Hemoglobin

Hemoglobin

Red blood cells consist of hemoglobin

What is normal value of hemoglobin

The normal level of hemoglobin in men between 11.5 to 17.5 gm/deciliter of blood.

The normal level of hemoglobin in female between 12.0 to 15.5 gm/deciliter of blood.

Normal value of hemoglobin

• Newborn baby - 14 to 24 gm/ deciliter of blood
• Pregnant women - 11 to 12 gm/deciliter of blood 
• Adult male - 11.5 to 17.5 gm/deciliter of blood
• Adult female - 12.0 to 15.5 gm/deciliter of blood

What is dangerously low level of hemoglobin

Dangerously low level of hemoglobin is 7 gm/deciliter, that level of hemoglobin require blood transfusion for ICU patients.

Hemoglobin is made up of which molecules

Hemoglobin is made up of protein and non protein pigment. protein pigment is globin and non protein pigment is heme. Heme portion consist iron ion.

What is normal level of vitamin B12

The normal level of vitamin B12 is between 190 to 900 nanograms / milliliter.

How many hemoglobin molecules in a red blood cells

A red blood cells contains about 280 million hemoglobin molecules.

How does hemoglobin form

Hemoglobin molecule consists of a protein, called globin. Hemoglobin composed four polypeptide chain - two alpha polypeptide chain and two beta poly peptide chain.

Hemoglobin contain a ring like non-protein pigment, called heme. heme is bound each of the four polypeptide chains. At the center of heme ring is an iron ion that can combine reversibly with only one oxygen molecule.

How many oxygen molecules will be bind to a hemoglobin molecule

Each hemoglobin molecule binds four molecules of oxygen.

What is the function of hemoglobin in blood

Hemoglobin has a property that it can bind oxygen or carbon di-oxide. Hemoglobin also known as oxygen carrying protein.  Hemoglobin play a important role in transporting oxygen and carbon di-oxide. hemoglobin transport oxygen to the cells. hemoglobin also transport carbon di-oxide from the cells. 

Hemoglobin also play a vital role in regulation of blood flow and blood pressure.

Epithelial cells that line blood vessels released gaseous hormone nitric oxide. Nitric oxide binds to hemoglobin. Nitric oxide cause vasodilation. Vasodilation improve blood flow. Nitric oxide is increase in blood vessels diameter.

  

What is carbamino-hemoglobin 

Hemoglobin that has bound carbon di-oxide is term known as carbaminohemoglobin.

What is oxy-hemoglobin

Hemoglobin that has bound oxygen is term known as oxyhemoglobin

What is hemoglobin lifetime or cycle

The lifetime of hemoglobin is about 120 days.

What is the function of dead hemoglobin in the body

Macrophages in the spleen, bone-marrow or liver by phagocytize ruptured or dead red blood cells. The heme and globin portion of hemoglobin are split apart.

Globin break down into amino acids which can be reused in synthesized some different proteins. Iron separated from heme portion of hemoglobin, in the form of Fe(+++) and it comes back to the blood stream by the help of transporter transferrine.

 

What is the non-iron portion heme

Non-iron portion of heme is called biliverdin which is a green pigment. biliverdin converted into bilirubin, which is a yellow pigment. bilirubin is also released by liver cells in bile. 

Which disease are caused by hemoglobin deficiency

Lack of hemoglobin can cause a lot of different types of disease. 

Disease cause by deficiency of hemoglobin are following-

Hypoxia - Hypoxia also known as cellular oxygen deficiency. decrease amount of oxygen delivered to body tissues.

Anemia - Anemia has many causes lack of certain amino acids, lack of iron and lack of vitamin B12.

