Rh Antibody Titres Tips

Normally, the body’s immune system recognizes any foreign body as an antigen and produces what are known as antibodies. However, in autoimmune disorders, the body produces antibodies against the body’s own tissue. This is an abnormality and depending on what factor is triggering the production of antibodies, there are various types of autoimmune disorders (AID). When we look at the musculoskeletal system, there are quite a few, the top 4 being:

1. Scleroderma
2. Systemic lupus erythematosus
3. Sjogren’s syndrome
4. Rheumatoid arthritis

In all these conditions, the body produces antibodies against its own tissue, producing these conditions.

Causes:

1. Family history is definitely an attribute to developing autoimmune diseases
2. Environmental pollution
3. Lifestyle including lack of exercise, smoking, excessive alcohol use

Know more about these:

1. Scleroderma: Can be localized or generalized, the upper layers of the skin get thicker (sclerosis). This can be nodular or diffuse, and can also affect children. The skin and muscles are usually affected, but in severe cases, it can affect internal organs such as lungs and heart.
2. Systemic lupus erythematosus: SLE, as it is often called, is very common and can be diagnosed as scleroderma in the initial stages. It can also occur with other autoimmune conditions and some of the types include cutaneous lupus, systemic lupus, drug-induced lupus, and neonatal lupus.
3. Rheumatoid arthritis: The most common autoimmune rheumatic disease is RA, which causes inflammation of the joint spaces. There would be pain, stiffness, and swelling of the joints. This needs to be segregated as RA, as the symptoms are similar to any other form of arthritis. Treatment includes a combination of pain killers, heat and cold therapy, massage, steroid injections, and immune controlling agents.
4. Sjogren’s syndrome: The symptoms are characteristic with dry mucous membranes including those of the eyes, mouth, and vagina. There could be accompanying pain and redness, significant fatigue, fibromyalgia, and complications relate06596a63c2bfa095274fedbd051133aing to other organs.

Diagnosis: Autoimmune diseases are tricky to diagnose as other diseases with similar symptoms need to be ruled out first. In some cases, there are specific antibodies, and checking their levels can help identify the underlying condition.

Management: For all the rheumatic autoimmune diseases, treatment is a multipronged approach with lifestyle changes, drugs, and alternative therapies.
Lifestyle changes: A healthy diet, regular exercise, and adequate vitamin and mineral supplementation is a must.

Drugs: Some drugs used are:

1. Anti-inflammatory drugs
2. Steroids
3. ACE inhibitors
4. Immunomodulatory therapy
5. Stem cell transplants

Alternative therapies such as massages with herbal oils, acupuncture, and cold therapy are widely used to control inflammation. In addition, alcohol and smoking and exposure to environmental pollution need to be controlled.

Normally, the body’s immune system recognizes any foreign body as an antigen and produces what are known as antibodies. However, in autoimmune disorders, the body produces antibodies against the body’s own tissue. This is an abnormality and depending on what factor is triggering the production of antibodies, there are various types of autoimmune disorders (AID). When we look at the musculoskeletal system, there are quite a few, the top 4 being:

1. Scleroderma
2. Systemic lupus erythematosus
3. Sjogren’s syndrome
4. Rheumatoid arthritis

In all these conditions, the body produces antibodies against its own tissue, producing these conditions.

Causes:

1. Family history is definitely an attribute to developing autoimmune diseases
2. Environmental pollution
3. Lifestyle including lack of exercise, smoking, excessive alcohol use

Know more about these:

1. Scleroderma: Can be localized or generalized, the upper layers of the skin get thicker (sclerosis). This can be nodular or diffuse, and can also affect children. The skin and muscles are usually affected, but in severe cases, it can affect internal organs such as lungs and heart.
2. Systemic lupus erythematosus: SLE, as it is often called, is very common and can be diagnosed as scleroderma in the initial stages. It can also occur with other autoimmune conditions and some of the types include cutaneous lupus, systemic lupus, drug-induced lupus, and neonatal lupus.
3. Rheumatoid arthritis: The most common autoimmune rheumatic disease is RA, which causes inflammation of the joint spaces. There would be pain, stiffness, and swelling of the joints. This needs to be segregated as RA, as the symptoms are similar to any other form of arthritis. Treatment includes a combination of pain killers, heat and cold therapy, massage, steroid injections, and immune controlling agents.
4. Sjogren’s syndrome: The symptoms are characteristic with dry mucous membranes including those of the eyes, mouth, and vagina. There could be accompanying pain and redness, significant fatigue, fibromyalgia, and complications relating to other organs.

