Monsoon Pregnancy Care Tips & Precautions

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Monsoon is one of the most loved seasons in India. The thundering sky, heavy rains, making paper boats, and wearing raincoats, everything related to monsoon brings back happy memories. Monsoon is that time of the year when you should be more cautious about your health, especially if you are pregnant. While the monsoon gives relief from hot summer, allergies, other hazards are lurking around.

The gloomy weather not only sets the stage for mood swings (though for some it can be just the opposite) but also makes you susceptible to various infectious or communicable diseases with an already suppressed immune system.

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Here are ways in which you can tackle the monsoons with ease :-

Increase your water intake:

Most people do not feel thirsty due to increase in humidity. During monsoons, you must keep yourself well hydrated and keep a count of your water intake. This will help you flush out toxins from the body. Drink purified or boiled water when you feel thirsty. Make it a habit to consciously drink at least 2 to 2.5 litres of water throughout the day.

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Dressing for the season:

Humidity increases manifold during monsoons, this can cause excessive sweating. ‘So avoid wearing uncomfortable clothes, especially if you are in your last trimester. Make sure that you wear clothes that fit you well or are a bit loose around the tummy. Choose light cotton to go with the season,’ says Dr. Bandita Sinha, consultant gynecologist and obstetrician, SSD hospital, Mumbai.

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Ensure optimal hygiene: 

To keep you cool and fresh bathe at least twice daily. Keep a wet tissue handy to wipe off sweat and grime. Wash your hands, ideally with warm water before you eat or touch your food. Use a hand sanitizer instead if you are outdoors or at work.

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Sanitize Your Home :

Pest Control your house during the monsoon to free your home from disease spreading insects like flies, cockroaches, termites, and mosquitoes, etc. But, make sure you stay away during the process as the smoke with chemicals may affect your pregnancy in a negative way.Use a high quality disinfectant to clean your house and keep it germs free.

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Pregnancy yoga:

While you are likely to stay indoors for most of the time, indulging in pregnancy yoga can be a good way to pass the time. Yoga during this time of the year can help you get through with minimal discomfort. It will also help child-birth and post-delivery stages. Read about yoga postures, exercise safety, and more – http://13.126.47.98/blog_/?cat=17

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Keeping the above pregnancy tips in mind will ensure happy monsoon and healthy pregnancy. All to-be mothers take utmost care of yourself and make the best effort secure the future of their upcoming baby.

 

 

Stem Cell Banking and importance of HLA

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Cord blood, which contains powerful stem cells, comes from a newborn’s umbilical cord and is collected immediately after birth. Once the umbilical cord has been clamped and cut, the remaining blood in the umbilical cord is drawn into a collection bag, which is then processed and preserved at -196 degree Celsius.

What makes cord blood cells different?

Cord blood stem cells are biologically younger and are more adaptable compared to adult stem cells from other sources like bone marrow. When saved, they have unique qualities and advantages:

Comparison of Stem Cell Sources Newborn Adult Embryonic
Ability to differentiate into various cell types ✓ ✓ ✓
High proliferation capacity ✓ ✓
Low risk of tumor formation ✓ ✓
Low risk of viral contamination ✓ ✓
Capacity for autologous transplantation ✓ ✓
Established / proven treatment in human patients ✓ ✓

 

Stem cells can heal the body, promote recovery, and offer an enormous amount of therapeutic potential. Preserving cord blood stem cells “stops the clock” and protects the stem cells from aging and being exposed to environmental factors and common viruses that can decrease their function.

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The effectiveness of cord blood stem cell therapy depends on many factors, with one of the most important being stem cell matching. Doctors determine stem cell matching based on human leukocyte antigen (HLA) markers. Passed down from parents to their children, these markers act like cell fingerprints, letting the immune system know which cells belong in the body and which cells are foreign to it. If a patient’s HLA markers exactly match those of the new stem cells being introduced, the patient’s body will readily accept the cells. If the HLA match is close but not perfect, chances are still favorable that the patient’s body will accept the cells. By storing cord blood from each child, parents can increase the chance of finding the best source for a match.