Deficiency of iron cause following disease :

• Anemia - iron deficiency anemia
• Excessive menstrual blood loss
• Restless legs syndrome
• Learning disabilities
• Hearing disabilities
• Impaired immune functions
• Tinnitus
• Delayed growth in infants
• Hair loss
• Complication during pregnancy
• Irregular heartbeat

Deficiency of vitamin B12 (Cyanocobalamin) cause of following disease :

• Fatigue
• Weakness
• Rapid heartbeat
• Pernicious anemia
• Pale or jaundiced skin
• Sensation of needles or pins
• Lack of Intrinsic factor

Which disease are caused by increased level of hemoglobin

• Polycythemia cera
• Emphysema
• Chronic obstructive pulmonary disease (COPD)
• Renal cancer
• Hepatic cancer
• Dehydration
• Heart failure
• Other many lung disease
• Other  many heart disease

What can cause  sudden drop of hemoglobin level

Many diseases such as cancer, liver and kidney complications can cause suddenly decrease hemoglobin levels.

What is the best treatment for low level of hemoglobin

Intake vitamin C containing food  are -

• Citrus fruits example - orange and grapefruit
• Kiwi 
• Pineapple
• Mango
• Papaya   
• Strawberry 
• Raspberry
• Watermelon 
• Blueberry  
• Vegetable rich in vitamin C such as 

                               - Cantaloupe

                               - Broccoli

                               - Cauliflower

                               - Green bell peppers 

                               - Kale

Eat Iron rich containing food are -

• Spinach 
• Pumpkin seed
• Masa
• Cuttlefish 
• Mung bean
• Chickpea
• Semolina 
• Oysters 
• Cocoa bean
• Lentil
• Tofu
• Sunflower seed 
• Soybean
• Almond 
• Peanut 

Folic acid containing food

• Rice
• Cornmeal
• Semolina

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TREATMENT AND PREVENTION FOR JAUNDICE

TREATMENT AND PREVENTION FOR JAUNDICE

Jaundice is yellowish discoloration of the skin, sclera and mucous membranes due to hyper bilirubinemia and deposition of bile pigments.

PREVENTION FOR JAUNDICE

Due to the wide range of potential causes, it's not possible to prevent all cases of jaundice. However, there are four main precautions that you can take to minimize your risk of developing jaundice. 

They are Following - 

Ensuring that you stick to the recommended daily amount (RDA) for alcohol consumption. 

Maintaining a healthy weight for your height and build.

If appropriate, ensuring that you're vaccinated against a hepatitis A or B infection, vaccination would usually only be recommended depending on where in the world you're travelling.

Minimizing your risk of exposure to hepatitis C because there's currently no vaccine for the condition.

TREATMENT FOR JAUNDICE

Treatment depends on the cause of the underlying condition leading to jaundice and any potential complications related to it. Once a diagnosis is made, treatment can then be directed to address that particular condition, and it may or may not require hospitalization. 

Treatment may consist of expectant management (watchful waiting) at home with rest. 

Medical treatment with intravenous fluids, medications, antibiotics, or blood transfusions may be required.

If a drug/toxin is the cause, these must be discontinued.

In certain cases of newborn jaundice, exposing the baby to special colored lights (phototherapy) or exchange blood transfusions may be required to decrease elevated bilirubin levels.

Surgical treatment may be required in case of obstruction jaundice.

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Complete Detail : Jaundice Type Symptoms Causes Diagnostic Test Prevention Treatment

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WHEN JAUNDICE DEVELOP DURING PREGNANCY

WHEN JAUNDICE DEVELOP DURING PREGNANCY

Jaundice is yellowish discoloration of the skin, sclera and mucous membranes due to hyper bilirubinemia and deposition of bile pigments.

Most of the diseases discussed previously can affect women during pregnancy, but there are some additional causes of jaundice that are unique to pregnancy.

CHOLESTASIS OF PREGNANCY

Cholestasis of pregnancy is an uncommon condition that occurs in pregnant women during the third trimester. The cholestasis often is accompanied by itching but infrequently causes jaundice. The itching can be severe, but can be treated with drugs (ursodeoxycholic acid or ursodiol [Actigall, Urso]).

There also is an association between cholestasis of pregnancy and cholestasis caused by oral estrogens, and it has been hypothesized that it is the increased estrogens during pregnancy that are responsible for the cholestasis of pregnancy.

