ABSTRACT
Background: Theory lectures in pharmacology are covering various oral and parenteral routes of drug administration, mainly focusing on knowledge domain, but soft and psychomotor skills were less taught in undergraduate students. Demonstrating correct method of subcutaneous route of drug administration and communication skills as introduced by competency-based medical education (CBME) competency-based curriculum will help in early acquisition of the skills and minimize the errors in administration in insulin, heparin, and vaccines. Aim and Objectives: The aims of this study were to teach the subcutaneous drug administration (S/C) and communication skills to undergraduate students in pharmacology and to evaluate the perception of students and teachers toward new CBME curriculum. Materials and Methods: Correct technique of subcutaneous drug administration was demonstrated on mannequins after browsing through the videos of S/C route. Students were told to perform it independently on mannequins. Perception of students and staff members were collected with pre-validated questionnaire provided after the practical teaching hours. Results: In our study, majority of students (94%) felt that learning S/C route of drug administration correctly will help in managing various patients like administration of insulin in diabetic patients in their near future days. They were well advanced in communicating with patients regarding usage of medications and were (90%) also in favor of introduction of this experiment in UG curriculum. Conclusions: Our study concluded that subcutaneous teaching technique introduced by CBME curriculum in practical classes was well accepted by students and were more confident in soft skills and psychomotor skills at the end of the study.
ABSTRACT
Resumen El miedo y la ansiedad de los niños por el tratamiento dental pueden conducir a dificultades en el manejo de la conducta por parte del profesional, lo cual puede ser una barrera para el éxito del tratamiento dental. Los niños no cooperadores pueden necesitar recibir tratamiento dental bajo sedación, la que se indica cuando la guía de comportamiento no farmacológico no tiene éxito. Existen ensayos controlados aleatorios que comparan diferentes protocolos sedantes para procedimientos dentales; sin embargo, la evidencia de superioridad de una forma sobre otra es débil. El objetivo del presente estudio es evaluar el efecto sedativo de Midazolam por vía subcutánea, con y sin ketamina, en procedimientos odontológicos realizados en pacientes pediátricos no cooperadores. Se llevó a cabo un ensayo clínico aleatorizado, cruzado, con cegamiento simple, en 13 niños (10 del género masculino y 3 del femenino) de 19 a 48 meses de edad, ASA I y comportamiento Frankl I. Los dos métodos se aplicaron en el mismo paciente, y el orden de los mismos fue asignado aleatoriamente, para las dos citas de tratamiento. En cada sesión se evaluaron: el comportamiento general del paciente, los movimientos corporales y el llanto, por medio de la escala de Houpt modificada. Además, se monitorearon la frecuencia cardíaca y la saturación de oxígeno por medio de un oxímetro de pulso.
Abstract Children's fear and anxiety about dental treatment can lead to difficulties in the behavior management by the practitioner, which can be a barrier to successful dental treatment. Non cooperative children may need dental treatment under sedation, which is indicated when the non-pharmacological behavioral guidance is unsuccessful. There are randomized controlled trials comparing different sedative protocols for dental procedures; however, evidence of superiority from one form over another is weak. The aim of the present study was to evaluate the sedative effect of midazolam subcutaneously, with and without ketamine, on dental procedures performed in non-cooperative pediatric patients. A randomized, crossover clinical trial with single blinding was performed in 13 children (10 males and 3 females) from 19 to 48 months of age, ASA I and Frankl I behavior. The two methods were applied in the same patient, and the order of the same was assigned randomly, for the two treatment appointments. In each session were evaluated the patient's general behavior, body movements and crying through the modified Houpt scale. In addition, heart rate and oxygen saturation were monitored by means of a pulse oximeter.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Anxiety/drug therapy , Midazolam/therapeutic use , Ketamine/therapeutic useABSTRACT
The approach and novelty of this scientific work was to formulate the appropriate Streptozotocin (STZ) and Alloxan dosage in different routes of administration to imply minimum mortality rate and high incidence of diabetes mellitus (DM) in the rat experiment model. Rats were randomly divided into STZ, Alloxan and control groups. 1-Alloxan group was divided into two subgroups: intraperitoneal (ip) subgroups which received a single dose of, 140, 120, 100 and 80 mg/kg; and the subcutaneous (sc) subgroups which received a single dose of, 120, 110, 100, 90, and 80 mg/kg. 2-STZ group was divided into four subgroups of ip route. The ip subgroup which received intraperitoneally a single dose of, 30, 35, 40 and 50 mg/kg. 3-The control group: This group received solo distilled water. The injection day was considered as the day zero. Blood glucose levels and mortality rate were recorded. Subsequently, 30 days after, the logistic regression modeling was used to evaluate the effect of the explanatory variables, the dose levels, and route approaches, on the probability of DM incidence, and mortality. According to the statistical logistic analysis for Alloxan, it is concluded that the minimum dosage needed to induce DM was 120 mg/kg by sc method (probability 0.712). In addition, the logistic analysis for STZ showed that the optimal dose-level for STZ was 40 mg/kg with ip with approximate induction of DM probability 0.764. Based on the data, male Wistar rats in which received a single dosage of Alloxan by sc injection at dose of 120 mg/kg showed the most desirable result of induction of type I DM; furthermore, those in which received STZ by ip injection at the dose of 40 mg/kg developed a persistent and optimal DM state characterized by high rate of DM induction and low- level of mortality.
