The finding of a prolonged bleeding time in a patient whose platelet count is normal suggests some abnormality in the function of the platelets. This situation may be due to an inherent platelet defect or to the deficiency of a plasma factor necessary for some aspect of platelet function. Defects of platelet function are also seen in a wide range of disease states and may be caused by many different classes of drugs. Simple methods are available to identify abnormalities in platelet numbers and/or function. Tests of platelet aggregation, using the aggregometer, are now widely used to investigate patients suspected of having platelet disorders. We observed in the last four years that thrombocythopenia is quite common amongst children and bleeding from platelet dysfunction, congenital or acquired, is not rare in Malaysia. This study was done to assess the prevalence of platelet abnormality in a section of the general 'healthy' population of school-going children and to study the possible causes of any abnormalities detected.
Management of pain plays an important role during prostate biopsy. Various types of management of pain plays an important role during prostate biopsy. Various types of anaesthetic methods have been used. The present study aimed to compare the efficacy and complication rate between periprostatic lidocaine infiltration and transrectal lidocaine gel in transrectal ultrasound guided prostate biopsy. All prostate biopsy patients were included except those with lidocaine, allergy, haemorrhagic diathesis, anticoagulation therapy, the inability to rate a visual analogue scale and inability to obtain consent. They were randomized into two groups. Group 1 received 20ml 2% transrectal lidocaine gel. Group 2 received 5ml 1% lidocaine infiltration for each periprostatic nerve block with 23-gauge spinal needle. After three minutes, prostate biopsy was performed with an 18 gauge 7-inch spring-loaded biopsy gun. Six biopsies were taken for each lobe. Pain during probe insertion, biopsy and immediately after the procedure was assessed using the Visual Analogue Scale. Any complication immediately after procedure, one day or after one week, was recorded. Mean pain score was lower after periprostatic lidocaine infiltration compared to transrectal lidocaine gel (3.1 + 1.9 versus 4.9 + 2.4, p = 0.027). There was no statistically significant difference in the complication rate. Transrectal ultrasound prostate biopsy using periprostatic lidocaine infiltration provides better anaesthesia as compared to the transrectal lidocaine gel application with no significant difference in complication. Thus, the use of periprostatic lidocaine infiltration in TRUS guided prostate biopsy is recommended.