scholarly journals Effects of Tranexamic Acid on Mortality and Blood Transfusion in Trauma Patients with Significant Hemorrhage: A Clinical Trial

2017 ◽  
Vol 5 (4) ◽  
pp. 24
Author(s):  
Farzad Kakaei ◽  
Peyman Virani ◽  
Shahriar Hashemzadeh ◽  
Sina Zarrintan ◽  
Samad Beheshtirouy ◽  
...  

Extensive hemorrhage is a significant cause of mortality in trauma patients. Tranexamic acid has been used for controlling bleeding in cardiovascular surgeries and dental manipulations in patients with hemophilia. However, in traumatic patients with bleeding, its use dates back to more recent years. This study aims to examine the effects of this drug on reducing mortality and blood transfusion rate in trauma patients with significant hemorrhage. A total of 60 patients with significant trauma-related hemorrhage (systolic blood pressure < 90 mmHg/heart rate > 110/min) from the emergency department of Imam Reza Hospital (Tabriz, Iran), were randomized in two groups. The case group received intravenous Tranexamic acid (1 g in 10 min and then 1 g over 8 h). The control group received placebo. Rate of transfusion and rate of one-month mortality were compared between the study groups. The mean ICU stay and overall hospitalization times did not have significant difference between two groups (p<0.05). Transfusion of packed cells was 6.03±1.50 and 6.03±1.22 units in case and control groups respectively. Transfusion of fresh frozen plasma (FFP) was 2.50±1.36 and 3.03±0.96 units in case and control groups respectively (p=0.09). Transfusion of platelets was 0.40±0.20 1.33±0.31 units in case and control groups respectively (p=0.01). Three patients (10%) in the case group and 4 patients (13.3%) in the control group were expired (p=0.50). Tranexamic acid is safe and effective in reducing platelet transfusion rate in patients with trauma-related significant hemorrhage. However, transfusion need and mortality would not reduce by its use in trauma patients. 

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K M Diab ◽  
R M Mohamed ◽  
A G Abdelhay

Abstract Background Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period. Patients and Methods This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology. Results No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p &lt; 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p &lt; 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p &lt; 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hematocrite was significantly less in study group than control group (p &lt; 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24). Conclusion The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.


2017 ◽  
Vol 25 (4) ◽  
pp. 234-9 ◽  
Author(s):  
Aryo N. Triyudanto ◽  
Andri M.T. Lubis

Background: Despite the advances in the design and fixation of implants in total knee replacement (TKR). the amount of postoperative bleeding is still an important issue that has not been resolved. This study aimed to measure the effectiveness of various tranexamic acid administration. Methods: This was a randomized controlled trial study, held from August 2014 to February 2016 at Cipto Mangunkusumo Hospital, Jakarta. Twenty two patients having TKR were divided into three groups: the control group, the tranexamic acid intra-articular-intraoperative group, and the intravenous preoperative group. Intraoperative bleeding, haemoglobin (Hb) level on preoperative to five-day-post-surgery, total drain production, total blood tranfusion needed and the drain removal timing were recorded and compared. Numerical data were analyzed by using parametric and non-parametric test, depended on the normality of the data. Results: The amount of blood transfusion needed in both the intra-articular group (200±SD 100 mL) and the intravenous group (238±SD 53 mL) were significantly different compared to those in the control group (1,016±SD 308.2 mL) (p=0.001). Meanwhile, there was no significant difference between the amount of blood transfusion needed in the intra-articular group and the intravenous group. Total drain production in the intra-articular group (328±SD 193 mL) and intravenous group (391±SD 185 mL) was significantly different compared to the control group (652±SD 150 mL) (p=0.003). No significant difference between the levels of both preoperative and postoperative haemoglobin, the amount of intraoperative bleeding, and the duration of drain usage. Conclusion: Intravenous and intra-articular tranexamic acid effectively decreased transfusion volume and drain production in patients undergoing TKR.


2019 ◽  
Vol 27 (4) ◽  
pp. 413-420
Author(s):  
Camelia Alkhzouz ◽  
Diana Miclea ◽  
Marius Farcas ◽  
Simona Bucerzan ◽  
Georgiana Cabau ◽  
...  

