Introduction :
Bevacizumab intravitreal injection could be detectable in plasma that might interfere the coagulopathy and hemostasis condition. The purpose of this study was to investigate the difference of APTT between hypertensive and nonhypertensive diabetic mellitus patients with bevacizumab intravitreal injection.
Methods :
This was cohort study conducted at Sardjito General Hospital from March 2019 to June 2019. Thirty-two hypertension patients and 30 nonhypertension patients with diabetes mellitus who underwent bevacizumab intravitreal injection were included. Value of APTT was measured using ACLTOP300 machine prior and 1 week after IVB. The difference in mean APTT value prior and after IVB, range APTT value between two groups were assessed using independent t-test. The percentage of patients who had shortening of APTT in both groups was tested by two populations proportion test.
Results :
Mean APTT before IVB in hypertensive patients was 36.47 ± 2.92 seconds and in nonhypertensive patients was 36.33 ± 4.39 seconds with p value > 0.05. Mean value of APTT after IVB in hypertension patients was 35.42 ± 3.63 seconds and in nonhypertensive patients was 35.60 ± 3.13 seconds with p value > 0.05. APTT shortening in hypertensive patients was -1.03 ± 3.65 and nonhypertensive patients was -0.73 ± 2.55 with p value > 0.05. The risk of APTT shortening in hypertensive patients was 1.370 (0.831-2.258). The risk of APTT shortening in hypertensive patients who used antihypertensive drugs regularly was 0.538 (0.331- 0.874).
Conclusion :
There was no difference in shortening of APTT value 1 week after intravitreal bevacizumab injection between hypertensive and nonhypertensive groups in patients with diabetes mellitus. Hence, administration of IVB in hypertensive patients with regular antihypertensive therapy might be safe.
Bevacizumab intravitreal injection (IVB) could be detected in plasma that might cause an imbalance in the coagulation system. A hypercoagulable state is potentially involved in the risk for thrombosis, which is associated with high cardiovascular mortality.The objective of the current study was to investigate the risk of elevated plasma fibrinogen levelsin hypertensive and normotensive patients after IVB in diabetic retinopathy. This study was conducted at Dr. Sardjito General Hospital, Yogyakarta from March to June 2019. A total of 64 patients were enrolled in the study, included of 32 hypertensive and 32 nonhypertensive patients with diabetic retinopathy who underwent IVB. Patients were interviewed and investigated for physical condition and opthalmological examination. Fibrinogen levelwas measured before and 1 week after IVB. The mean fibrinogen level beforeand after IVB was slightly high in hypertensive patients than normotensive but not significantly different(p>0.05). There was no significant risk of increased fibrinogen levels after IVB in the hypertension group compared to the normotension group in diabetic retinopathy patients. The proportion of patients at high risk for cardiovascular disease after IVB was not significantly different between both groups.
Coronavirus disease (COVID-19) is a pandemic disease which is caused by the latest discovered coronavirus. Conjunctivitis is allegedly the first presentation of COVID-19 since it can spread by aerosol contact with the conjunctiva. The present study aimed to systematically review the employment of conjunctival swab with Real-time Polymerase Chain Reaction in detecting SARS-Cov-2. The research is a systematic review of the published scientific literature on findings of conjunctival swab of COVID-19 from PUBMED database and other additional sources (i.e: Google Scholar). The search method was done using “COVID-19 OR coronavirus OR SARS-COV2, AND conjunctivitis, AND ocular manifestations, AND conjunctival swab” as keywords. Inclusion criteria were any papers that related to the entered keywords and have conjunctival swab as a reported outcome. Letters, reviews, and editorials describing other studies reporting COVID-19 and conjunctival swab were excluded. Only four research papers were found and included in the literature review. From the four current research papers, positive SARS-CoV-2 results were yielded from 0-5.26% of conjunctival swab specimens. In conclusion, although the presence of the SARS-CoV-2 virus on the ocular surface remains unclear, the prevention of infection transmission through an ocular surface is mandatory by wearing goggles (or shield), mask (N-95 recommended) and gown.
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