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By Dr. Androulla Efeftheriou

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Fever, malaise or muscle pain, is extremely important. Patients and parents who are planning to travel should also be aware of the different infectious diseases that may be prevalent in other parts of the world. e. above 800,000/mm3. This condition can be managed by administering 50-100mg aspirin/day until the platelet count returns to normal. Overall, the best approach is to avoid problems of the spleen altogether by administering safe and appropriately processed blood as soon as a diagnosis of thalassaemia major is confirmed, keeping Hb levels above 9-10g/dl.

Often the time needed to effectively infuse a dose of DFO is longer than that required for a blood transfusion. e. once every 2-4 weeks -- has extremely limited effect. However, this may be the only option where DFO is in short supply. On the other hand, some centres administer DFO intravenously during patients' blood transfusion therapy in addition to their regular daily treatment, in an effort to improve the overall effectiveness of iron chelation treatment. 46 Intramuscular injections are still used in some cases - for example, in countries where desferrioxamine is prohibitively expensive and therefore only available in very small quantities, or where infusion pumps are not available.

In 64 this way, the development of an enlarged spleen may be delayed and even prevented, avoiding the need for a splenectomy. In addition, maintaining the spleen at around its normal size helps ensure the efficiency of blood transfusions. Heart and endocrine complications Thalassaemia major patients often experience problems with the heart, liver and endocrine glands, all of which are usually associated with iron overload. However, unlike heart problems (see below), patients receiving insufficient or no blood transfusions rarely develop liver and endocrine problems, partly because these conditions occur in highly transfused patients on poor iron chelation regimes, and partly because insufficiently transfused patients will not usually live long enough for the condition to develop.

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