In this video, Dr. Sunil Bhat discusses effective ways to prevent thalassemia major. He covers key strategies, including genetic ...

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Part 3 | How Can We Prevent Thalassemia Major? | Dr Sunil Bhat, Narayana Health City, Bangalore

[Music] Hello friends uh my name is Dr Sunil b i the director and clinical lead of pediatric Hematology Oncology and bone transplant um at the majumdar Sha Medical Center narana H C Bangalore I've been coming to you with some series of videos on talism majure because as I said earlier it's one of uh very significant very important um you know conditions which we deal in our practice and it's quite relevant um in our country uh we have discussed till till now a couple of aspects of thalis meor in my previous videos um what I'm going to discuss today with you is um how can we prevent Thalia mejor so we have been talking about looking after children with thalis major which is of course an important aspect um the children who have been born with talisia major beta thalis measure how do we look after them and we have got you know various things we have been discussing and we keep on discussing but I think the most important element in the whole talisia um scenario is that how do we prevent talisia measure can we prevent it first of all yes we can prevent talisma measure um as I discussed you know earlier on it's it's a genetic disease and it comes from our parents uh parents are carriers of this disease and when they marry there's a 25% chance that their child can have Thalia measure but it's not 100% that means only 25% of the times their child May Thal meor there 75% of the times the baby is either normal or a thalmic carrier which is of course for all practical purposes also a normal uh person in the society now how can we prevent this now the preventive strategies I kind of divide into two categories one is prevention in the whole Community or in the whole society and the second is prevention in the family where the uh where where one child with tmia has been born it's very you know disheartening and sometimes very sad to see you know a family having two three four children with Talis measure born in the same family which is it's very sad now we'll take them one by one so first in a family who has already had a talisma major born in their in their in their family what can we do to prevent second third birth with tal measure it's extremely simple because by now we know already that the both the parents are carriers and both the carriers are the carriers of bet thalis measure Gene now in the next pregnancies we need to prevent it as I said 75% chances the next baby may be normal but there's 25% chance that the next baby may also have thalma measure so how can we prevent it we can prevent it by two different techniques or two different methodologies one is something called as pre-implantation gentic diagnosis what happens in PR genetic diagnosis is that mothers and fathers so OVA and sperm are there's there's there's a fertilization which is done outside in the lab so you create few embryos you you generate few embryos from this fertilization now you test these embryos in the lab and see which embryo does not have Thalia major does not have both the genes which are abnormal only the embryo which either is normal that means both the beta genes are normal or this one gene normal which one is abnormal is like a carrier so these are the embryos which are put back in the mother's womb through something called as IVF inital fertilization and we know that this embryo has been tested already does not have thalis measure and we have put in the mother's womb and then it grows in the mother's home and leads to a normal pregnancy and the baby which is born we know already that doesn't have talisma measure so that's one technique pre-implantation genetic diagnosis the second technique is something called as chonic Willer sampling that means the mother has had a natural pregnancy when the pregnancy is 11 12 weeks at that point of time we take a small tissue from the from the from the new pregnancy or from the um from the new feet and check it from the that's called as coric willness and we check it for talisia major genes if there are both the genes in that cor samp that means the baby's also having th measure and we can we have an option of medical termination of pregnancy or abortion we have an option of that if the family wishes to do so and if the gene is not there both the genes are not abnormal it's a carrier orthal minor or it is a normal then we continue the pregnancy so I what I discussed with use two techniques pre-implant gentic diagnosis and corul sampling both these techniques we can find out where the next baby which this couple is having has got Thal measure or not and if there's a Thal measure you know in the second Technique we have option of um ter medical termin pregnancy in the first Technique we we implant only that embryo in the mother's womb through IVF which is normal and doesn't have thalis measure so that's one aspect of how to prevent tmia birth in the same family who was already had a baby with thalis measure now come to the second aspect of how to prevent the first baby with thalis measure or how do we look in the community or the society at a large and prevent Talis measures from from being born again for this I kind of divide it into two categories one is that one is called as targeted screening that means the patients who are already having Thal measure we look at their families and extended families because it's a genetic disease and the other family members extended family members may be carrying the disease so we look at other members in the extended families from the particular patient and see if if if there are other carriers in that extended family and we then counsel them advise them and guide them that is one methodology the second is what's called as population based screening that means we check people especially uh you know uh the population which is either young that means they're in the colleges premarital before Mar marage and and you know those who are planning pregnancies planning families and planning marriage so this is the second aspect of looking at the talisia minor status in in this extended population and it can be done by a very simple technique or a simple blood test called HP electroforesis which tells us whether these normal looking people have Thalia carrier or not and this can be done in schools in colleges in in in in offices you know in in in in people who are planning to marry patients planning to have children who have already married in all these we can do it and we see what is the status of the couple or what is the status of that person who you have tested if a minor we need to educate them and tell them when you get married you need to check the status of your of your spouse and if the couple is already married if one of them is abnormal other is normal it doesn't matter nothing is going to happen but if both of them are carriers then we need to counsel them and tell them you need to go and you have baby babies or pregnancies you need to take one of these techniques which we discussed as PR gentic diagnos or cor sampling as a technique right so so friends one of the very important aspects which is a probably a message to my gynecological colleagues is that um always the couple you know especially when they're young and they're having you know they will always with a gynecologist one the mother has conceived that gives us a very very wonderful opportunity for testing the couple for for for thalis major and as I said it's a very simple blood test it takes 2 to 3 days for the report to come and you can tell whether the couple is thalis minor or not so my my request my message to all the gynecological colleagues is that if you could add the first antinal check check the elra forces of of the both the mother and the father and see if they Calis minor or not if they're not having it we'll forget about it if they are having both of them are having it then we can we can offer them this antinal testing or testing for you know uh by by the methodology of coral sampling or anal testing and we can prevent talisma measures being born into the community so friends talisia is preventable and you know let us aim at making India talisia free and that is only going to happen with when all of us join hands doctors patients and their caregivers um and we have got wonderful organizations you know working for Thalia especially there are parent organizations and societies all over the country um we need help of other medical fraternity especially the gynecologists and of course we need the help of the establishment or the political establishment or the administration and the governments to make this as a as a as a priority uh program for the country and also implement it you know quite effectively at the grassroot level so that we can get rid of this deadly Menace from our country so thank you very much [Music]

Dr.

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