1. Background: The incidence of venous thromboembolism (VTE) in children has been steadily increasing over the past 20 years, mainly due to increased use of central venous access devices AND significant advances in child management under chronic AND/or severe medical conditions (1). The rapid growth of VTE in pediatric tertiary care hospitals across the United States has become a problem that cannot be ignored. Pediatricians must deal with the fact that most of the latest treatment recommendations for VTE in children are derived from adult-related research in the treatment of VTE (2). UnderstANDing the reasons for the rapid increase in children with this disease, conducting identification of such children AND research on optimal treatment strategies is crucial...

Introduction: The inherent tendency of blood to clot plays a central role in the formation of clots. ANTICOAGULANT agents should be considered essential tools in the management AND treatment of patients with coagulation problems. The purpose of this study is to investigate the level of knowledge of dentists regarding ANTICOAGULANT DRUGS AND the necessary measures for the treatment of bleeding during dental procedures. Materials AND Methods: This article reports a cross-sectional analytical study conducted at the Faculty of Dentistry among general dentists at Qom University of Medical Sciences in 1401. The Chi-square AND Fisher tests were used to analyze the collected data, which were evaluated using SPSS version 26 software. Results: Among 121 general dentists with an average age of 30.56 ± 6.89 years AND an average work experience of 4.46 ± 5.80 years after graduation, 69 were male AND 52 were female. A significant percentage of responses to each question on the questionnaire indicated a lack of knowledge about ANTICOAGULANT AND antiplatelet DRUGS. There was no significant relationship between gender, age, or work experience of dentists AND most questions in the questionnaire (p > 0.81). Conclusion: The gender of dentists is not an effective factor in their level of knowledge. Only in the cases of discontinuation of clopidogrel AND the postponement of dental procedures due to the use of antiplatelet DRUGS was there a relationship with the age of general dentists. Additionally, there is a significant relationship between knowledge of the drug prasugrel AND the discontinuation of clopidogrel in relation to the work history of general dentists. This lack of connection between these factors demonstrates a need to improve the level of knowledge AND awareness among general dentists.

Introduction: Women's cancers such as endometrium, ovary, cervix, AND vulva are common AND one of the most effective treatments is the use of surgical techniques. Today, the use of injectable ANTICOAGULANTs (heparin AND enoxaparin) before AND after women's cancer surgeries is common in treatment protocols. The present study was performed with aim to compare the effect of oral (apixaban) AND injectable (enoxaparin) ANTICOAGULANT DRUGS in patients undergoing gynecological oncological surgeries. Methods: This clinical trial study was carried out from 2021 to 2022 on 80 women referred to the hospital of Iran University of Medical Sciences with the complication of women's cancer (ovary, uterus, cervix, vulva AND vagina, etc. ) whose disease was confirmed by diagnostic laboratory evaluations AND specialist physician AND were diagnosed for surgery. After discharge, all patients used two treatment protocols of oral ANTICOAGULANTs or injectable DRUGS within 28 days. Demographic information AND laboratory indices of patients were evaluated. Data analysis was done using SPSS statistical software (version 22) AND Mann-Whitney test. P<0. 05 was considered significant. Results: There was no significant difference between the groups receiving oral AND injectable ANTICOAGULANTs in terms of bleeding time AND hospitalization duration (p>0. 05). Also, the amount of hemoglobin AND platelets in both groups decreased after surgery compared to before surgery, which was statistically significant (p<0. 05). Conclusion: The use of oral AND injectable ANTICOAGULANTs has no effect on the amount of bleeding after surgery in patients with gynecological cancers.

Dear Editor, Inside the previous issue of "Research in Cardiovascular Medicine", Arya et-al presented a nice review of novel anticoagulation strategies in patients with non-valvular atrial fibrillation (1). Through this recent review AND the upcoming guidelines from various medical societies, it is plausible that the decades-long reign of coumadin in primary AND secondary prevention of systemic thromboembolism in atrial fibrillation (AF) will soon come to an end. However, what is less clear out of these recent developments might be this question: How should I treat my AF patient with a lower risk of embolic events?

