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Myelodysplastic Syndrome

Myelodysplastic syndrome or MDS refers to a group of blood disorders caused by defective blood cell production in the bone marrow. Bone marrow produces immature blood cells called blasts, which over a period of time develop into mature blood cells and divide themselves into red blood cells, white blood cells and platelets. In Myelodysplastic syndrome, these blasts fail to mature and either die in the marrow itself or soon after they reach the blood stream. When there are not enough healthy blood cells, the body becomes weak and is susceptible to infections. MDS is not a cancer, however, in 20 to 30% of patients, the condition may progress itself into cancer and thus this condition was earlier called preleukemia.

Causes of Myelodysplastic syndrome

Based on causes, Myelodysplastic syndrome can be classified into primary MDS and secondary MDS. Myelodysplastic syndrome presenting itself without any known cause is called primary MDS. Myelodysplastic syndrome may also occur due to some known reasons such as history of cancer treatment involving radiation and chemotherapy, exposure to certain industrial chemicals and smoking. When the cause of the MDS condition is known, it is called secondary Myelodysplastic syndrome. Identifying the type of MDS is vital to the treatment as primary MDS has better prognosis when compared to secondary MDS.


Symptoms

Myelodysplastic syndrome does not cause any symptoms in the initial stages of the disease. However, the following warning signs may show up as the disease starts to progress.


  • Fatigue due to anemia
  • Frequent infections due to damaged immune system
  • Shortness of breath
  • Paleness
  • Easy bruising or bleeding can occur due to low platelet count.
  • Small red spots just under the skin.

Diagnosis and treatment

MDS is diagnosed with the help of blood tests and bone marrow tests. A complete blood test is done to understand the different blood counts. However, blood tests alone cannot detect MDS. Bone marrow tests are conducted to confirm the presence of Myelodysplastic syndrome. This procedure involves taking bone marrow samples from the pelvic bone of the patient by inserting a needle under local anesthesia. Once MDS is determined, the following methods are followed to treat the condition.


  • Chemotherapy drugs
  • Blood transfusion to treat anemia and low platelet count.
  • Using medications called growth factors to allow the bones marrow to make more blood cells.
  • Antibiotics to treat infections
  • Stem cell transplant, an option that promises a cure to MDS, yet not widely adopted, as not many candidates qualify for this method. This method involves destroying the existing cells in the bone marrow via chemotherapy and radiation and infusing the stem cells from the donor.

Mefenamic Acid

A non steroidal anti-inflammatory drug NSAID, Mefenamic acid is predominantly used for treating mild to moderate dysmenorrhea or menstrual pain for a short term, for not more than a week. It may also be used for treating other symptoms at the discretion of the doctor. Mefenamic acid helps to reduce inflammation and thereby pain by blocking the production of some of the body chemicals that cause inflammation, pain, tenderness, stiffness, swelling and increased temperature.


Mefenamic acid blocks the body from producing prostaglandins that are linked to inflammation, thus treating the symptoms of pain and inflammation. In muscles and joints, Mefenamic acid helps to improve movement by reducing inflammation, although it may take a few weeks to relieve pain after the first few doses. This medicine is normally prescribed at the lowest possible dose for the shortest period of time to reduce chances of any side-effects. However, Mefenamic acid should not be taken if the patient exhibits the following:


  • Is allergic to any ingredient in Mefenamic acid.
  • If the patient has allergic reaction such as severe rash, trouble breathing, dizziness and is allergic to aspirin or to any NSAID such as ibuprofen etc.
  • Had bypass heart surgery recently.
  • Had kidney problems, ulcers, or inflammation of the stomach or bowel.
  • Is in the last 3 months of pregnancy.
  • It is not advised to use this acid on the elderly. They may be more sensitive to its effects, especially stomach bleeding and kidney problems.
  • Mefenamic acid should be used with extreme caution in children younger than fourteen years of age.

Before using Mefenamic acid, a woman must check the following:


  • If she is pregnant or planning to become pregnant or is breast-feeding.
  • If she is taking any prescription or non-prescription medicine (including herbal preparation) or dietary supplements.
  • If she exhibits allergies to medicines, foods or other substances.
  • If she has a history of liver disease, diabetes, or stomach or bowel problems such as bleeding, ulcers and perforation.
  • If she has a history of swelling or fluid buildup, breathing problems and asthma, or mouth inflammation.
  • Has high blood pressure, blood disorders, clotting, or is at risk of any other disease.
  • If she is in poor health, suffers dehydration or low fluid volume, low sodium levels, drinks alcohol or has a history of alcohol abuse.

Using Mefenamic acid

There are some medicines which could interact with Mefenamic acid and the healthcare provider has to be informed if any one of the following is taken:


  • Anticoagulants such as aspirin, corticosteroids, heparin; as there could be the risk of increased stomach bleeding.
  • Magnesium hydroxide; which could increase the side effects.
  • Cyclosporine, lithium, methotrexate (such as ciprofloxacin), sulfonylureas; as the risk of side effects are increased.
  • Angiotensin or diuretics because their effectiveness is reduced by Mefenamic acid.

This acid has to be used with great caution as it could cause dizziness or drowsiness. This can get worse if you take it with alcohol or certain medicines. As Mefenamic acid may interfere with certain lab tests, be sure that the doctor or lab technologist knows that Mefenamic acid is being taken - especially in case of blood cell counts, blood pressure, kidney function tests.



Hematologist

Hematologists are physicians who specialize in diagnosing and treating ailments related to blood, and blood systems such as bone marrow, vascular systems etc. They deal with conditions such as anemia, leukemia etc. Hematologists should be strong in the field of internal medicine, anatomy, physiology, and bio-chemistry too. A hematologist completes medical school and undergoes internship for three years in the field of internal medicine and further specializes for two years in the field of hematology. Few hematologists are also trained Oncologists, who treat problems related to blood cancer. Hematologists are specialists in treating blood disorders and anything to do with blood. They :


  • Interpret blood test results by studying the blood films and bone marrow films under the microscope.

  • Treat blood disorders like hemophilia.

  • Treat cancerous conditions linked to the blood like leukemia, lymphoma etc.

  • They deal with blood transfusion sciences etc.

  • They deal with bone marrow aspirations, bone marrow biopsy, chemotherapy etc. in a few cases they also prescribe medications for anemia etc.

  • Hematologists handle computerized diagnostic equipment and complicated bio-chemical analyses with proficiency and ease.

Modern techniques used in the field of hematology

  • Diagnostic equipment with latest computer technology helps in drawing clear conclusions on the disorders of the blood.

  • Various bio-chemical analyses help in understanding the condition of the blood and related problems in a better manner.


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Bibliography / Reference

Collection of Pages - Last revised Date: November 19, 2019