Haemoglobin

Haemoglobin is the iron-containing protein attached to red blood cellsthat transports oxygen from the lungs to the rest of the body. Haemoglobin bonds with oxygen in the lungs, exchanges it for carbon dioxide at cellular level, and then transports the carbon dioxide back to the lungs to be exhaled.

Whether haemoglobin binds with oxygen or carbon dioxide depends on the relative concentration of each around the red blood cell. When it reaches the oxygen-rich lungs, it releases the less-abundant carbon dioxide to bind with oxygen; when it goes back out into the body where cells are producing carbon dioxide, it releases the oxygen and binds with carbon dioxide. This is called the Bohr effect

When carbon monoxide is present, it competes with oxygen at the heme binding sites, and since haemoglobin is 200 times more likely to bond with carbon monoxide, forming a very bright red form of haemoglobin called carboxyhaemoglobin. A concentration of carbon monoxide as low as 0.02% in the air can cause nausea and headache; 0.1% causes unconsciousness and death. (compare that with the normal 20% oxygen saturation of the air!) Heavy smokers, who expose themselves regularly to carbon monoxide, may have as many as 20% of their haemoglobin's oxygen sites blocked by carbon monoxide.

Haemoglobin abnormalities result in very serious hereditary diseases, such as sickle-cell anaemia and thalassemia.Haemoglobin is made up of four subunits, with a haem (iron-containing) group in each for oxygen binding. There are slightly different haemoglobins in adults when compared to children and foetuses.

High 2,3-diphosphoglycerate levels are found in people who live in high altitudes; this chemical allows a larger amount of oxygen to be delivered to the tissues, preventing altitude sickness.

Haemoglobin levels are common blood tests, and your haemoglobin level can tell a doctor a lot about your health in general.

Body mass index (BMI)

The easiest way to determine whether you're too fat is to figure out your body mass index, or BMI. More accurate measures of body fatness exist -- total body water, for example, or total body potassium -- but they're expensive and not readily available. Your BMI is a better measure of fatness than just body weight and can help identify your risk of developing certain health problems, such as coronary heart disease, type 2 diabetes, and high blood pressure.

BMI is one of the most accurate methods of relating your weight to your height. It gives health care experts a way to understand how excess body weight affects health. You are considered overweight if your BMI is greater than/equal to 25; obesity is defined as a BMI greater than/equal to 30*.

Calculate your BMI - Standard BMI Calculator

Note: This chart is for adults 20 years and older.

Calculate your BMI - Standard BMI Calculator

Rh Blood Typing

Rh blood types were discovered in 1940 by Karl Landsteiner and Alexander Wiener. This was 40 years after Landsteiner had discovered the ABO blood groups. Over the last half century, we have learned far more about the processes responsible for Rh types. This blood group may be the most complex genetically of all blood type systems since it involves 45 different antigens on the surface of red cells that are controlled by 2 closely linked genes on chromosome 1.

The Rh system was named after rhesus monkeys, since they were initially used in the research to make the antiserum for typing blood samples. If the antiserum agglutinates your red cells, you are Rh+ . If it doesn't, you are Rh- . Despite its actual genetic complexity, the inheritance of this trait usually can be predicted by a simple conceptual model in which there are two alleles, D and d. Individuals who are homozygous dominant (DD) or heterozygous (Dd) are Rh+. Those who are homozygous recessive (dd) are Rh- (i.e., they do not have the key Rh antigens).

Clinically, the Rh factor, like ABO factors, can lead to serious medical complications. The greatest problem with the Rh group is not so much incompatibilities following transfusions (though they can occur) as those between a mother and her developing fetus. Mother-fetus incompatibility occurs when the mother is Rh- (dd) and the father is Rh+ (DD or Dd). Maternal antibodies can cross the placenta and destroy fetal red blood cells. The risk increases with each pregnancy. Europeans are the most likely to have this problem--13% of their newborn babies are at risk. Actually only about ½ of these babies (6% of all European births) have complications. With preventive treatment, this number can be cut down even further. Less than 1% of those treated have trouble. However, Rh blood type incompatibility is still the leading cause of potentially fatal blood related problems of the newborn. In the United States, 1 out of 1000 babies are born with this condition.

