1. Give the name of different forms of anemia with treatment.

There are several types and classifications of anaemia. This is a condition in which the body lacks the amount of red blood cells to keep up with the bodys demand for oxygen. Understanding the different classifications can help to recognise the symptoms and also to avoid anaemia in the first place Iron deficiency anaemia Iron deficiency anaemia is a condition in which the body has too little iron in the bloodstream. This form of anaemia is more common in adolescents and in women before menopause. Blood loss from heavy periods, internal bleeding from the gastrointestinal tract, or donating too much blood can all contribute to this disease. Other causes can be from poor dietary habits or from chronic intestinal diseases. The signs and symptoms of this disease are: 1. Paleness 2. Headache 3. Irritability Symptoms of more severe iron deficiency anaemia include: 1. Dyspnea 2. Rapid heartbeat 3. Brittle hair and nails Treatment usually takes the form of oral iron supplements and dietary modifications. Folic Acid Deficiency Anaemia This form of anaemia is characterised by a lack of folic acid, one of the B group of vitamins, in the bloodstream. This is usually caused by an inadequate intake of folic acid, usually found in vegetables or by the overcooking of the vegetables. Alcoholism can also be a contributing factor in this form of anaemia. During pregnancy when the folic acid is used more or in infancy, this disease can also manifest itself. It can also be caused as a side effect of other blood disorders. Symptoms of the disorder include: 1. Weakness 2. Fatigue 3. Memory lapses 4. Irritability This condition can be avoided by including foods with folic acid in the diet. Such foods include beef liver, asparagus, and red beans. Pernicious anaemia Pernicious anaemia usually affects people between the ages of 50 and 60 and is a result of a lack of vitamin B12. The disease can be hereditary but some forms of the condition can be autoimmune diseases. People who have any autoimmune diseases are more likely to contract pernicious anaemia. Symptoms of this form of anaemia may include: 1. Fatigue 2. Dyspnea

3. Heart palpitations 4. Numbness or tingling in extremities Aplastic anaemia Aplastic anaemia is caused by an absence or reduction of red blood cells. This can happen through injury where the blood forming tissue in the bone marrow is destroyed. Because of this, the sufferer is unable to fight infection and is likely to be a heavy bleeder. Symptoms include: 1. Lethargy 2. Paleness 3. Purpura 4. Bleeding 5. Rapid heartbeat 6. Infections 7. Congestive heart failure There is no definite known cause for aplastic anaemia but it is thought to be caused by exposure to certain toxins and also to the hepatitis virus. Sickle Cell Anaemia This form of anaemia is of a hereditary nature and is a result of an abnormal type of red blood cells. Sickle cell anaemia is a life threatening disease and there is no prevention. Symptoms of this condition include: 1. Painful attacks in arms, legs and stomach 2. Jaundice in whites of the eyes 3. Fever 4. Chronic fatigue 5. Rapid heartbeat 6. Paleness Complications include leg ulcers, shock, cerebral hemorrhage, and orthopedic disorders. Polycythemia Vera This disease is more common in middle aged men and is characterised by an increase in red blood cells, leucocytes, and thrombocytes. There is a very fast and intense reproduction of cells and the bone marrow cells mature more rapidly than usual. The cause of this condition is unknown. Symptoms are: 1. Purplish coloured skin 2. Bloodshot eyes 3. Headache 4. Dizziness 5. Enlarged spleen Although the signs and symptoms of anaemia may seem overwhelming, the good news is that most forms can be effectively controlled with medication and dietary changes.

Treatment:
Oral iron supplements are the best way to restore iron levels for people who are iron deficient, but they should be used only when dietary measures have failed. However, iron supplements cannot correct anemias that are not due to iron deficiency. Iron replacement therapy can cause gastrointestinal problems, sometimes severe ones. Excess iron may also contribute to heart disease, diabetes, and certain cancers. Doctors generally advise against iron supplements in anyone with a healthy diet and no indications of iron deficiency anemia. Treatment of Anemia of Chronic Disease. In general, the best treatment for anemia of chronic diseases is treating the disease itself. In some cases, iron deficiency accompanies the condition and requires iron replacement. Erythropoietin, most often administered with intravenous iron, is used for some patients.