HLA means Human Leukocyte Antigens, which are found on the surface of various types of nucleated cells in the human body. In the human anatomy, they are akin to an “identity card”, inherited from one’s parents and could distinguish “self” and “nonself”, through which the wholeness of an individual can be maintained. Briefly, there are 6 HLA types: A, B, DQ and DR. Out of which A, B and DR play a critical role during cord blood transplants.A cord blood transplant is just as effective at curing patients with only a 4 out of 6 match (67% match) between donor and patient whereas for bone marrow transplant the patient and donor must match at all 6 parameters (100% match).       The best potential for an HLA match is within the family. Each person inherits one A, B, DR antigen from each parent. Thus, we have 2 HLA-A antigens, 2 HLA-B antigens and 2 DR antigen which make up total 6 anitgens. In case of a Cord Blood Transplant 4/6 is a suitable match.

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When an unrelated donor is sought the number of potential HLA combinations becomes so enormous that finding the patient’s exact HLA type may seem like searching for a needle in a haystack. HLA helps to understand the acceptance and recovery after transplantation on two factors

  • Engraftment – Engraftment occurs when the donated cells that were transplanted begin to grow and make new cells.
  • Graft-Versus-Host Disease (GVHD)-A post-transplant complication, GVHD occurs when the immune cells from the cord blood (the graft) attack the patient’s own immune cells.

Considering the benefits of cord blood stem cells, need of stem cell banking and importance of HLA at the time of preservation, it is recommended for to-be parents to wisely choose a stem cell bank that provides HLA Typing service at the time of preservation. Saving your child’s cord blood is an investment towards your family’s future health; thus, its benefits cannot be measured in financial terms.  However, if one must make economic justifications, the cost of storing cord blood and tissue pales in comparison to the many expenses associated with raising a child today, such as the cost of child care and education. The potential return on investment in stem cell banking is paramount as it can save the lives of your loved ones.

Umbilical cord blood banking in India is emerging at very high pace and parents are realizing the potential of cord blood in curing previously incurable diseases. To know more about stem cells and umbilical cord blood banking in India visit – www.babycell.in

Tests and Services To Look Out For While Opting For Stem Cell Banking

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There are a number of things that need to be kept in mind while opting for stem cell banking such as cryopreservation facility, location, cost, collection and transportation facility. Over and above the basic services one must also ensure they choose a stem cell bank is transparency in providing the complete detailed reports of all the tests performed such as sterility, CD34 cell count, viability CFU, HLA Testing and more.

Stem cell banking benefits:

Storing these cells can help you treat over 80 diseases including cancers, blood disorders, and immune disorders. Stem cells also have the ability to rebuild cardiac tissue, repair damage due to stroke or spinal cord injuries, reverse the effects of diseases such as multiple sclerosis, Alzheimer’s and Parkinson’s, and much more. As a result, cord blood banking is worth spending for. Below is a list of tests and services you must look for:

Sterility Test: Sterility Test detects any kind of aerobic and anaerobic microbial contamination in the cord blood and cord tissue. Helps to ensure micro-organism and contamination free cord blood and cord tissue which can be used in future transplantation.

 

Stem Cell Count: Stem cells happen to be Mono-Nuclear Cells or MNC: when you look at them under a microscope there is only one nucleus. Unfortunately, one of the most difficult aspects of stem cell biology is that you can’t identify a stem cell just by looking at it.  There are other types of blood cells which are also MNC, such as nucleated red blood cells.  The only proof that a cell is a stem cell comes from how it behaves when it multiplies. Stem Cell Count test is done to determine the number of stem cells in the isolated fraction of cord blood cells. Stem Cell Count aids the hematologist in determining the treatment plan for stem cell transplantation.

 

CFU: Stem cells have the ability to differentiate, but how do you evaluate this ability? The answer to this is CFU test. This test is a two-week lab test that lets you estimate the cell potency. In the CFU test a small portion is observed under controlled conditions to see if stem cells differentiate to form colonies.  Earlier it used to be a subjective measure, but recently it has been standardized with technology to image the cells and count colonies in the image. During the test it takes 14 days for colonies to grow, therefore it is advised to perform the test at the time of preservation. As per US. Dept. of Health and Human Services and their prescribed guidelines CFU evaluation is a must at the tim

e of preservation as it determines potency, differentiation capacity and actual utility of stem cells. Babycell™ is the only stem cell bank in India that performs the CFU assay at the time of preservation and provides the test results along with client’s Cryopreservation Certificate.1

 

HLA testing and its importance:

HLA means Human Leukocyte Antigens, which are found on the surface of various types of nucleated cells in the human body. In the human anatomy, they are akin to an “identity card”, inherited from one’s parents and could distinguish “self” and “nonself”. Briefly, there are 6 HLA types: A, B, DQ and DR. Out of which A, B and DR play a critical role during cord blood transplants. A cord blood transplant is just as effective at curing patients with only a 4 out of 6 match (67% match) between donor and patient.

