Application of self-designed hip intramuscular injection positioning device in papaverine injection after finger replantation / 中国实用护理杂志

Objective:To explore the clinical effect and nursing experience of papaverine intramuscular injection after finger replantation with self-designed hip intramuscular injection positioning device.Methods:Totally 216 cases of patients treated with palavering for anti-vasospasm after of severed fingers from January 2018 to December 2019 were randomly divided into control group (108 cases) and observation group (108 cases) by random number table method. The control group received intramuscular injection of buttock muscle according to the conventional method, and the observation group used the auxiliary intramuscular injection with self-designed glutei muscle positioning device. The incidence of postoperative hip indurations and ecchymosed, survival rate of and buttock were analyzed Pain scores were compared.Results:Totally 76 cases (70.37%) and 62 cases (48.15%) in the control group, 12 cases (11.11%) and 6 cases (5.56%) in the observation group. The difference between the two groups was statistically significant ( χ2 values were 78.545, 67.307, P<0.01). 78 cases (72.22%) survived in the control group and 96 cases (88.89%) survived in the observation group ( χ2 value was 11.416, P<0.01). After papaverine intramuscular injection, there was no significant difference in hip pain score between the two groups on the first and second day ( P>0.05), but there was significant difference between the two groups on the third to seventh day ( t values were 17.17 to 45.97, P<0.05). Conclusion:Palavering intramuscular injection can reduce the incidence of hip indurations and ecchymosed, relieve buttock pain and improve the survival rate of amputated finger, which is worthy of clinical application.

Recommendation of the best site based on the distribution pattern of extramuscular and intramusular nerves for gluteal muscle injection / Recomendación del mejor sitio para la inyección del músculo glúteo basado en el patrón de distribución de los nervios extramusculares e intramusculares

To reveal the extra- and intramuscular nerve distribution patterns of the gluteus maximus, medius, and minimus, and to provide guidance for gluteal muscle injection in order to avoid nerve injury. Ten adult and 10 child cadavers were used. The superior and inferior gluteal nerves innervating the gluteus maximus, medius, and minimus were dissected, exposed, and sutured in-situ on the muscle. The three gluteal muscles were removed, and the distribution patterns of the intramuscular nerves were revealed by modified Sihler's nerve staining. The nerve distribution pattern was returned to the corresponding position in the body, and the patterns in the four quadrants of the buttock were analyzed. There were 3-12 extramuscular nerve branches of the gluteus maximus, medius, and minimus. After entering the muscle, these nerve branches arborized and anastomosed to form an arc-shaped, nerve-dense zone. The nerve distribution was most dense in the inferomedial region of the superolateral quadrant and the inferolateral region of the superomedial quadrant of the buttocks. The nerve distribution was relatively dense in the inferolateral region of the superolateral quadrant, and the medial region of the inferomedial quadrant. An arc-shaped, nerve-sparse zone in the superolateral and superomedial quadrants near the lower iliac crest accounted for about two-fifths of the two quadrants' limits. The arc-shaped, nerve-sparse zone in the superolateral quadrant is the preferred injection site, and the superomedial quadrant near the lower iliac crest is also recommended as a gluteal intramuscular injection region, free from nerve injury.

El objetivo de este trabajo fue revelar los patrones de distribución nerviosa extramusculat e intramuscular de los músculos glúteo máximo, medio y mínimo y proporcionar orientación para la inyección en la región glútea con el propósito de evitar lesiones nerviosas. Se utilizaron diez cadáveres adultos y diez niños. Los nervios glúteos superior e inferior que inervan a los músculos glúteo máximo, medio y mínimo fueron disecados, expuestos y suturados in situ en el músculo. Se extirparon los tres músculos glúteos y se revelaron los patrones de distribución de los nervios intramusculares mediante la tinción nerviosa de Sihler modificada. El patrón de distribución nerviosa se devolvió a la posición correspondiente en el cuerpo y se analizaron los patrones en los cuatro cuadrantes de la región glútea. Se encontraron 3 a 12 ramos nerviosos extramusculares de los músculos glúteo máximo, medio y mínimo. Después de ingresar al músculo, estas ramas nerviosas se arborizaron y anastomizaron para formar una zona densamente nerviosa en forma de arco. La distribución nerviosa fue de mayor densidad en la región inferomedial del cuadrante superolateral y en la región inferolateral del cuadrante superomedial de la región glútea. La distribución nerviosa era relativamente densa en la región inferolateral del cuadrante superolateral y en la región medial del cuadrante inferomedial. Una zona en forma de arco en los cuadrantes superolateral y superomedial y con escasa inervación, cerca de la cresta ilíaca representaba una parte de los límites de los dos cuadrantes. La zona de poca inervación en forma de arco en el cuadrante superolateral es el sitio de inyección preferido, y el cuadrante superomedial próximo a la cresta ilíaca también se recomienda como una región de inyección intramuscular glútea, libre de lesión nerviosa.

