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Sickle cell anemia

Chapter I

Introduction

Sickle cell disease is a genetic disease that causes a type of chronic anemia. A disease
that produces a defect in hemoglobin located in the red blood cells. This hemorrhage is
responsible for carrying oxygen to all parts of the body, if the lack of oxygen changes
hemoglobin and becomes viscous. The red blood cells in the thyme begin to take the shape
of the sickle instead of the normal spherical shape, and therefore have difficulty in
passing through the vessels and fine hairs, so it is difficult to reach the blood for
some parts of the body. Sporadic pains occur in the body and result in the breakage of
red blood cells. And hemoglobin decrease.
Symptoms of this disease appear mostly in childhood. It lasts a lifetime. Severe cases
may lead to death. This disease is characterized by the occurrence of seizures followed
by a return to normal.
Sickle cell disease may affect every member of the body.
And lead to a variety of different symptoms. These symptoms vary in quality, severity,
frequency and effect from one person to another and from one region to another. While
some patients do not complain about any exhibitor and may reach the age of fifty and do
not know they are infected with the disease.
In other regions, such as Africa, 50 percent of the infected population is under 2 years
of age. This disease has no permanent cure, which is now reversible and healing, but it
is possible to treat and alleviate the symptoms. It can also be prevented by a good
choice of life partner.
Early diagnosis is very important and it is useful to know if the child is ill. Or sick,
or healthy. Understanding the disease and its symptoms and the problems that result from
it. Another important aspect is the medical, health and psychological interest of the
patient, which enables him to lead a normal life and ease his pain.

Deployment:

According to statistics from the World Health Organization in 1985 , it generates every
year approximately 250,000 children in the world sick disease of blood diseases that are
caused by an imbalance in the gene component of a series of beta hemoglobin , Beta
Globin . Gene 75% of the number of people living with sickle cell anemia which it
generates Every year , 189 , 500 children are infected in the world and this number is
likely to increase significantly as a result of increased growth rates and increased
care of patients, increasing their resistance and prolonging their age. Population
migration has greatly affected the spread of the disease to various parts of the world
such as northern Europe, the Americas and others.
A 1985 study in Bahrain examined the prevalence of the disease on more than a thousand
thousands of moles. And found that 2.1% of them infected with the disease and 11% of
them are infected with the disease.
But it is believed that the proportion of carriers in Bahrain is much higher and the
reason is that the study was conducted on babies. In the immediate postpartum period,
beta is not complete, but the gene (P), ie, hemoglobin, is still functioning. So there
is a possibility that children with the disease as well as patients will not be detected
at this stage.
In another study, students were examined in second grade secondary school in all schools
in Bahrain. This study included approximately 6,000 students. This study showed that 2
and 1% of them had mengalemic anemia. And the proportion of those who carry the disease
is 13%.
In Saudi Arabia, the disease is also widespread, particularly in the Eastern Province,
Al-Hasa and Qatif, as well as in the Western Region.
In a similar study carried out in the Eastern Region on births, it was found that 24% of
the patients were infected. 24%
As we have said, this disease is widespread in tropical Africa. In Nigeria, 25% of the
population has the disease.
As well as in southern Italy, northern Greece and southern Turkey, where the proportion
of 1040% of carriers of the disease. The prevalence of the disease was found to be
proportional to the degree of localization of malaria in that region.

Source of disease:

We also said that sickle cell anemia is widespread in many countries of the world, but
if we look for the source we find that there are two theories.
1 The first theory:
Says that the disease has one source, and that as a result of population migration, this
gene has moved to all regions of the world. The majority says this source is Africa.
With the largest number of infected people in the world, including spread to India, the
Arab countries, America, Europe and the Middle East. The minority says that the source
from the Arabian Peninsula and from there moved to Africa and the world.
2 The second theory:
Says that gene sources are multiple. (This theory is based on accurate studies of
genetic material ” genes ” using microbiological enzymes).
This theory says there are at least two sources of this gene. One is the genetic factor
gene. Spread across West Africa, the Americas, the Middle East and western Saudi Arabia.

The second gene is prevalent in India, East Africa and the Eastern Province of Saudi
Arabia. It is likely to be the gene prevalent in Bahrain.

In other words, there are two sources of the genetic factor, the patient is a source of
Africa, and it is spread in the western regions of Saudi Arabia and is an Asian source
and spread in Lahband in the eastern regions of Saudi Arabia.

Hemoglobin

Hemoglobin or hemoglobin is a partial circular shape This molecule consists of four
chains of amino acids. Each of these amino chains wraps around an iron molecule. There
are two types of amino acids in the hemoglobin of a person older than 6 months.

1 amino chain (alpha) the Alpha Globin the Chain and contains 141 amino acid.

2 amino series (beta) Beta Globin the Chain and contains 146 amino acid.

This hemoglobin is made according to orders issued by genes (genetic factors) , these
genes are found on chromosomes ( Chromosomes ) that resides inside the cell nucleus.

That is to say, for the hemoglobin of the average person after the age of the sixth
month there are two types of genes:

Gene is the Beta Globin Chain Beta and is found on chromosome # 11.

Jane is the Alpha Globin Chain and is on chromosome 16.

Since there are two chromosomes, one is from the father and one is from the mother. That
is, it initiates two genes that determine the beta-amino acid chain on each chromosome
11.

If these genes are normal, their yield is normal hemoglobin. If the gene is abnormally
abnormal, the yield is abnormal.

In the case of sickle cell anemia, the gene of the beta chain was found to be abnormal.
As we have said, the beta globin chain ( B ) contains 146 amino acids. In the case of
sickle cell disease, the amino acid (glutamac acid)
And ( Glutamic acid ) to the amino acid (Valine) ( Valine ).
At the level of d. N. a . DNA Any genetic material or gene is very small. So that the
gene consists of a number of bases ( Nacleotide Bases ) change here is in the base of
one of the GAG to GTG any pay from the base A to the base t T this change in one rule
that makes partial hemoglobin ready to Tmangel Polymerization when less oxygen pressure.
We find that this simple difference in Mutation Point at the level of the gene ( DNA )
has changed the life of the whole human. And about a person who is a healthy person to a
person suffering from pain throughout
Old. Here is the great divine power that created and mortified this complex and
meticulous man.

Relationship with malaria:

 

The first observation of the disease was from Rhodesia in 1946.
Microscopy observed that the malaria parasite does not grow well and does not multiply
normally in the blood of people with the disease. It was also observed that the
mortality rate among people with malaria is lower among sickle cell anemia patients in
the common people and came out with several theories, including:
1. People with the disease are less likely to develop malaria.
2 – the rate of infection is one, but the complications are more in the ordinary people
than in people with the disease.
3. People with the disease and who have the immunity to this disease more than ordinary
people.
4. The presence of hemoglobin (o) provides protection against malaria at all ages,
especially among children.
5. The malaria parasite prefers to feed on the normal hemoglobin » A « and preferably
hemoglobin patient (s).
6 – The shape of sickle red blood cells does not help to grow better parasitic
parasitic, especially in children.

