الفهرس 
Vitamin K and its Role in Coagulation
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Abstract
Background: Vitamin K deficiency is an important cause of an acquired bleeding diathesis in neonates and infants. Vitamin K is synthesised by intestinal bacteria and its deficiency does not develop in healthy infants receiving a normal diet. However, in the presence of diarrhea and/or antibiotic usage vitamin K deficiency may occur leading to incomplete carboxylation of procoagulant factors II (prothrombin), VII, IX and X.
Aim of work: To determine the magnitude of persistent diarrhea on the bleeding profile and vitamin K status.
Methods: Sixty-seven children with persistent diarrhea and 75 healthy children as a control, aged from 6 weeks to 24 weeks, were recruited from both the outpatient clinic and in patients’ facility in pediatric department at Ain Shams university hospitals, Egypt. Clinical assessment was studied laying stress on dietetic history, as well as history of fever, diarrhea, antibiotic administration and vitamin K administration at birth. The following investigations were done: complete blood count; prothrombin time (PT); activated prothrombin time (APTT); liver function tests (ALT, AST) and vitamin K levels.
Results: Patients with persistent diarrhea showed significant decrease in vitamin K level in comparison to control. Impaired bleeding profile was present in 43.3% of the cases and only in 5.3% of the control group. There was significant correlation between duration of diarrhea and vitamin k level in blood. None of the studied patients and control had manifest bleeding, except only one case who presented with intracranial hemorrhage.
Conclusion: Patients with persistent diarrhea had significant decrease in vitamin K level and consequently vitamin K prophylaxis is of great value in those patients.