Oral Iron Supplements

Supplement Forms. There are two forms of supplemental iron: ferrous and ferric. Ferrous iron is better absorbed and is the preferred form of iron tablets. Ferrous iron is available in three forms: ferrous fumarate, ferrous sulfate, and ferrous gluconate. The label of an iron supplement contains information both on the tablet size (which is typically 325 mg) and the amount of elemental iron contained in the tablet (the amount of iron that is available for absorption by the body.) When selecting an iron supplement, it is important to look at the amount of elemental iron. A 325 mg iron supplement contains the following amounts of elemental iron depending on the type of iron:

Ferrous fumarate. 108 mg of elemental iron Ferrous sulfate. 65 mg of elemental iron Ferrous gluconate. 35 mg of elemental iron

Dosage. Depending on the severity of your anemia, as well as your age and weight, your doctor will recommend a dosage of 60 - 200 mg of elemental iron per day. This means taking one iron pill 2 - 3 time during the day. Make sure your doctor explains to you how many pills you should take in a day and when you should take them. Never take a double dose of iron.

2.Describe the disease condition where diethyl-carbamazepine s is used. Give its indication and contra indications of it.
Diethylcarbamazine (DEC) is an anthelmintic drug that does not resemble other antiparasitic compounds. It is a synthetic organic compound which is highly specific for several parasites and does not contain any toxic metallic elements.

Indication
Used for the treatment of individual patients with certain filarial diseases including tropical pulmonary eosinophilia, loiasis, and lymphatic filariasis caused by infection with Wuchereria bancrofti, Brugia malayi, or Brugia timori.

3. Diethyl Carbamazine and Other Contraindications Pregnancy, hypersensitivity; lactation; infants, elderly or debilitated patients; impaired renal function; cardiac disease. 5. Describe the Pharmacology of diethylcarbamazepine.
Class: Diethylcarbamazine citrate (N, N-diethyl-4-methyl-1-piperazine carboxamide dihydrogen citrate or DEC) is derived from the anthelminthic agent piperazine. Antiparasitic Activity: Diethylcarbamazine is the drug of choice for treatment of lymphatic filariasis, caused by the parasites Wuchereria bancrofti, Brugia malayi, and of loaiais caused by the filarial parasite Loa loa. A summary of the effects of DEC on geohelminths is shown in Table 1. Mechanism of Action: Proposed mechanisms of action include platelet-mediated triggering of the release of excretory antigen from microfilariae, with killing involving free radicals, drug-induced alteration of prostaglandin metabolism in microfilariae and/or in host endothelial cells, leading to immobilization of microfilariae on endothelial surfaces and adherence and killing by host platelets and granulocytes and inhibition of microtubule polymerization.

Pharmacokinetics: Diethylcarbamazine is well absorbed following oral administration with peak plasma concentrations reached within 1-2 hours. The elimination half life ranges from 10-12 hours. If the urine is alkalinized, renal excretion of unchanged drug is prevented and the half life of the drug increases.

Dosage: While the standard regimen for treatment of Bancroftian filariasis is traditionally 6 mg/kg/day, (generally divided into 3 doses for increased tolerability) for 12 days, to reach a total dose of 72 mg/kg, recent studies have shown that single doses of diethylcarbamazine (DEC) have the same longterm (1-year) effect in decreasing microfilaraemia as the formerly-recommended 12-day regimens of DEC. More importantly, the use of single doses of 2 drugs administered concurrently (optimally albendazole with DEC or ivermectin) is 99% effective in removing microfilariae from the blood for a full year after treatment. It is this level of treatment effectiveness that has made feasible the new efforts to eliminate lymphatic filariasis.

4. Why water soluble vitamins are used in tuberculosis treatment? Pantothenate is a water soluble vitamin essential in microorganisms and plants as it is the key precursor for the biosynthesis of coenzyme A (CoA) and acyl carrier protein (ACP; 11). Pantothenate synthetase, encoded by the panC gene, catalyzes the formation of pantothenate in bacteria, yeast, and plants (12). In mammals it is obtained through the diet. In most plants, bacteria and yeast, pantothenate biosynthesis is essential. The pathway is shown in Figure 1.

Figure 1 Pantothenate Biosynthesis in Bacteria, Plants, and Yeast. Recently Jacobs et al. (13) reported that an auxotrophic mutant of MTB defective in the de novo biosynthesis of pantothenate is highly attenuated in immune compromised mice. This indicates that a functional pantothenate biosynthetic pathway is essential for virulence of MTB. Also Jacobs (14) has been studying M. tuberculosis knock-outs of panC/panD and lysA in the virulent

H37Rv strain of M. tuberculosis. The phenotype of the mutant M. tuberculosis cells is the same as the one observed when the RD1 region (where RD1 is the biggest deletion region in the vaccine BCG strain compared to the virulent H37Rv strain) is also knocked out of H37Rv M. tuberculosis strain. This implicates the pantothenate biosynthetic pathway in the pathogenetic nature of H37Rv M. tuberculosis strain.