular sections of the lips. Iron deficiency anemia can also result from the bleeding of lesions of gastrointestinal tract. Fecal blood testing, occult blood testing, upper endoscopy and lower endoscopy can help in detection of bleeding of the gastrointestinal tract. In men and post-menopausal women the bleeding may be due to colorectal cancer. Parasitic infestations of parasites namely, Amoeba, hookworm, Schistosoma and whipworm is most common cause of iron deficiency anemia.

b. Macrocytic anemia
Macrocytic anemia can be further divided into megaloblastic and non-megaloblastic macrocytic anemias. The major cause of megaloblastic anemia is failure of DNA synthesis however, RNA synthesis occurs normally and this results in restricted cell division of the progenitor cells. This form of anemia can also be found associated with the neutrophil hypersegmentation. The non-megaloblastic anemia is most commonly found associated with alcoholism. Vitamin B12 deficiency is the most common feature of this type of anemia and the symptoms include peripheral neuropathy and subacute combined degeneration of the cord resulting in balance difficulties of the spinal cord. Other features comprise red and smooth tongue and glossitis. The treatment of the vitamin B12 deficiency anemia was first given by William Murphy. He allowed the dogs to bleed till they became anemic and then fed them a variety of substances in order to cure anemia. He concluded that ingestion of large amounts of liver resulted in diminished symptoms of anemia. George Minot and George Whipple then isolated vitamin B12 from liver and all these three scientists shared the Noble Prize in medicine in 1934.

c. Normocytic
This type of anemia occurs when the overall levels of hemoglobin keep on increasing but the size of red blood cells remain normal. This can be caused by acute blood loss, anemia due to chronic disease, hemolytic anemia and aplastic anemia.

d. Dimorphic anemia
When two or more factors causing anemia act simultaneously at a time then this form of clinical condition comes into play.

e. Heinz body anemia
Heinz bodies are formed in the cytoplasm of RBCs and appear like small dots when viewed under microscope. A number of factors are believed to be responsible for this clinical condition and some drugs may also participate in this form of anemia. It can be triggered in cats and dogs by feeding them on onions and zinc.

f. Hyperanemia
It is a very severe form of anemia characterized by lowered concentration of hematocrit about less than 10%.

g. Refractory anemia
This form of anemia fails to respond against any treatment. It is secondarily associated with the myelodysplastic syndromes. Iron deficiency anemia can also be placed under this category.

Causes

Anemia can be classified as a clinical condition with impaired red blood cell production, increased RBC destruction, blood loss and fluid overload. A number of factors act simultaneously to cause anemia. Blood loss is the most frequent symptom of anemia followed by iron deficiency. Anemia of impaired production can occur due to disturbance of proliferation and differentiation of stem cells. This symptom can cause pure red cell aplasia followed by aplastic anemia which affects all types of blood cells. Insufficient production of erythropoietin causes renal failure and anemia of endocrine disorders can also crop up. Disturbance of proliferation and maturation of erythroblasts is responsible for the appearance of pernicious anemia which is a form of megaloblastic anemia caused by vitamin B12 deficiency resulting in impaired vitamin B12 absorption. This form of megaloblastic anemia also causes anemia of folic acid deficiency.

The levels of hematocrit also decline so erythropoietin response also diminishes resulting in anemia of prematurity. It generally occurs in the infants of 2-6 weeks of age. Iron deficiency anemia also causes deficient heme synthesis. Thalassemias cause deficient globin synthesis. Myelophthisic anemia is a very severe form of anemia where bone marrow is replaced by other materials like granulomas or malignant tumors. Anemias of increased red blood destruction are generally classified as hemolytic anemias and are characterized by jaundice and increased levels of low density lipoproteins. Trauma and surgery also cause blood loss and even the gastrointestinal tract lesions also result in chronic blood loss. Fluid overload causes decreased hemoglobin concentration and apparent anemia
Signs and symptoms

Anemia in some individuals may remain hidden as the symptoms do not arise very frequently. The signs and symptoms may depend upon the underlying cause. Individuals suffering from anemia generally show non-specific symptoms like weakness, general malaise and poor concentration. They may also report shortness of breath on exertion. In very severe forms the body compensates for the lack of oxygen carrying capacity of blood cells by increasing the cardiac output. The patient may also complain of palpitation, angina, and intermittent claudication of legs and signs of heart failure. Other prominent symptoms include jaundice, bone deformities or leg ulcers. In severe forms tachycardia, bounding pulse, flow murmurs and cardiac ventricular hypertrophy may also occur. Symptoms of heart failure may also arise. Pica, a symptom of iron deficiency arises after the consumption of non-food items like paper, wax, glass and ice. Chronic anemia may also cause behavioral changes in the children resulting in impaired neurological development. Restless legs syndrome is very common in individuals with iron deficiency anemia. Less frequent symptoms include swelling of legs, arms, chronic heartburn, vomiting, increased sweating and loss of blood in stool.

Diagnosis

A complete blood count is typically used for the diagnosis of anemia. Apart from determining the number of red blood cells and hemoglobin levels automatic counters also measure the size of red blood cells by using flow cytometry which gives a clear picture of anemia. Examination of a stained blood smear under microscope also gives a clear cut idea about this disease. Reticulocyte count and kinetic approach are very commonly used in diagnosis. A recticulocyte count is actually a quantitative measure of bone marrow's production of new red blood cells. If automated blood count is not available then reticulocyte count can be taken into consideration for disease diagnosis.

Treatments

Treatments mainly focus on type and cause of anemia. Iron deficiency anemia arising due to nutritional uptake is generally rare in men and post-menopausal women. Mild to moderate iron deficiency anemia is treated by oral iron supplementation of ferrous sulfate, ferrous fumarate or ferrous gluconate. While taking iron supplements an individual may experience upset stomach as well as darkened feces. Vitamin C increases body's ability to absorb iron so taking orange juice along with iron supplements may be of great help. Vitamin supplements taken orally or intramuscularly can help in replacing some of the specific deficiencies. Chronic anemia can be treated with chemotherapy and the medical experts also advise use of recombinant erythropoietin to stimulate red blood cell production. In very severe cases blood transfusion becomes necessary. Anemia may be genetic. Hereditary disorders shorten the life span of red blood cells and thus, cause anemia. Hereditary disorders can also impair hemoglobin production and cause this disease. Depending upon the degree of genetic abnormality anemias may be mild, moderate and severe.

Navodita Maurice