Effect of injecting mouse nerve growth factor in different ways on motor development, cerebral hemodynamics and biochemical metabolism in children with cerebral palsy / 中国针灸

OBJECTIVE@#To compare the effect of acupoint injection and intramuscular injection with mouse nerve growth factor (mNGF) on gross motor function development of children with cerebral palsy (CP), and explore the treatment mechanism.@*METHODS@#A total of 63 children with CP were randomly divided into an observation group (32 cases, 4 cases dropped off ) and a control group (31 cases, 3 cases dropped off). Based on the routine rehabilitation therapy, the control group received intramuscular injection of mNGF(18 µg/2 mL), and the observation group received acupoint injection of mNGF at Xinshu (BL 15), Ganshu (BL 18), Pishu (BL 20), Shenshu (BL 23), Sanjiaoshu (BL 22), Shenting (GV 24), Baihui (GV 20), Fengfu (GV 16), Dazhui (GV 14), etc. Of them, 5-6 acupoints alternately were selected each time, and each acupoint was given 0.3-0.5 mL, totally 18 µg/2 mL. Both treatment were carried out once every other day for six months. Before and after treatment, the children's development of brain function was assessed using gross motor function classification system (GMFCS). Before treatment (T), after 2 (T), 4 (T) and 6 (T) months of treatment, the motor function was evaluated by gross motor function measure (GMFM-88). The systolic peak velocity (Vs), mean velocity (Vm) and vascular resistance index (RI) of anterior cerebral artery (ACA) and middle cerebral artery (MCA) were measured, and the level of N-acetyl aspartate acid (NAA), choline (Cho), lactate (Lac) and creatine (Cr) from the basal ganglia, thalamus and periventricular white mater were detected by magnetic resonance spectroscopy (MRS) technology with MAGNETOM Skyra3.0T magnetic resonance imaging system before and after treatment.@*RESULTS@#Compared with before treatment, the GMFCS classification of the observation group after treatment was significantly improved (0.05), however, the observation group had a 3.142 times of feasibility for good gross motor function development by more than level 1 compared to the control group (<0.05). After 2, 4, and 6 months of treatment, the GMFM-88 scores of the two groups showed an upward trend (<0.01), and the increase of the observation group was greater than that of the control group (<0.05). Compared with before treatment, in the ACA and MCA, the Vs and Vm increased, RI decreased in both groups after treatment (<0.01), and in the brain, NAA/Cr increased, Cho/Cr and Lac/Cr decreased (<0.01), and after treatment, the Vs, Vm of ACA and MCA and NAA/Cr of brain in the observation group were higher than those in the control group (<0.05), and the RI of ACA and MCA and Cho/Cr and Lac/Cr of brain in the observation group were lower than those in the control group (<0.05).@*CONCLUSION@#The mNGF acupoint injection has a better effect on the gross motor function in the children with cerebral palsy compared with the intramuscular injection, and the mechanism may be associated with exhibiting the double effects of acupoint effect and the targeting therapy of drug, which can effectively improve the cerebral hemodynamics and the metabolism of cerebral nervous substances.

Síndrome de Nicolau. Manejo conservador. Caso clínico / Nicolau syndrome, Conservative management: Clinical case

Introducción: el síndrome de Nicolau, embolia cutis o dermatitis livedoide, es una reacción adversa poco frecuente a la administración de inyección intramuscular, subcutánea o intraarticular de medicamentos, inicia con dolor intenso y eritema que evoluciona a lesión livedoide que se torna hemorrágica, progresa a necrosis isquémica de piel y tejidos más profundos. Caso clínico: niño de 7 meses de edad, luego de inyección intramuscular de metamizol sódico presenta llanto continuo, seguido de lesión purpúrica afectando espalda, glúteo, muslo y pierna derechos, evolucionando hasta cicatrización total en 18 semanas. Conclusión: el síndrome de Nicolau, condición iatrogénica por inyección de múltiples medicamentos, produce lesión necrótica en área de irrigación de vasos afectados. El conocimiento de este síndrome facilitaría su prevención, al igual que su diagnóstico y manejo tempranos