PRE ECLAMPSIA

Pre-eclampsia, previously called toxemia of pregnancy, is a disease that occurs during the second half of pregnancy and involves several systems within the body, including the liver. It may result in high blood pressure, fluid retention, and damage to the kidneys as well as anemia and reduced numbers of platelets (thrombocytopenia) due to destruction of red blood cells and platelets. It often causes problems in the fetus. Although the bilirubin level in the blood is elevated in pre-eclampsia, it usually is mildly elevated, and jaundice is uncommon. 

ACUTE FATTY LIVER OF PREGNANCY

Acute fatty liver of pregnancy (AFLP) is a very serious complication of pregnancy. The cause of AFLP is unclear, but is often associated with pre-eclampsia. It occurs late in pregnancy and results in failure of the liver. It can almost always be reversed by immediate delivery of the fetus. There is an increased risk of infant death. Jaundice is common, but is not always present in AFLP.

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Complete Detail : Jaundice Type Symptoms Causes Diagnostic Test Prevention Treatment

================================================================

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Diagnostic Test for Jaundice

Test For Jaundice

Jaundice is yellowish discoloration of the skin, sclera and mucous membranes due to hyper bilirubinemia and deposition of bile pigments.

The registered medical practitioner or doctor will perform a physical exam. This may reveal liver swelling.

1. - A bilirubin blood test will be done. 
2. - Other tests vary, but may include.

• Hepatitis virus panel to look for infection of the liver.
• Liver function tests to determine how well the liver is working.
• Complete blood count to check for low blood count or anemia.
• Abdominal ultrasound.
• Abdominal CT scan.
• Endoscopic retrograde cholangiopancreatography (ERCP).
• Percutaneous transhepatic cholangiogram (PTCA).
• Liver biopsy.
• Cholesterol level.
• Prothrombin time.

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Complete Detail : Jaundice Type Symptoms Causes Diagnostic Test Prevention Treatment

================================================================

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Causes of Jaundice

Causes of Jaundice

Jaundice is yellowish discoloration of the skin, sclera and mucous membranes due to hyper bilirubinemia and deposition of bile pigments.

Some following reason develop jaundice -

Too much bilirubin being produced for the liver to remove from the blood.

For example, patients with hemolytic anemia have an abnormally rapid rate of destruction of their red blood cells that releases large amounts of bilirubin into the blood.

A defect in the liver that prevents bilirubin from being removed from the blood, converted to bilirubin/glucuronic acid (conjugated) or secreted in bile.

Blockage of the bile ducts that decreases the flow of bile and bilirubin from the liver into the intestines. For example, the bile ducts can be blocked by cancer, gallstones, or inflammation of the bile ducts. The decreased conjugation, secretion, or flow of bile that can result in jaundice is referred to as cholestasis: however, cholestasis does not always result in jaundice.

================================================================

Complete Detail : Jaundice Type Symptoms Causes Diagnostic Test Prevention Treatment

================================================================

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Symptoms of Jaundice

Symptoms of Jaundice

Jaundice is yellowish discoloration of the skin, sclera and mucous membranes due to hyper bilirubinemia and deposition of bile pigments.

Common signs and symptoms seen in individuals with jaundice include : -

• Yellow discoloration of the skin
• Mucous membranes
• The white part of the eyes becomes yellow 
• Light-colored stools
• Dark-colored urine
• Itching of the skin
• Nausea and vomiting
• Abdominal pain
• Fever
• Weakness
• Loss of appetite
• Headache
• Confusion
• Swelling of the legs and abdomen

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Complete Detail : Jaundice Type Symptoms Causes Diagnostic Test Prevention Treatment

================================================================

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Types of Jaundice

Type Of Jaundice

Jaundice is mainly three types -

Pre-Hepatic / Hemolytic Jaundice

Excessive amount of bilirubin is presented to the liver due to excessive haemolysis, in pre-hepatic jaundice. Elevated un-conjugated bilirubin in serum. During pre-hepatic jaundice, haemolytic anemia develops.

