2 research outputs found
Evaluation of the toxic influence of vitamin E (dl-alpha-tocopheryl acetate) and treatment with aqueous extracts of cinnamon or anise on lipid profile and liver functions of female wistar rats
No full textThe toxic effects of vitamin E and its treatment with aqueous extracts of Cinnamon or anise on lipid profile and liver functions of female wistar rats were examined for six weeks during September 2016 at labs in al-Neelain University. 18 rats were divided into six groups: 1. negative control group (sunflower oil), 2. Positive control group and rest groups given (1500 mg/Kg/BW/day of Vitamin E). After two hours, the four treated groups received a low dose (2.13g/Kg) and a high dose (3.20g/Kg) 20g/Kg from Cinnamon aqueous extract (CAE) and Anise aqueous extract (AAE). At the end rats were sacrificed then serum and liver tissues were analyzed. Vitamin E toxic dose had caused a significant increase in serum Triglycerides (TG), Alanine amino transferase (ALT) levels, while it decreased the levels of High-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC) and Aspartate amino transferase (AST). All treatments decreased TG and ALT levels. CAE low dose significantly increased TC, LDL and HDL levels. CAE high dose caused a significant decrease in AST, TC, and LDL. Both doses of AAE, caused significant increases on AST levels, and only anise low dose caused a significant decrease on TC and LDL levels. Vitamin E toxic dose caused severe fatty change in liver histology, which was near normal in both doses of CAE with a small necrosis in a low dose. Only AAE low dose normalized the liver. To conclude Vitamin E oral administration with a dose of (1500 mg/Kg) induced liver injury with an elevation in ALT and TG levels, which was significantly ameliorated by both treatments. Cinnamon was better than anise in ameliorating the toxicity. Cinnamon high dose was better than Cinnamon low dose; in contrast anise low dose was better than Anise high dose.</jats:p
Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial.
No full textBACKGROUND: Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. METHODS: In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. FINDINGS: Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65-1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52-0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88-1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. INTERPRETATION: Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. FUNDING: London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation
