Effect of tranexamic acid on the treatment of patients with upper gastrointestinal bleeding: A double-blinded randomized controlled clinical trial

Objective:To determine the efficacy of tranexamic acid(TXA)in the management of acute upper gastrointestinal(GI)bleeding.Methods:A total of 70 patients with acute upper GI bleeding were included in this double-blinded randomized controlled clinical trial from September 2018 to December 2018.Patients were divided into the control group(received fluid therapy and intravenous infusion of pantoprazole,35 cases)and the TXA group(received intravenous TXA besides the treatment of control group,35 cases).Rebleeding,admission duration,and need for blood transfusion were compared between the two groups.Results:Fifteen patients(42.9%)in the TXA group and 10 patients(28.6%)in the control group stayed in hospital for more than 3 days during their admission(P=0.21).Rebleeding occurred in 8 patients(22.9%)and 5 patients(14.3%)of the TXA group and the control group,respectively(P=0.35).More patients in the TXA group(21 cases,60%)received blood transfusion than the control group(8 cases,22.9%)(P=0.02).Conclusions:TXA did not improve the outcome of patients with acute upper GI bleeding.

Toxoplasma gondii and human immunodeficiency virus co-infection in western Iran: A cross sectional study

Objective: To determine Toxoplasma gondii(T. gondii) as a cause of morbidity and mortality in human immunodeficiency virus(HIV) infected patients by ELISA method and to investigate toxoplasmosis-associated risk factors. Methods: This cross sectional study was conducted with 385 patients with HIV/AIDS referred to the behavior disease consultation center in Kermanshah, Iran between May 2012 and June 2013. Anti-Toxoplasma IgG and IgM antibodies were measured by using the ELISA method. Also, the relationship between the infection and age, gender, education, occupation, antiretroviral status, CD4+ cell counts and some other factors of the patients were assessed. P<0.05 was considered statistically significant. Results:Among the HIV-positive patients, 40.8%(157/358) and 2.6%(10/358) patients were positive for anti-T. gondii IgG and IgM antibodies, respectively. The mean CD4+ count in the patients with HIV was 327 cells/μL. A significant correlation was observed between the toxoplasmosis infections with the age group(P<0.05). Nevertheless, no statistically significant difference was found between gender, living area, educational level, occupational, marital status, antiretroviral status, prophylaxis, CD4+ cell count and toxoplasmosis. Conclusions: This study revealed that the patients with HIV infection were at the high risk of developing toxoplasmosis disease especially those patients who do not receive antiretroviral therapy and prophylaxis. The development and use of the effectiveness-based guidelines for controlling and the prevention reactivation of the latent T. gondii infection is required.