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Article
Evaluation of treatment modalities of acute idiopathic throm- bocytopenic purpura in Al-zahraa teaching hospital in Al-Najaf

Author: Aymen A . AL-Bakaa أيمن البكاء
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2015 Volume: 11 Issue: 19 Pages: 130-136
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Background: Acute idiopathic thrombocytopenic purpura(I.T.P) is a bleeding disorder in which the immune system for unknown reason produce antibodies against platelets, which are necessary for normal blood clotting resulting in decrease number of circulating platelets, manifested itself by bleeding tendency, easy brusing or extravasation of blood from capillaries in the skin and mucous membrane .Objective: to choose the most appropriate therapy for acute idiopathic thrombocytopenic purpura management .Methods : 65 patients were enrolled in this retrospective study, who were admitted to AL-Zahraa teaching hospital from January 2000 to January 2010 . Relevant information were collected according to preceding data collection sheet that include age, sex, initial hemoglobin and platelets count, treatment given, response to therapy…These patients subdivided into 3 groups according to initial drug used for their management either prednisolone, I.V.immunoglobulin-G, or anti-D. The response was analyzed according to rapid rise of platelets number in the pre-treatment state. chronic cases of I.T.P were excluded from this study .Results: All patients were aged from 2-12 years with peaks of 2-5 years. Sex ratio (femalemale) of 1:1.7 .Our study showed that out of 65 patients, 37(57%) of them were assigned as group 1 who received prednisolone as a conventional therapy ,the response was noted in 31( 86.5%) after few days of treatment. Regarding group 2 patients received I.V immunoglobulin-G, the response of platelets rise was noted in 16( 89%) of cases out of 18 patients . While(10) patients in group 3 who received anti-D as main line of treatment to Rh-positive individuals, the response is observed in only 6( 60%) of cases . Conclusion: Regarding various treatment modalities of idiopathic thrombocytopenic purpura ,it has been noted that oral prednisolone is the best, single, readily available, inexpensive drug that can be taken orally and as outpatient . Recommendation:The availability of other treatment options such as I.V-immunoglobulin-G should be adopted in our hospitals in cases of life- threatening illness as it induces more rapid rise in platelets in comparison with other drugs.

نبذة تعريفية : مرض نقص الصفيحات الدموية هو خلل نزفي ، حيث يقوم فيه جهاز المناعة ولأسباب غير معروفة بإنتاج أجسام مضادة ضد الصفيحات الدموية المسئولة عن تخثر الدم مما يؤدي إلى نقص عددها وبالتالي يؤدي إلى ظهور اعراض نزفية متمثلة بسهولة نضح الدم من الاوعية الدموية الشعرية تحت الجلد و الاغشية المخاطية.الاهداف : لاختيار العلاج المناسب لمرض نقص الصفيحات الدموية الحاد والغير معروفة اسبابه .الطريقة : ما يقارب من 65 مريضا وضع ضمن هذه الدراسة الراجعة من الذين أدخلوا الى مستشفى الزهراء التعليمي من الفترة كانون الثاني2000الى كانون الثاني2010 ، المعلومات المتعلقة جمعت حسب ورقة استبيان مسبقة شملت : العمر، الجنس ، النسبة الاولية للهيموكلوبين وعدد الصفيحات الدموية ، العلاج المعطى ، الاستجابة للعلاج ..... هؤلاء المرضى صنفوا الى ثلاث مجاميع بناءا على نوع الدواء المستخدم في العلاج كالبريدنيزولون أو الايميونوكلوبيولين-ج أو علاج الانتي-د . الاستجابة صنفت على اساس مدى سرعة الزيادة في عدد الصفيحات الدموية مقارنة بالحالة قبل العلاج. الحالات المزمنة لمرض نقص الصفيحات الدموية استثنيت من هذه الدراسة .النتائج :جميع المرضى يتراوح اعمارهم بين2-12 سنة مع زيادة نسبتهم قي الفئة العمرية2-5 سنة . وكانت نسبة الاناث للذكور 1/1.7 . دراستنا اظهرت ان 37 مريض من بين 65 صنفوا كمجموعة اولى والتي اعطيت حبوب البريدنيزولون كعلاج اولي حيث كانت الاستجابة عند31 (86.5%) مريضا بعد بضعة ايام من العلاج . وبالنسبة للمجموعة الثانية (18)التي اعطيت الائيميونوكلوبيولين-ج...كانت الاستجابة في زيادة عدد الصفائح(89%.)أما المجموعة الثالثة(10 )التي اعطيت الانتي-د فكانت الاستجابة (60%).الاستنتاج :اظهرت النتائج بالنسبة لمختلف الادوية المستخدمة في علاج نقص الصفيحات الدموية الحاد ان حبوب البريدنيزولون تعطي نفس النتائج تقريبا كما انها الافضل لانها متوفرة ورخيصة ويمكن استخدامها عن طريق الفم وفي البيت .التوصيات : ان توفبر خيارات اخرى من العلاج كلايمييونوكلوبيولين-ج الوريدي يجب ان تتبناه مستشفياتنا في حلات الامراض المهددة للحياة وذلك لانها تحدث استجابة سريعة في زيادة الصفيحات الدموية بالمقارنة مع بقية العلاجات .


