Administration Techniques Research Articles

Medication compliance by cat owners prescribed treatment for home administration.

Most veterinary literature examining medication compliance has described the phenomenon in dogs. The evidence available regarding factors affecting cat owner medication compliance is limited. Identify and describe factors associated with cat owners' noncompliance with veterinary recommendations for pet medications, as well as client-reported barriers and aids to administering medications prescribed by primary care veterinarians. Cat owners presenting their animals for veterinary examination and treatment. A cross-sectional survey of cat owners' compliance with veterinary medication recommendations was performed from January 9, 2019, to July 18, 2020. A convenience sample of owners prescribed medication for their pets by veterinarians during or after elective veterinary examination was recruited to respond to questions regarding medication administration experience and compliance. Follow-up was obtained from owners to determine if the course of medication had been completed. Compliance data were analyzed descriptively, and logistic regression was performed. Medication noncompliance was recorded for 39% (26/66) of cat owners. A quarter (16/66) reported challenges in administering medication to their pets; the most commonly cited reason was a resistant pet. Oral administration of antibiotics was significantly associated with noncompliance (P = .01). Clients with limited pet ownership experience were less likely to be noncompliant (P = .04). Clients' inability to medicate their cats PO may have implications for clinical outcomes and antimicrobial stewardship. Alternatives to direct PO administration of solid-form medications in cats should be considered. Demonstrating administration techniques to all clients may improve compliance and influence clinical outcome.

Incorporating the concept of overtransfusion into hemovigilance monitoring: An expert-based definition and criteria from the International HIT-OVER Forum.

Liberal or overtransfusion (OT) may be regarded as "inappropriate," but it is not reported as a transfusion-related adverse event. A definition of OT is lacking. OT may include overdosing of components, giving the incorrect component, or unnecessary administration without evidence of need for transfusion. OT can be associated with hypercoagulability, thrombosis, alloimmunization, increased mortality, longer hospital stay, increased infection rates, and adverse cardiocirculatory events. In 2023, an expert panel formed a hemovigilance international taskforce embedded in the German Interdisciplinary Taskforce for Clinical Hemotherapy (IAKH). The group was charged with proposing simple criteria to be used by hemovigilance systems to document instances of OT. This international initiative combined a narrative review of the literature for the rate and outcomes of OT with transfusion error reports to propose a definition for OT, including a definition for transfusion-induced hypercoagulopathy (TIH), three new codes for OT/TIH and subcodes A to G, three severity categories (serious adverse event, adverse event, near miss), and four incident codes (definite, probable, possible, not determinable). These codes can be used by hemovigilance systems to appropriately document instances of OT. Global adoption of these codes within hemovigilance systems would assist with the recognition and reporting of instances of OT, promote effective policies for adequate clinical administration techniques, and support technical guidelines for avoidance of OT. Thereby, incorporation of OT into hemovigilance strategies could support adequate use of blood products, increase patient safety, and facilitate blood supply and availability.

Magnetic-resonance tomography post injection contouring plastic face different type fillers: features of the picture and signal characteristics

