JAUNDICE; THE RED OIL FALLACY
The Black African man from time immemorial is as inquisitive and adventurous as his White Western counterparts. The only difference is that while the former's brain is a lazy slave to superstitious assumptions , the later's brain is master to the science of inductive and deductive reasoning. Same basic genetic composition, same rudimentary potentials, the difference is just in the approach to the ultimate goal of quest for answers to Nature's puzzles.
WHAT IS JAUNDICE
Jaundice is the yellowish discoloration or staining of the sclera (white of the eye) and mucous membrane due to high levels of a pigment called bilirubin which is a major constituent of bile in the body. It occurs when the level of bilirubin in the body exceeds a certain threshold, 2.0g/dl. Jaundice in itself is not a disease, but a mere symptom of underlying disease. It is mostly not harmful except in newborns where it can cause considerable permanent damage to the developing brain leading to mental retardation and physical disability with abnormalities of posture and movement. This phenomenon is called Kernicterus.
wikipedia creative commons: jaundice
HOW IS BILIRUBIN FORMED
A by product of Red Blood Cell [RBC] metabolism, Bilirubin is constantly being formed in the body. Senescent [old and aging] RBCs die and are cremated by the body's funeral pallor, the spleen. But before then, the Jewelries [ important proteins called Globins which are derived from RBC Haemoglobin] are removed and recycled for use. While the "odds and ends" [like Heme] are processed into less harmful materials [Bilirubin] before disposing of it to avoid " environmental pollution" with toxic wastes. Thus the Funeral pallor [the Spleen] cremates dead grand father RBCs . But before then it takes out the personal effects and sends it to the body's Factory [the Liver]. In the Factory, the workers [Liver Enzymes] sort out jewelries [Globin] from the odds and ends [Heme]. The odds and end is then processed into less harmful forms [Bilirubin] and then disposed through the plumbing channels [the Gall bladder and Bile ducts]. Then the system of pipes which constitutes the plumbing channels delivers it to the sewer [the intestine] and it is passed out as faeces,where it gives it it's characteristic yellow colour.
TYPES OF JAUNDICE
Jaundice, the excessive accumulation of Bilirubin occurs when there's a problem with the harmony described above. It could either be due to excessive destruction of red blood cells [so much deaths that the Funeral Pallor and Factory are overwhelmed], liver dysfunction [ the Factory has broken down ], or obstruction of bile flow [ the sewer is blocked and the contents are spilling over]. Based on these three
mechanisms, jaundice is classified into:
wikipedia creative commons: jaundice types
PREHEPATIC OR HEMOLYTIC JAUNDICE
Literary means Jaundice due to events occurring before the odds and ends gets to the factory the Liver. This is usually due to increased rate of RBC destruction, hence the term Hemolytic"which denotes break down of red blood cells. The increased rate of hemolysis leads to massive production of Bilirubin, more than the body can handle effectively.
Examples of conditions that can lead to this are:
Malaria
Sickle Cell Disease
Sepsis
Etc
HEPATIC JAUNDICE
This is jaundice occurring due to Liver dysfunction. Simply put, the Factory has broken down and thus cannot effectively process the odds and ends for proper disposal (excretion) leading to dumping along the streets in the system.
Examples include:
Hepatitis
Cirrhosis
Liver Cancer
Etc
POSTHEPATIC OR OBSTRUCTIVE JAUNDICE
This is Jaundice occurring due to events taking place of after the liver, that is after the waste has left the factory. Obstructive as this is usually due to obstruction of the sewer bile duct leading to spilling over of waste in the streets constituting nuisance.
Examples:
Gall bladders stone
Cancer of the head of Pancreas
Inflammation of the Gall bladder.
WHY JAUNDICE IS A TIME BOMB FOR NEWBORNS.
Unlike in Adults where the brain is protected by the water tight blood brain barrier (BBB), the BBB in Newborns is not yet well developed and hence porous. Thus the Bilirubin especially the unconjugated type which usually results prehepatic jaundice, and is therefore usually fatsoluble can penetrate through the BBB and stain the Brain causing environmental pollution leading to KERNICTERUS which manifests with incurable serious disability. The prospects are worse in Premature babies.
wikimedia cco: blood brain barrier
THERAPEUTIC OPTIONS FOR JAUNDICE IN NEWBORNS
Jaundice in Newborns can be Physiologic normal, not constituting harm or Pathologic (dangerous). But because of the seriousness of the dangers of Kernicterus, no one waits to know if it is the pathologic or physiologic type. Treatment is usually started promptly and the blood bilirubin level monitored religiously to make sure it doesn't get to toxic levels.
Depending on the severity, the following treatment options are available:
Phototherapy (Exposure to light of particular wavelength)
And
Exchange Blood Transfusion.
Also the cause of the jaundice should be identified and treated. Example using antibiotics for Sepsis.
CONCLUSION
Having no cure, Kernicterus is better prevented.
So mothers should be looking into their Babies' eyes whenever they are breastfeeding them.
Jaundice when detected in a newborn must be evaluated by a doctor.
REFERENCES
Jaundice in newborn
Wikipedia:jaundice
Why Do Babies Have Jaundice?
