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Prothrombotic markers in Thalassemia major patients: A paradigm shift

Sultan S, Irfan SM, Zaidi SM

Med J Malaysia, 2018 08;73(4):185-189.
PMID: 30121679

BACKGROUND: It is being increasingly recognised that thalassemia major patients, like intermedia, have increased propensity for thromboembolism. Deficiency of natural anticoagulants is more recently defined finding contributing to the hypercoagulable state. The aim this study is to determine natural anticoagulants levels and their correlation with maternal characteristics, haematological and biochemical markers.
METHODS: This is a prospective case-control study. We registered 80 patients and 60 healthy controls from Jan 2009 to Dec 2013. Complete blood counts, prothrombin time, activated partial thromboplastin time, protein C, protein S, antithrombin, serum ferritin, liver enzymes; HbsAg and Anti- HCV were evaluated.
RESULT: There were 42 males and 38 females with mean age of 12.30±5.50 years. The mean protein C, protein S and antithrombin in patients and control were 58.25±22.5 versus 110.67±22.60, 67.90±19.58 versus 98.70±21.54 and 89.73±18.09 versus 104.0±10.98 (p<0.001) respectively. Protein C was predominantly deficient in 65% followed by protein S and antithrombin in 35% and 20% respectively. Protein C deficiency divulged positive correlation with protein S deficiency (p = 0.035) and antithrombin deficiency with hemoglobin of ≤8gm% (p<0.0025). No significant correlation of prothrombotic markers was established with maternal characteristics, hepatic dysfunction, hepatitis and serum ferritin.
CONCLUSION: Substantial decrement in prothrombotic markers, primarily protein C, may be implicated in elevated thrombosis; however follow-up data is required to establish definitive thromboembolic events.

Matched MeSH terms: Partial Thromboplastin Time
Systemic lupus erythematosus in a malay boy

Wan Mohamad WM, Mohd Ashari NS, Wan AbHamid WZ

International Medical Journal (Tokyo), 2017;24(3):295-296.

Objective: We presented a case report, systemic lupus erythematosus (SLE) in a Malay boy. Interestingly, this case occurs in a boy, which is not so common because autoimmune disease usually occurs in female. Design: Case report. Methods: We highlighted a case of a boy with SLE who presented with clinical symptoms suggestive of SLE and fulfilled the criteria for SLE diagnosis. Results: The patient was successfully managed with antihypertensive, intravenous cyclophosphamide and oral prednisolone and respond well to the therapy. Conclusion: Systemic lupus erythematosus is a chronic autoimmune disease which rarely occurs in male. However we reported one such case which fulfilled the criteria for SLE. © 2017 Japan Health Sciences University & Japan International Cultural Exchange Foundation.

Matched MeSH terms: Partial Thromboplastin Time
Comparative analysis of chromogenic vs clot.based one stage APTT assay for determination of factor VIII level

Baig MA, Swamy KB

Indian J Pathol Microbiol, 2021 1 13;64(1):123-127.
PMID: 33433421 DOI: 10.4103/IJPM.IJPM_900_19

Background: In the laboratory, factor VIII can be measured by three different methodologies, such as one-stage clotting assay, two-stage clotting assay, and chromogenic assay. These assays differ in ease of use, variety of reagents available, sensitivity to mild hemophilia A, and interference from lupus anticoagulants (LACs). Certain factor VIII gene mutations can cause discrepancy in results between one-stage activated partial thromboplastin time (APTT) and chromogenic assays.
Materials and Methods: The coagulometer for factor VIII assay is Sysmex CS-5100. All data were expressed as mean ± standard deviation (SD).
Results: A total of 135 cases were studied. Of these, 100 cases were of mild hemophilia A diagnosed by molecular genetics and, 15 cases were positive for LAC, which were confirmed by dilute Russell Viper venom test. Clot-based one-stage APTT assay showed 65% sensitivity and 80% specificity in diagnosing mild hemophilia A cases and out of 15 LAC cases, it showed false positivity in five cases. Chromogenic assay showed 85% sensitivity and 90% specificity in diagnosing mild hemophilia cases and was 100% specific in excluding LAC cases.
Conclusions: One-stage APTT assay is the most commonly used test for determining factor VIII levels but chromogenic assay are considered as the gold standard and recommended as the reference method by European Pharmacopoeia and ISTH subcommittee. Mild hemophilia A patients with missense mutations show discrepancy between the one-stage clot-based APTT assay and chromogenic assays for determination of factor VIII level and this can lead to misdiagnosis or misclassification of mild hemophilia A. Therefore, it is recommended that both the assays should be used in the evaluation of mild hemophilia cases.