Purpose: to study the possibilities of magnetic resonance imaging in characterizing the soft tissues of the face after injection of various types of fillers.Material and methods. A group of 35 patients with a known cosmetic history was analyzed after combined (15) and non-combined (20) injection injections of fillers into various areas of the face. According to the anamnesis, with combined administration, hyaluronic acid (HA) + Ca hydroxyapatite (CaHA) was used in 10 cases, HA + L­polylactic acid (PLA) in 2 cases, HA + PLA + silicone in 1 case, HA + CaHA + silicone in 1 case, in 1 – HA + silicone. With non-combined administration, 16 patients received HA, 2 received Ca hydroxyapatite, one received L-polylactic acid, and one received polyacrylamide gel (PAGE).MRI of facial soft tissues was performed at different times after drug administration: HA – from 1 month. up to 4 years, CaHA – from 7 days to 1 year, PLA – from 1 to 8 months, silicone – 10–20 years, PAGE – after 6 months.The studies were carried out on 1.5 T MRI scanners, using T2-WI, T1-WI, STIR, DWI (b = 1000), T1-FS-WI, 3D-T2-WI sag. The location of the filler was determined, the type of filler was differentiated, and its location in relation to the surrounding structures was assessed.Results. Areas of the HA preparation were characterized by a hyperintense MR signal on T2-weighted images and Stir, isohypointense on T1-WI. Preparations based on CaHA and PLA were determined by isohypointense on T2, T1-WI, isohyperintense on Stir, iso- and isohyperintense on T1-FS-WI signal. Silicone demonstrated isohypointense signal with a hypointense capsule on T2-WI and Stir isointense on T1-WI; PAGE – isohyperintense on T2-WI and Stir, isohypointense on T1-WI with a hypointense capsule on all PIs.HA-based fillers were more clearly visualized on Stir and T2-WI. Preparations based on CaHA and PLA had identical signal characteristics on T2-WI, which made differential diagnosis difficult, but in a number of cases the following signal changes were detected on T1-FS-WI: iso- and isohypointense from CaHA, isohyperintense from PLA. The MRI picture varied depending on the timing, technique of administration and dilution of the drug.Conclusions. MRI allows you to visualize and differentiate the type of filler after injection contouring according to signal characteristics that depend on its chemical composition, timing of administration and mechanisms of biodegradation.

Botulinum Toxin for the Treatment of Raynaud's Conditions of the Hand: Clinical Practice Updates and Future Directions.

Raynaud's conditions of the hand, referred to commonly as Raynaud's phenomenon, both primary and secondary, represents a spectrum of disorders affecting the digits, characterised by recurrent episodes of vasospasm that result in a triad of symptoms: pain, pallor, and cyanosis. Various therapies, ranging from conservative hand therapy techniques to surgical sympathectomy, have been explored with inconsistent results. Recently, the local administration of botulinum toxin type-A (BTX-A) has re-emerged as a treatment option for this condition. This review delves into the mechanistic pathways of BTX-A therapy, optimal dosing concentrations, administration techniques, and its safety profile. A critical analysis of published studies to date demonstrates varied clinical efficacy of BTX-A in Raynaud's conditions based on patient-reported outcome measures and objective measures of outcomes assessment. Thus, in order to accurately assess the clinical effectiveness of BTX-A in future robust studies, this review emphasises the importance of streamlining patient selection to minimise heterogeneity in disease severity, optimising recruitment to ensure adequate statistical power, and establishing sensitive outcome measures to monitor response and discern treatment efficacy. Additionally, addressing concerns such as minimising antibody resistance, extending the duration of treatment effects on tissues, and exploring new modalities to assess hand perfusion will be focal points for future research and BTX-A drug development.

Current Practice and Perspectives on Subcutaneous Immunoglobulin Replacement Therapy in Patients with Primary Antibody Deficiency Among Specialized Nurses in Poland.

