Aplastic Anemia

Aplastic anemia is also sometimes associated with exposure to toxins such as  benzene, or with the use of certain drugs, includingchloramphenicol,  carbamazepine,  felbamate,  phenytoin,  quinine, and  phenylbutazone. Many drugs are associated with aplasia mainly according to case reports but at a very low probability. As an example, chloramphenicol treatment is followed by aplasia in less than 1 in 40,000 treatment courses, and carbamazepine aplasia is even more rare. Exposure to  ionizing radiation  from  radioactive materials  or radiation-producing devices is also associated with the development of aplastic anemia. Aplastic anemia is present in up to 2% of patients with acute  viral hepatitis[citation needed]. In some animals aplastic anemia may have other causes. For example, in the  ferret  (Mustela putorius furo) aplastic anemia is caused byestrogen  toxicity. This is because female ferrets are  induced ovulators, so mating is required to bring the female out of heat. Intact females, if not mated, will remain in heat, and after some time the high levels of estrogen will cause the bone marrow to stop producing red blood cells. The condition needs to be differentiated from pure red cell aplasia. In aplastic anemia the patient has pancytopenia (i. e. , anemia, neutropenia and thrombocytopenia) resulting in decrease of all formed elements. In contrast, pure red cell aplasia is characterized by reduction in red cells only. The diagnosis can only be confirmed on  bone marrow examination. Before this procedure is undertaken, a patient will generally have had other  blood tests  to find diagnostic clues, including a  complete blood count  (CBC),  renal function  and  electrolytes,  liver enzymes,  thyroidfunction tests,  vitamin B12  and  folic acid  levels. Following tests aid in determining differential diagnosis for aplastic anemia: 1. Bone marrow aspirate and biopsy: to rule out other causes of pancytopenia (i. e. neoplastic infiltration or significant myelofibrosis). 2. History of iatrogenic exposure to cytotoxic chemotherapy: can cause transient bone marrow suppression 3. X-rays, computed tomography (CT) scans, or ultrasound imaging tests: enlarged lymph nodes (sign of lymphoma), kidneys and bones in arms and hands (abnormal in Fanconi anemia) 4. Chest X-ray: infections 5. Liver tests: liver diseases . Viral studies: viral infections 7. Vitamin B12  and folate levels: vitamin deficiency 8. Blood tests for  paroxysmal nocturnal hemoglobinuria 9. Test for antibodies: immune competency. Treating immune-mediated aplastic anemia involves suppression of the  immune system, an effect achieved by daily  medicine  intake, or, in more severe cases, a  bone marrow transplant, a potential cure. [2]  The transplanted bone marrow r eplaces the failing bone marrow cells with new ones from a matching donor. The  multipotent  stem cells in the bone marrow reconstitute all three blood cell lines, giving the patient a new immune system, red blood cells, and platelets. However, besides the risk of graft failure, there is also a risk that the newly created white blood cells may attack the rest of the body (graft-versus-host disease). Medical therapy of aplastic anemia often includes a short course of  anti-thymocyte globulin  (ATG) or  anti-lymphocyte globulin  (ALG) and several months of treatment with  ciclosporin  to modulate the  immune system. Mild  chemotherapy  with agents such as  cyclophosphamide  andvincristine  may also be effective. Antibody  therapy, such as ATG, targets T-cells, which are believed to attack the bone marrow. Steroids  are generally ineffective, though are often used to combat  serum sickness  caused by ATG use. One prospective study involving cyclophosphamide was terminated early due to a high incidence of mortality, due to severe infections as a result of prolonged  neutropenia. [3] In the past, before the above treatments became available, patients with low leukocyte counts were often confined to a sterile room or bubble (to reduce risk of  infections), as in the famed case of  Ted DeVita. 4] [edit]Follow-up Regular  full blood counts  are required to determine whether the patient is still in a state of remission. 10-33% of all patients develop the  rare disease  paroxysmal nocturnal hemoglobinuria  (PNH, anemia with thrombopenia and/or  thrombosis), which has been explained as an escape mechanism by the bone marrow against destruction by the immune system. Flow cyto metry  testing is performed regularly in people with previous aplastic anemia to monitor for the development of PNH.

Employability in the community sector Essay Example | Topics and Well Written Essays - 2000 words - 1

Employability in the community sector - Essay Example Governments often do not have sufficient resources to train and employ highly skilled people. Therefore, to compensate for the workforce shortage, countries superficially train their youth cross functionally. However, with the passage of time, the concept of community worker became formalized. At the same time, it is important to understand the ideology of community workers; previously they were seemingly trained in health sciences, so that they can provide first aid in a case of emergency. Nevertheless, in the modern era governments came to understand the value of community work (Peacock, Issel, Townsell, Chapple-McGruder, & Handler 2011). This enlightenment led governments to initiate cross training for community workers. Along with this, they are offered excellent remuneration and health insurance, thus compelling increasing number of young individuals to join community work as full time profession. Notably, these community workers are actively participating in various sectors of economy such as financial, emergency and military services. In this way, they are developing cross-industrial skills, which can help them in earning a handsome pay at the later stage of their career. On the other hand, these workers are respected around the globe for their notable contributions in medical practice. Nowadays, these professionals are playing a significant role in spreading the general knowledge about various health issues worldwide. The effectiveness of these awareness programs conducted by social workers is admirable because, they are conducted with the help of limited resources without any formal organizational identity. Female social workers are also prominent in their respective field due to their heightened commitment towards benefiting humanity. This paper in addition, to the general description of social work, will provide few essential skills necessary for the successfulness of a social worker in the coming paragraph. The

Planning and Design Essay Example | Topics and Well Written Essays - 2000 words

Planning and Design - Essay Example It enables to prepare an efficient schedule for completing the project within a specified time (Public Procurement Guide, 2008). Resource Planning In this stage, the management should be focused on determining required materials or resources, laborers and tools that are required in each step of the project. This step would be useful for making proper allocation of available resources in required places. It would also facilitate to avoid any improper allocation and wastage of valuable resources so that the project completes in time (Public Procurement Guide, 2008). Cost Planning Preparation of plan with respect to allocation and use of cost is one of the vital parts for the management in the project plan. The stage comprises proper identification of required costs including internal and external costs. It also enables to make assessment of the amount of time required to complete the project, so estimation can be made regarding the budget of the project and whether the project would re quire over-budgeting or not (Public Procurement Guide, 2008). b. ... With this concern, Spencer Moneysworth consulted with Expert Industrial Developers (EID) regarding making an estimation of cash flow chart for the project. However, the EID provided an estimated plan of USD20 million with a schedule of 18 months for the project. However, the intention for Woody 2000 project was to prepare the project within USD17 million by including one million for first and last month and USD1.4 million each within the rest 10 months during the project. Moreover, the cost planning of EID depicts an excessive use of capital along with making an estimation of longer schedule for the plan including professional services and construction works. With this concern, it can be said that there is a requirement for making evaluation of available alternatives in terms of accessible contractors that can provide lowest possible cost with efficient time schedule for the project. In the successive phases of the project, the aspect of proper time scheduling would be crucial as it can largely affect positive or negatively on the factors such as project budget, delay and accessibility of resources among others (Public Procurement Guide, 2008). c. Did the project plan explain how the project and any changes would be controlled? Should this be part of the plan? Give reasons. The overall plan for the Woody 2000 project explains the facet of bringing in changes by involving software as well as hardware to efficiently complete the project related tasks. By appointing Ian Leadbetter, a mechanical engineer, specialized in ‘programming semi automatic manufacturing machinery’, efficiency in the whole process of project schedule was desired to be brought. This aspect