The best potential for an HLA match is within the family. Each person inherits one A, B, DR antigen from each parent. Thus, we have 2 HLA-A antigens, 2 HLA-B antigens and 2 DR antigen which make up total 6 anitgens. In case of a Cord Blood Transplant 4/6 is a suitable match.

When an unrelated donor is sought the number of potential HLA combinations becomes so enormous that finding the patient’s exact HLA type may seem like searching for a needle in a haystack. HLA helps to understand the acceptance and recovery after transplantation on two factors

  • Engraftment – Engraftment occurs when the donated cells that were transplanted begin to grow and make new cells.
  • Graft-Versus-Host Disease (GVHD)-A post-transplant complication, GVHD occurs when the immune cells from the cord blood (the graft) attack the patient’s own immune cells.

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Haemoglobinopathy Test:

Haemoglobinopathy is a condition that involves an abnormality in the structure of haemoglobin. An investigation of a hemoglobin disorder typically involves tests that determine the types and amounts of hemoglobin present in a person’s sample of blood. Information from the test, along with results from routine tests such as a complete blood count (CBC) and blood smear, aid in establishing a diagnosis of Hemoglobinopathies.

With this test, you can detect the disorders and arrange a treatment accordingly.

So the next time you are looking for a reliable stem cell banking in India or anywhere in the world, keep the above services in mind. They will definitely help you choose the right stem cell banking service that lets you make the most for your loved ones.

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To know more read –

  1. http://www.babycell.in/our-services/core-services.php
  2. http://parentsguidecordblood.org/en

A journey towards Fatherhood

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Becoming a father is a life changing and beautiful experience in a man’s life. The journey will be full of ups and downs but it’s definitely a memorable one.

The most memorable moments include the time spent with the newborn baby, giving the baby a bath, cooking for your wife when she is busy taking care of the baby, clicking innumerable photographs of the baby and your family and changing the diapers as it’s fun activity that encourages baby bonding.

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Here are a few easy ways that will guide you all to make your journey fun and easy –

1] Before Child’s Delivery –

When you come to know that you and your wife are expecting your first baby, you need to plan many things before the baby is born. Both the partners have to make sure that they raise their upcoming baby as a team and not at as individuals. The father always intend to plan the best for securing his baby’s future. One of the most important decisions that a couple takes for the baby before he/she is born is enrolling for stem cell banking. Check out the list of what you must look for in a stem cell bank – http://13.126.47.98/blog_/?cat=18. You can also read about benefits of cord blood banking on http://www.babycell.in/.  Cord blood stem cells have a potential to cure over 80 diseases, parents must ensure cord blood preservation to protect baby and family.

Dads-to-be must ensure that they accompany their wives to every doctor’s appointment and should also keep a tab on the health of mother and baby. They can attend parenting classes to understanding child delivery, baby care and more.

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2] During Child’s Delivery –

The moment your wife goes into labor instead of panicking, you have to make sure you are calm and supportive of her. Being calm during the delivery is a sign that you are off to a new start. Once your wife is in labor make sure that you have carried the cord blood collection kit box to collect the umbilical cord during the delivery and inform your cord blood bank to collect the cord post-delivery.

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3] Post Child’s Delivery –

Once the baby is born a family is complete, but at the same time, the challenges tend to grow. It is really important for you to spend time with the baby. Even if you are working outside the house, once you are back home you should it make it a point to spend as much time with the baby as possible. Giving the baby a bath is very important for baby – daddy bonding since this helps the baby get used to the dad’s touch. It’s important for you to provide emotional support to your wife by giving her an assurance that you are always there for her. The husband and the wife should make sure that they change the baby’s nappies together as it is a fun activity for family bonding. J The best way to increase family bonding is doing a photoshoot together to frame memories of a lifetime with your new bundle of joy! To check for tips on spending time with your baby read – http://13.126.47.98/blog_/?p=709

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Fatherhood is challenging, but your baby is always worth all the work!

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Why it’s important for every parent to spend quality time with their new-born

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Parenting is a fun, emotional and yet a tough journey; one needs a lot of patience to raise children. Parents have to understand babies and handle them with care in a friendly and patient manner, no matter what age they are.