Inborn errors of immunity (IEI) encompass various congenital disorders, resulting in immunity defects and recurrent infections. Home-based subcutaneous immunoglobulin replacement therapy (scIgRT) is the best treatment option for those with primary antibody deficiency (PAD). However, the lack of standardized procedures in patient training remains a challenge. Our study investigates nurses' practice and perspectives, aiming to identify areas for improvement in at-home scIgRT practice. We prepared a structured survey regarding scIgRT, including needle choice experience and perception of adverse events, and distributed it among qualified nurses involved in patient training and scIgRT supervising. We included 56 nurses with a median age of 50 years. Among them, 67.9% represented adult care providers, while 32.1% supervised IgRT in children. Most respondents (83.9%) used the classic or assisted with hyaluronidase scIgRT preparations. Single-channel needles were administered most commonly (85.7%). The needle length was mostly chosen solely by a nurse (57.1%) or in cooperation with the patient (23.2%). Next, 9 mm and 12 mm needles were used most often (92.9% and 78.6%, respectively). As expected, the 6 mm needle was more frequently applied for children compared to adults (n = 16, 88.9% vs. n = 11, 28.9%, p < 0.001), while 12 mm was primarily used in adults (n = 35, 92.1% vs. n = 9, 50.0%, p < 0.001). Visual skin fold assessment was the basis for the needle selection (58.9%), followed by the injection site rule (26.8%) or a choice between two available needle types for thinner or thicker patients (25.0%). Results of this survey indicate that, according to nurses' opinions presented in this survey, the needle length could be associated with local scIgRT adverse events, such as side needle leakage or local burning. Yet, it was likely unrelated to general adverse signs, such as headaches or dizziness. Most respondents (66.1%) indicated that, even if local adverse events occur, patients are reluctant to change scIgRT preparation or needle length. Most participants (69.6%) reported that the optimal administration technique needs to be discussed with the patient before and during scIgRT. This study sheds light on scIgRT practice in Poland, emphasizing deficiency in needle selection technique. Future research should focus on standardized training and advanced needle selection procedures on patient outcomes, investigating the correlation between needle strategies and adverse events, as well as the effectiveness of scIgRT.

The effect of peer tutoring on pediatric nursing education: a systematic review.

This study aimed to systematically review studies on the effect of peer tutoring on pediatric nursing education for nursing students and identify its contents and characteristics. A comprehensive search was conducted from November to December 2023 across databases including PubMed, Embase, CENTRAL, CINAHL, ProQuest, and others. We included both published and unpublished literature in English or Korean. Three reviewers independently screened and selected eligible studies that involved undergraduate nursing students participating in peer tutoring programs focused on pediatric nursing education. We analyzed quantitative outcomes related to learning effects and learner responses. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool for randomized trials and the risk of bias assessment tool for non-randomized studies. Five studies were reviewed, encompassing randomized controlled trials, a non-randomized controlled trial, a cohort study, and a before-after study. These interventions were conducted in school settings or pediatric clinical environments and featured different forms of peer teaching: horizontal, near-peer, and reciprocal. The tutor-to-tutee ratios ranged from 1:3 to 1:36.5. The educational content covered nursing care for major neonatal diseases, communication skills, medication administration, and resuscitation techniques. Significant improvements in cognitive knowledge and communication skills were observed among nursing students. However, there was noticeable variability in the design and reporting of the studies. Peer tutoring programs can effectively enhance pediatric nursing education by improving nursing students' knowledge and skills. For future meta-analyses, more studies in this field reported according to reporting guidelines are needed.

Contrast Enhancement in Breast Cancer: Magnetic Resonance vs. Mammography: A 10-Year Systematic Review.

Contrast Enhancement Magnetic Resonance (CEMR) and Contrast-Enhanced Mammography (CEM) are important diagnostic tools to evaluate breast cancer patients, and both are objects of interest in the literature. The purpose of this systematic review was to select publications from the last ten years in order to evaluate the literature contributions related to the frequency of contrast agents used, administration techniques and the presence of adverse reactions. We have selected, according to the PRISMA statement, publications reviewed on Pub Med in the period from 1 January 2012 to 31 December 2022. The search engine was activated using the following keywords: "CESM", "CEM", "CEDM", "Contrast mammography" for CEM, "DCE-MRI", "Contrast Enhancement MRI" for CEMR, excluding reviews, book chapters and meta-analyses. From the total number of publications, we made a preliminary selection based on titles and abstracts and excluded all articles published in languages other than English and all experimental studies performed on surgical specimen or animal population, as well as all articles for which the extended version was not available. Two readers evaluated all the articles and compiled a pre-compiled form accordingly. After a preliminary collection of 571 CEM publications, 118 articles were selected, relating to an overall population of 21,178 patients. From a total of 3063 CEMR publications, 356 articles relating to an overall population of 45,649 patients were selected. The most used contrast agents are Iohexol for CEM (39.83%) and Gadopentetic acid (Gd-DTPA) for CEMR (32.5%). Regarding the CEM contrast administration protocol, in 84.7% of cases a dose of 1.5 mL/kg was used with an infusion rate of 2-3 mL/s. Regarding the CEMR infusion protocol, in 71% of cases a dose of 1 mmol/kg was used at an infusion rate of 2-4 mL/s. Twelve out of 118 CEM articles reported allergic reactions, involving 29 patients (0.13%). In DCE-MRI, only one out of 356 articles reported allergic reactions, involving two patients (0.004%). No severe reactions were observed in either cohort of exams. CEM and CEMR are essential contrast methods to evaluate breast diseases. However, from the literature analysis, although there are preferences on the uses of the contrast agent (Iohexol for CESM, G-DTPA for CEMR), a wide range of molecules are still used in contrast methods, with different administration protocols. Based on the collected data, it is possible to state that both methods are safe, and no severe reactions were observed in our evaluation.