Matched MeSH terms: Partial Thromboplastin Time
Fulltext Enhanced blood compatibility of metallocene polyethylene subjected to hydrochloric acid treatment for cardiovascular implants

Jaganathan SK, Mohandas H, Sivakumar G, Kasi P, Sudheer T, Avineri Veetil S, et al.

Biomed Res Int, 2014;2014:963149.
PMID: 24955370 DOI: 10.1155/2014/963149

Blood compatibility of metallocene polyethylene (mPE) was investigated after modifying the surface using hydrochloric acid. Contact angle of the mPE exposed to HCl poses a decrease in its value which indicates increasing wettability and better blood compatibility. Surface of mPE analyzed by using FTIR revealed no significant changes in its functional groups after treatment. Furthermore, scanning electron microscope images supported the increasing wettability through the modifications like pit formations and etching on the acid rendered surface. To evaluate the effect of acid treatment on the coagulation cascade, prothrombin time (PT) and activated partial thromboplastin time (APTT) were measured. Both PT and APTT were delayed significantly (P < 0.05) after 60 min exposure implying improved blood compatibility of the surfaces. Hemolysis assay of the treated surface showed a remarkable decrease in the percentage of lysis of red blood cells when compared with untreated surface. Moreover, platelet adhesion assay demonstrated that HCl exposed surfaces deter the attachment of platelets and thereby reduce the chances of activation of blood coagulation cascade. These results confirmed the enhanced blood compatibility of mPE after HCl exposure which can be utilized for cardiovascular implants like artificial vascular prostheses, implants, and various blood contacting devices.

Matched MeSH terms: Partial Thromboplastin Time
Fulltext Risk factors associated with development of dengue haemorrhagic fever or dengue shock syndrome in adults in Hospital Tengku Ampuan Afzan Kuantan

Tee HP, How SH, Jamalludin AR, Safhan MN, Sapian MM, Kuan YC, et al.

Med J Malaysia, 2009 Dec;64(4):316-20.
PMID: 20954558 MyJurnal

A retrospective study was conducted to investigate 183 serologically-confirmed cases of dengue fever (DF) admitted from October 2004 to March 2005 in a large hospital in Pahang. Clinical and laboratory features, progress and outcome of these patients were analysed in order to identify risk factors associated with development of dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Individually, we found that older patients, secondary dengue infection, high baseline haematocrit levels, low platelet levels and prolonged activated partial thromboplastin time (APTT) ratio were significant associations with bleeding tendencies. Of these risk factors, haematocrit and APTT ratio were two independent significant risk factors on multivariate analysis. Older patients with primary infection and younger patients with secondary infection had significant bleeding tendencies. We also verified the validity of the haematocrit levels suggested as cut-off levels for plasma leakage for the Malaysian population by Malaysian Clinical Practice Guidelines for Dengue Infection in Adults (2003).

Matched MeSH terms: Partial Thromboplastin Time
Fulltext Evaluation of the merit of the methanolic extract of Andrographis paniculata to supplement anti-snake venom in reversing secondary hemostatic abnormalities induced by Naja naja venom

Nayak AG, Kumar N, Shenoy S, Roche M

3 Biotech, 2021 May;11(5):228.
PMID: 33959471 DOI: 10.1007/s13205-021-02766-z

Increasing evidence suggests a sizable involvement of hemotoxins in the morbidity associated with envenomation by the Indian spectacled cobra, Naja naja (N.N). This study investigates the ability of Indian polyvalent anti-snake venom (ASV), methanolic extract of Andrographis paniculata (MAP) and their combination in reversing the hemostatic abnormalities, viz. activated partial thromboplastin time(aPTT), prothrombin time(PT) and thrombin time(TT) in citrated plasma. These parameters were assessed in 2 groups of experiments. Group 1: Without the prior incubation of plasma with venom and Group 2: With prior incubation of plasma with venom for 90 min at 37°C. Venom caused significant (p

Matched MeSH terms: Partial Thromboplastin Time
Fulltext The prognostic value of tissue factor levels in acute ischaemic stroke

Halim AG, Hamidon BB, Cheong SK, Raymond AA

Singapore Med J, 2006 May;47(5):400-3.
PMID: 16645690

There is no biological marker that can accurately predict the prognosis after an acute ischaemic stroke. The main objective of this study was to evaluate the prognostic value of tissue factor (thromboplastin) levels in first ischaemic stroke.

