Displaying publications 41 - 60 of 123 in total

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  1. Review: the Multiple Roles of Monocytic Microparticles
    Halim AT, Ariffin NA, Azlan M
    Inflammation, 2016 Aug;39(4):1277-84.
    PMID: 27216803 DOI: 10.1007/s10753-016-0381-8
    Monocytic microparticles (mMP) are microparticles derived from human monocytes either under in vivo or in vitro conditions. The size of mMP is between 0.1 and 1.0 μm. Apart from the size range, mMPs are also identified based on phosphatidylserine and CD14 expression on their surface, though this is not always the case. Monocytic MP are critical players in inflammation, endothelial cell function, and blood coagulation. They exhibit dual function by either helping the progression of such conditions or limiting it, depending on certain factors. Furthermore, the numbers of mMP are elevated in some autoimmune diseases, infectious diseases, and metabolic disorders. However, it is unknown whether mMP play an active role in these diseases or are simply biomarkers. The mechanism of mMP modulation is yet to be identified. In this review, we highlight the mechanism of mMP formation and the roles that they play in inflammation, blood coagulation, and different disease settings.
    Matched MeSH terms: Blood Coagulation
  2. Management of Symmetrical Peripheral Gangrene
    Foead AI, Mathialagan A, Varadarajan R, Larvin M
    Indian J Crit Care Med, 2018 Dec;22(12):870-874.
    PMID: 30662227 DOI: 10.4103/ijccm.IJCCM_379_18
    Symmetrical peripheral gangrene (SPG) is a rare, debilitating disease that deserves more widespread concern among the medical fraternities. The objective of this review is to outline the etiology, pathology findings, and management practices of SPG. About 18%-40% mortality rate was reported, and survivors have high frequency of multiple limb amputations. SPG is the hallmark of disseminated intravascular coagulation (DIC). The main pathogenesis theory, to date, is microthrombosis associated with disturbed procoagulant-anticoagulant balance. The treatment of SPG is largely anecdotal and theoretically involves heparin-based anticoagulation and substitution of natural anticoagulants. Early recognition, prompt management of DIC, and underlying conditions may halt the progression of the disease. The multicenter randomized controlled trial should be set up to formulate the proper treatment guidelines.
    Matched MeSH terms: Blood Coagulation
  3. Anticoagulant-related nephropathy: A case report
    Lee KT, Kammal WSWA, Kong BH
    Saudi J Kidney Dis Transpl, 2021 2 11;31(6):1403-1406.
    PMID: 33565454 DOI: 10.4103/1319-2442.308356
    Anticoagulant-related nephropathy (ARN) is a recently described disease entity which is an underdiagnosed complication of anticoagulation. Despite widespread usage of anticoagulants, ARN is not commonly reported. We report a case of a 64-year old man with biopsy-proven ARN who presented with over anticoagulation and acute chronic kidney injury while on warfarin therapy for his left lower limb deep-vein thrombosis. Various investigations were performed and renal biopsy confirmed the diagnosis of anticoagulant-related nephropathy.
    Matched MeSH terms: Blood Coagulation
  4. Fulltext Normalisation of the International Normalised Ratio (INR) Prior to Interventional Procedure: is it necessary?
    Mohd Tarmizi Mohamad Mahyedin, Afifah Hassan, Abdul Rahim Hussein
    Malaysian Journal of Medicine and Health Sciences, 2018;14(201):1-7.
    MyJurnal
    The fresh frozen plasma (FFP) is frequently prescribed either for therapeutic or prophylactic transfusion. The international normalised ratio (INR) value of 1.50 and above is frequently reported to be a transfusion trigger for FFP prior to interventional procedure. This study aimed to evaluate the efficacy of prophylactic FFP transfusion in normalising the INR and to determine the post-transfusion outcomes. Methods: A prospective cross-sectional study involved 81 patients who received prophylactic FFP transfusion over a period of three months. All demographic, clinical data and outcomes of FFP transfusion were captured and filled in the research proforma. Results: The proportion of patients achieved posttransfusion INR below 1.51 was 30.30% (n=27). The majority of patients underwent the interventional procedures with posttransfusion INR > 1.50 (n=52) without experiencing any bleeding episodes. Overall, FFP transfusion resulted in significant median INR difference from 1.89 (IQR, 0.53) to 1.60 (IQR, 0.25); p< 0.001. The greater median INR difference was observed in group with pretransfusion INR > 2.00 and who received FFP doses between 10.00 to 20.00 ml kg-1 (p < 0.001). The INR difference showed the significant, positive correlation with pretransfusion INR values (rs= 0.83, p < 0.001) and FFP doses (rs= 0.72, p< 0.001). Conclusions: The interventional procedures were safely carried out despite abnormal posttransfusion INR. The prophylactic FFP transfusions could be avoided in patients with mild coagulopathy (INR 1.50 - 2.00) prior interventional procedures.