Assessment of enoxaparin‐related knowledge, administration technique, and self‐reported adherence among women after caesarean section delivery

AbstractBackgroundVenous thromboembolism is among the main causes of maternal morbidity and mortality, with caesarean section (CS) delivery carrying greater risk. Outpatient thromboprophylaxis, such as enoxaparin, is administered subcutaneously and prescribed as an outpatient; raising the issue of medication adherence.AimThis study aimed to evaluate women's adherence to enoxaparin administration after CS delivery, explore the reasons for non‐adherence, and assess the factors associated with patients' adherence to enoxaparin.MethodWomen after CS delivery, who had been given enoxaparin at discharge were included in the study. Eligible patients were contacted via telephone at the middle and the end of the enoxaparin treatment. Syringe count determined the main outcome of adherence during direct telephone interviews with the patient. Optimal adherence was defined as all the doses of enoxaparin being administered and suboptimal adherence was at least one dose not administered. Ethical approval was granted by the Malaysian Registry Ethics Committee belonging to National Medical Research Registry (Reference no: NMRR ID‐22‐02859‐P41) and the study conforms with the Declaration of Helsinki. Informed consent was obtained from all participants through completion of written consent forms, after an explanation of the study was provided by investigators.ResultsOut of 201 women included, the majority (91.5%) were fully adherent to enoxaparin, while 8.5% missed at least one dose. Most patients administering at home missed the dose due to reporting they were unwell (n = 6), busy (n = 4), or forgot to administer (n = 2). Among missed doses in patients administered in a healthcare setting, all participants (n = 5) forgot to bring their medication to the appointment. Only medication knowledge had a significant association with adherence to enoxaparin administration (p = 0.008).ConclusionThe study raised concern about the substantial percentage of patients missing at least one dose of enoxaparin, particularly among patients injecting at home. Initiatives should focus on customised enoxaparin administration counselling and providing educational materials.

Safe subdural administration and retention of a neurotrophin-3-delivering hydrogel in a rat model of spinal cord injury

Neurotrophic growth factor (GF) loaded hydrogels have shown promise as a treatment approach for spinal cord injury (SCI). However, SCI presents complex challenges for the direct administration of treatment due to the spinal cord’s intricate anatomy and highly sensitive environment. Many current hydrogel administration approaches overlook this complexity, limiting their translational potential. To address this, we propose a novel intrathecal administration method using an in situ gelling, hyaluronic acid-modified heparin-poloxamer hydrogel loaded with neurotrophin-3 (NT-3) for the direct delivery of NT-3 to the spinal cord. We injected a NT-3 loaded hydrogel into the intrathecal space immediately after contusion SCI in Sprague Dawley (SpD) rats. Our results indicate that injecting the NT-3 loaded hydrogel into the intrathecal space was safe and that the gel was retained alongside the cord for at least one week. Additionally, no adverse effects were observed on rat behaviour. While functional improvement trends were noted, statistical significance was not reached, and immunohistochemistry results showed no significant difference between treatment groups. Overall, our findings suggest the feasibility, safety, and potential of the developed intrathecal administration technique for delivering diverse therapeutic molecules for SCI recovery.

