Dietary Supplements Clinical Trial
Official title:
Viscoelastic Point-of-Care Coagulation Monitoring and Dietary Supplements: A Randomized, Double-blind, Placebo-controlled Trial
Dietary Supplements can affect platelet activation and aggregation, which could result in bleeding tendencies. This study wishes to evaluate the influence that these supplements has on platelet function using Rotational thromboelastometry.
The WHO informs us that more than 80% of patients in Africa use traditional/herbal medicines
as their primary source of health care. The Mayo Clinic stated that nearly 40% of adults
reported using complementary and alternative medicine (CAM). Many of these herbal medicines
as well as dietary supplements have effects on the coagulation cascade and have been
identified as such using laboratory tests including aPTT, PT, INR, light transmission
aggregometry and impedence aggregometry to mention but a few.
This study wishes to evaluate coagulation abnormalities using viscoelastic point-of-care
coagulation monitoring in this population. This test is readily available in large hospitals
and academic settings and is increasingly being used in perioperative medicine. It provides
information on coagulation and thrombolysis with minimal delay when compared to other
laboratory-based coagulation tests.
The dietary supplements which will be evaluated in this study are ginger, garlic, gingko
biloba and ginseng. These four herbal supplements were identified as the most commonly used
substances known to modulate the coagulation system. These herbal supplements will be
investigated within their maximum daily allowance dosages.
A five-armed placebo-controlled study will be undertaken and study subjects will be recruited
on a volunteer basis. Subjects will be divided into five groups and each group will receive
one of the four dietary supplements and the fifth group placebo, for a two week period.
Rotational thromboelastometry (ROTEM) studies will be performed on blood samples obtained
from each participant at baseline and at the end of the treatment period to identify
coagulation abnormalities. Most of these herbal medicines have been identified to affect
platelet function and this study will specifically look at platelet function determined by
maximum clot firmness (MCF) in the ROTEM analysis.
Viscoelastic point-of-care coagulation monitoring in patients using herbal medicines and
dietary supplements will aid decision making regarding cause of perioperative haemorrhage and
need for specific blood products. It will therefore assist with goal-directed management of
perioperative haemorrhage. It will also aid the anaesthetist wishing to employ a regional
anaesthetic technique in this patient group.
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