    Matched MeSH terms: Blood Coagulation Disorders
  5. Fulltext Massive hemothorax following administration of intrapleural streptokinase
    Chai FY, Kuan YC
    Ann Thorac Med, 2011 Jul;6(3):149-51.
    PMID: 21760848 DOI: 10.4103/1817-1737.82451
    The administration of intrapleural streptokinase (IPSK) is widely practiced in the management of loculated empyema thoracis. To our knowledge, there have been only 4 cases of hemorrhagic complications attributed to the administration of IPSK reported in the literature. In this article, we report a case of a 17-year-old girl who received IPSK and developed shock, anemia, coagulopathy and massive hemothorax. Our discussion focuses on the hemorrhagic complication of chest tube insertion and the role of IPSK in blood clot lysis and inhibition of local hemostasis.
    Matched MeSH terms: Blood Coagulation Disorders
  6. Fulltext Bioassay-guided fractionation of Melastoma malabathricum Linn. leaf solid phase extraction fraction and its anticoagulant activity
    Khoo LT, Abdullah JO, Abas F, Tohit ER, Hamid M
    Molecules, 2015 Feb 24;20(3):3697-715.
    PMID: 25719740 DOI: 10.3390/molecules20033697
    The aims of this study were to examine the bioactive component(s) responsible for the anticoagulant activity of M. malabathricum Linn. leaf hot water crude extract via bioassay-guided fractionation and to evaluate the effect of bioactive component(s) on the intrinsic blood coagulation pathway. The active anticoagulant fraction of F3 was subjected to a series of chromatographic separation and spectroscopic analyses. Furthermore, the effect of the bioactive component(s) on the intrinsic blood coagulation pathway was studied through immediate and time incubation mixing studies. Through Activated Partial Thromboplastin Time (APTT) assay-guided fractionation, Subfraction B was considered the most potent anticoagulant fraction. Characterisation of Subfraction B indicated that anticoagulant activity could partly be due to the presence of cinnamic acid and a cinnamic acid derivative. APTT assays for both the immediate and time incubation mixing were corrected back into normal clotting time range (35.4-56.3 s). In conclusion, cinnamic acid and cinnamic acid derivative from Subfraction B were the first such compounds to be discovered from M. malabathricum Linn. leaf hot water crude extract that possess anticoagulant activity. This active anticoagulant Subfraction B prolonged blood clotting time by causing factor(s) deficiency in the intrinsic blood coagulation pathway.
    Matched MeSH terms: Blood Coagulation/drug effects*
  7. Preventive transfusion in Dengue shock syndrome-is it necessary?
    Lum LC, Abdel-Latif Mel-A, Goh AY, Chan PW, Lam SK
    J Pediatr, 2003 Nov;143(5):682-4.
    PMID: 14615749
    We compared 53 patients with Dengue shock syndrome (DSS) who received preventive transfusions with 53 who did not. Significant differences in the development of pulmonary edema and length of hospitalization (P
    Matched MeSH terms: Blood Coagulation Disorders/complications
  8. Fulltext The use of antiplatelet agents for arterial thromboprophylaxis in COVID-19
    Kow CS, Hasan SS
    Rev Esp Cardiol (Engl Ed), 2021 01;74(1):114-115.
    PMID: 32933883 DOI: 10.1016/j.rec.2020.08.009
    Matched MeSH terms: Blood Coagulation*
  9. 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: Blood Coagulation; Blood Coagulation Tests
  10. Ancrod enhances the thrombolytic effect of streptokinase and urokinase
    Cercek B, Lew AS, Hod H, Yano J, Lewis B, Reddy KN, et al.
    Thromb Res, 1987 Aug 15;47(4):417-26.
