Joint International Conference and expo on Industrial Pharmacy & 5^th Global Pharmacovigilance Summit April 28-29, 2016 Dubai, UAE

Session Introduction

Madeeha Malik

Hamdard University, Pakistan

Title: Role of pharmacist in ADR reporting in Pakistan: A myth or reality?

Time : 13:50-14:15

Biography:

Madeeha Malik has completed her PhD in 2013 from University Sains, Malaysia and her Post-doc in 2015, in Pharmacy Practice from North West University, South Africa. She is currently serving as Director and coordinator for MPhil Pharmacy Practice at Faculty of Pharmacy, Hamdard University Islamabad, Pakistan. She is also serving as an appointed MPhil and PhD supervisor for Higher Education Commission of Pakistan. She has published more than 50 papers in reputed journals and serving as an Editorial Board Member of repute.

Abstract:

A cross-sectional study design was used to explore the perceptions’ and attitudes of pharmacists regarding ADR reporting in Pakistan. The study was approved by ethical committee of Hamdard University and Ministry of Health, Pakistan. A validated semi-structured questionnaire was used to collect data. Data was cleaned, coded and analyzed using SPSS vs. 16.

Nermine El-Maraghy

Suez Canal University, Egypt

Title: Pattern of hospital-acquired pneumonia in intensive care unit of Suez Canal University Hospital

Time : 14:15-14:40

Biography:

Nermine El-Maraghy is Associate Professor of Medical Microbiology & Immunology. She completed Master’s degree and PhD in Medical Microbiology & Immunology from Facuulty of Medicine Suez Canal University, Ismailia, Egypt. She is a member of tumor oncology unit, clinical epidemiology units at Faculty of Medicine Suez Canal University. She had great experience in the era of clinical immunology, allergy skin prick test, immunotherapy, diagnostic microbiology and infection control. She has several international publications on PubMed and Google Scholar. She is the reviewer of the Infectious & Non-Infectious Diseases (online), Suez Canal University Medical Journal and Eastern Mediterranean Health Journal (online).

Abstract:

Hospital acquired pneumonia occurs more than 48 h after hospital admission and was not present at the time of admission, while ventilator associated pneumonia occurs after 48–72 h of endotracheal intubation or within 48 h of extubation.HAP is the second most common nosocomial infection and accounts for approximately 25% of all infections in the Intensive Care Unit worldwide.

Hayam Ateyya

Cairo University, Egypt

Title: Amelioration of Cyclosporine Induced Nephrotoxicity by Dipeptidylpeptidase Inhibitior Vildagliptin

Time : 14:40-15:05

Biography:

Hayam Ateyya has completed her MBBch degree in Medicine & Surgery from Cairo University, Faculty of Medicine and MD Degree in Pharmacology from Cairo University, Faculty of Medicine. She is working now as Assistant Professor at Taibah University in KSA.

Abstract:

Cyclosporine A (CsA) is an immunosuppressive drug used in organ transplantation and autoimmune diseases but its clinical uses may be limited due to its dose-related nephrotoxicity. This study was carried out to evaluate the possible protective effects of vildagliptin (VLD) against CsA-induced nephrotoxicity in rats. Animals were divided into four groups treated as follows: control group (CsA & VLD vehicle); VLD group (10 mg/kg/day, orally); CsA group (20 mg/kg in sunflower oil, S.C.); and CsA-VLD group (CsA &VLD). Induced nephrotoxicity was evidenced by a significant elevation of serum creatinine, blood urea nitrogen (BUN), lactate dehydrogenase (LDH) and urinary micro total proteins (MTP), while serum albumin and urinary creatinine clearance were significantly decreased compared to control group. Moreover, renal dysfunction was further confirmed by a significant increase in renal lipid peroxide that was measured as renal malondialdehyde (MDA). Renal reduced glutathione (GSH) and superoxide dismutase (SOD) were significantly decreased. Nephrotoxicity was further confirmed by renal tissues histopathology. Also, a high protein expression of Bax with decreased Bcl-2 was revealed in renal tissue of CsA treated group. Administration of VLD significantly ameliorated the nephrotoxic effects of CsA suggesting antioxidant, anti-inflammatory and anti-apoptotic benefits of VLD in CsAinduced nephrotoxicity.