Matched MeSH terms: Thromboplastin/analysis*; Thromboplastin/biosynthesis
Fulltext Congenital urethrocutaneous fistula: an interesting case

Roger, A.I., Rachel, Anne J.

Journal of Surgical Academia, 2014;4(2):45-47.
MyJurnal

A congenital urethrocutaneous fistula is a rare anomaly which was first described in 1962 by Gupta. Clinically, children present when their guardian is alarmed by either frequent urinary dribbling or unusual stream when they pass urine. This congenital anomaly can present in isolation or be accompanied by a chordee, hypospadia and anorectal malformations in a newborn. The surgical management will either be a primary repair of the fistula or converting it to a hypospadia before proceeding with a single or staged hypospadia repair. Surgical technique will depend on the local tissue factors and associated anomalies.

Matched MeSH terms: Thromboplastin
Fulltext Effect of Ocimum sanctum (Tulsi) aqueous leaf extract on prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT) of human plasma

Gunendren, M., Noordin S.S., Muggundha, R., Nozlena A.S.

Journal of Biomedical and Clinical Sciences, 2017;2(1):62-68.
MyJurnal

Conventional anticoagulant therapy is the mainstay of medical treatment for deep vein thrombosis disorders. However,there are many complications associated with these agents such as bleeding. Hence, the search for novel anticoagulant derived from natural substances such as plants origin is in high demand nowadays. Ocimum sanctum(O.sanctum) also known as Ocimum tenuiform (OT), tulsi or holy basil from the family of Lamiaceae has been widely used for thousands of years in Ayurveda and Unani systems to cure or prevent a number of illnessessuch as headache, malaria, ulcers, bronchitis, cough, flu, sore throat and asthma. The objective is to investigate theeffect ofO. sanctum(Tulsi) aqueous leaf extract on prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT) in human plasma. Coagulation activity of O. sanctum was measured via PT, APTT and TT assay in citrated plasma collected from thirty-six healthy regular blood donors. The plasma was tested against different concentrations of O. sanctum aqueous extract as follows: 0.1mg/ml, 0.5 mg/ml and 1.0 mg/ml. Result shows the aqueous extract of O. sanctum prolonged the PT and APTT assays (p0.05). The gas chromatography-mass spectrometry (GC-MS) analysis had identified the linolenic acid at 1-10% of ethanol and aqueousconcentration at different retention time which was responsible for the coagulation activities of O. sanctumin human plasma. This study suggests that O. sanctum does affect coagulation activity in human plasma and can be potentially used as naturally derived anticoagulant products in the future.

Matched MeSH terms: Partial Thromboplastin Time; Thromboplastin
A case of immune thrombocytopenic purpura with prolonged aPTT time: A clotter hidden in a bleeder?

Lee MH, Khoo PJ, Gew LT, Ng CF

Med J Malaysia, 2017 12;72(6):365-366.
PMID: 29308775 MyJurnal

We report the case of a 23-year-old woman who presented with prolonged menstruation and multiple bruises on the limbs and trunk. Investigations revealed severe thrombocytopenia and deranged coagulation profile with markedly prolonged activated partial thromboplastin time (aPTT). Lupus anticoagulant, anti-cardiolipin antibody and anti-beta-2-glycoprotein 1 antibody were positive. She was diagnosed with Immune Thrombocytopenic Purpura (ITP) with positive antiphospholipid antibody serology and given a course of intravenous methylprednisolone and tapering doses of oral prednisolone. She was steroid free and had no bleeding or thrombotic event over two years follow up.

Matched MeSH terms: Partial Thromboplastin Time
Fulltext Electrospun polyurethane nanofibrous composite impregnated with metallic copper for wound-healing application

