International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
Bootstrap Slider

Indexed and Abstracted in: SCOPUS, Crossref, CAS Abstracts, Publons, CiteFactor, Open J-Gate, ROAD, Indian Citation Index (ICI), Indian Journals Index (IJINDEX), Internet Archive, IP Indexing, Google Scholar, Scientific Indexing Services, Index Copernicus, Science Central, Revistas Medicas Portuguesas, EBSCO, BOAI, SOROS, NEWJOUR, ResearchGATE, Ulrich's Periodicals Directory, DocStoc, PdfCast, getCITED, SkyDrive, Citebase, e-Print, WorldCat (World's largest network of library content and services), Electronic Journals Library by University Library of Regensburg, SciPeople.

Search Articles

Track manuscript

Readers around the world

Full Html

IJCRR - Vol 12 Issue 11, June, 2020

Pages: 18-20

Date of Publication: 03-Jun-2020


Print Article   Download XML  Download PDF

Coagulation Profile in Liver Disease

Author: Chetali Rupela, Bhavika Vaghela, Hansa Goswami

Category: Healthcare

Abstract:Background: The liver is the cornerstone of the coagulation system. The physiology of blood coagulation is closely linked to liver function as the liver synthesizes most of the factors of the coagulation cascade and fibrinolytic proteins.
Aims And Objectives: The objective of this study was to evaluate coagulation abnormalities associated with chronic liver diseases and determine the coagulation abnormalities using various coagulation studies PT (Prothrombin time), APTT (activated partial thromboplastin time).
Material and Methods: This study included 50 patients clinically diagnosed with liver disease and who were divided into three categories \? cirrhosis, hepatitis, and other liver diseases.
Results: Out of 45 patients with liver disease, 39 were having altered coagulation profile and 28 were having altered biochemical parameters.
Conclusion: We concluded that various abnormalities of coagulation tests vary greatly with different liver disorders, duration of the disorders, and their severity. Prolongation of prothrombin time (PT) and activated partial thromboplastin time (APTT) in advancing liver cirrhosis indicates damage to the liver parenchyma resulting in decreased production of coagulation proteins with increased risk of bleeding tendencies, which can be detected before these ensue.

Keywords: PT, APTT, Liver Disease

Full Text:

INTRODUCTION

The physiology of blood coagulation is closely linked to liver function as the liver synthesizes most of the factors of the coagulation cascade and fibrinolytic proteins. In addition, the liver is also involved in facilitating the clearance of activated clotting and fibrinolytic factors.(1,2)

Patients with liver disease are at a substantially increased risk of thrombosis and hemorrhage. Owing to the substantial overlap in the hemostatic abnormalities observed in the patients with acute infectious or toxic hepatitis, chronic hepatitis, and cirrhosis, the severity of hepatocellular dysfunction is typically more informative than the etiology. Prothrombin time (PT) correlates well with the severity of hepatocellular damage as well as with the occurrence of abnormal bleeding and the overall prognosis. Studies have shown that significant prolongation of prothrombin time and activated partial thromboplastin time (APTT) in the absence of significant hypofibrinogenemia suggests their importance as a reliable marker coagulopathies in chronic liver disease patients.(3,4)

MATERIALS AND METHODS:

This study included 3 months data from may 2019 to july 2019 ( 45 patients) clinically diagnosed with liver disease attending medicine clinics in civil hospital, Asarwa in Ahmedabad. Inclusion Criteria:

  • Primary criterion of inclusion was presence of liver disease including cirrhosis, hepatitis, pseudocyst, liver abscess, and all other liver diseases. All patients of both sexes, age ranging from 20 to 70 years and irrespective of socioeconomic status, were included.

  • Exclusion Criteria: Patients with previous history of coagulation disorders or who took any of the following drugs in the previous week were excluded: aspirin or nonsteroidal anti-inflammatory drugs, antihistaminics, penicillin, thiazides, sulfonamides, beta blockers, and anticoagulants.

  • Sample Collection and Procedure

  • Blood sample was withdrawn by specially trained phlebotomists from antecubital vein in the forearm by means of vacuttee containing 3.2% sodium citrate as anticoagulant. While taking the sample, tourniquet was not tied, as it can change the hemoconcentration and results may vary. The ratio of volume of blood to anticoagulant was 9:1. Plasma was obtained following centrifugation of the anticoagulated blood at 3000 rpm for 20 minutes.

    Coagulation tests for prothrombin time, activated partial thromboplastin time (APTT), International normalized ratio (INR)   were done using fully automated coagulometer. Biochemical parameters for liver disease were done using Fully auto analyzer. Both tests were done maintaining ultimate quality control.

RESULTS:

    • The findings for age and sex distribution are compatible with previous studies. The patient’s age ranged from 20 to 70 years. The maximum patients were in the age group ranging from 40 to 50 years. Thus, all the patients were above 20years.

       The patients presented with complaints, such as jaundice, fever, anorexia, fatigue, weight loss, edema of limbs, abdominal pain, and ascites. Among 45 cirrhotic patients, the most common presenting complaints

PRESENT STUDY DATA:

DISCUSSION:

The Prothrombin Time is the test widely accepted means to monitor patients having disorders of specific coagulation factors in the extrinsic and common pathway of coagulation. In the present study, 86.6% (39/45) patients had prolonged Prothrombin Time in liver disease. INR (International normalized ratio) was raised in 86.6% (39/45) patients with liver disease.

The Activated Partial Thromboplastin Time is the test for intrinsic coagulation pathway. It is especially sensitive for factors XII, IX, XI, XIII, and platelet factor 3 adequacies. There were 82.2% (37/45) patients of liver diseases having prolonged Activated Partial Prothrombin Time. Biochemical parameters for liver disease were raised in 28 patients out of 45 (62.2%).

