scholarly journals Abnormal Changes in Some Haemostatic Parameters in First-ever Stroke Patients in Port Harcourt, Nigeria: A Preliminary Findings

Author(s):  
Fiekumo Igbida Buseri ◽  
Serekara Gideon Christian ◽  
Evelyn Mgbeoma Eze

Background and Purpose: Cellular component and clotting factors are involved in thrombotic events such as stroke, but the type and nature of alteration of those haemostatic parameters remain unclear. Our objective was to identify possible abnormal changes in some haemostatic parameters in established stroke patients. Materials and Methods: This was a prospective case-control study conducted at Braithwaite Memorial Specialist Hospital, Port Harcourt, Nigeria. Standard operating procedures were adopted to assay fibrinogen, antithrombin, tissue plasminogen activator, prothrombin time and activated partial thromboplastin time as well as the determination of platelet count and platelet indices. The data were analyzed using Statistical Package for Social Science (SPSS) version 17.0 software. Results: A total of 108 individuals comprised of 54 stroke patients aged between 45 and 73 years (mean, 59± 13.04 years), 20 (37.04%) men and 34 (62.96%) women and another 54 age- and sex-matched healthy control subjects were studied. Significantly (p<0.05) higher mean values of mean platelet volume (MPPV), platelet distribution width (PDW), Platelet larger cell ratio (PLCR), antithrombin, tissue plasminogen activator and fibrinogen were observed in the stroke patients when compared to those of the control subjects. Whereas, significantly lower (p<0.05) mean values of platelet count, prothrombin time and activated partial thromboplastin time were observed in the stroke patients than in those of the control subjects. Conclusion: Several haemostatic parameters were found to be altered in stroke patients and have the potential to be risk factors but have not been demonstrated as being causative. Further work is needed to establish where they begin to contribute to stroke prognosis.

Author(s):  
Evelyn Mgbeoma Eze ◽  
Fiekumo Igbida Buseri ◽  
Serekara Gideon Christian ◽  
Andrew Temide Olasebiomo ◽  
Baribefe Daniel Koate ◽  
...  

The was a case control and comparative study aimed at investigating the possible effects of injectable and skin patch contraceptives on selected haematologic and haemostatic parameters in women attending primary healthcare centre at Eleme, Rivers State The study population consists of seventy-five (75) apparently healthy, non-pregnant, non- smoking women, aged between 25 and 45years; (31 women on DEPO-PROVERA contraceptive, 14 women on Implanon, and 30 apparently healthy non-contraceptive users as control group). Fibrinogen, antithrombin, tissue plasminogen activator was analysed with reagents prepared by Elabscience, Wuhan, China, using an ELISA machine (STAT FAX-2100). Prothrombin time and activated partial thromboplastin time was done manually with reagents prepared by Quimica Clinica Aplicada S.A, Spain. Haematologic parameters were analysed using SYSMEX KX-21-N auto analyser.  Graph-pad Prism 5.0 was used in analysing all data, p < 0.05 was considered statistically significant. For haemostatic parameters, results showed that there was statistically significant increase in mean values of antithrombin (38.48 ± 17.48/ml versus 21.02 ± 15.54ng/ml, p=0.0011) and tissue plasminogen activator (1.34 ± 1.35ng/ml versus 0.28 ± 0.46ng/ml, p=0.0047) in women using the two types of contraceptive, while activated partial thromboplastin time (28.11± 2.37s versus 29.87 ± 2.77s, p=0.0205) was statistically decreased in women on the investigated contraceptives, other haemostatic parameters were not statistically significant. For haematological parameters, the results showed that there was statistically significant increase in mean values of packed cell volume 38.13 ± 2.28% versus 36.21 ± 3.07% (p=0.0126), haemoglobin 12.35 ± 0.79g/dL versus 11.56 ± 0.99g/dL (p=0.0028), white blood cells 6.17 ± 1.22 x109/L versus 5.26 ± 1.18 x109/L (p=0.0143) in women using injectable (DEPO-PROVERA) and skin patch (IMPLANON) contraceptive, other parameters showed no statistically significance. Based on duration of use of contraceptive, there was no statistically significant difference (p>0.05) in women using skin patch; while for injectable, platelet count was high in those who had used it for more than a year. Comparing values obtained from using injectable and skin patch, there was no statistical significant difference in all the parameters. Using analysis of variance to compare values based on parity, there was no statistical significant difference. Conclusively, increase in antithrombin and tissue plasminogen activator, and a decrease in activated partial thromboplastin time in women using IMPLANON (skin patch) and DEPO-PROVERA (injectable) are the haemostatic changes that occurs while using contraceptives and these changes may likely predispose them to bleeding, therefore adequate monitoring of the blood haemostatic processes while taking these contraceptives is critical in order not to expose users to haemorrhage.


