European Journal of Molecular & Clinical Medicine

Background: Total hip arthroplasty could be associated with major intra-operative as well as post-operative blood loss. Post-operative anaemia is a recognized complication which can prolong hospital stay, delay rehabilitation and is poorly tolerated by elderly patients. Blood transfusion carries the risk of infections, anaphylaxis, etc. We examined whether tranexamic acid given before and after total hip arthroplasty reduces intra-operative, post-operative and total operative blood loss and whether the need for post-operative blood transfusion is reduced.
Materials & Methods: A total of 40 patients were included in this study. Group A (n=20, study group) received I.V tranexamic acid (15mg/kg body weight) infusion 10 minutes before incision. 4 hours later, 10mg/kg body weight I.V tranexamic acid was given. Group B (n=20, control group) did not receive any anti fibrinolytic agent. The amount of blood loss, post-operative drop in haemoglobin and the amount of blood transfused was recorded in each case.
Results: Tranexamic acid significantly reduced intra-operative blood loss by 35.68% and total operative blood loss by 22.87% with a 30% reduction in blood transfusion rates compared to the control group. There was no significant effect on post-operative blood loss, duration of surgery or length of hospital stay.
Conclusion: Tranexamic acid when administered perioperatively significantly reduces the operative blood loss in primary total hip arthroplasty surgery with minor side effects. Thus, it can be used effectively in patients undergoing primary total hip arthroplasty to reduce intra-operative blood loss and the need for blood transfusions.

Dry socket is an unavoidable complication of dental extraction facing the dental practitioners on a regular basis. We performed a brief systemic review of the etiopathogenesis, prevention and management of dry socket. The inclusion criteria for including articles were that all the studies discussed the dry socket etiopathogenesis, prevention and management and the exclusion criteria were all the studies that included other complications of tooth extraction. The method used for this systemic review was to search in the PubMed database using MeSH terms “dry socket”, “alveolar ostitis” for etiopathogenesis, prevention and management and published in the English language, 86 articles were identified by abstract for relevance to etiopathogenesis, prevention and management of dry socket and a total of 24 publications were included in the final systematic review according to the specific keywords and materials mentioned above. The audit of the literature showed that the prevention methods include avoiding smoking after surgery, atraumatic extraction, the use of antibiotics and other preventive measures such as use of chlorhexidine rinse or gel to reduce the incidence of dry socket. For management of dry socket, wide range of treatment options are being suggested including using chlorhexidine or saline solution irrigation, placement of non- absorbable obtundent dressing(zinc oxide eugenol dressing) or absorbable dressing(alveogyl dressing) and instruction of home rinsing with chlorhexidine mouthwash. There are also new agents in the field being tried that accelerates the healing of the socket such as PRF and GECB as well as combination of PRF with chlorhexidine gel. This paper is a brief review of the literature on etiopathogenesis, prevention and management of dry socket, in order to best guide clinical practice based on current available evidence

Thrombin activated fibrinolysis inhibitor, shortly known as TAFI, is a carboxypeptidase found in plasma. It is activated majorly by thrombomodulin associated-thrombin. It stabilizes clots and inhibits their lysis by decreasing their plasminogen binding sites. Besides, it activates protein C which is necessary to halt thrombin generation. Thus, it is more regulatory than inhibitory in function. Existing as three forms TAFI, TAFIa and TAFIi, assay methods of the same are not well standardized. However, TAFI is associated with conditions like hemophilia, venous thrombosis, myocardial infarction, angina pectoris, chronic liver disease and even disseminated intravascular coagulation (DIC). This review will throw light on the role, mechanisms and involvement of TAFI in associated pathological conditions.