Disposable Needle Research Articles

Spatiotemporal Trends in Discarded Needle Reports in San Francisco Over a 10-year Period, 2010-2019

BackgroundTo describe the geographic and spatiotemporal distribution of needle reports in San Francisco, and examine spatial relationships between needle reports and needle disposal boxes, needle disposal kiosks, and homeless shelters. MethodsWe conducted multiple geospatial analyses of a crowdsourced database of non-emergency service requests. We describe changes in discarded needle and bulky item reports across San Francisco between 2010 and 2019, and compared changes in the reporting patterns of these items, while 200-meter Euclidean buffers captured needle reports in close proximity to needle deposit boxes, needle deposit kiosks, and homeless shelters in 2019. Results34,912 needle reports were included. Yearly needle reports increased by 3827.1%, with a markedly different geospatial distribution from bulky item reports. 45.6% of needle reports originated in the five downtown neighborhoods with the highest needle report density, and 33.8% were identified within 200 meters of boxes, kiosks, or homeless shelters. ConclusionsReports of discarded needles in San Francisco increased dramatically over the last decade, and more than one third of 2019 reports were adjacent to harm reduction and homeless shelter locations. Needle reports provide an opportunity to understand changes in public injection drug use and target harm reduction services.

Evaluating implementation of "management of Possible Serious Bacterial Infection (PSBI) when referral is not feasible" in primary health care facilities in Sindh province, Pakistan.

BackgroundThe World Health Organization (WHO) launched a guideline in 2015 for managing Possible Serious Bacterial Infection (PSBI) when referral is not feasible in young infants aged 0–59 days. This guideline was implemented across 303 Basic Health Unit (BHU) Plus primary health care (PHC) facilities in peri-urban and rural settings of Sindh, Pakistan. We evaluated the implementation of PSBI guideline, and the quality of care provided to sick young infants at these facilities.MethodsThirty (10%) out of 303 BHU Plus facilities were randomly selected for evaluation. A survey team visited each facility for one day, assessed the health system support, observed the management of sick young infants by health care providers (HCP), validated their management, interviewed HCPs and caretakers of sick infants. HCPs who were unable to see a young infant on the day of survey were evaluated using pre-prepared case scenarios.ResultsThirty (100%) BHU Plus facilities had oral amoxicillin, injectable gentamicin, thermometers, baby weighing scales and respiratory timers available; 29 (97%) had disposable syringes and needles; 28 (93%) had integrated management of childhood illness (IMCI)/PSBI chart booklets and job aids and 18 (60%) had a functional ambulance. Each facility had at least one HCP trained in PSBI, and 21 (70%) facilities had been visited by a supervisor in the preceding six months. Of 42 HCPs, 19 (45.3%) were trained within the preceding 12 months. During the survey, 26 sick young infants were identified in 18 facilities. HCPs asked about history of breastfeeding in 23 (89%) infants, history of vomiting in 17 (65%), and history of convulsions in 14 (54%); weighed 25 (97%) infants; measured respiratory rate in all (100%) and temperature in 24 (92%); assessed 20 (77%) for movement and 14 (54%) for chest indrawing. HCPs identified two infants with fast breathing pneumonia and managed them correctly per IMCI/PSBI protocol. HCPs identified six (23%) infants with clinical severe infection (CSI), two of them were referred to a higher-level facility, only one accepted the referral advice. Only one CSI patient was managed correctly per IMCI/PSBI protocol at the outpatient level. HCPs described the PSBI danger signs to eight (31%) caretakers. Caretakers of five infants with CSI and two with pneumonia were not counselled for PSBI danger signs. Five of the six CSI cases categorized by HCPs were validated as CSI on re-examination, whereas one had pneumonia. Similarly, one of the two pneumonia patients categorized by HCPs had CSI and one identified as local bacterial infection was classified as CSI upon re-examination.ConclusionHealth system support was adequate but clinical management and counselling by HCPs was sub-optimal particularly with CSI cases who are at higher risk of adverse outcomes. Scaling up PSBI management is potentially feasible in PHC facilities in Pakistan, provided that HCPs are trained well and mentored, receive refresher training to appropriately manage sick young infants, and have adequate supplies and counselling skills.

Treatment of scapulohumeral periarthritis by "metal hook fishing"-like needling technique combined with Tuina manipulation

To observe the clinical effect of "metal hook fishing" (MHF)-like needling technique combined with Tuina manipulation in the treatment of scapulohumeral periarthritis. A total of 72 patients with scapulohumeral periarthritis were randomly divided into MHF-like needling (MHF) and conventional needling groups (n=36 in each group). For patients of the GHF group, the doctor pressed the acupoint with the left index finger, held the disposable acupuncture needles to insert into the Jianqian, Jianyu (LI15), Jianliao (SJ5), Jianzheng (SJ9) and Ashi-point respectively with the right hand, waited for qi-arriving, twirled the needles forward about 3 to 6 times. When a tightened feeling was achieved beneath the needle tip, the doctor held the needle body to slightly shake it 3 to 6 times which mimicked a fish to swallow a hook, kept the situation for a while till relaxation, followed by retaining the needle for 30 min and then withdrew it slowly. Afterwards, the doctor performed Tuina manipulation at the upper limbs for 20 to 30 min. For patients of the conventional needling group, the same acupoints were needled and stimulated with the uniform reducing and reinforcing method for 1 min, followed by retaining the needles for 30 min. Then, massage was performed for 20 to 30 min in the same way as those in the MHF group. The treatment was conducted once daily, 6 times a week for 2 weeks. After the treatment, the visual analogue scale (VAS) was used to assess the pain degree, the range of motion (ROM) scale of the shoulder joint adopted to assess the function, and the activity of daily living (ADL) scale used to assess the patients' daily living ability. The therapeutic effects of the two groups were evaluated after the treatment. After the treatment, the VAS scores of the two groups were notably decreased (P<0.05), being significantly lower in the GHF group than in the conventional needling group (P<0.05). The ROM score and ADL score of the two groups were obviously increased (P<0.05), being significantly higher in the MHF group than in the conventional needling group (P<0.05). Of the 36 cases in the conventional needling and MHF groups, 7 and 17 were cured, 11 and 12 experienced remarkable improvement, 13 and 4 were improved, and 5 and 3 were ineffective, with the total effective rate being 86.1% （31/36） and 91.7% (33/36), respectively. The total effective rate of MHF group was evidently higher than that of the conventional needling group (P<0.05). Both MHF and conventional needling is effective in relieving scapulohumeral periarthritis, and the effect of MHF is ob-viously superior to that of conventional needling in relieving pain state and improving function of the affected shoulder joint.

