Online ISSN: 2515-8260

Keywords : Bleeding


Clinical Profile of Immune Thrombocytopenic Purpura in Paediatric age Group

Pusala Venkatanarayana

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1966-1976

Background: Platelets play a vital role in hemostasis. Idiopathic / Immune
thrombocytopenic purpura (ITP) is a common bleeding disorder in children, where
autoantibodies mediated consumption of the platelets, suppression of platelet
production by bone marrow megakaryocytes leads to thrombocytopenia and bleeding
manifestations. Incidence is 6.4 per 10000 among children and 3.3 per 10000 adults per
year.1 There is highest male to female ratio in infancy and it decreases with older age
groupchildren. No significant seasonal variation. Vaccination may play an important
role in the etiology of ITP in infants. History of a preceding viral infection 1-6 weeks
before the onset disease is present in 60% of cases. Bone. narrow was routinely
performed but evidences confirmedthat its rarely needed at presentation, must be
considered if having severe bleeding or not responding to treatment.
Materials &Methods:Details about children with ITP who presented to our hospital
between October 2020 and August 2021 were collected using a proforma. The study was
designed as a cross-sectional study. To meet the sample size, convenience sampling was
used.
Results: Total number of children recruited with a clinical diagnosis of primary itp was
120 after excluding the ones which had a secondary cause identified, the total primary
itp studied were 100. among them based on the duration of symptoms (as per
definitions) they were categorized into newly diagnosed, persistent and chronic itp.
There were 46 cases of chronic itp and 44 cases of persistent ITP. 73 percent of all
patients were between the ages of 1 and 10 years. in total, 8.9 percent of them had severe
bleeds. there was no link discovered between bleeding and platelet count. a high nordic
score (10-14) had a high predictability for short-term symptoms.
Conclusion: In our study, there was a higher incidence of its presenting in the hospital.
Higher a percentage of them had severe bleeding.

A study to assess the safety, efficacy of PPIUCD in a tertiary care centre in a hilly region of South India

Dr. Sowmya D, Dr. Somashekar HK, Dr. Salma Shaziya, Dr. Sowjanya D, Dr. Harsha TN, Dr. Pradhyumn GK

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2162-2168

Background: In India 65% of women have unmet need for family planning during the first year post-partum, Insertion of PPIUCD appears appealing because, High unmet need for contraception during the first post-partum period, increasing rate of institutional delivery, Long term and reversible method, it requires only once motivation, Highly effective, Long-term benefits of reducing maternal mortality burden, hence in recent past PPIUCD as a method of contraception has evolved.
Objectives: To assess the safety and efficacy of PPIUCD.
Materials and methods: This is an observational study from June 2019 to May 2020, conducted in department of OBG, Kodagu Institute of Medical Sciences to assess the safety and efficacy of CuT380A when inserted within 10 mins of placental expulsion up to 48 hours after delivery. During this period total number of deliveries were 3293. Among them 833 women had PPIUCD insertion. Counselling of PPIUCD was done during their antenatal visit, early labour, immediate postpartum and while preparing for the scheduled caesarean delivery. Post-abortal and 6 weeks postpartum IUD insertion were excluded from study.
Results: Of 3293 total deliveries, women who had PPIUCD insertion were 833(25.9%). Among them Post placental 165(19.8%), Primary cesarean delivery 550(66%) and repeat cesarean delivery 24(2.88%). PPIUCD counselling were done during antenatal period in 211 (25.3%), during early labor in 528 (63.3%) and during postpartum period 94 (11.2%). Acceptance of PPIUCD insertion was found to be 526(63.14%) among women of age 20-25 years, primipara 651(67.34%), who had at least primary education 249(29.9%). 812 women attended follow up. 651(80.17%) had no complaints, continued counselling helped. Complications like string problem (5.91%), expulsion rate (2.83%), pain abdomen (6.4%), bleeding P/V (3.94%). PPIUCD was found to be safe as there was no evidence of perforation or failure rate. 10 women insisted for removal of PPIUCD, one of the main reasons was social factor.

A Review on the Evolution of Post Traumatic Haemorrhage Control

Waleed Badawyeh,Mohammad Abuzaid

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2846-2855

The mortality rate for trauma ranges from 1 to 34 years of age due to uncontrolled
hemorrhage. Trauma occurs for various reasons, including accidents and war zones.
Cumulative mortality among different traumatic experiences is the leading cause of death.
This has spurred the research community to focus on advancements in hemorrhage control to
control the trauma-related mortality rate. This review discussed numerous care options during
pre-hospitalization, operation theater, and emergency room, emphasizing emerging
methodologies, the challenges involved in controlling bleeding, and public health initiatives.