History of Malaria in Bahrain:
Malaria is known to have been prevalent in Bahrain. first
This report was issued by (Major Afridi) Major Afridi came in 1937 from the Institute
Malaria Institute in Malaria, and investigated malaria prevalence in Bahrain.

It has been found to be the most widespread parasite, M. Stephani, and that the degree
of malaria prevalence is:

He also wrote in a report that 70% of the villagers had been infected with malaria for a
period of
Their lives where the spleen are inflated. The infection rate in Manama is 15%
Muharraq 1/2 5%. He also examined different samples of canals and orchards throughout
Bahrain.

In 1938, the malaria control program began with the spraying of oily pesticides
Swamps.
In 1940 (the year of the edition) there was a significant increase in malaria prevalence
and has
The percentage of injury to the British army forces stationed in Bahrain in 1942 about
14%.
With a focus on efforts to combat malaria, the prevalence rate in 1946 dropped to 5
percent.
In 1946 , he used the » d. Dr.. T . DDT « for the first time in Bahrain to exterminate
Larvae and spraying at home has reduced the incidence of malaria significantly.

The malaria epidemic returned in 1959 again. The rate of injury was 5% among the
population of Bahrain and it is said that the reason for the failure of d. Dr . T .
Between 1965 and 1969, there was a significant decline, with only 25 cases registered
among Bahrainis. Among foreigners, 500 were registered from the affected areas, such as
India and Pakistan.

In 1971 it became necessary to declare and report any case of malaria after being
confirmed by a blood test. Since 1979, Bahrain has been free of malaria after this
continuous fight. Since then, only the cases received have been recorded.

In 1980, it was necessary to conduct a blood test for approximately 80 people with each
case detected by neighbors. As well as the continued use of strong and powerful
pesticides and the screening and treatment of arrivals from infected areas. Control and
inspect their areas of assembly.

Screening for sickle cell anemia:

1) The Sickle Cell Test

And depends on the vision of the change in the form of red blood cells when exposed to
hypoxia.

2 Solubility Test

This test is based on the fact that hemoglobin (S) is less soluble than normal blood
hemoglobin in fluids, and while normal hemoglobin dissolves, hemoglobin (X) remains
stable.

3 Electrophoresis testing Electro phoresis

Where separated blood hemoglobin normal » A « for patient hemoglobin (o). This shows
whether a person is sick or is sick.

4 DNA analysis

Especially during pregnancy (screening during pregnancy) and immediately after
childbirth.

 

Symptoms and treatment of sickle cell anemia:

Sickle cell disease as we have said may affect every member of the body and lead to
various and different symptoms. These symptoms vary in type, intensity, frequency and
impact from one person to another and from one region to another.
While most patients in Africa are severely affected, the patient is sick before reaching
the second year of life. We find that the same disease in other areas like our region is
relatively light. Where the infected person may reach the age of 20 and has not
complained of any exhibitor. Many girls do not know they are ill until the first
pregnancy.
Often, the symptoms of the disease do not start on the child until after the third month
g between the third month and the sixth where the hemoglobin of the child before that
age contains a different quality (fetal hemoglobin) ( Hb.F. ) This does not affect the
disease. After the sixth month usually disappears fetal hemoglobin or almost and
replaces normal hemoglobin ( Hb.A )
Which affects the disease.

Symptoms:

1 Pains: Painful Crisis

Pain seizures are the most common symptoms and are believed to be due to clogging of
small and fine blood vessels in the adherent and adherent clusters of red blood cells.
The patient complains here of different and different pains in the limbs and joints such
as the wrist joint. elbow . Ankle. And the knee. In the back, abdomen and chest. It is
pale and lack of appetite. Nubia is often accompanied by high temperature. The urine
color is dark and increases urination.
The episodes of pain occur in some patients every week and some of them every month or
every several years and between periods of seizures the person is completely normal.
This pain may last from 5 to 10 minutes and may last for several days or weeks depending
on its severity and may require the patient to be admitted to the hospital.

As for the causes of Nubia are many and sometimes occur Nubia without any obvious
reason.

Factors that help to occur include:

1 The oxygen content in the body is lower than the normal rate due to stress, as the
body’s need for oxygen increases.
Lack of fluids in the body. When sweating is increased in hot weather and in cases of
sunburn, diarrhea or vomiting.

2 when the body is infected with high temperature due to some diseases or infections.
Pregnancy: Pregnant women who suffer from sickle cell anemia are prone to seizures
because of the large changes that occur in their body during pregnancy.

3 Travel to high mountain areas where air pressure or air travel is low in helicopters.

4 during surgical operations if there is a decrease in the proportion of oxygen.

5 Exposure to cold or sudden change in atmospheric temperature.

6 slow circulation of some parts of the body , such as when using the compressor
ligament ( Torniquet ) during the operations.

Treatment of a bout of pain:

The goal of treatment here is to relieve pain along with the removal of the sphincter.

1 giving pain medication
Such as Pandol
Bonstan Ponstan
Provin Brufen
This should be under the guidance of the treating physician. As well as avoid the use of
narcotic drugs that lead to addiction. Avoid the use of aspirin if the patient has a
yeast deficiency disease ( G6pd ) as large amounts of aspirin may cause breakage of
blood cells in this disease.

2. Fluid and drought prevention:
You must give a large amount of fluids. If the patient is unable to drink or has vomit,
it should be given intravenously under the supervision of a physician such as
Physiological Saline
Or 5% Dextrose and increased acidity in the blood.

3 – Heating the patient and clothing appropriate clothing and prevent exposure to cold.

4 that the patient relax in the bed.

5. Treat infections as quickly as possible and prevent them from working the blood farm
to find out the bacteria causing the heat.

6 Blood transfusion is not given unless there is a strong cause for this, such as
hemoglobin deficiency. Blood transfusion may cause increased blood viscosity and a
second more serious seizure. The use of Packed Red Blood is recommended .

7 The liver and spleen should be monitored twice a day during the seizure at least.
In order to detect the rapid spleen ( Spellen Sequestration ), and quickly treat it as
it could lead to death if neglected.