Intravenous injection versus transhepatic intracholecystic injection of indocyanine green (ICG) to outline biliary tree during laparoscopic cholecystectomy

BackgroundTo potentially lessen injuries and associated complications, fluorescence cholangiography has been suggested as a technique for enhancing the visualization and identification of extrahepatic biliary anatomy. The most popular way to administer indocyanine green (ICG) is intravenously, as there is currently little data on ICG injections directly into the gallbladder. In order to visualize extrahepatic biliary anatomy during laparoscopic cholecystectomy (LC), we compared the two different ICG administration techniques. We also examined variations in visualization time, as well as the effectiveness, benefits, and drawbacks of each modality.MethodsIn this prospective randomized clinical study, 60 consecutive adult patients with chronic and acute gallbladder disease were included. Our study conducted from 2022 to 2024 in Surgical Department of Theodor Bilharz Research Institute. Thirty patients underwent LC with intravenous ICG administration (IV-ICG), thirty patients received a direct injection of gallbladder through transhepatic ICG (IC-ICG) and Preoperative, intraoperative, and postoperative patient data were examined.ResultsIn terms of their perioperative and demographic features, the groups were similar. Without a statistically significant difference, the IV-ICG group’s total operating time was less than that of the IC-ICG group (p 0.140). Compared to the transhepatic IC-ICG method, IV-ICG was more accurate in identifying the duodenum and the common hepatic duct (p = 0.029 and p = 0.016, respectively). In the transhepatic IC-ICG and IV-ICG groups, the cystic duct could be identified prior to dissection in 66.6% and 73.3% of cases, respectively, and this increased to 86.6% and 93.3% following dissection. In the transhepatic IC-ICG group, the common bile duct was visible in 93.3% of cases; in the IV-ICG group, it was visible in 90% of cases. Two cases in the IC-ICG group and every case following IV-ICG administration had liver fluorescence (6.6% versus 100%; p < 0.001).ConclusionThe current study shows that for both administration methods, ICG-fluorescence cholangiography can be useful in identifying the extrahepatic biliary anatomy during Calot’s triangle dissection. By avoiding hepatic fluorescence, the transhepatic IC-ICG route can increase the bile duct-to-liver contrast with less expense and no risk of hypersensitivity reactions than the intravenous ICG injection method. We recommend to use both techniques in case of acute cholecystitis with cystic duct obstruction. In cases of liver cirrhosis, we recommend transhepatic IC-ICG as IV-ICG is limited.

Intradermal Sterile Water Injections in Labour

Intradermal sterile water injections (SWIs) are used to provide pain relief for women experiencing back pain in labour and are becoming more frequently utilised among midwives practicing intrapartum care.1 SWIs have recently been introduced to practice at our health service. This two-phased project aimed to investigate midwives’ knowledge of and use of SWIs across the health service. SWIs were perceived as effective pain relief for labouring women and were very likely to be recommended by midwives to women and colleagues in the future. Identified barriers to the administration of SWIs included unfamiliarity with administration technique.

RFID Occupied Advanced Framework for Specialized Vehicle Access, Operating System, and Wireless Data Transmission Without Human Intervention