Rh type mother-fetus incompatibility occurs only when an Rh+ man fathers a child with an Rh- mother. Since an Rh+ father can have either a DD or Dd genotype.

Only the Rh+ children (Dd) are likely to have medical complications. When both the mother and her fetus are Rh- (dd), the birth will be normal.

The first time an Rh- woman becomes pregnant, there usually are not incompatibility difficulties for her Rh+ fetus. However, the second and subsequent births are likely to have life-threatening problems. The risk increases with each birth. In order to understand why first born are normally safe and later children are not, it is necessary to understand some of the placenta's functions. Nutrients and the mother's antibodies regularly transfer across the placental boundary into the fetus, but her red blood cells usually do not (except in the case of an accidental rupture). Normally, anti-Rh+ antibodies do not exist in the first-time mother unless she has previously come in contact with Rh+ blood. Therefore, her antibodies are not likely to agglutinate the red blood cells of her Rh+ fetus.

Placental ruptures do occur normally at birth so that some fetal blood gets into the mother's system, stimulating the development of antibodies to Rh+ blood antigens. As little as one drop of fetal blood stimulates the production of large amounts of antibodies. When the next pregnancy occurs, a transfer of antibodies from the mother's system once again takes place across the placental boundary into the fetus. The anti-Rh+ antibodies that she now produces react with the fetal blood, causing many of its red cells to burst or agglutinate. As a result, the newborn baby may have a severe life-threatening anemia because of a lack of oxygen in the blood. The baby also usually is jaundiced, fevered, quite swollen, and has an enlarged liver and spleen. This condition is called erythroblastosis fetalis . The standard treatment is immediate massive transfusions of Rh+ blood into the baby with the simultaneous draining of the existing blood to flush out Rh+ antibodies. This is usually done immediately following birth, but it can be done to a fetus prior to birth.

Erythroblastosis fetalis can be prevented for women at high risk (i.e., Rh- women with Rh+ mates or mates whose blood type is unknown) by administering a serum (Rho-GAM ) containing anti-Rh+ antibodies into the mother around the 28th week of pregnancy and again within 72 hours after the delivery of an Rh+ baby. This must be done for the first and all subsequent pregnancies. The injected antibodies quickly agglutinate any fetal red cells as they enter the mother's blood, thereby preventing her from forming her own antibodies. The serum provides only a passive form of immunization and will shortly leave her blood stream. Therefore, she does not produce any long-lasting antibodies. This treatment can be 99% effective in preventing erythroblastosis fetalis. Rho-GAM is also routinely given to Rh- women after a miscarriage, an ectopic pregnancy, or an induced abortion. Without the use of Rho-GAM, an Rh- woman is likely to produce larger amounts of Rh+ antibodies every time she becomes pregnant with an Rh+ baby because she is liable to come in contact with more Rh+ blood. Therefore, the risk of life-threatening erythroblastosis fetalis increases with each subsequent pregnancy.

Anti-Rh+ antibodies may be produced in an individual with Rh- blood as a result of receiving a mismatched blood transfusion. When this occurs, there is likely to be production of the antibodies throughout life. Once again, Rho-GAM can prevent this from happening.

Mother-fetus incompatibility problems can result with the ABO system also. However, they are very rare--less than .1% of births are affected and usually the symptoms are not as severe. It most commonly occurs when the mother is type O and her fetus is A, B, or AB. The symptoms in newborn babies are usually jaundice, mild anemia, and elevated bilirubin levels. These problems in a baby are usually treated successfully without blood transfusions.

Medical Checkup

HAEMOGRAM

• Haemoglobin
• MCHC, MCV, MCH
• Differential count
• Platelet count
• PCV
• Total WBC
• Peripheral smear

BIOCHEMICAL PARAMETERS

• Blood sugar (Fasting & PP)
• Urea Creatinine
• Uric Acid
• Lipid Profile

LIVER FUNCTION TESTS

• Total protein
• Globulin
• SGPT
• GGPT
• Albumin
• A/G Ratio
• Alkaline Phosphate

GENERAL TESTS

• BLOOD Grouping & RH Typing
• Complete Urine Analysis
• Faeces examination
• ECG (Resting)
• X-Ray (chest)
• Ultrasound of the abdomen screening
• Bilirubin (Total & Direct)
• Faces Examination