Introduction: Nicolau syndrome, embolism cutis or livedoid dermatitis, is a rare adverse reaction to the administration of intramuscular, subcutaneous or intra-articular injection of drugs, begins with intense pain and erythema that progresses to a livedoid lesion that becomes hemorrhagic, progresses to ischemic necrosis of skin and deeper tissues. Clinical case: A 7-month-old boy, after intramuscular injection of sodium metamizole, presented continuous crying followed by a purpuric lesion affecting the right back, gluteus, thigh and leg, evolving to total healing in 18 weeks. Conclusion: Nicolau Syndrome, iatrogenic condition by injection of multiple drugs, produces necrotic lesion in irrigated area of affected vessels. The knowledge of this syndrome would facilitate its prevention, as well as its early diagnosis and management.

The Effect on Pain of Buzzy® and ShotBlocker® during the Administration of Intramuscular Injections to Children: A Randomized Controlled Trial / 간호학회지

PURPOSE: To investigate the effect of Buzzy® and ShotBlocker® on reducing pain induced by intramuscular penicillin injections in children. METHODS: This was a randomized controlled study. A total of 150 Turkish children aged 7~12 years who presented to our pediatric emergency clinic and met the inclusion criteria were recruited. The children were randomly assigned to each group (control=50, Buzzy®=50, ShotBlocker®=50). Data were collected using an information form, the State-Trait Anxiety Inventory for Children, Visual Analog Scale, and Faces Pain Scale-Revised. RESULTS: The children in the control group had significantly higher pain scores during the penicillin injection than the children in the ShotBlocker® and Buzzy® groups. The children in the Buzzy® group had significantly less pain than the children in both the ShotBlocker® and control groups (p<.001). CONCLUSION: Buzzy® was more effective compared with ShotBlocker® in this study.

Effects of Oral Oxytetracycline-Therapy on Wound Progression and Healing Following Aeromonas caviae Infection in Nile Tilapia (Oreochromis niloticus L)

Abstract The effects of oral oxytetracycline (OTC)-therapy against Aeromonas caviae infection as well as the wound progression and healing in intramuscular (IM) and abrasion-immersion (AI) challenged Nile tilapia juveniles were evaluated. The IM challenge caused significantly (p < 0.05) high mortalities (90%) compared to AI challenge (40%). The mortalities recorded in 10 days OTC-fed (72% in IM group and 30% in AI group) and untreated Nile tilapia were significantly (p < 0.05) high compared to positive (5-10%) controls. The reduction in mortalities in OTC-fed Nile tilapia was significant (p < 0.05) with no further mortalities during the post-OTC therapy period. In IM group, the black scar disappearance, re-growth of dermal fibrous tissue and skin growth at the ulcerated region were seen on day 10 OTC-therapy. In contrast, the disappearance of wound scar and growth of skin and scales at the abraded area were noted on day 1-4 post-OTC therapy. On day10 post-OTC therapy, complete disappearance of wound scar with a mild spot at the abraded area was noted. The degree of wound healing was faster only initially with OTC- therapy. Nevertheless, the wounds were healed completely even in the surviving untreated tilapia in 30 days with no scars left behind. The extent of mortalities observed in Nile tilapia during the OTC-therapy period is a serious cause for concern, which require prudent planning on its suitability in tropical aquaculture.

Assessment of the level of knowledge regarding the intramuscular administration of medication among staff nurses

Background and Objectives: Intramuscular injection is an everyday procedure which is not without its hazards. Although insuring bodies have pointed out that the lateral thigh is the least unsafe site for an IM injection. The commonly used sites in the adult are gluteal and deltoid muscle. The present study was undertaken to assess the level of knowledge related to intramuscular administration of medication among staff nurses.Material and Methods: 30 samples were selected and descriptive research approach was used in the study. The level of study was assessed using self-administered questionnaire.Results: 46.67 % had inadequate knowledge, 40% had moderate knowledge regarding g the administration of IM injection. Efforts were also made to find the association between the level of knowledge and selected demographic variables. There is significant association between knowledge and educational status and years of clinical experience.Conclusion: The present study assessed the knowledge of staff nurses regarding the administration of intramuscular (IM) medication and tries to find association between the level of knowledge and selected demographic variables. At the nd of the study, the investigators found that there is association between the level of knowledge, age, educational status and year of experience.

