The liver plays a central role in haemostasis, being the site of synthesis of most of the clotting factors, coagulation inhibitors and fibrinolytic parameters, in addition to its clearance of activated clotting and fibrinolytic factors. Nonetheless, no haemostatic test(s) is included among the routine liver function tests and this study aims to probe this possibility. The liver disease group (n=258) included acute hepatitis (n=25), chronic viral hepatitis (n=128), hepatitis B (HB) carriers (n=25), liver cirrhosis (n=67), and hepatocellular carcinoma (HCC) (n=13). The prothrombin time was significantly prolonged in acute hepatitis, liver cirrhosis and HCC. However, the reptilase time was prolonged in all the groups except in HB carriers, while the thrombin time was prolonged only in the HCC group. Antithrombin III and protein C levels exhibited significant reduction in acute hepatitis, liver cirrhosis and HCC. On the other hand, protein S levels (total and free) were reduced significantly in all the patients groups, including HB carriers when compared with healthy controls. Derangement of haemostatic tests is a common feature in liver disease, being most significant in acute hepatitis, liver cirrhosis and hepatocellular carcinoma. The most sensitive markers of hepatocyte malfunction are protein S (total and free) and the reptilase time as they were abnormal, in the mildest liver affections, when other biochemical tests as well as other haemostatic tests were normal. Further studies are needed to see whether these two tests qualify for inclusion among the routine liver function tests.
Camels and many other desert animals are uniquely adapted to conserve water and other fluids in order to survive intense heat for long periods. Earlier studies have suggested that human platelets may be the trigger for the coagulopathy involved in heat prostration and stroke. The present study has compared the resistance of camel and human platelets to heat in order to see if they might help to protect camels from the effects of high body temperature for prolonged periods. The findings demonstrate that camel platelets are significantly less sensitive to heat than human platelets. Temperatures (43 degrees C-45 degrees C) that cause human cells to undergo marked structural alterations and lose their ability to spread and aggregate have no effect on camel platelets. Even higher temperatures (50 degrees C) that destroy human platelets have minor effects on camel cells and do not seriously compromise their function. Temperatures of 55 degrees C do destroy camel platelets and their functional capability. The resistance of camel platelets to heat may help protect camels from the effects of extreme body temperature and dehydration, which are everyday conditions in the desert.
Replacement blood donations are a major source of blood in KSA. This presentation highlights “the peace time and war experiences,” where the voluntary donor potential was tested. The “Peacetime Experience”—King Saud University Student Donor Drive This donor drive commenced in 1983 with 13 donors in its first and the annual collection reached 4500 blood units in the academic session 1995‐1996, when the student enrollment was around 30,000. In 2018 the enrollment jumped to 120,000 students. If we add the staff and auxiliary personnel, the population of potential voluntary blood donors will be enough to cover the current and future blood needs of King Khalid University Hospital. Unfortunately, this drive did not survive due to administrative and organizational difficulties. The “First” Gulf War Experience At the end of 1990, when the Allied Forces started to end the Iraqi occupation of Kuwait, the Saudi Ministry of Health waged a publicity campaign asking healthy individuals to donate their blood. The response was phenomenal, and the blood inventory in blood banks swelled about five‐ to sevenfold. First‐time donors broke the “fear barrier,” went through the donation experience, and it is hoped they will return to donate voluntarily. Conclusions The major lesson learned from the King Saud University student donor drive and Gulf War experience is the enormous voluntary donor potential in Saudi Arabia. There is a need for forward planning to shift the current partial involuntary donor system to a voluntary system based on nonremunerated donors.
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