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The aim of this study is to assess the practice of heparin administration in real-life situations. This study was conducted at the coronary care unit (CCU) in one of the busiest hospitals in Kuwait; with special attention to the rate of heparin resistance, potential factor that may predict resistance or responsiveness and heparin related complications. A prospective observational study was conducted in Farwania hospital over a 4-month period; this study included 146 patients admitted to the CCU. Patients were treated with UFH according to a standard normogram. Several variables were collected and analyzed, including demographic data, initial diagnosis, activated partial thromboplastin time (APTT) on admission and at 6, 24, and 48 h after UFH administration, and any complications that occurred. A significant number of patients had subtherapeutic APTT at 6, 24, and 48 h (41.1%, 42.3%, and 46.7%, respectively). There were four factors that predicted heparin resistance, including race, gender, admitting diagnosis (unstable angina vs. acute myocardial infarction), and an APTT ratio of less than one on admission. There was no significant difference in the rate of development of complications among different groups. Heparin resistance is a common phenomenon especially in the first period of heparin therapy. Special attention should be given to some groups like females, patients admitted with unstable angina, and those with APTT below the normal range. Evidence based protocols for Heparin administration and monitoring must be adopted to prevent the risk of under or over anticoagulation. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the efficacy and safety of rituximab in the treatment of patients with idiopathic thrombocytopenic purpura (ITP). A prospective study was performed at Mubarak Al-Kabeer University Hospital involving the use of rituximab in 14 patients who had previously been treated with steroids, steroid sparing drugs, and splenectomy. Several variables have been collected and analyzed including age, gender, treatment received prior to rituximab, co-morbid condition, platelet count before treatment, response to treatment, duration of response, relapses, response to re-treatment, and adverse effects. Of the 14 treated patients, complete remission was achieved in 11 patients, partial remission in two patients, and no response in one patient. Median duration of responses were 12.5 months, ranging from 2 to 19 months. Four patients had at least one relapse. Responses were seen in splenectomized and non-splenectomized patients. This study is the first attempt to evaluate the efficacy and safety of rituximab in the treatment of ITP in the Middle East area. Our findings support the result of other case reports, case series, and pilot studies; however, a randomized control trial is needed to confirm the results of our study. [ABSTRACT FROM AUTHOR]