The development of sickle cell anaemia in the patient is through polymerization of the molecules found in deoxygenated haemoglobin. The polymerization results in the formation of rigid polymers that appear like rods. Some of the symptoms that the patients were showing include marrow depression and paleness. The patients were becoming pale as they lacked blood enough blood in their bodies. Marrow depression was as a result of low red-blood-cell count in the patient's body. The symptoms indicate that the oxygenated haemoglobin in the patient's body was inadequate. The treatment of the condition was done using Hydroxyurea and placebo. Hydroxyurea was administered to the patient in amounts of 15 mg per kilogram of the body. The payment was increasing by 5 mg per kilogram of the body after 12 months. However, if there was a low red blood cell count, the red blood cells' treatment was stopped to increase. The investigation's retrieval was for the patient to regain the red blood cell and continue with the medication.
The management of the pain from sickle cell anaemia is challenging. The patient's treatment aimed at realizing if Hydroxyurea or placebo is effective in managing the problem. Studies indicate that there are limitations to the treatment and pain crisis of sickle cells despite a better understanding of the pathophysiological nature of the disease. Hydroxyurea has been proven to be effective in the management of sickle cell anaemia pain. However, patients still have crises as it results in end-organ damage (Niihara et al., 2018). The condition is genetic and thus is inherited from the parents. The major crises that result from the disease are vaso-occlusive. There is a limitation to the number of treatments of the situations. Prasugrel underwent clinical trials to try and establish the level of effectiveness in the treatment of vaso-occlusive concerns (Heeney et al., 2016). The outcomes indicate that the prasugrel is not sufficient and results in an increase in the overall hemorrhagic and no hemorrhagic effects.
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Sickle cell disease alters the structure and functioning of the kidney. In the process, there will be changes in renal syndromes and illnesses. The diverse outcomes of the kidney functioning represent the unique vascular pathobiology of sickle cell anaemia. Also, there is a reflection on the propensity in of the red blood cells to sickle cell due to hypoxic and acidic nature of the hyperosmolar conditions. The prominent role of the kidney in the body is to remove waste from the blood. There are small vessels that are key in necessitating the process of waste removal from the blood. The waste is made part of the urine and is released from the body. Sickle cell anaemia blocks the flow of blood to the kidney. That means there is less supply of oxygenated blood to the kidney, and it affects the normal functioning. There is a high chance of development of hypoxia which is a condition of low blood oxygen. Also, there can be a renal failure as the kidney will not be able to remove waste from the blood and regulate the amount of salt in the body.
The primary symptom that led to the diagnosis of the condition is a crisis. Crises are periodic pains that arise when an individual is suffering from sickle cell anaemia. The main results from there is blockage of blood flow to the tiny vessels found in the chest, abdomen and the joints. The blockage of blood flow is because of the sickle-shaped red blood cells that do not have oxygenated blood. There is a variation of the intensity of the pain in the patient. The problem that the patient is experiencing lasts for a few hours. Another clinical symptom that the patient was experiencing which led to the diagnosis of anaemia. Anaemia is visible from pale fingernails and below the eyes. Anaemia is as a result of low red blood cell count in the blood (Ataga et al., 2017). Sickle cell easily breaks apart and die, and that leaves an individual with fewer blood cells. A normal red blood cell can leave up to 120 days before they die and are replaces. However, for the sickle cell, they live up to between 10 and 20 days, and that makes an individual have a shortage of red blood cells in the blood.
There are also some subclinical symptoms in the patient that can lead to the diagnosis of sickle cell disease. One is the swelling of the feet and the hands. The node is because of the sickle-shaped red blood cells that prevent the smooth flow of blood to the hands and the feet of the patient. Another subclinical symptom is a frequent attack of other diseases that the patients were experiencing, such as pneumonia. The frequent attacks are because of the damage of the spleen by sickle cell. The examination of both the subclinical and clinical symptoms show the relationship that exists between the two. The subclinical symptoms appear before, and they act as red flags indicating that the patient might be suffering from sickle cell anaemia. Suppose there is persistence in conditions like pneumonia. In that case, it is fit to start considering other clinical symptoms for anaemia, such as determining the red blood cell count in the blood of the patient.
From the research article graph B in figure two shows measures the number off-cells in the treatment progress of the patient. The f-cell in the measured in both the patient that was receiving Placebo and Hydroxyurea as a treatment intervention for crises. The outcomes indicate an increase in the number off-cell among the patients being treated with Hydroxyurea that those being treated with placebo. From the results, it is evident that hydroxyureas are more compelling is the management of the crises (Harache et al., 1995). There is an increase in the number of red blood cells in the body and thus more oxygen circulation to the chest, abdomen and joints, which are the main areas resulting in the pain. In the cumulative event rate, the graph measures the number of episodes of crises that individual get while in the treatment progress. The outcomes show a low number if cumulative events in the hydroxyurea group that in the group being treated by placebo. A reduction in the number of episodes of the pain shows the level of effectiveness of the treatment.
The mechanism being affected by the medication and treatment is the number of red blood cells in the body and circulation of oxygen which affects the functioning of other body organs like the kidney. With the treatment, there is an increase in oxygenated blood in the body that is transported to the kidney small blood vessels, and that increases its function of removing waste from the blood. The main concern of the mode of action of the treatment is that Hydroxyurea might be carcinogenic. The treatment affects the synthesis of DNA material, and that affects the alternative treatment mechanisms (Harache et al., 1995). The main focus is to reduce the pain but affecting other body organs means there is need to have alternative treatment mechanisms. To improve on the effectiveness of the treatment patient that show kidney failure will need to undergo dialysis or even a kidney transplant is many challenging situations. If the condition is causing pneumonia, there is a need to have a prescription for the pneumonia condition. For the selling of the hands and legs, the treatment will be towards controlling the selling.
In conclusion, sickle cell disease mainly affects the oxygen supply in the body. The main symptom that the patient is showing is crises which are episodes of pain. The treatment is done using two drugs. The mediations are Hydroxyurea and placebo. The aim if to determine the level of effectiveness of the two drugs in reducing the intermittent pain that the patient experience. The problem is as a result of the limitation of supply of oxygen to the joints, chest and the abdomen. Sickle cell disease affects the functioning of the kidney. The sickle-shaped red blood cells prevent the flow of oxygenated blood to the small vessels of the kidney. Thus, the kidney is not able to purify the blood, and it worse conditions it many leads to kidney failure. Therefore, in the treatment mechanism, there is a need to consider dialysis or kidney transplant for severely affected patients. The outcomes of the treatment indicate that Hydroxyurea is more effective in the treatment of crises than placebo. However, there are other adverse effects of the drugs as they are carcinogenic, and the main concern is its effects on pregnant women.
References
Ataga, K. et al. (2017). Crizanlizumab for the prevention of pain Crises in sickle cell disease. New England Journal of Medicine, 376 (1), 429-439.
Heeney, M. et al. (2016). A multinational trial of prasugrel for sickle cell vaso-Occlusive events. New England Journal of Medicine, 374 (1), 625-635.
Niihara, Y. et al. (2018). A Phase 3 trial of l-Glutamine in sickle cell disease. New England Journal of Medicine, 379 (1), 226-235.
Harache, S. et al. (1995). Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia. New England Journal of Medicine, 332 (20), 1318-1322.
