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Petroselinum crispum(parsley or garden parsley), besides its use as an edible vegetable, is used in the treatment of various ailments with documented evidence validating some of these medicinal uses. The present study evaluates the impact of oral administration of P. crispumon blood coagulation parameters. Fresh leaves of P. crispum were locally sourced, authenticated and extracted using ethanol to obtain an ethanolic extract of P. crispum (PCE). Twenty-five (25) male Wistar rats were used for the study and were randomly assigned to five (5) animals of five (5) rats each. Group I served as the control group and was given distilled water, whereas groups II, III, and IV were treated as experimental groups and administered PCE at 200, 400, and 800mg/kg via oral gavage, respectively. Group V also received 800mg/kg of PCE with the administration terminated on the 28thday to allow for a 14-day recovery period. Platelet count (PLT) and other platelet indices were determined using an automated Haematology analyzer. Bleeding time (BT), clotting time (CT), prothrombin time (PT), activated partial thromboplastin time (aPTT) and plasma fibrinogen (FIB) were assayed following standard laboratory protocols. The results of the study show that the mean PLT were significantly reduced in the experimental animals compared to the control (p<0.05) while BT, CT, PT, aPTT and FIB significantly increased compared to the control (p<0.05). Also, BT, CT, PT, and aPTT recovered towards the control values after the 14-day withdrawal period. The present study shows ethanolic leaf extract of P. crispumprolonged blood coagulation. The current evidence suggests that P. crispumcould be a candidate for further exploration as a natural plant-based antithrombotic agent.
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Background: The aim of this study was to assess clinico-epidemiological profile, prevalent treatment practices and outcome of snake bite patients in a tertiary care hospital in a hilly North central region of Himachal Pradesh. Methods: A hospital record based retrospective descriptive study was done which included demographic data, clinical profile, prevalent traditional treatment methods of snake bite, treatment given at hospital and outcome among 144 patients. Results: The 123 (83%) patients were young (age group of 17-50 years) and number of female patients was 89 (62%), 29 (38%) more than male patients. Most of snake bite cases recorded, presented in the months of July to September 56 (72.7%). The most frequently bitten sites were the upper limbs particularly left hand. 61 (42%) of patients presented without any features of envenomation. Hematotoxicity was the commonest presentation in 68 (82%) of patients followed by neuroparalysis in 26 (18%) of the symptomatic cases. Green snake (Green pit viper) was the commonest snake seen. Cure rate in our study was more than 80%. Major reason for delayed presentation was consultation of traditional healers. Conclusions: In the tropics and subtropics, snake bite is a life threatening health hazard especially in poor rural people who usually waste precious time by indulging in harmful activities. This needs public as well as health care workers’ awareness and prompt intervention in a health care facility.
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A 72-year-old female was diagnosed with systemic lupus erythematosus and antiphospholipid syndrome (APS) in 2014 and was followed up. Severe mitral regurgitation coexisted with APS, but the case was nonsymptomatic, and surgery involved high risk. Therefore, the physicians continued their observation. In 2020, the patient experienced rheumatic severe mitral stenosis and shortness of breath on exertion. Paroxysmal atrial fibrillation and coronary stenosis were also detected. Therefore, we planned mitral valve replacement, tricuspid annuloplasty, coronary artery bypass, pulmonary vein isolation and left atrial appendage closure. During extracorporeal circulation (ECC), we performed coagulation management based on blood heparin concentration using HMS PLUS. Because the APS patient showed prolonged activated clotting time (ACT), and coagulation therapy based on ACT is unreliable. She was discharged from our hospital on postoperative day 23. No complications, including bleeding and thrombosis, were observed 2 years after the operation. We experienced a case of APS who underwent cardiac surgery and performed coagulation management by measuring heparin concentration during ECC. We targeted a 3.5 U/ml heparin concentration, and her clinical course was uneventful.
