• Bruises on body
• Spontaneous bleeding into large joints like knee, elbow and ankle resulting into swelling of the affected joint
• Prolonged bleeding after getting a minor cut or falling out of a tooth
• Stiffness in joints
• Blood in urine or stool

• Severe: Factor VIII or Factor IX level is less than 1% of normal. Spontaneous joint and soft tissue bleeding several times a month.
• Moderate: Factor VIII or Factor IX level is in the range of 1-5% of normal. Spontaneous bleeding is uncommon but occurs after minor trauma or surgery.
• Mild: Factor VIII or Factor IX level is in the range of 5-30% of normal. Only occasional bleeding related to significant trauma or surgery.

It includes a physical exam, blood screening tests, and clotting factor tests. The blood screening tests are necessary to determine the delay in blood clot formation. Clotting factor tests, also called factor assays, are required to determine the levels of clotting factors. The results of these tests reveal the type and severity of hemophilia.

This condition can’t be cured but can only be managed. Every bleeding episode should be adequately treated by replacing deficient clotting factor; the process called Factor Replacement Therapy which involves intravenous infusion of deficient clotting factor. Good joint health should be maintained by regular exercises recommended by a physiotherapist trained in management of hemophilia as strong joints bleed less. Crippling joint deformities can be effectively prevented by adequate care of each episode of bleeding, including replacement of the clotting factor lacked by the patient and very deliberate and persistent physical therapy. The care of people with hemophilia requires a multidisciplinary team to address different aspects of the patient’s problems.

Thalassemia is an inherited blood disorder characterised by less haemoglobin and fewer red blood cells in the body than normal.

There are two main types of Thalassemia:

• Alpha-thalassemia: It occurs when a gene or genes related to the alpha globin protein are missing or mutated.
• Beta-thalassemia: It occurs when a gene or genes related to the beta globin protein are missing or mutated.

The signs and symptoms depend on the type and severity of the condition.
Thalassemia signs and symptoms can include:

• Anaemia
• Fatigue
• Weakness
• Pale or yellowish skin
• Facial bone deformities
• Slow growth
• Abdominal swelling
• Shortness of breath
• Dark urine

Diagnosis of Thalassemia requires certain blood tests. When seen under microscope red blood cells from the blood sample of affected person appear small and abnormally shaped. A Complete Blood Count ( CBC) would reveal anaemia. A test called Hemoglobin Electrophoresis shows the presence of an abnormal form of hemoglobin.

Treatment for thalassemia major (severe form of Thalassemia) often involves regular blood transfusions and folate supplements. People who receive a lot of blood transfusions need a treatment called chelation therapy. This is done to remove excess iron from the body.