Effect of aspiration and non-aspiration of syringe prior to intramuscular administration of influenza vaccine in pain perception of children 9 to 15 years of age consulting at the out-patient department of a tertiary government hospital

OBJECTIVE@#To determine the effect of aspiration and non-aspiration of syringe prior to intramuscular administration of influenza vaccine in pain perception of children 9 to 15 years of age consulting at the Out Patient Department of a Tertiary Government Hospital.@*DESIGN@#Randomized controlled clinical Trial@*SETTING@#Out Patient Department of a Tertiary Government Hospital@*PARTICIPANTS@#One-hundred twenty children 9 to 15 years old consulting at the Out Patient Department.@*METHODOLOGY@#Subjects were randomized into two groups and were given influenza vaccine with and without aspiration prior to intramuscular injection.@*OUTCOME MEASURES@#Primary outcome measure is the degree of pain experienced by the subject using the Numeric Rating Scale.@*RESULTS@#A total of one hundred twenty children were randomized to either Group A or Group B. IBMSPSS version 21 was used as statistical software. Differences in mean heart rate at baseline and after the intervention within group is significantly different (p value < 0.01). Mean heart rate in between group at baseline and after administration of influenza vaccine is not significantly different ( p value >0.05). The difference in mean oxygen saturation at baseline and after immunization within group is significantly different. Mean oxygen saturation between group pre and post immunization is not statistically different (p value 0.309). Analysis showed there is a significant difference in mean pain scores between Group A and Group B ( p value 0.046)@*CONCLUSION@#This study showed a statistically significant lower pain score for Group A (without aspiration) than Group B (with aspiration). The physiological pain responses, used as outcome measures in this study did not have significant differences between two groups. The result of this study will unleash in health care professionals the burden on whether or not to aspirate before intramuscular administration of vaccine.

Evolution of rabies vaccination regimen / 中华实验和临床病毒学杂志

Rabies vaccine has gradually evolved from the birth of nerve tissue vaccine to cell vaccine, and vaccination time has been simplified from the initial implementation of 14-21 needles to current 4-5 needles. Four types of vaccination procedures are recommended by WHO for rabies pre and post-exposure prophylaxis: two types of intradermal (ID) multipoint injection and two types of intramuscular (IM) injection. The most commonly used vaccination procedures are the 5-dose regimen (" 1-1-1-1-1" regimen i. e. Essen regimen) and 4-dose regimen (" 2-1-1" regimen i. e. Zagreb regimen). Vaccination according to the above vaccination procedures recommended by WHO could effectively prevent human rabies. The vaccination procedures of rabies vaccine approved in China are Essen regimen and Zagreb regimen.

Effect of human umbilical cord mesenchymal stem cells by intramuscular injection on cardiac function and mi-crovascular regeneration in rats with dilated cardiomyopathy / 中华实用儿科临床杂志

Objective To evaluate the effect of human umbilical cord mesenchymal stem cells (hUCMSCs) treatment through intramuscular administration on the heart function and angiogenesis of the myocardium in dilated car-diomyopathy (DCM)rats induced by Adriamycin(ADR). Methods One hundred male SD rats were randomly divided into the normal group and the DCM group. Rats in the DCM group were treated with ADR by intraperitoneal injection of 2. 0 mg/ kg dose per week for 8 weeks in order to induce DCM. Sixty modeled surviving rats with DCM were randomly divided equally into 3 groups,and they were treated with hUCMSCs or DMEM by intramuscular injection. Rats in the DMEM group (20 cases)received intramuscular infusion 2 mL DMEM alone;rats in the low - dose group (20 cases) underwent intramuscular infusion of 1 × 106 hUCMSCs/ 2 mL in DMEM;rats in the high dose group (20 cases)under-went intramuscular infusion of 10 × 106 hUCMSCs/ 2 mL in DMEM. Echocardiography and plasma brain natriuretic pep-tide(BNP)were used to assess cardiac function in modeled rats. The morphological changes in myocardial cells were observed by using HE and Masson staining after ADR injection stopped for one week. Four weeks after administration of hUCMSCs,echocardiography was performed to evaluate the cardiac function,and plasma BNP level was detected by en-zyme immunoassay kit. Western blot was used to analyze the expression of vascular endothelial growth factor(VEGF)in myocardium of rats in each group. Myocardial microvessel density was detected by using anti - CD34 monoclonal antibody and transmission electron microscopy (TEM)were performed to observe the ultrastructure of microvessel. Results Left ventricular ejection (LVEF)and left ventricular fractional shortening (LVFS)in the DCM groups [(66. 17 ± 3. 54)％,(31. 33 ± 3. 20)％]were significantly decreased compared to those in the normal group [(77. 25 ± 3. 40)％,(41. 00 ± 2. 94)％],and the differences were statistically significant(t = 10. 620,10. 328,all P < 0. 05);the morphological changes in myocardial cells was observed by using HE and Masson staining. Pit - induced typical his-tological lesion of myocardial tissue was observed in the DCM group,such as congestion,edema,a disorganization of myocytes and focal necrosis and myocardial tissue with wispy,broad collagen fibers predominating in the matrix. Four weeks after administration of hUCMSCs,LVEF in the low dose group or the high dose group were significantly higher compared with those in the DMEM group[(72. 27 ± 2. 44)％ or (70. 92 ± 2. 68)％ vs. (62. 89 ± 2. 54)％],and the differences were statistically significant(t = 2. 145,2. 131,all P < 0. 05);and LVFS were significantly higher compared with that in the DMEM group [(34. 96 ± 2. 08)％ or (33. 49 ± 2. 19)％ vs. (30. 98 ± 2. 22)％],and the differences were statistically significant (t = 2. 491,4. 086,all P < 0. 05). The plasma level of BNP was significantly declined in the hUCMSCs treated rats as compared to those before treatment [low dose group (352. 68 ± 41. 25)ng/ L vs. (202. 68 ± 20. 38)ng/ L,t = 2. 052,P < 0. 05;high dose group (355. 79 ± 48. 32)ng/ L vs. (193. 62 ± 15. 41)ng/ L,t = 2. 074,P < 0. 05]. Quantitative analysis demonstrated that microvessel density was significantly hi-gher in low - dose and high - dose hUCMSCs treated DCM rats than that in the DMEM treated DCM rats [(84. 00 ± 19. 18)/ mm2 or (86. 67 ± 20. 88)/ mm2 vs. (27. 14 ± 13. 97)/ mm2 ,t = 2. 109,2. 101,all P < 0. 05];Western blot test showed that there had high expression of VEGF in myocardium and TEM in the high dose group,and vessel injury in DMEM treated rats were more serious than that of hUCMSCs treated rats. Conclusion It suggests that hUCMSCs in-tramuscular injection may improve heart function and angiogenesis of myocardium in DCM rats induced by adriamycin.