RFID tags are tiny electronic devices that include a distinctive code that can be detected by a reader that supports RFID. The string of characters is used for recognizing and monitoring the object to which the tag is connected. RFID tags interact with RFID readers using radio frequency. While the tag comes into close proximity to the scanner, that device sends a radio signal that triggers the tag. The tag then responds by sending its unique identity. RFID pinpointing ability is verified experimentally in two different techniques, one utilizing radar and the other a photosensitive transition. The initial phase is intended to test if the continuously changing location provided from RFID tags equals the precise position recorded by sonar. It is also excellent for getting into parking lots, private spaces, professional parking spots, and offices quickly and easily. The implementation of RFID will bring a revolutionary transformation in the authorization, administration, correspondence, computerization, and security systems for specialized vehicle Access, Operating System, and Wireless Data Transmission without Human Intervention using an internet based wireless communication system. RFID vehicular registration is an authentication system which employs RFID readers to give authorization for automobiles. The technique normally consists of installing a reader with RFID technology at the entrance/exit entrance to an enclosed or a limited region. RFID scanning can deliver efficient techniques for transportation administration, making the process straightforward, dependable, as well as secure. Received: 22 April 2024 | Revised: 20 September 2024 | Accepted: 8 October 2024 Conflicts of Interest The authors declare that they have no conflicts of interest to this work. Data Availability Statement Data available on request from the corresponding author upon reasonable request. Author Contribution Statement Abdullah All Mamun Anik: Conceptualization, Methodology, Software, Validation, Formal analysis, Investigation, Resources, Data curation, Writing - original draft, Writing - review &amp; editing, Visualization, Supervision, Project administration; Mosammat Sadia Akter Moon: Conceptualization, Software, Validation, Formal analysis, Resources, Writing - review &amp; editing; Fahim Faysal Arnob: Conceptualization, Software, Formal analysis, Writing - original draft, Writing - review &amp; editing, Supervision; Mehedi Hasan: Conceptualization, Formal analysis, Investigation, Resources, Data curation, Writing - original draft, Writing - review &amp; editing, Supervision; S. A. Naimul Hoque: Conceptualization, Methodology, Formal analysis, Investigation, Resources, Data curation, Visualization, Supervision; Mohammad Mashhunur Rahman: Methodology, Software, Validation, Formal analysis, Investigation, Resources, Visualization, Supervision, Project administration; Tanzim Bin Ahmed: Methodology, Software, Validation, Formal analysis, Data curation, Writing - review &amp; editing, Visualization, Project administration; Tonmoy Barua: Conceptualization, Software, Formal analysis, Investigation, Resources, Writing - original draft, Visualization, Project administration.

Factors that Influence Intraocular Pressure Target in a Sample of Iraqi Patients Using Antiglaucoma Medications: A Cross-Sectional Study

Background: Anti-glaucoma eye drops are mainly used to lower intraocular pressure (IOP) and manage glaucoma. Many studies found that achievement of the IOP target is poor. Objective: This study aimed to assess the achievement of the IOP target and factors affecting it among a sample of Iraqi patients with glaucoma. Methods: A single-center, cross-sectional study was conducted on patients with glaucoma from December 2023 to April 2024 at Ibn Al-Haytham Hospital, Baghdad, Iraq. All patients who received medical therapy for at least one month were eligible to participate in this study. Intraocular pressure values at the time of initial diagnosis and at the time of enrolment in the study were documented for all included patients. Medication adherence was measured by the Arabic version of the Morisky medication adherence scale-4. Eyedrop administration technique was assessed through direct observation by the researcher using a newly developed and validated checklist. Results: Most participants in the current study were males with primary education. The average disease duration was 14 months. The target IOP was achieved among 36% of participants. The adherence to eye drops was good in 55% of participants. Only 9% of participants administered eye drops with a good technique. Achievement of the IOP target was significantly influenced by good adherence and technique for administration of eye drops (p&lt;0.05). Conclusions: IOP-target achievement is poor among Iraqi patients. Adherence to and administration technique of eye drops are significant factors that could affect IOP-target achievement.

Partnering for Progress: Lessons Learned From Mental Health Assessment for Youth Living With HIV in India Through Community-Based Participatory Research