Urine color - Normal

Stool color - Normal

Pruritus  - No

Hepatic Jaundice

Impaired cellular uptake, defective conjugation or abnormal secretion of bilirubin by the liver cell. Both conjugated and un-conjugated  bilirubin may be elevated in serum.

Symptoms 

Hepatitis
Cirrhosis
Crigler-Najjar Syndrome
Dubin-Johnson Syndrome
Rotor’s Syndrome

Diagnostic Test result -

Urine color - Dark
Stool color - Normal 
Pruritus - No

Post hepatic / Obstructive/ Surgical jaundice

Obstructive jaundice caused by following factors :-

1. Failure of hepatocyte to initiates bile flow.
2. Obstruction of bile flow in the bile duct or portal tracts.
3. Obstruction of bile flow in the extra-hepatic bile duct.
4. Bilirubin formation rate is normal.
5. Conjugation is normal equal to direct bilirubin.

Symptoms 

Gallstone

Malignancy

Inflammation

Diagnostic Test result 

Urine color - Dark

Stool color - Acholic

Pruritus - Yes

Some other type of Jaundice-

Pathologic Jaundice

Pathologic jaundice can occur in children and adults and is diagnosed when jaundice presents a health risk. Several forms of hepatitis, cirrhosis of the liver and other liver diseases, bile duct blockage, along with infections and medications, can also cause pathological jaundice.

Gilbert Syndrome jaundice

Gilbert's syndrome is a harmless hereditary condition that results in mild jaundice. During times of illness or stress, people with Gilbert's syndrome will experience low levels of some bilirubin-processing enzymes in their livers. Once diagnosed, Gilbert's syndrome does not require further medical treatment.

Obstructive Jaundice

Obstructive jaundice caused by following factors :-

• Failure of hepatocyte to initiates bile flow.
• Obstruction of bile flow in the bile duct or portal tracts.
• Obstruction of bile flow in the extra-hepatic bile duct.
• Bilirubin formation rate is normal.
• Conjugation is normal equal to direct bilirubin.

Neonatal Jaundice

Jaundice is clinically detectable in the newborn when the serum bilirubin levels are greater than 85 μmol/L. This occurs in approximately 60% of term infants and 80% of preterm infants.

Neonatal jaundice first becomes visible in the face and forehead. Blanching reveals the underlying color. Jaundice then gradually becomes visible on the trunk and extremities.

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Complete Detail : Jaundice Type Symptoms Causes Diagnostic Test Prevention Treatment

================================================================

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What is Bilirubin and Normal Range

Bilirubin

Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. The breakdown product of Hgb from injured RBCs and other heme containing proteins. Bilirubin produced by reticulo-endothelial system. Bilirubin released to plasma bound to albumin. Hepatocytes conjugate it and excrete through bile channels into small intestine.

Causes of increase Bilirubin

Bilirubin overproduce by reticulo-endothelial system. Bilirubin failure uptake from hepatocyte. Bilirubin failure to conjugate or excrete. Obstruction of biliary excretion into intestine. 

Normal range of Bilirubin

Direct (also called conjugated) bilirubin: 0 to 0.3 mg/dL

Total bilirubin: 0.3 to 1.9 mg/dL

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Complete Detail : Jaundice Type Symptoms Causes Diagnostic Test Prevention Treatment

================================================================

Read More

What Is Jaundice

Jaundice

Jaundice is yellowish discoloration of the skin, sclera and mucous membranes due to hyper   bilirubinemia and deposition of bile pigments. Equilibrium between bilirubin production and clearance is disturbed. Serum bilirubin level greater than 2mg/dL. Jaundice is NOT a disease, but rather a sign that can occur in many different diseases.

================================================================

Complete Detail : Jaundice Type Symptoms Causes Diagnostic Test Prevention Treatment

================================================================

Read More

Jaundice Type Symptoms Causes Diagnostic Test Prevention Treatment

Jaundice

Jaundice is yellowish discoloration of the skin, sclera and mucous membranes due to hyper bilirubinemia and deposition of bile pigments. Equilibrium between bilirubin production and clearance is disturbed. Serum bilirubin level greater than 2mg/dL. Jaundice is NOT a disease, but rather a sign that can occur in many different diseases.

