Introduction: Hemophilia is one of the most important coagulation disorders. At the present time the current treatment is factor replacement which may lead to many socio-economic problems and also transmission of some viral infections. In this study we evaluate an alternative treatment to factor replacement to decrease the aforementioned problems. Material and Methods: This was an interventional study and the statistical population included all Hemophilia patients that referred to Besat Hospital. They were randomly divided into two groups: an intervention group of 13 patients and a control group of 15 patients. Tranexamic Acid was only used for the intervention group (15 patients). Then the data was assessed by spss win software. Results: In the intervention group bleeding episodes were reduced significantly (from 4.07 episodes per month to 3 episodes per month) and so was the need for factor replacement (from 80.1 u/kg/m to 58.7 u/kg/m). In the control group bleeding episodes and the need for factor replacement did not differ prior to and during the study. Conclusion: The results of this study showed that daily prophylactic use of TEA is effective in reducing bleeding episodes and decreasing the need for factor replacement in hemophilia patients. However, due to increased PTT and decreased serum clotting factors in patients, the risk of life threatening bleeding is likely to be high. Thus we don’t recommend the use of TEA as a prophylactic measure in hemophilia.  

Background: Hemostasis has turned into one of the major concerns in surgery and anesthesia. Anesthesiologists are always pursuing new methods and medications to avoid allogenic and autologous blood transfusion. The present study aimed at examining the effects of Tranexamic Acid on the reduction of hemorrhage and the need for transfusion. Methods: A sequential controlled clinical trial was performed on 60 patients referred to Imam Hossein Hospital, with femoral fracture, aged between 20 to 50, and with no coexisting diseases. The patients were divided into trial and control groups of 30 each. Prior to the surgery, the trial group received 10mg/kg dose of Tranexamic Acid. Results: There were significant differences between the two groups with the average blood loss in trial group 675±208.7cc and in control group 998.4±230.9cc. In trial group, 5 patients and in control group 14 patients received Allogenic blood in which the difference was also statistically significant (P<0.02). Conclusion: It is concluded that the use of Tranexamic Acid reduces operational hemorrhage and blood transfusion during femoral fracture surgery. Further evaluation of safety is required before recommending the use of antifibrinolytics in orthopedic surgery.

Introduction: Management of postoperative bleeding in patients receiving warfarin, has always been one of the most challenges for dentists. Cessation in using warfarin 2-3 days before tooth extraction is one of the methods for preventing bleeding in these patients, but it may increase the risk of thromboembolism. The aim of this study was to use localized haemostatic drugs instead including gelatin sponge and Tranexamic Acid mouthwash.Materials & Methods: In this clinical trial study, 22 patients who were currently receiving warfarin with INR range of 2-4 were selected. For each patient 3 teeth were extracted in several times. After extraction of each tooth, Gelatin sponge, Tranexamic Acid 4/8% mouth wash and sterile gauze (without any haemostatic drug) were used.Tendency of bleeding in 66 teeth, 2 and 24 hours after extraction was checked. No suture was used for any patient. Data were analyzed with descriptive statistics (frequency and average) and Chi-square and Fisher's exact tests.Results: Rate of bleeding in three groups were measured: Gelatin sponge: 9.1%, Tranexamic Acid 4.8% mouthwash: zero and sterile gauze (without any haemostatic drug): 27.3%.Conclusions: In patients treated with warfarin, interruption in use of warfarin for tooth extraction is not needed. Local haemostasis with Tranexamic Acid 4.8% mouthwash without any suture is sufficient.

Introduction: Excessive menstrual bleeding is a common complaint and each year around 5% of 30-49 year old women have this problem. The aim of this study is to compare the efficacy and acceptability of mefenamic Acid and Tranexamic Acid for treating menorrhea. Attempts have been made to choose a more effective with less complication to treat hyper menorrhea.Materials and Methods: This study is a control trial study and the setting is Shahid Sedugh University, department of obstetrics and gynecology, Yazd in 2001-2005. 75 women with excessive uterine bleeding (hyper menorrhea) were under treatment for five days from day 1 of menses during three consecutive menstrual periods. 36 patients were randomized to take mefenamic Acid 500 mg, Tid; and 39 patients to take 500 mg Tranexamic Acid, Qid.Menstrual loss was measured in three control menstrual periods and three menstrual periods during treatment. Duration of bleeding patient's estimated blood loss, sanitary towel usage and unwanted events were also taken into consideration.Results: mefenamic Acid reduced blood loss by 20% and Tranexamic Acid reduced blood loss by 50% (P=0.001). Duration of bleeding was not different in patients treated with mefenamic Acid and Tranexamic Acid.Conclusions: Tranexamic Acid given during menstruation is a safe and highly effective treatment for excessive bleeding. Patients with dysfunctional uterine bleeding should be offered medical treatment with Tranexamic Acid before a decision is made about surgery.

Background: Wagener's granulomatosis (WG) is a systemic necrotizing vasculitis characterized by upper and lower respiratory tract involvement and glomerulonephritis in most instances.Case Report: We report a 36 years old man with DAH secondary to WG, as the presenting feature. He successfully treated with standard immune suppressive agents including pulse methylprednisolone and cyclophosphamide, along with Tranexamic Acid as adjunctive therapy for control of active bleeding. Laboratory results showed mild to moderate anemia, increased serum lactate dehydrogenase and very highc-ANCA titer. Chest radiograph showed bilateral alveolar infiltrates.Conclusion: Diffuse Alveolar hemorrhage (DAH) is a dread complication of Wagener's granulomatosis. Control of acute phase of hemorrhage with Tranexamic Acid can improve out come of patients.

Serious bleeding in cardiac surgery leads to re-exploration, blood transfusion and increases the risks of mortality and morbidity.Using the lysine analogous of antifibrionlytic agents are the preferred strategy to suppress the need for transfusion procedures and blood products. Although Tranexamic Acid has been very influential in reducing the transfusion requirement after operation, Tranexamic Acid induced seizures is one of the common side effects of this drug. Due to inhibiting the fibrinolysis, thrombotic events are other possible side effects of using Tranexamic Acid. There are no certain results regarding decreasing the mortality rate by using the drug but it is identified that Tranexamic Acid does not increase the mortality. In this article, we aimed to review the literature on using Tranexamic Acid in cardiac surgeries.