8 Repeated blood tests to determine the degree of anemia during the bout Most often the
proportion of hemoglobin is low and there is an increase in the number of leukocytes (
Leukocytosis )

Abdominal pain:
The Nubia comes in the form of abdominal pain. Especially around the navel and sometimes
accompanied by pain in the limbs as well.
The causes are not known exactly what is due to inflammation of the intestine or
affected by the nerves of pain or inflammation of one of the lymph nodes or a clot in a
vein or affected the bones of the back.
If the pain in the upper right of the abdomen may be caused by pebble in the
gallbladder. Or inflammation of the gallbladder or hepatitis and hypertrophy. If it is
in the upper left, the cause is affected by the disease. In the upper middle part, the
cause may be inflammation of the chest and lung membranes. In the lower abdomen, the
cause is inflammation of the urinary tract or kidney. Sometimes back pain occurs due to
spinal cord injury.
Sometimes the disease causes inflammation in the 12 as a result of muscle injury and
lining of the 12. It causes vomiting and hemorrhage. This symptom occurs here at a
younger age than the normal age of 12-year-old ulcer disease. It is also not accompanied
by an increase in acidity. Sometimes inflammation of the small intestine or large
intestine and ulceration.
Abdominal pain often affects children and is repeated from time to time and lasts for
several days. Most abdominal pain episodes are mild but sometimes severe and accompanied
by vomiting, constipation, diarrhea, high fever, leukocytosis and anemia.
It may be confused with the symptoms of appendicitis, but many patients have had
abdominal surgery to look for the causes of the pain.

Treatment of abdominal pain:
Rest in bed and monitor and give intravenous fluids as directed by your doctor.
Most abdominal pain attacks end after 1012 hours.

Inflammation:
Patients with sickle cell anemia are easily susceptible to various infections. And
resistance to these infections is weak and the reason for the presence of anemia factor
in addition to the immune system in this child is less than the average child. The work
of the spleen affected the disease and affected the function of white blood cells.
So the child is susceptible to inflammation. Especially with species of bacteria such as
Salmonella Salmonella and Pneumonia These inflammation include meningitis. Inflammation
of blood. Bone inflammation. Skin ulcers when wounds occur. Chest infections. And
urinary tracts.
So we should try to protect him from exposure to infections and attention to him when a
rise in temperature and speed consultation with the doctor. And treat these infections
quickly and effectively so as not to cause complications. It is recommended that the
child wear appropriate protective clothing. Socks and shoes to prevent man’s wounds and
pollution. In some centers, Pneumo coccal Vaccine is recommended for children above the
second. Penicillin use penicillin for children before the age of two.
Inflammation of the parties Dactylitis Hand foot Syndrane
Inflammation of the limbs and fingers is painful swelling in the fingers of the hand,
toes, back and foot and this symptom occurs often in childhood. It may be the first
symptom. It occurs after the sixth month of age confuse with rheumatoid arthritis.

Urinary tract infections:

This is a common symptom, especially for children. As well as pregnant women and is
mostly caused by bacteria. Special E. coli bacteria .

Bleeding with Urine Haematuria

This is also a common symptom in patients as well as carriers of the disease. There is a
slight bleeding with urine due to congestion of blood vessels in the kidney, ureter and
bladder. This symptom is common in children and affects males more than females.

the cure :

1 Increased use of liquids.

Give alkalis to treat acidity of urine.

3 may need to use drugs to increase coagulation in case of severe bleeding.
Spleen:

1) Increased spleen activity:

Where it increases the activity of the spleen occurs acute anemia. A decrease in the
number of Leukopenia and a decrease in the number of thrombo-cytopenia, making the
patient less resistant. And are more prone to inflammation.

2) Inflammation of the spleen: Hypersplenism

Where the spleen increases in size and increases its activity to a degree that requires
the work of a process to get rid of it, but the process of disposal of the spleen have
surgical complications. Since the spleen is an important member of the immune system,
the elimination of the patient presents the ease of infection. If the process is decided
to give the vaccination
Vaccine Pneaumococca prior to the operation to increase erectile patient. After the
operation, antibiotics such as Penicillin are given every two months if needed.

Spleen extension: Splenic Sequestration

This occurs for some patients, especially children between the ages of 9 months and 5
years. Which leads to accumulate very large numbers of cells Almtmangelh and deformed
red blood in the spleen and enlarged spleen sudden, rapid and spoke acute anemia in the
fluid in the body and this affects the flow of blood in the veins occurs very low blood
pressure and lead to shock ( Shock ) , along with severe pain in Abdominal swelling is
caused by a significantly increased size of the spleen and this may endanger life and
must be detected and treated quickly.
The treatment is concentrated in the recovery of fluid and blood lost in the spleen by
giving fluids quickly and concentrated red blood cells ( Packed Red Blood Cells) and if
treated quickly, healing is fast.
But if delayed treatment may lead to death. This patient may return several times and
here must be a process to get rid of the spleen. This dangerous symptom is rare in
Bahraini patients.

Bone pain:

The bones are also affected by the clogging of the blood vessels as well as by
increasing the size of the bone to increase the activity of secretion of more red blood
cells. So that they can be compensated for. This affects the strength and strength of
bones. It gets an increase in the size of the core component of the blood Krlt
Erythropiotic Expansin then gets where necrosis Necrosis and weaken the bones and easily
broken and changed the bones of the skull and become skull tower as a result of swelling
of the bone marrow. It also delays the vertebrae and becomes brittle and easy to break.
Head bone necrosis thigh Aseptic Necrosis of Head of Femur where weakens and gets
rounded thigh fracture and gets it.

Leg ulceration and leg ulceration

This occurs around the ankle and the bones of the man where the arrival of blood to
those areas, coupled with the ease of clogging blood vessels Vtnaghar after the less
shocks and strength begins to ulcer and the incidence of the presentation varies
according to age and standard of living. It decreases in children while it increases at
the age of 1019 years and should pay attention to these ulcers from the beginning. To
prevent trauma and injuries. Secondly by cleaning it with disinfectants, using
antibiotics, rest in bed and treating other symptoms.

Painful erection Priapism

A condition that occurs to the male. Erectile dysfunction occurs without any sexual
consultation and is painful and lasts for a long time. This causes the accumulation and
accumulation of sickle red blood cells in the blood vessels of the reproductive organ,
which clogs the veins and obstructs the normal return of blood. He may need surgery to
speed up the return of blood. The incidence of this offer is very low in Bahrain.
Stop Allanesi for the formation of red blood cells Aplastic Anaemia
The production of red blood cells in the spinal cord may stop abruptly, completely, and
for different periods (for several days). This leads to severe anemia and requires rapid
blood transfusion and patient monitoring.

Hepatic Crisis : Heparic Crisis

The liver is sometimes affected by the disease. Red blood cells may break down and break
down as they pass through the microcircules of the liver, causing them to break down.
The passage of blood stops, the pellets break down, the bile excretes increase, and the
patient’s face appears brushed. The patient may also complain of pain in the upper right
of the abdomen. Repeated blood transfusion can cause hepatitis and its complications.
The liver is also affected by iron accumulation due to repeated blood transfusions.

Lung inflammation: Acute Chest Syndrome type

This disease is common , particularly in children where the sickling process occurs in
the lung veins and prevent blood access and cause lung infarction ( Infraction ) and
inflammation of the lung Pneamonia are treated with rest and give fluids and give blood
if needed and prefer erythrocytes concentrated blood and give the necessary vaccinations
Pneaumococcal Vaccine for children after the Second Age And Penicillen for the treatment
of children under the age of two.