Khaudeja Bano

AbbVie Inc , Chicago, IL – USA

Title: Combination Products – The Paradigm Shift

Time : 15:05-15:30

Biography:

Khaudeja is a Physician with a Masters in Clinical Research (UCSD), Pharmaceutical engineering Certification, an Oracle DBA, and a certified Project Management Professional. She is an Abbott President’s award winner, avid Toastmaster and certified coach. Khaudeja has more than 25 years professional experience, including clinical practice. She has held several global safety positions at Abbott Vascular, Abbott Diagnostics, Abbott Established Pharma Division and now AbbVie Inc. Her career in safety includes global leadership roles in devices, diagnostics, pharmaceuticals and combination products.

Abstract:

Combination products present a unique challenge globally for industry and the regulators regardless if you consider pharmaceuticals or biologics, devices or diagnostics. As the US and Japan have expressed their views in the form of draft guidance and regulations, organizations are working towards a streamlined process that best meets their needs. Combination products present challenges that need to be evaluated to better prepare for the future and to demonstrate an organization’s compliance. Let us consider how to develop integrated cGMP and Regulatory Strategies for combination products. With two or more components; two Quality Systems; two or more databases; one or more Postmarketing Safety Report(s) what Is an Organization to do? How does the organization set up the right culture? Some best practices to consider. Risk based safety assessments may be a solution.

Session Introduction

Ehab Darwish

TopLab, Egypt

Title: A preliminary report of successful cleavage after calcium ionophore activation at ICSI in cases with previous arrest at the pronuclear stage

Time : 17:05-17:30

Biography:

Ehab Darwish founded TopLab co. For IVF (In vitro fertilization) labs consultations in 2014. He did many researches in ART (Assisted reproductive techniques). He got his Master’s degree in Health Care Management in 2013, after his Post-graduate studies from University of Bristol, United Kingdom in 2009. He is a medical school graduate, Ain Shams University, Egypt. He is running many IVF labs in Egypt and UAE. His consultations company is running national and international training courses for ART techniques. His years of expereinces gave him the ability to set up labs., and improve others’ performances through his company’s services.

Abstract:

Artificial oocyte activation (AOA) has been previously suggested as a means to overcome the problem of total fertilization failure, which affects about 1–3% of the intracytoplasmic sperm injection (ICSI) cycles. A preliminary study on the application of chemical AOA was conducted using A23187 Ca2+ ionophore to improve embryonic development in four women with a history of complete fertilization arrest and inability to transit to cleavage stage during previous ICSI trials. Data indicated that activated oocytes resulted in better fertilization, embryonic development and clinical pregnancy in one of the four couples. Therefore, ICSI combined with AOA using Ca2+ ionophore may be useful in selected patients with cleavage failure, and may help the zygotes to reach more advanced developmental stages. I have to say that this is a novel usage to Ca2+ ionophore in treating embryo cleavage block

Sangameshwar Mahangaonkar

IMS Health, Dubai, United Arab Emirates

Title: Drug safety assessment using Dubai Real World Claims Database (DRWD)

Time : 17:30-17:55

Biography:

With over 16 years of experience spanning clinical practice, medical education, public health research and pharmaceutical consulting, Sangameshwar currently leads the practice of Real World Evidence Solutions at IMS Health based in Dubai. At IMS Health, in addition to outcomes research, his work interests include post-authorization safety and effectiveness studies. A trained physician with specialization in epidemiology and public health, Sangameshwar obtained his MBBS from Bangalore Univesrity, his MD in public health. He is also an adjunt professor of Public Health in the Department of Community Medicine at PES Institute of Medical Sciences & Research, Kuppam, India.

Abstract:

The large databases of health insurance claims often contain information on potential adverse events (AE). If investigated further, this information could complement other methods of drug safety assessments. The Dubai Real World Claims Database (DRWD) is an anonymized longitudinal patient level database of all insurance claims generated from private healthcare sector in the Emirate of Dubai. Covering over 1.9 million lives, the DRWD currently represents about 15% of the total UAE national population and is available since January 2014. Major data fields available are: patient demographics, physician specialty, provider, details of prescriptions, clinical diagnosis (ICD10), few lab test results, procedures and hospitalizations, which ultimately generate an insurance claim. DRWD is a rich source of healthcare data in UAE that may be valuable for epidemiological and outcomes research. We are conducting a retrospective observational study to evaluate the suitability of using the DRWD adverse event reporting. We have considered all categories of lipid-modifying drugs for this exercise, given that these drugs are amongst the 5 most prescribed drugs in the United Arab Emirates. We are thereby confident of securing a robust sample of patient records with lipid modifying therapy. Those patient records currently existing within the database, aged 18 years or above and receiving 2 or more prescriptions for lipidmodifying drugs between January 1, 2014 and September 30, 2015 will be included in the study. Hospitalizations with diagnosis codes (ICD-10) related to common and known adverse drug reactions of lipid modifying therapy such as muscle, kidney, and liver affections will be determined for patients receiving statins, fibrates, cholesterol absorption inhibitors, or combination therapy. The key criteria to be considered for suitability of DRWD for this exercise, would be two fold. First would be an attribute of the DRWD itself – the availability of actual data on the four elements of adverse event reporting – suspected drug, actual adverse event, identifiable patient and an identifiable physician. The second criterion is the consistency of findings from DRWD with reported rate of adverse events in real world clinical practice. The latter will be confirmed through a survey among clinical experts.

