Dr Pritesh Junagade

A condition in which the blood doesn't have enough healthy red blood cells. Anaemia results from a lack of red blood cells or dysfunctional red blood cells in the body. This leads to reduced oxygen flow to the body's organs. Symptoms may include fatigue, skin pallor, shortness of breath, light-headedness, dizziness or a fast heartbeat. Treatment depends on the underlying diagnosis. Iron supplements can be used for iron deficiency. Vitamin B supplements may be used for low vitamin levels. Blood transfusions can be used for blood loss. Medication to induce blood formation may be used if the body’s blood production is reduced.

Bleeding Related Problem

Thrombophilia and Associated Problems

Acute Leukemia Treatment

Chronic Leukemia Treatments

A cancer of the lymphatic system. The lymphatic system is the body's disease-fighting network. It includes the lymph nodes, spleen, thymus gland and bone marrow. The main types of lymphoma are Hodgkin's lymphoma and non-Hodgkin's lymphoma. Symptoms include enlarged lymph nodes, fatigue and weight loss. Treatment may involve chemotherapy, medication, radiation therapy and rarely stem-cell transplant. Requires a medical diagnosis Symptoms include enlarged lymph nodes, fatigue and weight loss. People may experience: Whole body: fatigue, loss of appetite, or night sweats Also common: shortness of breath, swollen lymph nodes, or weight loss

A cancer of plasma cells. The plasma cells are a type of white blood cell in the bone marrow. With this condition, a group of plasma cells becomes cancerous and multiplies. The disease can damage the bones, immune system, kidneys and red blood cell count. Symptoms may not be present or may be non-specific, such as loss of appetite, bone pain and fever. Treatments include medication, chemotherapy, corticosteroids, radiation or a stem-cell transplant.

A disorder in which blood doesn't clot normally. When blood can't clot properly, excessive bleeding (external and internal) occurs after any injury or damage. Symptoms include many large or deep bruises, joint pain and swelling, unexplained bleeding and blood in urine or stool. Treatment includes injections of a clotting factor or plasma. Requires a medical diagnosis Symptoms include many large or deep bruises, joint pain and swelling, unexplained bleeding and blood in urine or stool. People may experience: Pain areas: in the joints Also common: bleeding, blood in stool, blood in urine, bruising, heavy or prolonged periods, internal bleeding, nosebleed, or swollen joint

Thrombocytopenia and Low Platelets Treatment

Dengue Fever Treatment

Pregnancy Related Hematological Problems

Clinical Laboratory Blood and Transfusion Problems

Pediatric and Neonatal Hematology Problems

Stem cells and derived products offer great promise for new medical treatments.

A bone marrow transplant is a medical treatment that replaces your bone marrow with healthy cells. The replacement cells can either come from your own body or from a donor. A bone marrow transplant is also called a stem cell transplant or, more specifically, a hematopoietic stem cell transplant. Transplantation can be used to treat certain types of cancer, such as leukemia, myeloma, and lymphoma, and other blood and immune system diseases that affect the bone marrow.

A blood disorder involving lower-than-normal amounts of an oxygen-carrying protein. Thalassemia is an inherited blood disorder characterised by less oxygen-carrying protein (haemoglobin) and fewer red blood cells in the body than normal. Symptoms include fatigue, weakness, paleness and slow growth. Mild forms may not need treatment. Severe forms may require blood transfusions or a donor stem-cell transplant. Requires a medical diagnosis Symptoms include fatigue, weakness, paleness and slow growth. People may experience: Whole body: anaemia, fatigue, or weakness Also common: failure to thrive, iron overload, pallor, shortness of breath, or yellow skin and eyes

