Glucose–6–Phosphate Dehydrogenase Deficiency ( G6PD deficiency )

Customer A : My son/ daughter has G6PD , can they take this medicine??

What is G6PD ??

       G6PD is a protein found in red blood cells (rbc) that help the rbc to function normally. If there is not enough G6PD, the rbc maybe destroyed when one have fever or taking certain medicine ( haemolysis ) and this may lead to haemolytic anaemia. G6PD deficiency is a genetic- inherited - disease. The gene affecting this disease is linked to X-chromosome and so, affect males  more than females.

What are the dangers G6PD deficiency posses??

     Usually, people with G6PD deficiency have completely normal health. However, problems can occur occasionally when they are exposed to a drug or chemical that can cause a sudden attack of red cell breakdown.The affected person may feel unwell, pale and jaundiced (yellow) , have a backache and pass dark urine.  

Problems for newborn babies

      The babies with G6PD deficiency may get jaundiced in the newborn period. It is usually treated by putting the baby under a special UV light for a few days and sometimes blood transfusion. Many babies with G6PD are diagnosed because they have jaundice soon after birth. Normally, these babies will not get other complications once their jaundice have been treated, unless they took broad beans and drugs listed below. G6PD deficiency does not cause any problem in unborn child.

List of drugs that a person with G6PD should avoid: 

• Ciprofloxacin
• Dapsone
• Levofloxacin
• Methylthioninium Chloride (Methylene blue)
• Moxifloxacin
• Nalidixic Acid
• Nitrofurantion
• Norfloxacin
• Ofloxacin
• Primaquine
• Rasburicase
• Sulphonamides including Cotrimoxazole (Septrin®)

Avoid eating:

• Fava (Broad) beans

Points to remember

1) Make sure to let your Dr and pharmacist knows if you have G6PD deficiency.

2) In people with severe G6PD deficiency, haemolysis may occur in other situations, e.g : infection 

Some articles that you can read :

1) Medicinenet : G6PD deficiency

2) NHS : G6PD deficiency

3) NHS : Drugs And Chemicals To Be Avoided In G6PD Deficiency

Nappy Rash

      Did this post specially for a friend of mine who just deliver her baby. Congratulations ya my friend, you know who you are =)

A cartoon showing a baby crying due to nappy rash

       Nappy rash or diaper rash is a very common disorder  It might occurs any time but usually it occurs more frequently when the babies are between 9-12 months. It causes the baby's skin to become sore and irritated in the nappy area and the affected area are covered in pink or red spots or blotches. Nappy rash is usually cause by the contact of the baby's skin with urine and faeces in their nappy.

So, how do we treat nappy rash and what to do to prevent it??

Remember this easy ABCD rules

A= air out the skin by allowing your baby to go diaper free to reduce skin contact with feces & urine.

B = Barrier, the barrier can be created by using a paste or an ointment to protect the skin of your baby (  choose those without preservative and avoid using powder due to inhalation risk).

Some Barrier creams that are available in Malaysia

A mummy applying barrier cream for her baby

C= Clean , keep the baby's skin clean. Carefully clean the baby's bottom between diaper changes.

D= Disposable diapers. If the baby really has a nappy rash, consider using disposable diapers rather than the normal cloths one as the disposable diapers have  better absorption proterties and thus, keep the skin dry.

       Usually, a parents do not need to be too worry if the baby develope nappy rash unless the baby develops a fever > 38 ºC or has bloody stool, diarrhoea,  blisters or sores , then, you should bring your baby to the doctor. I hope this article will be able to help and congratulation again in your new born baby.

Cute Baby

Deworming

        These are some common questions that were directed to me during my practice:

Customer A:  My son/ daughter is very thin and his/ her stomach is very big, can i give him/ her Zentel ??

Customer B: It has been quite some times since i last give my son/ daughter Zentel. Can i give him/ her now??

Customer C : Can i take Zentel if i am an adult?? Zentel is not only for children right??

Worm Infections

      The most common worm infection are whipworm, roundworm, hookworms, tapeworms, threadworm  and fluke. Normally, people will get worm infection if they touch contaminated faeces, play with soil, walking barefoot, eat undercooked food like beef, pork and fish, or drink water that containing contaminated faeces.        

Life cycle of the worms

Symptoms of Worm infections:

Stomach pain, perianal itch that occurs at night as the female worms deposits their eggs, diarrhoea and vomiting, appearance of worms in the faeces as white or cream colour thread-like objects, weight loss and maybe malnutrition

Treatments

Adults and children above 2 years old : Deworming agent (e.g : Albendazole or mebendazole) once daily. 
Affected individuals should take shower each morning to wash away  the eggs deposited outside the anal during the previous night.                                                        

Some deworming agents that are available in Malaysia

Prevention :

1) Wash the hands thoroughly before preparing, handling and eating food.
2) Use disinfectant on toilet seats and bathtube

3) Cut the nails regularly.
4) Hands should be washed and nails brushed after going to toilet.

5) Children can take the deworming agent 2-3 times a year to stay worm- free.

These are some articles and guidelines that you can read for further information:

1) NHS Guide line for tapeworm infections: 

 http://www.nhs.uk/conditions/Tapeworm-infections/Pages/Introduction.aspx

2) http://emedicine.medscape.com/article/998401-treatment

p/s: The image of " life cycle of worms" is adapted from google image