Prothrombin-activator (thromboplastin) generation in the blood of water snake (Natrix piscator).

The generation of prothrombin-activator (thromboplastin) in water snake (Natrix piscator) is clearly delayed, compared to a mammalian system, but the final activity is well comparable to that in man, when homologous sources of "phospholipid" (erythrocyte-lysate) and of substrate plasma are employed in one stage "thromboplastin generation test". The use of heterologous source of either of the above reagents resulted in significantly longer clotting times; hence the need for homologous source of above reagents in the test is emphasized for comparative studies on animal haemostasis.

Comparative studies of blood coagulation in hibernating and non-hibernating frogs (Rana tigrina).

1. During hibernation in frogs (Rana tigrina) there occurs prolongation of several clotting tests, viz, whole blood clotting time, plasma recalcification time, cephalin time and prothrombin time. 2. The ambient body temperature of the frog during winter hibernation is low and the retarded blood clotting at lower temperature may play an important protective role against intravascular thrombosis. 3. Shorter plasma recalcification time in low-spun plasma as compared to high-spun plasma indicated the presence of procoagulant activity in platelets/leucocytes of frogs.

Hemostatic parameters in newborn--I. Effect of gestation and rate of intrauterine growth.

The present study comprises of 208 term, 159 preterm and 18 post-term neonates born to mothers with no history of drug intake or any disease likely to effect coagulation of the newborn. PT, TT and KCCT were relatively prolonged and plasma fibrinogen reduced to varying degree in newborns (as compared to adults). There was further prolongation of TT and reduction in plasma fibrinogen levels amongst preterm newborns as compared to term babies; TT was more prolonged amongst post-term babies also. PT was significantly more prolonged till 30 weeks of gestation, after which a near plateau was formed. KCCT showed significant improvement after 33 weeks and a further trend to normalisation after 38 weeks of gestation. Serum FDP values showed too much of variation for any meaningful statistical analysis but generally FDPs were higher in preterm babies. Intrauterine growth rate had no significant effect on these parameters amongst preterms - similar values for SGA (small for gestational age), AGA (appropriate for gestational age) and LGA (large for gestational age). On the other hand, amongst term babies SGA neonates had significantly prolonged PT and low plasma fibrinogen as compared to AGA; LGA babies also showed more prolongation of TT as compared to AGA.

Hemostatic parameters in newborn--II. Sequential study during the first four weeks of life.

A sequential study of kaolin cephalin clotting time (KCCT), prothrombin time (PT), thrombin time (TT), plasma fibrinogen and serum FDP was conducted during the first four weeks of life on term and preterm babies. A "physiological dip" of PT and TT was noted inappropriate for gestational age (AGA) babies both term and preterm; in case of KCCT, the dip was significant in term AGA babies only. At the end of four weeks, PT and TT had moderately improved in term babies but showed little improvement in preterm ones; KCCT reached almost an adult value in all babies except in preterm AGA and term LGA (large for gestational age) ones. Plasma fibrinogen showed no "physiological dip" and reached adult level in two to four weeks. Serum FDP levels were appreciably raised in preterm AGA babies only at birth and there too normalised by 72 h.

Blood fibrinolytic system in rana tigrina.

Fibrinolytic activity as well demonstrable in the blood of Rana tigrina. There occurs prompt lysis of diluted plasma; and the plasma euglobulin fraction shows lysis on both unheated and heated fibrin (human or bovine) plates, implying the presence of plasmin-like enzyme in this fraction. The fibrinolytic activity is remarkably inhibited by the erythrocyte-lysate and is moderately enhanced by leucocytes-thrombocytes. EACA suppresses the lysis of dilute cell-free plasma clots at concentrations of 10(-4) M or more, possibly indicating the presence of plasminogen activator in the plasma. Activation of fibrinolysis by human urokinase and not by streptokinase, shows the probable presence of plasminogen and absence of proactivator.

Blood coagulation and fibrinolysis in haemorrhagic stroke.

Studies of 11 patients with haemorrhagic stroke revealed no significant change in kaolin cephalin clotting time, prothrombin time, thrombin time, PF 3 availability, platelet count and factor V and VIII during the first week. Plasma fibrinogen was significantly increased while factors VII + X were decreased (borderline significance). Prolongation of plasma recalcification time and decrease in heparin tolerance reached borderline significance. There was moderate, but significant, increase in serum antithrombin activity and plasma (euglobulin fraction) fibrinolytic activity.

Use of antifibrinolytic therapy in prostate surgery.

The prophylactic use of the antifibrinolytic drug, PAMBA, in a small intravenous dose preoperatively, combined with local irrigation postoperatively, effectively reduces blood loss. The drug is safe and relatively free of adverse side effects, but attentive postoperative care is warranted.

Hemostatic changes in neonates with anoxia and sepsis.

Hemostatic profile (prothrombin time (PT), thrombin time (TT), kaolin cephalin clotting time (KCCT), plasma fibrinogen, serum fibrin/fibrinogen degradation products (FDP) and platelet counts) was examined in 153 neonates with birth anoxia and 86 with sepsis. Remarkable hemostatic alterations occurred in neonates with severe anoxia and sepsis, while those with moderate anoxia exhibited minimal or no change. Vitamin K administration to anoxic babies showed no improvement in the hemostatic profile after 48-72 hours. The hemostatic alterations were presumably due to incipient disseminated intravascular coagulation (DIC). In spite of the marked coagulation changes, only 3 neonates with sepsis and none of the anoxic newborns presented with clinical bleeding indicating a well balanced hemostatic mechanism.

Reduced fibrinolytic activity in aqueous humor of chronic simple glaucoma.

Fibrinolytic activity of aqueous humor was tested by the Astrup fibrin plate lysis technique in 7 patients who had chronic simple glaucoma and was compared with a control group of 7 patients with senile cataract. The plasminogen activator content of aqueous humour in glaucoma patients was remarkably reduced; it was not demonstrable in as many as six out of seven patients. The lysis zones in the control group ranged from 110 to 900 mm2 with an average of 423 mm2. The want of aqueous fibrinolytic activity may have a pathogenetic implication for glaucoma since deposition of fibrin in the angle of the eye to depressed fibrinolytic activity could increase resistance to aqueous flow.

A study of factors related to rural job preference among prospective nursing graduates.

Four hundred and thirty prospective nursing graduates from ten schools and five colleges in India were studied to identify factors related to their preferences for work in urban or rural areas. Seventy per cent expressed a preference for urban work. Significant factors related to rural preferences were: religion and background (rural or urban); type of educational institution (government or non-government); and living in a rural setting during community nursing experience. Of the personal, professional and socio-cultural factors related to rural work preference, the most significant were: accomodation, sanitation and safe water; job availability for spouse, security, and school for children. Of the personal and professional factors, the most important were: continuing education opportunities, job satisfaction, and intellectual stimulation.