Critical review of haemolytic disease of the newborn Essay

Critical review of haemolytic disease of the newborn - Essay Example The mother's immune system sees the baby's Rh positive red blood cells as "foreign." Just as when bacteria invade the body, the immune system responds by developing antibodies to fight and destroy these foreign cells. The mother's immune system then keeps the antibodies in case the foreign cells appear again, even in a future pregnancy. The mother is now "Rh sensitized." In a first pregnancy, Rh sensitization is not likely. Usually it only becomes a problem in a future pregnancy with another Rh positive baby. During that pregnancy, the mother's antibodies cross the placenta to fight the Rh positive cells in the baby's body. As the antibodies destroy the red blood cells, the baby can become sick. This is called erythroblastosis fetalis during pregnancy. In the newborn, the condition is called hemolytic disease of the newborn. (Vucinovic M, Jadric H, Karelovic D, Roje D, Haspl-Hundric Z, Hrgovic Z, Vucinovic Z, 2004). Hemolytic disease of the newborn (HDN) occurs due to maternal IgG antibodies crossing the placenta thereby producing hemolysis mainly due to Rh, ABO and Kell groups. A systematic approach to the Rh HDN involves an obstetric history of previous isoimmunized baby, timing and regular monitoring of maternal Rh antibodies and pigment assay of amniotic fluid. Timely decision regarding in utero transfusion and early termination of pregnancy based on the maternal monitoring has radically improved the outcome of these babies. Antenatal prophylaxis with anti D has resulted in great reduction in the magnitude of Rh problem. The fetal blood sampling and in-utero intravenous transfusions has made it possible for almost 100% survival of isoimmunized pregnancies without hydrops. Alternative methods--IVIG and plasma exchange are still of limited application. ABO HDN though common is not a serious form of disease and dose not warrants invasive antenatal monitoring. Anti-Kell is found in patients hav ing received multiple transfusions and the rapid progress of hemolysis in them may not allow such systematic follow up as in Rh HDN. (Narang A, Jain N, 2001). Antibodies are produced by B lymphocytes. Maturation culminates with migration of the B cells to the reticulo-endothelial tissues of the body including the lymph nodes and parts of the spleen, bone marrow, liver, gastrointestinal tract and other tissues. Antibodies are a miscellaneous mixture of serum globulins and share the ability to bind individually to specific antigens. Those serum globulins with antibody activity are known as immunoglobulins (Ig). All immunoglobulin molecules have common structural features. The part of the molecule that binds to the corresponding antigen is different in each immunoglobulin. The basic

Family and Kinship in Japan Essay Example | Topics and Well Written Essays - 1250 words

Family and Kinship in Japan - Essay Example The sayings, or â€Å"Analects† of Confucius were written some 500 years BC and they contain many references to the duties of parents and children, in particular stressing the duty of the young man to respect his elders (Confucius and Leys, 1997, p. 4). In those days peasant families had no social security systems or means of supporting themselves in old age, and so children were expected to provide for their parents. Japanese culture is no longer based on a peasant, agricultural economy, but in the urban centers there is still an expectation that children should respect their elders, and a collectivist approach to society which involves each family unit being responsible for their own members. With the rise of industrial society in Japan male and female roles continued to be quite clearly segregated, so that women maintained the role of homemaker and provide care for the elders, while the men are expected to work long hours with a few holidays. A relic of older times can be seen in the way that Japanese religion has a place for ancestor worship. The Japanese Shinto religion involves interactions with kami or spirits, and these can include the ghosts of ancestors who have died. Hori noted in the 1960s that this practice is â€Å"even today, widespread and important† (Hori, p. 32) but points out at the same time that there is a difference between this kind of lowly household deity and the more absolute deities of Judaism, Christianity and Islam. Japanese religious beliefs are syncretistic, drawing on many different sources for inspiration so that the same family can have a Shinto New Year celebration, a Buddhist funeral and a Christian wedding ceremony, without seein g any conflict between the underlying world views. This makes it rather difficult for researchers to work out how deeply embedded any cultural phenomena in modern Japan actually are.