apter 1
The Problem and Its Setting
Introduction
Thrombocytopenia or abnormally low platelet counts in the body are typically caused by genetic disorder or fatal diseases. This condition may result from thromboembolic or hemorrhagic complications caused by heparin as well as from various diseases states such as chronic liver disease and dengue hemorrhagic fever. In most rural areas a health care institution is often inaccessible and most patients cannot afford high cost medication. Henceforth, herbal medicines are often used as an alternative treatment. Inadequacy of providing supportive treatment to correct the decrease of platelet is fatal to patients. Thus, several decoctions of herbal plants are purportedly used to improve platelet count.
Recently, the mortality rate in heparin – induced thrombocytopenia (HIT) has been reported as high as 20% (Greinacher & Lubanow, 2003). Retrospective data shows that up to 8% of heparinized patients will develop the antibody associated with HIT and that approximately 1–5% of patients on heparin will progress to develop HIT with thrombocytopenia suffering from venous and/or arterial thrombosis in at least one-third of cases (Warkentin et al., 1998). Heparin – induced thrombocytopenia (HIT) is a potentially devastating immune mediated adverse drug reaction caused by the emergence of antibodies that activate platelets in the presence of heparin. Despite thrombocytopenia, bleeding is rare; rather, HIT is strongly associated with thromboembolic complications such as death and amputation which involves in both arterial and venous systems (Franchini, 2005). One of the popular diseases in the tropical country that is responsible for the drastic decrease in platelet count (thrombocytopenia) could be Dengue as reported by the Department of Health in the Philippines; National Epidemiology Center in 2005, there were 17,934 dengue cases and 249 deaths reported from January to September 2005. Moreover, in the year 2006, there is 2, 125, 039 cases with reported 257 deaths in January to October 2006. But despite its notoriety and prevalence in such areas, in depth research into its nature and mechanism of infection and pathogenicity has been partially stifled by the complicated structural and physiological aspects of the virus once it has entered a suitable host. According to Agapito Hornido, Davao del Norte provincial health officer, said that dengue figures are usually higher in highly urbanized cities such as Davao City. At a press conference briefing on dengue held at the Big 8 Corporate Hotel in Tagum City, Hornido qouted ‘’ Davao del Norte’s dengue cases reached 2,930, with one recorded death, last year.’’ Stated by Ebol that 234 of that dengue cases were considered severe. Nowadays people are being bombarded with thousand of medications, the level of sensibility in front of diseases is very high and that's why the use of medicinal plants can represent the best solution. Practically in the Philippines, an old herbal medicine known as the Tawa-tawa plant (Euphorbia hirta Linn.) - a common folkloric plant that also otherwise recognized as gatas-gatas or mangagaw (Quisumbing 1978 ). Practitioners of traditional medicines believe that Tawa-tawa is good for patient suffering from Dengue, which can cause thrombocytopenia – a persistent decrease in the number of platelets in the blood that is often associated with hemorrhagic conditions. Patients and professionals alike have continued to use of Tawa-tawa plant (Euphorbia hirta Linn.), due to its claimed ability to increase platelet counts even without solid evidence to support its clinical use (Philippine Pharmaceutical Association, 2009) As evident from folklore uses of Tawa-tawa plant (Euphorbia hirta Linn.) , they cause alleviation from number of diseases. Traditionally, one of the common remedial actions was for combating fall in platelet count and their influence on blood disorders. Even though modern method of treatment is successful in ameliorating the pains and discomforts of human being, there is still dearth of discovery for effective management of thrombocytopenia. In line with this scenario, the research envisaged is designed to explore the role of Tawa-tawa (Euphorbia hirta Linn.) plant, as well as in combination on heparin - induced thrombocytopenia in albino mice.
Statement of the Problem
The researchers intended to determine the effectiveness of the Tawa-tawa (Euphorbia hirta) on increasing the platelet count of thrombocytopenic mice. The researchers are intended to find out the extent of the effects of “Tawa-tawa” in increasing the platelet count in heparin – induced thrombocytopenic mice.
Specifically, this research seeks the answers of the following questions:
Is there a significant increase of platelet in heparin – induced thrombocytopenic mice?
Is there a possible difference on platelet count of heparin – induced thrombocytopenic mice on the following group:
Group A – Control Group (Distilled Water)

Group B –Experimental Groups (Ethanolic Extract of Euphorbia hirta) On Different Concentrations:

100mg/ml
150mg/ml
200mg/ml Null Hypothesis
There is no significant effect in increasing platelet in Aqueous Extract of Tawa – tawa (Euphorbia hirta) plant.
Is there a possible difference on platelet count of heparin – induced thrombocytopenic mice on the following group:
Group A – Control Group (Distilled Water)
Group B –Experimental Group (Ethanolic Extract of Euphorbia hirta) On Different concentrations:
100mg/ ml
150mg/ml
200mg/ml

Theoretical Framework The oldest remedies known to mankind are herbal medicines. Tawa-tawa (Euphorbia hirta L.) in the Philippines is one of them. It has been considered as a folkloric herbal remedy for Dengue that causes faster recovery compared to the body’s natural restoration of health. . Practitioners of traditional medicines believe that decoction of tawa–tawa leaves can reverse viral infection and prevent the fever from moving into critical stages, although there are no scientific studies proving its effectiveness. More recently, concerns from local authorities have been raised in the reported rampant indiscriminate use of E. hirta in the management of dengue patients. Despite, warnings from health authorities that there is not enough efficacy and safety data to support its clinical use, patients and health professional continued to use E. hirta.
The confidence of the general public in the effectiveness of E. hirta in treating dengue cases was solely based on the results of animal studies showing that it exerts a platelet count-increasing activity, and testimonials from patients or health professionals who claimed to experience clinical benefits from its use. To safeguard the public, more detailed information should be provided to let both the patients and the health professionals fully understand the potential dangers of using E. hirta in dengue patients or in any other medical conditions that concerns in increasing platelet activity (National Drug Information Center, Philippines).
Conceptual Framework The researchers will use this to conceptualize the theoretical data gathered. It is to identify the thrombogenic activity of Euphorbia hirta. The illustration below shows the dependent and independent variable of data. The dependent variable is the Platelet Count Activity of Heparin – Induced Thrombocytopenic mice. The independent variable is the Ethanolic Extract of Tawa-Tawa (Euphorbia hirta) Plant.