Abstract Introduction: GAD2 gene encodes the glutamate decarboxylase enzyme which catalyses the transformation of glutamate into γ-aminobutyric acid, GABA. It is suggested that some polymorphic alleles of GAD2 gene, such as -243A>G, have an increased transcriptional effect compared with the wild type, which results in an increase of GABA in the hypothalamus with the subsequent increase of the neuropeptide Y, thus exacerbating the hunger centre and the appetite. The aim of this study was to observe an association between the -243A>G polymorphism with obesity, comparatively studying a group of obese patients and a group of patients with normal weight. Patients and method: 127 patients were clinically evaluated in the Genetic and Endocrine Department of Children’s Emergency Clinical Hospital, Cluj. The patients were included in two study groups, case group, with obesity (BMI higher than 97 kg/m2) and control group, with normal weight (BMI less than 97 kg/m2). Genotyping for GAD2-243A>G polymorphism was performed using PCR-RFLP technique, the two groups being compared regarding the genotypes and phenotypes. Results and conclusions: In the obesity group, there is a statistically significant difference in BMI (kg/m2) between the subgroups with different genotypes (p=0.01), the AA genotype being less severely affected than AG and GG genotypes. In the normal weight group there is no association between BMI and different genotypes (AA, AG or GG). Also, there is a greater distribution of GG genotypes and G allele in the obesity group compared with the control group, with an odds ratio which suggest that -243A>G polymorphism is a risk factor in obesity development (GG genotype OR=3.76, G allele OR=1.73, p=0.04). The finding of our study is important in explaining the multifactorial model of obesity, our research demonstrating that the GAD2-243 A> G variant could be a risk factor that added to other obesogenic factors would potentiate their effect.


2017 ◽  
Vol 5 (3) ◽  
pp. 305-309 ◽  
Author(s):  
Javad Ghaffari ◽  
Ghasem Rahmatpour Rokni ◽  
Armaghan Kazeminejad ◽  
Hosein Abedi

BACKGROUND: Alopecia areata is a non-scarring hair loss, which typically starts quickly. Atopy is one of the possible predisposing risk factors for this condition.AIM: This study aimed to evaluate the prevalence of thyroid disease, atopic dermatitis and allergic diseases in children with alopecia areata and compare the results with healthy individuals.METHODS: This case-control study was conducted on 50 patients with alopecia areata, diagnosed by a dermatologist, and 150 healthy individuals as the control group. Participants filled the questionnaires, and necessary tests were performed.RESULTS: In this study, the mean age of the participants was 2.55 ± 14.26 and 3.19 ± 11.92 in the case and control groups, respectively. Prevalence of asthma was 22% in the case group and 12.5% in control group (P = 0.109). Also, allergic rhinitis and eczema were observed in 20% and 22% of the subjects of the case group, whereas they were reported to be 8% and 10% in the control group (PV = 0.03 and 0.175, respectively). Moreover, 28% and 8% of the participants in the case and control groups had a family history of atopy and allergic disorders, respectively (P = 0.046). A significant difference was observed between the two groups regarding gender, type of delivery and contact with animals.CONCLUSIONS: According to the results of this study, a significant association was observed between the prevalence of alopecia areata and atopic conditions, such as allergic rhinitis and history of atopic dermatitis.


2016 ◽  
Vol 130 (10) ◽  
pp. 928-933 ◽  
Author(s):  
A Akyigit ◽  
Ş Yalcin ◽  
E Ö Etem ◽  
İ Kaygusuz ◽  
T Karlidag ◽  
...  

AbstractBackground:This study investigated genetic polymorphisms affecting the inducible nitric oxide synthase, superoxide dismutase and catalase enzymes in chronic otitis media patients with and without tympanosclerosis, and the role of genetic susceptibility in the disease aetiology.Methods:A total of 162 patients who underwent surgery for chronic otitis media were divided into two study groups: a tympanosclerosis group and a chronic otitis media group. A third, the control, group comprised 188 healthy volunteers. Venous blood samples were evaluated using reverse transcriptase polymerase chain reaction.Results:There was a significant difference in GG genotype distribution of the −277A>G polymorphism in the NOS2 gene between the tympanosclerosis and control groups (p < 0.05). However, there were no significant between-group differences in the CC genotype distribution of the p.Ala16Val (C>T) polymorphism in the SOD2 gene (p > 0.05). There were significant differences in the TT genotype distribution of the −21A>T polymorphism in the CAT gene between the tympanosclerosis and control groups, and between the chronic otitis media and control groups (p < 0.05).Conclusion:These results suggest that genetic predisposition may play a role in the aetiopathogenesis of tympanosclerosis.