Samira Saleh

Future University, Egypt

Title: Why do we need Pharmacovigilance?

Time : 17:55-18:20

Biography:

Samira Saleh, PhD, Cairo University and Post-doctoral studies from Strathclyde University, UK, is currently the Head of the Department of Pharmacology, Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University. She is a Board member of The Egyptian Society of Pharmacology and Experimental Therapeutics and the Editor-in-Chief of the Egyptian Journal of Basic and Clinical Pharmacology. She makes evaluation of Science and Technology Development Fund (STDF) projects. She has published around 85 papers, supervised more than 50 thesis and gave presentations at more than 60 conferences. She received many awards from the Supreme Council of universities for publishing papers in international journals.

Abstract:

In the 1960’s, the thalidomide disaster led to limb deformities in the newborns of those mothers who took the drug while pregnant. This implies that premarketing evaluation of drug safety, in animal experiments and in phase 1-3 clinical trials, provides insufficient evidence of safety. Accordingly, it is vital to monitor safety of all medicines throughout their marketed life because adverse drug reaction-related cost to the country may exceed the cost of the medications themselves. The study of ADRs is the concern of the field of pharmacovigilance which is gaining importance as the number of stories of drug recalls increases. The WHO international drug monitoring program started in 1968; it is located in Uppsala, Sweden. In Egypt, the Egyptian PV Centre was established in 2009 and is linked to the global PV system. The program is based on voluntary ADR reporting and monitoring and is vital for maintaining drug safety. Voluntary reporting by physicians and other health providers and consumers may alert the authorities and pharmaceutical companies to possible adverse effects of drugs. It aims in reducing the risks associated with drug prescribing and administration and improving patient care, safety and treatment outcome. The Yellow Card Scheme was founded in 1964 after the thalidomide disaster. It receives more than 20,000 reports of possible side effects each year. To conclude, pharmacovigilance is a dynamic clinical and scientific discipline. It provides reliable, balanced information for the effective assessment of the risk/benefit profile of medicines. Under-reporting remains the corner stone that hinders pharmacovigilance activities.

Session Introduction

Mohamed M El-Khawanki

Najran University, KSA

Title: Title: Does Clozapine induce Myocarditis, Myocardia l oxidative stress and DNA damage in Rats?

Biography:

Mohamed M. Elkhawanky MD-PhD; Associate professor of Clinical Hematopathology in College of Medicine, Najran University, Saudi Arabia. He is a founding member of the PBL Medical Education Committee at the Najran University. Dr. Elkhawanky received his medical degree from College of Medicine, Zagazig University, Egypt in 1999. He subsequently completed a 3-years residency program at Zagazig University Hospitals. He holds MD-PhD in Clinical Hematopathology from College of Medicine, AL-Azhar University. Dr. Elkhawanky conducts several funded research projects concerning medical problems and their solutions and has published widely. He has been invited to speak at several international scientific conferences.

