INR is called the international normalized ratio. INR is checked for the patients taking anticoagulants. INR is assessed by taking the prothrombin time test, which tells the blood's ability to form clots. With an intake of Warfarin (and other anticoagulants), the INR lies between 2.0 to 3.0. Without taking anticoagulants, the PT time lies between 11 to 13 seconds, and the INR lies between 0.8 to 1.2.
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With elevated INR,is it safe to undergo surgery?
Query: Hi doctor,My wife is 34 years old. Her INR is 3.34 and blood factor VII activity test showed less than 2%. Her CT and BT are normal. She has been advised to undergo gallbladder removal.With same condition, she had given birth to two babies through normal delivery (second one was one and a half years... Read Full »
Answer: Hi, Welcome to icliniq.com. Based on your query, my opinion is as follows: The values are highly abnormal to think of any major surgery. Bleeding should have occurred during tooth extraction, but I am not sure why it did not happen. If any bleeding occurs during surgery due to present values, ... Read Full »
What causes delayed wound healing?
Query: Hi doctor, I am a traveler. Recently, I noticed that any of my cuts were taking a very long time to heal and are never fully recovering. They are leaving a small scar or discoloration. Initially, I thought that the cut did not heal as I was in the water every day for a few hours. Insect bites are t... Read Full »
Answer: Hi, Welcome to icliniq.com. The cut seems to be healed now as most of it show scarring. Other than that, the marks appear from scratching the skin might be due to irritation. Also, the bite is clearly visible and does not look serious. Certain mosquitoes are more notorious for causing itching... Read Full »
Why am I getting bruises on my legs often?
Query: Hi doctor, I keep getting bruises on both of my legs and they are in different colors. I have not banged recently and I do not know the reason. What can it be? I am regularly using an inhaler for asthma. Read Full »
Answer: Hi, Welcome to icliniq.com. Easy bruisability is not an uncommon complaint and has multiple causes for it.As a baseline, you would need to undergo a panel of investigations to know regarding the status of your bleeding and clotting profile.Reasons can vary from simple normal skin tendency to vitamin... Read Full »
Query: Hello doctor, I take the tablet Warfarin 15 mg daily, but my INR is still below 2. And my doctor advises me to stay on 15 mg of tablet Warfarin for three more months. What is your opinion on this? Read Full »
Dr. Mahmoud Ahmed Abdelrahman Abouibrahim
Answer: Hello, Welcome to icliniq.com. I read your query and can understand your concern. Your symptoms are most likely due to Warfarin resistance which causes low INR (international normalized ratio), although the dose of Warfarin is high. The possible causes are hereditary or acquired by eating food r... Read Full »
Can Ortho Tri-Cyclen Lo cause bruises?
Query: Hello doctor, I began taking Ortho Tri-Cyclen Lo at the start of this month due to follicular cysts. I have observed two bruises on my arms and one on my leg. Are these side effects of the contraceptive? Read Full »
Answer: Hello, Welcome to icliniq.com. I would be in a better state to answer if you could attach a photograph of the area. Also, mention if is there any itching. Do the lesions appear and disappear, or are they persistent? Read Full »
How to prevent clots and blockages after an ischemic stroke?
Query: Hello doctor,My 71-year-old mother got a couple of ischemic strokes nearly two months ago. She was then given strong blood thinning injection, which led to a couple of blood vomits and a hemorrhage as well. During the hospitalization as well as afterward, she has been taking Pradaxa 110, etc. (presc... Read Full »
Answer: Hello, Welcome to icliniq.com. I have gone through the files attached (the attachment was removed to protect the patient's identity). The clots which are found at so many places in the body are basically originating from the heart and being thrown into the body as she is post-MVR (mitral valve re... Read Full »
Why does my father have repeated subdural hemorrhages?
Query: Hello doctor, My 70 year old father had undergone left frontal and parietal, right frontal burr hole craniostomy with an evacuation of subdural hemorrhage under LA and sedation last month. Before the operation, his right side was not working and the problem was resolved after the operation and the ... Read Full »
Answer: Hello, Welcome to icliniq.com. The SDH (subdural hemorrhage) diagnosis usually does not go wrong. Since they have operated for the same, it is very unlikely that there is any diagnostic dilemma. Chronic SDH recurrence is known to happen. And re-exploration needs to be done for the same. The cause of... Read Full »
Query: Hello doctor, I am writing on behalf of my sick father. Last year, he suffered a brain stroke on the right side of the brain, which caused paralysis on his left side of the body. A week after that, he was diagnosed with heart blockage, which needed a bypass procedure. After treatment, he started rec... Read Full »
Answer: Hello, Welcome to icliniq.com. I read your query and understand your concerns. If you ask me with the formed conclusion that the bladder bleeding is resulting from the use of blood thinners, I would say yes there is need to stop Aspirin. This is a straight forward answer, as the risk of bleeding is... Read Full »
I am on Warfarin. Can a sudden blow result in a stroke?
Query: Hello doctor, I am on warfarin for life. Yesterday, while I was working in my house, I knocked the upper back part of my head on the marble roof of the window pane. It was neither a hard blow nor a soft one. It was medium. I did not feel any pain. I did not have any blackout but was stunned for two... Read Full »
Answer: Hello, Welcome to icliniq.com. Firstly, I would like to know the indication for which you were prescribed Warfarin. Secondly, 3.73 is a higher INR (international normalized ratio) than normally desired which usually is between 2 to 2.5 or 2.5 to 3 according to indications, in most of the cases. Now,... Read Full »
What are the effects of Paracetamol poisoning?
Query: Hi doctor, My cousin is a 20-year-old female with a weight of 73 kg and a height of 5'6 feet. She took 18 tablets of Dolo 650 in a day. What will happen to her? She took the medicine yesterday, and she vomited it after eating some food in the evening. Now, she is feeling quite well. What can happen... Read Full »
Answer: Hello, Welcome to icliniq.com. I have gone through your query and understand your concern. I would like to know the following: 1) Does she have any symptoms like nausea, malaise, vomiting, or abdominal pain? 2) How many hours have passed since she has taken the PCM (Paracetamol) tablets? 3) Di... Read Full »