A randomized, open labeled study comparing the serum levels of cobalamin after three doses of 500 mcg vs. a single dose methylcobalamin of 1500 mcg in patients with peripheral neuropathy

BACKGROUND: Vitamin B12 deficiency has been associated with peripheral neuropathy, loss of sensation in the peripheral nerves, and weakness in the lower extremities. Methylcobalamin is the most effective analogue of vitamin B12 used to treat or prevent the complications associated with vitamin B12 deficiency. The current study aimed to compare the serum cobalamin levels after administration of two different regimes of methylcobalamin in peripheral neuropathy patients. METHODS: The present study was a prospective, randomized, comparative study. The study consisted of two parallel groups, group A (methylcobalamin 500 µg injection intramuscularly three times a week) and group B (methylcobalamin 1500 µg injection intramuscularly once a week). A control group of healthy volunteers was also included. RESULTS: A total of 24 patients (12 in each group) were included in the study. Five healthy volunteers were also included as a control in each group. At the end of treatment, serum cobalamin levels were significantly (P = 0.028) higher in group A (1892.08 ± 234.50) as compared with group B (1438.5 ± 460.32). The serum cobalamin levels in Group A healthy volunteers were also two times higher than that of group B (P = 0.056). Both the LANSS scale and DN4 questionnaire reported similar results at end of treatment. CONCLUSIONS: The 500 µg methylcobalamin thrice weekly regime is more effective in increasing the serum cobalamin levels as compared to the 1500 µg methylcobalamin once weekly regime.

Síndrome de Nicolau: A propósito de un caso / Nicolau syndrome: About a case

Se evaluó paciente femenino de 51 años, con antecedentes de diabetes mellitus tipo II e infecciones urinarias a repetición, procedente de la comunidad Mario Briceño Iragorry, quien acude al ambulatorio centro de especialidades "Los Grillitos", de la Corporación de Salud del Estado de Aragua - Venezuela, presentando lesión ulcerada a nivel de hemicadera izquierda, posterior a la colocación vía intramuscular de diclofenac sódico el 28/03/17, el que fue indicado por facultativo para tratar dolor por infección urinaria alta. Posteriormente, a las 24 horas presenta en la zona de la inyección una coloración violácea, induración y mucho dolor, motivo por el que acude nuevamente al facultativo. Se le realizó ecosonograma de partes blandas en región glútea izquierda, reportando imagen heterogénea a predominio hipoecoico con ecos internos de mediana intensidad, que genera reforzamiento posterior de 49x39 mm, con aproximadamente 30 cc de líquido, que correspondería a un proceso inflamatorio e infeccioso (absceso). Posteriormente a la evaluación, se indica antibiótico terapia a base de oxacilina 1 g cada 8 horas vía endovenosa por siete días, además 100 mg cada 12 horas vía oral de nitrofurantoína para el proceso infeccioso urinario, que el urocultivo indica ser sensible a la E. Coli. Al tercer día de la enfermedad actual, se le drena absceso con material purulento aproximadamente 20 cc y cura sucesiva por cinco días, evolucionando satisfactoriamente del proceso infeccioso de partes blandas e infección urinaria.

