Injection Of Tranexamic Acid Research Articles

Comparison of the Effectiveness of Platelet-Rich Plasma Versus Tranexamic Acid Plus Vitamin C Mesotherapy in the Treatment of Periorbital Hyperpigmentation: A Split-Site, Randomized Clinical Trial.

Periorbital hyperpigmentation (POH) is a common cosmetic problem with a negative impact on the patient's self-confidence, leading to a decrease in the quality of life. Current treatments include topical agents and mesotherapy, but research remains limited. Due to the undesirable effect of the available treatments, the present study was designed to compare the effectiveness of platelet-rich plasma (PRP) injection and intradermal injection of tranexamic acid plus vitamin C mesotherapy as a therapeutic method to treat POH. Patients received an intradermal injection of PRP randomly on one side and an intradermal injection of tranexamic acid + vitamin C on the other side of their face, for three sessions with an interval of 3 weeks. Digital photography was taken, and data were assessed based on physician global assessment (PGA) and patient satisfaction. Eighteen patients were studied. Among all, 12 patients had a positive family history, 2 had asthma, and 4 had a history of atopic dermatitis. Even though patient satisfaction was higher in the PRP group than in mesotherapy, it was not statistically significant. Both groups showed similar rates of improvement. However, improvement rates did not significantly differ based on various factors including gender, skin type, family history, or medical history. Age and the age of disease onset also did not significantly affect the improvement rates. Both methods revealed successful results in the reduction of POH. Comparing the efficacy of these two methods showed that both treatments had similar improvements.

The advantages of using tranexamic acid in anterior cruciate ligament reconstruction: a randomized controlled trial.

The number of participants in sports or some form of recreation globally has led to an increase in the incidence of anterior cruciate ligament (ACL) injuries and the number of surgeries performed. Although it does not belong to risky surgical interventions, this operation is accompanied by complications that slow down post-operative rehabilitation. The objective is to analyze the effects of intra-articular (IA) injection of tranexamic acid (TXA) on the reduction of post-operative drained blood volume, pain intensity, and incidence of hemarthrosis after ACL reconstruction. This prospective research included 124 patients undergoing ACL reconstruction surgery, randomly divided into two groups. The TXA group received IA TXA, whereas an equal amount of placebo was administered using the same route in the control group. The research has shown that IA injection of TXA effectively reduces post-operative blood loss (TXA group 71.29 ± 40.76 vs. control group 154.35 ± 81.45), reducing the intensity of post-operative pain (p < 0.001) and the incidence of hemarthrosis. The application of TXA significantly reduced post-operative bleeding and pain intensity, which accelerated the post-operative period.

Comparison between local application on placental bed versus systemic injection of tranexamic acid in elective cesarean section

Comparison between local application on placental bed versus systemic injection of tranexamic acid in elective cesarean section

Intrafocal injection of tranexamic acid decreases early return to hospital after high tibial osteotomy.

High tibial osteotomy (HTO) is a surgery performed to treat the symptoms and prevent the progression of medial osteoarthritis. Post-operative bleeding has led to early returns to hospital following surgery. Intrafocal injection of tranexamic acid (TXA) could reduce this bleeding complication. The objective of the study was to evaluate the effect of TXA during HTO on the incidence of post-operative complications and early returns to hospital. This retrospective study included 251 cases of HTO performed between May 2012 and October 2021, with the use of TXA introduced in May 2017. The experimental (n = 102) and control (n = 149) groups were compared as to the rate of post-operative early returns. The influence of confounding factors was evaluated, including age, sex, body mass index (BMI), tobacco use, grade of medial femorotibial osteoarthritis (MFTO), magnitude of angular correction (MAC), and surgery duration. No statistically significant difference was found between the groups with regards to all variables except age. The experimental group was significantly older (54.4 years; σ = 7.5) than the control group (50.4 years; σ = 7.9; p < 0.001). We observed a decrease in emergency department (ED) visits in the experimental group (15.7%) compared to the control (30.2%; p = 0.008) and a decrease in early returns in the experimental group (28.4%) compared to the control (40.5%; p = 0.049). No statistically significant difference in demographic data, MFTO, or MAC was found among patients with and without an early return, in both the experimental and control groups. The intrafocal injection of TXA during HTO decreases early returns to hospital.

