Bisnis: Maket Risec mo Manejmen

OK, mi redi blong raetem ol stadi not long Bislama.

Anemia Microcytes

• Anemia microcytes hemi wan kaen anemia.
• Hem minim i gat wan les big pipol blong hemoglobin long blad.

Level blong Hemoglobin

• Long man, em mas les long 13g/dl.
• Long woman mo pikinini, em mas les long 11.5g/dl.
• Be long bebi we i bon, em mas les long 14g/dl.

Wanem Mekem Microcytose I Hapen?

• Hem hapen taem Mean Corpuscular Volume (VGM) i daon.
• Long big man, em mas les long 80 fl.
• Long pikinini, em mas les long 74 fl.

Hypochromie

• Hypochromie hemi wan nara samting we i save hapen, be i no oltaem.
• Hem minim Mean Corpuscular Hemoglobin Concentration(TCMH) i les long 27 pg mo Mean Corpuscular Hemoglobin (CCMH) i les long 30g/dl.

Impoten blong Iron

• Anemia microcytes we i kamaot from iron deficiency hemi 3.75% blong olgeta man long wol mo 50% blong olgeta anemia microcytes.

Metabolim blong Iron

• Long evri dei, body i lusum mo tekem semak amount blong iron (1mg/j).

Kakae we I Gat Iron

• Ol kakae we i gat plante iron long wan dei, olsem lentils, mit, egg, chokolet, spinach.

Amount blong Iron we Needim

• Man i nidim 1-2mg/j blong iron.
• Woman i nidim 2-3mg/j.
• Taem woman i pregnant, lactating, mo taem pikinini i gro, oli nidim moa iron.

Olsem Wanem Body Tekem Iron?

• Body i tekem iron long duodenum mo fastaem jejunal loops.

Usem Bakegen Iron

• 80% blong iron we body i yusum blong mekem erythrocytes i kamaot long iron we body i yusum bakegen.

Taem Blad Sel I Daed

• Taem ol blad sel i daed, plante blong iron long hemoglobin i go long circulation olsem complex wetem transferrin.

Hao Iron I Go Long Blad?

• Hemoglobin molekul i go long blud wetem transferrin (Tfe) o siderophilin protein.
• Wan transferrin molekul i save holdem tu iron atom (Fe 3+).
• Transferrin concentration mas stap bitwen 30 to 45%.
• Ferritin hemi kamaot long ples we i no gat planti blad sel mo hem soem amount blong iron we stap storem.

Level blong Adalt

• level blong adult hemi 12 - 300 µg/l.

Storage blong Iron

• Ferritin: Hem wan complex protein we i gat 24 subunits (L blong liver, mo H blong heart), and hem save holdem ap long 4500 iron atoms.
• Hemosiderin: Hem lysosomal protein we i kamaot from ferritin. Hem storem iron long stabol wei we i hard blong movim.

Long Wanem Ples Body Storem Iron?

• Long macrophages blong liver ( 40-50%), long bone marrow, and long small amount long spleen and long musol.

Lusum Iron

• Body i lusum smol amount blong iron evri dei, we wan balance daet i save help blong winimbak (1 mg/dei ).
• Sam wei we body i lusum iron : urine, ol strong samting, sweat, mo taem skin i foldaon.
• Woman i lusum iron taem oli breastfeeding (1 mg/dei), menstruating (35 mg/cycle), and taem oli bonem pikinini (700 mg).

Hao Hem Werken?

• Taem iron availability i daon, i save stopem hemi globin synthesis.
• Mitosis i worked tru long amount blong hemoglobin, taem level i kasem bitwen(32-36%), it stops.

Olsem Wanem I Save Hapen?

• Blad i save les long mekem hemoglobin.
• I save no gat iron blong mekem hemoglobin synthesis.
• Long microcytosis, i save gat plante mitosis.

Wanem Kasem I No Gat Inaf Hemoglobin?

• No inuf iron: Anemie and Carence Martiale.
• Problem wetem metabolism: Anemies inflammatoire.
• Problem blong synthesis blong globins: Thalassemias.
• Problem blong synthesis heme : Anémies sidéroblastiques.
• Iron i no save go insaet gut:
• Atransferrinémie congenital.
• Hypotransferrinémie acquise.
• I gat problem wetem erythrocyte.