Diagnosis: Autoimmune diseases are tricky to diagnose as other diseases with similar symptoms need to be ruled out first. In some cases, there are specific antibodies, and checking their levels can help identify the underlying condition.

Management: For all the rheumatic autoimmune diseases, treatment is a multipronged approach with lifestyle changes, drugs, and alternative therapies.
Lifestyle changes: A healthy diet, regular exercise, and adequate vitamin and mineral supplementation is a must.

Drugs: Some drugs used are:

1. Anti-inflammatory drugs
2. Steroids
3. ACE inhibitors
4. Immunomodulatory therapy
5. Stem cell transplants

Alternative therapies such as massages with herbal oils, acupuncture, and cold therapy are widely used to control inflammation. In addition, alcohol and smoking and exposure to environmental pollution need to be controlled.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Necessity is the mother of invention. Ironically, accidents to end up in discoveries. Sir Alexander Fleming accidentally discovered Penicillin in 1928. After many years of research and experiments, Penicillin eventually came into use during World War II. Though it’s believed to be a blessing, it has opened the doors for various allergic reactions and bacterial resistance over the period of time. About 10% of people report allergies to Penicillin, wherein more than 90% of these patients are found not to be allergic to Penicillin after skin testing.

Reactions to Penicillin:
Penicillin belongs to a family of antibiotics known as beta-lactams which also comprises of Penicillin G, Cloxacillin, Ampicillin, Amoxicillin, Piperacillin, and many more which are believed to be effective in eradicating common bacterial infections and relatively inexpensive.

The major problem in the use of Penicillin is hypersensitivity reactions. Your immune system can work wonders when encountered with any foreign body (antigen) by producing its antibody, which fights against the antigen. When your body is attacked by bacteria the lymphocytes (T-Cells) trigger the production of antibodies (immunoglobulin) to fight against the bacteria. However, in some people Penicillin administration can be considered as an invader and their immune system produces antibodies against it, thereby resulting in allergic reactions.

Acute and Sub - acute reactions:
You can observe two clinical pictures resulting from penicillin allergy:
Acute allergic reaction:

• Mediated by IgE(Immunoglobulin E) antibodies as a result of previous exposure.
• Arises immediately within minutes to an hour or two.
• Results in release of histamine and other mediators from mast cells.

Sub-Acute allergic reaction:

• Mediated by IgG (Immunoglobulin G) antibodies.
• Occurs 7 to 10 days after Penicillin treatment.
• Results in the activation of the complement reactions producing inflammation.

Risk factors for IgE mediated reaction:

• Frequent or repetitive courses of Penicillin.
• High dose parenteral (rather than oral) administration.
• A history of other allergies, such as food allergy or hay fever.
• Certain illness commonly associated with allergic drug reactions, such as infection with HIV or Epstein - Barr virus.

Watch out for:
While people are taking a Penicillin medication several different rashes can appear:

• Hives:
  • Suggest a true allergy.
  • Raised and intensely itchy spots.
  • Come and go over hours.
  • Occur with other allergic symptoms like wheezing or swelling of the skin or throat.
• Rashes:
  • Typically start after several days of treatment.
  • Flat, blotchy and non-itchy.
  • Spread over days but do not change by the hour.
  • Unlikely to be the result of a dangerous allergy.
• Anaphylaxis:
  • Very rare but life-threatening condition.
  • Causes the widespread dysfunction of the body systems.
• Signs and symptoms of anaphylaxis include:
  • Itching of soft palate
  • Nausea, vomiting
  • Sub sternal pressure
  • Shortness of breath
  • Hypotension
  • Urticaria
  • Laryngeal edema
  • Bronchospasm
  • Cardiac arrhythmias
  • Diarrhea

Other conditions resulting from Penicillin allergy:

• Serum sickness
• Drug induced anemia
• Drug reaction with eosinophilia and systemic symptoms(DRESS)
• Inflammation of the kidneys (nephritis)

In case you have a concern or query you can always consult an expert & get answers to your questions!

The abnormal growth of the endometrium tissue outside the uterus is known as endometriosis. Ideally, the abnormal tissue is supposed to break down and exit the body. However, in this condition, the tissue is unable to pass out of the body. As a result, the surrounding tissue tends to get irritated and leads to the formation of scar tissues.