    PMID: 3660351
    Since thrombi continue to incorporate fibrin during lysis we tested the effect of pretreatment with ancrod, a defibrinating agent from Malaysian pit viper venom, on thrombolysis with urokinase and streptokinase. Thrombi were induced by copper-coils in the carotid arteries of the dogs, weighed after 1 hour and inserted into the femoral arteries of the same animals. They were then exposed for 15 min to iv boluses of streptokinase 10,000 U/kg, urokinase 10,000 U/kg and urokinase 25,000 U/kg with or without pretreatment with ancrod. Ancrod depleted fibrinogen within 5 min and enhanced the lytic effect of streptokinase from 25 +/- 8% to 59 +/- 13% (p less than .05), urokinase 10,000 U/kg from 16 +/- 11% to 66 +/- 18% (p less than .01) and urokinase 25,000 U/kg from 27 +/- 17% to 85 +/- 8% (p less than .001) of the initial thrombus weight. Ancrod itself did not activate plasminogen to plasmin. We conclude that ancrod enhances thrombolysis probably by depleting fibrinogen and preventing new fibrin incorporation into the thrombus during lysis.
    Matched MeSH terms: Blood Coagulation/drug effects
  11. Clinico-hematological and thromboelastographic profiles in glanzmann's thrombasthenia
    Ahammad J, Kamath A, Shastry S, Chitlur M, Kurien A
    Blood Coagul Fibrinolysis, 2020 Jan;31(1):29-34.
    PMID: 31789664 DOI: 10.1097/MBC.0000000000000870
    : Glanzmann's thrombasthenia is a rare inherited bleeding disorder characterized by the quantitative or qualitative defect of glycoprotein IIb/IIIa receptor on platelets which leads to ineffective aggregation. Light transmittance aggregometry is considered as the gold standard for diagnosis of Glanzmann's thrombasthenia. Thromboelastography (TEG) is a global hemostatic assay which measures clot formation, clot strengthening and fibrinolysis. This study evaluates the clinical, laboratory and TEG profiles in patients with Glanzmann's thrombasthenia. Bleeding score by (International Society on Thrombosis and Haemostasis) ISTH-bleeding assessment tool (bleeding score), laboratory tests to diagnose Glanzmann's thrombasthenia, and TEG parameters were correlated in 11 Glanzmann's thrombasthenia patients. Seventeen participants with normal bleeding score were included as controls. Bleeding score was increased in all patients. The highest bleeding score was in an adult female (26), whereas the lowest score (4) was in two children of less than 1 year. Majority of TEG parameters (except R-time) showed a statistically significant difference between Glanzmann's thrombasthenia patients and controls (K-time: P 
    Matched MeSH terms: Blood Coagulation Tests/methods*
  12. 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: Blood Coagulation Disorders; Blood Coagulation Tests
  13. Novel usage of fresh frozen plasma in hereditary angioedema
    Hanizah N, Affirul CA, Farah NA, Shamila MA, Ridzuan MI
    Clin Ter, 2016 Nov-Dec;167(6):182-184.
    PMID: 28051822 DOI: 10.7417/CT.2016.1969
    Hereditary angioedema (HAE) is a rare and potentially life threatening autosomal dominant disease characterized by recurrent episodes of cutaneous and mucosal oedema. It results from reduced expression or loss of function of CI-esterase inhibitors (C1-INH). As opposed to the more common histamine-mediated angioedema, HAE does not respond well to conventional treatments with anti-histamines, steroids and adrenaline. Early recognition and timely intervention with the correct treatment are crucial particularly preventing airway obstruction. New disease specific treatment including plasma derived or recombinant C1-INH, ecallantide and icatibant have recently emerged and its appropriate use can reduce HAE-associated mortality and morbidity. However due to its costs, these disease specific treatments have yet to reach Malaysia. Despite that no randomized clinical trial on FFP has been performed, its efficacy in treating acute attacks of HAE is only demonstrated in case studies. This case report illustrates the successful treatment of acute HAE episode with FFP in a Malaysian government hospital setting.
    Matched MeSH terms: Blood Coagulation/drug effects
  14. Comparison of rivaroxaban concentrations between Asians and Caucasians and their correlation with PT/INR
    Ng Tsai HO, Goh JJN, Aw JWX, Lin Y, Fong AYY, Tiong LL, et al.
    J Thromb Thrombolysis, 2018 Nov;46(4):541-548.