Article
Childhood Idiopathic Thrombocytopenic Purpura: A Retrospective Analysis Of Clinical Features And Response To Treatment

Author: Sawsan S. Abbas
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2006 Volume: 48 Issue: 3 Pages: 258-261
Publisher: Baghdad University جامعة بغداد

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Abstract

Background : A retrospective study was done in the Pediatric ward /AL-Kadhimiyia Teaching Hospital on cases diagnosed as idiopathic thrombocytopenic Purpura admitted since the first of January1992 – the end of December 2004.
Aim of the study : The objective of this paper is to review the natural history of idiopathic thrombocytopenic Purpura , presenting feature and response to treatment.
Patients and methods : The review included age ,sex , clinical presentation , physical finding , complications , investigation ,treatment and course of the diseases .
Results: total number of the patients were 65, peak age was between (2 -5) years, 40 cases (61.53 %). Females were affected more than Males with male: female ratio of 1: 2.09 .There was no seasonal variation and all of the cases were preceded by viral upper respiratory tract infection .The main presentation was petechiae and ecchymosis, were found in all of them (100%) followed by epistaxis, 43 cases (66.15 %). In the majority the platelet count was < 20.000 X 10 9 /L, 32 cases (49.23 %) and the hemoglobin level was between 10 – 11gm /dl in most of them, 43 cases (66.15%). Steroid was the first line treatment, response occur within 2 – 3 weeks in the majority, 51 cases (78.46%). Chronic idiopathic thrombocytopenic Purpura occurred in 3 cases only (4.61 %).Splenectomy was done in 2 of them (66.66%). No mortality detected.Conclusion : Idiopathic thrombocytopenic purpura is a mild disease with complete recovery in the majority of patients.

Keywords

Thrombocytopenia --- Purpura --- Children


Article
Chronic Idiopathic Thrombocytopenic Purpura Effects of Certain Variables on the Response to Treatment.

Author: Khudhayer A. Al-Khalissi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 1 Pages: 45-49
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Idiopathic thrombocytopenic purpura is an acquired chronic autoimmune disease .Treatment whenindicated is usually by corticosteroids,then splenectomy if no acceptable response,with variableresponse rate to both types of treatment.OBJECTIVE:To look for the effects of certain variables on the type of response to steroid therapy in patients withadult idiopathic thrombocytopenic purpura, and to study the outcome of splenectomy in relation toprevious steroid therapy.METHOD:A prospective study on 80 patients, presented with bleeding and a platelet count of ≤ 30 X 109 / L.Initially treated with prednisolone and the response was studied in relation to gender , age , duration ofbleeding and platelet count on presentation. Patients who failed to maintain permanent completeremission were advised to have splenectomy.RESULTS:Of the 80 patients, 62 (77.5 %) were females and 18 (22.5%) were males. Mean age was 23 ± 10.1years. Ten (12.5%) patients only had permanent complete remission after steroid therapy. While 70(87.5%) patints failed. Response to steroid therapy was significantly related to duration of bleeding butnot to gender, age and platelet count. Thirty seven (46%) patients underwent splenectomy, permanentcomplete remission were achieved in 29 (78.2%).CONCLUSION:1. Duration of bleeding of ≤ 3 weeks is a good predictor of successful steroid therapy.2. Results after splenectomy is not related to previos steroid therapy


