Sodium bicarbonate is a base when its concentration in blood increases the pH also increases and becomes more basic. When its concentration in the blood decreases pH decreases too and becomes more acidic.
Sodium bicarbonate must not be over-replaced, it may cause cerebral edema or in some cases, severe metabolic alkalosis.
The general rule to replace bicarbonate is;
Previously sublingual captopril was given to lower blood pressure in the emergency room. But several cases of large cerebral stroke are reported and it is no longer used worldwide. But in developing countries and peripheral rural areas, it is still used by those physicians who don’t have the means to get the latest information, either electronically,
Aplastic anemia is a syndrome of pancytopenia and hypocellular bone marrow. The differential point of Aplastic anemia is that there must not be any abnormal hematopoietic cell in the peripheral film or bone marrow.
Dr. Adil Ramzan, MBBS, MD Internal Medicine resident talks about aplastic anemia at Pakistan Institute of Medical Science, Shaheed Zulfiqar Ali Bhutto Medical University Islamabad in June 2016.