Outcome and Management of Occipitofrontal Contrecoup Head Injury.

Contrecoup brain injury refers to the classical opposite of the primary impact. Tamil Nadu has the highest rate of road traffic accident in India. Madurai has peak mortality due to accidents in India. Previous studies done on contrecoup head injury had shown patterns of injuries and mechanism of injury. Outcome and management of only occipitofrontal contrecoup head injury has been taken in this study. Mortality in this specific group is very high. Seventy-six patients of this specific head injury were admitted at Government Rajaji Hospital, Madurai. Patients were assessed for Glasgow coma scale (GCS), age, sex, progression of volume, mortality, traumatic brain injury-induced coagulopathy, and pillion rider outcome. Fourteen patients were surgically treated by decompressive craniectomy. Conservative management was done by antiepileptic and antiedema measures. Mostly affected were males ( n = 54) followed by females ( n = 22). GCS on admission mean value 9. In our study, mortality was 32% with sudden death of three patients due to hypothalamic compression. Hospital stay of the patient was significantly increased with progression of lesion with mean 9 days and p -value less than 0.01. Pillion riders ( n = 18) were also affected in our study. Traumatic brain injury-induced coagulopathy ( n = 12) was also detected, which was treated by injection tranexamic acid and injection vitamin K, thereby not leading to any death due to coagulopathy with significant p -value less than 0.01. We recommend helmet for both main and pillion rider with strict speeding regulations.

The necessity of suction drainage when intra-articular injection of tranexamic acid is used during primary total knee arthroplasty: a retrospective study

BackgroundSuction drainages are commonly used after total knee arthroplasty (TKA) procedures; however, their use is somewhat controversial. Recently, some reports have claimed that the administration of tranexamic acid (TXA) may prevent postoperative bleeding following TKAs. Although numerous studies have reported regarding different dosages, timings of administration, or drain clamping times for intravenous and intra-articular TXA injections (IA-TXAs), few have examined whether suction drainage is necessary when TXA is administered. In this study, we compared using suction drainage without TXA administration and IA-TXA without suction drainage and aimed to examine the need for suction drainage during IA-TXA.MethodsThis retrospective study was conducted on 217 patients who had received TKA for osteoarthritis; 104 were placed on suction drainage after TKA without TXA (Group A), whereas the remaining 113 received IA-TXA immediately after surgery without suction drainage (Group B). Our clinical evaluation included assessments of the need for transfusion, presence of postoperative complications, incidence of deep vein thrombosis (DVT), and changes in hemoglobin (Hb), hematocrit (Hct), and D-dimer levels.ResultsNo significant differences were observed in terms of postoperative complications and preoperative Hb, Hct, or D-dimer levels between the two groups. Although the prevalence of DVT was significantly higher in Group B (p < 0.05), all cases were asymptomatic. Hb and Hct levels were significantly lower in Group A than in Group B at 1, 3, 7, and 14 days postoperatively (p < 0.05), although none of the cases required blood transfusions. D-dimer levels were significantly higher in Group A than in Group B at 1 and 3 days postoperatively (p < 0.05).ConclusionSuction drainage might not be necessary when IA-TXA is administered after TKA procedures.

Clinical Efficacy of Intra-articular Tranexamic Acid Injection in the Management of Hemophilia with Total Hip Arthroplasty: A 24-month Retrospective Cohort Study.