Jaganathan SK, Mani MP

3 Biotech, 2018 Aug;8(8):327.
PMID: 30073112 DOI: 10.1007/s13205-018-1356-2

In this study, a wound dressing based on polyurethane (PU) blended with copper sulphate nanofibers was developed using an electrospinning technique. The prepared PU and PU nanocomposites showed smooth fibers without any bead defects. The prepared nanocomposites showed smaller fiber (663 ± 156.30 nm) and pore (888 ± 70.93 nm) diameter compared to the pristine PU (fiber diameter 1159 ± 147.48 nm and pore diameter 1087 ± 62.51 nm). The interaction of PU with copper sulphate was evident in the infrared spectrum through hydrogen-bond formation. Thermal analysis displayed enhanced weight residue at higher temperature suggesting interaction of PU with copper sulphate. The contact angle measurements revealed the hydrophilic nature of the prepared nanocomposites (71° ± 2.309°) compared with pure PU (100° ± 0.5774°). The addition of copper sulphate into the PU matrix increased the surface roughness, as revealed in the atomic force microscopy (AFM) analysis. Mechanical testing demonstrated the enhanced tensile strength behavior of the fabricated nanocomposites (18.58 MPa) compared with the pristine PU (7.12 MPa). The coagulation assays indicated the enhanced blood compatibility of the developed nanocomposites [activated partial thromboplastin time (APTT)-179 ± 3.606 s and partial thromboplastin time (PT)-105 ± 2.646 s] by showing a prolonged blood clotting time compared with the pristine PU (APTT-147.7 ± 3.512 s and PT-84.67 ± 2.517 s). Furthermore, the hemolysis and cytotoxicity studies suggested a less toxicity nature of prepared nanocomposites by displaying low hemolytic index and enhanced cell viability rates compared with the PU membrane. It was observed that the fabricated novel wound dressing possesses better physicochemical and enhanced blood compatibility properties, and may be utilized for wound-healing applications.

Matched MeSH terms: Partial Thromboplastin Time
Macular haemorrhage in adult acute leukaemia patients at presentation and the risk of subsequent intracranial haemorrhage

Jackson N, Reddy SC, Harun MH, Quah SH, Low HC

Br J Haematol, 1997 Jul;98(1):204-9.
PMID: 9233585

Retinal changes are common in adult acute leukaemia patients at presentation, but whether they correlate with the risk of subsequent intracranial haemorrhage is unknown. A 4-year study has been carried out in 82 newly-diagnosed acute leukaemia patients, aged 12-77 years, who were studied prospectively for the presence of intra-retinal haemorrhages (IRH), white-centred haemorrhages (WCH), cotton-wool spots (CWS) and macular haemorrhages (MH). Groups with and without these features were compared for their risk of intra-cranial haemorrhage (ICH) within the first 30 d following diagnosis. There was no association between the incidence of ICH and the presence of IRH, WCH or CWS. However, 6/13 of those with MH developed ICH, compared to 6/69 of those without MH (relative risk 5.0, CI 95% [2.03-12.33], P=0.003). The only other identifiable risk factor for ICH was the M3 subtype of AML, but if the four cases of M3-AML were discounted from analysis, MH remained a highly significant risk factor for ICH. Patients with MH should be monitored intensively for the development of ICH, and receive priority in the allocation of platelets where these are in short supply.

Matched MeSH terms: Partial Thromboplastin Time
Expression and characterization of anticoagulant activity of salivary protein alALP from Asian tiger mosquito Aedes albopictus

Li XP, Lin D, Zhang Y, Chen SQ, Bai HQ, Zhang SN, et al.

Trop Biomed, 2020 Mar 01;37(1):116-126.
PMID: 33612723

Several bioactive molecules isolated from the saliva of blood-sucking arthropods, such as mosquitoes, have been shown to exhibit potential anticoagulant function. We have previously identified a 30kDa allergen named Aegyptin-like protein (alALP), which is highly homologous to Aegyptin, from the salivary glands of female Aedes albopictus (Asian tiger mosquito). In this study, we identified the conserved functional domain of alALP by using bioinformatic tools, and expressed the His-tagged alALP recombinant protein in sf9 insect cells by generation and transfection of a baculoviral expression plasmid carrying the fulllength cDNA of alALP. We purified this recombinant protein and examined its function on the inhibition of blood coagulation. The results showed that the purified His-alALP prolonged the Activated Partial Thromboplastin Time (APTT), Prothrombin Time (PT) and Thrombin Time (TT) in vitro as well as the Bleeding Time (BT) in vivo, which suggest that alALP could be a novel anticoagulant.

Matched MeSH terms: Partial Thromboplastin Time
Does Menses Affect the Risk of Blood Loss in Adolescent Idiopathic Scoliosis Patients Undergoing Posterior Spinal Fusion Surgeries?: A Propensity-Score Matching Study

Chiu CK, Gani SMA, Chung WH, Mihara Y, Hasan MS, Chan CYW, et al.

