A 25-year-old female asked:
raise aptt 45.2 secs cut of 36.5 and raised pt is this dangerous health anxiety terrified of clots?! gp wasnt concerned but my fibrinogen raised too
1 doctor answer • 1 doctor weighed in
Thoracic Surgery 52 years experience
Aptt 45.2 secs: Hi, what you mean cut of 36.5? is it mm, cm? and why is your aptt 45.2? Are you taking any medication to prolong the APTT? Have you had embolic events in the past?
Causes for elevated APTT
In a study of 100 cases with prolonged APTT, patients were assigned to various aetiological groups by specific investigations. Haemophilia A was seen in 20% males and Haemophilia B in 8% males in our study. Incidence of Haemophilia A has been reported in Western population to be 5 to 10 times greater than Haemophilia B, which has incidence of 1 in 5000 and 1 in 50,000 respectively.5 A study from India describes 42.4% of the patients with coagulation defects having Haemophilia A.6 after reviewing 3224 patients with inherited blood coagulation disorders have reported 46.9% having Haemophilia A and 7.4% Haemophila B.7.
In the present study 39% of patients with prolonged APTT had chronic liver disease. Raised PT and APTT in liver disease has been reported by many workers and is attributed to decreased synthetic capacity of liver resulting in reduction of coagulation factors. However in many cases a marginal increase in APTT may be seen.
In the present study 20% patients had disseminated intravascular coagulation (DIC), out of which 70% were females. Raised APTT does not reflect true incidence of DIC in patients as increase in APTT is seen only in 50% to 85.7% patients of DIC.5,11 Raised APTT and bleeding episodes have been reported in 87% patients of acute DIC, while in chronic DIC, PT and APTT may be normal and the underlying cause of DIC may affect the laboratory findings.
In the present study mean age of Haemophilia A patients was 19.45+2.0 years and of Haemophilia B patients was 23.25+3.10 years. In haemophiliacs congenital defect is often discovered by a prolonged episodes of bleeding after minor injuries.13 A considerable higher mean age of 30.9 years for Haemophilia A and 29.2 years for haemophilia B has been reported from Europe.7 A higher mean age of haemophilia patients in developed countries may be due to better emergencies / medical facilities available to these patients.
In the present study liver disease patients belonged to a higher age groups (mean age of males 38.5+2.96 years and of females 47.00+2.76 years which is lower than many studies reports on chronic liver disease.
In this study DIC patients mean ages were 28.83+5.56 and 31.6+3.6 years in males and females respectively. There is consensus that DIC may occur at any age.2,10,11,16 In the present study mean haemoglobin in Haemophilia A was significantly (p<0.05) lower than controls, although degree of anaemia was not remarkable. Anaemia has been described as a common feature of Haemophilia A but haemoglobin level varies with degree and proximity of bleeding episodes.
In the present study liver disease patients showed a significant ( p value <0.005) lower level of haemoglobin as compared to normal controls. Anaemia in chronic liver disease has been to be post haemorrhagic or due to hypoplastic bone marrow, viral infections and shortened red cells life span. Folate (folic acid) deficiency in alcoholic cirrhosis, haemolysis due to congestive splenomegaly or lipid disturbances may also contribute towards anemia.
APTT test should be included in the investigations for screening in bleeding tendencies and preoperative to prevent fatal haemorrhage. In order of frequency the causes of prolonged APTT in our set up are liver disease, followed by DIC, Hemophilia A, an
1.3k viewsAnswered >2 years ago
A 21-year-old member asked:
What exactly is generalized anxiety disorder (gad)?
4 doctor answers • 20 doctors weighed in
Psychiatry 21 years experience
GAD: Gad is the presence of anxiety that is impairing, problematic, and/or extreme. The anxiety is present most days, throughout the day, and does not have to have a trigger. The anxiety tends to be about anything & everything (hence the generalized part) and out-of-proportion to the reality of one's situation. It's rooted in biological, life story, dimensional, spiritual and/or behavioral perspectives.
6.1k viewsReviewed >2 years ago
A 21-year-old member asked:
What are the best treatments for gad, social anxiety, and free-floating anxiety?
2 doctor answers • 3 doctors weighed in
General Practice 18 years experience
Mindfulness: Reading on "mindfulness" is an effective way to treat anxiety without medications.
6.3k viewsAnswered >2 years ago
A 52-year-old member asked:
What do you do when you're experiencing anxiety attacks?
2 doctor answers • 4 doctors weighed in
Preventive Medicine 43 years experience
4:7:8 breathing: Dr. Andrew weill recommends this breathing technique: put the tip of your tongue behind your upper teeth, breathe in through your mouth for a count of 4, hold your breath for a count of 7, then exhale through slightly pursed lips for a count of 8. Practice twice a day, but don't do more than 4 breath cycles at a time. It can be useful when you start to feel anxious or any time for relaxation.
6.3k viewsReviewed >2 years ago
A 34-year-old member asked:
Could somebody tell me if vaseline will help fight infection if I cut myself to the bone?
2 doctor answers • 2 doctors weighed in
Wound care 35 years experience
Vasoline: Vasoline will not directly help fight infection in a cut to the bone. It will provide a moisture barrier for the wound. In wound care, we like the concept of moist healing. However, any cut that makes it as deep as bone requires a visit to a clinician to make sure the wound base is clean. In addition, we have many products to place into the wounds that are better than vasoline.
6.2k viewsAnswered >2 years ago
My 11 year old son cut his shin open on a piece of metal, does not need stitches, we can't remember when his last tetnus shot was, what are symptoms to look for ? Thank you.
2 doctor answers • 4 doctors weighed in
Family Medicine 25 years experience
Things to consider. : Your son is 11 years of age and he is due to have a tetanus booster at this age. As for the shin cut, hopefully it was cleaned with hydrogen peroxide and treated with an antibiotic ointment. The best thing to do is to schedule an appointment with his pediatrician or family physician to get his shot and check on his cut.
5.7k viewsReviewed >2 years ago
Last updated Sep 26, 2016
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