Standardization of Anti-Xa Assay and its Comparison with Activated Partial Thromboplastin Time for Monitoring Unfractionated Heparin Therapy.

Monitoring of anticoagulant activity of unfractionated heparin (UFH) is primarily done with activated partial thromboplastin time (aPTT), which is affected by many factors. Anti-Xa assays are considered to overcome these factors and may provide a better method for monitoring patients on UFH with a narrow therapeutic range. This study aimed to compare the effectiveness of aPTT and anti-Xa assays in UFH monitoring. A prospective non-randomized study was carried out in two stages: first, the anti-Xa assay was standardized using kit instructions; each sample was then analyzed by both tests. The outcomes of the two assays were compared and assessed for agreement of maintaining therapeutic anticoagulant levels. These levels for anti-Xa assay were between 0.3 and 0.7 IU/ml, while it was 1.5-2.5 times the control for aPTT assay. Below this range was regarded as subtherapeutic, and above this as supratherapeutic. A total of 90 samples were tested and analyzed using both assays. Most of them (> 70%) were noted to be in subtherapeutic levels with both tests. The overall concordance was 73.3%, and the estimated kappa value was 0.483 (0.396-0.57). The correlation between aPTT and anti-Xa assay was 0.74 (p < 0.001). With anti-Xa levels in the therapeutic range, aPTT levels were in subtherapeutic in 60% and supratherapeutic in 13.3% cases. Although both the testing strategies had a good agreement and correlation, discordance was observed in interpretative values with anti-Xa levels in therapeutic range and aPTT levels in non-therapeutic range. Its clinical implications need to be evaluated further in future studies.

Haematological screening and its correlation with sociodemographic profile among the indigenous communities in and around Puducherry.

Background: Haemoglobin disorders are unique and important health challenges for tribal populations. Hence, this study was undertaken with the aim to screen for haematological disorders, particularly anaemia and haemoglobinopathies, and to assess the sociodemographic profile in indigenous communities residing in and around Puducherry. Methods: This was a community-based cross-sectional study conducted in both urban and rural areas of Puducherry district. We included 556 participants through convenient sampling. Trained research associates visited community to enrol eligible participants and sought information on sociodemographic parameters, health status, and disease profile, using a structured questionnaire; 2-3 ml of blood was collected in ethylene diamine tetra acid anticoagulant for analysis of haematology parameters. Results: Median age of participants was 28 (17-42) years. Majority (58.8%) of the participants were female, married (52.8%). On thalassemia screening, none of the study participants had any haemoglobinopathy. The burden of anaemia among the study population was 38.7% (95% CI: 34.6-42.8%) and was higher among the female participants in both adolescent (54.5%) and adult (57.8%) age groups. The next common haematological abnormality observed was eosinophilia 21.4% (95% CI: 18-25%), more prevalent among males in the age group of 30-60 years. Conclusion: More than half of the women were anaemic. Multidimensional planning and implementation are needed to improve the socio-economic profile and overall health of this vulnerable population.