Total hip arthroplasty (THA) effectively treats end-stage hemophilic hip arthropathy. Given hemophilia's unique characteristics, perioperative bleeding remains a significant risk for patients undergoing THA. Tranexamic acid (TXA), an efficient antifibrinolytic agent, may benefit the outcomes of THA for patients with hemophilia (PWH). This study aims to explore the clinical efficacy of intra-articular injection of TXA in treating perioperative bleeding in PWH and assess its additional clinical benefits. The retrospective study comprised data of PWH who received THA from January 2015 to December 2021 in the research center. A total of 59 individuals were included in the study, divided into a TXA group (n = 31) and a non-TXA group (n = 28). We compared various parameters, including total blood loss (TBL), visible blood loss (VBL), occult blood loss (OBL), intraoperative coagulation factor VIII (FVIII) consumption, perioperative total FVIII consumption, hemoglobin (HB), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), length of hospital stay, hospitalization costs, length of surgery, total protein, activated partial thromboplastin time (APTT), D-dimer, rate of joint swelling, hip joint range of motion (ROM), visual analogue scale (VAS), and Harris hip joint function scale (HHS) between the two groups. Follow-up assessments were conducted for up to 24 months. A Student's t test was utilized for the statistical analysis. This study demonstrated that intra-articular TXA effectively reduced TBL (1248.19 ± 439.88 mL, p < 0.001), VBL (490.32 ± 344.34 mL, p = 0.003), and OBL (757.87 ± 381.48 mL, p = 0.004) in PWH who underwent THA. TXA demonstrated effectiveness in reducing VAS scores on POD1, POD7, and POD14 and joint swelling rates on POD1, POD7, POD14, and at discharge (p < 0.05). Additionally, the TXA group achieved higher HHS ratings at all follow-up time points (p < 0.05), showing superior hip joint mobility, lower postoperative inflammation levels, reduced factor VIII consumption during surgery, and less postoperative nutritional loss. No statistically significant differences were observed between the two groups in terms of hospital stay, hospitalization costs, surgery duration, and coagulation indicators. Intra-articular injection of TXA reduces perioperative bleeding in PWH undergoing THA while also improving joint mobility, post-operative rehabilitation, and quality of life. This may provide value for the future application of TXA in PWH.

Subcutaneous injection of tranexamic acid reduces postoperative bleeding following Mohs micrographic surgery: A single-institution cohort study

Subcutaneous injection of tranexamic acid reduces postoperative bleeding following Mohs micrographic surgery: A single-institution cohort study

Intraprostatic Injection of Tranexamic Acid Decrease Blood Loss During Monopolar Transurethral Resection of the Prostate: A Randomized Controlled Clinical Trial

ObjectiveTo assess the role of intraprostatic injection of tranexamic acid (TXA) in reducing blood loss during transurethral resection of the prostate (TURP). MethodsWe conducted a randomized, controlled, double-blind trial involving 60 patients with benign prostatic hyperplasia (BPH) aged 50–85 years, undergoing monopolar TURP. Patients' prostatic weights ranged from 50 to 80 grams. They were divided equally into two groups: Group I received an intraprostatic injection of 1 gram of TXA (Cyklokapron) dissolved in 50 ml of 0.9% saline at multiple sites, while Group II (control) received a 60 ml saline injection. Comprehensive clinical assessments and standard laboratory tests, including screenings for TXA hypersensitivity, were performed for all patients. ResultsGroup I exhibited significantly lower intraoperative blood loss and hemoglobin concentration in irrigation fluid immediately post-surgery and at the 6-hour postoperative mark compared to Group II (P < 0.05). Coagulation parameters—activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen level (FB), and thrombin clotting time (TT)—showed no significant differences between the groups preoperatively or at 6 and 24 hours postoperatively. No thromboembolic events or other complications were reported in either group. ConclusionThe intraprostatic injection of TXA during monopolar TURP is safe, with minimal adverse effects, and effectively reduces blood loss.

Effect of Tranexamic Acid on Hidden Blood Loss in Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion: A Retrospective Study.

Percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) has become one of the most popular minimally invasive surgeries today. However, the issue of hidden blood loss (HBL) in this surgery has received little attention. This study aims to examine the HBL in PE-TLIF surgery and the effect of tranexamic acid (TXA) on blood loss. In our research, We conducted a retrospective analysis of 300 patients who underwent PE-TLIF from September 2019 to August 2023. They were divided into 2 groups based on whether they received intravenous TXA injection before surgery. The variables compared included: demographic data, pre-and postoperative hemoglobin (HB), hematocrit (HCT), platelets (PLT), red blood cells (RBC), total blood loss (TBL), visible blood loss (VBL), HBL, operation time, postoperative hospital stay, inflammatory markers, coagulation parameters, and adverse events. Regarding demographic characteristics, besides the operation time, no significant differences were observed between the two groups. Compared with the control group, the TXA group showed a significant reduction trend in TBL, HBL, and VBL (P < 0.05). On the first day after surgery, there were significant differences in prothrombin (PT), activated partial thromboplastin time (APTT), and D-dimer (D-D) levels between the two groups. Similarly, HCT also found similar results on the third day after surgery. No adverse events occurred in either group. Research has found that there is a significant amount of HBL in patients undergoing PE-TLIF. Intravenous injection of TXA can safely and effectively reduce perioperative HBL and VBL. Additionally, compared to the control group, the TXA group shows a significant reduction in operation time.

Injection Tranexamic Acid in Preventing Postpartum Hemorrhage Following Vaginal Delivery: A One-year Hospital-based Randomized Placebo-controlled Trial

Injection Tranexamic Acid in Preventing Postpartum Hemorrhage Following Vaginal Delivery: A One-year Hospital-based Randomized Placebo-controlled Trial

Comparative effectiveness of combined peri-articular and intra-articular injection versus intravenous and intra-articular injection of tranexamic acid in total knee arthroplasty: a randomized controlled trial study.

Tranexamic acid (TXA) administration is supported by numerous evidence in reducing blood loss after total knee arthroplasty (TKA). The combination of intravenous (IV) and intra-articular (IA) TXA administration revealed good result in blood loss reduction with less evidence of venous thromboembolism event (VTE). Several literature reviews portray that peri-articular (PA) administration yields similar hemostasis in comparison to IV route. However, there is no report on the clinical effect of combining PA + IA TXA in blood loss reduction and its complications, compared to combining IV + IA TXA after TKA. We conducted a double-blind, randomized controlled trial comparing the use of PA + IA TXA administration and IV + IA TXA administration in 70 patients who were scheduled for unilateral primary TKA. Thirty-five patients were assigned for PA + IA injection (Group 1) and anoter 35 patients were assigned for IV + IA injection (Group 2). Primary outcomes included total blood loss at 48h, and the need for blood transfusion. Secondary outcomes included thigh and leg circumference, degree of knee flexion, and postoperative complications. The calculated blood loss at 48h showed no difference between Groups 1 and 2 (617ml vs. 632ml, p = 0.425). The total hemoglobin and hematocrit changes were not different (1.89g/dL vs. 1.97g/dL, p = 0.371 and 5.66% vs. 5.87%, p = 0.391). There was no need for blood transfusion in either group. However, lower thigh swelling was significant in Group 1 (2.15cm vs. 2.79cm, p = 0.04). Leg circumferences at 48h was also lower in Group 1(42.12cm vs. 42.77cm, p = 0.04). There was no significant difference in knee flexion decrease between the two groups (38° vs. 37°, p = 0.425). There were no VTE complications or infections found in either group. Combined PA + IA TXA administration had similar efficacy in blood loss reduction and blood transfusion when compared to combined IV + IA TXA. The first group displayed less soft tissue swelling. The combination of PA + IA TXA administration can be used as an alternative regimen to avoid IV TXA administration.

A comparison of the effectiveness of intralesional tranexamic acid against platelet-rich plasma in the treatment of melasma

Background: Melasma, derived from the Greek word "melas" meaning "black", manifests as an acquired, more or less symmetrical hypermelanosis of sun-exposed skin. This study aimed to compare and evaluate the efficacy and safety of intradermal injection of tranexamic acid and platelet-rich plasma in treating various types of melasma. Methods: Conducted from June 2022 to December 2023 at the outpatient department of dermatology, Sri Lakshmi Narayana institute of medical sciences, Puducherry, this split-face prospective study involved 40 melasma cases. Tranexamic acid (4 mg/ml) was intradermally injected into the right side of the face, while PRP was injected into the left side. Improvement was assessed using the modified Melasma area severity index (MASI) grading system and dermoscopy, measuring disease severity and percentage of improvement before and after therapy on both sides of the face. Results: The study comprised predominantly females (80%) aged 20 to 30 years (50%), followed by those aged 30 to 40 years (35%). Most cases (93%) exhibited a gradual onset, with centrofacial (52.5%) and malar (37.5%) patterns being predominant. Mixed pattern (67.5%) was common. Pre-treatment mean MASI scores for tranexamic acid and PRP sides were 7.54 and 6.92, respectively, with post-treatment scores of 4.6 and 2.83, respectively. Conclusions: Intradermal PRP demonstrated significantly superior efficacy over intradermal tranexamic acid in managing melasma, particularly in the longer term. Thus, PRP, coupled with good compliance, may substantially reduce the disease burden compared to conventional tranexamic acid treatment.