Abstract:

Clozapine is an atypical antipsychotic drug selectively effective in the treatment of refractory schizophrenia. However, myocarditis, as a serious cardiotoxic effect, has in several case reports been associated with clozapine therapy. An increase in the free radical production and ischemia, probably induced by clozapine-induced release of catecholamines, have been hypothesized to trigger an inflammatory response that leads to the clinically observed cardiomyopathy and sudden death even in young patients. The aim of this work is to study the role of oxidative stress in clozapine induced myocarditis and myocardial DNA damage in a rat model. Methods: Male Wistar rats, age _6 weeks, were administered 5, 10 or 25 mg/kg clozapine daily for 21 days; saline-treated rats served as the control. Heart sections were stained with hematoxylin and eosin for histopathological examination. Plasma CK-MB, LDH and TNF-α concentrations were determined. Myocardial oxidative stress (MDA and NO), antioxidant (GSH and GSH-Px) parameters, and the marker of oxidative DNA damage (8-OHdG) were determined. Results: Clozapine treatment resulted in significant dose-related increases in myocardial inflammation with increased plasma TNF-a, CK-MB and LDH levels. Myocardial MDA, NO and serum and cardiac 8-OHdG levels increased while GSH level and GSH-Px activity decreased with the highest significance seen with the largest tested dose (25 mg/kg) of clozapine. Conclusions: Clozapine, in relatively large doses induced myocarditis consistently with increased myocardial oxidative stress, DNA damage and inflammatory cytokines in a rat mode.

Marwa M Fawzi

Taibah University, KSA

Title: Medicolegal aspects concerning Tramadol abus e. The new Middle East youth Plague

Biography:

Dr Marwa M Fawzi Associate Professor & Coordinator of Forensic Medicine and Clinical Toxicology, Medical Professionalism, Medical Ethics and law courses Faculty of Medicine Taibah University ,KSA .She has received her M.D. degree in Forensic Medicine from Ain Shams University. Egypt 2006 .She had joined the academic line as a demonstrator in 1998 up to 2011 as an Assistant Professor in the department of Forensic Medicine and Clinical Toxicology ,ASU ,Egypt. She contributed in management of toxicological emergencies cases in Poison Control Center Ain Shams University Hospitals PCCASU 2000-2011. Specialized in Health Care Quality Management, patient safety MOH. She participated in WHO projects, conferences, workshops and committees. She has national and international publications in the field of medical ethics ,forensic , clinical toxicology and communications skills .She is member of national and international Forensic societies

Abstract:

An increasingly alarming phenomenon of tramadol drug abuse has been demonstrated in the Egyptian community in the last four years. Although the issue of drug abuse is not a newcomer to the Egyptian society, tramadol has been associated with a wide range of drug abuse and its illegal drug transactions had made it easily accessible and readily provided at cheap costs despite of its being a scheduled drug. The alleged usages of tramadol had also contributed greatly to its popularity and massive use especially among Egyptian youth as a remedy for premature ejaculatory function and for extended orgasm and increase sexual pleasure as promoted through many online drug stores and media.Aim of the work:To study the impact of tramadol increasing rates of drug abuse on the observed association with forms of aggression and accidents.Patients and methods:This study was carried out on the patients who presented to Poison Control Center of Ain Shams University Hospitals, Egypt in the year 2010 presented with trauma with suspected associated drug toxicity for toxicological assessment. RESULTS: Number of studied cases was 640 with the adult population showing ahigher prevalence (67.9%). The prevalence was higher in males (77.2%). Abuse form of drug intake was the highest (50.8%). The oral route of intake is the highest (96.8%). Patients abusing tramadol presented with any clinical finding denoting involvement in an act of violence or giving history of it (36.3%), forms of accidents whether road traffic accidents (18.7%), acts of violence as fights and domestic violence (33%) and accidental fall and unintentional self-induced injuries (48.3%).The most frequent forms of injuries were cerebral edema (55.9%) and the least being inter cerebral hemorrhage (5%) both diagnosed both clinically and as a CAT SCAN brain finding. Whilst as forms of injuries were lacerated wounds (38.9%), contusions (35.3%), abrasions (31.3%), cerebral concussion (22%), and bone fracture (17.8%), and polytrauma (11%).Conclusions:The significantly notable increasing violence forms are closely related to drug abuse. Tramadol’s prevalence is the mostly noted due to its wider availability and cheaper prices than other types of abused drugs.Recommendations:Drug screening for tramadol should be added to all forms of basic toxicological screening. Especially in cases of patients involved in violent crimes and road traffic accidents, also for those applying for drivers’ license fitness program

Massoud Toussi

IMS Health,France

Title: Using routinely collected electronic Healthc are data for Safety evaluation of drugs: Lessons learneds

Biography:

Massoud Toussi, MD, PhD, MBA, is leader of Pacharmoepidemiology and Drug Safety Activities in IMS Health. Massoud is medical doctor with an MD degree in general medicine and a university degree in psychiatry. After working as a clinician for about three years he specialized himself in in medical informatics and pharmacoepidemiology and the analysis of healthcare data by obtaining a Master’s degree and a PhD in this domain. He also obtained an MBA from University of Paris Dauphine (France) and a Master’s degree international management from Unviersity of Quebec-Montreal (Canada). He is an active member of the International Society of pharmacoepidemiology (ISPE), European Network of centers of Pharmacoepidemiology and Pharmacovigilance (ENCePP) and European Public Health Association (EUPHA).

