@article {2448, title = {Successful Practice of Massive Transfusion in Traumatic Amputation of Digit I-V Manus Dextra: A Case Report}, journal = {Pharmacognosy Journal}, volume = {16}, year = {2024}, month = {December 2024}, pages = {1436-1438}, type = {Case Report}, chapter = {1436}, abstract = {

Introduction: Massive blood is the main cause of mortality and morbidity in trauma patients, in which 6 out of 10 cases are reported to die. Case presentation: A 29-year-old man appears to have experienced an amputation of digit I-V manus dextra. Vital signs are in stable condition and the patient is also conscious (GCS of 15) with ASA PS 1. The patient underwent debridement and replantation for 18 hours. Post-first surgery, we found blood seepage in the surgical wound, which for 4 hours showed 2000 mL of blood. The patient experiences decreased consciousness (GCS of 9), hypotension (77/40 mmHg), HR of 130 {\texttimes}/min, and cold extremities. The patient received resuscitation with 1000 mL of crystalloid, 500 mL of colloid, 800 mL of WB, and 400 mL of PRC transfusion. Abnormal laboratory examination revealed Hb 4.6 g/dL, albumin 1.4 g/dL, and prolongation of hemostasis function 2 times. The patient underwent reoperation and was found to have ruptured muscles and veins for which musculorraphy and venorraphy were performed for 16 hours. On the 3rd day, the patient experienced breathing difficulties (RR of 30 {\texttimes}/ min and SO2 of 95\%) and the chest x-ray showed lung edema. The patient was placed on a ventilator using NIV and furosemide 20 mg/8 h. The patient regained consciousness on the 7th day. Discussion: The principle of managing massive bleeding is to stop the bleeding, restore blood circulation volume, and maintain peripheral vascularization. Conclusion: Massive transfusion is a management strategy for preventing death due to hemorrhagic shock.

}, keywords = {Bleeding, Blood massive protocol, Hemorrhagic shock, Trauma}, doi = {10.5530/pj.2024.16.231}, author = {Kashi Ameta Resijiadi Juwono and Maulydia and Prananda Surya Airlangga} } @article {1975, title = {Sub Chronic Toxicity Study of Coumacines}, journal = {Pharmacognosy Journal}, volume = {15}, year = {2023}, month = {March 2023}, pages = {160-164}, type = {Research Article}, chapter = {160}, abstract = {

Coumacine is a brand-new heterocyclic molecular nucleus that was discovered in 2018. In addition to the unique heterocycle known as coumacine, the designer has developed two variants known as coumacine I and II. Coumacine derivatives had been evaluated for their antibacterial effects in vitro against a variety of aerobic and anaerobic bacteria using conventional bacterial strains, using ciprofloxacin and metronidazole as positive controls. The purpose of this research is to look into the relationship between the anticoagulant activity and hepatotoxicity of coumarin and coumacine because the former is a synthetic precursor of the latter and many natural and synthetic coumarins involving warfarin have anticoagulant activity. Thirty male mice were used in this study and exposed to a subchronic dose of 250 or 500 mg/kg of coumacine I or coumacine II. The results of histochemistry showed dramatic changes in hepatocellular morphology that were dose-dependent for both coumacine I and II. Traditionally, higher doses of Coumacine I and II resulted in a significant increase in liver enzymes. Coumacine I or II did no effect on bleeding time. In conclusion, coumacines at subchronic high doses might have hepatotoxic effects through a mechanism that does not affect the coagulation process

}, keywords = {Bleeding, Clotting., Coumacine, Hepatotoxicity}, doi = {10.5530/pj.2023.15.23}, author = {Wejdan Al-Shakarchi and Yasir Saber and Marwan M. Merkhan and Yasser Fakri Mustafa} }