Effect of Tranexamic Acid on Intra- and Postoperative Bleeding in Eyelid Surgery: A Prospective, Randomized, Multicenter, Double-Masked, Control Trial.

Pilot studies suggest that waiting 15 minutes after a subcutaneous tranexamic acid injection is associated with decreased intraoperative bleeding and postoperative ecchymosis in eyelid surgery. The outcomes of commencing eyelid surgery immediately after injection without a waiting period remain unexplored. This prospective, randomized, multicenter, double-masked, controlled study examined bilateral symmetric upper and/or lower lid blepharoplasty or ptosis repair. Patients received tranexamic acid in 1 eyelid and control in the contralateral eyelid. The surgeon recorded the side with more intraoperative bleeding. Two masked graders evaluated periocular ecchymosis at postoperative day 0 and postoperative week 1 (POW 1) with a 5-point scale. At POW 1, patients reported subjective grading of bruising as increased on 1 side or similar on both sides. Results were analyzed with Wilcoxon signed-rank and sign tests. Of 130 patients, there was less eyelid ecchymosis on the tranexamic side at postoperative day 0 ( p = 0.001) and POW 1 ( p < 0.001). By surgery type, the 69 levator advancement surgeries had significantly less ecchymosis at postoperative day 0 ( p < 0.001) and POW 1 ( p = 0.001), while upper eyelid blepharoplasty, combined upper and lower lid blepharoplasty, and conjunctivomullerectomy trended toward significance. Of 68 patients reporting a POW 1 grading, 69% reported less bruising on the tranexamic side ( p < 0.001). Intraoperative bleeding was not significantly different between sides ( p = 0.930). Without a postinjection waiting period, subcutaneous tranexamic acid for eyelid surgery significantly decreased postoperative ecchymosis on postoperative day 0 and POW 1 but did not affect intraoperative bleeding. Subcutaneous tranexamic acid was not associated with any complications.

Comparative Study of Topical Application of Injection Tranexamic Acid and Anterior Nasal Packing in the Management of Epistaxis.

Epistaxis, defined as bleeding from the nose, is one of the common ENT cases coming to emergency department. Epistaxis is experienced by at least 60% of the population once in their life time and about 6% of them will require medical attention. The different treatment modalities include: local pressure, application of topical vasoconstrictor substances, or nasal packing depending on personal physician preference. Tranexamic acid (TXA), a synthetic analogue of the amino acid lysine, belongs to a class of drugs known as antifibrinolytics. It acts by reversibly binding four to five lysine receptor sites on plasminogen and can be used in emergency department for reducing the bleeding time in epistaxis. To evaluate the efficacy of topical application of injection TXA compared to cases managed with anterior nasal packing for the treatment of patients with epistaxis. 100 patients presenting with epistaxis in emergency department, above the age of 18years were randomly divided into two groups with 50 patients each. Group 1 were managed with anterior nasal packing with gel foam and Group 2 with topical application of injection TXA. Causes,duration to control epistaxis, and occurrence of rebleeding were recorded. Our study showed homogenous distribution of age and sex among the patients. Bleeding stopped within 10min in 38 patients in group 2 compared to 17 patients in group 1. For 31 patients in group 1, bleeding stopped between 10 and 15min compared to 12 in group 2. In group 1, 8 patients had rebleeding compared to 2 patients in group 2. Our study showed that topical application of TXA reduces the bleeding time and number of rebleeds compared to anterior nasal packing with gelfoam. Since it is easily available in an emergency setup and cheaper compared to gelfoam, it can be used as an elective method in managing epistaxis in emergency department.