Coagulation and Fibrinolysis Profiles of Acute Myeloblastic Leukemia: Preliminary Assessment of Hypercoagulability

Edward Kurnia Setiawan Limijadi; Imam Budiwijono; Indranila Kustarini Samsuria; Purwanto Adhipireno; Wivina Riza Devi

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 607-615

Acute Myeloblastic Leukemia is an abnormality of haematological malignancy that often causes bleeding and death. Coagulation and fibrinolysis examinations are screening parameters that need to be reviewed related to the incidence of bleeding events in AML patients in a hypercoagulability assessment.This was a cross-sectional study conducted at Ulin Regional Hospital Banjarmasin on patients with a recent diagnosis of AML patients for the first time using a consecutive sampling method. The measurement of PT, aPTT, fibrinogen, and D-dimer levels were done at the Diponegoro National Hospital using Coalab-1000 tool. The analysis of the correlation between the
 ncidence of bleeding events with coagulation and fibrinolysis parameters used Fisher's exact test.The significance of the correlation test of the incidence of bleeding events with PT, aPTT, Fibrinogen, and D-dimer were 0.731; 0.086; 0.617; 0.587, and 0.731, respectively.The parameters of PT, aPTT, Fibrinogen and D-dimer were not associated with the incidence of bleeding events. The extension of PT and aPTT in most AML patients is suspected due to the deficiency of coagulation factors. Screening tests of PT, aPTT, fibrinogen and D-dimer levels should be performed in AML patients, although the results do not always show abnormalities

RETROSPECTIVE EVALUATION OF CORRELATION OF POST EXTRACTION HEMORRHAGE AND ANTI COAGULANT THERAPIES IN YOUNGER POPULATION: A PREVALENCE BASED CLINICAL STUDY

Sachin Kumar; Varun Kumar Verma; Karan Sublok; Ashish Kumar Kushwaha; Priyanka Singh; Sheikh Abrar

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 1964-1972

Background and Aim: Post operative bleeding is very common post operative complication seen in extraction cases. Anti coagulant therapies are employed to manage several clinical conditions. Patients those who are already on anti coagulant therapy, can show different patterns of post extraction hemorrhage. Anti coagulant makes blood flow via veins more easily. So, blood will be less likely to make a dangerous blood clot (like thrombosis or embolism). The sole endeavor of present study was to evaluate the correlation of post extraction hemorrhage and anti coagulant therapies in younger population. This study was retrospectively performed to assess the related prevalence also in the studied population. Materials & Methods: Patients case history, follow up case sheet and discharge summaries were explored. Younger age group patients those had undergone single tooth atraumatic extraction for different reasons, were selected for study. Patients who reported to be on anticoagulant therapy for more than one year, were studied in group one. Patients who reported to be on anticoagulant therapy for six to twelve months, were segregated in group two. Patients who reported to be on anticoagulant therapy for less than six months, were studied in group three. Patients not receiving this therapy were served as control group or group four. Post operative bleeding was studied under five categories in each group. These were mild, moderate, severe, uncategorized and no bleeding. Statistical Analysis and Results: Statistical analysis was done by statistical software Statistical Package for the Social Sciences (SPSS). P ≤ 0.05 was considered as statistically significant. Total 84 male and 36 female patients were studied in this study. Therefore, majority of the studied patients were male. In group I, 9 out of 30 patients had no bleeding. However, 8 patients showed severe post operative bleeding. 5 patients showed only mild bleeding. In this group (group I), P value was significant for all five severities of bleeding. In group IV, 23 patients had no post operative bleeding. Nevertheless, only 1 patient showed severe post operative bleeding. Only 1 patient showed mild bleeding. In this group (group IV), P value was significant for patients with no post operative bleeding (0.03). Conclusion: Within the limitations of the study, authors concluded that anti coagulant therapies are significantly affecting post operative bleeding in extraction cases. The relative severity and prevalence of bleeding are also exaggerated by time period of anti coagulant therapy. Patients those who were on anti coagulant therapy for more than one year, showed maximum prevalence and severity of bleeding.

EFFICACY OF HEMOCOAGULASE AS A TOPICAL HEMOSTATIC AGENT AFTER EXTRACTIONS: A REVIEW

Dr. Balakrishnan Ramalingam; Dr. Vijay Ebenezer

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1933-1936

Extractions are the most common surgical procedures carried out and postextraction bleeding is most commonly seen complication. The aim of this review was to determine the effectiveness of topical hemocoagulase as a hemostatic agent and its role in reducing postextraction bleeding and its comparison to routine saline pressure pack after tooth extraction. Various differences was present between the hemostatic agent and saline pressure pack in relation to pain, swelling, wound healing, bleeding time, and other complications. Topical hemocoagulase is effective in reducing bleeding, pain, and swelling after extraction when compared to saline pressure packs. It also act as a promoter of wound healing.

Retrospective analysis of the birth histories of women who have suffered bleeding in order to optimize approaches to the prediction and prevention of postpartum bleeding

Poyonov O. Yoldoshevich; Karimova N. Nabidjanovna

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 6236-6243

The aim of our study was to retrospectively examine the history of childbirth and the quality of primary care for bleeding and evaluate the prescribed rehabilitation measures for women who have suffered postpartum hemorrhage and massive bleeding. The materials and methods of the study were 242 birth histories with postpartum hemorrhage for the last 6 years (2013-2018) in the city maternity hospital of Bukhara. The average age of the patients was 26.7 ± 1.2 years. The obstetric pathology leading to bleeding mainly consists of uterus hypotonia - 143 (59.1) and large fetus - 68 (28.1), and preeclampsia and DIOV are equal amounts - 33 (13.64). Only about 20% of women who had postpartum hemorrhage underwent early rehabilitation in the form of prescribing contraceptives.The aim of the research was to study the effectiveness of modern principles of stopping postpartum obstetric bleeding. From 127 cases of bleeding in 101 women (79.5%) the childbirth were with the operational method. With the development of blood loss was renderedstepwise ways to stop bleeding. During hemostasis of the bleeding, ligatures were imposed on the ovarian arteries and the ascending branch of the uterine artery for ischemicization of the uterus, which was effective in 30 (30%) women, and in 114 (89.7%) women managed to achieve organ-sparing tactics.