2011 ◽  
Vol 21 (6) ◽  
pp. 684-691 ◽  
Author(s):  
Jo Bønding Andreasen ◽  
Anne-Mette Hvas ◽  
Kirsten Christiansen ◽  
Hanne Berg Ravn

AbstractBackgroundSuccessful management of bleeding disorders after congenital heart surgery requires detection of specific coagulation disturbances. Whole-blood rotation thromboelastometry (RoTEM®) provides continuous qualitative haemostatic profiles, and the technique has shown promising results in adult cardiac surgery.SettingTo compare the performance of RoTEM®with that of conventional coagulation tests in children, we conducted a descriptive study in children undergoing congenital cardiac surgery. For that purpose, 60 children were enrolled and had blood samples taken before, immediately after, and 1 day after surgery. Conventional coagulation tests included: activated partial thromboplastin time, prothrombin time, fibrinogen, fibrin D-dimer, thrombin clotting time, factor XIII, and platelet count.ResultsPost-surgical haemostatic impairment was present to some degree in all children, as seen by pronounced changes in activated partial thromboplastin time, prothrombin time, thrombin clotting time, and platelet count, as well as RoTEM®analysis. RoTEM®showed marked changes in clotting time – prolonged by 7–18% – clot formation time – prolonged by 46–71% – maximum clot firmness – reduced by 10–19%, and maximum velocity – reduced by 29–39%. Comparison of the two techniques showed that conventional coagulation tests and RoTEM®performed equally well with regard to negative predictive values for excessive post-operative drain production – more than 20 millilitres per kilogram per 24 hours after surgery – with an area under the curve of approximately 0.65.ConclusionRoTEM®can detect haemostatic impairments in children undergoing cardiac surgery and the method should be considered as a supplement in the perioperative care of the children where targeted transfusion therapy is necessary to avoid volume overload.


2016 ◽  
Vol 19 (2) ◽  
pp. 359-364
Author(s):  
A. Snarska ◽  
P. Sobiech

Abstract The aim of the study was to evaluate the megakaryocyte lineage of bone marrow and coagulation parameters in fallow deer during the last month of pregnancy. The animals were managed in the barn-feeding system. Twenty female fallow deer, aged 2-3 years, divided into 2 groups were used in the study. Group 1 comprised the females in the last month of pregnancy, and the non-pregnant females were used as the control. All the animals were clinically healthy. Coagulation parameters were measured in all the deer: thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), and plasma concentrations of fibrinogen, D-dimer, and antithrombin III. A quantitative assessment of bone marrow was carried out for the erythroblastic, myeloid, lymphoid, monocyte-macrophage, and megakaryopoietic cell lines. A detailed analysis of megakaryocyte lineage was performed after whole blood and platelet count. There were no significant differences in the erythroblast, granulocyte, monocyte-macrophage and lymphoid systems between the animal groups. Thrombocyte count in the pregnant deer was lower than that found in the control group. Bone marrow smears revealed a slightly decreased megakaryocyte count, while the megakaryoblast and promegakaryocyte counts were unchanged. The analysis of coagulation parameters showed increased levels of fibrinogen, thrombin time, prothrombin time and activated partial thromboplastin time in the pregnant animals. The study suggested a hyperactivation of the coagulation system with a slight reduction in the megakaryocyte count in bone marrow, and a reduction in platelet count in peripheral blood at the end of pregnancy.


1981 ◽  
Author(s):  
R Leclercq

Prothrombin time (PT) and activated partial thromboplastin time (APTT) results are statistically different, not only in function of reagent used but also, with a same reagent, in function of the degree of automation of the measuring device. It has been claimed that using time ratio of pathological to normal samples would reduce these discrepancies.In a national voluntary quality control program using Verify Citrate Normal and Pathological I/II plasmas, pairs of results obtained in the same analytical batch were computed to compare mean values and reproducibility of ratios and seconds for both PT (n=1764) and APTT (n=1392). Results were screened simultaneously for origin of reagent and measuring technique.Concerning PT, the ratio expression did not improve the intralaboratory dispersion of results for both pathologies levels. Neither in group comparisons between couples reagent-device, nor for the whole set of pooled values, a significant improvement of the dispersion of the ratio results could be observed if compared to the dispersion expressed in seconds. In the 6 groups reagent-instrument, difference between average values was never greater than 1.0 sec for the Normal control plasma (mean: 11.7 sec), 2.4 sec for the level 1 plasma (mean: .18.9 sec) and 4.9 sec for plasma level 2 (mean: 29.3 sec).Concerning APTT, dispersion was strongly enhanced in semi-automated equipments. Chemical activators gave times longer than the particulate ones. Here again, no significant improvement was offered by the ratios.In conclusion, ratio expression of PT’s and APTT’s results does not abolish the influence of the couples ‘origin of reagent’ - ‘automation of measuring device’.


2017 ◽  
Vol 126 (2) ◽  
pp. 338-344 ◽  
Author(s):  
Ton Lisman ◽  
Robert J. Porte

Preoperative hemostasis testing may have limited use in patients with liver disease, and an abnormal platelet count, prothrombin time, activated partial thromboplastin time, and fibrinogen level should not trigger prophylactic transfusion of blood product components.