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Background: Preeclampsia is a condition of unknown etiology of multiorgan disease and is distinguished by a raised blood pressure (B.P. >140/90 mmHg) and proteinuria (>300 mg per 24 h) and/or edema following 20 weeks of pregnancy. Aims and Objectives: The study was conducted to differentiate coagulation variables between normotensives and preeclamptic patients. Materials and Methods: Prior consent was obtained from Institutional Ethics Committee. Patients diagnosed with preeclampsia aged between 20 and 35 years were incorporated into the study. Patients with a previous history of hypertension, thyroid disease, and diabetes were excluded from the study. Age-matched controls were taken and analyzed. Data collection done by (i) BP measured in supine posture; (ii) bleeding time (B.T) estimation – by Duke’s method; (iii) clotting time (C.T) estimation – by Wright’s capillary tube method; (iv) platelet count (P.C) estimation – by automated hematology analyzer; and (v) prothrombin time (P.T) and activated partial thromboplastin time (APTT) – estimation by semi-automated analyzer. Results: The study revealed a significant interrelation between P.C and B.T when preeclampsia patients were correlated with normotensives patients while P.T, APTT, and C.T were insignificant statistically. Conclusion: A statistically significant change was observed proposing parameters derangement as the disease becomes more progressive.
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Objective:To explore solutions to the "grey zone" of activated partial thromboplastin time (APTT) mixing study, and establish the clinical application pathway of it.Methods:Patients treated in West China Hospital of Sichuan University from January 1, 2018, to December 31, 2019, with a prolonged APTT were included in this study. The ROC curve was used to analyze the"cut-off"of different methods and explore solutions to the "grey zone" by combination of the 1∶1 and 4∶1 mixing study. Similar samples from January 1, 2020 to December 31, 2020 were included to verify the diagnostic efficiency of the clinical application pathway.Results:The traditional Rosner index criterion had a low diagnostic accuracy in differentiating factor deficiencies from inhibitors. A total of 49 cases (15%) in the establishment group and validation group were located in the "grey zone". The optimal cut-off value of the Rosner index in our 1∶1 mixing study for determining factor deficiency was 5.0%, and inhibitor was 9.1%. The sample between 5.0% and 9.0% needed 4∶1 mixing studies, which could significantly improve the detection sensitivity of inhibitors. The percentage of extended time after incubation-P (1∶1 mixing>10.8% and 4∶1 mixing>13.5%) was better than the traditional criterion mentioned by"consensus"in determining whether the inhibitor was time-dependent. The sensitivity, specificity, positive predictive value and negative predictive value of combined the 1∶1 and 4∶1 mixing study in differentiating factor deficiencies from inhibitors all attained more than 90%. Only 7% (3/43)of inhibitors were incorrectly classified into the factor deficiency group by the combination, which was 20.9% (9/43) by traditional criterion. The specificity for detecting time-dependent inhibitor was increased from 54.2% to 100%, and accuracy was increased from 63.3% to 97.4%.Conclusions:The combination of 1∶1 and 4∶1 mixing study can better resolve the "grey zone". The established clinical application pathway is beneficial for the further promotion and clinical application of APTT mixing study.
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@#Introduction: Lupus anticoagulant (LA) is a well-known risk factor for thrombosis. Correct diagnosis of LA is essential in patient management with anticoagulation. The objectives of this study were to document the clinical and laboratory characteristics of patients tested for LA and to evaluate existing LA testing methods in our laboratory with the aim of improving the performance of LA test interpretation and reporting. Methods: Tests for LA include dilute Russell’s viper venom time (dRVVT) and Kaolin clotting time (KCT). Patients with LA ratio (dRVVT screen ratio/dRVVT confirm ratio) of ≥1.2 were considered as LA positive irrespective of KCT results. KCT was considered positive if there was a prolongation in KCT screening test which was not corrected on mixing with normal plasma. Results: Of 577 patients’ results, 295 were normal, 178 were KCT positive with negative dRVVT and 104 were LA positive. Incidences of thrombosis, connective tissue disease (CTD) and bad obstetric events were noted in 13%, 16% and 44% of normal patients, 9%, 22% and 49% of KCT+ patients and 23%, 37% and 17% of LA+ patients respectively. On further evaluation of dRVVT screen ratios, 431 had a ratio of <1.1, 59 had a ratio between 1.1 and 1.2 and 87 had a ratio of >1.2. Positive LA results were found in 3%, 29% and 87% of patients with dRVVT screen ratios of <1.1, 1.1 - 1.2 and >1.2 respectively. Conclusion: LA+ patients had higher incidences of thrombosis and CTD as compared to normal and KCT only positive patients. There was no significant difference in clinical characteristics between normal and KCT+ patients which suggests the presence of a high rate of false-positive KCT results. Since confirmatory testing for KCT is not widely used, the option of using another LA screening test method should be considered. In regard to dRVVT testing, confirmatory test should only be performed in patients with prolonged dRVVT screening result which was not corrected upon mixing with normal plasma as required by the International Society of Thrombosis and Haemostasis guidelines on LA testing. This practice will not only result in significant cost reduction but also avoid diagnostic confusion.