The various causes of endometriosis include:

1. Immune system disorder: Complications in the immune system might render it incapable of destroying the endometrial tissue that grows outside the uterus.
2. Surgical scar implantation: Certain surgeries such as a C-section may result in the attachment of endometrial cells to the incision area.
3. Embryonic cell transport: These cells may be transported to other parts of the body by the blood vessels which may lead to endometriosis.
4. Retrograde menstruation: Instead of passing out of the body, under this condition, the blood flows back into the pelvic region via the fallopian tubes. When these cells attach themselves to the pelvic cavity, it causes endometriosis.

Symptoms
1. Pain during sexual intercourse
2. Pain during periods including pelvic pain, especially during periods, lower back pain and abdominal pain.
3. Excessive bleeding during periods
4. Fatigue
5. Constipation
6. Bloating

The major complication that results is fertility problems. Endometriosis may prevent the combination of the egg and the sperm and thus, impairs your ability to conceive. It is recommended not to delay pregnancy if you have endometriosis. This disorder also tends to increase the risk of ovarian cancer in some women.

How can it be treated?

Endometriosis is usually done using surgery or medications. 

1. Medication: It usually involves painkillers.
2. Hormone therapy: Some of the hormonal therapies include:
   1. Hormonal contraceptives
   2. Progestin therapy
   3. Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists
3. Conservative surgery: If a patient wants to become pregnant, surgery is done as much as possible without harming the uterus and ovaries. Suggested procedures include laparoscopy and traditional abdominal surgery.
4. Assisted reproductive technologies: An example of this form of treatment is In Vitro Fertilization.
5. Hysterectomy: Under severe circumstances, total hysterectomy is conducted in order to facilitate the removal of cervix and uterus. 

The uterine fibroids are one of the most common gynecologic problems, with over 40-50% of women having them at some point in their life. The number and size of the fibroids, the age of onset, associated symptoms like dysfunctional bleeding and pelvic pain will determine the management of fibroid. The following is a series of management measures, starting from the most conservative to the most invasive. 

1. Wait and watch: In women who are asymptomatic, it is best to watch them for the development of symptoms without any intervention. Also, in women nearing menopause, it is best to just watch the fibroids as they just shrink once menstruation ceases. 

2. Medical therapy: In some women, menstrual cycles could be heavy or irregular and require hormonal replacement. They could also have occasional pain, and so may require painkillers. 

1. Tranexamic acid is a non-hormonal medication that can be used on heavy bleeding days only to ease the heavy menstrual flow. 
2. Nonsteroidal anti-inflammatory drugs (NSAIDs) are useful in pain control. Iron and vitamin supplements are also useful in managing anemia and weakness associated with heavy bleeding. 
3. Oral contraceptives and/or progestins are also used to control abnormal menstrual bleeding. They do not have any effect on fibroid size though. 
4. Progestin could also be delivered through an intrauterine device (Mirena) to relieve heavy bleeding and prevent pregnancy. 
5. Gonadotropin-releasing hormone (Gn-RH) agonists: They block the production of oestrogen and progesterone, and so induce a temporary postmenopausal state. This can also be used to shrink the fibroid so it is easier to remove it surgically. This is not used for more than 3 to 6 months as they can cause hot flashes and bone loss. 
6. Newer drugs like Mifepristone and Ulipristal acetate are being used to shrink the size of fibroids. 

3. Noninvasive procedure: MRI-guided focused ultrasound surgery is when the women are inside the MRI scanner and an ultrasonic transducer is used for treatment. The exact location of the fibroids are identified and sound waves are used to destroy the fibroid. Done on an outpatient basis, it is safe and effective. 

4. Minimally invasive procedures: Uterine artery embolization is where the arterial supply is cut off to reduce fibroid growth. Myolysis is where laparoscopically heat or cold waves are used to lyse off the fibroids. Endometrial ablation is where the uterine lining is destroyed through high-intensity heat or cold waves. 

5. Invasive procedures: Abdominal or Laparoscopic myomectomy is where the fibroids are removed through an abdominal incision or keyhole surgery. If fibroids are extensive and completed family, hysterectomy is the choice of treatment. Given their high incidence, fibroids require management based on symptoms, age, and other considerations as discussed and decided between the patient and the doctor.

When tissues that usually grow inside the uterus, start growing outside the organ, it is called endometriosis. Painful periods, pain during sex, pain while urinating or bowel movements, extreme bleeding, fatigue, infertility, diarrhea, bloating and nausea are some of the symptoms of endometriosis.