The effect of perioperative sequential application of multiple doses of tranexamic acid on postoperative blood loss after PLIF: a prospective randomized controlled trial.

Tranexamic acid (TXA) has been utilized in spinal surgery to effectively reduce intraoperative blood loss (IBL) and allogeneic blood transfusion rates. However, the traditional TXA regimen might last the entire duration of hyperfibrinolysis caused by surgical trauma, resulting in its limited ability to reduce postoperative blood loss (PBL). Therefore, the aim of this study was to investigate the effectiveness of perioperative sequential administration of multiple doses of TXA in reducing PBL in patients who underwent posterior lumbar interbody fusion (PLIF). From October 2022 to June 2023, 231 patients who were diagnosed with lumbar degenerative disease and scheduled to undergo PLIF were prospectively enrolled in the present study. The patients were randomly divided into three groups. Moreover, all patients received an intravenous injection of TXA at a dose of 15mg/kg 15min before the surgical skin incision. Patients in Group A received a placebo of normal saline after surgery, while patients in Group B received three additional intravenous injections of TXA at a dose of 15mg/kg every 24h. Patients in Group C received three additional intravenous injections of TXA at a dose of 15mg/kg every 5h. The primary outcome measure was PBL. In addition, this study assessed total blood loss (TBL), IBL, routine blood parameters, liver and kidney function, coagulation parameters, fibrinolysis indexes, inflammatory indicators, drainage tube removal time (DRT), length of hospital stay (LOS), blood transfusion rate, and incidence of complications for all subjects. The PBL, TBL, DRT, and LOS of Group B and Group C were significantly lower than those of Group A ( P <0.05). The level of D-dimer (D-D) in Group C was significantly lower than that in Group A on the first day after the operation ( P =0.002), and that in Group B was significantly lower than that in Group A on the third day after the operation ( P =0.003). The interleukin-6 levels between the three groups from 1 to 5 days after the operation were in the order of Group A > Group B > Group C. No serious complications were observed in any patient. The results of multiple stepwise linear regression analysis revealed that PBL was positively correlated with incision length, IBL, smoking history, history of hypertension, preoperative fibrinogen degradation product level, and blood transfusion. It was negatively correlated with preoperative levels of fibrinogen, red blood cells, blood urea nitrogen, and age. Compared to female patients, male patients had an increased risk of PBL. Finally, the incidence of PBL was predicted. Sequential application of multiple doses of TXA during the perioperative period could safely and effectively reduce PBL and TBL, shorten DRT and LOS, reduce postoperative D-D generation, and reduce the postoperative inflammatory response. In addition, this study provided a novel prediction model for PBL in patients undergoing PLIF.

Evaluation of outcome of systemic tranexamic acid injection in drain output in ventral hernia repair

The primary objective of the study was to determine the mean drain output after systemic tranexamic acid injection in patients undergoing ventral wall hernia repair. This was a descriptive cross-sectional study conducted in the Department of General Surgery, Hamdard University Hospital Karachi, Pakistan for a period of six months from Oct 2020 to April 2021. The patients undergoing ventral hernia repair were included. Injection tranexamic acid 1gm intravenous twice a day for 1st post-operative day and then capsule Tranexamic acid 500mg per oral three times a day for two consecutive days was given and drain output was measured for 3 days. A total of 63 patients with ventral hernia were included, mean age of patients was 41.476 (±SD= 8.693). There were 41 male patients (65.1%) and 22(34.9%) females. The mean drain output on first day, second and third day was 115.047+14.678 ml/day, 91.919+9.947 ml/day, 66.914+7.070 ml/day and 273.254+29.165 ml/day respectively. The results showed overall reduction in postoperative drain output after oral and intravenous tranexamic acid for 72 hours. However further large scale randomized controlled trials are recommended for confirmation of these findings.