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Background: Blood clotting is a process which prevents blood loss during injuries. Blood clots even when it is coming out from the blood vessels. Aloe vera is a perennial plant found all over India. It is commonly used in traditional system of medicine for treatment of wound healing, mouth ulcers, constipation, skin wrinkles and diabetes mellitus It is also used as antioxidant and antimicrobial agent. As it is used in traditional system of medicine for wound healing, this study was under taken to test the possible haemostatic effect of aloe vera.Methods: 12 rats were divided into two groups (control and test) with 6 rats in each group. Determination of Bleeding Time (BT), rat tail was warmed for one minute in water at 40?C and then dried. A small cut was made in the middle of the tail with a scalpel. In test group, a drop of aloe vera leaf extract was applied on the injured area immediately after making the cut in the middle of the tail, where as in the control group nothing was applied, and BT estimated. Determination of Clotting Time (CT), 12 test tubes were arranged in water bath at 37?C. Control Group: 0.4 ml of blood was collected from each rat in the control group and added to 6 test tubes kept in the water bath. Test group: For the remaining 6 test tubes 0.1 ml of aloe vera leaf extract was added. 0.4 ml of blood collected from the test group was added to these test tubes. The CT was estimated for both control group and test group.Results: The results were statistically analyzed by using unpaired t-test. The reduction in BT and CT for test group was statistically highly significant (p<0.001) compared to control group.Conclusions: In this study aloe vera leaf extract significantly reduced both BT and CT in the test group.
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Background: In India, about 1 million people are bitten by snakes more in the rural area and they get admitted to hospitals. About 50,000, people die of snake bites every year in India. The patients admitted with poisonous snake bites were treated with polyvalent anti snake venom serum. Aim: To determine the significant difference and outcome between High Dose and Low dose Polyvalent Anti Snake Venom Serum (PVASVS), with regards to age gender and severity of coagulation abnormalities. The cost of ASV has an economic impact and if low dose ASV saves the scarce resource. Materials and Methods: 45 patients bitten by snake admitted and treated which included both males and females were taken up for this study based on Poisson model of sampling. All the patients had cellulitis, renal failure and varying degree of coagulation abnormalities. They were classified into LDG and HDG depending on the number of PVASVS they received which was ≤25 vials or >25 vials respectively. This was decided based on the treatment of ASV analyzed using chi-square contingency statistically for its significance. Results: The age and clotting time as such do not have association to distinguish HDG or LDG. It was revealed that Gender has an effect that female HDG are 26.3% (5 out of 19) as compared to male 73.7% (14 out of 19). In each group, 2 patients died out of 18, LDG (11%) 27 in HDG (7.4%) 62.9% of patients in LDG and 38.8% in HDG required hospital stay more than 10 days. Conclusions: The female gender falls in low dose conserving ASV. The LD ASV demands higher duration of stay (more than 10 days) in the hospital. The age, coagulation abnormality did not establish the significant results in the LDG and HDG.
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Objective To observe the effects of four kinds of extracts of Crataegi Folium on hemorheology, erythrocytes, platelets, coagulation time, and other indicators of 27 indicators in blood stasis rats from the aspects of whole and local double aspects by using the combination method of principal component and one-way ANOVA, and analysis of indicators contained in the information, in order to provide new analytical ideas for the mechanism of Crataegi Folium extract on activating blood and resolving stasis. Methods Forty-eight wistar rats were randomly divided into blank group, model group, and drug group. Blood stasis model was prepared by using adrenaline in ice water bath. Both blank group and model group were given normal saline, and drug group was given hawthorn leaves extract aqueous solution. Blood samples were collected and 27 indicators such as hemorheology, erythrocyte, platelet, and prothrombin time were selected. The principal component analysis (PCA) was used to decompose all the index data by dimensionless treatment and dimensionality reduction, and then the principal components were generated. The new variables (ie, principal component scores) were subsequently analyzed by one-way ANOVA. The results combined with the contribution rate of principal components and the correlation coefficient of each index was analyzed. Finally, the index groups and individual indexes in each group were analyzed synthetically, and the regularity conclusions were drawn. Results Eight principal components were extracted by principal component analysis, and the contribution rate was 77.992%. The results of theprincipal component analysis combined with the ANOVA showed that nine main components in the first principal component could replace the original 27 indicators to reflect the effect of Crataegi Folium extract on blood circulation and blood stasis, namely FIB, total number of red blood cells, total platelet count platelet volume, platelet count, blood viscosity at low shear rate, blood viscosity at middle shear rate, blood viscosity at high shear rate, and plasma viscosity. The results showed that the effects of the four extracts of Crataegi Folium on the index components were different. Conclusion The effect of activating blood and resolving stasis is mainly by reducing blood viscosity and plasma viscosity, promoting hemoglobin degradation and increasing the number of platelets, shortening the blood clotting and so on to achieve.
