OROFACIAL MANIFESTATIONS OF HEMATOLOGICAL DISORDERS

Various anemic disorders which shows different orofacial manifestations are iron deciency anemia,plummer Vinson syndrome,megaloblastic anemia,sickle cell anemia,thalassemia and aplastic anemia.These orofacial manifestations are facial pallor,atrophic glossitis,angular stomatitis,magenta tongue,midface growth etc. Spontaneous & post traumatic hemorrhage,prolong bleeding after tooth extraction are sign of different hemostatic disorder such as VonWillebrand disease or Hemophilia. Oral manifestations of most of the hematological diseases are nonspecic. In this article I have reviewed various literatures to identify orofacial manifestations of various hematological disorders.

Tranexamic acid in trauma-induced coagulopathy

Trauma is still the leading cause of death in the world among the population under the age of 45 and bleeding is the dominant cause of early mortality in one third of all injured. Coagulopathy in trauma is directly related to the outcome and is considered to be the most significant preventable cause of death. Trauma-induced coagulopathy is a complex, multifactorial disorder that can be roughly divided into three phases. The entity of acute traumatic coagulopathy is characterized as an endogenous hemostatic disorder that occurs in the first few minutes of injury associated with tissue damage caused by severe trauma and hemorrhagic shock, regardless of external factors. The pathogenesis of trauma-induced coagulopathy is not fully known and is still the subject of research. According to the latest recommendations of the European Guide for the Management of Massive Bleeding and Coagulopathy in Trauma, tranexamic acid should be used as soon as possible, and no later than three hours after the injury in a patient who is bleeding or at risk of significant bleeding. Its prehospital application should be considered. In the light of new knowledge, the question of the justification and safety of the free use of tranexamic acid in trauma has been raised. The use of tranexamic acid in trauma-induced coagulopathy is a simple and affordable therapeutic approach that should be used in the prehospital period in those patients who are bleeding or at risk of significant bleeding. The implementation of this therapy in our country has not yet come to life.

COVID-19-Associated Hyper-Fibrinolysis: Mechanism and Implementations

The emerging novel coronavirus disease (COVID-19), which is caused by the SARS-CoV-2 presents with high infectivity, morbidity and mortality. It presenting a need for immediate understanding of its pathogenicity. Inflammation and coagulation systems are over-activated in COVID-19. SARS-CoV-2 damages endothelial cell and pneumocyte, resulting in hemostatic disorder and ARDS. An influential biomarkers of poor outcome in COVID-19 are high circulating cytokines and D-dimer level. This latter is due to hyper-fibrinolysis and hyper-coagulation. Plasmin is a key player in fibrinolysis and is involved in the cleavage of many viruses envelop proteins, including SARS-CoV. This function is similar to that of TMPRSS2, which underpins the entry of viruses into the host cell. In addition, plasmin is involved in the pathophysiology of ARDS in SARS and promotes secretion of cytokine, such as IL-6 and TNF, from activated macrophages. Here, we suggest an out-of-the-box treatment for alleviating fibrinolysis and the ARDS of COVID-19 patients. This proposed treatment is concomitant administration of an anti-fibrinolytic drug and the anticoagulant.

Disseminated intravascular coagulation syndrome

Presented material reveals main links in the pathogenesis of hemostatic disorder. In particular, attention is paid to the role of the lungs, liver and other organs in the development of this process. Role of vascular wall and blood cells in regulation of the physical state of blood is described in detail. The most frequent factors leading to hypercoagulation are indicated. Difference between hypercoagulation and thrombophilia is shown. The latter is found in clinical practice quite often, but at the same time, it is poorly diagnosed. Such a terrible complication of hemostatic disorder as disseminated intravascular coagulation is described. Its classification, stages of development, clinical manifestations are offered to the readers.