2018 ◽  
Vol 12 (1) ◽  
pp. 567-571 ◽  
Author(s):  
Faezeh Khozeimeh ◽  
Zahra Saberi ◽  
Atefeh Tavangar ◽  
Fahime Fakhari Badi

Background: The oral aphthous is a common oral ulcer with intense pain and there is no treatment for it, yet. Echinacea is an herbal medicine that moderated the immune system. Objective: The aim of this study was to investigate the effects of Echinacea on the treatment of aphthous ulcer. Methods: 50 patients with minor aphthous participated in our study. 25 patients take 3 tablets in a day for five weeks (case group) and 25 patients didn’t take any tablets (control group). The patients were monitored for one month before taking the tablets for six months. During this period, the number of lesions, complete improvement of ulcers, recurrence rate and intensity of pain were considered in each month. Finally, the Friedman and ANOVA tests used to analyze the obtained data. Result: Our study showed a significant difference between a number of lesions during six-month in case and control groups (p>0.001). In this way, we observed that the number of lesions was decreased significantly after six months in the case group. Hence, ANOVA analysis showed a significant decrease between each month for the intensity of pain (p=0.025), complete improvement (p<0.001) and recurrence rate (p=0.026). Conclusion: In conclusion, we showed that Echinacea tablets as an herbal medicine have positive effects on a number of lesions, intensity of pain, complete improvement and recurrence rate in patients with recurrent minor aphthous ulcers.


Author(s):  
Munise Daye ◽  
Fatma Cihan ◽  
Begüm Işık ◽  
Berna Hafızoğlu

Purpose: To evaluate the bowel habits of patients with acne vulgaris Method: In this case control study, socio-demographic characteristics of the participants (age, gender, marital status, educational status, profession, economic status, smoking-alcohol habits, chronic diseases, previous operations, people they live with, diet) were questioned and the global acne grading scores of the patients were calculated. Bristol Stool Scale, Rome III Criteria for IBS, International Physical Activity Questionnaire-Short Form, Hospital Anxiety Depression and KADF (dietary fiber information) scales fulfilled. Results: The patient group consisted 102 and the control group consisted 104 participants. The mean age was 20.9 ± 3.9 years old in the case group and 21.8 ± 5.0 years old in the control group. Patient and control groups were similar in terms of age and gender. Smoking rates were significantly higher in the patient group (p=0,035). The amount of coffee consumed per day were significantly higher in the patient group (p=0,040). According to the global acne grading scores, 55.9% (n = 57) had medium, 39.2% (n = 40) had mild, 3.9% (n = 4) had severe and 1% (n=1) had very severe acne. Anxiety scores were found to be significantly higher in the patient group (p = 0.005). When the case and control groups were compared for IBS presence, no significant difference was found (p = 0.317). Also, IBS was not related with acne severity (p = 0.162). Conclusion: Further large sample sized studies are needed on this subject, as there is strong evidence about brain–gut–skin axis existence.


2021 ◽  
Vol 25 (2) ◽  
pp. 114-121
Author(s):  
Müzeyyen Seda Altop ◽  
Özge Özdal Zincir ◽  
Meral Ünür ◽  
Necat Vakur Olgaç ◽  
Sevgi Özyeğin

Summary Background/Aim: This study aimed to evaluate the effect of local zeolite and tranexamic acid application on hemostasis duration and histopathological changes in the experimental bleeding model, created by puncturing femoral arteries in rats. Material and Methods: A total of 36 Sprague Dawley female rats weighing an average of 240 ± 20 g were used in the study. The three main study groups were the zeolite, zeolite+tranexamic acid, and control groups. Each group was sacrificed on the seventh and fourteenth days of the study, using subgroups for histopathological findings. After piercing the femoral artery of each rat, one gram of the material assigned to the group was applied to the bleeding site after which a 100-gram scale weight was placed on the site for 30 sec intervals, during which temperature was measured. The same sequence of procedures was repeated for the control group, using only standard compression. Statistical analysis was performed using IBM Statistical Package for Social Sciences (SPSS) 15 statistical software. Significance was evaluated at the level of p< 0.05. Results: The bleeding stop time of the control group was significantly longer than the zeolite and zeolite+tranexamic groups (p< 0.05). There was no statistically significant difference between the zeolite and zeolite+tranexamic groups’ bleeding stop times (p> 0.05) or between the mean wound temperatures of the control and zeolite+tranexamic acid groups when bleeding stopped (p> 0.05). Conclusions: The effectiveness of the zeolite group and zeolite+tranexamic acid mixture is more than the control group in ensuring bleeding control. Their efficacy has been clearly observed in providing hemostasis. In addition, it has been determined that zeolite tranexamic acid mixture causes less exothermic reaction than zeolite group. We believe that this new formula should be developed and used to guide new studies.


