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World Hemophilia Day: Blood Clotting Factors and How To Cure Them






Every year, April 17 is observed as World Hemophilia Day. Hemophilia is a bleeding disorder in which the blood doesn’t clot in the usual way. While Hemophilia A is caused by deficiency of clotting Factor VIII, Hemophilia B is caused by deficiency of Factor IX. Hemophilia A and B are both inherited in X-linked recessive pattern of genetics. Thus, males are most commonly affected by Hemophilia A and B, and females are usually carriers of the disease. The severity of the disease, however, varies from individual to individual.

Hemophilia makes a person bleed from any site in the body. The condition can damage joints because of repeated episodes of bleeding.

A person with hemophilia lacks enough blood-clotting proteins or clotting factors. Small cuts don’t cause much of a hassle among people with haemophilia. However, it is the deep bleeding inside the body which is a major cause of concern. This is especially if the bleeding happens in ankles, knees and elbows. Internal bleeding because of haemophilia can be life-threatening as it can cause damage to organs and tissues.


Hemophilia symptoms

Depending on the clotting factors, signs and symptoms of haemophilia vary from person to person. Among people whose clotting factor is only mildly reduced, the bleeding might occur only after a surgery or trauma. But in case of severe deficiency of clotting factor, the bleeding is severe and spontaneous.

Spontaneous bleeding is characterised by excessive bleeding from cuts and injuries, or excessive bleeding after a surgery or a dental operation. If a person has numerous large and deep bruises, it might be because of spontaneous bleeding. People with spontaneous bleeding also experience unusual bleeding after vaccinations, pain and swelling in joints, blood in urine and/or stool, sudden nose bleeding and unexplained irritability in infants.

Causes for hemophilia

While most forms of hemophilia are inherited, about 30% of them happen to people without any family history of the disorder. These people suffer from the condition because of an unexpected change or spontaneous mutation in the genes.

A rare form of hemophilia is known as acquired hemophilia, in which a person clotting factors in the blood are attacked by a person’s immune system. This condition can be associated with multiple sclerosis, autoimmune conditions and pregnancy.

Bleeding in the brain

People with severe hemphilia might experience bleeding in the brain with a slight bump in the head. Symptoms for bleeding in the brain include severe and prolonged headaches, repeated vomiting, lethargy, weakness and convulsions.

Inheritance of hemophilia

Hemophilia is known to be passed from mothers to son through one of mother’s genes. Most women are simply carriers and experience no symptoms of hemophilia. However, some carriers can experience symptoms of bleeding in case their clotting factors are reduced mildly.

When to seek treatment

In case you witness symptoms of bleeding in the brain, an injury in which the bleeding won’t stop or swollen joints that are extremely hot and painful, you need to seek treatment for hemophilia.

Treatment of hemophilia

Replacement of the specific clotting factor is the main treatment of hemophilia. This replacement therapy helps in stopping the bleeding episode which is in progress. The clotting factor can be replaced through donated blood or recombinant clotting factors which aren’t made from human blood.

  1. Physical therapy

A physical therapy can help in easing symptoms if there has been damage to joints because of internal bleeding. Severe damage to joints may need treatment through surgery.

  1. Clot-preserving medications

These medicines help in preventing breakdown of blood clots.

  1. Desmopressin

This treatment is used in case of milk hemophilia. Desmopressin is a hormone which can stimulate your body to release more clotting factors. The hormone is injected in the body through a vein or is provided as a nasal spray.
4. Fibrin sealants

These are medicines which are applied directly on the wounds in order to promote blood clotting and healing. This kind of treatment is helpful in dental therapy.

  1. First aid

For minor cuts, using bandages and pressure can take care of the bleeding. Ice pack can be used to treat bleeding beneath the skin. To reduce bleeding in the mouth, you can use ice pops.

  1. Vaccinations

Immunisation against hepatitis A and B can he taken in order prevent symptoms of hemophilia.



Hepatitis A Causes and Symptoms

The Kashmir Monitor



Generally speaking, hepatitis A is more common in parts of the planet that are developing. It’s for the fact that sanitation and food handling practices are by and large poor. However, medical experts say that living in developed countries can also put you at risk of having hepatitis A, but it’s really a rare occurrence.

Just like what’s mentioned earlier, hepatitis A is caused by the hepatitis A virus or HAV. It can be spread around by someone who has hepatitis A because he or she is a carrier of the virus behind it. It is said that a person with hepatitis A is most infectious about 2 weeks before he or she begins to experience signs and symptoms.