Youth living with HIV (YLHIV) face diverse mental health challenges necessitating interventions informed by their lived experiences. Failure to do so can perpetuate a self-reinforcing cycle of misaligned and ineffective support, further exacerbating existing vulnerabilities. This study directly addresses this gap by using a community-based participatory research (CBPR) approach to empower YLHIV in India to address their mental health challenges. YLHIV actively participated in adapting and implementing a culturally responsive mental health screening program. The study, incorporating CBPR principles at every step aimed to identify practical methods for integrating YLHIV voices in research, and showcase the value of YLHIV participation in co-creating and implementing impactful interventions. Six youth investigators aged 18-24, born with HIV and residing in southern Indian states underwent certification in human subjects’ protection and training in mental health screening and survey administration techniques. They actively shaped the research process by culturally adapting standardized mental health screening tools (PHQ-9, GAD-7) through iterative discussions with experts, drawing on their own perspectives. Following field assessments of the mental health screening tools among their peers, they documented their reflections in surveys and written essays. Youth investigators’ involvement improved the research process by optimizing tools, combating stigma, and facilitating reliable data collection. Beyond data collection, the youth investigators’ participation significantly boosted their own knowledge, self-confidence, and research skills. This study serves as an illustrative model of CBPR in mental health research among YLHIV, highlighting the importance of interactive training, continuous feedback mechanisms, and respectful youth engagement in fostering impactful research that can inform tailored sustainable interventions.

Preventing perioperative infections: a call to action for anesthesiologists

Purpose of review Surgical site infections (SSI) are one of the most costly complications and hospital organizations are promoting multidisciplinary approaches to address this harm. Anesthesiologists are increasingly recognized as key players influencing surgical outcomes and patient safety, and play a key role in preventing SSIs. Recent findings Recent guidelines and strategies to prevent SSI are focused on the areas which anesthesiologists can impact including antimicrobial prophylaxis, proper hand hygiene, decontamination of environmental surfaces and operating room equipment coming in direct contact with patients. Summary Timely interventions, including appropriate antibiotics’ administration, practicing sterile and aseptic techniques when performing intraoperative procedures and handling medications are impactful steps in the process of improving rates of SSIs. Multidisciplinary participation in local and regional collaborative initiatives to improve adherence to best practices as well as integrated education of all the stakeholders are some of the principles of patient-centered care described in our review.

Chitosan, a Natural Polymer, is an Excellent Sustained-Release Carrier for Amide Local Anesthetics.

Local anesthetics, particularly amide types, play a crucial role in perioperative anesthesia to alleviate pain and manage chronic, long-term pain, with their brief effect period remaining a universal challenge that needs resolution. There is a high anticipation for creating materials that maintain prolonged effectiveness of local anesthetics through a straightforward administration technique. Chitosan is the most typical natural amino polymer, which is highly reactive and easy to modify. It has been widely and deeply used in the field of medicine. At present, it is mainly used in tissue regeneration and repair, hemostasis and wound healing, antibacterial and anti-infection, disease diagnosis and treatment detection, and drug delivery. In the field of anesthesia, chitosan is regarded as a potential perfect carrier for the sustained release of amide local anesthetics. This document aims to analyze the current application of chitosan as a prolonged-release substance in amide-type local anesthetics, encapsulate the associated research advancements, and subsequently investigate the practicality and prospects of its medical uses.

Comprehensive Survey on the Performance of Lignocaine in Root Canal Treatment

Objective: The study aimed to evaluate the efficacy of lignocaine as a local anesthetic in root canal treatment, particularly focusing on its use in lower teeth, different administration techniques, and its performance in patients with specific challenges such as inflammation or allergy. Methods: A survey-based approach was utilized to gather data from clinicians on their experiences with lignocaine in endodontic procedures. The study assessed the success rates of various techniques, including the inferior alveolar nerve block (IANB), intraligamentary, and intraosseous injections. The impact of different adrenaline ratios (1:100,000, 1:80,000, and 1:200,000) on anesthesia duration and effectiveness was also analyzed. Results: Lignocaine with 1:100,000 adrenaline was effective in the majority of cases, with IANB being the primary technique used for lower Lignocaine was identified as the anesthetic of choice by the majority of participants, preferred for its rapid onset and adequate duration of action. Most clinicians reported that lignocaine provided effective anesthesia for routine root canal procedures when inflammation was present or additional duration was required, clinicians recommended using supplemental techniques such as intraligamentary and intraosseous. Alternative anesthetics like articaine and bupivacaine were used successfully in patients with lignocaine allergies. Conclusion: Lignocaine remains a reliable anesthetic for root canal treatments, particularly in the lower jaw, when used with appropriate techniques and adrenaline ratios. However, challenges such as inflamed tissues and patient allergies require alternative strategies, including supplemental injection techniques and the use of different anesthetic agents. Clinicians should be adaptable in their approach to ensure effective anesthesia and patient safety. The study aimed to evaluate the efficacy of lignocaine as a local anesthetic in root canal treatment, particularly focusing on its use in lower teeth, different administration techniques, and its performance in patients with specific challenges such as inflammation or allergy.