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Objective To investigate curative efficacy of ginkgo biloba extract dripping pills in treatment of acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI) and its effects on platelet aggregation rate(PAR), activated clotting time(ACT) and antithrombin(AT)Ⅲ. Methods 90 patients of ACS treated with PCI who received therapy from January 2014 to October 2016 in Zhejiang green town cardiovascular hospital were selected and randomly divided into the observation group and the control group , 45 cases in each group.The control group was treated with routine treatment after PCI, while the observation group was combined with ginkgo biloba extract dripping pills.After treatment of seven days, the changed of PAR, ACT, ATⅢ and adverse cardiovascular events were compared, after treatment three months, the seattle angina scale were compared. Results After treatment, the levels of PAR in the observation group were significantly lower than that of the control group, and the levels of ACT and ATⅢ were significantly higher than that of the control group, the difference was statistically significant (P<0.05), the total incidence of adverse cardiovascular events in the observation group was significantly lower than that of the control group , the difference was statistically significant ( P<0.05), in the seattle angina scale, the scores of stable state of angina pectoris, the attack of angina pectoris, physical activity limitation, treatment satisfaction in the observation group were significantly better than that of the control group, the difference was statistically significant (P<0.05). Conclusion Ginkgo biloba extract dripping pill is well for ACS after PCI, which can effectively relieve clinical symptoms, to improve the expression of PAR, ACT and ATⅢ, helps to reduce the incidence of adverse cardiovascular events.
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Objective To observe the correlation between protein C activity-dependent clotting time-normalized ratio (PCAT-NR) and the related blood coagulation parameters,e.g.,fibrinogen (Fib),factor Ⅶ coagulant activity (Ⅶ:C),factor Ⅷcoagulant activity (F Ⅷ:C),antithrombin (AT),D-dimer (DD) in patients with acute cerebral infarction.Methods One hundred cases of patients who were diagnosed as acute cerebral infarction according to clinical manifestations and imaging examinations were taken as the test group and 75 healthy subjects were taken as control group.The values of Fib,FⅦ:C,FⅧ:C,AT,PCAT-NR,DD were tested and the difference between the two groups were compared.The differences of Fib,FⅦ:C,FⅧ:C,DD and AT between declined PCAT-NR group and normal PCAT-NR group in the patients with acute cerebral infarction were analyzed.The correlations of PCAT-NR with other coagulation parameters in acute cerebral infarction cases were compared.Results The values of Fib (3.38 ± 1.25) g/L,F Ⅶ:C (130.5 ± 15.9) ％,FⅧ:C (135.8 ± 43.1) ％ and DD (2.12:±:3.01) mg/L in the acute cerebral infarction group were significantly higher than those of control group,while the values of AT (83.94 ± 14.95) ％ and PCAT-NR (0.87 ± 0.23) in test group were significantly lower than those the control group (P＜0.05).The values of Fib (4.03 ± 1.25)g/L,FⅦ:C (138.2 ±6.9)％ and FⅧ:C (151.5 ± 54.9)％ of PCAT-NR declined group in the patients with acute cerebral infarction were significantly higher than those of PCAT-NR normal group (P ＜ 0.05),while the values of DD,AT were not statistically different between two groups (P ＞ 0.05).The values of PCAT-NR were significantly negatively correlated with Fib,FⅧ:C and DD in the patients with acute cerebral infarction (r =-0.484,-0.356 and-0.473,respectively (all P ＜ 0.05).There was no correlation of PCAT-NR with FⅦ:C and AT (P ＞ 0.05).Conclusion The PCAT-NR decline was associated with high coagulation state in patients with acute cerebral infarction.This decline has some correlation with high level of blood clotting factor Ⅷ and Fib.
