Why blood is central to the diagnosis of the disease

Through Enyeribe Ejiogu ([email protected]yahoo.com)

Some blood is a specialized fluid in the human body that carries oxygen and nutrients such as sugars, amino acids and lipoproteins to cells and carries away carbon dioxide and other wastes. It also carries hormones. It is pumped by the heart to the lungs and all other parts of the body, then returned to the heart for the process to repeat, to sustain life.

Sanguis, as blood is called in Latin, is so critical that without it there is no life. This is why the Bible says in Leviticus 17:11 “the life of the flesh is in the blood”. Until the coming of Christ and his subsequent vicarious death on the cross of Calvary, the blood of animals was used by the Jews in altar sacrifices for sin. Even in traditional or pagan religion, blood was also used for sacrifices because it symbolized life. Blood is basically made up of plasma, which is the fluid that gives it the fluid nature; Plasma contains three types of cells: red blood cells, white blood cells and platelets. Platelets help blood to clot, a process that prevents blood from flowing out of the body when a vein or artery is broken. Red blood cells (RBCs) carry oxygen to tissues while white blood cells (WBCs) perform the extremely important function of being the core of the body’s defense architecture against infection. It is this critical function of white blood cells that helps immunize the body. Beyond these primary functions, the blood also carries antibodies that fight infections and help the body regulate temperature.

At the University of Calabar, Professor Anthony Emeribe, consultant hematologist and former registrar of the Medical Laboratory Science Council of Nigeria, has devoted his academic career to the study of blood. This area of ​​study, known as hematology, covers the formation, kinetics and function of blood in the field of health, diagnosis, management and research of disease. “Blood is by far the most widely used bodily fluid or tissue in the study of human and animal health and disease, including various clinical trials, diagnosis, monitoring, forecasting, surveillance, control and prevention,” a- he recently declared to an august audience during his speech. the 102sd The institution’s inaugural lesson on the theme “Sanguis: gateway to quality diagnosis, management and research of human diseases”.

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A proper and timely blood test is essential to the ability of physicians to make an effective diagnosis of certain diseases. For this reason, doctors may order blood tests, including a complete or complete blood count (FBC / CBC), and other tests to rule out other causes of symptoms. “Sometimes a blood disorder doesn’t cause any symptoms, but is discovered when a lab test is done for some other reason. For example, a full blood count taken as part of a regular check-up may indicate anemia. When a blood disorder is suspected, a complete blood count and other tests may be needed to determine the specific diagnosis. Common blood disorders include anemia, bleeding disorders such as hemophilia, blood clots, and blood cancers such as leukemia, lymphoma and myeloma, ”Emeribe explains, adding that there are many various blood diseases that are diagnosed and managed by hematologists. Some of them are benign (non-cancerous) and others are various types of blood cancer. They can involve one or more of the three main types of blood cells (red blood cells, white blood cells and platelets) or the coagulation system.

Imagine a situation where hemostasis does not kick in when the need arises. Really scary. Hemostasis is the body’s normal physiological response to preventing and stopping bleeding or hemorrhaging. It results in the blocking of any vascular breach. In general, it helps ensure the fluidity of the blood and the integrity of the blood vessels. How is it going, you ask? Emeribe explains: “Hemostasis is an orderly process. When a blood vessel is damaged, von Willebrand factor (VWF) binds to both exposed connective tissue (eg, collagen) and circulating platelets, causing platelets to build up at the site of injury. These platelets become activated and both recruit additional platelets and trigger the coagulation system, ultimately leading to the generation of fibrin, which covers the platelet plug. This system is tightly regulated by important negative feedback mechanisms, including a series of coagulation factor inhibitors as well as the fibrinolytic system. Finally, repair of damaged endothelium and remodeling occurs to ensure a smooth vessel surface. This process focuses first on the interactions between platelets and the vascular wall, then on the formation of thrombin, which cleaves fibrinogen into fibrin, and the subsequent formation of a fibrin clot.

Then he clarified this essential point: “At the present time, there is no effective or acceptable alternative to human blood for therapeutic use. Human blood and tissue are scarce national resources that should not be traded as commodities. A good blood transfusion policy should facilitate the provision of safe and adequate blood and blood products to the population. Blood from regular, voluntary and selfless unpaid donors has been proven around the world to be the safest blood for therapy. Donated blood, being a scarce national resource, must be shared fairly and used in the most effective and efficient manner. The supply and administration of blood must protect and promote the health not only of the recipient but also of the donor.

It is heartwarming that President Muhammadu Buhari enacted the National Blood Transfusion Service (NBTS) Bill on July 29, 2021, an initiative that paved the way for the creation of the National Blood Transfusion Commission (NBTC).

The path to enactment of the new law began when the Federal Government, through the Ministry of Health, set the vision and accepted ultimate responsibility for providing a comprehensive blood transfusion service in Nigeria by establishing a national service. effective blood transfusion. To achieve this laudable goal, he drew up the national policy which created the framework for the National Blood Transfusion Service in 2006. As Emeribe reveals, “the vision is to have a national blood transfusion service of quality, in accordance with standards. international, which will be recognized as one of the best in Africa. He adds, “The mission of the National Blood Service is to provide safe, quality and adequate blood in a fair and cost-effective manner to everyone residing in Nigeria. The objectives of this policy are to establish and coordinate blood transfusion services nationwide within the framework of the national health plan.

Like most other Nigerians, who have long dreamed that the country’s health system would experience a renaissance, Emeribe sincerely hopes that the national blood service policy will lead to the reestablishment of relationships with partners and stakeholders for more efficiency. and efficiency. To deepen the process, he makes the following suggestions: enlighten and sensitize communities and Nigerians on the importance and necessity of voluntary unpaid blood donation, while working on different strategies to attract and convince donors even in the face of COVID -19 pandemic; the reorganization of administrative and functional structures, to pave the way for the execution of the NBTS mandate, by focusing energies and resources on the establishment of functional area centers, letting the States take charge of their centers and those who do not have one, to create one, while providing them with technical support; creation of public-private partnerships for the organization and distribution of donor blood using geographic information system (GIS) mapping software; advocacy for functional hospital transfusion committees; replacement of old and dysfunctional equipment; improved capacity building; advocacy for the use of blood components and drugs derived from plasma; and finally, support for autologous blood transfusion. Incidentally, autologous blood transfusion is the collection of blood from a single patient and retransfusion to the same patient when necessary. This contrasts with allogeneic blood transfusion where blood from unrelated / anonymous donors is transfused to the recipient. The creation of the infrastructure, operational mechanism and deployment of expertise required to effectively and efficiently conduct autologous blood transfusion in Nigeria offers excellent prospects for the growth of the health sector.

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