What is Bilirubin

Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. The breakdown product of Hgb from injured RBCs and other heme containing proteins. Bilirubin produced by reticulo-endothelial system. Bilirubin released to plasma bound to albumin. Hepatocytes conjugate it and excrete through bile channels into small intestine.

What causes increase Bilirubin

Bilirubin overproduce by reticulo-endothelial system. Bilirubin failure uptake from hepatocyte. Bilirubin failure to conjugate or excrete. Obstruction of biliary excretion into intestine. 

What is normal range of Bilirubin

Direct (also called conjugated) bilirubin: 0 to 0.3 mg/dL

Total bilirubin: 0.3 to 1.9 mg/dL

How many types of Jaundice

Jaundice is mainly three types -

1. Pre hepatic / Hemolytic jaundice
2. Hepatic jaundice
3. Post hepatic / Obstructive/ Surgical jaundice

Some other type of jaundice - 

• Pathologic Jaundice 
• Gilbert Syndrome jaundice 
• Obstructive Jaundice 
• Neonatal Jaundice 

What is symptoms of Jaundice

Common signs and symptoms seen in individuals with jaundice include : -

• Yellow discoloration of the skin
• Mucous membranes
• The white part of the eyes becomes yellow 
• Light-colored stools
• Dark-colored urine
• Itching of the skin
• Nausea and vomiting
• Abdominal pain
• Fever
• Weakness
• Loss of appetite
• Headache
• Confusion
• Swelling of the legs and abdomen

What is the causes of Jaundice

Some following reason and causes of develop jaundice -

• Too much bilirubin being produced for the liver to remove from the blood (for example, patients with hemolytic anemia have an abnormally rapid rate of destruction of their red blood cells that releases large amounts of bilirubin into the blood)
• A defect in the liver that prevents bilirubin from being removed from the blood, converted to bilirubin/glucuronic acid (conjugated) or secreted in bile.
• Blockage of the bile ducts that decreases the flow of bile and bilirubin from the liver into the intestines. For example, the bile ducts can be blocked by cancer, gallstones, or inflammation of the bile ducts. The decreased conjugation, secretion, or flow of bile that can result in jaundice is referred to as cholestasis: however, cholestasis does not always result in jaundice.

Which diagnostic test for Jaundice

The registered medical practitioner or doctor will perform a physical exam. This may reveal liver swelling.

- A bilirubin blood test will be done. - Other tests vary, but may include:

• Hepatitis virus panel to look for infection of the liver
• Liver function tests to determine how well the liver is working
• Complete blood count to check for low blood count or anemia
• Abdominal ultrasound
• Abdominal CT scan
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Percutaneous transhepatic cholangiogram (PTCA)
• Liver biopsy
• Cholesterol level
• Prothrombin time

Can we prevent Jaundice

Due to the wide range of potential causes, it's not possible to prevent all cases of jaundice. However, there are four main precautions that you can take to minimize your risk of developing jaundice. They are Following - 

1. Ensuring that you stick to the recommended daily amount (RDA) for alcohol consumption. 
2. Maintaining a healthy weight for your height and build.
3. If appropriate, ensuring that you're vaccinated against a hepatitis A or B infection, vaccination would usually only be recommended depending on where in the world you're travelling.
4. Minimizing your risk of exposure to hepatitis C because there's currently no vaccine for the condition.

What is treatment for Jaundice

Treatment of Jaundice depends on the cause of the underlying condition leading to jaundice and any potential complications related to it. Once a diagnosis is made, treatment can then be directed to address that particular condition, and it may or may not require hospitalization. 

• Treatment may consist of expectant management (watchful waiting) at home with rest. 
• Medical treatment with intravenous fluids, medications, antibiotics, or blood transfusions may be required.
• If a drug/toxin is the cause, these must be discontinued. 
• In certain cases of newborn jaundice, exposing the baby to special colored lights (phototherapy) or exchange blood transfusions may be required to decrease elevated bilirubin levels.
• Surgical treatment may be required in case of obstruction jaundice.