A 51-year-old female patient with a history of type II diabetes mellitus and recurrent urinary tract infections from the Mario Briceño Iragorry community, attended the outpatient clinic "Los Grillitos" of the health corporation of Aragua Venezuela, with an ulcerated lesion at the left hemi-hip level, following the intramuscular placement of diclofenac sodium on 03/28/17, which was indicated by facultative to treat pain due to high urinary tract infection, afterwards approximately 24 hours presents at the injection site a violet coloration, induration and a lot of pain, which is why she returned to facultative, she performed a soft-tissue echosonogram in the left gluteal region reporting a heterogeneous image to hypoechoic predominance with internal echoes of medium intensity that generates posterior reinforcement which measures 49x39 mm with approximately 30 cc of liquid that could correspond to an inflammatory and infectious process (abscess), post-evaluation is indicated antibiotic therapy based on oxacillin 1 g every 8 hours intravenous route for seven days plus 100 mg every 12 hours oral route of nitrofurantoin for the urinary infectious process that the urine culture indicates to be sensitive E. coli, the third day of illness is drained abscess purulent material approximately 20 cc and successive cure for five days. Satisfactory evolution of the infectious process of soft tissue and urinary tract infection.

Efficacy and safety of vitamin D3 B.O.N intramuscular injection in Korean adults with vitamin D deficiency

OBJECTIVE: There has been no prospective study that examined intramuscular injection of high-dose vitamin D in Korean adults. The aim of this study was to assess the efficacy and safety of high-dose vitamin D3 after intramuscular injection in Korean adults with vitamin D deficiency. METHODS: This study was a 24-week, prospective, multicenter, randomized, double-blind, placebo-controlled trial. A total of 84 subjects ≥19 and <65 years of age were randomly allocated to either the vitamin D3 or placebo group in a 2:1 ratio. After randomization, a single injection of plain vitamin D3 200,000 IU or placebo was intramuscularly administered. If serum 25-hydroxyvitamin D (25[OH]D) concentrations were <30 ng/mL on week 12 or thereafter, a repeat injection was administered. RESULTS: After a single intramuscular injection of vitamin D3 to adults with vitamin D deficiency, the proportion of subjects with serum 25(OH)D concentrations ≥30 ng/mL within 12 weeks was 46.4% in the vitamin D3 group and 3.6% in the placebo group (p < 0.0001). The proportion of subjects with serum 25(OH)D concentrations ≥30 ng/mL within 24 weeks was 73.2% in the vitamin D3 group and 3.6% in the placebo group (p < 0.0001). Mean change in serum 25(OH)D concentrations at weeks 12 and 24 after vitamin D3 injection was 12.8 ± 8.1 and 21.5 ± 8.1 ng/mL, respectively, in the vitamin D3 group, with no significant changes in the placebo group. Serum parathyroid hormone concentrations showed a significant decrease in the vitamin D3 group but no change in the placebo group. CONCLUSION: Intramuscular injection of vitamin D3 200,000 IU was superior to placebo in terms of its impact on serum 25(OH)D concentrations, and is considered to be safe and effective in Korean adults with vitamin D deficiency.

Intoxicación por mercurio elemental por inyección intramuscular: presentación de caso y revisión de literatura / Poisoning with elemental mercury by intramuscular injection. Case report and review of literature

Se han reportado en la literatura pocos casos de intoxicación por mercurio por administración en tejidos blandos. No se cuenta con suficiente evidencia acerca del manejo con terapia quelante en este tipo de intoxicación. Se reporta el caso de una mujer de 34 años con antecedente psiquiátrico la cual se administró mercurio intramuscular en fosa cubital izquierda con fines autolíticos. Acudió al servicio de urgencias 24 horas posteriores a su administración, el motivo principal fue el dolor intenso en la zona y la presencia de edema, sin efectos sistémicos. La radiografía mostró depósitos metálicos en 1/3 de brazo, localizados en músculo, y que migraron a través de la fascia hacia 2/3 del antebrazo. La placa de tórax no mostró alteraciones. Fue intervenida quirúrgicamente en 3 ocasiones extrayendo mínimas cantidades de mercurio. La paciente fue manejada con antibióticos por presencia de celulitis. Un mes después presentó temblor mercurial, razón por la cual se tomaron muestras de sangre y orina para la determinación de mercurio, el cual resulto elevado en ambas muestras, por lo que se le administró terapia quelante con D-penicilamina.

