MyMedR

Primary thrombocythaemia presenting as postpartum haemorrhage: a case report

Rashid Z, Hamidah NH, Othman A, Cheong SK, Fairuz AK, Adeeb N

J Obstet Gynaecol (Tokyo 1995), 1995 Jun;21(3):221-5.

A young primigravida presented with postpartum haemorrhage with no apparent cause following a low forceps delivery. She was extremely pale with gross hepatosplenomegaly. Hysterectomy was performed following three episodes of disseminated intravascular coagulation. Investigations revealed an extremely high platelet count with poor aggregatory function. A diagnosis of primary thrombocythaemia was made.

Matched MeSH terms: Postpartum Hemorrhage/etiology*

Fulltext Severe post-coital bleeding in the second trimester

Ravindran J, Anandaraj N

Med J Malaysia, 1993 Dec;48(4):459-60.

PMID: 8183175

Matched MeSH terms: Uterine Hemorrhage/etiology*

Fulltext Congenital leukaemia--a case report

Lee KT

Med J Malaysia, 1991 Sep;46(3):218-20.

PMID: 1839915

Congenital leukaemia which is characterised by proliferation and extrahaemopoietic infiltration of immature leucocyte precursor cells is a rare disorder encountered in the neonatal period. Although more than 100 cases of congenital leukaemia have been reported in the literature, the experience of most general paediatricians with this condition is very likely to be limited. Thus a patient presenting with congenital leukaemia admitted to Alor Star General Hospital is reported.

Matched MeSH terms: Hemorrhage/congenital

Spontaneous lateral pontine hemorrhage with associated trigeminal nerve root hematoma

Veerapen R

Neurosurgery, 1989 Sep;25(3):451-3; discussion 453-4.

PMID: 2771016

Spontaneous hemorrhage into the lateral part of the pons with sequelae compatible with survival has been documented previously. The author describes an unusual case with spontaneous hemorrhage into the lateral pons, with intraneural extension into the right trigeminal nerve root. Radiological features were of an expanding mass of the cerebellopontine angle. The patient was treated surgically with success.

Matched MeSH terms: Cerebral Hemorrhage/surgery*

Torsion of ovarian tumors: a clinicopathological study

Lee CH, Raman S, Sivanesaratnam V

Int J Gynaecol Obstet, 1989 Jan;28(1):21-5.

PMID: 2565826

Torsion of ovarian tumors occurred predominantly in the reproductive age group. The majority of the cases presented in pregnant (22.7%) than in non-pregnant (6.1%) women. The major presenting symptom was pain but an abdominal mass was palpable in 79.4% of cases. Torsion was more common on the right ovary and 50% were gangrenous at laparotomy. Most of the tumors were benign cystic teratomas. Only 8.7% of the tumors were malignant.

Matched MeSH terms: Hemorrhage/pathology

Acute puerperal inversion of the uterus--an obstetric emergency

Rachagan SP, Sivanesaratnam V, Kok KP, Raman S

Aust N Z J Obstet Gynaecol, 1988 Feb;28(1):29-32.

PMID: 3214380

Over a 17-year period, 15 patients with acute puerperal inversion of the uterus were managed at the University Hospital, Kuala Lumpur, an incidence of 1 in 4,836 deliveries. Injudicious traction on the umbilical cord before the uterus was well contracted, was probably the most important causative factor. Haemorrhage was more severe when removal of the placenta was done prior to correction of the inversion. Either the hydrostatic method or manual replacement were used but more often a combination of both techniques was found necessary. With careful management of the third stage of labour, this complication can be avoided.

Matched MeSH terms: Uterine Hemorrhage/therapy

Mortality in SLE nephritis

Suleiman AB, Morad Z, Tong CT

Ann Acad Med Singap, 1987 Jan;16(1):175-8.

PMID: 3496037

In a review of 112 patients with SLE nephritis treated between 1976 and 1982, 31 were known to have died. Renal failure (32.2%) was the commonest cause of death. Gastrointestinal haemorrhage (16%), infections (12.8%) and central nervous system involvement (6.5%) were important causes of death. Thirteen out of 17 patients dying in the presence of renal failure had initially presented with renal impairment. Renal biopsies in 16 patients who have died showed diffuse proliferative glomerulonephritis in all except 1 patient, and uraemia was the commonest cause of death in these patients. Pregnancies terminating in abortions were followed by complications in 5 patients. Discontinuation of steroid therapy by patients was followed by complications, and ended in death in 6 patients.

Matched MeSH terms: Gastrointestinal Hemorrhage/mortality

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: Hemorrhage/blood*

Ergometrine stability in postpartum haemorrhage kits: Does temperature and light matter?

Donnan F, Senarathna SMDKG, Ware B, Rawlins MDM, Dontham C, Chuang VTG, et al.

Aust N Z J Obstet Gynaecol, 2020 06;60(3):344-349.

PMID: 31512230 DOI: 10.1111/ajo.13046

BACKGROUND: Postpartum haemorrhage (PPH) kits containing uterotonics are used on obstetric units for the timely management of PPH. Visible discolouration of ergometrine and ergometrine-oxytocin injections was observed in PPH kits stored in medical refrigerators on the obstetric unit at our hospital.

AIM: To investigate the stability of ergometrine and ergometrine-oxytocin injections in PPH kits under simulated clinical storage conditions and to determine the potency of ampoules quarantined from PPH kits on our obstetric unit.

MATERIAL AND METHODS: Ergometrine and ergometrine-oxytocin injection ampoules were stored exposed to and protected from light at 4°C and room temperature (25°C) for up to three months, and assayed by high-performance liquid chromatography. Stability was based on the time for the ergometrine or oxytocin concentration to fall to 90% of the original concentration (t90 ). The potency of quarantined discoloured ampoules also was determined.

