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Foetal Alcohol Syndrome

Foetal Alcohol Syndrome

The effects of alcohol consumption by a pregnant woman on her fetus are alarming. Foetal alcohol syndrome (FAS)refers to the distressing features observed in babies who have been exposed to alcohol before birth. In fact in some cases, the baby stands a risk of dying before birth. Alcohol crosses the placental barrier into the baby's bloodstream. It can reduce the amount of oxygen available to the growing fetus and lead to nutritional deficiency too. There may be retarded growth of brain cells. When a child suffers lesser symptoms due to maternal alcohol consumption, it is referred to as FAE - Foetal Alcohol Effect.

One of the most common features of a child suffering from Foetal Alcohol syndrome is low birth weight. The infant may have small eyes and flattened face. The head circumference is smaller than average. There might be heart defects. Foetal alcohol syndrome is not always diagnosed at birth. It may be diagnosed when there is a learning or growth problem. Babies suffering from FAS tend to have low IQ and learning difficulties. The child is at increased risk for behaviour and mental health issues. There are cases of cleft palate deformity and joint abnormalities in children born to mothers who consume large quantities of alcohol during their pregnancy. It is advisable for pregnant women to refrain from alcohol during their pregnancy to avoid FAS and FAE among their offsprings. It can lead to a lifetime of impaired mental and physical growth.

Cirrhosis

The liver is responsible for neutralizing the blood of toxins, germs and bacteria as well as producing immune agent to contrl infections. Bile, critical to the absorption of fats and fat-soluble vitamins is made by the liver. Cirrhosis is a condition where the liver is affected by irreversibble scar tissue leading to its damage and consequent failure. Blood flow to the liver is then affected. Symptoms of cirrhosis range from exhaustion and fatigue to weight loss and abdominal pain. A person suffering from liver cirrhosis may experience abdominal pain and loss of appetite. There are noticeable red spider veins under the skin and the skin and eyes may turn yellow. There is decreased interest in sex and edema (swelling on hands and legs) might be noticed. A person suffering from cirrhosis and damaged liver may notice an increased tendency to bruise and bleed easily. Intense itching is felt on account of the bile products being deposited in the skin. Gallstones may develop as a result of inadequate bile reaching the gallbladder. There might be a buildup of toxins in the brain bringing about bouts of unresponsiveness and forgetfulness. Cirrhosis can bring on Portal hypertension - a condition where there is reduced flow of blood to the portal vein and increased pressure within it. Cirrhosis can eventually lead to liver cancer caused by carcinoma. Impotence, kidney dysfunction and osteoporosis are other likely complications of liver disease.

Cirrhosis of the liver is usually caused by chronic alcoholism or hepatitis C. Other possible factors leading to cirrhosis are problems in the immune system and damaged bile ducts.
Chronic Alcoholism - One of the common causes for cirrhosis is alcoholism. But this condition occurs only after atleast 10 years or more of heavy drinking. Alcohol affects the liver's ability to metabolise proteins, fats and carbohydrates.
Chronic hepatitis - Hepatitis C virus can lead to severe inflammation and damage of the liver, thereby causing cirrhosis. Hepatitis B is one of the most common causes of liver inflammation in many of the developing nations.
Blocked bile ducts - In such a condition, the bile is unable to travel out of the liver and instead ends up damaging liver tissue. This can be a congentinal defect in some infants.

Cirrhosis of the liver can cause many other abnormalities. It can leads to elevated levels of triglycerides, cholesterol and sugar. Diabetes mellitus is a common fallout. There might be a fall in platelet count and GI bleeding. In severe cases of cirrhosis, there can be an immune system dysfunction or even brain swelling and later coma. The liver of an affected person will feel be larger and harder to touch. A liver scan or ultrasound can help detection of cirrhosis. A liver biopsy is sometimes resorted to. Damage to the liver due to cirrhosis cannot be reversed but further complications can be reduced with the right treatment. Cirrhosis caused by excess alcohol consumption needs lifestyle changes such as avoiding alcohol and following a nutritious diet. Low-sodium diet can help drain excess fluid-buildup within the body. Chronic viral hepatitis B and C are treated with prednisone and azathioprine. Any bacterial infection is treated with appropriate antibiotics. Liver transplantation surgery is done on cases where the liver is not capable of functioning. With the help of modern drugs such as cyclosporine and tacrolimus, the success of liver transplantation surgery has risen manyfold.

Hepatocarcinoma

Malignant hepatoma, which is primary cancer of the liver is termed hepatocarcinoma. Hepatocarcinoma is secondary in about 20% to either a viral hepatitide infection (hepatitis B and C) and about 80% to cirrhosis. In some cases, it is metastasis of cancer, spread from elsewhere in the body. It is also associated with chronic alcohol abuse. Hepatocellular carcinoma is relatively rare in the United States but quite common in the African and Southeast Asian countries. Infact, this is the fifth most common tumor worldwide. In some African countries the disease onsets between late teens and 30s although the normal occurrence is in patients over age 50. Hepatocarcinoma is more common in males than females.

Hepatocarcinoma patients are put under surveillance with ultrasound. Possibly the best method of diagnosis involves a CT scan of the abdomen. This is done using intravenous contrast agent and three phase scanning, enabling the radiologist to detect subtle tumors as well. Another possible alternative to a CT imaging is MRI, using contrast agents which is used to detect the presence of a tumor capsule. Diagnosis is further confirmed by percutaneous biopsy and histopathological parameters.

Treatment for hepatocarcinoma depends especially on the size of the tumor and staging. Some of the treatment options are liver transplantation, which is to replace the liver with a cadaver liver or a live donor lobe; surgical resection wherein the tumor is removed if diagnosed early; Percutaneous ethanol injections in case of solitary tumors and transcatheter arterial chemoembolization for large tumors.

Sometimes sealed source radiotherapy is used to destroy the tumor from within. Here, the radioactive particles are deposited to the area of interest using a catheter. Radiofrequency ablation uses high frequency radio waves to ablate the tumor. As an adjuvant therapy in resected patients, intra-arterial-iodine-131-lipiodol administration is performed. High intensity frequency ultrasound is a relatively new but powerful technique used to treat the tumor. Hormonal therapy and adjuvant chemotherapy are other treatment modalities adopted. Cryosurgery is yet another new technique that can destroy tumors in a variety of sites, in the brain, breast, kidney, prostrate and liver.