Every parent intends to raise a happy, smart and well-adjusted child. Children from birth to adulthood need time and attention from their parents. Parents are often anxious to raise a “successful” child and they overlook the importance of spending time with them or interacting personally with the child. Quality time is the time when both child and parents are fully engaged in an activity together and enjoy the same.

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The ultimate motive behind spending quality time with the new-born is to love, understand, and develop your child as a happy, well-adjusted, and contributing member of society. If the relationship between parent and child is unhealthy, there are several negative outcomes when the child or adolescent does not receive the right love, attention, and guidance from the parents.

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There’s no particular way to build a strong relationship with the child – every family has to figure it out for themselves. There will be times when the parents don’t or can’t do what they would like to do for the child, but if proper quality time is spent it would lead to positive relationship between the newborn and the parent.

The relationship can be built by:

1] Playing with the Baby – It’s really very important for new parents to play with their babies as much as they can. Parents should engage playing games like peekaboo, playing soft toys etc. with their newborn as it helps to develop a bond with them and it also makes the newborn explore other things.

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2] Baby Bathing – Give a bath to your baby every day is a great way to develop a bond with your child. It is helpful in developing the ability to recognize their parent’s touch and also it helps them to get familiar with a particular surrounding

43] Taking your baby for a stroll – Taking your baby out for rounds from a very young age helps in making the baby adjusted to the surroundings out there and also during this period there are chances for the baby to develop a close bond with their parents

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4] Being in the moment with the newborn – Being in the moment would be giving attention to the new-born so that the child feels valued and loved. This kind of attention doesn’t have to be a big deal – the parent just needs to be in that moment mentally, physically and emotionally with the new-born.

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Taking some time out every day for the baby. Also scheduling a time exclusively for you and your child. Be sure that you do not get interrupted and disturbed. This exclusive time can be anytime during the day, just before bedtime and lead to giving bedtime story lessons to the child or right after coming from your office or after some time. Keeping in mind that the child will be waiting at that time and there should not be any distractions.

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If you’re expecting a baby and thinking what best you can do to strengthen the bond with your upcoming baby you must think about preserving your baby’s umbilical cord blood and strengthen the cord of love.

Preserving this eternal bond not only helps you secure a healthy future for your child but also builds a connection right from the time of birth!

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Pregnancy Diet – Essential Nutrients – Folic Acid

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Choosing a balanced diet during pregnancy is a must, it will help you meet your daily calorie requirements, keep a check on your intake and maintain a healthy body weight. During this phase, pregnant women should consume the right amount of protein, calcium, iron, vitamins, folic acid and more.

Take a look at some of the nutrients which deserve a star position in your pregnancy diet.

Folic Acid:

Is vital for the normal development of your baby’s brain, skull and spinal cord.

Proteins:

Proteins help pregnant mother’s produce amino acids that are the building blocks of the baby’s body.

Iron:

Iron is useful in the production of haemoglobin that helps to deliver oxygen and prevent premature delivery.

Calcium:

Calcium helps in the development of the baby’s brain.

Vitamin A:

Vitamin A helps in the creation of cells that will make up baby’s internal organs

Vitamin C:

Vitamin C helps in building a healthy immune system.

While every nutrient is important, there are a few that should be consumed on a larger scale. One of them is folic acid.

Why folic acid during pregnancy?

Folic acid is a B vitamin that helps a baby’s neural tube to develop properly which then becomes the brain and spinal cord. On the other hand, folic acid also helps prevent other birth defects, such as a cleft palate, etc. While folic acid plays a vital role, we have listed few myths and truths about this essential nutrient.

Folic acid is not the same as folate.

Myth 1:

Pregnant mothers who do not have a history of ‘spina bifida’ do not have to take folic acid.

Truth 1:

Most (95%) spina bifida cases happen in families without a history, so it is important to plan ahead and take folic acid regularly.

Myth 2:

Women, who are not planning to get pregnant anytime soon, do not need to consume folic acid.

Truth 2:

As half of all pregnancies are not planned, it is important to take folic acid every day.

Myth 3:

Foods that have folate, like orange juice also have folic acid. So, having a glass of orange juice will provide the required folic acid.

Truth 2:

Our bodies absorb a man-made form of folic acid found in vitamins easily. The best way to get the folic acid is by taking a vitamin with it.

Now that you know the myths and the truth associated with ‘Folic acid’, take a look at the top foods that serve as a rich source

1. Dark Leafy Greens 

If you are looking for an immediate boost in folic acid, make sure to include spinach, collard greens, kale, turnip greens and romaine lettuce into your daily diet.