    PMID: 30155672 DOI: 10.1007/s11239-018-1726-y
    The objectives of this study are to compare steady-state trough (Cmin,ss) and peak (Cmax,ss) concentrations of rivaroxaban between Asians and Caucasians and to evaluate the relationship between rivaroxaban concentrations and prothrombin time/international normalized ratio (PT/INR). Recruited patients were advised on the time to take rivaroxaban. Cmin,ss and PT/INR were taken when patients arrived. Cmax,ss and PT/INR were drawn between 2 and 4 h later after the patient took rivaroxaban with food. Thirty patients were included in the analyses: 57% (n = 17) males and 43% (n = 13) females, 77% (n = 23) on 20 mg and 23% (n = 7) on 15 mg. Median PTtrough and PTpeak are moderately correlated with Cmin,ss (r2 = 0.43) and Cmax,ss (r2 = 0.49), respectively. Patients on 15 mg have lower Cmin,ss and Cmax,ss versus Caucasians [12 ng/ml vs. 57 ng/ml (Cmin,ss); 87 ng/ml vs. 229 ng/ml (Cmax,ss), p 
    Matched MeSH terms: Blood Coagulation Tests*
  15. Fulltext Coagulation profile in women on low-dose oral contraceptive pills
    Roshidah I, Khalid H, Baharum Y
    Malays J Reprod Health, 1990 Dec;8(2):97-100.
    PMID: 12343152
    A cross-sectional study looking at the coagulation system was carried out involving 175 women attending the National Population and Family Development Board's Clinic at the Maternity Clinic, General Hospital, Kuala Lumpur. Study subjects comprise of 50 combined low-dose estrogen/progestrogen oral contraceptive (DC) pill users and 75 non-DC users, acting as controls. The subjects were on the pill for a period of one year or more. There were significant shortening of the prothrombin time (PT) and partial thromboplastin time (PIT) in the DC group as compared to the control group. However, the activities of factors II, Vand VIII assayed were not significantly different between the two groups, suggesting that the changes in the PT and PIT were not significant clinically. The effect of long term usage of combined 10w..cJose DC pills does not seem to indicate changes in the coagulation profile of the women in our study.
    PIP: The effect of low dose combined oral contraceptives containing 30 mcg ethinyl estradiol and either 150 mcg levonorgestrel or 150 mcg desogestrel on coagulation indices in Malaysian women was examined. 50 women who had been using the pills for 1 year or more, were compared to 75 non-users. All were attending the Maternity Clinic of the General Hospital, Kuala Lumpur. Pill users registered shorter prothrombin time, 11.5 vs. 11.1 seconds (p=0.016), and partial thromboplastin time, 40.1 vs 35.1 seconds (p=0.000). Since there were no significant differences in Factors II, V, VII, or VIII, the overall effects of low-dose pills on coagulation is probably not clinically significant.
    Matched MeSH terms: Blood Coagulation*
  16. Growth hormone deficiency and cardiovascular risk
    Hew FL, O'Neal D, Kamarudin N, Alford FP, Best JD
    Baillieres Clin. Endocrinol. Metab., 1998 Jul;12(2):199-216.
    PMID: 10083892
    It is now recognized that growth hormone (GH) deficiency in adults represents a distinct clinical syndrome that encompasses reduced psychological well-being as well as specific metabolic abnormalities. The latter features, which include hypertension, central obesity, insulin resistance, dyslipidaemia and coagulopathy, closely resemble those of metabolic insulin resistance syndrome. The increased cardiovascular morbidity and mortality demonstrated in these GH-deficient (GHD) adults reinforce the close association between the two syndromes. Replacement of GH in GHD adults has resulted in a marked reduction of central obesity and significant reduction in total cholesterol but little change in other risk factors, in particular insulin resistance and dyslipidaemia. The persistent insulin resistance and dyslipidaemia, together with the elevation of plasma insulin levels and lipoprotein (a) with GH replacement in these subjects are of concern. Long-term follow-up data are required to assess the impact of GH replacement on the cardiovascular morbidity and mortality of GHD adults. Further exploration of the appropriateness of the GH dosage regimens currently being employed is also indicated.
    Matched MeSH terms: Blood Coagulation Factors/metabolism; Blood Coagulation Factors/physiology
  17. Fulltext Coblation tonsillectomy versus dissection tonsillectomy: a comparison of intraoperative time, intraoperative blood loss and post-operative pain
    Izny Hafiz Z, Rosdan S, Mohd Khairi MD
    Med J Malaysia, 2014 Apr;69(2):74-8.
