ABSTRACT
Aim: We designed this study to determine whether the fibrinolytic marker D-dimer is a useful early marker of acute mesenteric ischemia
Methods: We measured plasma D-dimer levels in 25 patients presenting with severe abdominal pain, in addition to 10 healthy controls. Based on laparotomy findings, patients were categorized into those with acute mesenteric ischaemia [AMI][15 patients] and those without acute mesenteric ischaemia [NAMI] [10 patients]
Results: We demonstrated significant increase of plasma D-dimer level in AMI group compared to NAMI group [P < 0.01]. Furthermore, plasma D-dimer level was significantly elevated in NAMI group compared to controls [P < 0.001]
Conclusion: Plasma D-dimer > 3.8 ug/ml combined with relevant clinical variables has a high positive predictive value for early identification of patients with AMI. However, plasma D-dimer < 0.53 ug/ml has a high negative predictive value for AMI and could be used as an exclusion test. This strategy could aid in the decision for urgent surgery with subsequent improvement of the surgical outcome
ABSTRACT
Background: Viral infection has been implicated in the pathogenesis of bone marrow failure. We designed this study to explore the influence of chronic HCV infection on the bone marrow status in patients withliver cirrhosis presenting with peripheral blood cytopenias
Patients and Methods: The present study was conducted on 70 patients with different grades of liver cirrhosis based on Child-Pugh scoringsystem . They were categorized into those positive for HCV infection [50patients] and those without [20 patients]based on assay of anti-HCV anti-bodies and qualitative PCR for HCV-RNA. Complete blood count and bonemarrow examination have been performed to all studied patients
Results: Normal bone marrow cellularity was more evident in pa-tients without HCV infection. However, hypercellular bone marrow wasmore evident in patients with positive HCV infection .Furthermore, no significant changes in different bone marrow elements in patients with posi-tive HCV infection were demonstrated when compared to patients withnegative HCV infection [P<0.05]
Conclusion: HCV infection has no evident direct suppressive effecton bone marrow elements in cirrhotic patients presenting with mono, biorpancytopenia. Understanding the pathogenetic mechanism of cytopeniasin cirrhotic patients is important to improve the management strategy andoutcome
ABSTRACT
Severe infection and inflammation almost invariably lead to hemostatic abnormalities, ranging from insignificant laboratory changes to severe disseminated intravascular coagulation [DIC]. The aim was to assess the effect of infection on coagulation parameters in infected burn wound that could predict for the development of DIC in those patients. This Study included 60 patients [16 male and 44 female], with mean age of 32.9 +/- 10.5 years, they were treated in burn surgery unit Mansoura University Hospitals. They were classified into two groups, group I included 38 patients with burn wound infection, and group II included 22 patients with clean burn wound [control group]. All cases were subjected to through history taking and clinical examination. For cases with infected wounds, sterile swabs were used for aspiration of deeply seated wound pus for microbiologic examination. Blood samples were collected for prothrombin time [PT], activated partial thromboplastin time [APTT], platelet count and fibrinogen concentration detection. This study revealed females [73.3%] were mostly affected by burn insults than males [26.7%]. Out of 60 studied cases 61.7% had 3rd degree of burn and 63.3% developed burn wound infection. The most frequently isolated organisms from infected wound [38] were pseudomenas aeruginosa [31.6%], E.coli [18.4%], proteus [13.2%], coagulase negative Staphylococci [coag. -ve Staph] [10.5%], while the least were anaerobes [5.3%] and Candida albicans [2.6%]. On comparing burn cases with infected wounds [gpl] to those with clean burn wound [gpll] for the hemostatic changes, there was highly significant increased both PT and APTT in gpl than gpll [P