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Objective: To determine the index weight and optimize the microwave processing technology of carbonized Gardenia jasminoides (CGJ). Methods: The contents of geniposid and tannins in CGJ processed by traditional method were determined by HPLC and used as comprehensive evaluation indexes, the weighting coefficient was determined by CRITIC method, and the microwave processing technology of CGJ was optimized by Box-Behnken response surface methodology (BBRSM). The pharmacological activity of CGJ processed by microwave was also evaluated. Results: The weighting coefficients of geniposid and tannins in CGJ processed by traditional method were 0.27 and 0.73. The optimal parameters of microwave processing technology were as follows: microwave power of 600 W, microwave time of 6 min and medicines mass of 120 g, the contents of geniposidic and tannins were 35.19 and 4.76 mg/g. The results of pharmacological evaluation showed that CGJ processed by microwave and traditional method could shorten the bleeding time and clotting time of mice. There was no obvious difference between the two processed products. Conclusion: Microwave processing can be used as a processing method to enrich the traditional processing technology.
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Objective To investigate the effect of different doses of protamine neutralizing heparin on perioperation of on-pump coronary artery bypass graftting (CABG).Methods A total of 180 on-pump CABG patients hospitalized from January 2015 to November 2016 were randomly divided into three groups,the protamine group l,protamine group 2 and protamine group 3,60 patients in each group.Heparin (3 mg/kg) was used before extracorporeal circulation.After intracardiac operation was over,protamine was used to neutralize the heparin to adjust the activated clotting time (ACT) in protamine group 1,which was 10％ higher than that of intubation.Meanwhile,protamine group 2 was neutralized to equal to the ACT before intubation,and protamine group 3 was 10％ lower than that before the intubation.The differences of intraoperative and postoperative parameters were compared between the three groups.Results No death was found in the three groups during hospitalization.Comparing with protamine group 1 and protamine group 2,the time of operation,the ACT before the leaving operation room,the ACT of the first hour after returning to ICU,the amount of bleeding during operation,the time of closing and the amount of red blood for transfusion were decreased in protamine group 3 (P ＞ 0.05).The total amount of protamine for neutralizing and the ratio of protamine and heparin were significantly increased in protamine group 3 (P ＜ 0.05).The heart dysfunction after operation,perioperative myocardial infarction,pulmonary edema,pulmonary infection,renal dysfunction,poor wound healing,neurological complications,and time of in hospital stay showed no significant differences between three groups (P＞0.05).Conclusion ACT below 10％ of preoperation is safe,after neutralization of heparin by protamine,which can obviously reduce the bleeding,the time of sternal closure and the amount of red blood cell transfusion,showing a positive clinical significance.
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Los objetivos del trabajo fueron verificar la calidad analítica del ensayo tiempo de trombina diluido (DTI) para medición de la concentración plasmática (cc) de dabigatran comparando dos coagulómetros de detección foto-óptica, comparar los resultados con el tiempo de Ecarin (ECT) y correlacionar las cc con las pruebas básicas de coagulación Tiempo de protrombina (TP), APTT y Tiempo de trombina (TT), y tiempo de veneno de víbora de Russell con fosfolípidos concentrados (DRVVTC). Se tomaron 43 muestras de plasma en el valle (10-14 h de la última toma) de 40 pacientes que recibían dabigatran. DTI y ECT presentaron (%) repetitividad <5,4% y <7,5%, CV interensayo <6% y <9%, respectivamente, en el protocolo EP15A2, aceptables para un Error Total permitido (TEa) <15%. Las cc medidas en pacientes fueron: mediana 83 (4-945) ng/mL. La comparación de equipos ACL TOP 300 y 500 dio resultados equivalentes por procedimiento alternativo de comparación de métodos. La comparación ECT vs. DTI fue satisfactoria por regresión de Deming (pendiente 1,143, ordenada al origen -19,33). Las correlaciones de cc vs. APTT, TP y DRVVTC fueron moderadas y no lineales tendiendo a plateau a cc>350 ng/mL, r2 0,59, 0,66 y 0,59, respectivamente. El TT fue extremadamente sensible: >120 s a cc 50 ng/mL. DTI presentó un buen desempeño analítico y permitió cuantificar dabigatran plasmático a cc bajas y altas en ambos equipos utilizados. ECT presentó resultados comparables a DTI. Se verifica una correlación moderada entre cc de dabigatran y las pruebas clásicas y DRVVTC, pudiendo ser estimadores de cc a partir de los 50 ng/mL.