    PMID: 25241816 MyJurnal
    The objective of this study was to compare the intraoperative time, intraoperative blood loss and post operative pain between coblation tonsillectomy and cold tonsillectomy in the same patient. A prospective single blind control trial was carried out on 34 patients whom underwent tonsillectomy. The patients with known bleeding disorder, history of unilateral peritonsillar abscess and unilateral tonsillar hypertrophy were excluded. Operations were done by a single surgeon using cold dissection tonsillectomy in one side while coblation tonsillectomy in the other. Intraoperative time, intraoperative blood loss and post operative pain during the first 3 days were compared between the two methods. Results showed that the intraoperative time was significantly shorter (p<0.001) and intraoperative blood loss was significantly lesser (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. Post operative pain score was significantly less at 6 hours post operation (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. However, there were no differences in the post operative pain scores on day 1, 2 and 3. In conclusion, coblation tonsillectomy does have superiority in improving intraoperative efficiency in term of intraoperative time and bleeding compared to cold dissection tonsillectomy. The patient will benefit with minimal post operative pain in the immediate post surgery duration.
    Matched MeSH terms: Blood Coagulation Disorders
  18. Bleeding manifestations in snake bite
    Devaraj T
    Southeast Asian J. Trop. Med. Public Health, 1979 Jun;10(2):255-7.
    PMID: 524151
    Bleeding following bites by the Malayan Pit Viper can either be local or systemic. Bleeding at the site of the bite is due to the local action of the venom as a vasculotoxin. Systemic bleeding occurs with severe poisoning and appears to be mainly dependent on platelet deficiency and the co-existing defibrination syndrome appears to play a minor role in the initiation of bleeding. Thus in the clinical situation non-clotting blood with no overt bleeding can continue up to weeks when specific antivenene is not given. Assessment of the severity of poisoning can easily be made at the bedside. Specific viper antivenene rapidly corrects the spontaneous bleeding and clotting defect of severe systemic poisoning but has no effect on local poisoning.
    Matched MeSH terms: Blood Coagulation Tests
  19. Fulltext Doing less is better: challenges in complex polytrauma management - case report
    Farah, N.A., Johar, M.J., Ismail, M.S.
    Medicine & Health, 2018;13(1):251-258.
    MyJurnal
    Damage control resuscitation, characterized by hemostatic resuscitation with blood products, rapid arrest of bleeding and when possible, permissive hypotension with restricted fluid load form a structured approach in managing a polytrauma patient. When complicated with traumatic rhabdomyolysis however, permissive hypotension strategy may cause more harm resulting in subsequent ischaemicreperfusion injury and acute kidney injury. We present a case involving a 20-yearold man who was rolled over by a lorry and sustained an open unstable pelvic fracture with vascular injury and left lower limb ischaemia. Permissive hypotension strategy was pursued for 4 hours prior to bleeding control in OT. This was followed by protracted surgery of 6 hours. Coagulopathy, acute kidney injury and rhabdomyolysis ensued in the post-operative period and patient succumbed to his injury on Day 3 post-trauma. Challenges and pitfalls in managing a complex polytrauma patient and recent evidences on damage control resuscitation is discussed.
    Matched MeSH terms: Blood Coagulation Disorders
  20. Fulltext Double-edged sword effect of anticoagulant in COVID-19 infection
    Ohn MH, Ng JR, Ohn KM, Luen NP
    BMJ Case Rep, 2021 Mar 22;14(3).
    PMID: 33753396 DOI: 10.1136/bcr-2021-241955
    Coagulation predominant-type coagulopathy such as microthrombosis and macrothrombosis is a well-known recognised complication found in COVID-19 infected critically ill patients. In the context of high incidence of thrombotic events in patients with COVID-19, supplementation with anticoagulant therapy has been routinely recommended and shown to reduce mortality. However, the recommended type, dose, duration and timing of anticoagulant has not been determined yet. Spontaneous retroperitoneal haematoma secondary to anticoagulant therapy is one of the well-known but self-limiting conditions. We report a 51-year-old COVID-19 positive woman, who was taking intermediate-intensity heparin therapy for venous thromboembolism prophylaxis and died from complication of retroperitoneal bleeding. Further studies are needed to verify the risk-benefit ratio of anticoagulant therapy in patients with COVID-19. Although anticoagulant deems appropriate to use in patients with COVID-19, clinicians should be cautious about major bleeding complication such as retroperitoneal haemorrhage even when full therapeutic dosage is not used.
    Matched MeSH terms: Blood Coagulation
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