Before initiating treatment for TB in women, she should be asked about current or planned pregnancy
• EXCEPT Streptomycin, all first line anti –TB drugs are safe for use in pregnancy
–Streptomycin is ototoxic to the fetus and should not be used during pregnancy
In case of MDR –TB: Test for pregnancy
• If not pregnant advised to use birth control
– OCPs should be avoided
– Use of barrier methods or IUD is recommended
• The most common causes of infant and child mortality in developing countries (including India) are:
– Acute respiratory infections
– Diarrhoea
– Malaria
– Measles and
– Malnutrition
• Making a single diagnosis may not be feasible or appropriate
– Because many children present with overlapping signs and symptoms of diseases
– Clinical outcome depends upon treating not only the immediate presenting symptom but the underlying disorders as well
Reference:
WORLD HEALTH ORGANIZATION, 2003. Review of Ethical Issues in Medical Genetics: Human Genetics Programme, Management of Non-communicable Diseases; Geneva: WHO/HGN/ETH/00.4
• Some traits like intelligence, physical ability and longevity are genetically determined but the effect of external and environmental influences are the main determinants of health and survival
• With increased control of environment, genetic makeup is becoming more important determinant of individual health
• Genetic predisposition may lead to the premature onset of common diseases of adult life such as
– Cancer
– Coronary heart disease
– Diabetes
– Hypertension and
– Mental disorders
• Cancer:
• This occurs:
– If the fetus is Rh positive and
– mother is Rh negative
• Some fetal red cells cross the placenta and enter maternal circulation in all pregnancies
– The Rh +ve fetal cells act as foreign antigen and stimulate production of Rh antibodies in the Rh negative mother
• The Rh antibodies are of two main types:
– The ‘strong’ or saline antibodies and
– The ‘weak’ or albumin antibodies: these are small 7s gamma globulins which can cross the placental barrier.
It is the introduction of a gene sequence into a cell with the aim of modifying the cell’s behaviour in a clinically relevant fashion
It may be used in several ways, e.g.
o To correct a genetic mutation (as for cystic fibrosis),
o To kill a cell (as for cancer) or
o To modify susceptibility (as for coronary artery disease)
Prenatal diagnosis or screening is testing for diseases or conditions in a fetus or embryo before it is born
Such diseases include Thalassaemia, Sickle cell anaemia, cystic fibrosis, haemophilia, fragile X syndrome, Neural tube defects, birth defects etc.
New-borns deserve the special protection afforded by screening for disorders where early diagnosis and treatment favourably affect outcome.
Following guidelines are recommended by W.H.O for neonatal screening:
It is the most immediate and practical service that genetics can render in medicine and surgery
Counselling should include a full description of the risks, diagnosis, symptoms, and treatment of the disorder(s) in question
• “Euthenics" is “improvement in the environment.”
• Mere improvement of the genotype is of no use unless the improved genotype is given access to a suitable environment which will enable the genes to express themselves readily
• Thus the solution of improving the human race does not lie in contrasting heredity and environment but rather in the mutual interaction of heredity and environment factors
• This environmental manipulation is called euthenics and has considerable broader prospects for success