Intravenous Injection of Tranexamic Acid in Patients with Pelvis or Acetabulum Fractures to Reduce Blood Loss: A Double-Blind, Randomized, Controlled Trial

Background: Despite their low incidence, pelvis and acetabular fractures have a high mortality rate due to extensive hemorrhage. Tranexamic acid (TXA) is an antifibrinolytic drug that inhibits the production of plasminogen. The aim of the current study is to evaluate the safety and efficacy of TXA use for blood loss reduction and the need for blood transfusion in patients with fractures of the pelvis or acetabulum.&#x0D; Methods: 108 patients were recruited from two tertiary care hospitals and assigned evenly either to the intervention (TXA) or the control group. TXA group received 15 mg/kg TXA 30 minutes before the fracture reduction and fixation surgery. The number of transfused blood units before, during, and after the surgery was recorded. Blood loss was assessed by calculation of estimated blood loss (EBL), collected blood with drain, collected blood with suction, and weight of the used gauzes during the surgery. The time between fracture occurrence and the surgery, the duration of the surgery, and the days of admission were assessed.&#x0D; Results: The mean age was 39.49 ± 15.81 years, and 69.4% were women. 6 patients had pelvic, and 102 patients had acetabulum fractures. The duration of the surgery was not significantly different. The time gap between the reconstructive surgery and fracture occurrence was significantly higher in the TXA group (P = 0.032). The mean postoperative hospitalization time was significantly lower among TXA group patients (P = 0.037). The mean hemoglobin (Hb) in the TXA group was significantly higher, postoperatively (P = 0.028). The mean EBL, the blood volume collected by suction or drain, the weight of the consumed gauze during the surgery, and the number oftransfused blood units were significantly lower in the TXA group. The transfusion rate was significantly lower in patients with a shorter time gap between fracture occurrence and reduction surgery (P = 0.021).&#x0D; Conclusion: TXA can decrease blood loss, the transfused blood units during and after the operation, and hospital admission days. Moreover, it did not increase the chance of pulmonary thromboembolism (PTE) or deep vein thrombosis (DVT) in the patients receiving TXA; thus, it can be assumed as a safe and efficient drug in patients with acetabulum or pelvis fractures.

The Compatibility of Oxytocin and Tranexamic Acid Injection Products When Mixed for Coadministration by Infusion for the Treatment of Postpartum Hemorrhage: An In Vitro Investigation

(BJOG. 2023;130:741–749) Postpartum hemorrhage (PPH) is defined as the loss of more than 1000 mL of blood after childbirth. Signs and symptoms are present after birth, and they can be prevented. The World Health Organization has defined treatment for PPH. World Health Organization has created a bundle of recommendations based on evidence consisting of uterotonic medications, tranexamic acid (TXA), intravenous fluids, and uterine massage. This treatment bundle is known as E-MOTIVE intervention and is to be administered in cases of PPH.

Non-Surgery Management of Globe Rupture in Rural Area

Introduction : Globe rupture is a vision-threatening emergency. The management of globe rupture must arrange immediate.&#x0D; Case Illustration : A 59-year-old woman presented with painful and sudden vision loss on her left eye after hit by wood an hour prior. From the examination, the palpebra was oedema, and spasm, the conjunctiva was chemosis and bleeding, the sclera was laceration. Visual acuity of the left eye was 1/~. We diagnosed as globe rupture of the left eye. We gave levofloxacin injection, methylprednisolone injection, tranexamic acid injection, prednisolone eyedrop every 3 hours, levofloxacin topical every hour, and oxytetracycline eye ointment once a day in night. After 10 days, clinical manifestation was improved, but the visual acuity. From the examination, we found retinal detachment on her left eye. Patient was referred to the primary health care.&#x0D; Discussion : In globe rupture, infection risk is high and requires immediate systemic empiric antibiotics and surgical management. The conservative treatment was administered since the patient rejected for the globe exploration and scleral suture surgery. The aim treatment for this case is to prevent the infection. We used combination systemic and topical levofloxacin antibiotics and corticosteroid. Systemic tranexamic acid was to control the bleeding. No improvement of visual acuity after 10 days, we suspected because of retinal detachment and need surgery management.&#x0D; Conclusion : Surgical exploration and infection prevention are needed for globe injury. The sooner management, the better prognosis it could be.