The aims of the study were to verify the analytical performance of Dilute Thrombin Time (DTI) test to measure plasma dabigatran concentration (cc) in two photo-optical coagulometers, compare Ecarin clotting Time (ECT) and DTI results, and correlate cc with classical coagulation tests: prothrombin time (PT), APTT, thrombin time (TT) and diluted Russell Viper Venom Time tests with high phospholipid concentration (DRVVTC). Forty three plasma samples from 40 patients taking dabigatran were drown at through (10-14 hs.since last dose). DTI and ECT showed repetitivity (%) <5.4% and <7.5%, interassay CV <6% and <9%, respectively, following EP15A2 protocol, acceptable considering a Allowed Total Error (TEa)<15%. Patients` cc: median 83 (4-945) ng/mL. The comparison between ACL TOP 300 and 500 coagulometers showed equivalent results by using the alternative method comparison test. ECT vs. DTI: acceptable by Deming`s regression (slope 1.143, Y insert -19.33). cc vs. APTT, TP and DRVVTC: nonlinear and moderate correlations with plateau reached at cc >350 ng/mL, r2 0.59, 0.66 y 0.59, respectively. TT is extremely prolonged at cc >50 ng/mL. In conclusion: DTI showed a good analytical performance in both coagulometers. ECT showed comparable results to DTI. We verified that dabigatran cc presented moderate correlations with PT, APTT and DRVVTC, and that these tests could only qualitative estimate cc >50 ng/mL.
Os objetivos do trabalho foram verificar a qualidade analítica do ensaio tempo de trombina diluído (DTI) para medição da concentração plasmática (cc) de dabigatrana, comparando dois coagulômetros de detecção foto-óptica, comparar os resultados com o tempo de Ecarina (ECT) e correlacionar as cc com os testes básicos de coagulação Tempo de protrombina (TP), APTT e Tempo de trombina (TT), e tempo de veneno de víbora de Russell com fosfolipídios concentrados (DRVVTC). Foram tomadas 43 amostras de plasma no vale (10-14 h. da última toma) de 40 pacientes que recebiam dabigatrana. DTI e ECT apresentaram (%) repetitividade <5,4% e <7,5%, CV interensaio <6% e <9%, respectivamente, no protocolo EP15A2, aceitáveis para um Erro Total permitido (TEa) <15%. Cc medidas em pacientes: mediana 83 (4-945) ng/mL. Comparação de equipamentos ACL TOP 300 e 500: resultados equivalentes por procedimento alternativo de comparação de métodos. Comparação ECT vs. DTI: satisfatória por regressão de Deming (pendente 1,143, ordenada à origem -19,33). Correlações cc vs. APTT, TP e DRVVTC: moderadas e não lineares tendendo a plateau a cc>350 ng/mL, r2 0,59; 0,66 e 0,59, respectivamente. O TT é extremamente sensível: >120 s a cc 50 ng/mL. DTI apresentou um bom desempenho analítico e permitiu quantificar dabigatrana plasmática a cc baixas e altas em ambos os equipamentos utilizados. ECT apresentou resultados comparáveis com DTI. Verifica-se uma correlação moderada entre cc de dabigatrana e os testes clássicos e DRVVTC, podendo ser estimadores de cc a partir dos 50 ng/mL.
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Humans , Male , Female , Prothrombin Time , Thrombin , Dabigatran , Phospholipids , Thrombin TimeABSTRACT
The study evaluated anticoagulant properties of the methanol extract of Newbouldia laevis leaves using blood clotting time, bleeding time and thrombin-induced clotting assay as standard procedures. Oral acute toxicity studies showed that the extract had a high safety margin, up to 2000 mg/kg in Wistar rats. The methanol leaf extract of N. laevis significantly (p<0.05) prolonged blood clotting times from the baseline value of 11.0 ± 0.6 s for the blood sample to 18.0 ± 0.7 s and 32.0 ± 1.0 s at 5 % and 10 % concentrations respectively. The crude extract also exhibited appreciable in vivo and in vitro anticoagulant potency. High doses of the extract were most significant (p<0.01) in inducing rabbit bleeding which became prolonged to 55.8 ± 1.4 s and 73.1 ± 0.8 s at 100 and 200 mg/kg respectively compared to the baseline (18.0 ± 0.2 s) and effects of the reference anticoagulants. Aspirin was found to have produced bleeding intervals of 47.0 ± 0.3 s and 70.1 ± 0.2 s at 1.0 and 2.0 mg/kg while heparin (0.75 and 1.5 mg/kg) induced bleeding times of 41.6 ± 0.8 s and 61.0 ± 1.7 s respectively. The vehicle (distilled water) induced a transient baseline bleeding time of 18.0 ± 0.2 s. However, the leaf extract of N. laevis also potentiated elevation in thrombin-induced clotting time in a dose dependent manner but at a reduced potency compared to heparin. Phytochemical analysis revealed the presence of reducing sugars, alkaloids, tannins, flavonoids, resin, phenols, proteins and acid compounds in the crude extract. The results demonstrated that the methanol leaf extract of N. laevis possesses pharmacologically active anticoagulant principles that could be isolated and evaluated for clinical or physiological purposes.
