Thrissur

This research aims to compare the effects of oral anticoagulation versus no anticoagulation in patients aged 55 and older who have had recent episodes of transient atrial fibrillation triggered by stress and have additional factors that increase their risk of stroke. The study is a multinational, investigator-initiated, prospective, randomized, open-label trial evaluating the impact of non-vitamin K oral anticoagulants NOACs on preventing stroke and other serious cardiovascular events. Participants will be randomly assigned to either receive one of several NOACs, such as edoxaban, apixaban, dabigatran, or rivaroxaban, prescribed by their physician for the duration of the follow-up, or to a control group that will not receive anticoagulants unless medically indicated during the study. The choice of specific NOAC and dose adjustments are determined by the prescribing doctor. The study excludes patients with certain conditions like chronic atrial fibrillation, severe kidney or liver disease, recent cardiac surgery, or bleeding risks. During the study, participants will be monitored for up to 24 months to assess the occurrence of non-hemorrhagic stroke, systemic embolism, vascular mortality, myocardial infarction, peripheral arterial thrombosis, amputation, and venous thromboembolism. Regular follow-up will include evaluation of these outcomes to measure the effectiveness and safety of anticoagulation compared to no anticoagulation. Participants will provide informed consent and remain under medical supervision throughout the trial.

Trauma is a major cause of injury and death worldwide, often leading to significant health challenges. This research aims to evaluate how well the platelet-lymphocyte ratio PLR and platelet-neutrophil ratio PNR predict early trauma-induced coagulopathy ETIC in patients arriving at the emergency department ED within six hours of injury. These ratios reflect the balance between inflammation and immune response, which may help identify patients at risk early in their hospital stay. The study observes trauma patients who come to the ED and have blood tests ordered by their physician, specifically coagulation profiles. It focuses on measuring the PLR and PNR values upon admission, without administering any new treatments or interventions. The goal is to see how these markers predict outcomes such as the need for blood transfusions, prolonged ventilatory support, surgeries, and length of hospital stay during their admission. Participants will be monitored during their hospital stay, with researchers assessing laboratory results and clinical events such as transfusions, surgeries, and intensive care days. The main outcome is the accuracy of PLR and PNR in detecting ETIC within 24 hours. Secondary outcomes include comparing predictive values for transfusion needs, ventilatory support duration, emergent surgeries, and hospital stay length up to 30 days. The study is observational and does not involve additional treatments or procedures beyond usual care.