Author(s):  
Ehiaghe-Shepherd, Bridget Obofoni ◽  
Christian, Serekara Gideon ◽  
Eze, Evelyn Mgbeoma

Aim: The aim of this study was to assess the levels of some hematological, coagulation and immune parameters among male oil refinery workers in Port Harcourt, Nigeria. Study Design: This study is a cross-sectional study. Place and Duration of Study: Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Shell Petroleum Development Company of Nigeria Limited and Modular Oil Refinery, Rivers State, between January 2021 and September 2021. Methodology: A total of one hundred (100) subjects (50 oil and gas workers as test subjects and 50 non-oil and gas workers as control subjects), were enrolled in the study. The convenient sampling technique was employed in the study. Venous blood samples were collected from all subjects and tested for Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Fibrinogen concentration, Full Blood Count (FBC) (Haemoglobin (Hb), Packed Cell Volume (PCV), Total White Blood Cell (WBC) count, Lymphocyte, Neutrophils, monocytes and Platelet Count), CD4 cell count, CD3 cell count and CD8 cell count. Data generated were analyzed statistically using Graph-Pad Prism, Version 8.0.2. Results: There was statistically significant decrease (P<.001) in Prothrombin time (PT) (11.55±0.73s), International Normalized Ratio (INR) (0.85±0.05), Fibrinogen (202.4±27.4mg/dl), Platelet count (185.6±37.1(103/μl)) and Neutrophils (46.6±6.4%) in oil refinery workers exposed to gas flare, while there was a statistical significant increase in APTT (31.8±4.15s), Hb (13.7±1.0g/dl), PCV (41.1±3.2%), Monocytes (8.4±3.0%) in subjects exposed to gas flare over control subjects with Prothrombin time(12.23±0.82s), INR(0.90±0.06), Fibrinogen(252.0±57.0mg/dl), platelet count(213.3±49.5(103/μl)) and Neutrophils(52.6±11.7%). Other parameters showed no statistical significant difference at P<.05 in both test and control subjects. Comparison of the mean ± standard deviation of the studied parameters in test subjects based on age using Analysis of Variance showed no statistically significant difference in all parameters at P<.05. Also, Comparison of the mean ± standard deviation of the studied parameters in test subjects based on duration of Exposure using Analysis of Variance showed a significant decrease in CD8 cells as the years of exposure increase (2-5years exposure = 865±319, 6-10years exposure = 579±288, 11-20 years exposure = 591± 286, F- Value = 3.869, P- Value = 0.0278). Conclusion: In conclusion, based on the findings, some haematogical, coagulation and immune parameters increased while others decreased in male oil refinery workers and duration of exposure can also be considered as a risk factor and age was considered not a risk factor as to cause any aberrations in the studied parameters.


2021 ◽  
pp. 57-62
Author(s):  
Iyevhobu Kenneth Oshiokhayamhe ◽  
Amaechi R. A. ◽  
Turay A. A. ◽  
Okobi T. J. ◽  
Usoro E. R. ◽  
...  

An estimated 50,000 Nigerian women die each year from complications of pregnancy and childbirth, accounting for 10% of global estimates of pregnancy maternal death with about 2% resulting from drug induction. This cross-sectional study sets out to evaluate the Prothrombin time test (PT), activated partial thromboplastin time test (aPTT) Erythrocyte sedimentation rate (ESR), and Platelet count (PC) of pregnant women attending antenatal clinics at Oredo Health Centre in Benin City, Edo State. A total number of 130 subjects comprising 100 pregnant women and 30 non-pregnant women were recruited for the study. Prothrombin time (PT), Activated Partial Thromboplastin Time (APTT), Platelet count and Erythrocyte Sedimentation Rate (ESR) were studied using standard manual methods. The prothrombin time (sec) of the pregnant women 1st trimester (19.12±0.77b), 2nd trimester (19.90±1.02 b) and 3rd trimester (19.66±0.56 b), activated partial thromboplastin time (sec) 1st trimester (44.02±1.17 b), 2nd trimester (47.72±1.47 b) and 3rd trimester (45.88±1.10b), Erythrocyte sedimentation rate (mm/hr) 1st trimester (24.37±3.04 a), 2nd trimester (37.83±4.53 a) and 3rd trimester (43.25±5.24 a) and platelet count (X109/L) 1st trimester (248.29±23.18a), 2nd trimester (236.33±13.84 b) and 3rd trimester (239.10±16.07 a) were significantly higher than the prothrombin time (sec) 16.48±0.81 a, activated partial thromboplastin time (sec) 36.53±1.42 a, ESR (mm/hr) 29.83±4.14 a and platelet count (X109/L) 201±9.54 an of the non-pregnant women (p<0.05). The ESR (mm/hr) of the 3rd trimester (43.25±5.24) was observed to be significantly higher than that of the 1st trimester (24.37±3.04) and 2nd trimester (37.83±4.53) (p<0.05). Our investigation showed that antibiotics in pregnancy have a deleterious effect on PT, ESR, APTT and PC studied. We recommend that pregnant women should be given due attention throughout the course and events of pregnancy to prevent or reduce the risk of thrombotic episodes and possible disseminated intravascular coagulation (DIC) with resultant better maternity/child safety and health outcome and educated on the effects of antibiotics to pregnancy.


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