What is pre hepatic Jaundice

Excessive amount of bilirubin is presented to the liver due to excessive haemolysis, in pre-hepatic jaundice. Elevated un-conjugated bilirubin in serum. During pre-hepatic jaundice, haemolytic anemia develops. 

• Urine color - Normal 
• Stool color - Normal 
• Pruritus  - No

What is hepatic jaundice

Impaired cellular uptake, defective conjugation or abnormal secretion of bilirubin by the liver cell. Both conjugated and un-conjugated  bilirubin may be elevated in serum.

Symptoms 

• Hepatitis
• Cirrhosis
• Crigler-Najjar Syndrome
• Dubin-Johnson Syndrome
• Rotor’s Syndrome

Diagnostic Test result - 

• Urine color - Dark
• Stool color - Normal 
• Pruritus - No

What is post-hepatic jaundice

Impaired excretion due to mechanical obstruction to bile flow. Elevated conjugated bilirubin in serum. 

Symptoms 

• Gallstone
• Malignancy
• Inflammation

Diagnostic Test result -

• Urine color - Dark
• Stool color - Acholic
• Pruritus - Yes

When jaundice develop during pregnancy

Most of the diseases discussed previously can affect women during pregnancy, but there are some additional causes of jaundice that are unique to pregnancy.

Cholestasis of Pregnancy

Cholestasis of pregnancy is an uncommon condition that occurs in pregnant women during the third trimester. The cholestasis often is accompanied by itching but infrequently causes jaundice. The itching can be severe, but can be treated with drugs (ursodeoxycholic acid or ursodiol [Actigall, Urso]).

There also is an association between cholestasis of pregnancy and cholestasis caused by oral estrogens, and it has been hypothesized that it is the increased estrogens during pregnancy that are responsible for the cholestasis of pregnancy.

Pre Eclampsia

Pre-eclampsia, previously called toxemia of pregnancy, is a disease that occurs during the second half of pregnancy and involves several systems within the body, including the liver. It may result in high blood pressure, fluid retention, and damage to the kidneys as well as anemia and reduced numbers of platelets (thrombocytopenia) due to destruction of red blood cells and platelets. It often causes problems in the fetus. Although the bilirubin level in the blood is elevated in pre-eclampsia, it usually is mildly elevated, and jaundice is uncommon. 

Acute fatty liver of pregnancy

Acute fatty liver of pregnancy (AFLP) is a very serious complication of pregnancy. The cause of AFLP is unclear, but is often associated with pre-eclampsia. It occurs late in pregnancy and results in failure of the liver. It can almost always be reversed by immediate delivery of the fetus. There is an increased risk of infant death. Jaundice is common, but is not always present in AFLP.

What is Pathologic Jaundice

Pathologic jaundice can occur in children and adults and is diagnosed when jaundice presents a health risk. Several forms of hepatitis, cirrhosis of the liver and other liver diseases, bile duct blockage, along with infections and medications, can also cause pathological jaundice.

What is Obstructive Jaundice

Obstructive jaundice caused by following factors :-

• Failure of hepatocyte to initiates bile flow.
• Obstruction of bile flow in the bile duct or portal tracts.
• Obstruction of bile flow in the extrahepatic bile duct.
• Bilirubin formation rate is normal.
• Conjugation is normal equal to direct bilirubin.

What is Gilbert syndrome Jaundice

Gilbert's syndrome is a harmless hereditary condition that results in mild jaundice. During times of illness or stress, people with Gilbert's syndrome will experience low levels of some bilirubin-processing enzymes in their livers. Once diagnosed, Gilbert's syndrome does not require further medical treatment. 

What is Neonatal Jaundice

Jaundice is clinically detectable in the newborn when the serum bilirubin levels are greater than 85 μmol/L. This occurs in approximately 60% of term infants and 80% of preterm infants. 

Neonatal jaundice first becomes visible in the face and forehead. Blanching reveals the underlying color. Jaundice then gradually becomes visible on the trunk and extremities.

Read More