Hematology focuses on diseases of the blood, bone marrow, and lymphatic system. Learn about the diagnosis and treatment of anemia, leukemia, and lymphoma.
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The landscape of hemophilia treatment has advanced dramatically. The standard of care has shifted from reactive treatment (treating bleeds after they occur) to prophylaxis (preventative treatment). The goal of modern management at Liv Hospital is to convert a severe phenotype into a mild one, preventing spontaneous bleeding and protecting joint health. Treatment is highly personalized, involving hematologists, specialized nurses, physical therapists, and orthopedists.
The primary treatment involves injecting the missing clotting factor (VIII for Hemophilia A, IX for Hemophilia B) directly into the bloodstream.
These are genetically engineered in a lab and do not use human plasma. They are the safest option as they eliminate the risk of blood-borne viruses.
These are made from donated human blood. While modern screening and viral inactivation processes make them safe, recombinant products are generally preferred.
This involves the regular infusion of clotting factor (e.g., 2 to 3 times a week) to keep factor levels high enough to prevent spontaneous bleeding.
The aim is to preserve joint function and allow the patient to lead a normal, active life. It is the gold standard for children with severe hemophilia.
Newer factor concentrates have been modified to last longer in the body.
EHL products allow patients to inject less frequently (e.g., once a week or every two weeks depending on the type) while maintaining protective levels, significantly reducing the treatment burden.
For Hemophilia A, a revolutionary treatment called Emicizumab (Hemlibra) is available. It mimics the function of Factor VIII.
Unlike factor concentrates which must be injected into a vein, this medication is injected under the skin (subcutaneous) and can be given as rarely as once a month. It is effective even for patients with inhibitors.
For patients who develop inhibitors, ITI involves giving high doses of factor daily to “teach” the immune system to tolerate it.
When standard factor doesn’t work due to inhibitors, bypassing agents (like FEIBAs or recombinant Factor VIIa) are used. These bypass the missing step in the clotting cascade to form a clot through an alternative route.
Gene therapy represents the frontier of hemophilia management. It involves using a viral vector to deliver a functional copy of the Factor VIII or IX gene into the patient’s liver cells.
If successful, the liver begins to produce the clotting factor on its own, potentially eliminating the need for regular infusions for years. This therapy is currently available for select adults with severe hemophilia.
Desmopressin is a synthetic hormone that stimulates the release of stored Factor VIII from the body’s cells.
It can be given as a nasal spray or injection. It is useful for treating minor bleeds in patients with mild Hemophilia A but is ineffective for severe cases or Hemophilia B.
In addition to factor replacement, acute joint bleeds are managed with Rest, Ice, Compression, and Elevation to reduce pain and swelling.
Medications like tranexamic acid help hold a clot in place once it has formed. They are particularly useful for dental procedures or mouth bleeds but are often used in conjunction with factor replacement.
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A urologist is a surgeon trained to treat conditions of the urinary tract in both men and women. A urogynecologist has specific training in female pelvic medicine and reconstructive surgery, focusing on conditions like bladder prolapse and female incontinence.
The bladder lining (urothelium) has a high regenerative capacity and heals quickly after minor trauma or infection. However, the muscle layer (detrusor) does not regenerate well. If the muscle is damaged by chronic overdistention or fibrosis, the loss of function is often permanent.
Yes, psychological stress can exacerbate bladder symptoms. The bladder has many nerve receptors sensitive to stress hormones. “Stress incontinence” refers to physical pressure (coughing/sneezing), but anxiety can trigger “urgency” and frequency, mimicking Overactive Bladder symptoms.
Yes, the bladder’s functional capacity tends to decrease with age. Furthermore, the elasticity of the bladder wall reduces, and the kidneys produce more urine at night (nocturnal polyuria), leading to increased nighttime urination in older adults.
Neurogenic bladder is a term used when the nerve control of the bladder is disrupted due to a brain, spinal cord, or nerve condition (like diabetes or MS). This can cause the bladder to either be unable to hold urine (incontinence) or unable to empty it (retention).
Hemophilia is a genetic disorder that makes it hard for blood to clot. It’s often found in newborns. About 1 in 5,000 male births are
Hemophilia B, also known as “Christmas disease,” is a rare genetic disorder. It affects the blood’s ability to clot, leading to prolonged bleeding. At Liv
Hemophilia is a rare bleeding disorder found in about 1 in 10,000 people worldwide. It can greatly affect individuals and their families. It leads to
Hemophilia is a rare bleeding disorder. It makes it hard for the body to form blood clots. This can lead to long-lasting bleeding, which can
A rare genetic disorder makes it hard for the body to form blood clots. This is key to stopping bleeding. It leads to prolonged or
Hemophilia is often seen as a birth defect. But, it can also appear later in life. This rare form, called acquired hemophilia A (AHA), happens
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