Requires a medical diagnosis Infections, pain and fatigue are symptoms of sickle cell disease. People may experience: Pain areas: in the joints Pain types: can be sudden in the chest Whole body: dizziness, fatigue, low oxygen in the body, or malaise Urinary: inability to make concentrated or dilute urine or blood in urine Also common: abnormal breakdown of red blood cells, inflamed fingers or toes, pallor, shortness of breath, or yellow skin and eyes Requires a medical diagnosis Infections, pain and fatigue are symptoms of sickle cell disease. People may experience: Pain areas: in the joints Pain types: can be sudden in the chest Whole body: dizziness, fatigue, low oxygen in the body, or malaise Urinary: inability to make concentrated or dilute urine or blood in urine Also common: abnormal breakdown of red blood cells, inflamed fingers or toes, pallor, shortness of breath, or yellow skin and eyes

A blood clot in a deep vein, usually in the legs. This condition is serious because blood clots can loosen and lodge in the lungs. Leg pain or swelling may occur, but there may be no symptoms. Treatments include medication and use of compression stockings.

Pulmonary embolism is a blockage in one of the pulmonary arteries in your lungs. In most cases, pulmonary embolism is caused by blood clots that travel to the lungs from deep veins in the legs or, rarely, from veins in other parts of the body (deep vein thrombosis).

Bone Marrow Tests Email this page to a friend Print Facebook Twitter Pinterest What are bone marrow tests? Bone marrow is a soft, spongy tissue found in the center of most bones. Bone marrow makes different types of blood cells. These include: Red blood cells (also called erythrocytes), which carry oxygen from your lungs to every cell in your body White blood cells (also called leukocytes), which help you fight infections Platelets, which help with blood clotting. Bone marrow tests check to see if your bone marrow is working correctly and making normal amounts of blood cells. The tests can help diagnose and monitor various bone marrow disorders, blood disorders, and certain types of cancer. There are two types of bone marrow tests: Bone marrow aspiration, which removes a small amount of bone marrow fluid Bone marrow biopsy, which removes a small amount of bone marrow tissue Bone marrow aspiration and bone marrow biopsy tests are usually performed at the same time. Other names: bone marrow examination What are they used for? Bone marrow tests are used to: Find out the cause of problems with red blood cells, white bloods, or platelets Diagnose and monitor blood disorders, such as anemia, polycythemia vera, and thrombocytopenia Diagnose bone marrow disorders Diagnose and monitor certain types of cancers, including leukemia, multiple myeloma, and lymphoma Diagnose infections that may have started or spread to the bone marrow Why do I need a bone marrow test? Your health care provider may order a bone marrow aspiration and a bone marrow biopsy if other blood tests show your levels of red blood cells, white blood cells, or platelets are not normal. Too many or too few of these cells may mean you have a medical disorder, such as cancer that starts in your blood or bone marrow. If you are being treated for another type of cancer, these tests can find out if the cancer has spread to your bone marrow. What happens during a bone marrow test? Bone marrow aspiration and bone marrow biopsy tests are usually given at the same time. A doctor or other health care provider will perform the tests. Before the tests, the provider may ask you to put on a hospital gown. The provider will check your blood pressure, heart rate, and temperature. You may be given a mild sedative, a medicine that will help you relax. During the test: You'll lie down on your side or your stomach, depending on which bone will be used for testing. Most bone marrow tests are taken from the hip bone. Your body will be covered with cloth, so that only the area around the testing site is showing. The site will be cleaned with an antiseptic. You will get an injection of a numbing solution. It may sting. Once the area is numb, the health care provider will take the sample. You will need to lie very still during the tests. For a bone marrow aspiration, which is usually performed first, the health care provider will insert a needle through the bone and pull out bone marrow fluid and cells. You may feel a sharp but brief pain when the needle is inserted. For a bone marrow biopsy, the health care provider will use a special tool that twists into the bone to take out a sample of bone marrow tissue. You may feel some pressure on the site while the sample is being taken. It takes about 10 minutes to perform both tests. After the test, the health care provider will cover the site with a bandage. Plan to have someone drive you home, since you may be given a sedative before the tests, which may make you drowsy. Will I need to do anything to prepare for the test? You will be asked to sign a form that gives permission to perform bone marrow tests. Be sure to ask your provider any questions you have about the procedure. Are there any risks to the test? Many people feel a little uncomfortable after bone marrow aspiration and bone marrow biopsy testing. After the test, you may feel stiff or sore at the injection site. This usually goes away in a few days. Your health care provider may recommend or prescribe a pain reliever to help. Serious symptoms are very rare, but may include: Long-lasting pain or discomfort around the injection site Redness, swelling, or excessive bleeding at the site Fever If you have any of these symptoms, call your health care provider. What do the results mean? It may take several days or even several weeks to get your bone marrow test results. The results may show whether you have a bone marrow disease, a blood disorder, or cancer. If you are being treated for cancer, the results may show: Whether your treatment is working How advanced your disease is If your results are not normal, your health care provider will likely order more tests or discuss treatment options. If you have questions about your results, talk to your health care provider.

