No abstract

Ankaferd Blood Stopper® (ABS), a standardized mixture of the plants Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica has been used as a haemostatic agent. However, the essential ‘mechanism of action’ of ABS is currently unknown. The aim of this study is to search the essential mechanism underlying the haemostatic actions of ABS. In our study, ABS induced a very rapid (less than 1 second) formation of a protein network within the plasma and serum. Individual clotting factors namely factor V, factor VII, factor VIII, factor IX, factor X, factor XI, factor XIII are not affected during the consecutive measurements. Plasma fibrinogen activity and antigen decreased from 302 mg/dl to 10 mg/dl, and fibrinogen antigen decreased from 299 mg/dl to 30 mg/dl, in parallel to the prolongation of thrombin time (TT). Biochemical tests also revealed that total protein, albumin, and globulin levels significantly decreased with the interactions of ABS. Red blood cells come together to form vital erythrocyte mass blocks in the presence of ABS. Vital physiological red blood cell aggregation after the exposure to Ankaferd Bloood Stopper in less than one second is depicted in Figure 1. The network of ABS could cover the entire physiological haemostatic process without unequally disturbing individual clotting factors. The basic mechanism of action for ABS appears to be the formation of an encapsulated protein network representing focal points as a niche for vital erythrocyte aggregation. ABS is a novel effective haemostatic agent that has the therapeutic potential for the management of hemorrhage in medical practice. Clinical trials with that promising medicine can provide the development of a new drug particularly active in pathological haemostasis. Figure Figure

SummaryBnckgmund: Large platelets are shown to be hemostatically more active. It has been suggested that mean platelet volume (MPV) is increased during acute myocardial infarction (AMI) and unstable angina pectoris (USAP). However, the underlying mechanism of the phenomenon remains unclear.Hypothesis: In this study, platelets, MPV, and thrombopoietin (TP) levels were investigated in patients with coronary artery disease (CAD) and healthy controls.Methods: Twenty patients with AM1 and 20 patients with USAP were included in this study. Seventeen healthy adult subjects served as controls. Venous blood samples of the subjects were drawn within 12 h after admission. Thrombopoietin levels were measured by ELISA and platelet counts and MPV were assayed by autoanalyzer.Results: Patients with AM1 and USAP had higher platelet counts than those in the control group. Although the platelet counts were slightly higher in AM1 than in USAP, this did not reach statistical significance. Mean platelet volume and levels of TP were found to be elevated in patients with AM1 and USAP compared with control subjects (p

ABS has in vivo hemostatic actions that may provide a therapeutic potential for the management of patients with deficient primary hemostasis in clinical medicine.

Objective: The purpose of this study was to show the hemostatic effect of spray, solution and tampon forms of Ankaferd Blood Stopper® (ABS), a unique medicinal plant extract historically used as a hemostatic agent in Turkish folklore medicine, in a porcine bleeding model. Materials and Methods: Two 1-year-old pigs were used as bleeding models for superficial and deep skin lacerations, grade II liver and spleen injuries, grade II saphenous vein injury and grade IV saphenous artery injury. Spray, solution or tampon forms of ABS were applied after continuing bleeding was confirmed. The primary outcome was time to hemostasis. Volume of blood loss was not measured. The pigs were euthanized at the end of the experiment. Results: Spray or direct application of ABS solution resulted in instant control of bleeding in superficial and deep skin lacerations as well as puncture wounds of the liver. A 40-second application of ABS tampon was sufficient to stop bleeding of skin lacerations, while 1.5- and 3.5-min applications were used to control hemorrhage from the saphenous vein and artery, respectively. No rebleeding was observed once hemostasis was achieved. However, repeated applications of ABS solution and tampon were only temporarily effective in the hemostasis of spleen injury. Conclusions: The data showed that ABS was an effective hemostatic agent for superficial and deep skin lacerations and minor/moderate trauma injuries in a porcine bleeding model.

Ultrastructural and morphological analyses of a novel hemostatic agent, Ankaferd Blood Stopper (ABS), in comparison to its in vitro and in vivo hemostatic effects were investigated. High-resolution scanning electron microscopy (SEM) images accompanied with morphological analysis after topical application of ABS revealed a very rapid (<1 second) protein network formation within concurrent vital erythroid aggregation covering the classical coagulation cascade. Histopathological examination revealed similar in vivo ABS-induced hemostatic network at the porcine hepatic tissue injury model. Instantaneous control of bleeding was achieved in human surgery-induced dental tissue injury associated with primary and secondary hemostatic abnormalities. Ankaferd Blood Stopper could hold a great premise for clinical management of surgery bleedings as well as immediate cessation of bleeding on external injuries based on upcoming clinical trials.

Ankaferd comprises a standardized mixture of plants Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum and Urtica dioica. Ankaferd Blood Stopper (ABS) as a medicinal product has been approved in the management of external hemorrhage and dental surgery bleedings in Turkey. This study aimed to evaluate the in-vivo hemostatic effect of ABS in rats pretreated with acetylsalicylic acid or enoxaparin. Wistar rats (210-270 g) of both sexes were used in this study. The animals were pretreated with acetylsalicylic acid (10 mg/kg) orally for 4 days or enoxaparin sodium (8 mg/kg) subcutaneously for 3 days or did not receive any anticoagulant before tail cut at 4th day. ABS was administered topically [a total of 4 ml (1 ml/puff x 4)] to the cut tail in the studied animals. The duration of bleeding and the amount of bleeding were measured in order to evaluate the hemostatic effect of ABS. In acetylsalicylic acid-treated animals, topical ABS reduced both the duration and also the amount of bleeding volume by 68.4 and 54.6%, respectively. It was also effective in shortening the duration of bleeding (30.6%) and decreasing the amount of bleeding (32.8%) in enoxaparin-treated animals. ABS, a traditional folkloric medicinal plant extract, has in-vivo hemostatic actions, which may provide a therapeutic potential for the management of patients with deficient hemostasis in the clinical medicine.

The aim of this study was to assess retrospectively the hemostatic efficacy and safety of the topical use of Ankaferd Blood Stopper (ABS) in the setting of dental surgery. Following the approval from of the Local Research Ethics Committee ABS as a hemostatic agent in Dentistry, ABS was topically applied by homogeneously spraying to the 25 patients during dental interventions. Based on this retrospective evaluation; Tissue healing was evaluated at the 48th hour. The patients received 1 to 5 mL of ABS; the median dose was 2 mL. Bleeding stopped in median 1.8 seconds (1 to 3 seconds) in the first ABS application in 20 patients. Five patients needed a second dose of ABS; four of them were given 5 mL ABS totally. No patient had wound infection and the healing process appeared to be normal. ABS is useful for the local hemostasis and wound healing in periodontal surgeries.