Background AND Objectives Familiarity with dental management to control bleeding in patients taking ANTICOAGULANT DRUGS is necessary. Purpose of this study was to investigate level of awareness of general dentists AND final year dental students of Yazd about dental management for patients prone to unusual bleeding in 2023. Materials AND Methods This cross-sectional study selected 135 general dentists AND final-year general dental students in Yazd using convenient sampling. Level of knowledge was evaluated using the questionnaire of Moshaverinia et al., which was valid AND reliable. Data were analyzed using Mann-Whitney AND Kruskal-Wallis statistical tests of SPSS V. 25 statistical software. Results 50 of the general dentists were male (58. 8%), 35 were female (41. 2%), 28 of the students were male (56%), 22  were female (44%). Mean ages of general dentists AND students were 29. 20 ± 4. 93 AND 25. 16 ± 1. 63, respectively. Average knowledge score of dental students was 8. 72 ± 2. 67 (Range: 1-14), while that of general dentists was 8. 20 ± 2. 86 (Range: 2-15). There was no statistically significant difference between average knowledge score of general dentists AND variables such as age, gender, work experience AND university. There was no statistically significant difference between average score of students' knowledge AND variables of age, gender AND academic semester. There was no statistically significant difference between the average knowledge score of general dentists AND students. Conclusions  The results showed general dentists AND final-year dental students in Yazd had moderate knowledge of dental management for coagulopathic patients.

Background: While there are multiple guidelines for the management of bleeding complications AND hematoma if being treated with antithrombotic AND ANTICOAGULANT DRUGS, these risks are not yet stratified for procedures with regional anesthesia. Materials AND Methods: This study was an umbrella review of systematic studies AND meta-analysis based on PRISMA guidelines in databases of Scopus, PubMed, Medline, Cochrane Library, AND Web of Science databases. Due to heterogeneity in evaluated outcomes AND methods of studies, only the qualitative evidence synthesis was performed. AMSTAR checklist was used to assess the risk of bias in included systematic reviews. Results: After an extensive search of relevant studies, 971 primary cases were identified. Following a thorough screening process, 5 systematic reviews were selected. The evidence suggests that head AND neck punctures generally do not result in bleeding complications, except for rare cases of hematoma associated with Infraclavicular brachial plexus block. A deep cervical plexus block is not recommended. Interscalene blocks have varying findings, with some studies reporting hematoma incidence AND spinal injury, while others consider them low risk. Supraclavicular brachial plexus block might be associated with hemothorax AND infraclavicular blocks are not favored by reviews. Axillary brachial plexus blocks have a minor incidence of hematoma. Abdomen blocks, TAP blocks, ilioinguinal blocks, AND rectus sheath blocks carry a higher risk of hematoma. Pectoral nerve (PECS) blocks have a relatively high risk, while paravertebral AND intercostal blocks are considered high risk, but further research is needed regarding paravertebral blocks. Conclusion: The available evidence from systematic reviews AND studies suggests varying levels of risk for different blocks AND procedures that should be considered before decision-making.

Hip fractures are among the most common fractures operated by orthopedic surgeons. Many elderly patients, who account for a significant percentage of hip fractures, suffer from medical conditions requiring antiplatelet AND ANTICOAGULANT administration. Meanwhile, considerable evidence recommends early surgery within 48b hours of admission. We aim to review the existing evidence regarding the perioperative management of antiplatelet AND ANTICOAGULANT DRUGS in hip fractures. It was concluded that surgery for hip fractures in patients with antiplatelet drug consumption should not be delayed unless a clear contraindication exists. Active reversal strategies are indicated for patients with hip fractures AND warfarin therapy. However, evidence for the safety of these agents in pregnancy, breastfeeding state, AND adolescence has not yet been established. Little data exists about perioperative management of direct-acting oral ANTICOAGULANTs in hip fractures. Early surgery after 12-24 hours of drug cessation has been suggested in studies,however, it should be employed cautiously. Despite extensive research, the importance of the issue necessitates additional higher-quality studies.