 

12. Asparagus

Asparagus is rich in folic acid that makes it one of the best sources. Eating asparagus will provide you with Vitamin K, Vitamin C, Vitamin A, Manganese and more.

23. Broccoli

This source of folate is also one of the best detox foods. One cup of broccoli will provide you with approximately 24% of your daily folic acid needs and other nutrients.

34. Citrus Fruits

Fruits that are rich in citrus, contain a high amount of folic acid. Consider eating papaya, grapefruit, banana, cantaloupe and strawberries in your diet.

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How to include them in your diet?

There are a number of ways you could include folic acid in your diet. Some of the popular ways are listed below:

Juice: If you don’t prefer your greens boiled or cooked, put them in a juicer. You can consider having them with your breakfast. It is advised that you consume them fresh.

Salad: Salads too are a healthy and easy way to consume greens rich in folic acid. You can mix different sources of greens and enjoy.

Fortified cereals:

Most fortified cereals supply a whopping 100 to 400 mcg of folic acid in half cup to one and a half cup serving.

Mask it with your favourite dish:

While some of you might not like the taste of these greens, a good way to enjoy them is to add it to your favourite food dishes.

The best way to find out the right amount of folic acid that a women needs to consume varies from person to person. Hence, it is best to ask your experts who can help you with your diet.

So if you are pregnant or are about to conceive, make sure to include folic acid in your diet that can be vital for you and your baby.

 

 

 

Basics of Postnatal Care

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Whether you’re expecting or have just delivered your bundle of joy, you need to take special care of yourself. Mothers face a lot of emotional and physical changes that last anywhere from six to eight months. It ranges from hormonal changes, emotional highs and lows, uterus contractions, post-partum depression, breast problems, vaginal discharge and more.

While most mothers are often lost when it comes to dealing with these issues, the article below will enlighten you with the basics of postnatal care. Here are some tips that you should keep in mind.

Postnatal Check-ups:

You endured the nine months of pain, survived labour and brought your beautiful baby into this world, make sure all that was not for nothing. Make it a mandate to do a postnatal check-up and ensure your wellbeing as well as that of your baby.

You can consider opting for a postnatal care package that guarantees to provide extensive personalized care. A good package will ensure the following:

  • Tracking your healing progress
  • Removing sutures if present
  • Checking your blood pressure
  • Breastfeeding support, education, and much more.

Diet and Exercise:

Every women wants to look her best and the same can be said for mothers after childbirth. What new mums should keep in mind, is that losing weight immediately after is a big no-no. It can affect the quality of breast milk supply and in turn affect your baby during their crucial stages of development. Have plenty of fluids and consume a balanced diet consisting of fruits, vegetables, grains and protein food is a must, to keep yourself healthy.

There are some substances like alcohol (wine, beer), caffeine (tea, coffee, and chocolate) that need to be completely avoided.

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Post-partum depression:

Monday blues have a cure, it’s called any other day. Baby blues? Well, if you ever face anxiety, crying spells, mood swings and the likes for more than two weeks in more severe forms than normal, that’s post-partum depression. Consulting a doctor for assistance can do wonders, also you must spend quality time with your loved ones to overcome any stress or emotional imbalances.

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Breastfeeding:

Mothers are a source of a child’s strength. That statement holds true especially considering that breastfeeding your newborn provides the essential nutrients and vital elements for its development. It goes without saying, proper hygiene during breastfeeding should be maintained.

In case you are facing over lactation and your baby is not consuming, you can store the milk. Use sterilised containers. Label and date your containers. Keep your breast pump clean and wash your hands before expressing and handling breast milk for storage.

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Vaginal Care

There are always few complications after childbirth. If you happen to have a vaginal tear during delivery, you are likely to experience pain for a few weeks. Extensive tears might take longer to heal and scheduling a check-up with your doctor is highly advised. Besides that, it is advisable to abstain from sexual intercourse for four to six weeks after delivery, giving your vagina time to properly heal.

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Urination problems:

The swelling or bruising of the tissues surrounding the bladder and urethra may lead to difficulty while urinating. With time, this difficulty usually resolves on its own. However, in the meantime, pouring water across your vulva while sitting on the toilet might help. Practicing Kegel exercises can help tighten your pelvic muscles.

In case you experience a strong, persistent urge to urinate, burning sensation when urinating or pass frequent but small amounts of urine, contact your doctor immediately.