 

Nervous system :
It is important to make sure that there is no difference in mental abilities and
intelligence between sick children and ordinary children, but in severe and rare cases
may occur in the brain and the vagina leads to:

1) Half paralysis.

2) Bleeding in the brain.

3) Fainting and convulsions.

4) The consideration is affected.

5) Impaired hearing.

6) peripheral nerve injury.

7) the occurrence of stroke ( Stroke ) absence of consciousness (stroke).

Here the treatment should be quick and effective and give rapid blood transfusion to
increase the proportion of sickle cell hemoglobin.

Different species and the relationship of disease to other diseases:

1) Pregnant to the genetic agent of the disease Sickle Cell Trait
This situation caused by the fact that the person carries a genetic factor and the other
one patient and the worker shall be properly (holder genetic factor patient » Q. A « ).
The disease is widespread, with 11% to 15% of Bahrain’s population.
It is believed that the pregnant female patient is healthy and that this condition is
not a disease in the sense of the concept, but this person may suffer some complications
in exceptional cases, for example in the case of hypoxia. This occurs when traveling to
high mountain areas where air pressure is low or when traveling by non-air-conditioned
aircraft or as a result of stress factors. In this case, the pregnant woman may suffer
from the following:

1) feeling tired.

2) Feeling pain in different parts of the body.

3) bleeding with urine. Haematurea

4) Lack of ability to focus urine Hypothesurea

5) Uterine infections Bacterurea

6) Splenic Sequestration

The risk of this situation is in the possibility of her inheritance to the children. If
a pregnant woman marries the genetic factor, another person, like the one with the
genetic factor, has a 25 per cent chance of having sickle cell disease.
This is why:

1) Examine the next couple to get married.

2) Provide necessary genetic counseling.

3) neonatal screening to identify the quality of blood early. So that symptoms can be
avoided.

2) Pregnant to the genetic factor of the disease of the disease and the disease of
sickle cell disease:
The two diseases react negatively, showing symptoms of anemia and some of the symptoms
of thalassemia. The patient complains of pain and seizures. But the degree of disease
depends on the type of beta thalassemia carried by the person.

3) Pregnant to the genetic factor of the disease of schistosomiasis and sickle cell
disease:
The genetic factor of the disease is widespread in our society. Where approximately 20%
of the population carry this factor. Many studies say this factor reacts positively to
sickle cell anemia.
The presence of this agent alleviates some symptoms, not all. May reduce the incidence
of inflammation of the chest and osteoporosis, but the incidence of pain is not less
than the incidence.
Continue to form Hetero-cellular Persistant of Fetal

Haemoglobin

The formation of embryonic hemoglobin persists in some people, which usually stop
forming between the third month of life, thus increasing hemoglobin ( H ) f and the
presence of fetal hemoglobin decreases the proportion of hemoglobin ( Hb S ) this
pigment Polymerization any phenomenon that reduces sickling and relieves the symptoms of
the disease. It was found that a large proportion of patients in Bahrain carry Hbf fetal
hemoglobin by a variable rate.

5) the presence of yeast deficiency disease besides sickle cell disease

Glucose 6 phosphate Defeciency

It may occur that the person is infected with both diseases, since both of these
diseases have a different gene. The genetic factor of sickle cell anemia is found on the
chromosome (11). The genetic factor of yeast deficiency disease is found on the
chromosome.
Many studies say that the two diseases interact positively with some that leads to some
of the symptoms.

Environmental factors:

The appropriate environmental factors affect the mitigation of symptoms of the disease
as:

1) Care for the sick child.

2) take into account the nutrition appropriate health nutrition.

3) Give him all the necessary vaccinations.

4) Pay attention to clean and remove from the sites of infection and inflammation and
heating and rapid response to each change gets.

5) in addition to interest in education and follow-up study.

6) You should also pay attention to the speed of presentation to the doctor if it
happened and the temperature rose or any serious viewer appeared and follow the doctor’s
advice.

7) Give medicines and give tonics such as Folic acid , iron and zinc all according to
the doctor’s instructions.
All of this affects less pain, less inflammation and complications.

Pregnancy, childbirth and use of contraceptives:

Many patients do not know they have the disease until the first pregnancy, especially
between 30 and 40 weeks of pregnancy. If the disease is severe, there may be some
serious complications that lead to the death of the fetus or the death of the mother.
The death of mothers during pregnancy and postpartum was found to be very low due to
medical care and medical supervision of childbirth, but it was found that sickle cell
anemia accounted for 20-30% of maternal deaths in Bahrain. Complications during
pregnancy and childbirth include:

1) Severe anemia:
The pregnant woman is usually exposed to anemia due to the consumption of the fetus part
of the mother’s diet. If the mother does not take her food and take the necessary
supplements, anemia occurs especially in the third period of pregnancy between 30 and 35
weeks.
However, with sickle cell anemia, the anemia in the pregnant woman is much larger and
may have serious complications such as liver and spleen enlargement. This offer is rare
in our region but many occur in other regions such as African countries. It is
recommended to follow the pregnant patient accurately and give the tonic, vitamins and
iron along with good nutrition may need to transfer blood.

2) Bone pain:
Bone and limb pain may increase especially in the last trimester of pregnancy and after
childbirth. The reason may be the change in the hormones besides the increased spleen.

3) Acute chest pain Acute chest pain
Inflammation of the lung membranes Pleuretic pain
Difficulty breathing Dyspnea
Inflammation of the chest Pneumonia
It is usually increased in pregnant women with sickle cell anemia.

4) Eclampsia and Pre-eclampsia
And includes high blood pressure, swelling and albumin urine, where it was found to
increase the proportion of pregnant women with sickle cell disease.

5) Urinary tract infections. Urinary Tract Infection
As the proportion increases with any pregnancy, but it is a greater proportion with
pregnant women sick with sickle cell disease, especially the incidence of hepatitis.

Fertility Fertility
Many studies say that the disease does not affect fertility and that pregnancy is
normal.

Birth :
Most pregnancies for pregnant women are normal and easy, especially since babies are
often less fat than normal due to lack of growth due to anemia in the mother. However,
surgery or assistance during childbirth may be recommended if the doctor doubts any
exhibitor that may affect the life of the mother or child.

Obstetrics : Perperium
Postpartum infections are more common among patients with MS than normal births.
Low Birth Weight : Low Birth Weight
Pregnant women often have less than normal weight (2500 pounds), with children growing
less as a result of child poverty.

Death of children:
Some studies show that abortion rates and preterm and postpartum deaths are higher than
those among normal mothers. Health care and follow-up by pregnant women for medical
visits during pregnancy reduce this.

Contraindications:

The best way to prevent pregnancy in this case is to perform the sterilization process
which is safe and secure. Especially if the parents have only the number of children. It
is preferable to follow family planning methods and spacing between births to give both
the mother of the patient and the child enough time to regress and restore health. This
alleviates many of the complications of the disease. There are complications for the
pill and the contraceptive pills. The dependence on the safety period and ejaculation
abroad is not guaranteed.