Spine (Phila Pa 1976), 2020 Aug 15;45(16):1128-1134.
PMID: 32205708 DOI: 10.1097/BRS.0000000000003484

STUDY DESIGN: Retrospective propensity score matching study.
OBJECTIVE: To investigate whether menses affect intraoperative blood loss in female adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF) surgeries.
SUMMARY OF BACKGROUND DATA: There were concerns whether patients having menses will have higher intraoperative blood loss if surgery were to be done during this period.
METHODS: This study included 372 females who were operated between May 2016 to May 2019. Fifty-five patients had menses during surgery (Group 1, G1) and 317 patients did not have menses during surgery (Group 2, G2). Propensity score matching (PSM) analysis with one-to-one, nearest neighbor matching technique and with a match tolerance of 0.001 was used. The main outcome measures were intraoperative blood loss (IBL), volume of blood salvaged, transfusion rate, preoperative hemoglobin, preoperative platelet, preoperative prothrombin time, preoperative activated partial thromboplastin time (APTT), international normalized ratio (INR), and postoperative hemoglobin. Postoperative Cobb angle and correction rate were also documented.
RESULTS: At the end of PSM analysis, 46 patients from each group were matched and balanced. The average operation duration for G1 was 140.8 ± 43.0 minutes compared with 143.1 ± 48.3 minutes in G2 (P = 0.806). The intraoperative blood loss for G1 was 904.3 ± 496.3 mL and for G2 was 907.9 ± 482.8 mL (P = 0.972). There was no significant difference in terms of normalized blood loss (NBL), volume of blood salvaged during surgery, preoperative hemoglobin, postoperative hemoglobin, hemoglobin drift, estimated blood volume (EBV), IBL per EBV and IBL per level fused (P > 0.05). No postoperative complications were encountered in both groups. On average, the postoperative hospital stay was 3.5 ± 0.8 days for both groups (P = 0.143).
CONCLUSION: Performing corrective surgery during the menstrual phase in female AIS patients is safe without risk of increased blood loss.
LEVEL OF EVIDENCE: 4.

Matched MeSH terms: Partial Thromboplastin Time
Fulltext Acquired Hemophilia in a Patient Presenting with Swollen Left Limb

Kiam GWP

Korean J Fam Med, 2019 Mar;40(2):129-132.
PMID: 30001614 DOI: 10.4082/kjfm.17.0126

Acquired hemophilia is a rare, potentially life-threatening disease that usually remains under-recognized especially in a primary setting; thus, diagnosing this disease is very challenging. Given its prevalence in elderly patients, awareness and diagnosis of this condition in the aging population (particularly those with unexplained bleeding or prolonged activated partial thromboplastin time) should be improved and better managed by the clinicians. Early diagnosis and prompt treatment are usually effective in preventing the adverse outcomes of this disease. In this report, we discuss a case of an elderly patient with acquired hemophilia who initially presented with swelling of his lower left limb. The diagnosis of acquired hemophilia was made a month after the appearance of symptoms. Early diagnosis with proper treatment could have been provided to this patient, if the initial assessment had been thoroughly conducted.

Matched MeSH terms: Partial Thromboplastin Time
Fulltext Microwave-assisted fibrous decoration of mPE surface utilizing Aloe vera extract for tissue engineering applications

Balaji A, Jaganathan SK, Supriyanto E, Muhamad II, Khudzari AZ

Int J Nanomedicine, 2015;10:5909-23.
PMID: 26425089 DOI: 10.2147/IJN.S84307

Developing multifaceted, biocompatible, artificial implants for tissue engineering is a growing field of research. In recent times, several works have been reported about the utilization of biomolecules in combination with synthetic materials to achieve this process. Accordingly, in this study, the ability of an extract obtained from Aloe vera, a commonly used medicinal plant in influencing the biocompatibility of artificial material, is scrutinized using metallocene polyethylene (mPE). The process of coating dense fibrous Aloe vera extract on the surface of mPE was carried out using microwaves. Then, several physicochemical and blood compatibility characterization experiments were performed to disclose the effects of corresponding surface modification. The Fourier transform infrared spectrum showed characteristic vibrations of several active constituents available in Aloe vera and exhibited peak shifts at far infrared regions due to aloe-based mineral deposition. Meanwhile, the contact angle analysis demonstrated a drastic increase in wettability of coated samples, which confirmed the presence of active components on glazed mPE surface. Moreover, the bio-mimic structure of Aloe vera fibers and the influence of microwaves in enhancing the coating characteristics were also meticulously displayed through scanning electron microscopy micrographs and Hirox 3D images. The existence of nanoscale roughness was interpreted through high-resolution profiles obtained from atomic force microscopy. And the extent of variations in irregularities was delineated by measuring average roughness. Aloe vera-induced enrichment in the hemocompatible properties of mPE was established by carrying out in vitro tests such as activated partial thromboplastin time, prothrombin time, platelet adhesion, and hemolysis assay. In conclusion, the Aloe vera-glazed mPE substrate was inferred to attain desirable properties required for multifaceted biomedical implants.