The Takeaway:

Every mother should try to stay healthy before, during and after pregnancy. Staying on top of your healthcare appointments and following your doctor’s instructions ensures you and your baby are healthy, happy and safe.

World Thalassemia Day | Stem Cell Therapy

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Here’s an infographic that explains how stem cell therapy has a cure for Thalassemia.
Now that we all know how stem cell therapy serves as the best possible cure for Thalassemia, we should make a point to spread awareness about this to our family and friends.
Thalassemia infographic (1)

Importance of Vaccination in India

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Immunization is the process of one’s immune system fortifying itself against attacks by foreign antibodies. When we sniff dust, we sneeze. Same is with the way the immune system functions. When the body senses any agents of a foreign nature, it responds with a solution to get rid of the agents. When it finds the right formula, it stores that information for when there is a need to find a solution again, but this time around much quicker than the last. This is called immunological memory. Thus, when you expose one to a strand of virus or foreign agent in controlled conditions, the body quickly learns to adapt and defend itself from future attacks. This is called active immunization.

Because of advances in medical science, your child can be protected against more diseases than ever before. Some diseases that once killed thousands of children, have been eradicated completely and others are close to extinction– primarily due to safe and effective vaccines. Eradication of Polio is one example of the great impact that vaccines have shown in India.

Parents want to do everything possible to make sure their children are healthy and protected from preventable diseases. Vaccination is the best way to do that.

Vaccination protects children from illness and complications of vaccine-preventable diseases such as measles, mumps, and cough, which are still a threat when it comes to disease progression.

Vaccines are only given to children after a long and careful review by scientists, doctors, and healthcare professionals. Vaccines will involve some discomfort and may cause pain, redness, or tenderness at the site of injection but this is minimal compared to the pain and discomfort of the diseases these vaccines prevent.

The World Health Organization (WHO) reports that licensed vaccines are currently available to prevent or contribute to the prevention and control of twenty-five infections.

The various types of Vaccines are: –

  • Live Attenuated Vaccines
  • Inactivated Vaccines
  • Toxoid vaccines
  • Conjugate Vaccines
  • Subunit Vaccines

Vaccines

  • Birth – 6 weeks
  1. BCG
  2. OPV 0
  3. Hep-B 1

These vaccines must be given to all newborns immediately after birth before they can go home.

  • 6 – 10 weeks
  1. DTP – DTaP vaccine/combinations should preferably be avoided for the primary series. They should be preferred in certain specific circumstances only. No need of repeating/giving additional doses of whole – cell pertussis (wP) vaccine to a child who has completed their primary schedule with cellular pertussis (aP) vaccine-containing products.
  2. Polio – All doses of IPV may be replaced with OPV if administration of the former is unfeasible. No child should leave the facility without polio immunization (IPV or OPV), if indicated by the schedule.
  3. Rotavirus – 2 doses of RV1 and 3 doses of RV5 should be given. RV1 should be employed in 10 & 14 weeks schedule, instead of 6 & 10 week. 10 &14 week schedule of RV1 is found to be far more immunogenic than existing 6 & 10 weeks schedule.
  • 10 – 14 weeks
  1. Rotavirus 2
  2. PCV 2
  3. IPV 2
  4. HIb 2

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  • 14 weeks – 6 months
  1. IPV 3
  2. Hib 3
  3. Rotavirus 3
  4. PCV 3
  • 6 – 9 months
  1. OPV 1
  2. Hep B – The final (third or fourth) dose in the HepB vaccine series should be administered no earlier than age 24 weeks and at least 16 weeks after the first dose.
  • 9 – 12 months
  1. MMR – Measles-containing vaccine ideally should not be administered before completing 270 days or 9 months of life; the second dose must follow in the second year of life. No need to give stand-alone measles vaccine.
  2. Hepatitis A – Single dose for live attenuated H2-strain Hep-A Vaccine. Two doses for all killed Hep-A vaccines are recommended now.

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  • 15 months
  1. MMR – The second dose must follow in the second year of life. However, it can be given at any time between 4-8 weeks after the first dose.
  2. Varicella - The risk of breakthrough varicella is lower if given 15 months onwards.
  • 16 – 18 months to 2 years
  1. The first booster (fourth dose) may be administered as early as 12 months of age, provided at least 6 months have elapsed since the third dose.
  2. DTP – First & second boosters should preferably be of DTwP. Considering a higher reactogenicity of DTwP for certain cases, DTaP as an alternative can be considered for the boosters.

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