Local Tranexamic Acid for Local Hemostasis in an Animal Liver Injury Model.

BACKGROUND: Hyperfibrinolysis is a state of increased clot resolution often seen in trauma patients with ongoing hemorrhage. Tranexamic acid (TXA) inhibits fibrinolysis preventing clot resolution affecting hemorrhage continuation and is used by intravenous administration. AIMS: The purpose of this study was to evaluate the local tranexamic acid application for hemostatic control in an experimental animal liver injury model. SETTINGS AND DESIGN: This study was an experimental prospective treatment study to check the local TXA effects on liver injury. This study was approved by the Ethics Committee. MATERIALS AND METHODS: Twenty adult male Sprague-Dawley white rats were equally randomized to two groups after a standardized liver injury was conducted under anesthesia. One group were "liver-packed" with gauze (TXA [-]) and the other group with gauze soaked in TXA (TXA [+]). Bleeding from the injured middle liver lobe was measured at 2 and 15 min, and at 48h second-look surgery, with euthanasia conducted at 14 days. The liver was sent for histopathological and stereological analysis. STATISTICAL ANALYSIS AND RESULTS: There was no difference in bleeding at 2 or 15 min after packing; however, larger amount of free blood at 48 h in the TXA (-) group was noticed. Five animals in the TXA (-) were alive at 14 days compared to eight animals in the TXA (+) group. Significantly larger volume density of fibrosis, granulation tissue, and amorphous tissue were seen in the TXA (+) group compared to the TXA (-) group at the stereological analysis. CONCLUSION: Local TXA application on the injured liver surface might offer better hemostatic control than packing alone. Further studies are mandated before the clinical application of our findings.

Ibn al-Haytham (965-1039 AD), the original portrayal of the modern theory of vision.

Abu ՙAli al-Hasan ibn al-Hasan ibn al-Haytham, known in the West as Alhazen, was an Arab-Islamic scholar who helped develop the science of ophthalmology during the medieval era. He was the first to reject firmly the extramission theory of vision, which was prevalent during his time, and suggested that the eyes are the source of the light rays responsible for vision. Ibn al-Haytham in his book entitled Kitab al-Manazir (Book of Optics) explained vision based on light emanating from objects. In this study we review Ibn al-Haytham's life and introduce his major contribution to the field of ophthalmology, his theory of vision.

Johannitius (809-873 AD), a medieval physician, translator and author.

The medieval physician, translator and author Abu Zayd Hunayn ibn Ishaq al-'Ibadi, best known in the West as Johannitius, is considered the best translator of Greek texts, particularly medical writings, into Arabic. He made great inroads in the art of translation in the Islamic world. In addition to his own translations, Johannitius put significant effort into training pupils and passing knowledge about translation to succeeding generations. He was also a great writer, compiling over 100 books on different subjects, especially medical. Among his own works, the illustrious Kitab al-Ashr Maqalat fil-Ayn (Ten Treatises on the Eye) contains the oldest known illustration of the structure of the eye. It served as the primary source for Galen's theory of vision and subsequent use by Western scholars.

Rhazes (865-925 AD), the icon of Persian cardiology.

For many long centuries, the function of the human cardiovascular system was an important issue among scholars of different eras and areas. Abubakr Muhammad ibn Zakariyya al-Razi (865-925 AD), known by the Latin name Rhazes, was one of the scholars concerned with this issue. This physician is recognized as the first great scientist of the Golden Age of Islamic Medicine (9th-12th centuries AD). He authored Kitab al-Mansuri (Liber Al-Mansuri), a ten-volume medical encyclopedia that covers a large number of medical subjects. The first chapter of this book is allocated to human anatomy and functions. In this article, we review the chapter from Al-Mansuri that deals with Rhazes' views on the cardiovascular system.