Anemia / पाण्डु रोग 

Introduction -

It is defined as low RBC count or low concentration of Hb in blood. Lack of blood , low RBC, low Hb.

Blood contains Blood cell and Plasma Blood cells like RBC, WBC, Blood coagulation factors, and Plasma contains Water and Protein.

Function of RBC- RBC helps in inhale of exhale, To pick up inhale O2 from lungs and transport it to body tissue for inhale.

To pick up CO2 waste from tissue and to transport it to lungs from exhalation.

RBC formed in medial part of Red bone marrow. 25 million RBC are produced cell, Rate of RBC production is equal to the Rate of RBC loss. Each RBC contain approx 270 million Hb. RBC are anucleated  and biconcave.

RBC production-

The formation of RBC are called Erythropoisis. Erythro means Red and Poisis means To make or to produce. In intrautrine life RBC produced in liver which is called Entramedullary erythropoisis. Stem cell are present in Red Bone Marrow where if  RBC, blood volume, O2 in blood in low then Kidney secrete erythropetin protein. Erythropoetin stimulate Proerythrooblast, which further become Normoblast and then Recticulocyte , remains in blood for 24-48 hours to become RBC. After 120 days cycle RBC are damage and go to spleen. In spleen macrophages engulf RBC but not engulf Hb.

Hematocit (HCT) - percentage of RBC in blood 

                               HCT = volume of RBC / volume of blood

normally 40% to 50% . 

If HCT is less then normal then it called Anemia.

In dehydration HCT is more , water loss in blood and RBC are same.

Cause-

• Iron deficiency
• Chronic disease - Acute Renal failur, cancer, Hiv
• Active Bleeding - Accident, Menstrual cycle, GIT bleeding
• Pregnency - Mild anemia is normal
• Poor nutrition - Iron deficiency, B9 and B12 deficiency
• Bone marrow disease
• Haemolytic cause ( RBC production is less then RBC destruction
• Medications - long term usage of NSAID
• Vitamin deficiency - normally vitamin B12
• Other disease - malaria ( anemia main cause)
• Leukemia

Pathophysiology -

Causes > low RBC and Hb% and Heamotocrit > low Oxygen carrying capacity > Hypoxia > Organs cant get Oxygen properly > Anemia

Types-

• According to morphology-

1. If cell size is smaller then Normal -> Microcytic Anemia
2. If cell size is larger then Normal > Macrocytic Anemia
3. If cell size is Normal > Normocytic Anemia

• Heamorrhagic Anemia
• Heamolytic Anemia
• Aplastic Anemia

• Abnormal Hb.-

1. Thalassemia
2. Sickle cell Anemia

• Low Hb. Content

Symptom-

• Lake of concentration
• Irritability
• Fatigue
• Dizziness
• Common infection
• Weakness
• Hair loss
• Brittleness
• Pale skin
• Warm infestation
• Palpitation (dsyponea)
• Pulse rate high

Investigation-

• CBC
• Hb%
• RBC count
• HCT
• Comment on peripheral smear ( size and shape of RBC )

पाण्डु रोग 

निदान - 

• अतिव्यायम 
• अति अम्ल लवण सेवन 
• अतिमद्धपान 
• मृतभक्षण 
• दिवास्वपन 
• अति तीक्षण द्रव्य सेवन 

सम्प्राप्ति -

निदान सेवन > दोष प्रकुपित > रक्त धातु दूषित > त्वचा में आश्रित > त्वचा पाण्डु वर्ण > पाण्डु रोग 

प्रकार -

1. वातज 
2. पित्तज 
3. कफज 
4. सन्निपातज 
5. मृतिकाभक्षण 

पूर्वरूप -

1. त्वक सफुट्ना (crack skin )
2. ष्ठीवन 
3. गात्र साद (शरीर में स्थिलता )
4. प्रत्भक्षण 
5. मल मूत्र पीतवर्ण 
6. भुक्त आहार अविपाक 

Normally साध्य 

असाध्य - यदि चिरकाल तक , सभी yellow दिखे , हरित वर्ण मल , कफयुक्त मल , शवेत वर्ण शरीर , दन्त , नेत्र व नख पीतवर्ण ,पाण्डु ज्वर अतिसार