The role of tranexamic acid in prevention of hemorrhage in major spinal surgeries.

BACKGROUND: Blood loss that necessitates blood transfusion is one of the most frequent complications of major spinal surgeries. This study has been designed to evaluate the efficacy and safety of prophylactic tranexamic acid (TA) in decreasing perioperative blood loss. MATERIALS AND METHODS: From January to August 2011, all the patients who needed major spinal surgeries and aged between 18 and 60-year-old were divided into two groups randomly, the experimental group received 10 mg/kg of TA 20 min after inducing the anesthesia as loading dose followed by 0.5 mg/kg/h until skin closure and the control group received equal amounts of normal saline as placebo. Intraoperative blood loss was recorded by estimating blood with the suction tube plus the number of bloody gasses. The amounts compared between the 2 groups and analyzed. RESULTS: Forty patients were enrolled in this study in the first group intraoperative, the 1st and 2nd postoperative days, the mean blood loss were 574 ml, 80.5 ml, and 669.5 ml while in the second group were 797 ml, 124 ml, and 921.5 ml. CONCLUSION: TA seems to be safe and can be considered in spinal surgeries with significant excepted blood loss especially in female patients and instrumental procedures. We suggest further studies on TAs efficacy and safety in larger scales.

The investigation of ADHD prevalence in kindergarten children in northeast Iran and a determination of the criterion validity of Conners' questionnaire via clinical interview.

In this study, the prevalence of attention-deficit hyperactivity disorder (ADHD) in kindergarten children in northeast Iran was investigated, and the criterion validity of Conners' parent-teacher questionnaire was evaluated through the use of clinical interviews. This study was a cross-sectional descriptive research project with children in kindergartens that was supported by the Behzisti Organization, which included 155 kindergartens and 4143 children. To study the prevalence of ADHD, cluster random sampling was used; 1083 children were chosen as a reference, and random sampling was used to determine the criterion validity. Twenty-two children scoring below a specified cut-off score and 32 children scoring above the cut-off score were interviewed. In the first stage, ADHD was assessed using Conners' parent-teacher questionnaire, and in the second stage, it was assessed with a clinical interview based on DSM-IV-TR criteria. Finally, the prevalence rate was evaluated with descriptive parameters, and the criterion validity was assessed using the tetracoric correlation coefficient. The prevalence of ADHD was estimated at 12.3% ± 2.12%. Moreover, test sensitivity and specificity were evaluated at 90.3% and 81.2%, respectively. Therefore, the criterion validity with α = 0.05 is 90.3%. The prevalence of ADHD among children was high, suggesting a need to screen all children for ADHD before school age. The Conners' questionnaire proved to be a good test for the primary screening of ADHD among kindergarten children.

Razi's description and treatment of facial paralysis.

In the modern medical era, facial paralysis is linked with the name of Charles Bell. This disease, which is usually unilateral and is a peripheral facial palsy, causes facial muscle weakness in the affected side. Bell gave a complete description of the disease; but historically other physicians had described it several hundred years prior although it had been ignored for different reasons, such as the difficulty of the original text language. The first and the most famous of these physicians who described this disease was Mohammad Ibn Zakaryya Razi (Rhazes). In this article, we discuss his opinion.