Article
Study of risk factors for neonatal thrombocytopenia in preterm infants

Author: Basil M. Hanoudi
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2015 Volume: 14 Issue: 1 Pages: 64-69
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Thrombocytopenia is a common hematological problem in neonatal care units. Neonatal thrombocytopenia has been defined as platelet count less than 150x109 /L, regardless of gestational age.Objectives: To determine the frequency and assess the severity of neonatal thrombocytopenia in preterms, and the maternal and neonatal conditions as risk factors. Patients and methods: A cross sectional study was carried out in the neonatal care unit of Child Central Teaching Hospital/ Baghdad, over a period of six months (30th of June to 31st of December 2013). Study group included only preterms who had thrombocytopenia. Data of neonates was collected by direct interviewing of the mothers or other family members, clinical assessment and examination and relevant investigations were done.Results: The frequency of preterm neonatal thrombocytopenia was 95 (13.04%), out of 728 neonates admitted to neonatal care unit. Male to female ratio was 1.37:1, male gender was significantly associated with prematurity and mild to moderate severity thrombocytopenia (P 0.016, P 0.019). Prematurity was significantly associated with late onset neonatal thrombocytopenia (P 0.035). Late-onset thrombocytopenia, and 32- <37 wk gestational age group were significantly associated with mild to moderate severity thrombocytopenia group (P 0.008, and 0.004 respectively). Sepsis was a frequently associated risk factor in thrombocytopenic preterms, and found in 70 (73.68%) cases of preterm thrombocytopenia (with only 8 cases were culture positive and 62 cases were clinical based diagnosis). Also birth asphyxia, respiratory distress syndrome, and Rh incompatibility were significantly associated with thrombocytopenic prematures (P 0.026, 0.001, 0.008 and 0.036 respectively). Birth asphyxia, respiratory distress syndrome, sepsis and Rh incompatibility were significantly associated with moderate to severe thrombocytopenia (P 0.001, 0.001, 0.003 and 0.011 respectively). There was no significant difference between the presence of maternal disease and gestational age to the severity of neonatal thrombocytopenia (P 0.458, 0.698 respectively).Conclusions: Preterm thrombocytopenia is relatively common in neonatal care units. Sepsis, respiratory distress syndrome and birth asphyxia were significant neonatal risk factors of thrombocytopenia at lower gestational age preterms. Most episodes were late onset with mild or moderate severity.


Article
Idiopathic Autoimmune Thrombocytopenic Purpura (ITP) in adult; review of 50 cases admitted to Baghdad teaching hospital

Authors: Alaa F. Alwan --- Adil S. Al-Aqabi
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2010 Volume: 52 Issue: 2 Pages: 169-173
Publisher: Baghdad University جامعة بغداد

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Background: Idiopathic autoimmune thrombocytopenia purpura (ITP) is an isolated thrombocytopenia in a patient with no clinically apparent associated conditions or factors that can cause thrombocytopenia. The syndrome of ITP is caused by platelet-specific auto-antibodies that bind to autologous platelets. The diagnosis of ITP is usually a diagnosis of exclusion based on a demonstration of peripheral thrombocytopenia. Steroids are the conventional first-line therapy for adult ITP. Most patients demonstrate a response to steroids within 2 to 4 weeks, but a late response is possible.
Patients and Methods: A prospective study on 50 patients with diagnosis consistent with ITP, initially treated by steroid, patients who were non responders to steroids or relapsed following its withdrawal offered splenectomy
Results: Ten patients (20 %) had permanent satisfactory remission following steroid therapy, while other 40 patients (80 %) were either non responders (20 patients, 40 %) or relapsed (20 patients, 40%). Twenty patients (40%) underwent splenectomy, all of them initially responded, after 3-6 months, 17 patients of them (85%) were still in complete remission, while 3 patients (15%) were refractory ITP and required further treatment.
Conclusion: Steroid therapy is less effective in achieving satisfactory remission in adult patient with ITP; on the other hand, splenectomy had more sustained response after steroid failure.