The present study correlates with Sohail Ahmed Siddiqui study in which there was 87.7 % alteration in PT and 71.3 % alteration in APTT in patient with liver disease. Also it correlates with Sylvester Chuks Nwokediuko study in which there was 36.6 % alteration in PT and 22.6 % alteration in APTT in patient with liver disease.

CONCLUSIONS:

In this study, we conclude that patients with liver disease have prolonged prothrombin time (PT), activated partial thromboplastin time (APTT) and international normalized ratio (INR). There was significant prolongation of Prothrombin Time in 39 patients out of 45 (86.6%) and Activated Partial Thromboplastin time in 37 patients out of 45 (82.2%) with liver disease.

Study of coagulation profile can help in assessing hepatic cell function and detecting cellular injury. Prolongation of Prothrombin Time and Activated Partial Thromboplastin Time in advancing liver cirrhosis indicates a damage of liver parenchyma resulting in decreased production of coagulation proteins with increased risk of bleeding tendencies, which can be detected before these ensue, by the determination of Prothrombin Time and Activated Partial Thromboplastin Time levels.Thus, preventing patients from landing in life- threatening bleeding complications.

 ACKNOWLEDGEMENT: I would like to thank below mentioned references for their useful suggestions during publication making.

Lastly, I would like to thank patients of B.J medical college, Ahmedabad  for support and cooperation.

Financial Support: None

Conflict of interest: None

References:

      1. Kaul V, Munoz JS., Coagulopathy of liver disease. Curr Treat Options G Astroenterol 2000 Dec; 3 (6): 433-437.

      2. Shah SN, Jansari T., Coagulation profile in liver disease—study of  100 cases. Gujarat Med J 2014; 69 (1): 37-40.

      3. Devrajani BR, Ali Talpur MA, Atta-ur-Rahman A, Ali Shah SZ, Das T, Devrajani T. ,  Coagulopathies in patients with liver cirrhosis. World Appl Sci J 2012; 17 (1): 01-04.

      4. Ahmad Hameed NS, Irfan Khursheed AS, Hamid A, Naveed IA An assessment of coagulation parameters in liver cirrhosis. Biomedica 2006 Jan-Jun; 22: 74-77.

      5. Siddiqui SA, Ahmed M, Ghani MH, Memon MA, Mustafa G, Ghori MA: Coagulation abnormalities in patients with chronic liver disease in Pakistan, J Pak Med Assoc, Vol. 61,No. 4,April 2011;363-367.

      1. Nwokediuko SC, Ibegbulam OG: Platelet Function and Other Indices of Hemostasis in Chronic Liver Disease, Gastroenterology Research,2010;3(4):167-170

      2. Van Nieuwenhuizen RC, Peters M, Lubbers LJ, Trip MD, TijssenJGP , MulderBJM . Abnormalities  in liver function and coagulation profile following the Fontan procedure. Heart 1999;82:40-46.

                               8. Devrajani BR, Ali Talpur MA, Atta-ur-Rahman A, Ali Shah SZ, Das T,  Devrajani                                    T. Coagulopathies in Patients with Liver  Cirrhosis, World Applied Sciences                                             Journal, 2012; 17 (1):01-04.

Research Incentive Schemes

Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

Emerging Researcher Award:

‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma COLAKOGLU entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by Arpita M. et al entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09
Late to bed everyday? You may die early, get depression
Egg a day tied to lower risk of heart disease
88 Percent Of Delhi Population Has Vitamin D Deficiency: ASSOCHAM Report

List of Awardees

Awardees of COVID-19 Research

Woman Researcher Award

A Study by Neha Garg et al. entitled "Optimization of the Response to nCOVID-19 Pandemic in Pregnant Women – An Urgent Appeal in Indian Scenario" published in Vol 12 issue 09

A Study by Sana Parveen and Shraddha Jain entitled "Pathophysiologic Enigma of COVID-19 Pandemic with Clinical Correlates" published in Vol 12 issue 13

A Study by Rashmi Jain et al. entitled "Current Consensus Review Article on Drugs and Biologics against nCOVID-19 – A Systematic Review" published in Vol 12 issue 09

Emerging Researcher Award

A Study by Madhan Jeyaraman et al. entitled "Vitamin-D: An Immune Shield Against nCOVID-19" published in Vol 12 issue 09

Study by Dheeraj Kumar Chopra et al. entitled "Lipid-Based Solid Dispersions of Azilsartan Medoxomil with Improved Oral Bioavailability: In Vitro and In Vivo Evaluation" published in Vol 12 issue 19


RSS feed

Indexed and Abstracted in


Antiplagiarism Policy: IJCRR strongly condemn and discourage practice of plagiarism. All received manuscripts have to pass through "Plagiarism Detection Software" test before forwarding for peer review. We consider "Plagiarism is a crime"

IJCRR Code of Conduct: We at IJCRR voluntarily adopt policies on Code of Conduct, and Code of Ethics given by OASPA and COPE. To know about IJCRRs Code of Conduct, Code of Ethics, Artical Retraction policy, Digital Preservation Policy, and Journals Licence policy click here

Disclaimer: International Journal of Current Research and Review (JICRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal.



Company name

International Journal of Current Research and Review (JICRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

Contact

148, IMSR Building, Ayurvedic Layout,
        Near NIT Complex, Sakkardara,
        Nagpur-24, Maharashtra State, India

editor@ijcrr.com

editor.ijcrr@gmail.com


Copyright © 2020 IJCRR. Specialized online journals by ubijournal .Website by Ubitech solutions