Study objective: The primary objective of this study is to compare the effectiveness of 3 treatment protocols to stop anterior epistaxis: classic compression, nasal packing, and local application of tranexamic acid. It also aims to determine the frequency of rebleeding after each of these protocols.Methods: This single-center, prospective, randomized controlled study was conducted with patients who had spontaneous anterior epistaxis. The study compared the effect of 3 treatment options, tranexamic acid with compression but without nasal packing, nasal packing (Merocel), and simple nasal external compression, on the primary outcome of stopping anterior epistaxis bleeding within 15 minutes.Results: Among the 135 patients enrolled, the median age was 60 years (interquartile range 25% to 75%: 48 to 72 years) and 70 patients (51.9%) were women. The success rate in the compression with tranexamic acid group was 91.1% (41 of 45 patients); in the nasal packing group, 93.3% (42 of 45 patients); and in the compression with saline solution group, 71.1% (32 of 45 patients). There was an overall statistically significant difference among the 3 treatment groups but no significant difference in pairwise comparison between the compression with tranexamic acid and nasal packing groups. In regard to no rebleeding within 24 hours, the study found rates of 86.7% in the tranexamic acid group, 74% in the nasal packing group, and 60% in the compression with saline solution group. Conclusion:Applying external compression after administering tranexamic acid through the nostrils by atomizer stops bleeding as effectively as anterior nasal packing using Merocel. In addition, the tranexamic acid approach is superior to Merocel in terms of decreasing rebleeding rates. [

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Aims In this study, we aimed to determine the relationship between EAT thickness in patients with STEMI who underwent primary percutaneous coronary intervention (pPCI) and the development of new-onset atrial fibrillation during hospital follow-up. Material and methods Four hundred and thirteen consecutive patients [284 men (69%) and 129 women (31%)] with a mean age of 59 ± 11 years diagnosed with STEMI were included in this study. Atrial fibrillation developed in 52 (12.5%) patients during in-hospital follow-up and the remaining 361 patients were determined as the control group. There was no difference between the two groups in terms of age and sex. EAT thickness was measured using transthoracic echocardiography. Multiple regression analysis was performed to determine the independent predictors of atrial fibrillation. Results EAT thickness was higher in the group with atrial fibrillation than in the control group (P < 0.001). The SYNTAX risk score was higher in the atrial fibrillation group (P < 0.001). A positive correlation was observed between EAT thickness and SYNTAX score (r = 0.523, P < 0.001). In the logistic regression analysis, EAT was detected to be an independent predictor for the development of atrial fibrillation (odds ratio: 4.135, 95% confidence interval 1.245–8.176, P < 0.001). Conclusion EAT thickness is an important marker of atrial fibrillation development in STEMI patients in the post-pPCI period. We think that EAT thickness can be used as a cardioembolic risk factor in STEMI patients.

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