Purpose: This study aimed to evaluate the efficacy of tranexamic acid (TXA) in treating melasma through a meta-analysis and systematic review of randomized controlled trials (RCTs). The study focused on identifying associated adverse effects and comparing TXA's effectiveness with other melasma treatments.Materials and methods: Following PROSPERO and PRISMA guidelines, an extensive electronic search was conducted across four databases for RCTs on TXA use in melasma. Inclusion criteria encompassed full-text English articles with specific outcome measures, while studies with high bias risk or non-English publications were excluded. Data were extracted from 22 relevant studies and analyzed using the RevMan software, with heterogeneity identified using I² statistics and forest plots.Results: A total of 22 studies with 1280 patients were included. TXA was administered orally, topically, or via injection, with treatment durations ranging from 8 weeks to nearly 2 years. TXA significantly reduced melasma severity, evidenced by reductions in MASI, mMASI, MI, and hemi-MASI scores. Oral TXA showed the most substantial decrease in MASI scores, followed by injections and topical applications. However, studies exhibited high heterogeneity, particularly in combined treatments. Adverse effects included gastrointestinal discomfort, skin irritation, and menstrual irregularities.Conclusions: TXA is effective in treating melasma, either alone or combined with other treatments. Despite significant reductions in melasma severity, further research is necessary to standardize TXA administration methods and address long-term effects. The high heterogeneity observed suggests a need for more consistent treatment protocols.

Background/Objectives: Basic life support (BLS) and cardiopulmonary resuscitation (CPR) are essential emergency interventions. This exploratory study described BLS awareness, reported training, self-assessed and objectively scored CPR knowledge, and attitudes in a self-selected online sample of adults in the Aseer Region, Saudi Arabia, and examined how these constructs related to one another; it was not designed to estimate regional prevalence. Methods: A cross-sectional online survey (April–June 2025) used convenience recruitment through social media. The study-specific questionnaire was expert-reviewed and pilot-tested but not psychometrically validated; the five technical items (Kuder–Richardson 20 = 0.59) were analyzed individually. Analyses were primarily descriptive; comparisons, including a multivariable logistic regression, were exploratory. Results: Of 364 respondents, 87.1% were female, 49.5% were students, and 67.9% held a bachelor’s degree. Overall, 90.9% had heard of BLS, 47.3% reported CPR training, and 45.1% reported knowing how to perform CPR; 27.5% to 57.1% selected the keyed answer on individual objectively scored items. Only 20.7% of those reporting knowing how to perform CPR selected all four keyed answers. Respondents reporting CPR training selected keyed answers more often on every objectively scored item, most markedly for the 30:2 compression-to-ventilation ratio (50.6% vs. 18.2%), yet only 41.3% of them selected the “at least 100 compressions/min” option. Measured sociodemographic characteristics explained little of the variation in reported training (McFadden pseudo-R² = 0.11). Conclusions: In this demographically imbalanced sample, self-reported awareness and self-assessed ability to perform CPR were often not matched by objectively scored knowledge. Associations with reported training may reflect who seeks training rather than training effects, and item wording may have influenced responses. The shared dataset and identified instrument weaknesses can inform representative studies using validated measures and objective skills assessment.