Intermittent versus continuous intravenous epoprostenol for the treatment of digital ischemia.

Digital ischemia can be a painful complication of Raynaud's phenomenon or systemic sclerosis, which is caused by narrowing of blood vessels in the toes and hands. Epoprostenol is a potent vasodilator that may be used to treat digital ischemia in this patient population. Our institution provides epoprostenol infusion using two different administration techniques: a 30-h continuous infusion option and a 5-day intermittent 6-h infusion. In this retrospective chart review, we compared two administration techniques of intravenous epoprostenol administered to patients with digital ischemia. The primary outcome was to compare the efficacy of intravenous epoprostenol 30-h continuous infusion versus 5-day intermittent infusion, as defined by the presence of treatment failure. Between June 2019 and June 2020, 72 adult patient encounters met the inclusion criteria (intermittent: n = 20; continuous: n = 52). The primary outcome did not achieve a statistically significant difference between the two groups: intermittent 20% versus continuous 33.3% p = 0.390, odds ratio = 0.57 (95% confidence interval = 0.17-1.90). Adverse reactions were documented in 28% of patients across both treatment groups, and there was no difference detected when treatment groups were compared (25% vs 28.8%). Patients who received the 5-day infusion experienced a significantly longer average length of stay, with a mean of 8.9 days versus 3 days for those treated with the continuous 30-h infusion (p < 0.05; 95% confidence interval = 2.15-9.47). This study determined that the efficacy and safety profiles of the two administration techniques may not be comparable. Each protocol offers advantages over the other, and selection should be guided by patient history and risk factors to optimize management.

A Comprehensive Review of Nanogel-Based Drug Delivery Systems.

Polymers can be crosslinked chemically or physically to create three-dimensional hydrogel particles with sub-micron dimensions, known as nanogels. Their customizable size, ease of manufacture, expansion potential, bio-integration, water affinity, and reactivity to various stimuli, including temperature, pH, light, and biological agents, provide them with considerable advantages over conventional drug delivery techniques. Nanogels possess properties of both hydrogels and nanoparticles and can be categorized into nanohydrogels and nano-organogels. These systems exhibit exceptional drug-loading capability, stability, biological consistency, and environmental responsiveness. Their hallmark lies in their swelling behavior, enabling substantial water absorption while maintaining structural integrity. Preparation methods involve polymer precursors or heterogeneous polymerization of monomers. Nanogels are promising for various drug administration techniques, including local anesthetics, vaccines, and transdermal drug delivery, due to their ability to encapsulate multiple bioactive ingredients, enhancing therapeutic efficacy and stability.

Update: Prevention and Treatment of Parotid/Submandibular Gland Fistula/Sialocele Following Rhytidectomy with Botulinum Toxin A.

Dissecting deep to the superficial musculoaponeurotic system, SMAS, a popular option for facelifts, has the potential for injury to the parotid gland leading to post operative sialoceles and fistulas. Similarly, deep plane procedures in the neck which include partial submandibular gland resection may lead to salivary gland leaks. We previously described the management of sialocele following rhytidectomy.1 Since then, administration of Botulinum toxin A has emerged as the primary treatment and prevention of this rare complication. The technique of administration and dosage of botulinum toxin in the treatment algorithm is not well-defined. We present a literature review and our current protocol of the most efficacious injection technique and dosing to prevent and treat injury to the parotid and submandibular glands.