Suspected Compartment Syndrome, Consumptive Thrombocytopenia, and Anemia Secondary to a Ruptured Arterial Aneurysm or Pseudoaneurysm Following Multiple Stifle Surgeries

ABSTRACT A 12 yr old male neutered beagle was presented on transfer to the intensive care unit with severe anemia, thrombocytopenia, and bruising detected 1 day after undergoing tibial plateau leveling osteotomy surgery. The patient had undergone extra-capsular stifle stabilization surgery 14 wk prior to treat ligament disease in the same knee. Laboratory testing and treatment for anemia, presumptive immune-mediated thrombocytopenia, and possible hemostatic disorder was initiated. A persistent anemia, progressive thrombocytopenia, and the development of a firm swelling and neurologic impairment in the limb raised concerns for compartment syndrome (CS). A musculoskeletal ultrasound revealed a large aneurysm in the caudal thigh surrounded by abnormal muscle tissue. The patient underwent amputation of the limb and recovered without further complication. Pathology findings were consistent with the development of femoral CS secondary to a ruptured peripheral arterial aneurysm or a pseudoaneurysm. A consumptive thrombocytopenia and regenerative anemia were attributed to periodic or progressive thrombosis of the vessel and regional hemorrhage. Postoperative CS can develop in combination with peripheral arterial aneurysm or pseudoaneurysm, and screening for vascular abnormalities as well as CS should be considered in complicated recovery from orthopedic surgery with compatible clinical signs including progressive soft tissue swelling, persistent anemia, and thrombocytopenia.

UJI AKTIVITAS JUS BUAH JAMBU BIJI BERDAGING MERAH (Psidium guajava L.) TERHADAP PENINGKATAN TROMBOSIT PADA MENCIT (Mus musculus L.) YANG DIINDUKSI KLORAMFENIKOL

Thrombocytopenia is the most common hemostatic disorder acquired in dogs and can be a life-threatening. Guava fruit and leaves extract are believed to improve thrombocyte counts. The purpose of this study was to prove that administration of guava juice could improve thrombocyte count in mice that have thrombocytopenia after induced by chloramphenicol. We were used 24 mice as samples divided into 4 groups : KS group (given aquades for 12 days), KN group (induced by chloramphenicol for 7 days, then aquades on next 5 days), group P1 (induced by chloramphenicol for 7 days then guava juice 5 g/ml concentration on 5 next day); and group P2 (induced by chloramphenicol for 7 days then guava juice 10 g/ml concentration on the next 5 days). Thrombocyte count was measured three times, before treatment (day 0), after chloramphenicol induction (day 7), and after guava juice (day 12). Data of thrombocyte count was analyzed using one way Anova and Post Hoc LSD test. The results showed that the guava juice (Psidium guajava L.) concentration of 5 g/ml and 10 g/ml had significant effect (p <0,05) to increase platelet numbers in mice after induced by chlorampenicol dose 30mg/30grBW.

UJI AKTIVITAS JUS BUAH JAMBU BIJI BERDAGING MERAH (Psidium guajava L.) TERHADAP PENINGKATAN TROMBOSIT PADA MENCIT (Mus musculus L.) YANG DIINDUKSI KLORAMFENIKOL

Thrombocytopenia is the most common hemostatic disorder acquired in dogs and can be a life-threatening. Guava fruit and leaves extract are believed to improve thrombocyte counts. The purpose of this study was to prove that administration of guava juice could improve thrombocyte count in mice that have thrombocytopenia after induced by chloramphenicol. We were used 24 mice as samples divided into 4 groups : KS group (given aquades for 12 days), KN group (induced by chloramphenicol for 7 days, then aquades on next 5 days), group P1 (induced by chloramphenicol for 7 days then guava juice 5 g/ml concentration on 5 next day); and group P2 (induced by chloramphenicol for 7 days then guava juice 10 g/ml concentration on the next 5 days). Thrombocyte count was measured three times, before treatment (day 0), after chloramphenicol induction (day 7), and after guava juice (day 12). Data of thrombocyte count was analyzed using one way Anova and Post Hoc LSD test. The results showed that the guava juice (Psidium guajava L.) concentration of 5 g/ml and 10 g/ml had significant effect (p <0,05) to increase platelet numbers in mice after induced by chlorampenicol dose 30mg/30grBW.