2015 ◽  
Vol 23 (1) ◽  
pp. 89-93 ◽  
Author(s):  
Zinat Begum ◽  
Iffat Ara ◽  
Shaorin Tanira ◽  
Kashfia Ahmed Keya

Background: Exact aetiology of this potentially fatal disorder remains poorly understood. A number of theories have been put forward where different biochemical markers have been implicated in the causal association of preeclampsia. This study was intended to find the association between serum b-hCG level and preclampsia Methods: This cross-sectional, case-control study was conducted on 74 pregnant women with preeclampsia (cases) who were admitted in the Eclampsia ward of Dhaka Medical College Hospital, Dhaka between January and July of 2013. A total of 76 normotensive pregnant women were also taken from the Obstetrics & Gynaecology Out-patient Department of the same hospital as control. The study subjects were selected on the basis of predefined eligibility criteria. The serum levels of b-hCG were compared between case and control groups as well as between mild and severe preeclampsia. Result: The case and control groups were almost similar in terms of all the baseline demographic and obstetric characteristics except past history of PET which was significantly higher in the former group than that in the latter group. Majority (97.1%) of the cases had severe hypertension (74.3%) with mean systolic and diastolic blood pressures being 162.6 and 110.8 mmHg respectively. The mean serum ?-hCG was much higher in the case group than that in the control group (p<0.001). The mean serum ?-hCG was the highest in severe preeclampsia and the lowest in the control group, while that in mild preeclampsia lie in between the two (p<0.001). The serum ?-hCG exhibits a significantly linear correlation with systolic and diastolic blood pressures (p<0.001 respectively). Conclusion: There was a significant difference between the ?-hCG level in the preeclamptic women compared to the normotensive pregnant women and the severity of preeclamsia increases with further rise of ?-hCG level. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22701 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 89-93


Author(s):  
Marjan Shafabakhsh ◽  
HosseinAli Sadeghian ◽  
Mohammad Hassan Ehramposh ◽  
Abas Aflatonian ◽  
Arefeh Dehghani ◽  
...  

Introduction: Male infertility has increased during recent years in countries of the world including Iran. Among many factors that influence the infertility, smoking, alcohol, and addictive drugs were investigated in this study. Methods: This case-control retrospective study was conducted on 600 male patients consisting of 300 individuals with natural semen and 300 people with defective semen. The first step in investigation of infertility in each couple was to conduct a spermogram to detect the male infertility. The case group included men who referred to the Yazd Infertility Treatment Center and had at least one abnormal test result among considering the parameters of semen test. The control group included the men who referred to the same center and had normal semen test result. The data collection tools were a researcher-made checklist based on the parameters required for the study with epidemiological and observational design, as well as the semen analysis test.  Results: The age mean in the case and control groups were 34.71 and 33.82 years with the standard deviation of ± 7.3 and ± 6.41, respectively. The means of marriage age in the case and control groups were 26.28 and 26.28 ±5.3 years, respectively. The mean duration of infertility in the case group was 6.30 ± 4.60 and in the control group was 5.15± 3.88. No significant difference was observed between the mean age (P = 0.084) and marital age (P = 0.448) in two groups, but the mean duration of infertility (P <0.001) was significantly different between the two groups .The prevalence of smoking was significantly different between the two groups (P = 0.032). Considering the daily frequency of smoking, the highest rate was 11-20 cigarettes in both groups (case group 21.7% and control group 15.3%). The P value was set at 0.018. Conclusion: In this study, smoking and consumption of alcohol were not considered as the predictive factors of semen quality, but  consumption of drugs and the age of starting consumption of drugs had a significant relationship with the semen disorders.  


Sign in / Sign up

Export Citation Format

Share Document