Role of prophylactic tranexamic acid in reducing blood loss during elective caesarean section in rural area

Background: To reduce maternal mortality and morbidity caused by bleeding, it is important to reduce the amount of bleeding during and after lower segment caesarean section [LSCS]. Tranexamic acid helps to reduce bleeding during and after Caesarean section

Aim of the Work: To analyse the effectiveness of Tranexamic Acid [TXA] in reducing blood loss during elective caesarean section

Patients and Methods: The current study was conducted as a double blinded, randomized, controlled trial on 300 women recruited from labor ward in Kafr Elsheikh General Hospital whom planned to have scheduled casaerean section. A total number of 150 patients received tranexamic acid before induction of anesthesia in addition to oxytocin after delivery of the baby; the other 150 patients received oxytocin only

Results: In the current study, no significant difference between study and control groups as regards age [p 0.374]. In the current study, no significant difference between study and control groups as regards gestational age [p 0.335]. In the current study, number of soaked towels and amount of blood in suction set, which reflect the volume of blood loss from placental delivery to the end of surgery was significantly lower in study group than control group. In the current study, no significant difference between study and control groups as regards preoperative hemoglobin [p 0.614]. Postoperative hemoglobin was significantly higher in study group than control group [p<0.004]. Reduction in hemoglobin was significantly less in study group than control group [p<0.001]. In the current study, no significant difference between study and control groups as regards preoperative hematocrit [p 0.527]. Postoperative hematocrit was significantly higher in study group than control group [p0.17], Reduction in Hematocrit was significantly less in study group than in control group [p<0.001]. In the current study, need to iron replacement or blood transfusion was significantly less frequent in study group than in control group [p<0.031]

Conclusion: The use of tranexamic acid prior to cesarean section is significantly effective in reducing blood loss during caesarean section with no observed maternal or neonatal side effects

Recommendations: Further studies are needed to assess possibility of use of tranexamic acid for treatment of postpartum hemorrhage

Incidence and evaluation of cases of cannabis use among injured patients admitted to Al Azhar university emergency hospitals in Cairo

Background: Trauma remains the leading cause of death among young adults, excessive alcohol and drug consumption are not only significant contributors to this epidemic, but are also independent predictors of injury recidivism [repeated trauma]

Patients and Methods: In the present study five hundred injured patients with different types of injuries were randomly selected from Al-Azhar University Emergency Hospital. Trauma sheet was done for every patient. Ten ml urine was obtained from each patient at the time of admission and before receiving any kind of treatment whether medical or surgical. Then, toxicological screening was done for every patient by using D-THC-123626[one step Drug of Abuse rapid test] is a uni drug panel Enzyme Immunoassay [EIA] test

Results: Toxicological screening of urine samples of the studied injured patients for drug of abuse revealed that the overall prevalence of positive screen was 84.2 % of the total injured patients

Assessment of cases of acute tramadol toxicity as regards clinical, laboratory and management procedures in some university hospitals in Cairo

Tramadol, a widely used opioid in recent years, is a centrally acting analgesic drug that has been used clinically for the last two decades to treat pain in humans. Tramadol also has antitussive activity. Tramadol is a centrally acting analgesic which is extensively used in the management of moderate to severe pain. It slightly affects opioid receptors and inhibits the reuptake of norepinephrine and serotonin in the CNS. The aim of this study was to evaluate the clinical manifestations, the laboratory findings, the different lines of treatment and the outcome of cases presented with acute toxicity by tramadol overdoses. This study was carried out at Al-Azhar University Emergency Hospitals in Cairo [El-Hussein and Bab El-Shaaria University Hospitals] and Ain Shams University Hospitals on one hundred subjects in the period from July 2016 to February 2018. Toxicological screening was done for every patient by rapid lateral flow chromatographic immunoassay for detection of tramadol and its principal metabolites in human urine by special kits at a cut off level of 1000 ng/ml. In this study, 95% of studied cases fully recovered and 5% died