1.Intravenous Injection of Tranexamic Acid in Patients with Pelvic Fractures: A Prospective Randomized Trial
Mahmoud FAHMY ; Mahmoud Abdel KARIM ; Ahmed Hazem ABDELAZEEM ; Ahmed Magdy ABDELRAZEK
Hip & Pelvis 2025;37(1):64-71
Purpose:
The purpose of the study is to examine the efficacy of intravenous injections of tranexamic acid (TXA) in reducing perioperative blood loss in patients scheduled for open reduction and internal fixation for pelvic fractures (Tile B and C). A study population with greater homogeneity was selected to minimize confounding variables related to fracture and fixation methods that may reflect an accurate result.
Materials and Methods:
A prospective randomized controlled trial including 100 patients who received either 15 mg/kg of TXA added to 40 mL saline twice separated by 3 hours interval or a similar volume of normal saline (~50 mL twice in same manner) intravenously. Measurement of hemoglobin was performed preoperatively and postoperatively. Blood loss in drain, blood units transfused, and complications were recorded.
Results:
The mean decrease in hematocrit levels (preoperatively and postoperatively) was 3.2% in the trial group versus 3.7% in the control group (P>0.05). Mean total blood loss was 1,106 and 1,340 mL (trial vs. control group [P<0.05]). The mean operative time was 122.5 and 130.3 minutes (trial vs. control group [P>0.05]). Mean collected blood from the drain was 155 and 170 mL (trial vs. control group [P>0.05]). The transfusion rate was 28% and 76% while the mean for transfused units was 0.72 and 1.1 units (trial vs. control group [P<0.05]). There were no venous thromboembolic events.
Conclusion
Intravenous injection of TXA in pelvic fractures was effective in reducing blood loss and the rates of blood transfusion. There were no associated thromboembolic complications.
2.Intravenous Injection of Tranexamic Acid in Patients with Pelvic Fractures: A Prospective Randomized Trial
Mahmoud FAHMY ; Mahmoud Abdel KARIM ; Ahmed Hazem ABDELAZEEM ; Ahmed Magdy ABDELRAZEK
Hip & Pelvis 2025;37(1):64-71
Purpose:
The purpose of the study is to examine the efficacy of intravenous injections of tranexamic acid (TXA) in reducing perioperative blood loss in patients scheduled for open reduction and internal fixation for pelvic fractures (Tile B and C). A study population with greater homogeneity was selected to minimize confounding variables related to fracture and fixation methods that may reflect an accurate result.
Materials and Methods:
A prospective randomized controlled trial including 100 patients who received either 15 mg/kg of TXA added to 40 mL saline twice separated by 3 hours interval or a similar volume of normal saline (~50 mL twice in same manner) intravenously. Measurement of hemoglobin was performed preoperatively and postoperatively. Blood loss in drain, blood units transfused, and complications were recorded.
Results:
The mean decrease in hematocrit levels (preoperatively and postoperatively) was 3.2% in the trial group versus 3.7% in the control group (P>0.05). Mean total blood loss was 1,106 and 1,340 mL (trial vs. control group [P<0.05]). The mean operative time was 122.5 and 130.3 minutes (trial vs. control group [P>0.05]). Mean collected blood from the drain was 155 and 170 mL (trial vs. control group [P>0.05]). The transfusion rate was 28% and 76% while the mean for transfused units was 0.72 and 1.1 units (trial vs. control group [P<0.05]). There were no venous thromboembolic events.
Conclusion
Intravenous injection of TXA in pelvic fractures was effective in reducing blood loss and the rates of blood transfusion. There were no associated thromboembolic complications.
3.Intravenous Injection of Tranexamic Acid in Patients with Pelvic Fractures: A Prospective Randomized Trial
Mahmoud FAHMY ; Mahmoud Abdel KARIM ; Ahmed Hazem ABDELAZEEM ; Ahmed Magdy ABDELRAZEK
Hip & Pelvis 2025;37(1):64-71
Purpose:
The purpose of the study is to examine the efficacy of intravenous injections of tranexamic acid (TXA) in reducing perioperative blood loss in patients scheduled for open reduction and internal fixation for pelvic fractures (Tile B and C). A study population with greater homogeneity was selected to minimize confounding variables related to fracture and fixation methods that may reflect an accurate result.
Materials and Methods:
A prospective randomized controlled trial including 100 patients who received either 15 mg/kg of TXA added to 40 mL saline twice separated by 3 hours interval or a similar volume of normal saline (~50 mL twice in same manner) intravenously. Measurement of hemoglobin was performed preoperatively and postoperatively. Blood loss in drain, blood units transfused, and complications were recorded.
Results:
The mean decrease in hematocrit levels (preoperatively and postoperatively) was 3.2% in the trial group versus 3.7% in the control group (P>0.05). Mean total blood loss was 1,106 and 1,340 mL (trial vs. control group [P<0.05]). The mean operative time was 122.5 and 130.3 minutes (trial vs. control group [P>0.05]). Mean collected blood from the drain was 155 and 170 mL (trial vs. control group [P>0.05]). The transfusion rate was 28% and 76% while the mean for transfused units was 0.72 and 1.1 units (trial vs. control group [P<0.05]). There were no venous thromboembolic events.
Conclusion
Intravenous injection of TXA in pelvic fractures was effective in reducing blood loss and the rates of blood transfusion. There were no associated thromboembolic complications.
4.Comparative evaluation of gold nanoparticles and Alum as immune enhancers against rabies vaccine and related immune reactivity, physiological, and histopathological alterations: in vivo study
Rehab Essam El-Din EL-HENNAMY ; Sahar Mohamed MAHMOUD ; Nabil Ahmed EL-YAMANY ; Hanaa Hassan HASSANEIN ; Mohamed Elsayed AMER ; Aly Fahmy MOHAMED
Clinical and Experimental Vaccine Research 2023;12(1):32-46
Purpose:
The present study aimed to compare the immune-enhancing potential of gold nanoparticles (AuNPs) to Alum against rabies vaccine and the related immunological, physiological, and histopathological effects.
Materials and Methods:
Alum and AuNPs sole and in combination with rabies vaccine were used at 0.35 mg/mL and 40 nM/mL, respectively. Rats used were categorized into six groups (20/each): control rats, rabies vaccine, aluminum phosphate gel, rabies vaccine adsorbed to Alum, AuNPs, and rabies vaccine adjuvant AuNPs.
Results:
Liver and kidney functions were in the normal range after AuNPs and Alum adjuvanted vaccine compared to control. Interleukin-6 and interferon-γ levels were significantly increased in groups immunized with Alum and AuNPs adjuvanted vaccine, the peak level was in the case of AuNP adjuvanted vaccine on the 14th day. Ninety days post-vaccination, total immunoglobulin G (IgG) against adjuvanted rabies vaccine showed a significantly elevated anti-rabies IgG with AuNPs and Alum adsorbed vaccine compared with unadjuvanted one. The total antioxidant capacity, malondialdehyde (MDA) levels, superoxide dismutase, and glutathione peroxidase activities were significantly increased post-adjuvanted AuNPs adjuvanted vaccine vaccination than in Alum adsorbed vaccine, while MDA was significantly decreased. The histopathological examination revealed detectable alterations post-AuNPs and Alum adjuvanted vaccine immunization compared with liver and kidney profiles post-administration of unadjuvanted and non-immunized groups, meanwhile, splenic tissue revealed hyperplasia of lymphoid follicles indicating increased immune reactivity.
Conclusion
The AuNPs are promising enhancers of the immune response as Alum, and the undesirable effects of AuNPs could be managed by using suitable sizes, shapes, and concentrations.