There are just a few cases of mercury toxicity after administration in soft tissue, reported in the literature. There is insufficient evidence about the management with chelation therapy in this type of poisoning. We report the case of a 34 year-old woman with a psychiatric history who administered herself a mercury injection into de muscle in the left cubital fossa, referred as a suicide attempt. She came to the emergency department 24 hours after administration; the main reason was the intense pain in the area and the presence of edema, with no systemic effects. Radiography showed metallic deposits in 1/3 arm, located in muscle, which moved through the fascia to 2/3 of the forearm. Chest radiography was normal. She underwent surgery trhee times extracting trace amounts of mercury. The patient was managed with antibiotics by the presence of cellulite. One month later she had tremor mercuralis, so a blood and urine samples were sent to the laboratory in order to determinate mercury levels, which resulted high in both fluids, therefore chelation therapy with D-penicillamine was administered.

Cefalea crónica tipo tensión: una nueva experiencia de tratamiento / Chronic tension-type headache: a new treatment experience

Introducción: la cefalea tipo tensión es la forma más común de dolor de cabeza y su forma crónica una de lasmás difíciles de tratar, causa gran discapacidad a pacientes y representa enormes costos socioeconómicos, estárelacionada con factores de tensión emocional y muscular. Las propuestas terapéuticas con las que se cuentaincluyen AINE, fisioterapia, infiltraciones con toxina botulínica en músculos pericraneales.Objetivo: evaluar la efectividad en el tratamiento de la cefalea crónica tipo tensión con infiltración intramuscularcon betametasona, un esteroide de depósito más lidocaína al 1%, en puntos de tensión muscular aniveles suboccipital, paraespinales cervicales y trapecio, acompañados de fisioterapia y un proceso educativoa pacientes y familiares.Materiales y métodos: estudio retrospectivo, en el que se midió la efectividad del tratamiento utilizandola escala visual análoga (EVA). Los datos fueron analizados en el programa SPSS por medio de porcentajes,frecuencias y proporciones.Resultados: de un total de 138 casos de cefalea crónica diaria tipo tensión, con edad promedio 51 años, 76,8%sexo femenino, 21% se asocia a trastorno ansioso; 8,7% a sensación vertiginosa y 8,7% síntomas depresivos;8% insomnio; 78,2% de los pacientes refirieron mejoría con el tratamiento propuesto y de estos, 85,5% delos casos se cuantificaron según la EVA, 66,8% presentaron mejoría entre 7 y 10 puntos; el mayor porcentajeestuvo asintomático durante tres meses, 22,5% libres de crisis durante el seguimiento total de siete meses y58,7% reincidieron.Conclusión: se evidencia que la combinación de infiltraciones intramusculares con betametasona más lidocaínay fisioterapia y un proceso de educación del personal médico a pacientes y familiares es un tratamiento eficaz, sinefectos adversos, en el manejo de la cefalea crónica tipo tensión, considerada una de las más difíciles de tratar.

Introduction: the tension-type headache is the most common form of headache and chronic one of the most difficult to treat form, causes severe disability to patients and enormous socioeconomic costs is related to emotional stress factors and / or muscle. Therapeutic proposals, which are considered, include NSAIDs, physical therapy, injections of botulinum toxin in pericraneal muscles.Objetives: to evaluate the effectiveness in the treatment of chronic tension-type headache with intramuscular infiltration with steroid betamethasone one deposit plus 1% lidocaine at points of muscle tension level sub-occipital, cervical paraspinal and trapezius, accompanied by physiotherapy, more an educational process to patients and families.Materials and methods: retrospective study where treatment effectiveness was measured using the Visual Analogue Scale (VAS). Data were analyzed in SPSS using percentages, frequencies and proportions.Results: total 138 cases of chronic daily headache tension type, mean age 51 years, 76.8% female, 21% is associated with anxiety disorder, 8.7% giddy feeling and 8.7% depressive symptoms, 8% type insomnia sleep disorders. 78.2% of patients reported improvement with the proposed treatment, of these, 85.5% of cases were quantified according to VAS, 66.8% showed improvement between 7 and 10 points; the highest percentage was asymptomatic for 3 months, 22.5% seizure-free for the total up of 7 months, 58.7% relapsed.Conclusion: it is evident that the combination of intramuscular injections of lidocaine plus Betamethasone more Physiotherapy and a process of education of medical staff to patients and families, is an effective treatment without adverse effects in the management of chronic tension headache, considered one of the most difficult to treat.