RESULTS: Ergometrine was stable at both temperatures for >6 months, when stored protected from light in simulated clinical conditions. When exposed to light, ergometrine was stable for approximately 4 days at 25°C and 10 days at 4°C. Discoloured ergometrine and ergometrine-oxytocin injection ampoules were found to be <90% of the nominal concentration.

CONCLUSION: Stability of ergometrine in PPH kits is largely unaffected by temperature fluctuations (at 4°C and 25°C) over 6 months when protected from light. Ergometrine and ergometrine-oxytocin ampoules should be inspected prior to use and any discoloured ampoules discarded.

Matched MeSH terms: Postpartum Hemorrhage/drug therapy*

Concurrent amoebic and histoplasma colitis: a rare cause of massive lower gastrointestinal bleeding

Koh PS, Roslani AC, Vimal KV, Shariman M, Umasangar R, Lewellyn R

World J Gastroenterol, 2010 Mar 14;16(10):1296-8.

PMID: 20222177

Infective colitis can be a cause of massive lower gastrointestinal bleeding requiring acute surgical intervention. Causative organisms include entamoeba and histoplasma species. However, concurrent colonic infection with both these organisms is very rare, and the in vivo consequences are not known. A 58-year-old male presented initially to the physicians with pyrexia of unknown origin and bloody diarrhea. Amoebic colitis was diagnosed based on biopsies, and he was treated with metronidazole. Five days later, the patient developed massive lower gastrointestinal bleeding with hemorrhagic shock. Emergency total colectomy with end-ileostomy was performed. However, he deteriorated and died on the second postoperative day. Histopathological examination revealed multiple deep ulcers at the hepatic flexure where fungal bodies of mycelial and yeast forms were noted. Isolated lymph nodes showed abscess formation with fungal bodies. Infective fungal colitis with Histoplasma capsilatum was diagnosed. In vitro, amoebic parasites can increase virulence and pathogenicity of histoplasma which may account for the fulminant presentation in this patient. Although rare, this unusual dual infection should be considered in the differential diagnosis of infective colitis, as appropriate antimicrobial treatment may prevent progression to massive lower gastrointestinal bleeding, obviating the need for urgent surgical intervention.

Matched MeSH terms: Gastrointestinal Hemorrhage/etiology*

Biological properties of Trimeresurus purpureomaculatus (shore pit viper) venom and its fractions

Nget Hong Tan, Chon Seng Tan

Toxicon, 1988;26(11):989-96.

PMID: 3245058

The toxic and biological activities of four samples of Trimeresurus purpureomaculatus venom were examined. The lethality, protein composition and biological activities of the four venom samples were similar. Three of the venom samples had LD50 (i.v.) values of 0.9 micrograms/g while the fourth had a lower LD50 (i.v.) of 0.45 micrograms/g. All four venom samples exhibited hemorrhagic, edema-inducing, anticoagulant and thrombin-like activities as well as the usual enzymes found in crotalid venoms. DEAE-Sephacel ion exchange chromatographic fractionation of the venom yielded 10 protein fractions. Only two fractions (fractions A and F) were lethal to mice; the major lethal fraction being fraction F. This fraction had an LD50 (i.v.) of 0.2 micrograms/g and exhibited hemorrhagic, edema-inducing and thrombin-like activity. It also exhibited phospholipase A, arginine ester hydrolase, arginine amidase, protease, 5'-nucleotidase, acetylcholinesterase and alkaline phosphomonoesterase activities. The lethal potency of fraction F is potentiated by fraction G, which exhibited anticoagulant activity as well as hemorrhagic, edema-inducing and enzymatic activities. Fractions F plus G account for almost 100% of the lethal potency of the venom.

Matched MeSH terms: Hemorrhage/chemically induced

Fulltext Enucleation for haemophthalmus secondary to choroidal neovascularisation in polypoidal choroidal vasculopathy: a therapeutic and diagnostic dilemma

Azmi NA, Ahem A, Mustapha M, Bastion MC

BMJ Case Rep, 2016 Sep 28;2016.

PMID: 27681348 DOI: 10.1136/bcr-2016-215987

We report a case of enucleation for painful blind eye secondary to recurrent bleeding from choroidal neovascularisation in an eye that was irradiated following presumed metastatic breast carcinoma to the choroid. A 58-year-old woman with a history of treated breast malignancy presented with haemophthalmus and intractable glaucoma in the right eye. One year previously she had presented with right vitreous haemorrhage with subretinal mass that had been irradiated given her history of breast carcinoma. Following irradiation, vitrectomy was performed to clear the blood. Intraoperative and postoperative angiography findings suggested a diagnosis of breakthrough bleeding secondary to polypoidal choroidal vasculopathy. At this presentation, however, the intraocular bleeding was recurrent resulting in elevated intraocular pressure and pain. Despite repeat surgery and medical therapy, the eye had to be enucleated. Histopathology showed choroidal neovascularisation.

Matched MeSH terms: Eye Hemorrhage; Vitreous Hemorrhage

[Enterovirus type 70, a pathogenic agent of acute haemorrhagic conjunctivitis (author's transl)]

Kopecká D

Cesk Epidemiol Mikrobiol Imunol, 1977 Nov;25(6):342-4.

PMID: 188556

Matched MeSH terms: Hemorrhage/microbiology

Megaloblastic anaemia in Malaysia: a review of 26 cases

Dutt KA, Velathaun T

Med J Malaya, 1971 Sep;26(1):65-7.

PMID: 4258580

Matched MeSH terms: Retinal Hemorrhage/etiology

Complications in cataract surgery