Kamran Nazir, Suhaib Ahmed, Shawana Kamran, Jaleel Anwar.
Frequency of bleeding disorders diagnosed at Armed Forces Institute of Pathology Rawalpindi.
Pak Armed Forces Med J Jan ;61(3):387-90.

Objective: To determine the frequency of bleeding disorders diagnosed at Armed Forces Institute of Pathology, Rawalpindi (AFIP Rwp). Study design: Descriptive study. Setting and duration: Department of Hematology, AFIP Rwp from January 2006 to June 2009. Materials and Methods: A total of 1836 patients of bleeding diathesis were included in the study. Hess test was done to investigate the vascular defects. Bleeding Time (BT) was done to screen platelet function defects. The ‘clotting screen’ and mixing studies were done to detect coagulation protein defects. Clot solubility test was performed to screen factor XIII deficiency. Results: Out of 1836 patients of bleeding diathesis 435 (23.7%) were diagnosed as having haemostatic defects. Out of these 435 patients 273 (62.8%) had coagulation factor deficiency, 81 (18.6%) had platelet function defects and 81 (18.6%) had vWF deficiency. Among the 273 coagulation factor deficiency patients, factor VIII deficiency was in 121 (44.3%), factor IX deficiency in 32 (11.7%), factor V deficiency in 18 (6.6%), factor XIII deficiency in 15 (5.5%), factor VII deficiency in 12 (4.4%), factor X deficiency in 9 (3.3%), factor I deficiency in 8 (2.9%) and factor II deficiency was in 3 (1.1%). Multiple factor deficiency was 55 (20.1%). No defects of vasculature were identified. Conclusion: Coagulation factor deficiencies, with factor VIII deficiency being the commonest are the most frequent bleeding disorders. Platelet function defects and vWF deficiency also comprise significant proportion of the bleeding disorders.

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