Abstract:

Routinely collected data include a wide variety of data sources such as electronic medical records (EMR), hospital and outpatient claims databases, pharmacy dispensing, laboratory exam, genetic data and patient reported databases as well as the data gathered through connected devices such as glucometers. Good understanding of the value and caveats of each type of data can help a better selection of data sources for research and avoiding bias. To present lessons learned and return of experience on different categories of databases and discuss on usages, data collection methods, strengths and weaknesses of each data. Generating evidence form real world data involves using a variety of data sources. Unlike the data gathered through clinical trials, the real world data sources are numerous and heterogeneous. Although there is growing interest for the use of routinely collected data in pharmacoepidemiology, the experience with some types of data such as dispensing data and prescription-diagnosis surveys is very limited in pharmacoepidemiology whereas they can provide useful insights on the appropriate use of drugs and the assessment of risk minimization measures. The methods of data collection for each type of database will be explained. Using examples from their real life practice, the speaker will discuss on the common caveats of different types of data sources and the potential biases related to their use, as well as strategies to avoid them. They will also address how to combine and link different types of data.

Hayam Ateyya

Cairo University, Egypt

Title: Amelioration of Cyclosporine induced Nephrot oxicity by Dipeptidylpeptidase inhibitior Vildagliptin

Biography:

Hayam Ateyya has completed her MB.Bch degree in medicine& surgery at the age of 25 years from Cairo University, Faculty of Medicine and M.D Degree in Pharmacology from Cairo University, faculty of Medicine. She is working now as assistant professor at Taibah university in KSA.

Abstract:

Cyclosporine A (CsA) is an immunosuppressive drug used in organ transplantation and autoimmune diseases but its clinical uses may be limited due to its dose-related nephrotoxicity. This study was carried out to evaluate the possible protective effects of vildagliptin (VLD) against CsA-induced nephrotoxicity in rats. Animals were divided into four groups treated as follows: control group (CsA & VLD vehicle); VLD group (10 mg/kg/day, orally); CsA group (20 mg/kg in sunflower oil, S.C.); and CsA-VLD group (CsA &VLD). Induced nephrotoxicity was evidenced by a significant elevation of serum creatinine, blood urea nitrogen (BUN), lactate dehydrogenase (LDH) and urinary micro total proteins (MTP), while serum albumin and urinary creatinine clearance were significantly decreased compared to control group. Moreover, renal dysfunction was further confirmed by a significant increase in renal lipid peroxide that was measured as renal malondialdehyde (MDA). Renal reduced glutathione (GSH) and superoxide dismutase (SOD) were significantly decreased. Nephrotoxicity was further confirmed by renal tissues histopathology. Also, a high protein expression of Bax with decreased Bcl-2 was revealed in renal tissue of CsA treated group. Administration of VLD significantly ameliorated the nephrotoxic effects of CsA suggesting antioxidant, anti-inflammatory and anti-apoptotic benefits of VLD in CsA-induced nephrotoxicity

Nermine El Maraghy

Suez Canal University, Egypt

Title: Pattern of Hospital-acquired Pneumonia in in tensive care unit of Suez Canal University Hospital

Biography:

Dr/ Nermine El-Maraghy is associate professor of medical microbiology & immunology . I had master and Ph.D in medical microbiology & immunology from facuulty of Medicine suez Canal University ; Ismailia, Egypt. I am member of tumor oncology unit, clinical epidemiology units at faculty of medicine suez canal University. I had great experience in the era of clinical immunology, allergy skin prick test, immunotherapy, diagnostic microbiology and infection control. I have several international publications (13) on pubmed , google scholar a. I am reviewer of the Infectious & Non-Infectious Diseases(online), Suez Canal University Medical Journal and Eastern Mediterranean Health Journal( online) .As well as professional diplome of infection control from AUC , Egypt ..

