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Haemostasis & Blood Groups
• Presented By – • Prof.Dr.R.R.Deshpande • (M.D in Ayurvdic Medicine & M.D. in
Ayurvedic Physiology)• www.ayurvedicfriend.com• Mobile – 922 68 10 630• professordeshpande@gmail.com
10/4/2017 1Prof.Dr.R.R.Deshpande
Haemostasis
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Contents of this PPT
• 1) What is Haemostasis ? 3 Steps in Blood Clotting
• 2) 13 Clotting Factors • 3) Process of Blood Clotting –Intrinsic &
Extrinsic Pathway • 4) Blood Group --Landsteiner’s Law• 5) Types of Blood Groups • 6) Importance of Blood Groups
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Haemostasis
• Haemostasis means stoppage of bleeding.• Process of clotting of blood• It consists of following 3 steps –
• i) Vascular spasm. • ii) Platelet plug formation.• iii) Clotting
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Coagulation factors - Total = 13
• 1) Fibrinogen • 2) Prothrombin• 3) Thromboplastin ( Tissue Factor) • 4) Ca++• 5) Labile Factor or Proaccelerin • 6) 6th factor - Not named (Presence has not
been proved)
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Coagulation factors - Total = 13
• 7) Proconvertin ( Stable Factor) • 8) Anti haemophilic factor A • 9) Christmas factor • 10) stuart Prower Factor• 11) Anti haemophilic factor C ( Plasma
Thromboplastin Antecedent ) • 12) Hageman factor ( Contact Factor) • 13) Fibrin stabilizing factor.( Fibrinase) 10/4/2017 Prof.Dr.R.R.Deshpande 6
Intrinsic Pathway
• Intrinsic Pathway for the Formation of Prothrombin Activator –
• In this pathway, the formation of prothrombin activator is initiated by Platelets, which are within the blood itself
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Extrinsic Pathway
• Extrinsic Pathway for the Formation of Prothrombin Activator –
• In this pathway, the formation of prothrombin activator is initiated by the tissue Thromboplastin, which is formed from the injured tissues.
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Clotting Process
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Applied Part
• Investigations for Haemostasis• Normal values –
• B. T. = 2 - 3 min.• C. T. = 4 - 9 min.
• P. T = 10 - 25 sec. (P. T. = Prothrombin Time)
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Why B. T. < C. T. ?
• B. T. is time interval between skin puncture and arrest of bleeding. Bleeding is arrested quickly by vascular spasm and platelet plug formation.
• C. T. is interval between skin puncture and formation of clot. Formation of clot occurs by Multiple reactions (Enzyme cascade) and so, it takes a longer time
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BT -- When High ?
• Conditions in which B. T. ↑
• Thrombocytopenic Purpura and vascular purpura.
• Normal Thrombocyte or platelet count = 2.5 to 4. 5 laks/cmm
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Conditions in which C. T. ↑
• Haemophilia - Due to lack of Antihaemophillic Globullin (Factor 8 and 11)
• Obstructive Jaundice - Because in absence of Bile, vit. K is not absorbed from Intestine.
From vitamin k - Pro - thrombin is synthesized. Due to deficiency of prothrombia, clotting will be delayed.
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Conditions in which C. T. ↑
• Liver disease (Cirrhosis, cancer) - Due to disturbance of Prothrombin and fibrinogen forming functions of liver
• New born baby - Due to low prothrombin level, during early days of life
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When BT ,CT is done ?
• 1) Pre Operative
• 2) When we suspect any bleeding disorders
• 3) Before Panchakarma –Leech Application for Raktamokshan or blood letting
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Blood Group
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Blood groups
• Landsteiner’s Law
• Antibodies present in plasma is of opposite type as that of Antigen on RBC
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Blood groups
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Blood Group Importance
• i) Before Blood transfusion → Grouping and Cross matching of donor and Recipient
• ii) Identifying paternity• iii) To identify criminals
• iv) In Rh – ve, pregnant lady, to avoid the problem of Erythroblastosis foetalis.
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Erythroblastosis foetalis
• First one should know that anti D antibodies do not exist naturally.
• They are produced
• a) Only by Rh – ve person• b) When Rh +ve Blood is given to him.
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Erythroblastosis foetalis
• Now in Rh – ve lady, if Rh +ve baby in uterus. At birth +ve cells of baby escape to mother.
• Mother develops anti -D antibodies• (First baby may escape from complications).
Antibodies remain in circulation of mother. • When next pregnancy occur and the child is
Rh+ve, then in the child’s blood Rh Antigen of self and Rh antibodies coming through mother’s blood, will react with each other.
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Erythroblastosis foetalis
• Haemolysis occurs, Jaundiced baby. If reaction is severe, Miscarriage, Abortion also can occur.
• In this type of High Risk Pregnancy – Anti D Inj. is given to mother, to avoid sensitization by foetal blood.
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Other Blood Groups
• LEWIS BLOOD GROUP --first found in a subject named Mrs Lewis.
• The antigens, named Lewis antigens are formed in the tissues, released in the body secretions and then absorbed by the RBC membrane.
• These antigens are also known as secretor antigens.
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LEWIS BLOOD GROUP
• Presence of Lewis antigens in children create complications like retarded growth.
• Also it can cause transfusion reactions .
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MNS BLOOD GROUPS
• Determined by their reactions with anti-M, anti-N and anti-S.
• But rarely cause any problem like hemolysis following transfusion
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Different Blood Group system
• Diego group• Bombay group• Duffy group• Lutheran group • P group• Kell group
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What is cross matching of blood ?
• Blood is collected from donor and recipient. Plasma and red cells are separated in each.
• Then Donor’s cells are mixed with Recipient’s plasma (major cross).
• Recipients cells are matched with Donor’s plasma (minor cross).
• This is called cross matching. • If there is No Agglutination - in either of the
cases above, recipient can safely receive donor’s blood.
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Hazards of mismatched blood transfusion
• 1) Agglutination of Donor’s RBC in recipients circulation
• 2) Agglutinated cells may block certain vessels, leading to Tissue Ischaemia
• 3) Agglutinated RBCs get haemolysed - leading to greater breakdown of Hb and greater formation of bile pigments - causing “Haemolytic Jaundice”
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Hazards of mismatched blood transfusion
• 4) Haemolysis of RBC also causes Haemoglobinaemia (increased amount of circulating Hb in blood).
• This free Hb gets excreted into renal tubules, forming Acid Haematin, which blocks renal tubules - Anuria or renal shutdown - uraemia - shock - unconsciousness - may be lethal (if untreated).
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Distribution of Blood Group
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Donor & Recipient
• O Group - Universal donor• AB Group - Universal recipient• Why O - Universal donor ?• Because their RBC do not carry any Antigen (so
no problem of Antigen - Antibody reaction)• Why AB - Universal recipient ?• Because No Antibodies in their serum.• (So no problem of Antigen - Antibody Reaction)
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Susceptibility to disease
• i) Group A - Diabetes, cancer of stomach
• ii) Group O - Peptic ulcer
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Prof.Dr.R.R.Deshpande
• Sharing of Knowledge
• FOR
• Propagating Ayurved
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