Screening during pregnancy:

It is possible to discover whether the fetus will be healthy or pregnant or sick by
testing during pregnancy:

1) Take a sample of the amyonic fluid that surrounds the child after the third to fourth
month and carefully examine the genes to determine if the genes are healthy at the
fetus.

2) Examine part of the placenta at week 8 (10) and perform gene examination. In African
and European countries it is recommended to abort fetuses if they have the disease.
Especially that the disease is severe and may eliminate the child in the first life. The
situation is different. As the subject of abortion is sensitive and unacceptable to us
in addition to that the disease is mildly debilitating and patients live almost normal
life. There are among us patients who have continued their studies and work and have
been families. So we do not recommend abortion in this case.

Surgery and anesthesia:

Patients with this disease are exposed to operations such as gastrointestinal processes.
Bones. Urinary tract . Spleen. Operations in the eye. Ear, Nose and Throat Nerves.

These operations are often the result of complications of the disease or as a result of
accidents and emergencies, women and childbirth and others. Those who suffer from the
disease have such operations as any normal person unless the oxygen given to the patient
during the operation is significantly reduced. This is not usually the case. Hundreds or
even thousands of operations have been carried out for carriers without any
complications.

In the case of disease, the preparation must be well before the operation and should be
kept as far as possible when conducting operations during seizures. And the proportion
of hemoglobin 10 grams or more and opinions differ for giving blood if the proportion of
hemoglobin 7 9 and advised to give oxygen before the operation and during anesthesia and
continue to give oxygen more than the average patient.

Anesthesia: Anaesthesia
Precise devices are now available to monitor patient, breathing and enough oxygen to
prevent all complications.

Usage of compressor ligature : Torniqnet

Surgeons sometimes need surgery especially for the use of the compressor to squeeze the
limb so that blood is less and blood is reduced during the operation. This is a risk for
sickle cell anemia. Where it gets tinged in the blood stopped in the end organ and when
the pressure increases these cells go to the parts of the body and cause the stroke.
Caution should be used when using the compressor ligament.

Process Complications:

Chest pain. Inflammation of the wound and painful attacks and strokes. But the patient
here gives all care and attention to prevent the occurrence of these complications.

Inheritance of sickle cell anemia:

We also said that the disease is hereditary. Hemoglobin is determined by two genes.

One from the mother and the other from the father and the proper genetic factor
resulting in a normal hemoglobin called ” A ” and the genetic factor of the patient
produces hemoglobin ” X ” .

If the person inherited the gene responsible for hemoglobin » A « Father shall » A + A «
which it carries normal blood hemoglobin.

If the worker inherits the ” X ” from a parent, his blood will be ” A “, a carrier of
the hereditary factor for sickle cell anemia.

If the worker inherits the ” S ” from the mother and the father, the blood type is ” X ”
and this person is sick with sickle cell anemia.

The children will inherit one gene from the father and the other from the mother, as the
parents inherit one gene specific to the hemoglobin from the father and the other from
the mother. The gene will be inherited by the child. This only God knows. No one can say
which genes the next son will inherit. Is it the infected gene or the healthy gene?

Here the wife carries hemoglobin (A) and the husband carries a normal hemoglobin gene
(AA) in this family. All children will be normal and there is no risk of a child being
infected or having a disease.

Second Family:

The wife carries the normal hemoglobin (A) and the husband carries the genetic factor
(AS). This means that the wife carries two of the normal genes (A) and the husband
carries a healthy gene and a healthy gene. If they have a child,

1) The first possibility is that the son inherits two of the healthy genes and is intact
(AA)

2) The second possibility is that the healthy gene inherits from the mother and the
infected gene from the father becomes himself a carrier of the disease (AS) but there is
no possibility of injury to a child, as he can not get the gene from the mother because
it is healthy. That is, each child in this family has a 50% chance of being pregnant and
50% likely to be healthy.

Third Family:

Here the wife is infected with the disease, which carries (SS) and the husband pregnant
of the genetic factor, ie, carrying the (A) that the wife has two of the genes infected.
The husband has a healthy gene and the other is infected. If they have a child, there
are two possibilities.

1) The first possibility is that the child takes the infected gene from each of his or
her parents so that he or she is infected with the disease, such as the mother.

2) or take the right gene from the father and the infected gene from the mother (since
the mother in this case can only give the gene infected) and be pregnant with the
genetic factor of the disease (AS).

In other words, for every child there is a 50% probability of being a hereditary parent
and 50% having the disease but can not be 100% healthy.

Fourth Family:

In this case both spouses carry the genetic factor of the disease. That is, the mother
and the father have the blood type (AS), meaning that both parents have a diseased gene
and a healthy gene.

What will happen now:

1) The first possibility: that the son inherits the proper gene from each of the parents
(AA) is a healthy person.

2) to inherit the gene of the patient from each of his parents becomes (C) any infected
with the disease.

3) inherit the infected gene from one parent and the healthy gene from another, and
become the holder of the genetic agent of the disease (AS), ie, there is a 25% chance
that the child is infected. 25% to be healthy and 50% to be pregnant with the genetic
factor of the disease.

When 25% say that one out of every four children does not mean that if the parents have
a child who is infected, they will be followed by three healthy children. Because this
probability is true for each child. It depends on the coincidence not its memory. All
children may come healthy or all of them are sick or two of them are sick and two are
healthy.

Fifth Family:

Here the father is sick. Ie carrying two of the diseased genes and intact mother ie
carrying two healthy genes. Each child will take a hereditary patient from the father
and a healthy hereditary parent.

So all children will be sick. But the disease does not appear to them. There is no
possibility of having sick children or completely healthy children.

This marriage ..

Marriage is the most appropriate for a sick person. All the children are healthy, so
advice is for everyone to know the quality of their blood. The disease spreads in our
country. Every person who is married should know the quality of his blood and the blood
of his wife so as not to be surprised to bring children suffering from illness
throughout their lives.

In families where people are sick, prenuptial screening is necessary. Especially if the
marriage of relatives is decided.

the cure :
There is no cure that cures the disease completely and eliminates it. But treatment
includes symptom treatment and continuous care for these patients, which reduces the
frequency of attacks and relieve their suffering and makes their lives more likely.

1) Proper nutrition:

The patient needs to calories ( Calories ) more than the average person also needs more
proteins. As well as the need for iron and Folic acid, which means that the food must be
balanced and contain all the food needs and includes the fruits and vegetables.

2) Prevention of infections:

You should speed in the treatment of the infections. Especially if accompanied by high
temperature. Fatigue, paleness and swelling of the joints. Here the patient should be
presented to the doctor so that he can quickly diagnose the cause of the infection and
give the necessary treatment. However, immunity in these patients is weak as we said
earlier and simple inflammation may lead to multiple infections including septesaemai
seborrheic inflammation, bone inflammation and meningitis.

4) Fluid:
Drink plenty of liquids, especially diarrhea and vomiting. Lack of fluids and drought
can cause a seizure.