Diagnos Blong Bioloji

• Lukluk taem yu faendem problem
• Yu save luk ol saen blong anemia olsem skin i white, yu breathless, yu feel dizzy, hed i pen, yad i fastaem, yu asthmatic.

Saen blong Sideropenie

• Nail i brittle, hea i dry mo i brekem isi, lips i crackem, skin i drae, mucous membranes i atrophied, yu gat digestive problems olsem glossitis and dysphagia, mo prurit vulvaire.

Hemogram

• Fasting Nutritional Status (FNS)
• Level blong hemoglobin i daon:
• Long man = les long 13g/dl
• long woman and pikinini = les long 11.5g/dl
• bebi = les long 14g/dl
• VGM i les long 80 fl (Microcytose) – save go down go kasem 50 fl.
• TCMH les long 25 pg mo CCMH les long 28% (Hypochromie i stap)
• White Blood Cell (GB) count and platelet count: normal or smol rise from compensative medullar overactivity.

Blad Smear

• Smal sel, light, decolorized in middle wetem small blud koloring long side (annulocytes).
• Hematies lukaot olsem tagets.
• Big anisocytosis
• Big poikilocytosis.

Reticulocyte Count

• Regenerative anemia i > 120 G/L
• Aregenerative anemia i < 80 G/L

Diagnos we Ikolem mekenisim

• Iron report
• Sérique iron: Measured by method colorimétrique , normaly 18 ± 6 µmol/L.
• Laplas we hem olgeta i stikim long transferrine TIB: 55±10 µmol/L.
• Hem Stik gud wetem saturation blong transferrine CS: 30 à 40%.
• Ferritinémie: dose radio- immunologiques or immunoenzymatiques: Man hem(40 à 150 ng/mL) , Woman hem (20 à 80 µg/L)
• Level blong transferrine SRTE

Inflammatori Report

• VS, CRP, éléctrophorèse blong protein serques, fibrinogéne

hemoglobin Lookaut

• Ol defect blong hemoglobin , isofovalisation

Etiology Diagnose

• Anémie Ferriprive Hem long( Carence Martiale VRAIE)

Kinetic

• Kamaot long 3 phase
• Fastem wan: Iron storedaon
• Tude wan: Saturation blong siderophiline im luk down.
• Aftar plante bulan lukluk long anemia microncytose.

Etiologies

• Lusum blood long bleeding lelebet

Diagnose blong bio

• Hemogram anemia microctaire.
• Iron lookim Hem hypo.
• Capacity blong hemi holem Transferine luk big.
• Koaliti luk Down
• The Ferrinelimi imluk smol

Diagnose Blong Etiologe

1 . Lusum iron bleeding long Hem

• Hem digastaem tumas

Inflammatori Anamie

• Platne factors hem olsem Hem kolum Cytopine i kat micro.

Etiologie

1. Inpection lukaut

• Mekem long abces blong long long
• . Hemi kashrem long HIV

Diagnosis Blong Microcyte Long defalt

• Long Eryhtrob last olsem
• Atranfurmine congemale Sik i les long luk luk long ol skin hem olsem long anemia.

Hypotransferrinémie aquise i gat big problem long liver Yumi no lukautem Gut. Ingeksin long ol kanker i go fastaem i lukautem long transfurine.

Diagnose blong Anamy

Hem olsem fer seriq i ko antap wetem saturation Ferritin im i big mo hemi kat fek

Taswe tu hemi kolum sideoblastes Oli gat samtin luk otlong aea luk long Prusse

Physic pataluge

• Hemi go long enzyme taem samtem in daon.
• Vitamin hemi impoten tumas blong hem wan
• Taswe tu hemi olsem isomiagide orsam tubem
• Eanol plam zinc long kapem

Yumi flasufae

• Ol anemye i kat long botol taem olgeta samtin i mixem oli luk olsem autosome.
• Sero blasrem hemi olsem hemi oltaem kat problem i kat.

Long finak ia Hem olsem blangke i miksem wetem diagnosin.

Conclusion

Lukluk long olsem anemia mikrosayt hem is defre olsem olgeta i defren. Tas we tu Diagnosin Etiologik i lukaut tumas long olsem hemi kat ol saen fulup.

Tingting long 'opportunity cost' mo 'supply and demand'. Faenem aot wanem i impoten long 'market research'. Mekem sua se mane blong bisnis i sef. Gro blong bisnis i nidim plan.