Matched MeSH terms: Partial Thromboplastin Time
Shortened activated partial thromboplastin time, a hemostatic marker for hypercoagulable state during acute coronary event

Abdullah WZ, Moufak SK, Yusof Z, Mohamad MS, Kamarul IM

Transl Res, 2010 Jun;155(6):315-9.
PMID: 20478546 DOI: 10.1016/j.trsl.2010.02.001

Various factors may contribute to a hypercoagulable state and acute vascular thrombosis. A prospective study was conducted involving 165 coronary heart disease (CHD) patients from the Cardiology Unit, Hospital Universiti Sains Malaysia. The purpose of this study was to investigate the relationship among factor VIII (FVIII), prothrombin time (PT), activated partial thromboplastin time (APTT), and activated protein C resistance (APC-R) state among CHD patients and to look for potential clinical applications from these laboratory findings. There were 110 cases diagnosed as acute coronary syndrome (ACS), whereas another 55 were stable coronary artery disease (SCAD) patients. PT, APTT, FVIII, and APC-R assays were performed on all subjects. There was a significant difference between the FVIII level and the APTT results (P value < 0.0001). A negative relationship was found between the FVIII level and the APTT from linear regression analysis (R(2) = 10%, P value < 0.0001). For each 1% increase in the FVIII level, the APTT was reduced by 0.013 s (95% confidence interval (CI) between -0.019 and -0.007). Interestingly, none of the SCAD patients had abnormally short APTT. Approximately 68.4% of cases with a positive APC-R assay were found to have a high FVIII level. In conclusion, the APTT test is a potential hemostatic marker for hypercoagulable state including in arterial thrombosis.
Study site: Cardiology unit (outpatient and inpatient), Hospital Universisti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Partial Thromboplastin Time/statistics & numerical data*
Fulltext Development and blood compatibility assessment of electrospun polyvinyl alcohol blended with metallocene polyethylene and plectranthus amboinicus (PVA/mPE/PA) for bone tissue engineering

Qi J, Zhang H, Wang Y, Mani MP, Jaganathan SK

Int J Nanomedicine, 2018;13:2777-2788.
PMID: 29785105 DOI: 10.2147/IJN.S151242

Introduction: Currently, the design of extracellular matrix (ECM) with nanoscale properties in bone tissue engineering is challenging. For bone tissue engineering, the ECM must have certain properties such as being nontoxic, highly porous, and should not cause foreign body reactions.
Materials and methods: In this study, the hybrid scaffold based on polyvinyl alcohol (PVA) blended with metallocene polyethylene (mPE) and plectranthus amboinicus (PA) was fabricated for bone tissue engineering via electrospinning. The fabricated hybrid nanocomposites were characterized by scanning electron microscopy (SEM), Fourier transform and infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), contact angle measurement, and atomic force microscopy (AFM). Furthermore, activated partial thromboplastin time (APTT), prothrombin time (PT), and hemolytic assays were used to investigate the blood compatibility of the prepared hybrid nanocomposites.
Results: The prepared hybrid nanocomposites showed reduced fiber diameter (238±45 nm) and also increased porosity (87%) with decreased pore diameter (340±86 nm) compared with pure PVA. The interactions between PVA, mPE, and PA were identified by the formation of the additional peaks as revealed in FTIR. Furthermore, the prepared hybrid nanocomposites showed a decreased contact angle of 51°±1.32° indicating a hydrophilic nature and exhibited lower thermal stability compared to pristine PVA. Moreover, the mechanical results revealed that the electrospun scaffold showed an improved tensile strength of 3.55±0.29 MPa compared with the pristine PVA (1.8±0.52 MPa). The prepared hybrid nanocomposites showed delayed blood clotting as noted in APTT and PT assays indicating better blood compatibility. Moreover, the hemolysis assay revealed that the hybrid nanocomposites exhibited a low hemolytic index of 0.6% compared with pure PVA, which was 1.6% suggesting the safety of the developed nanocomposite to red blood cells (RBCs).
Conclusion: The prepared nanocomposites exhibited better physico-chemical properties, sufficient porosity, mechanical strength, and blood compatibility, which favors it as a valuable candidate in bone tissue engineering for repairing the bone defects.

