A study of Vitamin K status in children on prolonged antibiotic therapy.

Vitamin K deficiency is known to cause coagulopathy and bleeding in patients on prolonged antibiotic therapy. This study was conducted to evaluate the status of vitamin K deficiency in hospitalized children on prolonged antibiotic therapy and its role in reversing the coagulopathy. A prospective non-randomized study was conducted on children on antibiotic therapy at a tertiary care hospital. Children in the 1 month-1 year age group developed significant coagulopathy as compared to other age groups. Coagulation abnormalities were also seen to be more in children with greater grades of malnutrition, on a more prolonged course of antibiotics and in children who were critically ill in intensive care. Hypoprothrombinemia previously reported to be due to B-lactam antibiotics containing the N-Methyl Thio Tetrazole (NMTT) group also resulted from antibiotics without this side chain. Inhibition of intestinal microorganisms by antibiotics was thought to be a likely explanation of this phenomenon. We suggest Vitamin K prophylaxis in severely ill patients, on extended periods of antibiotics and inadequate diet to prevent morbidity and mortality.

Dicumarol content in alcoholic herb elixirs: one of the factors at risk induced IVKD-I.

Nine medicinal plants known to be the ingredients of the traditional herbal medicinal elixir, and seven popular commercial alcoholic herb elixirs were investigated for the content of dicumarol by using high pressure liquid chromatography (HPLC) and thin layer chromatography (TLC) methods. Umbelliferae (Conioselinum Univittatum) were the only medicinal plants found to contain dicumarol 0.04 mg/dl. Dicumarol content was also found in three out of seven brands of commercial alcoholic herb elixirs with the concentration of 0.58, 1.86 and 6.00 mg/dl. These findings indicated that the traditional herbal medicinal elixirs containing dicumarol in varying amount may play a role in inducing bleeding diathesis in breast-fed infants of mothers known to consume the elixir.

The possibility of the native alcoholic drugs as etiological factor of the acquired prothrombin complex deficiency syndrome.

This study was attempted to determine whether the native alcoholic drugs had any significant role in the pathogenesis of the APCD syndrome. The native alcoholic drugs, breast milk and maternal serum were analysed for vitamin K antagonists (dicoumarol, warfarin and coumarin). No vitamin K antagonists were detected from 14 commercial native alcoholic drugs, but one of the two homemade samples had a positive test of coumarin but not dicoumarol and warfarin. Seven breast milk and serum samples from the mothers of APCD infants showed no detectable amount of vitamin K antagonists. Negative results were found in 35 postpartum women who did not consume the drugs and 22 postpartum women who took the drugs. The results suggested that the native alcoholic drugs are unlikely to be the etiological factor of APCD syndrome.