5) Provide oxygen:
Keep away from all causes of hypoxia such as stress, presence in closed and crowded
areas, travel in non-air-conditioned aircraft or travel to high mountain areas.

6) Health Education:
Health education about the disease for patients and their parents is very important.
Where he knows more about the type of disease. Symptoms. Methods of prevention and
treatment. It is possible to treat simple seizures at home to accept the disease as
satisfied with the justice of God and mercy.

7) Wear socks and shoes while walking, to prevent exposure to foot wounds and
infections.

8) Continuing Study and Education:

There are many periods of absence from school and this affects educational attainment.
Parents must cooperate with the school to reduce the period of scientific loss.
Education is very important. Because these patients are more in need of office work than
the work that needs a great muscle effort.

9) Games:
The child should be encouraged to play, but not to the degree of stress and must be
allowed to stop playing when he feels tired and tired.

10) Do not use ice and cold water compresses when the temperature rises.

11) Do not immerse the head in the water when swimming until sufficient amount of oxygen
to the body.
To remember:

1 The genetic factor of sickle cell anemia is not sick but may transmit the disease

To his children.

If you are pregnant with the hereditary agent for any of the blood diseases, do not
forget it. And kept
On the result of a blood test between your personal papers.

3 There is nothing wrong with carrying a hereditary factor for a disease of blood. Many
of us
Carry it with your family. with your wife . I advise your relatives to do a blood test.

4 If your partner does not have the same genetic agent for the disease you are carrying,
there is no
Risk to children, but must be screened for them in a timely manner.
Some will be as sick as you are.

5 If you and your partner carry the same genetic factor of the disease. Best to visit
Department of Genetic Diseases.
Sickle cell anemia
Instructions to avoid pain
Here are some guidelines to help you prevent or reduce the pain of sickle cell anemia:

1 – more than the intake of fluids, and the doctor tells you about the amount of fluids
that must be consumed daily, and it is known that the pain episodes increase when the
body’s fluid content decreases. Milk and natural fruit juices are considered as
beneficial fluids for the body.

2. Eat well, and let your food be well balanced to include the four food groups.

3 – Keep your body warm, roll back and shoes and a coat when the weather is cold. The
underwear is also worn under the outer clothing to warm the legs and remember that
exposure to the cold may cause pain.

4 – Do not wear tight clothes, narrow clothes press on the blood vessels and disruption
of blood flow, which helps the blood cells of the patient to acquire the shape of
sickle.

5. Relax and sleep enough at night, and you may need a short nap during the day. Do not
strain yourself too much. Fatigue and stress can cause pain.

6. Clean all wounds. If you bite an animal or if you have been injured or scratched, you
should wash the wound with soap and water while keeping it clean and dry. Consult a
doctor if you are injured. Wounds and sores from biting or scratching can be inflamed if
not treated with care and speed, and inflammation causes pain.

7. Take care of your teeth. Dental hygiene is very important. Use a soft brush to gently
brush your teeth after each eyebrow and ask dental technicians to show you the right way
to use the brush. Consult your dental clinic regularly. Any tooth decay may cause
inflammation and this may cause pain.

8. Importance of vaccination and regular medical care. It is known that infections and
diseases may cause pain and some of these diseases can be prevented by vaccination.

9 – March Exercise in moderation, exercise is important for the overall health of the
body, but those with anemia Cagli to be cautious when exercising and must be moderate
and without stress. If you have this disease you may not participate in sports
competitions, and you should ask your doctor about the appropriate sports and the length
of time to exercise.

10. Avoid high-altitude or non-air-conditioned aircraft, low oxygen levels and low blood
oxygenation cause pain in patients.
If you feel any symptoms, see your doctor at the health center as soon as possible.