Article
Evaluation of Prognostic Factors in Newly Diagnosed Childhood Primary Immune Thrombocytopenia (ITP): Two - Year Prospective Study at Al-Sadder Hospital, Missan Province
تقييم عوامل التكهُن في ندرة الأقراص الدموية المناعي الأولي: سنتان من الدراسة التقدمية في مستشفى الصدر / محافظة ميسان

Author: Salah Hashim AL-Zuhairy
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2013 Volume: 10 Issue: 4 Pages: 855-869
Publisher: Babylon University جامعة بابل

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Background: Primary immune thrombocytopenia (ITP) is a common benign bleeding disorder in childhood. It generally presents with the sudden appearance of bruising, bleeding, or petechiae in an otherwise healthy child, often after a preceding viral illness. Objective: Study the presenting socio demographic, clinical and laboratory features, and types of treatment of newly diagnosed children with ITP, and to determine their effects on the course, and outcome of the disease.Materials and Methods: This is a prospective study. The presenting features and types of treatment for 25 children with newly diagnosed ITP admitted to the pediatric ward of AL-Sadder Hospital, Missan / Iraq, between 1st of December 2009 and 1st December 2011, were evaluated to determine their prognostic significance on the course of the disease. The patients were followed up for at least 6 months.Rsultes: The presenting features of 25 children with newly diagnosed ITP were analyzed. At diagnosis ITP was more prevalent in males (64%) with male: female ratio 1.7: 1, 1-5-year group (60%), and urban residency (60%) children. It was commonly occurred in spring (44%), and nadir in autumn (12%), with preceding history of acute viral illness (76%). ITP was commonly presented as sudden onset of petechiae and/or bruising (92%), with initial platelet count less than 20 x 109/L (84%). Among studied children, (72%) had a favorable outcome and followed an acute course, while (28%) developed chronic ITP. Univariate analysis was demonstrated that, only onset of the disease and history of preceding acute viral illness were significantly affecting the course of ITP. Gradual onset of symptoms and absence of history of preceding acute viral illness correlated with a chronic course of ITP. Intravenous immunoglobulin (IVIG) was commonly used (60%), and mode of treatment had no significant effect on the clinical course of ITP. Conclusion: Childhood ITP has a favorable outcome. Only a small number of children go on to develop chronic phase.Among initial presenting features, only gradual onset of symptoms and absence of history of preceding acute viral illness correlated with a chronic course of ITP. Future large prospective studies are recommended to confirm our results.

المقدمة: ندرة الأقراص الدموية المناعي الأولي من الاضطرابات ألنزفيه الحميدة الشائعة في الطفولة. هو عامة يتقدًم بظهور مفاجئ للكدمات ، نزف،أو نزف تحت الجلد في ما عدا ذلك الطفل صحي، وغالبا" بعد مرض فيروسي.الهدف: دراسة الصفات الاجتماعية – السكانية ، ألسريريه والمختبرية، وأنواع العلاج للأطفال المشخًصين حديثا" بندرة الأقراص الدموية المناعي ، وتحديد تأثيرها على سياق المرض.المواد والطرق: هذه دراسة تقدمية . العلامات التقدمية وأنواع العلاج ل 25 طفل مشخًص حديثا" بندرة الأقراص الدموية المناعي الداخلين لردهة الأطفال في مستشفى الصدر ، محافظة ميسان- العراق ، للفترة بين الأول من كانون الأول 2009 والأول من كانون الأول 2011، قيمت لتحديد أهميتها التكهُنية على سياق المرض. المرضى توبعوا لحد أدنى 6 أشهر.النتائج: العلامات ألتقدميه ل 25 طفل مشخص حديثا" بندرة الأقراص الدموية المناعي تم تحليلها. في وقت التشخيص ندرة الأقراص الدموية المناعي كانت أكثر شيوعا" في الذكور (64% ) مع نسبة الذكور : الإناث1: 1,7، المجموعة العمرية5-1 سنوات ( 60% )، والسكن الحضري ( 60%). المرض أكثر حدوثا" في فصل الربيع ( 44%) ونادرا في الخريف (12%) ، مع تاريخ مسبق لأمراض فيروسية حادة ( 76%). ندرة الأقراص الدموية المناعي يتقدم بصورة شائعة كظهور مفاجئ لنزف تحت الجلد، مع / أو كدمات ( 92%)، مع عدد ابتدائي للصفائح الدموية أقل من 20,000 ملم مكعب (84%). بين الأطفال المدروسين ( 72%) لهم نتيجة مفضًلة واتبعًوا سياق حاد، بينما ( 28%) تطوًروا إلى ندرة الأقراص الدموية المناعي المزمن.التحليل ألآحادي بينً أنً فقط بداية المرض، وتاريخ مسبق لمرض فيروسي حاد لهما تأثير هام على سياق المرض .البداية التدريجية للأعراض، وغياب التاريخ المسبق لمرض فيروسي حاد يترافقان مع سياق مزمن لندرة الأقراص الدموية المناعي. الامينوكلوبيولين الوريدي كان المستخدم شيوعا"( 60%)، ونمط العلاج ليس له تأثير هام على السياق ألسريري لندرة الأقراص الدموية المناعي .الاستنتاج: ندرة الأقراص الدموية المناعي الطفولي يمتلك نتيجة مشجعة. في عدد قليل فقط من الأطفال يستمر إلى الطور المزمن. ما بين الصفات المتقدمة الأولية ، البداية التدريجية للإعراض وغياب التاريخ المسبق لمرض فيروسي حاد يترافقان مع سياق مزمن لندرة الأقراص الدموية المناعي. نوصي بدراسات تقدمية كبيرة مستقبلية لدعم نتائجنا.