Polycythaemia Polycythaemia, also known as erythrocytosis, means having a high concentration of red blood cells in your blood. This makes the blood thicker and less able to travel through blood vessels and organs. Many of the symptoms of polycythaemia are caused by this sluggish flow of blood. Symptoms of polycythaemia Not everyone with polycythaemia has symptoms – but many do. Make an appointment to see your GP if you have persistent symptoms of polycythaemia. These include: headaches blurred vision red skin – particularly in the face, hands and feet tiredness high blood pressure dizziness discomfort in the tummy confusion bleeding problems – such as nosebleeds and bruising gout – which can cause joint pain, stiffness and swelling itchy skin – especially after a bath or shower When to seek immediate medical advice Polycythaemia can cause blood clots. These put you at risk of life-threatening problems such as: pulmonary embolisms – a blockage in the blood vessel that carries blood from the heart to the lungs deep vein thrombosis (DVT) – a blockage that forms in the blood vessels in your leg before moving elsewhere in your body Seek medical help immediately if you or someone you're with shows signs of DVT or a pulmonary embolism. These include: pain, swelling, redness and tenderness in one of your legs a heavy ache in the affected area warm skin in the area of the clot breathlessness chest or upper back pain coughing up blood feeling lightheaded or dizzy fainting Polycythaemia also increases your risk of heart attack and stroke. Seek emergency medical help if you think that you or someone you're with is having a heart attack or stroke. What causes polycythaemia? Polycythaemia can be divided into several different types, depending on the underlying cause. In some cases, an underlying cause can't be identified. Apparent polycythaemia "Apparent polycythaemia" is where your red cell count is normal, but you have a reduced amount of a fluid called plasma in your blood, making it thicker. Apparent polycythaemia is often caused by being overweight, smoking, drinking too much alcohol or taking certain medicines – including diuretics (tablets for high blood pressure that make you pee more). Apparent polycythaemia may improve if the underlying cause is identified and managed. Stopping smoking or reducing your alcohol intake, for example, may help. Relative polycythaemia This is similar to apparent polycythaemia. It can happen as a result of dehydration. Absolute polycythaemia "Absolute polycythaemia" is where your body produces too many red blood cells. There are 2 main types: primary polycythaemia – there's a problem in the cells produced by the bone marrow that become red blood cells; the most common type is known as polycythaemia vera (PV) secondary polycythaemia – too many red blood cells are produced as the result of an underlying condition Polycythaemia vera (PV) PV is rare. It's usually caused by a change in the JAK2 gene, which causes the bone marrow cells to produce too many red blood cells. The affected bone marrow cells can also develop into other cells found in the blood, which means that people with PV may also have abnormally high numbers of both platelets and white bloods cells. Although caused by a genetic change, PV isn't usually inherited. Most cases develop later in life. The average age at diagnosis is 60. Secondary polycythaemia Secondary polycythaemia is where an underlying condition causes more erythropoietin to be produced. This is a hormone produced by the kidneys that stimulates the bone marrow cells to produce red blood cells. Health conditions that can cause secondary polycythaemia include: chronic obstructive pulmonary disease (COPD) and sleep apnoea – these can cause an increase in