Chapter II
Endogamy
Cohabitation is common in our society and is prevalent in many areas. Especially Islamic
countries, what are its advantages and what are the problems that may result from it?
What is its negative response? Does it have any positive impact?
Relatives are those who share a common ancestor, whether this grandfather is near or
far. The common ancestor may be on the father’s or mother’s side. The relationship of
kinship is significant between:
1) Sons and cousins.
2) Sons and daughters of the uncle.
3) Sons and daughters of the aunt.
4) The sons and daughters of the aunt.
As well as aunts and maidens and nephews and nephews. The distant relatives, who share a
single ancestor far from Jiayin or three ancestors, have a distant degree of kinship and
have little influence.
The marriage of relatives does not always mean that there is a risk for children from
genetic diseases. Some people believe that the marriage of relatives should lead to
children who are deformed or have inherited diseases. And that all genetic diseases were
caused by the marriage of relatives. This is a common mistake. In some cases, the
marriage of relatives may be useful if you have good family traits such as intelligence.
Beauty and other desirable qualities. But may have bad effects if there are genetic
diseases transmitted by the family.
If we talk about heredity we find that each of us takes many of the characteristics of
his parents like hair color. The color of the skin form the nose type hemoglobin. Length
… etc. In both cells of the body there are two genetic factors that determine this
genetic status. One inherited from the father and the other from the mother. You
yourself will transfer these factors to your children. Most of the factors inherited
from your parents that you will inherit for your children are 100 percent healthy, but
some are sick.
We also know that the Son shares with the Father in 2/1 his genes. Where the other half
comes from the mother.
Brother and sister share 4/1 genes. The first-degree cousins ​​share 8/1 genes. Second
cousins ​​(parents cousins) are involved in 32/1 of genes. Third-class cousins
(grandparents and cousins) share 128.1 genes. Thus, the probability of carrying the
same gene as the patient as the relative pair decreases as the kinship diverges. We also
believe that in any marriage, even if there is no relative, the probability of any
pregnancy for the wife to have an abnormal child is 23%. That is, the probability of
non-natural or sick children exists even in the case of non-kin marriages.
The specialists in genetic diseases have studied boat marriage. Their study suggests
that there is a significant risk to children of genetic diseases only in certain cases.
It was also found that only one type of genetic disease is affected by the marriage of
relatives. Genetic diseases.
Other genetic diseases, such as:
1) Common genetic diseases:
In this type of disease, it is sufficient for one parent to be infected, even a mild
illness, to transmit the disease to the children by 50% even if he does not marry his
relatives. Or married a perfectly healthy person.
These diseases represent dwarfism. And some cases of mental retardation prevailing
dominant does not affect the marriage of relatives significantly.
2) Gender-related genetic diseases:
The genetic factor here is on the chromosome X that determines sex. The female has two
chromosomes. The male chromosome Alyy × one and the other chromosome , the Y . The
nations transmit the genetic agent to the children and become ill and the girls become
carriers of the disease. The father will transmit the disease to the girls and become
carriers of the disease. The boys can not transmit it to them and the reason is that Y
chromosome gives them to become Y chromosome males without any genetic factors. With
this type of disease, yeast deficiency is G 6 pd .
3) Chromosomal Diseases:
Where there is a defect in chromosomes either to be in the number of chromosomes or in
their composition and shape. Examples of these diseases are: Down syndrome or Mongolian
child disease. These diseases are rare and their frequency is rare in the family. If a
parent has chromosome refraction. These diseases are not related to the marriage of
relatives.
4) congenital malformations at birth:
Many studies say that there is no direct relationship to the marriage of relatives with
most of these diseases since most of them are common causes of the environment and
heredity. Only a few of them are repeated in the family and the marriage of relatives
has an effect.
5) Common diseases between genetics and the environment:
Such as diseases that appear with age or as a result of exposure to certain conditions
such as diabetes and hypertension, so that the marriage of relatives has no direct
impact. These diseases can be inherited by the presence or non-marriage of relatives.
If we talk about recessive genetic diseases. These diseases need to have two genetically
ill patients in the same person to become sick.
If you have one hereditary agent is sick. The other is sound. You are a healthy person
because the healthy worker compensates for the effect of the patient. That is, the
patient is stepping down or disappearing behind the healthy factor does not show its
effect and this person is called the holder of the genetic factor of the disease.
A disease that a person can carry and do not show. They are common in our society:
1) sickle cell anemia.
2) Thalassemia.
3) Some diseases of mental retardation.
4) Some metabolic diseases.
If we use sickle cell disease as an example and we reviewed the inheritance of this
disease in the previous chapter. To give us a complete example of the inheritance of
genetic diseases recessive. Here we wonder how marriage can cause hereditary diseases.
Sickle cell disease is a genetic disease but there are several thousand genetic
diseases, some of which are rare. Only some of these diseases are recessive genetic
diseases. That is, they need two genetic agents to show the child. Only this quality is
affected by the marriage of relatives. Some of these symptoms have an examination that
determines the genetic factor of the disease. But many of them do not have this
examination. It is not possible to detect the carriers of the disease.
Each of us, however healthy, must have many diseased genetic factors (from 5 to 8) a
hereditary genetic factor for certain diseases we do not know about and may not be aware
of. All diseases are rare.
Often, the patient’s genetic factor is different from the patient’s genetic factor. It
is rare for two people to have the same genetic factor to cope with the same disease.
And here happens to produce an infected child.
If you and your wife are from one family. There is a possibility that you inherited the
inherited genotype from the same grandfather if there is a hereditary inherited disease.
Here we review some of the families resulting from the marriage of relatives.
First Family:
There is no genetic disease in the family. So there is no danger of marriage cousins.
Second Family:
General children. There is a genetic disease in the family but the couple do not carry
the genetic factor patient so there is no risk to the children.
Third Family:
Public children. There is a hereditary disease in the family but one of them only
carries the genetic factor patient and the other carries it there is no risk to the
children.
Fourth Family:
Public children There is a genetic disease in the family and the two parties carry the
genetic factor
Patient . Here, there is a risk for children to get the disease. That is even if it is
There is a hereditary disease in the family that does not mean that all couples should
be pregnant
Of the hereditary factor. It was found that the probability of the first class being the
same
The genetic factor is 8/1 to 12 or 5%.
When should we beware of the marriage of relatives:
If a person knows that a member of his or her partner’s family has children with a
chronic illness that begins at the beginning of his life and is frequent in the family,
it means that the disease is likely to be genetically.
In this case it is best to consult with the doctor and to study the condition and the
extent of recurrence and the necessary tests and then can be sure whether the disease is
repeated in the family hereditary or not. The disease may not be genetic and there is no
possibility of transmission of the disease to the children. There is therefore no risk
of marriage to relatives.
If there is a possibility of a genetic disease in the family, the doctor will explain
the disease in detail and the risk of injury to children. Is there a cure for this
disease? Are there ways to find out if you are pregnant or not? What are the
possibilities if you marry your relative?
As we have said, even if the couple thought they had the same genetic factor. The
probability of having healthy children is 75% and the probability of having two children
is 25%.
Therefore, we find that the appropriate advice to our society and our circumstances is
not advised not to marry relatives. But to advise against the marriage of carriers of a
specific genetic disease of diseases prevalent in society.
Do not forget that blood diseases such as sickle cell anemia Thalassemia yeast and
others are widespread in our society. Where it was found that one out of ten individuals
in Bahrain carries the genetic factor of sickle cell anemia. So it is very likely that
two people will meet and not get close together and get married and both will have the
same genetic factor.
It is important to remember that
1) A perfectly healthy person can marry anyone else even if he is sick or ill.
2) Aka a pregnant person is better to improve the choice of partner so that it is
completely intact.
3) The patient must check the selection and choose the right person.
Hence, each pregnant woman of the disease will be healthy and will have a healthy and
fully healthy family if he chooses the best partner, and even the patient can marry and
have healthy children. It is true that all of them are still sick but do not show any
symptoms. This is the case if you marry a perfectly healthy person.
For the safety of your children and your family and building healthy and healthy
generations, we recommend you know your blood type and your partner’s blood type and
improve your choice.

 

Chapter III

Prenatal examination

Prenuptial examination should not be considered a duty. But indeed the rights of every
person to marry. Many societies apply it. Especially in communities where there are many
genetic diseases, especially if there is an examination to detect the carriers of the
genetic disease prevalent in that community.

For example, in Cyprus, the disease is spread, and the disease is dangerous, as the
child is unable to form a red blood color, so it needs constant blood transfusions every
three weeks. The spleen and liver are enlarged and the child lives in constant torment.

So they fought the disease by creating a national program to spread awareness and
information about the disease, and through medical education and examination of the
carriers and the victims of marriage. By examination during pregnancy and after the
birth of approximately 60 to 70 children with thalassemia each year in Cyprus, no child
is born at all.

It was also found that when Jews spread Tay Sach disease, which is a metabolic disease.
It is a serious disease that destroys the child (mostly) before reaching the age of one.
It was found that many Jews carry the genetic factor of the disease. It was found that
in Ashkenazic Jews it was 25: 1, 25 out of every 25 people diagnosed with the disease.
They studied the disease extensively and studied the genes that caused it and reached
the examination of it during pregnancy and through health education and the examination
of the carriers of the disease and feet to marriage and the examination during pregnancy
were able to reduce the incidence of them by a large proportion.

Here, we find that genetic blood diseases are widespread in our country and to know the
size of the problem, we say that one in every 10 people is pregnant with sickle cell
anemia and generates every year about 200 200 Bahraini children infected with the
disease and will continue to suffer from him throughout his life. And the proportion of
carriers of the disease more than 11% of the population and spread between us
Thalassemia both (alpha and beta) as well as yeast deficiency disease. With 20% of the
population suffering from this disease.

All two agree to marry and have hope to settle and have a healthy offspring. Having one
child is seriously affected by their lives and all family members suffer. The mother and
the father are busy with the sick child and the other children are not getting enough
care. The family is far from comfortable and happy. This child will continue to suffer
for the rest of his life. The father and mother will take care of him during their
lives, but for those who will leave a sick person who is weak and who will care after
them.