Article
Platelet indices and their relations to platelet count in hypo-productive and hyper-destructive Thrombocytopenia

Authors: Khaleed Jumaa Khaleel --- Abeer Anwer Ahmed
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 2 Pages: 1952-1958
Publisher: Kerbala University جامعة كربلاء

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ackground: Thrombocytopenia is low platelets count which is either due to defective platelet production (hypo-productive thrombocytopenia) or due to increased platelet breakdown (hyper-destructive thrombocytopenia). Measurement of platelet counts alone do not explain the underlying patho-mechanism of thrombocytopenia.. Recent advances in automated blood cell analyzers facilitate the measurement of several blood cell parameters automatically such as, platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) and these parameters could provide some important clinical information.Aim of the study: to investigate whether platelet indices( MPV,PDW,PCT) could serve as diagnostic tools in the differential diagnosis of thrombocytopenia and, if there is any correlation between platelet count and platelets indices .Subjects and Methods: A total of 77 Iraqi patients (28 males and 49 females) with thrombocytopenia were subjected to the following tests:1. Complete blood count using Mindway haematologic autoanalyser.2. Peripheral blood film .3. Bone marrow aspirate with bone marrow trephine biopsy when indicated.A group of 50 healthy person (age & sex matched) were included as a controlResults: hyper-destructive thrombocytopenia (immune thrombocytopenia) representing 12.9% of total patients, while hypo-productive thrombocytopenia due to various causes representing 87.1% of total patients. The MPV, PDW are significantly higher in immune thrombocytopenia group as compared with thrombocytopenia of hypo-productive patho-mechanism and there were no correlations between platelets count and both MPV and PDW in hyper-destructive and hypo-productive thrombocytopenia but there was a direct correlation between platelet count and PCT .Conclusion: Platelet indices provide plenty of clinical information about the causes and patho-mechanism of thrombocytopenia and could be helpful tests to distinguish hyper-destructive thrombocytopenia from hypo-productive thrombocytopenia easily, so more interest for the use of these indices in differential diagnosis of thrombocytopenia is required.


Article
The addition of acetic acid or ethanol to orally taken aluminum salt solution enhanced its availability and then induced toxic effects

Authors: Omar AM. Alhabib --- Sadiq M. A. Alhiti --- Mehdi I. Hilmy
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2010 Volume: 52 Issue: 3 Pages: 326-330
Publisher: Baghdad University جامعة بغداد