erythropoietin, due to not enough oxygen reaching the body's tissues a problem with the kidneys – such as a kidney tumour or narrowing of the arteries supplying blood to the kidneys How polycythaemia is diagnosed Polycythaemia can be diagnosed by carrying out a blood test to check: the number of red blood cells in your blood (red blood cell count) the amount of space the red blood cells take up in the blood (haematocrit level) A high concentration of red blood cells suggests you have polycythaemia. Polycythaemia is sometimes only discovered during a routine blood test for another reason. Your GP may refer you to a haematologist (a specialist in blood disorders) for more tests, to confirm the diagnosis and to determine the underlying cause. These may include: a blood test to look for the changed JAK2 gene an ultrasound scan of your tummy to look for problems in your kidneys Treatments for polycythaemia Treatment for polycythaemia aims to prevent symptoms and complications (such as blood clots), and treat any underlying causes. Venesection (removing blood) Venesection is the simplest and quickest way of reducing the number of red cells in your blood. It may be recommended if you have PV, a history of blood clots, or symptoms suggesting your blood is too thick. Venesection involves removing about 1 pint (half a litre) of blood at a time, in a similar way to the procedure used for blood donation. How often this is needed will be different for each person. At first, you may need the treatment every week, but once your polycythaemia is under control you may only need it every 6 to 12 weeks or less. For more information, read an NHS leaflet on having a venesection (PDF, 336kb). Medicine to reduce red blood cells In cases of PV, medicine may be prescribed to slow down the production of red blood cells. Many different medicines are available and your specialist will take into account your age and health, response to venesection and red blood cell count when choosing the most appropriate one for you. Examples include: hydroxycarbamide – this medicine is taken as tablets every morning and is generally tolerated well. But you should not take it if you're pregnant or trying to become pregnant interferon – this medicine is given by injection into the abdomen or thigh 1 to 3 times a week. You can inject it yourself at home once you've become familiar with how to do it. Interferon has the advantage that it can be taken in pregnancy, but it may cause unpleasant side effects, such as hair loss and flu-like symptoms Medicine to prevent blood clots If you have PV, daily low-dose aspirin tablets may be prescribed to help prevent blood clots and reduce the risk of serious complications. You may also be offered treatment with low-dose aspirin if you have apparent or secondary polycythaemia and another health problem affecting your blood vessels, such as coronary heart disease or cerebrovascular disease. Treating and preventing other symptoms Some people may also need treatment for any other symptoms or complications of polycythaemia they have, or for any underlying cause of the condition. For example, you may be given medicine to help relieve itching or manage COPD. Read more about: treatments for itching treating COPD Lifestyle changes that help As well as improving some cases of apparent polycythaemia, making healthy lifestyle changes can also reduce the risk of potentially serious blood clots for people with all types of polycythaemia. Having polycythaemia means you're already at high risk of a blood clot, and being overweight or smoking only increases this risk. You may find the following advice and information helpful: losing weight healthy weight calculator preventing cardiovascular disease managing high blood pressure stopping smoking

