Teng Sung Shin, Joyce Lam Ching Mei, 20180903000000
Bleeding disorders in children can be divided into acquired and congenital conditions, with the acquired being far more common than the congenital. Clinical bleeding manifestations can vary in severity. Identifying the root cause early is crucial to control and halt bleeding as well as to prevent the risk of future bleeding in a vulnerable age group. This can be achieved by a thorough and salient history, physical evaluation, and appropriate investigations. This review will describe the common causes of bleeding disorders in children and will suggest an approach to the workup and diagnosis of such disorders.
Thrombocytopenia, defined as a platelet count of less than 150,000/microL, is clinically suspected when there is a history of increased bruising or bleeding, or when there is petechiae noted which is often referred to as a “rash”. Thrombocytopenia is usually asymptomatic until platelet counts fall below 50,000/microL, and may also be detected incidentally in a full blood count (FBC) during routine evaluation of an asymptomatic patient or during investigations performed for other reasons.1
Chronic hepatitis B virus (HBV) infection is a global problem. Chronic
HBV infection is probably the most common maternal infection encountered
in Hong Kong, China, and Southeast Asia. In Hong Kong, which is one of
the endemic areas, immunisation against HBV was first provided in 1983
to infants born to mothers who were screened positive for hepatitis B
surface antigen (HBsAg). Immunisation became widespread since November
1988, but HBsAg-positive mothers are still encountered frequently.1
Asia's trusted medical magazine for healthcare professionals.
Get your MIMS Pharmacist - Malaysia digital copy today!
Nonvitamin K antagonist oral anticoagulants (NOACs) appear to confer more clinical benefits to elderly patients with atrial fibrillation (AF) than vitamin K antagonist anticoagulants (VKAs), suggests a study, adding that this is primarily driven by the lower rates of major bleeding.
In patients with atrial fibrillation (AF) naïve to oral anticoagulants (OACs), standard-dose nonvitamin K antagonist OACs (NOACs) provides better survival benefits than warfarin, a recent meta-analysis has shown.
Use of diclofenac, a traditional nonsteroidal anti-inflammatory drug (NSAID) with cyclo-oxygenase-2 (COX-2) selectivity similar to COX-2 inhibitors, is associated with higher cardiovascular health risk compared with nonuse, paracetamol use and use of other traditional NSAIDs, a recent study has shown.