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Paralysis

Paralysis is a neurological disorder which is associated with the impairment of voluntary functions of the muscles. The important cause for paralysis is metabolic disorders of the neuromuscular functionalities. The attack of paralysis in the body is categorized into various types such as paraplegia (lower body), hemiplegic (one side of the body) and quadriplegia which is localized only to the legs. The motor and sensory activities are impaired at respective regions where the onset of paralysis takes place.


Causes of paralysis

The onset of paralysis has many predisposing factors and medical conditions. Thorough understanding and evaluation of these conditions paves the way for comprehensive diagnosis and treatment.

Ischemic cerebral stroke: Stroke is one of the fatal causes for paralysis. It happens because of the lack of blood supply to the cerebral region. The neuromuscular junctions are subjected to damage because of oxygen deficiency and hence the nerve cells associated with the efferent and afferent functions are impaired.


Trauma: Injuries to the head and spinal cord result in blood vessel and neural cell damage. In some cases paralysis associated with trauma can be localized and affects one region of the body. This phenomenon depends upon the site of the head injury and the peripheral neuromuscular fibre associations.

Infections and other causes: Paralytic occurrences can happen in patients who have a history of meningitis and abscesses present in the brain because of bacterial infections. Other causes of paralysis include Guillian Barre syndrome, cerebral palsy and multiple sclerosis.


Diagnosis and treatment

The definitive diagnosis of paralysis depends upon the source of its onset and progression. Paralysis neuromuscular dysfunction for which many causes are possible. Pathologically, paralytic sites indicate appearances of tissue necrosis caused because of gangrene associated hypoxia and ischemia. Cellular pathology often indicates dead cells and tissue debris because of necrosis. Surgical intervention is recommended in order to remove the necrotic tissue present in the regions like central nervous system.

Diagnostic interventions to paralysis include radiological examinations of the necrotic sites, nerve conduction studies in order to understand the myogenic and neurogenic abnormalities along with sensory and motor functions of a respective region. If malignancies are suspected, fine needle aspiration, cytology and biopsy tests are recommended to understand cellular pathology.


Treat of paralysis is mostly therapeutic in origin. It is necessary to identify the cause of the paralytic disease and to treat it appropriately with antimicrobial drugs in case of infections. Physiotherapy is advised to facilitate motor and sensory functions.

Pathologist

Pathology is the study of disease origin and it paves a way for comprehensive diagnosis of medical conditions for effective prognosis. The role of a pathologist offers significant diagnostic approach in the field of clinical laboratory science. It is important position as it requires exceptional interpretational skills associated with anatomical and physiological changes in the cells, tissues and body fluids.


Pathologists have diverse responsibilities ranging from cytology to molecular studies. Studies such as autopsy are essential in the field of forensic medicine, identification of genetic disorders and also the origin of disease. The results are interpreted by a pathologist. Biopsy on the other hand is a routine procedure for many major health complications to detect the presence of inflammatory diseases and cancer. Many important fields such as microbiology, hematology, biochemistry, immunohistochemistry, transfusion medicine come under clinical pathology, which is very important to determine the cause of any disease. Pathologists in clinical research pave the way for the discovery of new drugs and better diagnostic ventures for comprehensive patient care.


Roche DNA Test

Recently the Federal health, Food and Drug Administration regulators in the US cleared the Roche HPV test to detect the Human Papillomavirus in women aged 25 and above. Roche's is primarily a genetic test that could be done as a first-choice screening option for cervical cancer. This is an advance on the decades-old Pap smear.

Roche diagnostics conducted a study that provided the FDA with reasonable assurance of the safety and effectiveness. Roche's trial included 47,000 women who underwent cervical screening using either Pap or HPV screening. The results were checked for accuracy against final biopsy results that confirmed whether they actually had cancer.


As such doctors use DNA-based tools as a follow-up to confirm Pap smear results. Now, Roche DNA test can be used as a first-choice option for cervical cancer screening, ahead of the Pap test.

The FDA approval comes despite warning from health advocates that approving the DNA test as an alternative to Pap could lead to confusion, higher costs and over treatment of younger women who carry the virus that have little risk of developing actual cancer.

While Roche supported its study results suggesting that genetic testing is more accurate and objective at identifying cancerous growth than the Pap smear, there are no major medical guidelines that recommend HPV testing alone for cervical cancer screening. Some physicians and gynecologists advice holding off using the test until medical societies can provide guidance to some key questions which include how frequently it should be used.


Pap test was the only available screening option for cervical cancer for decades. Due to increased Pap screening, in the US, the number of reported cases of cervical cancer has decreased more than 50 percent in the past 30 years. Yet, an estimated 12,000 cases of cervical cancer are expected to be diagnosed this year. Hence Roche and other test markers developed HPV tests – although the cost of Roche's HPA is twice and even more as that of the Pap which is $ 40.


The American Cancer Society has tried to evolve latest guidelines incorporating both techniques. A Pap test is recommended every three years for those aged between 21 and 29 years of age and older women should have both a Pap test and an HPV test every five years, or only a Pap every three years. Also, according to FDA, women who test positive for HPV 16 or 18 should proceed directly to colposcopy, which is an invasive procedure in which the cervix is viewed with a magnifying device and often tissue sample is collected for testing. A positive test for one or more of the other 12 high-risk HPV strains should be followed by a Pap test to determine the need for colposcopy.


As women in their 20s could be exposed to the danger of more invasive testing that could leave the cervix less able to handle pregnancy later in their life if they undergo a HPV screening, they are advised not to do so.

Roche DNA test claims to have the superior ability to detect HPV DNA and individual types. It is also capable of detecting HPV genotypes present in multiple infections. This can occur in up to 35% patient samples. It uses standardized and quality controlled reagents to do the test. Due to co amplification primer concentrations are used. This minimizes competition.

It helps identify women at risk and optimizes treatment strategies. It helps further stratify women with normal cytology who are HPV positive into different categories. The test also provides physicians with actionable information to treat the highest risk patients immediately.


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Bibliography / Reference

Collection of Pages - Last revised Date: June 24, 2019