Here are some of the ways that hepatitis A is spread around:


Consumption of food that is prepared by a person who has hepatitis A. This is most especially true if he or she has not properly washed his or her hands.

Drinking of water that is contaminated with the hepatitis A virus.

Intake of raw or undercooked seafood obtained from contaminated water.

Close contact with someone who has hepatitis A. This includes having sexual intercourse with an infected person, especially when the rectal or anal area has been touched with the fingers, mouth or tongue.

Using illegal drugs, especially when paraphernalia contaminated with the hepatitis A virus are used.


Medical experts say that it may take a while before the various signs and symptoms associated with hepatitis A show up. They say that someone may experience them about 4 weeks after getting infected. It’s even possible for someone with hepatitis A to not experience any sign and symptom at all.

Some of the initial signs and symptoms of hepatitis A include:

Tiredness and malaise
Achy muscles and joints
Pain in the upper right section of the abdomen
Loss of appetite
Mild fever
Sore throat
Diarrhea or constipation
Hives or raised rash that’s itchy

These initial signs and symptoms associated with hepatitis A can last anywhere from a few days only to a couple of weeks. Afterwards, as the infection of the liver progresses, the following may be experienced by the individual:

Jaundice, which is the yellowing of the skin as well as the whites of the eyes (sclera)

Pale colored stools
Dark colored urine
Skin itching

Tenderness and swelling of the upper right section of the abdomen

Although it rarely happens, hepatitis A can cause liver failure. When such develops, the person who is infected may experience severe vomiting, frequent bruising, bleeding of the nose and gums, drowsiness and confusion.

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Busting myths around blood donation

The Kashmir Monitor



As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

Contrary to the myth about blood donations making a person weak or anaemic, the body replenishes the lost blood in a matter of a few days, say experts.

“A healthy bone marrow makes a constant supply of red cells, plasma and platelets, so there is no question of becoming weak, much less anaemic. It is a myth and should not deter people from donating blood,” says Dr RK Singal, chairman, internal medicine department, BLK super-speciality Hospital.


The donors can give either whole blood or specific blood components, as there is sophisticated equipment available these days that extract relevant components from blood and the rest of the blood can be transfused back to the donor.

As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

About 65% of India’s population is young and if this section donates blood regularly, chances of the country facing blood shortage will be remote. Hence, there is all the more reason for people, especially youngsters, to come forward and be regular blood donors.

How to prepare

Have enough fruit juice and water in the night and morning before you donate

Have a full meal 3 hours before donation; never on an empty stomach

Have some rest for about 10-15 minutes after donation

Have some snacks or a juice with high sugar content after donation

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Erectile dysfunction’s connection with lifestyle

The Kashmir Monitor



By Dr Anjani Kumar Agrawal

healthy-lifestyle-can-reverse-effects-of-hypertensionAll over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED).

All over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED). From my research, I have found a strong link between ED and stress. Other major causes include smoking, drinking, diabetes, hypertension or high blood pressure and cholesterol levels. My advice to these patients is — do not get even more stressed over this situation. Instead, focus on taking the right medication and making some changes to your lifestyle, so you can once again enjoy a satisfactory sexual life.



We normally diagnose ED and its underlying causes by asking the patient a few questions about his medical and sexual history. This is sometimes done by sharing a questionnaire with the patient. The questions that we ask are designed to help us understand the cause of ED in the particular patient.

We also do a physical exam, ask for certain blood tests to rule out other medical conditions responsible for erectile dysfunction, and recommend imaging tests (if required) to determine whether the person is physically able to have an erection or not.


Underlying medical conditions such as diabetes, hypertension and hypercholesterolaemia (high cholesterol levels) can cause ED. In these cases, ED can be reversed once the patient starts treatment.

In my experience, many men suffer from ED because of work stress, family pressure and anxiety. So, changes in lifestyle with regular exercise, yoga, abstaining from alcohol and smoking, and proper counselling help in treating ED. Along with this, medicines for ED are usually prescribed for about 3 to 6 months by which time lifestyle changes start to take effect and the patient is physically and mentally healthier, which helps resolve the problem.

An estimated 16% to 25% of men experience ED at some point in their lives. I would urge them not to be embarrassed about it. Seek medical help from a urologist or andrologist; get the necessary advice/medication; and go on to enjoy a healthy, fulfilling sexual life.

The author of this article is Dr Anjani Kumar Agrawal, head, andrology, department of urology sciences, Max Smart Super Speciality Hospital, Saket

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June 2019
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