Dr Pritesh Junagade heads the department of stem cell transplantation at Lotus Institute. He has performed over 300 allogeneic and autologous bone marrow (stem cell) transplant. He was trained in London at King's College hospital, Royal free hospital , St George's and Royal Marsden hospital, all premier institutes of global reputation, where bone marrow (stem cell) transplants are being done. Dr Junagade's dream of affordable bone marrow transplantation was realized in Nashik, India in August 2010 when he performed the first bone marrow transplant at half the price of what is charged in Mumbai, India or rest of the country. Nashik also became the first tier 2 city in India to perform such a feat. The patient had a disease called aplastic anaemia, where blood cells are not formed. Till date 38 Bone Marrow Transplant completed in Lotus Hospital. We have also performed Haploidentical Allogeneric Bone Marrow transplant. A boy with Adrenoleukodysttrophy was also transplanted recently. We perform stem cell transplant for: Thalassaemia major. Progressive Sickle cell disease. Aplastic anaemia. Acute leukemia. Chronic leukemia. Multiple Myeloma. Fanconi;s anaemia. Rare immunodeficiency diseases etc. Facilities for Irradiated blood products and 24 hours blood banking support is available.

Haemophilia can be a difficult disease to manage. We at Lotus Institute strive hard to make life comfortable for the patients and their relatives. We keep all the records of our haemophilia patients and provide factor replacement when necessary. Complex surgeries can also be done at our institute if needed. We have social workers who assist the patients to get financial support from private institutions and private donors affiliated with Lotus institute.

Acute Leukaemia (Blood Cancer) treated in Lotus Hospital Nashik.

Medical oncology services include all diagnostic workup of a suspected cancer patient and then plan chemotherapy and radiotherapy treatments. We deal with all kinds on cancers. Chemotherapy is planned and given according to the schedule. Chemotherapy is prepared in a designated area with all aseptic precautions and checked thoroughly before reaching patient bedside. All the expected side-effects are explained in detail to the patient and their relatives. We understand that it can be a stressful time for the family and hence take utmost care to make this a pleasant experience. Follow up appointments and day unit chemotherapy is preferred so that patient can go home the same day

Department of Haematology and Haemato-Oncology is headed by our dynamic founder director Dr Pritesh Junagade. We deal with all kinds of blood diseases like: Weakness/ loss of energy (Anaemia). Bleeding/ purpura (Thrombocytopenia). Repeated infections/ boils (Neutropenia). Pancytopenia (combination of above) in aplastic anaemia, Leukemia. Swollen leg (Deep venous thrombosis, DVT). Weight loss/ loss of appetite (Blood cancer, Leukemia). Bone pain/ bone fracture (Multiple Myeloma). Lymphadenopathy (Lymphoma/ Hodgkin's Lymphoma). Splenomegaly (CML, Lymphoma, Myelofibrosis, infections, fever). Joint bleeding/ rare site of bleeding (Haemophilia). Excessive menstrual bleeding (No obvious Gynaec. cause). Increased Haemoglobin (Polycythaemia). Excessive platelet count (Thrombocytosis). Excessive WBC count (Chronic Leukemia like CLL). Warfarin monitoring with INR and advice on thrombophilia screening. Pyrexia of unknown origin (fever for 1-2 weeks and not responding ). Thalassaemia/ sickle cell anaemia. Blood transfusion problems. Bone marrow transplant and stem cell problems. Pregnancy related haematology problem/ DIC. We have well equipped haematology laboratory with state of the art instruments to accurately diagnose haematology diseases so that the treatment offered is best. The laboratory instruments we have are:

Dr Pritesh Junagade heads the department of stem cell transplantation at Lotus Institute. He has performed over 300 allogeneic and autologous bone marrow (stem cell) transplant. He was trained in London at King's College hospital, Royal free hospital , St George's and Royal Marsden hospital, all premier institutes of global reputation, where bone marrow (stem cell) transplants are being done. Dr Junagade's dream of affordable bone marrow transplantation was realized in Nashik, India in August 2010 when he performed the first bone marrow transplant at half the price of what is charged in Mumbai, India or rest of the country. Nashik also became the first tier 2 city in India to perform such a feat. The patient had a disease called aplastic anaemia, where blood cells are not formed. Till date 38 Bone Marrow Transplant completed in Lotus Hospital. We have also performed Haploidentical Allogeneric Bone Marrow transplant. A boy with Adrenoleukodysttrophy was also transplanted recently. We perform stem cell transplant for: Thalassaemia major. Progressive Sickle cell disease. Aplastic anaemia. Acute leukemia. Chronic leukemia. Multiple Myeloma. Fanconi;s anaemia. Rare immunodeficiency diseases etc. Facilities for Irradiated blood products and 24 hours blood banking support is available.