الفهرس 
BLEEDING IN UREMIAOnly 14 pages are availabe for public view
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Abstract
This study was done on twenty patients suffering from
chronic renal failure with bleeding tendency.
They were divided into two groups :
(1) Group (A) of patients to whom D.D.A.V.P (Minirin) was
given by intranasal inhalation in a dose of 0.1 ml of the
solution.
(2) Group (B) of patients to whom D.D.A.V.P {Minirin) was
given by intravenous infusion in a dose of 0.4 ug/kg body
weight in 20 ml saline over 20 - 30 min.
All cases were clinically examined and investigated by
estimation of : blood urea, serum creatinine, platelet count,
platelet aggregation and bleeding time before and 90 minutes
after D.D.A.V.P (Minirin) inhalation and/or infusion.
Our results were summarized as follows
(I) Group (A) of Patients to Whom D.D.A.V.P was Given by
Inhalation :
1, Blood urea level ranged from 112 to 300 mgm/dl with a
mean value of 186.8 mgm/dl and ±S.D of 55.02 • Serum creatinine level ranged from 2.5 to 17.7 mgm/dl
with a mean value of 4.43 mgm/dl and±S.D of 4.67.
3. Bleeding time estimated before D.D.A.V.P inhalation
was found to range from 6 to 14 minutes with a mean
value of 9.5 minutes and ±S.D of 2.8, as compared with
the same group 90 minutes post D.D.A.V.P. inhalation
which ranged from 4 to 11 minutes with a mean value of
6.8 and±S.D of 2.57 The mean difference of bleeding
time before and 90 minutes after D.D.A.V.P inhalation
was found to be- 2.7 and ±S.D of the difference was
0.8232 • S.E of the difference was 0.26 •
4. Platelet count estimated before D.D.A.V.P inhalation
was found to range from 190 X 10• to 380 X 10 3 /cmm
blood with a mean value of 280 X 10 3 /cmm blood and ±S.D
54.49 as compared with the same group 90 minutes after
D.D.A.V.P inhalation which ranged from 198 X 10• to
365 X 103 /cmm blood with a mean value of 277.9 X 10’/
cmm blood and ±S.D of 58.56
The mean difference of platelet count before and 90
minutes after D.D.A.V.P inhalation was found to be 3
±S.D of the difference was 39.288 and S.E of the difference
was 12.424 • 5. Platelet aggregation estimated before D.D.A.V.P inhalation
was found to range from 70 to 91.1 % with a mean
value of 77.3 %, and tS.D 9.57, as compared with the
same group 90 minutes post D.D.A.V.P inhalation which
ranged from 64 to 85.6 %, with a mean value of 77.27%
andtS.D of 6.28 .
The mean difference of platelet aggregation before and
90 minutes after D.D.A.V.P inhalation was found to be
- 2.73 and tS.D of the difference was found to be
9.593 and S.E of the difference was 3,033.
(II) Group {B) of Patients to Whom D.D.A.V.P {Minirin) was
Given by Intravenous Infusion :
1. Blood urea level ranged from 150 to 290 mgm/dl with a
mean value of 198.9 mgm/dl and ±S,D of 52.99 •
2. Serum Creatinine level ranged from 2.5 to 11 mgm/dl
with a mean value of 4.8 mgm/dl and ±S.D of 2.65 •
3. Bleeding time estimated before D.D.A.V.P infusion was
found to range from 7 to 16 minutes with a mean value
of 9,9 minutes and S.D of 2.998, as compared with the
same group 90 minutes post D.D.A.V.P infusion which
ranged from 4 to 10 minutes with a mean value of 5.9 minutes and ±S.D of 2. 08 •
The mean difference of bleeding time before and 90
minutes after D.D.A.V.P infusion was found to be - 4
and ±S.D of the difference was 1.633 • The S.E of the
difference was 0.516 .
4. Platelet count estimated before D.D.A.V.P infusion was
found to range from ll4 X 10 3 to 347 X 103 /cmm blood
with a mean value of 240.6 X 103 /cmm blood and ±S.D of
69.45, as compared with the same group 90 minutes after
D.D.A.V.P infusion which ranged from 112 X 103 to
412 X 103 /cmm blood with .a mean value of 270 X 10 3 /crnm
blood and±S.D of 100.61.
The mean difference of platelet count before and 90
minutes after D.D.A.V.P infusion was found to be 19.4
and±S.D of the difference was 41.258
difference was 13.047 •
S.E of the
5. Platelet aggregation estimated before D.D.A.V.P infusion
was found to range from 45 to 92.6 % with a mean value
of 72.66 % and±S.D of 12.86, as compared with the same
group 90 minutes after D.D.A.V.P infusion which ranged
from 49.1 to 91.1 %with a mean value of 75.33 % and
±S,Dof 14.27
The mean difference of platelet aggregation before and
67
90 minutes after D.D.A.V.P infusion was found to be
4.47 and±S.D of the difference was 5.999 • The S.E
of the difference was 1.897 .
In comparison between the differences of bleeding times
for inhalation and infusion, t-test was found
2.878, p < 0.01)
= 2.101, P < 0.05]
= 4.165
from these results we concluded that
{I) Group (A) of Patients, i.e, Inhalation Group
1. There is a statistically significant shortening
(P < 0.01) of the bleeding time 90 minutes after
D.D.A.V.P inhalation, as compared with the same
group before inhalation.
2. There is a statistically insignificant increase in
platelet count (P < 0.01} 90 minutes after D.D.A.V.P
inhalation, as compared with the same group before
inhalation.
3. There is a statistically insignificant decrease in
platelet aggregation (P < 0.01} 90 minutes after D.D.A.V.P inhalation as compared with the same group
before inhalation.
(II) Group (B) of Patients, i.e, Infusion Group
1. There is a statistically significant shortening
(P < 0.01) of the bleeding time 90 minutes post
D.D.A.V.P infusion, as compared with the same group
in the preinfusion state.
2. There is a statistically insignificant increase
(p < 0.01) of platelet count 90 minutes post
D.D.A.V.P infusion, as compared with the same group
in the preinfusion state.
3. There is a statistically significant increase
(P < 0.05) of platelet aggregation 90 minutes post
D.D.A.V.P infusion, as compared with the same group
in the preinfusion state.
Comparatively, there is a statistically significant
shortening (P < 0.01) of the bleeding time in group (B) of
patients to whom D.D.A.V.P was given intravenously as compared
with group (A) of patients who had been given the drug intranasally.
from these results we concluded that D.D.A.V.P shortens the
bleeding time in chronic uremic patients with bleeding tendency by enhancing platelet aggregation while platelet count increased
when the drug was given to these patients insignificantly.
Nevertheless, these results showed that the bleeding time
in those patients was found to be shortened when D.D.A.V.P was
given by intravenous infusion rather than been given by intranasal
inhalation.
This accounts for the beneficial effect of D.D.A.V.P in
shortening of the bleeding time in chronic uremic patients with
bleeding tendency, especially when it is given to those patients
by intravenous infusion as it increases the platelet aggregation,
a process that participates in shortening of the abnormally
increased bleeding time in those patients.