Subject(s)
Animals , Humans , Male , Rats , Alloxan , Blood Glucose , Diabetes Mellitus , Incidence , Logistic Models , Methods , Mortality , Rats, Wistar , Streptozocin , WaterABSTRACT
Evaluation and screening of vaccines against tuberculosis depends on development of proper cost effective disease models along with identification of different immune markers that can be used as surrogate endpoints of protection in preclinical and clinical studies. The objective of the present study was therefore evaluation of subcutaneous model of M.tuberculosis infection along with investigation of different immune biomarkers of tuberculosis infection in BALB/c mice. Groups of mice were infected subcutaneously with two different doses : high (2x10(6) CFU) and low doses (2x10(2) CFU) of M.tuberculosis and immune markers including humoral and cellular markers were evaluated 30 days post M.tuberculosis infections. Based on results, we found that high dose of subcutaneous infection produced chronic disease with significant (p<0.001) production of immune markers of infection like IFNgamma, heat shock antigens (65, 71) and antibody titres against panel of M.tuberculosis antigens (ESAT-6, CFP-10, Ag85B, 45kDa, GroES, Hsp-16) all of which correlated with high bacterial burden in lungs and spleen. To conclude high dose of subcutaneous infection produces chronic TB infection in mice and can be used as convenient alternative to aerosol models in resource limited settings. Moreover assessment of immune markers namely mycobacterial antigens and antibodies can provide us valuable insights on modulation of immune response post infection. However further investigations along with optimization of study protocols are needed to justify the outcome of present study and establish such markers as surrogate endpoints of vaccine protection in preclinical and clinical studies in future.
Subject(s)
Animals , Mice , Antibodies , Biomarkers , Chronic Disease , Hot Temperature , Lung , Mass Screening , Shock , Spleen , Tuberculosis , VaccinesABSTRACT
Introducción: La vía subcutánea es una alternativa que se emplea con frecuencia en enfermos de cáncer avanzado para administrar medicación, sin embargo, la hidratación por ella es excepcional en nuestro medio por lo que se realiza el presente estudio para conocer si es factible administrar hidratación subcutánea en pacientes con enfermedades oncológicas terminales, las características de la técnica y las dificultades que se pueden presentar durante su aplicación. Métodos: Se incluyeron 10 pacientes con cáncer avanzado y deshidratación o riesgo de padecerla que recibieron hidratación subcutánea con volumen y ritmo de infusión adaptados a cada enfermo. Resultados: Se realizaron 18 punciones en 10 pacientes, con un total de 55 d de infusión. El volumen medio administrado fue 1 000 mL/d con un ritmo de infusión que osciló entre 20 y 80 mL/h. El punto de infusión se cambió cada 2-4 d, como promedio, con una duración variable entre 1 y 10 d, principalmente por acumulación en zona de punción. Conclusión: La vía subcutánea para la hidratación de pacientes con enfermedades oncológicas en estadio terminal es sencilla y parece exenta de complicaciones importantes
Introduction: The subcutaneous route is an alternative frequently used in patients with advanced stage cancer to administer medication, however, its hydration is exceptional in our country, thus, present study was conducted to know if it is feasible to administer subcutaneous hydration in patients with terminal oncologic diseases, the technique's characteristics and potential difficulties during its implementation. Methods: Ten patients presenting with advanced stage cancer and dehydration or its risk underwent subcutaneous hydration with infusion volume and rhythm fitted to each patient. Results: Eighteen punctures were carried out in 10 patients for a total of 55 days of infusion. The mean volume administered was of 1 000 mL/d with an infusion rhythm fluctuating between 20and 80 mL/h. The infusion point was changed each 2-4 d, as average, with a variable length between 1 and 10 d, mainly due to accumulation in the puncture zone. Conclusion: The subcutaneous route for hydration of patients with oncologic diseases in terminal stage is simple and seems free from significant complications