Alterations in haematological and clotting profile of post-menopausal women in Benin City, Nigeria

Background: The cessation of ovarian functions at menopause and the accompanying decline in the production of ovarian steroid hormones creates a unique set of health concerns for women. Reductions in sex steroid levels, particularly oestrogen, have been associated with various diseases and conditions, including bleeding disorders, coronary heart disease (CHD), osteoporosis, cognitive dysfunction, urinary incontinence, hot flushes, and mood changes, among others. Objective: To determine changes in haemorheological and clotting profile in post-menopausal women. Methods: Two hundred participants comprising one hundred and fifty post-menopausal women and fifty healthy pre-menopausal control subjects were studied. The investigations carried out include whole blood viscosity, plasma viscosity, fibrinogen concentration, Prothrombin time (PT), Activated partial thromboplastin time with kaolin (APTTK) levels and complete blood count using standard methods. Results: The mean age (p=0.01), platelet count (p= 0.013), neutrophil (p= 0.03), neutrophil to lymphocyte ratio (p= 0.045) and platelet to lymphocyte ratio (p=0.044) in postmenopausal women were significantly higher while lymphocyte count (p= 0.004) was significantly lower in postmenopausal compared to premenopausal women. Similarly, plasma oestradiol (p= 0.001), plasma viscosity (p= 0.03), relative blood viscosity (p= 0.03), whole blood viscosity (p= 0.03) and PTTK(p= 0.04) were significantly lower among postmenopausal women compared to premenopausal control subjects. Conclusion: Relative plasma viscosity correlated positively with age. There were significantly lower levels of haemorheological and clotting profile in post-menopausal women. These changes may be due to age or a decline in circulating oestrogen levels.

Prostatic Fossa Gauze-Packing in the Prevention of Blood Clot Obstruction of the Bladder after Transvesical Prostatectomy

BACKGROUND: Clot obstruction often complicates transvesical prostatectomy. Any measure that prevents this will be a great relief to both surgeon and patient. OBJECTIVE: To demonstrate that packing the prostatic fossa with roller gauze bandage after transvesical prostatectomy can prevent post-operative clot blockage of bladder drainage. METHODS: Charts of all patients who had transvesical prostatectomy at Jasman Hospital Udo by me from 1988 to 1997 were sorted into two groups ; Group A; not packed and Group B; packed. Information sought included patient's age; type of prostatectomy performed; whether the prostatic fossa was packed or not ; average duration of catheter drainage; and complications. RESULTS: There were 68 patients who had no fossa packing and 72 in Group B with fossa packing. The age range of the two groups A and B were respective 45-85year-old and 50-83 years. In both groups the highest number of patients was in the 60 t0 79 age bracket (48 in group A ; 70; and 56 in group B (78). Bladder blockage occurred in 32(47) patients without packing and none (0) in group B with packing. Average duration of bladder drainage was 14 days in each group. There was no persisting vesico-cutaneous fistula. Temporary urinary incontinence occurred in three (3) patients who had no packing and in five (7) with packing. CONCLUSION: Gauze-packing of the prostatic fossa during transvesical prostatectomy can prevent bladder obstruction from clot retention without undue complications