Background:Uncontrolled hemorrhage is a well-recognized cause of mortality in trauma victims and the control of active hemorrhage is among the initial steps in resuscitation.Objectives:The purpose of this study was to assess the role of a hemostatic agent “celox” in the management of civilian stab-wound trauma.Patients and Methods:In this clinical trial study, 160 patients with penetrating limb trauma were randomly allocated to either the control or intervention group (n = 80, each group). Controls were treated with the simple pressure dressing, while the celox-coated gauze was used in the intervention group. The time for achievement of hemostasis and the amount of bleeding were recorded. Data were analyzed using SPSS Version 21 and Stata 13. A P value of less than 0.05 was considered statistically significant.Results:The mean age of participants was 30.5 and the majority of patients were male (90.6%). The forearm and distal leg were the most sites of injury. Hemostasis was achieved within 5 minutes in 32.5% of the control group and 51.3% of the intervention group. Using the celox-coated gauze significantly reduced the time to hemostasis (P = 0.01). Moreover, the blood loss was significantly lower in the celox group compared to the controls (P < 0.05).Conclusions:Using the celox-coated gauze is able to achieve hemostasis in penetrating limb trauma faster than the conventional pressure bandage. Further research is required to clarify the subset of patients who will benefit the most from this effect in the emergency department.

There is controversy over the role of magnesium in the etiology of migraine headaches. We aimed to evaluate and compare serum levels of magnesium between healthy individuals and those with migraine headaches during migraine attacks and between attacks to evaluate the role of magnesium in the etiology of migraine headaches. Forty patients with migraine headaches and 40 healthy individuals were enrolled in this matched case-control study. Malnutrition, digestive system disorders, history of smoking, drug abuse, and history of medications use were recorded at baseline. The pain scores of patients were measured and recorded based on a 10 cm visual analog scale. Subsequently, blood samples were collected at 8-10 in the morning to determine serum levels of magnesium. Analysis of variance, χ-test, and conditional logistic regression were used for data analysis. There were no significant differences in demographic data between the two groups. There were significant differences in magnesium serum levels between the three groups (1.09±0.2 mg/dl during migraine headaches; 1.95±0.3 mg/dl between the attacks; and 1.3±0.4 mh/dl in the control group; P<0.0001). Odds of acute migraine headaches increased 35.3 times (odds ratio=35.3; 95% confidence interval: 12.4-95.2; P=0.001) when serum levels of magnesium reached below the normal level. The odds in patients who are not in the acute attack phase were 6.9 folds higher (odds ratio=6.9; 95% confidence interval: 1.3-2.1; P=0.02). The serum level of magnesium is an independent factor for migraine headaches and patients with migraine have lower serum levels of magnesium during the migraine attacks and between the attacks compared with healthy individuals.