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Background:Aluminum (Al) intoxication was initially reported in patients undergoing hemodialysis and then was linked to Alzheimer's disease. Man usually is exposed to Al containing antacids, vaccines or foods cooked in Al utensils. The assumption of ingesting sour juices as acetic acid or ethanol may affect favorably the degree of Al absorption is justified when taken in conjunction with the above mentioned appetizers.
Materials and methods: Four groups of 10 mature male rats each were used. The drinking water (DW) containing 5mM of Al2(SO4)3 with 1% glacial acetic acid and/or 10% ethanol made available ad-libidum. Weekly body weight and each other day drinking water volume were measured. Brain and plasma analysis at and Ca were determined from blood obtained by cardiac puncture, in addition to automated complete blood count (CBC), after 10 wks of treatments.
Results: The results of plasma Al levels indicated that, the addition of acetic acid or ethanol to Al containing drinking water enhanced significantly its absorption and even more when combined relative to control. This enhancement was evident as well in increased Al and Ca deposited in the brain while no change in plasma Ca. The CBC results showed highly significant thombocytopnia for the 1st time, in addition to microcytosis and hypochromia. Evidently, thrombocytopoietin synthesis, and/or action is blocked by Al from acting on the cellularity of bone marrow.Conclusion: The addition of acetic acid and/ or 10% ethanol to Al containing drinking solution enhanced Al absorption when acid is used and an addative effect when both are used. The toxic plasma level caused hypochromia, microcytosis and severe thrombocytopenia in addition to brain atrophy.


Article
The prevalence of thrombocytopenia in pregnant women in Baghdad: single centre study
نسبة حدوث نقص الصفيحات عند النساء الحوامل في بغداد: دراسة مركزية واحدة

Authors: Hussam D. Saeed د.حسام داود سعيد --- Ekhlass H. Sabri د. اخلاص حسين صبري --- Eaman M. Muhammad د. ايمان معروف محمد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2018 Volume: 60 Issue: 2 Pages: 98-101
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The prevalence of thrombocytopenia in most studies ranges from 7 to 10% of all pregnant females. Although pregnancy is associated with physiological changes that may affect platelet count, several pathological conditions can cause thrombocytopenia which have a significant impact on both the mother and her baby.Objective: The aim of this study was to determine the prevalence of thrombocytopenia in pregnant women attending an out-patient clinic in Al-Yarmouk Teaching hospital in Baghdad.Material and Methods: A cross sectional study conducted at Al-Yarmouk Teaching Hospital from 1st October 2016 to 1st July 2017. Five hundred sixty pregnant women randomly selected as the study group and another 100 non-pregnant women as the control group were enrolled in this study. A complete blood count and blood film were done for both the selected groups.Results: Thrombocytopenia was found in 7.1% of the cases. The most common cause of thrombocytopenia was gestational thrombocytopenia seen in 19(47.5%) patients and PE & HELLP syndrome 9 (22.5%) patients. Most of our cases were asymptomatic and only one case developed heavy vaginal bleeding while there were 2 cases who had platelets below 50,000 considered as severe thrombocytopenia without significant bleeding.Conclusion: Thrombocytopenia is not a rare condition in pregnancy. Accurate etiological diagnosis is essential for effective management. Most of the cases are mild, self-limiting and rarely cause with complicationsKeywords: prevalence, Thrombocytopenia, Pregnancy,

الخلاصة:الخلفية: تراوحت نسبة حدوث نقص الصفيحات في معظم الدراسات من 7 إلى 10٪ من جميع النساء الحوامل. على الرغم من أن الحمل في حد ذاته يرتبط بالتغيرات الفسيولوجية التي قد تؤثر على تعداد الصفائح الدموية ، إلا أن العديد من الحالات المرضية يمكن أن تسبب نقص الصفيحات التي لها تأثير كبير على كل من الأم والطفل.الهدف: الهدف من هذه الدراسة هو تحديد معدل حدوث نقص الصفيحات عند السيدات الحوامل اللواتي يحضرن عيادة خارجية في مستشفى اليرموك التعليمي ببغداد. المواد والطرق: أجريت دراسة مقطعية مستعرضة في مستشفى اليرموك التعليمي في الفترة من 1 أكتوبر 2016 حتى 1 يوليو 2017. تم تسجيل خمسمائة وستون امرأة حامل كمجموعة دراسية و 100 امرأة أخرى غير حامل كمجموعة سيطرة في هذه الدراسة. تم إجراءفحص عدد كامل من الدم وفيلم الدم لكلتا المجموعتين.النتائج: كانت نسبة حدوث نقص الصفيحات 7.1 ٪. السبب الأكثر شيوعا لنقص الصفيحات الدموية هو نقص الصفيحات الحملي في 19 (47.5٪) من المرضى يليه متلازمة ارتفاع ضغط الدم لدى الحوامل & HELLP9 (22.5%) من المرضى. معظم حالاتنا كانت بدون أعراض وظهرت حالة واحدة فقط من نزيف مهبلي كثيف في حين كان هناك حالتان كان لديهما صفيحات أقل من 50،000 حالة تعتبر نقصًا حادًا في الصفيحات.الاستنتاج : نقص الصفيحات ليست حالة نادرة في الحمل. التشخيص المسبب للمرض هو أمر ضروري للإدارة العلاجية المثلى. معظم الحالات معتدلة ومحددة ذاتياً ونادراً ما تنتهي بمضاعفاتكلمات البحث: الإصابة ، نقص الصفيحات ، الحمل


Article
THE EFFECT OF HELICOBACTER PYLORI ERADICATION THERAPY ON PLATELET COUNT IN IDIOPATHIC THEROMOBOCYTOPENIA : APILOT STUDY
تأثير استئصال جرثومة الهليكوباكتر على عدد الأق ا رص ألدموية لدى المرضى المصابين بنقص الأق ا رص ألدمويه الفرفريه العفوي

Authors: ASWAD AL-OBEIDY اسود العبيدي --- AHMED Y. ELMESHHEDANY احمد المشهداني
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2012 Volume: 6 Issue: 1 Pages: 28-33
Publisher: University of Dohuk جامعة دهوك

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Abstract

Background and objectives Conflicting reports on the relationship between Helicobacter pylori infection and idiopathic thrombocytopenia had previously appeared in the literatures.This study examines the effect of Helicobacter pylori eradication on platelet counts in Iraqi patients with Idiopathic Thrombocytopenic Purpura (ITP).Methods The study population comprised 31 Iraqi patients with chronic ITP and a platelet count of less than 100.0 x109/L and positive serum H pylori antibodies (indirect immunofluorescence). They were divided into two groups, the first (17 patients) received anti H Pylori plus conventional treatment for ITP, the second group (14 patients) received conventional treatment for ITP only. The effect of H pylori eradication on platelet count was evaluated 6 months after therapy.Results There was significant improvement in platelet count in response to conventional treatment in both groups but there were no significant improvement after H Pylori eradication therapy.Conclusions Based on this pilot study eradication of H pylori does not appear to be effective in increasing platelet count in H pylori–positive patients with chronic ITP.

خلفية واهداف البحث: العلاقة بين الهليكوباكتر ونقص الأق ا رص ألدمويه الفرفريه العفوي مثبته سابقا. هذه الدر اسه تحدد تأثير استئصال جرثومة الهليكوباكتر على عدد الأق ا رص ألدمويه.طرق البحث: هذه الدر اسه تتضمن واحد وثلاثون مريض ع ا رقي مصابون بمرض نقص الأق ا رص ألدمويه الفرفريه العفوي مع عدد الأق ا رص اقل من 100000 مصابون بجرثومة الهليكوباكتر.المرضى قسموا إلى مجموعتين ألمجموعه الأولى 17 ) استلمت علاج استئصال جرثومة الهليكوباكتر مع العلاج التقليدي لمرض نقص الأق ا رص ألدمويه الفرفريه. )ألمجموعه ألثانيه استلمت العلاج التقليدي لمرض نقص الأق ا رص ألدمويه الفرفريه فقط . تأثير استئصال جرثومة الهليكوباكتر على عدد الأق ا رص ألدمويه تم تقييمه لمدة 6 أشهر.النتائج: كان هناك تحسن معتبر بعدد الأق ا رص ألدمويه في المجموعتين ردا على العلاج التقليدي ولكن لم يكن هناك تحسن معتبر بعد استئصال جرثومة الهليكوباكتر.الاستنتاجات: استئصال جرثومة الهليكوباكترغير فعال في زيادة عدد الأق ا رص ألدمويه عند مرضى نقص الأق ا رص ألدمويه الفرفريه المصابون بجرثومة الهليكوباكتر.

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