Treating endometriosis usually depends on the following factors

1. Age
2. Severity of symptoms
3. Severity of the disease
4. Future plans for children

Depending on these the doctor might opt for any of the following treatments

1. Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain killers like Nonsteroidal anti-inflammatory drugs. 
2. Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may come back. Some of the hormone therapies include: 
   • Hormonal Contraceptives: Birth control pills, vaginal rings and patches are useful in controlling the hormones that are responsible for tissue build-up outside the uterine cavity. 
   • Medroxyprogesterone: This drug stops menstruation, which in turn stops the tissue build-up and put an end to all the symptoms. But on the other hand, gaining weight, low bone production and depression are some of the common effects of this drug. 
   • Gonadotropin-releasing hormone (Gn-RH) antagonists and agonists: Hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence prevent menstruation. 
   • Danazol: This drug prevents menstruation and symptoms of endometriosis by blocking the hormones that stimulate the ovaries. However, Danazol may not be a favourable option because of its side effects. The drug should be avoided during pregnancy.
3. Conservative Surgery: If you are trying to get pregnant, but you already suffer from endometriosis, then removing endometriosis surgically is a viable solution. Your uterus and ovaries will be preserved, which might increase your chances of becoming pregnant. Even suffering from severe pain might find relief from conservative surgery. 
4. Hysterectomy: In extreme cases, the only way to deal with the symptoms is to completely remove the uterus, ovaries and cervix. Since a hysterectomy means you cannot have children, it is kept as the last option for women in their reproductive age.

The abnormal growth of the endometrium tissue outside the uterus is known as endometriosis. Ideally, the abnormal tissue is supposed to break down and exit the body. However, in this condition, the tissue is unable to pass out of the body. As a result, the surrounding tissue tends to get irritated and leads to the formation of scar tissues.

The various causes of endometriosis include:

1. Immune system disorder: Complications in the immune system might render it incapable of destroying the endometrial tissue that grows outside the uterus.
2. Surgical scar implantation: Certain surgeries such as a C-section may result in the attachment of endometrial cells to the incision area.
3. Embryonic cell transport: These cells may be transported to other parts of the body by the blood vessels which may lead to endometriosis.
4. Retrograde menstruation: Instead of passing out of the body, under this condition, the blood flows back into the pelvic region via the fallopian tubes. When these cells attach themselves to the pelvic cavity, it causes endometriosis.

Symptoms
1. Pain during sexual intercourse
2. Pain during periods including pelvic pain, especially during periods, lower back pain and abdominal pain.
3. Excessive bleeding during periods
4. Fatigue
5. Constipation
6. Bloating

The major complication that results is fertility problems. Endometriosis may prevent the combination of the egg and the sperm and thus, impairs your ability to conceive. It is recommended not to delay pregnancy if you have endometriosis. This disorder also tends to increase the risk of ovarian cancer in some women.

How can it be treated?

Endometriosis is usually done using surgery or medications. 

1. Medication: It usually involves painkillers.
2. Hormone therapy: Some of the hormonal therapies include:
   1. Hormonal contraceptives
   2. Progestin therapy
   3. Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists
3. Conservative surgery: If a patient wants to become pregnant, surgery is done as much as possible without harming the uterus and ovaries. Suggested procedures include laparoscopy and traditional abdominal surgery.
4. Assisted reproductive technologies: An example of this form of treatment is In Vitro Fertilization.
5. Hysterectomy: Under severe circumstances, total hysterectomy is conducted in order to facilitate the removal of cervix and uterus. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.

When tissues that usually grow inside the uterus, start growing outside the organ, it is called endometriosis. Painful periods, pain during sex, pain while urinating or bowel movements, extreme bleeding, fatigue, infertility, diarrhea, bloating and nausea are some of the symptoms of endometriosis.

