fitness
 Be an iron man
Anaemia can cause some serious health problems. A healthy and iron-rich diet can prevent this condition

We sometimes find people commenting how pale we look or how tired our face looks. We may feel unhappy at these negative comments and on thinking we do realise how fatigued we feel in reality, irritated as we are most of the time of the day. A physical examination tells us our nails aren't growing; seem pale, fragile and brittle. And then we head to a doctor who diagnoses the symptoms as signs of anaemia. Ignorant towards the disadvantages of being anaemic we continue to be careless, till we land up losing consciousness on one day and are rushed to a clinic. Blood tests show the blood haemoglobin is not just less than 12, which is the lower end of the reference range, but even less than 10 that can have serious consequences. But why go through all this drama when a healthy diet regimen is your key.


For better absorption of iron in the body include foods having vitamin C 

Most meats, especially liver, are rich sources of iron 

Green leafy vegetables like spinach are a good source of iron

Dates are rich in iron

Let us understand briefly what anaemia is. Anaemia is characterised by lower than normal red blood cells (RBCs) or haemoglobin in the blood. Anaemia for men is defined as haemoglobin less than 14g/100ml and for women less than 12g/100ml.

Anaemia can be caused either due to lack of production of RBCs in the bone marrow or over-destruction of RBCs through some processes. There are various causes of anaemia apart from the most known - iron deficiency. Following are some causes of anaemia.

  • Stomach ulcers and colon cancers are one of the common ailments that cause internal bleeding leading to loss of iron.

  • Certain medicines such as aspirin and ibuprofen also cause gastric and intestinal bleeding leading to the loss of iron.

  • Anaemia due to iron deficiency is one of the most common and known causes of anaemia since iron forms a part of the haemoglobin molecule structure. Inadequate iron would result in insufficient haemoglobin synthesis and thus anaemia.

  • Another cause of anaemia that we mostly overlook is vitamin B12 deficiency leading to pernicious anaemia. Vitamin B12 is synthesised in the stomach and any hampering to its absorption in the abdomen would cause abnormal synthesis and absorption of vitamin B12. This vitamin plays an important role in building the structure of 'heme' which is a part of haemoglobin. Deficiency of which would cause inadequate haemoglobin formation and thus anaemia.

  • Folic-acid deficiency can also be responsible for causing anaemia since folate also plays a role in the structure of heme.

  • Haemolytic anaemia involves destruction of RBCs by the body's own immune system antibodies. This is generally seen in infants suffering from haemolytic disease of the new born, blood transfusions, organ transplants, auto-immune responses etc.

  • Our kidneys are the organs involved in the production of hormone erythropoietin. Erythropoietin is responsible for the production of RBCs. Hence any damage to the kidneys or kidney failure will cause lesser production of RBC's and subsequent anaemia.

  • Other causes include chronic alcoholism, certain cancers, infections, destruction to the bone marrow where RBCs are produced, chemotherapy and HIV.

Signs and symptoms of anaemia

The most common symptom of anaemia is fatigue (feeling tired or weak). If you have anaemia, you may find it hard to find the energy to do normal activities. Other signs and symptoms of anaemia include:


Fatigue and pale skin are most common symptoms of anaemia 

  • Shortness of breath

  • Dizziness

  • Headache

  • Coldness in the hands and feet

  • Pale skin

  • Chest pain

These signs and symptoms can occur because your heart has to work harder to pump oxygen-rich blood through your body. Mild to moderate anaemia may cause very mild symptoms or none at all.

Complications

  • Some people who have anaemia may have arrhythmias. Arrhythmias are problems with the rate or rhythm of the heartbeat. Over time, arrhythmias can damage your heart and possibly lead to heart failure.

  • Anaemia also can damage other organs in your body because your blood can't get enough oxygen to them.

  • Anaemia can weaken people who have cancer or HIV/AIDS. This can make their treatments not work as well.

  • Anaemia also can cause many other health problems. People who have kidney disease and anaemia are more likely to have heart problems. With some types of anaemia, too little fluid intake or too much loss of fluid in the blood and body can occur. Severe loss of fluid can be life threatening.

 


In a heartbeat
 As many as 1,75,000 newborn babies are born with heart defects in India every year
Dr Vikas Kohli

The most common birth defect seen in infants and newborns are related to the heart. The abnormality is seen in almost one in 100 pregnancies. As many as 1,75,000 children are born in India each year with this problem. At least 30 per cent of these babies will die if not treated before their first year. The diagnosis maybe made during pregnancy if an ultrasound detects the problem early.

A child with a congenital heart disease may take too long to feed and may sweat while feeding. The baby may not gain weight
A child with a congenital heart disease may take too long to feed and may sweat while feeding. The baby may not gain weight 

After birth, the diagnosis usually involves a paediatric doctor hearing a heart murmur that happens to be an abnormal heart sound. Once suspected, a cardiologist performs an echocardiogram to confirm whether the murmur is abnormal or innocent. Innocent murmur is the murmur in which the heart is innocent and normal and which doesn't require immediate treatment or surgery.

There are two main types of heart diseases — one in which the baby turns blue and the other doesn't turn blue. Almost all conditions in which the baby turns blue require surgical treatment. For others, surgery may not be required at times. It may be treatable by non-surgical methods such as balloon angioplasty or device closure. In the other condition the more common defect of the heart involves a "hole in the heart". An isolated hole in the heart which could be a ventricular or atrial defect would require immediate treatment.

The common problems in children include a hole between the lower chambers called ventricular septal defect (VSD). The wall between the upper atrial septal defect and lower VSD chambers separates red blood from the blue blood. A hole would result in extra blood flow to the lungs. This makes the child prone to more chest infections. The child gains weight with difficulty and feeding also becomes a problem.

On the other hand child could be blue when in addition to a hole in heart there is a blockage of blood flow to the lungs. This is the common condition in which the baby becomes blue. Such conditions always require surgery. Other defects in which the child becomes blue includes when the red blood from lung with oxygen drains abnormally into the blue blood. Or the tubes coming out of the heart carrying red and blue blood get switched where body receives blue blood wrongly and the lungs get red blood. These conditions usually require a single operation and the child becomes normal. Finally, in the condition when one of the valves or of the pump is not normal then child requires more than one operation in lifetime. It may affect the quality of life or the life span. Children may show many symptoms when they have a birth heart defect, which parents may recognise as being abnormal. Most common symptoms in congenital heart disease include:

  • A child may take too long to feed and may sweat while feeding, or may not gain weight in spite of feeding. The child also may have a faster breathing rate.

  • Sometimes, child may gradually become bluer and reach a point where toddler may not be able to walk.

  • Occasionally more in the new-born age group a child may present as an emergency when the presentation may vary between a very blue baby, a baby with low blood pressure or in shock or a baby with very rapid breathing or breathing difficulty.

  • Older children may present with fainting episode which may be the only indicator of a major underlying heart problem. This is referred to as an acute life-threatening heart problem. These are electrical problems of the heart. A small child may not be able to verbalise what the problem is.

  • Sometimes the heart disease may not be picked up till late in life and such presentations are called adult presentation of congenital heart disease.

With the current technology, the early diagnosis can be made of heart disease in the 18th week of pregnancy. This test is called foetal echocardiogram. Specialised heart ultrasound machines are used for this test with advanced features like spatio-temporal image correlation (STIC) or fetal cardiac intervention. Once the diagnosis is made the family can be counselled for future treatment.

The writer is director, BLK Children Heart Institute, New Delhi





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