Background Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0•9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0•9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124.
Tissue samples were collected at random from cattle (Bos taurus) and buffalo (Bubalus bubalis) from an abattoir of the district of Lahore and were analyzed for the presence of Mycobacterium avium subsp. paratuberculosis and Mycobacterium bovis through acid-fast staining and polymerase chain reaction (PCR). Body condition of animals and diarrhea were recorded. Most of the animals were emaciated. Diarrhea was noticed in 15.6% of buffaloes and 19.2% of cattle. Intestinal pathology was observed in 29% of buffaloes and 32.8% of cattle. Number of mesenteric lymph node (MLN) showing gross lesions was a bit higher (35.6%) in cattle than buffalo (31.2%). Acid-fast staining of tissue scraping smears revealed the presence of acid-fast bacilli (AFB) in 17.4% intestinal and 16.4% MLN tissue samples in buffalo, while in cattle 19.2% intestinal and 17.8% MLN were found positive for AFB. In buffaloes, PCR confirmed 12.8% intestinal and 12.4% MLN positive samples for M. avium subsp. paratuberculosis. However, in cattle, PCR analysis demonstrated 14.2% positive results for M. avium subsp. paratuberculosis in both MLN and intestinal tissue samples. PCR also confirmed M. bovis in 5.8% of cattle and 5% of buffalo MLN and intestinal tissues. PCR positive tissue samples for M. avium subsp. paratuberculosis were from those animals which were emaciated, having diarrhea, and severe gross lesions. AFB were also detected in tissue scraping smears of these animals. It is concluded that infection by various mycobacterium species can be differentiated by PCR, which is not possible by acid-fast staining technique.
Data regarding the prevalence of skin diseases reducing the market value of skins and hides and ultimately refined leather were not available in Pakistan. The current study was conducted in the hide/skin markets and abattoirs of Lahore and Faisalabad and tanneries of Sheikhupura, Kasur and Sialkot. The record of various skin diseases and conditions damaging the skin/hide of cattle, goat and sheep was made. Lesions, extent and type of damage were recorded. A total of 21,671 skins / hides were examined out of which 3918 of skins and 600 hides were examined at the abattoirs of Lahore and Faisalabad, 6784 Skins and 1399 hides at hide markets and 8091 skins and 879 hides at tanneries. Out of total 21,671 skins / hides, 66.12% were normal and 33.88% were having some sort of damage. The data were gathered on questionnaire sheets. The prevalence of skin diseases was assessed through Strata V.9 software program. The correlation of the disease and area was analyzed by the chi-square. The prevalence of various diseases and damages due to mal-management in sheep, goats and cattle has been discussed in detail. The damages in goat skins were significantly less as compared with cattle and sheep. However, the type of defects and severity varied amongst various ruminants studied. The most common damages observed, overall in all species studied were atrophy of skin (Thin skin) 6.38%, followed in descending order observed was lesions of wounds 4.94%, old lesions of pox 4.82%, flaying cuts 3.17%, tick infestation 3.08%, lesions caused by mites infestation 2.45%, scratches 2.33%, lesions caused by warble fly larvae 1.47%, decomposition 1.32%, charr (fibrosis) 1.28%, ringworm infection 1.10%, extensive soiling by dung 0.84%, chronic abscesses 0.46%, and Lice infestation 0.17%.
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