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Objective To screen the hemostatic active extracts from Callicarpa nudif lora .Methods The powdered Callicarpanudiflora was extracted with 70% EtOH and concentrated to give EtOH-extract .The EtOH-extract was further chromatographed over HP-20 macroporous resin column ,eluting with aqua and 95% EtOH to get HP-H2 O-elution and HP-EtOH-elution ,respectively .The obtained three extracts of EtOH-extrract ,HP-EtOH-elution and HP-H2 O-elution were set as large ,middle and small dosage groups for drug preparation ,respectively .Yunnan Baiyao was used as a positive control group . The weight increment ,bleeding time and clotting time of fed mice were detected by cutting tail and grass slide methods after in-tragastric administration for 7 days .Results As compared with blank model and positive control ,each dosage groups of HP-EtOH-elution could significantly shortened the bleeding time ,of which the small dosage group and middle dosage group even ex-hibited better results than the positive control group .Whereas the EtOH-extract ,HP-EtOH-elution and HP-H2 O-elution didn′t demonstrated significant effect on clotting time as well as the weight increment .Conclusion The HP-EtOH-elution was suggested to be the major active extract possessing hemostatic activity to mice under tested dosages .The hemostatic mechanism may through in-trinsic coagulation pathway .This study would be helpful for further phytochemical investigation of C .nudi f lora .
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In India, viper bites are more common than any other poisonous snake bites. In these patients, the cardinal features are local pain, swelling and mild coagulation abnormalities; but gangrenous changes involving bilateral upper and lower limbs are uncommon. We are reporting a case of a 62-year-old man bitten by a Russell viper on the right thumb. He experienced local pain, swelling and later developed disseminated intravascular coagulopathy, pre-renal azotemia, sepsis, acute respiratory distress syndrome (ARDS) and peripheral gangrenous changes involving bilateral upper and lower limbs. He succumbed to his ailment 5 months after the bite. There have been very few cases of gangrenous changes involving distal part of extremities associated with snake bite.
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Antecedentes: en Colombia, el alto recuento de células somáticas (RCS) en la leche es un problema para la industria lechera. Altos recuentos pueden afectar de manera considerable los rendimientos y calidad final del queso. Varios países han establecido límites máximos estandarizados para el RCS. Colombia no lo ha hecho de manera oficial y tan solo unas pocas industrias manejan sus propios límites. Objetivos: Determinar el efecto del RCS sobre parámetros de aptitud quesera de la leche y la calidad sensorial del queso campesino. Métodos: Se tomaron muestras de leche de seis tanques con altos y bajos RCS y se realizaron mezclas para obtener 30 baches con diferentes RCS (desde 150.000 hasta 1.200.000 cel/ml). Con estas mezclas se elaboraron 30 quesos tipo campesino a los cuales se les determinaron variables de aptitud quesera (tiempo de coagulación, rendimientos y pérdidas en suero) y la calidad organoléptica a través de una prueba sensorial descriptiva de puntajes con panel de seis jueces con experiencia previa y entrenados en queso campesino. Las variables de aptitud quesera fueron analizadas por regresión múltiple y los resultados de la evaluación sensorial con la prueba no paramétrica de Friedman. Resultados: La aptitud quesera disminuyó con RCS superiores a 200.000 cel/ml. El tiempo de coagulación (R² = 0.74; P< 0.001) y las pérdidas de proteína en el lactosuero (R² = 0.55; P<0,001) aumentaron, mientras que los rendimientos (R²=0.31; P<0.01) disminuyeron a medida que aumentó el RCS. La calificación de los panelistas respecto de la textura y la apariencia disminuyó con RCS mayores a 600.000 cel/ml (P<0.01) y el sabor y el aroma, a partir de 800.000 cel/ml (P<0,01). Conclusiones: Aumentos en el RCS en leche afectan negativamente parámetros de aptitud quesera y la calidad sensorial del queso campesino. Se sugiere que los impactos serán menores sobre el rendimiento cuanto menor sea el RCS, mientras que la calidad organoléptica mejorará cuando la leche tenga RCS por debajo de 600.000 cel/ml.