That sickle cell anemia and thalassemia are recessive genetic diseases that need to meet
two of the diseased genes in the child to make this child sick. If the father and mother
carry the diseased gene, there will be a danger to the children. If only one of the
parties is pregnant or sick and the other is completely intact, there is no risk to the
children.

We do not mean only blood diseases , but there are diseases that may be inherited by the
family such as mental retardation and genetic deafness. Genetic blindness. Other
diseases Some of these diseases can only be prevented when choosing a life partner.

Therefore, we recommend that you protect your children and future generations from these
diseases as much as possible through prenatal examination.

What happens in prenuptial counseling?

Often the parties attend the fiancé and fiancé and inquire about the existence of any
genetic disease in the family such as blood diseases, mental retardation. bone diseases
. Deafness. Endocrine sight. Frequent abortions in the family. Early and recurrent child
deaths. The presence of twins. And other diseases such as blood pressure. Diabetes and
the frequency of these diseases. We also inquire about the degree of kinship. This
information is used for family members for at least three generations and the family
tree is drawn.

When there is one of the genetic diseases in the family, it is necessary to do the
necessary for that disease and the blood test is conducted in addition to tests to
detect:

1) Genetic diseases transmitted by the family.

2) common genetic blood diseases in society.

3) infections that can be treated and the protection of embryos from their effect.

As for the diseases inherited by the family, the tests are specific to each case for
blood tests in the community. These are general and include tests to find out whether a
person is pregnant or sick with sickle cell anemia, thalassemia and yeast deficiency.

Tests have been conducted to determine the extent of infection diseases such as measles.
Syphilis. Toxoplasma and others.

Impact of German measles:

The injury of the mother with German measles is often a minor injury, for example, that
you get colds, colds and blisters on the skin, face, neck, body and limbs and disappear
after several days. This is similar to infection with other viruses but has a
significant impact on the fetus during the first pregnancy.

1) The child affects various types of eye diseases.

2) may have mental retardation, small head size, heart disease, small weight, lack of
growth and deafness, and the sooner the injury, the greater the deformities caused by
it.

3) Fibrin is transmitted by the placenta and may cause miscarriage or death of the fetus
as the child may die in the first year of life.

In 1964, this disease caused the deformity of nearly 20 , 000 children worldwide. In
order to protect against it, women should be vaccinated before marriage and also during
the pregnancy.

Effect of Toxoplasma:

Toxoplasma infection is a common disease that is spread by saliva or spray, by having
cats at home or by some birds or by touching raw meat and transmitted to the fetuses by
the placenta. And symptoms in adults are similar to the symptoms of influenza may swell
lymph nodes and accompanied by a slight rise in temperature and affects women more than
men, especially in the age of 25 to 35 years. If the fetus is infected at an early stage
(during the first trimester of pregnancy) it may be affected by some diseases such as
eye diseases, especially retina and convulsions. The brain may also be affected, the
size of the skull increases, the spleen and liver grow and the baby becomes yellow. A
skin rash or pneumonia may be detected and can be detected by a blood test for both the
baby and the mother. And treatment by giving antibiotics such as pyramidine and sulfa.

Effect of syphilis infection:

Syphilis and chronic affect the fetus especially in the first months of pregnancy and it
affects every member of the body and is transmitted through the placenta and may cause
abortion or death of fetuses before or immediately after birth. Or the birth of a dead
and deformed child.

If the child is infected in the last period of pregnancy may be born with syphilis. Here
it must be treated quickly.
Gonorrhea:

It also causes injury to the fetus, especially eye diseases and infections. If the
results of inflammation are positive, the infection can be treated or given the
necessary vaccination before marriage and before the start of pregnancy.

It is important to know that it is not our duty to dissuade persons who are married from
completing this marriage. But the goal is to protect their children and help them create
a healthy family. We study each case individually and provide the necessary advice and
often in 95% of the cases there is no objection as our task is to advise and know the
person to ensure the injury of children. Then the person must decide and choose what he
wants for himself and he must bear the result of his decision, whether negative or
positive. There is no coercion of any kind.

If he chose to marry, despite the risk of injury to children, we try to help him avoid
the injury of children by advising the organization of the navel and its methods and
examination during pregnancy and other procedures. In spite of all the tests and care
that may reduce the common genetic diseases prevalent in us, but the proportion of
approximately 23% of births may be born and have a deformation or disease. This
percentage is normal in the whole world and beyond what we can use to avoid it.

HIV testing:

If the person so requests or the circumstances so warrant.

Fertility and Reproductive Testing:

Does not work where the majority of infertility diseases have a cure now. Also, in some
cases the parties are completely Solomon but do not happen to have children.

Why genetic blood diseases?

With the development of effective treatment and prevention methods such as vaccination,
the risk of epidemic infectious diseases has been reduced to human health. The problem
of controlling fetal and hereditary diseases has emerged, including some blood diseases
affecting a significant proportion of people. In the UAE society, the incidence of
serious hereditary blood diseases, especially thalassemia, causes permanent suffering
for the patient and a material and moral drain on his family is the frustration of
myself and the high costs of treatment that everyone can not afford. Therefore, the
importance of health education is important for the nature, seriousness and prevention
of these diseases.

What are the components of blood?

Until we have a clear picture of the nature of these diseases, we first have to identify
the components of blood:

Plasma: A watery liquid in straw color with 90% water that dissolves 10% of vital
substances such as mineral salts and organic matter such as proteins. The plasma
function is to carry food into the tissues and provide a liquid medium for the red balls
to be pumped through the blood vessels.

White blood cells: White blood cells resemble the body guard against the attacks of
bacteria that invade the tissues and cause diseases, so the number of white balls
increases when the person gets the disease.

Red blood cells: red balls derive their color from a pigment containing them called
hemoglobin or hemoglobin. The number of red balls is higher than that of white, and its
function is to transfer oxygen to all tissues of the body.

Platelets: These platelets are smaller in size and number of red and white blood cells
and their function is based on blood clotting events when we are injured.

Prevention of serious hereditary blood diseases.

After reviewing the nature of some serious genetic blood diseases and methods of
treatment and impossibility of healing, it became clear to us the extent of the
seriousness of these diseases and the magnitude of the psychological and material burden
on the family. Psychologically, parents suffer from feelings such as rejecting the
reality of their child, overprotecting him, or sometimes avoiding him and being careful
not to build a close relationship with him for fear of feelings of grief and separation
later, although the child may live and lead a relatively normal life if he has treatment
Appropriate early.

Therefore, in order to avoid all these burdens and the suffering of the patient, we
emphasize the need to commit to prevention, especially that our religion has been
singled out by many of the verses and honorable speeches that urge us to reserve and
forbade giving up the soul with its consent and choice in the destruction. The issue of
prevention in Islam has included protecting parents from deadly or dangerous diseases
that may cause them death or disability to lead a miserable life that interferes with
the parents’ feelings.