ABSTRACT
Background & objectives: Haemophilia is a debilitating bleeding disorder with significant comorbidities affecting the quality of life. In India, the management of these individuals is still limited to on-demand institutional treatment with coagulant factors. In this study, we highlighted the problems faced by these patients in the COVID-19 period due to nationwide lockdown. Methods: A retrospective study was done to ascertain the trend in the number of patients with haemophilia A and B visiting the hospital, those succumbing to haemophilic complications and indications for factor requirement in the pre-COVID (October 2019-March 2020) and during the COVID-19 period (April-September 2020). Representative cases with unusual complications were described along with significant challenges faced in providing standard care of treatment to these individuals due to the COVID-19 pandemic. Results: A total of 818 and 162 individuals with haemophilia A and B, respectively, were registered with the department. The overall number of patient visits to the hospital significantly reduced from an average of 6.9 outpatient department (OPD) visits per patient in the pre-COVID-19 period to an average of 3.9 OPD visits per patient and admissions reduced to 50 per cent during the COVID-19 period. This led to a reduction in utilization of factors VIII and IX except VIIa for haemophilia with inhibitors. There was no factor utilization for elective surgeries during the COVID-19 period. A total of eight patients succumbed to haemophilia-related complications during the COVID-19 period due to delay in reaching the hospital. The challenges faced in the management of three cases with musculoskeletal bleeds, one case with scrotal haematoma and one with haemothorax during the COVID-19 period were also highlighted. Interpretation & conclusions: COVID-19 pandemic has unveiled the need for on-demand home treatment with coagulant factors and has also brought to light the existing need for primary prophylaxis, especially for younger individuals with haemophilia.
ABSTRACT
Objective To evaluate the quality of cryoprecipitates prepared from fresh frozen plasma via deepfreeze method and siphonage method thawing at 4℃ water bath,and to select a proper preparation method for cryoprecipitates.Methods Sixty samples of cryoprecipitate prepared by deepfreeze method,and 60 samples of cryoprecipitate prepared by siphonage method were selected randomly.Factor FⅧ,fibrinogen(Fg) in cryoprecipitates were measured by coagulometer,and the qualification rates were calculated.Results The concentration of FⅧ(IU/pack) in the cryoprecipitates prepared via deepfreeze method and siphonage method were(70.30?23.68),and(161.62?39.45),respectively;the qualification rate of FⅧ prepared via the two methods were 43.33%(26/60),and 93.33%(56/60),respectively(P0.05).Conclusion Siphonage method,with a higher qualification rate of FⅧ,is simple and fast,which deserves a popular application.
ABSTRACT
Ojective To study the coagulant state in the patients with deep vein thrombosis(DVT)caused by low level of coagulant factor Ⅻ.Methods Blood samples were obtained from 125 patients with deep veins thrombosis and 32 normal people(control group).Before thrombolysis the following parameters were tested:thrombolysis Ⅻ:C coagulant activity(FⅫ:C),prothrombin time(PT),activated prothrombin time(APTT),thrombin time(TT),fibrinogen(FIB),antithrombin activity(AT:A),D-dimer(D-D),plasminogen activity(PLG:A),lupus anticoagulant(LAC),protein C(PC),tissue plasminogen activator antigen(t-PA:Ag),plasminogen activator inhibitor-1 antigen(PAI:Ag).According to the activity of FⅫ:C,the patients were divided into 2 groups:normal Ⅻ:C group and low FⅫ:C group.Results The PLG:A,PC,AT:A,t-PA:Ag in the low FⅫ:C group was lower evidently than those in normal group(P0.05).Compared to the FⅫ:C normal group,t-PA:Ag in the low FⅫ:C group decreased(P