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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.

Objective: Acute inflammation of the appendix is a very common finding in patients representing the emergency department. Here, we assessed the levels of the serum laboratory biomarkers in the patients with complicated (defined by the presence of perforation, abscess, or peritonitis) and simple appendicitis. Methodology: This observational study was conducted in Sina Hospital, Tabriz-Iran, between March 2019 and August 2019. Data regarding age, sex, body temperature, length of hospital stays, clinical signs and symptoms, and time of symptom onset for each patient. Laboratory values including white blood cells (WBC) count, neutrophil percentage, erythrocyte sedimentation rate (ESR), C-reactive protein (CRO), mean platelet volume (MPV), and lactate dehydrogenase (LDH) were evaluated. Results: A total of 279 patients were enrolled in the study. 131 patients (46.9%) had complicated and 148 (53.0%) had simple appendicitis. Mean body temperature (P-value <0.05) and CRP levels (P-value <0.0001), were significantly higher in the complicated appendicitis group. (P-value >0.05). There were no significant differences regarding WBC, neutrophil, 1 st and 2 nd hour ESR, MPV, and LDH levels, and mean length of hospital stay (P-value>0.05). Conclusion: CRP concentrations are reliable markers showing an increased risk of developing complications in acute appendicitis patients.

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Brachiobasilic AVF fistula provides a suitable option for vascular access in cases with failed previous AVF. Relocation of basilic vein for brachiobasilic AVF is technically feasible, safe and with excellent patency in short-term and complication rates are acceptable.