Treating endometriosis usually depends on the following factors

1. Age
2. Severity of symptoms
3. Severity of the disease
4. Future plans for children

Depending on these the doctor might opt for any of the following treatments

1. Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain killers like Nonsteroidal anti-inflammatory drugs. 
2. Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may come back. Some of the hormone therapies include: 
   • Hormonal Contraceptives: Birth control pills, vaginal rings and patches are useful in controlling the hormones that are responsible for tissue build-up outside the uterine cavity. 
   • Medroxyprogesterone: This drug stops menstruation, which in turn stops the tissue build-up and put an end to all the symptoms. But on the other hand, gaining weight, low bone production and depression are some of the common effects of this drug.
   • Gonadotropin-releasing hormone (Gn-RH) antagonists and agonists: Hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence prevent menstruation.
   • Danazol: This drug prevents menstruation and symptoms of endometriosis by blocking the hormones that stimulate the ovaries. However, Danazol may not be a favourable option because of its side effects. The drug should be avoided during pregnancy.
3. Conservative Surgery: If you are trying to get pregnant, but you already suffer from endometriosis, then removing endometriosis surgically is a viable solution. Your uterus and ovaries will be preserved, which might increase your chances of becoming pregnant. Even suffering from severe pain might find relief from conservative surgery.
4. Hysterectomy: In extreme cases, the only way to deal with the symptoms is to completely remove the uterus, ovaries and cervix. Since a hysterectomy means you cannot have children, it is kept as the last option for women in their reproductive age. If you wish to discuss about any specific problem, you can consult a gynaecologist.

Precocious puberty is a medical condition in which the process of a child turning into an adult i.e. puberty is initiated at an earlier stage than what is considered as normal. Certain characteristics like rapid growth of bones and muscles change the body structure, its ability to reproduce and manifest during puberty. If puberty is initiated before the age of 8 in girls and 9 in in case of boys, then it is a case of precocious puberty.

Causes
Studies to determine the actual cause as to why precocious puberty occurs have been inconclusive. In some cases, due medical conditions, such as hormonal disorders, brain abnormalities, brain tumor, and infections might cause precocious puberty. Generally medication is prescribed in such conditions to delay the process of puberty until later.

Symptoms
In case of girls, if you notice the below mentioned symptoms in a child who is about 8 years of age then it is a sign of precocious puberty:

• Breast Growth
• Menarche (First Period)

In case of boys if you notice the below mentioned symptoms in a child who is about 9 years of age then it is a sign of precocious puberty:

• Enlarged testicles and penis
• Facial hair
• Deepening voice

Also, there are few characteristics or traits which are common to both girls and boys and indicate precocious puberty if it occurs at an early age:

• Underarm hair or pubic hair
• Acne
• Rapid growth
• Adult body odor

Complications
Precocious puberty might induce a few complications. A few have been stated below:

Short height: Children who are suffering from precocious puberty in many cases grow taller at a quicker rate at first. This generally causes such children to be of below average height when they enter adulthood. By early diagnosis and treatment of precocious puberty, such a situation could be avoided and the child in question would be taller than he/she would if they did not undergo treatment.

Social and emotional problems: Children who undergo puberty before their peers can end up being self-conscious about their body, which may result in low self-esteem or in extreme cases substance abuse.

Treatment
Treatment of patients suffering from precocious puberty can be administered through medications like GnRH antagonist treatment. This is a monthly injection, which delays further development and has to be continued up to the point till normal puberty period sets in. If you wish to discuss about any specific problem, you can consult a Pediatrician.

When tissues that usually grow inside the uterus, start growing outside the organ, it is called endometriosis. Painful periods, pain during sex, pain while urinating or bowel movements, extreme bleeding, fatigue, infertility, diarrhea, bloating and nausea are some of the symptoms of endometriosis.

Treating endometriosis usually depends on the following factors

1. Age
2. Severity of symptoms
3. Severity of the disease
4. Future plans for children

Depending on these the doctor might opt for any of the following treatments

1. Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain killers like Nonsteroidal anti-inflammatory drugs. 
2. Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may come back. Some of the hormone therapies include: 
   • Hormonal Contraceptives: Birth control pills, vaginal rings and patches are useful in controlling the hormones that are responsible for tissue build-up outside the uterine cavity. 
   • Medroxyprogesterone: This drug stops menstruation, which in turn stops the tissue build-up and put an end to all the symptoms. But on the other hand, gaining weight, low bone production and depression are some of the common effects of this drug. 
   • Gonadotropin-releasing hormone (Gn-RH) antagonists and agonists: Hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence prevent menstruation. 
   • Danazol: This drug prevents menstruation and symptoms of endometriosis by blocking the hormones that stimulate the ovaries. However, Danazol may not be a favourable option because of its side effects. The drug should be avoided during pregnancy.
3. Conservative Surgery: If you are trying to get pregnant, but you already suffer from endometriosis, then removing endometriosis surgically is a viable solution. Your uterus and ovaries will be preserved, which might increase your chances of becoming pregnant. Even suffering from severe pain might find relief from conservative surgery. 
4. Hysterectomy: In extreme cases, the only way to deal with the symptoms is to completely remove the uterus, ovaries and cervix. Since a hysterectomy means you cannot have children, it is kept as the last option for women in their reproductive age. If you wish to discuss about any specific problem, you can consult a gynaecologist.