Abstract:

Hospital acquired pneumonia occurs more than 48 h after hospital admission and was not present at the time of admission, while ventilator associated pneumonia occurs after 48–72 h of endotracheal intubation or within 48 h of extubation. HAP is the second most common nosocomial infection and accounts for approximately 25% of all infections in the Intensive Care Unit worldwide. Purposes To identify the etiology, initial evaluation, prevention, and treatment of adult patients with ICU HAP, and VAP in Suez Canal University hospital and their management strategies. Methods This study was conducted in the department of ICU, Suez Canal University Hospital; Ismailia, Egypt in the period from May to August 2013. All the patients were subjected to clinical and radiological assessment, Endotracheal aspirate samples for culture, and sensitivity to determine the causative organisms, Clinical Pulmonary Infection Score was done in order to determine the severity of HAP. Results 89% of patients were suffering from VAP, while 11% were suffering from HAP, with mean age of 63.8 ± 10.47 years. Methicillin-resistant Staphylococcus aureus, and Klebsiella pneumoniae represented the most common isolated organisms that accounted about 65% of the studied population. The isolated microorganisms were resistant to Amoxicillin, MRSA showed highest sensitivity (44.4%) to Vancomycin and (27.8%) to Imipenem. K. pneumoniae were sensitive mainly to Imipenem (75.9%) and to Levofloxacin (44.8%). Conclusion Gram-negative organisms were isolated in 46% of cases, gram-positive organisms in 41% and the isolated organisms showed high resistance to most of the tested antibiotics

Samira Saleh

Future University, Egypt

Title: Why do we need Pharmacovigilance?

Biography:

Samira Saleh, PhD Cairo University and postdoctoral studies Strathclyde University, UK, is currently Head of the Department of Pharmacology, Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University. She is a Board member of The Egyptian Society of Pharmacology and Experimental Therapeutics and the Editor-in-Chief of the Egyptian Journal of Basic and Clinical Pharmacology. She makes Evaluation of Science and Technology Development Fund (STDF) projects. She has published around 85 papers, supervised more than 50 thesis and made presentations at more than 60 conference. She won Prizes from the supreme council of universities for publishing papers in International journals.

Abstract:

In the 1960’s, the thalidomide disaster led to limb deformities in the newborns of those mothers who took the drug while pregnant. This implies that premarketing evaluation of drug safety, in animal experiments and in phase 1-3 clinical trials, provides insufficient evidence of safety. Accordingly, it is vital to monitor safety of all medicines throughout their marketed life because adverse drug reaction-related cost to the country may exceed the cost of the medications themselves. The study of ADRs is the concern of the field of pharmacovigilance which is gaining importance as the number of stories of drug recalls increases. The WHO international drug monitoring program started in 1968; it is located in Uppsala Sweden. In Egypt, the Egyptian PV Centre was established in 2009 and is linked to the global PV system. The program is based on voluntary ADR reporting and monitoring and is vital for maintaining drug safety. Voluntary reporting by physicians and other health providers and consumers may alert the authorities and pharmaceutical companies to possible adverse effects of drugs. It aims at reducing the risks associated with drug prescribing and administration and improving patient care, safety and treatment outcome. The Yellow Card Scheme was founded in 1964 after the thalidomide disaster. It receives more than 20,000 reports of possible side effects each year. To conclude, pharmacovigilance is a dynamic clinical and scientific discipline. It provides reliable, balanced information for the effective assessment of the risk/benefit profile of medicines. Under-reporting remains the corner stone that hinders pharmacovigilance activities.

Session Introduction

Tomaz Crochemore

Israelita Albert Einstein Hospital, Brazil

Title: Thromboelastometry-guided Hemostatic therapy : An efficacious approach to manage bleeding risk in acute fatty liver of Pregna ncy: A case report

Biography:

Dr. Tomaz Crochemore is physician, a specialist in intensive care medicine, whose area of expertise is in Hemostasis and Thrombosis, with extensive experience in the study of rotational thromboelastometry. Doctor responsible for the Support Group in coagulation and hemostasis of the intensive care unit of the Hospital Israelita Albert Einstein, São Paulo - Brazil

Abstract:

INTRODUCTION: Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening disease. AFLP is characterized by liver failure with different degrees of coagulopathy. Outcome and survival can be dramatically improved with prompt recognition and treatment. Thromboelastometry has been considered a point of care for the management of bleeding patients. It could, therefore, be an alternative tool to treat the complex cases of AFLP involving liver failure and coagulopathy. Through this study, we present our successful experience of an AFLP case that was submitted to an emergency cesarean section in which blood transfusion was guided by thromboelastometry