Matched MeSH terms: Partial Thromboplastin Time
Fulltext Engineering electrospun multicomponent polyurethane scaffolding platform comprising grapeseed oil and honey/propolis for bone tissue regeneration

Chao CY, Mani MP, Jaganathan SK

PLoS One, 2018;13(10):e0205699.
PMID: 30372449 DOI: 10.1371/journal.pone.0205699

Essential oils play an important role in reducing the pain and inflammation caused by bone fracture.In this study, a scaffold was electrospun based on polyurethane (PU), grape seed oil, honey and propolis for bone tissue-engineering applications. The fiber diameter of the electrospun PU/grape seed oil scaffold and PU/grape seed oil/honey/propolis scaffold were observed to be reduced compared to the pristine PU control. FTIR analysis revealed the existence of grape seed oil, honey and propolis in PU identified by CH band peak shift and also hydrogen bond formation. The contact angle of PU/grape seed oil scaffold was found to increase owing to hydrophobic nature and the contact angle for the PU/grape seed/honey oil/propolis scaffold were decreased because of hydrophilic nature. Further, the prepared PU/grape seed oil and PU/grape seed oil/honey/propolis scaffold showed enhanced thermal stability and reduction in surface roughness than the control as revealed in thermogravimetric analysis (TGA) and atomic force microscopy (AFM) analysis. Further, the developed nanocomposite scaffold displayed delayed blood clotting time than the pristine PU in the activated prothrombin time (APTT) and partial thromboplastin time (PT) assay. The hemolytic assay and cytocompatibility studies revealed that the electrospun PU/grape seed oil and PU/grape seed oil/honey/propolis scaffold possess non-toxic behaviour to red blood cells (RBC) and human fibroblast cells (HDF) cells indicating better blood compatibility and cell viability rates. Hence, the newly developed electrospun nanofibrous composite scaffold with desirable characteristics might be used as an alternative candidate for bone tissue engineering applications.

Matched MeSH terms: Partial Thromboplastin Time
Fulltext Coagulation Factor Activities Changes Over 5 Days in Thawed Fresh Frozen Plasma Stored at Different Initial Storage Temperatures

Noordin SS, Karim FA, Mohammad WMZBW, Hussein AR

Indian J Hematol Blood Transfus, 2018 Jul;34(3):510-516.
PMID: 30127563 DOI: 10.1007/s12288-017-0879-8

Thawed plasma is fresh frozen plasma (FFP) that has been stored for 5 days at 1-6 °C. Duration of storage and different storage temperatures might affect the coagulation factor activity in thawed FFP. This study measured the changes of coagulation factor activities over 5 days in thawed FFP and stored at two different initial storage temperatures. Thirty-six units of FFP, which consisted of nine units each from blood groups A, B, AB, and O, were thawed at 37 °C. Each unit was divided into two separate groups (Group A and Group B) based on initial storage temperature. The first group was stored at 2-6 °C for 5 days (Group A). The second group was stored at 20-24 °C for initial 6 h followed by 2-6 °C for 5 days (Group B). Prothrombin time (PT), activated partial thromboplastin time (APTT), coagulation factor activities of fibrinogen, factor (F) II, FV, FVII, FVIII, FIX, FX, and von Willebrand factor antigen (vWF Ag) were assessed at baseline after thawing, at 6 h, and on days 1, 3, and 5 of storage for both groups. All coagulation factors mean activities in both storage groups decreased significantly over 5 days of storage. The mean FVIII activity at day 5 of storage was 36.9% in Group A and 39.8% in Group B. The other coagulation factors mean activities were > 50% on day 5 of storage in both groups. The coagulation factor activities of thawed FFP stored for 5 consecutive days were reduced in the two storage groups but most of the activities were still above 30%. This study suggests that thawed FFP stored for 5 days has the potential to ameliorate coagulation factor deficiencies in affected patients.

Matched MeSH terms: Partial Thromboplastin Time

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