{"version":"1.0","provider_name":"Kliniki ya Huduma ya Mjini","provider_url":"https:\/\/urbancare.clinic\/sw","title":"Warfarin induced skin necrosis - Urban Care Clinic","type":"rich","width":600,"height":338,"html":"<blockquote class=\"wp-embedded-content\" data-secret=\"Ad4IQl7e5g\"><a href=\"https:\/\/urbancare.clinic\/sw\/warfarin-induced-skin-necrosis\/\">Warfarin iliyosababishwa na necrosis ya ngozi<\/a><\/blockquote><iframe sandbox=\"allow-scripts\" security=\"restricted\" src=\"https:\/\/urbancare.clinic\/sw\/warfarin-induced-skin-necrosis\/embed\/#?secret=Ad4IQl7e5g\" width=\"600\" height=\"338\" title=\"&#8220;Warfarin induced skin necrosis&#8221; &#8212; Urban Care Clinic\" data-secret=\"Ad4IQl7e5g\" frameborder=\"0\" marginwidth=\"0\" marginheight=\"0\" scrolling=\"no\" class=\"wp-embedded-content\"><\/iframe><script>\n\/*! This file is auto-generated *\/\n!function(d,l){\"use strict\";l.querySelector&&d.addEventListener&&\"undefined\"!=typeof URL&&(d.wp=d.wp||{},d.wp.receiveEmbedMessage||(d.wp.receiveEmbedMessage=function(e){var t=e.data;if((t||t.secret||t.message||t.value)&&!\/[^a-zA-Z0-9]\/.test(t.secret)){for(var s,r,n,a=l.querySelectorAll('iframe[data-secret=\"'+t.secret+'\"]'),o=l.querySelectorAll('blockquote[data-secret=\"'+t.secret+'\"]'),c=new RegExp(\"^https?:$\",\"i\"),i=0;i<o.length;i++)o[i].style.display=\"none\";for(i=0;i<a.length;i++)s=a[i],e.source===s.contentWindow&&(s.removeAttribute(\"style\"),\"height\"===t.message?(1e3<(r=parseInt(t.value,10))?r=1e3:~~r<200&&(r=200),s.height=r):\"link\"===t.message&&(r=new URL(s.getAttribute(\"src\")),n=new URL(t.value),c.test(n.protocol))&&n.host===r.host&&l.activeElement===s&&(d.top.location.href=t.value))}},d.addEventListener(\"message\",d.wp.receiveEmbedMessage,!1),l.addEventListener(\"DOMContentLoaded\",function(){for(var e,t,s=l.querySelectorAll(\"iframe.wp-embedded-content\"),r=0;r<s.length;r++)(t=(e=s[r]).getAttribute(\"data-secret\"))||(t=Math.random().toString(36).substring(2,12),e.src+=\"#?secret=\"+t,e.setAttribute(\"data-secret\",t)),e.contentWindow.postMessage({message:\"ready\",secret:t},\"*\")},!1)))}(window,document);\n\/\/# sourceURL=https:\/\/urbancare.clinic\/wp-includes\/js\/wp-embed.min.js\n<\/script>","thumbnail_url":"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/warfarin-induced-skin-necrosis.jpg","thumbnail_width":1024,"thumbnail_height":1024,"description":"Warfarin, a double sword not only helps in anticoagulation by inhibition of vitamin K dependent clotting factors but also prevents clot lysis by inhibiting protein C and protein S. The half-life of protein C and S is shorter than vitamin K dependent clotting factors hence its plasma concentration falls faster. If started alone the patient is at risk of developing warfarin induced skin necrosis, a potentially disastrous although a rare complication (0.01%&ndash;0.1%) usually occurring 2&ndash;5 days after initiation of warfarin therapy. A 63-year-old man recently diagnosed rheumatic heart disease with severe mitral stenosis presented with a 2-day history of decreased urine output. He was started on tablet warfarin 5 mg once a day and tablet furosemide 20 mg two times a day 2 weeks ago. Physical examination showed pulse rate of 98 bpm, blood pressure of 140\/88 mm Hg, respiratory rate of 26 breaths\/min. Cardiac auscultation showed irregular rhythm...."}