Nicolau Syndrome Following Intramuscular Diclofenac Injection / 대한정형외과학회잡지

Nicolau syndrome is a rare complication causing severe pain and tissue necrosis after intramuscular injection. In Korea, the Korea Dermatological Association has reported 12 cases, and some severe cases required surgical treatment. Most cases have been related to the administration of a variety of drugs, including nonsteroidal anti-inflammatory drugs, corticosteroids, and antibiotics. We present two patients who developed this complication, 1 case of typical Nicolau syndrome and 1 case of atypical Nicolau syndrome.

The Efficacy of Intramuscular Calcitonin Injection in the Management of Lumbar Spinal Stenosis

STUDY DESIGN: A prospective, cross-sectional, non-randomized study. PURPOSE: To assess the effectiveness of intramuscular calcitonin injection in the treatment of lumbar spinal stenosis (LSS). OVERVIEW OF LITERATURE: LSS, manifesting as chronic low back pain and neurogenic claudication, is a chronic condition with an increasing incidence in the elderly population having inadequate effective conservative treatment options. METHODS: In this study, 36 patients with LSS who were diagnosed based on the clinical findings and magnetic resonance imaging were included. Patients received 100 IU of calcitonin per week for one month and were evaluated before and after treatment using the Oswestry disability index (ODI) questionnaire and visual analogue scale (VAS). Before treatment, the patients were divided into two subgroups based on their ODI results: patients with mild to moderate low back pain (disability, 0%-40%) and patients with severe or very severe low back pain (disability, 40%-100%). RESULTS: In patients with mild to moderate low back pain, there were no significant changes in the ODI and VAS after calcitonin injection. But in patients with severe or very severe low back pain, pain severity, personal functions, ability to lift and carry objects, time interval between standing and initiation of pain, social life, disability percentage, and VAS were significantly improved after treatment with calcitonin. CONCLUSIONS: It seems that an intramuscular injection of low dose of calcitonin may have some beneficial effects on the pain due to LSS, especially in patients who suffer from severe or very severe low back pain.

A Case of Pseudomonas aeruginosa Abscess Developing after Gluteal Intramuscular Injection / 대한피부과학회지

No abstract available.

Effect of kangaroo mother care on children′s comfort with intramuscular injection / 现代临床护理

Objective To investigate the effect of kangaroo mother care on children′s comfort with intramuscular injection. Methods One hundred children with an intramuscular injection were grouped according to the injection date. Those treated with injection on odd-numbers days were assigned as the intervention group , and those with injection on even-numbered days as the control group, with 50 cases in each group. The control group received routine care and the intervention group with kangaroo mother care. The two groups were compared in terms of comfort level. Result The comfort level of the observation group was higher than that of the control group with statistical significance (P<0.01). Conclusion Kangaroo mother care can improve the comfort level of children patients with intramuscular injection. It is a simple, safe and effective in non-pharmaceutical pain therapy.

Comparison of the Efficacy of Methotrexate with Different Methods of Administration Combined with Hyster-oscopy in the Treatment of Scar Pregnancy / 中国药房

OBJECTIVE:To compare the efficacy and safety of methotrexate with different methods of administrations com-bined with hysteroscopy in the treatment of scar pregnancy(CSP). METHODS:Data of 56 CSP patients were retrospectively ana-lyzed and divided into group A(26 cases)and group B(30 cases)by different methods of administrations. The fluid in group A was injected methotrexate 50 mg/m2 into the capsule,once a week. After 1 week,if the β-HCG was decreased less than or equal to 50%,the patient was additionally injected methotrexate;and if the β-HCG was decreased more than 50%,no more methotrexate was given,the lesion electrosurgical excision was conducted under hysteroscopy when β-HCG0.05). After treatment,the β-HCG in 2 groups was significantly lower than before,14 d<10 d<7 d<4 d,and group A was lower than group B,the differences were statistically significant(P<0.05). The incidence of adverse reactions in group A was significantly lower than group B,the difference was statis-tically significant(P<0.05). CONCLUSIONS:Methotrexate with different methods of administrations combined with hysteroscopy has good efficacy in the treatment of CSP,however,the safety of intracapsular injection is better than intramuscular injection.