Background: A high milk somatic cell count (SCC) is a problem for milk industry in Colombia. These high counts can affect considerably yield and final quality of cheese. Several countries have established maximum limits for SCC. In Colombia these limits have not been established officially, only a few industries have their own limits. Objectives: To determine the effect of somatic cell count (SCC) on milk potential for cheese making and sensorial quality of fresh cheese. Methods: Six milk samples with high and low SCC, were taken from bulk tanks and mixed to obtain 30 samples with SCC of 150.000 to 1.200.000 somatic cells/mL. Thirty fresh cheeses were prepared and clotting time, yield (protein, fat, dry matter) and whey losses were determined. Additionally, score descriptive sensorial quality test was performed by 6 trained judges. Protein, fat, dry matter in milk and cheese yields were analyzed by multiple regressions and information of sensorial test by Friedman method. Results: When milk SCC (somatic cells/ml) increased from 150.000 to 1.200.000, clotting time (R² = 0,74; P<0.001), and whey protein losses increased (R² = 0.55; P<0.001) and cheese yield decreased (R²=0.31, P<0.01). According to panelists, texture and appearance were affected negatively when SCC was higher than 600.000 cells per ml (P<0.01), flavor and aroma when they were higher than 800000 cells/ml. Conclusions: Increases in SCC have a negative effect on milk potential for cheese making and quality sensorial parameters on fresh cheese. It is suggested that minor impacts in fresh cheese yield would be obtained with a lower SCC and for good sensorial quality when the milk has SCC, lower than 600.000 cells per ml.
ABSTRACT
Objective: To prepare triterpenoid ilexoside O from the roots of Ilex pubescens and to investigate its antithrombotic activity. Methods: Ilexoside O was separated and purified by column chromatography and recrystallization, and was identified by 1H-NMR and 13C-NMR analyses. Afterig administration, the pharmacological effects of ilexoside O were evaluated by clotting time (CT), bleeding time (BT), and the amount of the abdominal aortic blood clots induced by FeCl3 in rats, respectively. Results: In comparison with placebo group, ilexoside O showed the obvious effects on BT (P<0.01). The low-dose group (25 mg/kg) of ilexoside O showed no obvious effect on CT (P≤0.05), but the mid-(50 mg/kg) and high-(100 mg/kg) dose groups obviously increased CT of mice (P<0.05); Ilexoside O obviously decreased the amount of the abdominal aortic blood clots in the induction of FeCl3 in rats (P<0.01). Conclusion: Ilexoside O shows obvious anticoagulant effect and could decrease the amount of the abdominal aortic blood clots, and its related mechanism is one of the problems which need to be further studied.
ABSTRACT
Background: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed agents for various conditions in general psychiatry. There is a strong consensus that blockade of serotonin reuptake affects primary hemostasis, namely platelet activity, thus resulting in a bleeding tendency. Considering that SSRIs are commonly prescribed, this study was conducted to assess if they were associated with an increased risk of bleeding. Methods: This was a prospective, open-label study of 30 patients attending the Psychiatry out-patient department, Dr. B. R. Ambedkar Medical College, Bangalore who satisfied DSM-IV criteria for a primary diagnosis of depression, treated with SSRIs. Bleeding time, clotting time, prothrombin time, partial thromboplastin time and platelet count were assessed at baseline and at the end of 6 weeks of treatment or occurrence of bleeding symptom. Results: The patients aged between 18-55 years of whom 21 were females, were treated with an SSRI (fluoxetine 12, escitalopram 12 and sertraline 6 patients). Six patients had overt symptoms of bleeding (upper gastrointestinal bleeding (hematemesis) 4; epistaxis 2 and petechiae 2) of whom one patient gave a history of both hematemesis and petechiae and another of hematemesis and epistaxis. The average day after treatment beginning, on which patients reported with bleeding was 30.33 (26-40 days). There was a significant increase in the bleeding time (p=0.028) and clotting time (p=0.042), implying derangement in platelet aggregation. There was no significant change in the other parameters. Conclusion: Treatment with SSRIs increases the risk of bleeding. However, large, randomized controlled trials are required to re-affirm these findings.