Melomed Articles

14 February 2019 - Dr. Shahroch Narhwar

What is Haematology?

Haematologists are physicians specialized in haematology (study of blood diseases) 

Their routine work mainly includes diagnosis and treating patients with blood diseases:
  • Lack of red blood cells is anaemia (too little red blood cells or haemoglobin causing fatigue or abnormal tiredness). Affects more than a third of the world population of which more than half due to iron deficiency because of parasites (world-wide) and heavy periods and colon cancer in SA and other first world countries. Haemoglobin is the protein in our red blood cells bound to iron that transports oxygen in the blood because only very little oxygen can dissolve in plasma.
  • Sickle Cell Anaemia (abnormal haemoglobin causing misshapen blood cells able to occlude blood vessels affecting millions of young people originating from  central Africa)
  • Thalassemia (caused by one of the most common world-wide genetic mutations in  hundreds of millions of people with underproduction of haemoglobin leading to various degrees of anaemias, enlarged spleen and abnormal bone due to abnormal expansion of bone marrow in hundreds of thousands of children)
  • G6PD-deficiency (caused by the most common genetic mutation world-wide affecting hundreds of millions of mainly boys/men causing fragile red blood cells).
  • Lack of white blood cells (immune cells) or antibodies causing infections.
  • Lack of platelets (cells that form plugs in injured blood vessels) causing bleeding.
  • Lack of coagulation or clotting factors (proteins that form clot around platelet plug).      Haemophilia A (more than B) affects 1:7500 sons world-wide leading to various degrees of severity of bleeding in the joints, muscles and brain lacking clotting factor VIII. Von Willebrand's disease is the most common genetic blood clotting problem affecting 1% of all people (however only causing significant bleeding in 1% of all patients also affecting women.
  • Abnormal clotting: Deep venous thromboses occur in 15% of all hospitalized patients!     
  • Reticuloendothelial system comprises of the bone marrow (factory of all blood cells), spleen (organ that filters old blood cells and fights bloodstream infections and liver, the biggest organ that detoxifies your body).   
  • Lymphatic system (lymph nodes, lymph vessels and lymph fluid) is the home for the white cells in every single tissue or organ of the body!
  • Haematological malignancies/cancer of blood, reticuloendothelial and lymphatic system causing about 10% of all new cancers per year (about 14 million new cases per year and increasing) leading to 8% of all cancer deaths ( 8 million per year and increasing)  (world-wide and ranking about 10 of top 20 cancer deaths in SA with about 40000 dying per year. Half of them are wide-spread at diagnosis but with more than ⅔ survival rates which is better than compared with any other wide-spread cancer

  • TREATMENT of blood diseases:
  • Diet
  • Iron deficiency ( for example, meat, poultry, fish, vitamin C in high doses, destroyed by over-cooking ; organic acids like citric acid, tartaric acid, lactic acid, alcohol enhance iron absorption; while phytates in cereal bran,  cereals incl. rice, polyphenols (tannins),  coffee,  tea,  cocoa, calcium in  milk( products), oxalic acid in spinach decrease iron absorption).
  • Vegans need monthly vitamin B12 intramuscular injections (too little vitamin B12 in plants).
  • Increased fluid-intake requirements while receiving chemotherapy to flush the drug through the kidneys and too thin blood/plasma in patients with thick blood or plasma
  • Vitamin K (four clotting factors depend on it; mainly made by bacteria in the gut).
  • Oral medication - tablets or liquid medicines (like for any other condition).
  • Antiplatelet therapy (to thin the blood): aspirin or Ecotrin and clopidogrel for mainly artery calcification causing heart attacks and strokes.  
  • Anticoagulation therapy (to thin the plasma):heparin,warfarin, Clexane, Xarelto, Pradaxa prevent worsening of clots in the legs and lungs or prevent stroke by irregular heartbeat.
  • Chemotherapy (against cancer).

  • Intramuscular injections (for example, vitamin B12 injections, antibiotics, chemotherapy and vaccinations or immunizations)
  • Intravenous blood transfusions (blood products like red blood cells, platelets and plasma) (donated blood is very safe with less than a million chance of contracting HIV)
  • Chemotherapy (chemicals that kill all fast dividing cells with possible hair loss, drying and peeling of the skin, nausea and vomiting, diarrhoea and possible injury to the internal organs depending on the type of chemotherapy which usually recover afterwards.
  • Bone marrow or blood stem cell transplant (to replace your bone marrow for example when you have leukaemia after destroying the leukaemia and bone marrow with chemo radiotherapy which administers high energy rays that destroys all cells in its way).
  • Venesection (bloodletting) also known as therapeutic phlebotomy (for iron overload or polycythaemia; too much blood) where 450ml of blood is tapped of the patient with a large needle in a large vein.

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