Effect of Cassava Peels and Palm Kernel Cake Meal Mixtures on the Heamatological and Serum Biochemical of Finisher Pigs

The research was carried out for a period of twenty two (22) weeks at the Piggery unit of the Teaching and Research Farm of the Faculty of Agriculture, Ambrose Alli University, Ekpoma, Edo State, Nigeria. The objective of this study was to assess the effect of cassava peels and palm kernel cake (PKC) mixture at 1:1 ratio on haematological and serum biochemical of finisher pigs. Fourty (40) finisher pigs of large white breed were used for the study. Each group of finisher pigs contained eight pigs per treatment, were respectively allocated to five treatment diets in a completely randomized design (CRD). At the end of the twenty two (22) weeks feeding trial, ten pigs consisting of two pigs per treatment were randomly selected; animals were starved of feed for 12 hours before blood samples were collected from the two pigs each per treatment via the ear vein using a sterilized disposable syringe and needle. The parameters determined were red blood cells (RBC), haemoglobin (Hb), packed cell volume (PCV), white blood cell (WBC), total protein, albumin, globulin and serum cholesterol. This finding therefore recommended that cassava peels/pkc mixtures can successfully replace maize in finisher pigs ration without any adverse effect on the animals and consumers, since the haematological and serum biochemical parameters fell within normal values for pigs.

Pharmacokinetics of Cefquinome on Single Intravenous Administration in Marathwadi Buffalo Calves by Microbiological Assay Technique

Experiment was performed on six healthy Marathwadi buffalo calves of either sex of age above 6 months and weighing between 80 to 120 kg to study the different pharmacokinetic parameters after single intravenous administration @ 2 mg/kg body weight by microbiological assay technique. After intravenous administration of the drug, blood samples (4 ml each) of buffalo calves were collected from external jugular vein using disposable needles in clot activator tubes at different time intervals. The schedule of blood collection for pharmacokinetic studies after intravenous administration was at 0, 5, 10, 15, 30 min and 1, 2, 4, 6, 8, 10, 12 and 24 hrs. The serum levels of cefquinome were estimated by microbiological assay technique using large glass plate. Different Pharmacokinetic parameters were calculated as described by different scientists. The peak serum concentration, elimination half life, volume of distribution, total body clearance, absorption half life and area under curve values found were 1.74 ± 0.151 mcg/ml at 2.5 min of sampling time, 1.97±0.14 h, 3.97 ± 0.83 L/kg (Vd(B)) and 2.86 ± 0.34L/kg (Vdss), 1.11 ± 0.13 L/kg.h−1, 0.10 ± 0.02 h, and 1.93 ± 0.23 μg/ml/hr respectively. The bioavailability of cefquinome in buffalo calves was found to be 100 %. It may be concluded that the elimination half life of cefquinome was 2.54 h in Marathwadi buffalo calves indicating the repeating of doses at 12 to 15 h intervals in Marathwadi buffalo calves and the loading dose would be double than the maintenance dose of cefquinome after intravenous administration.

Adverse effects of foot-and-mouth disease vaccine in dairy cattle

ABSTRACT: Foot-and-mouth disease represents an important barrier to the international commerce of animal products, potentially associated with significant economic losses. The systematic vaccination of bovines and buffaloes was fundamental for the eradication of this disease; however, the use of vaccines can lead to reactions at the application site. The objectives of this study were to evaluate the effects of the vaccination protocol to the production of dairy cows and to observe the occurrence of vaccinal reactions in the animals. At one property located in the municipality of Salvador do Sul, Rio Grande do Sul, 270 dairy cows were vaccinated against foot-and-mouth disease in May 2019. The vaccine was administered via a subcutaneous application using disposable syringes and needles for each animal. Inspection of the animals was performed before and 20 days after the vaccination to verify the presence of reactions to the vaccine. The study’s sample was set by convenience, including 203 lactating animals with or without bovine somatotropin (BST) administration during the data collection period, which was limited to 20 days before and 20 days after the vaccination. Milk production data was obtained through SmartDairy® HerdMetrix™ software, tabulated in electronic spreadsheets using Microsoft Excel® and processed using the program SAS®, considering a 5% significance level for mixed model statistical analysis. A total of 160 animals (78.82%) presented local lesions at the application site, even when the recommended vaccination practices were followed, suggesting that the high reaction power was provoked by the vaccinal components. In regards to milk production, a statistically significant (p&lt;0.05) decrease of 0.30kg of milk per animal/day was observed in the average daily production in the 20 days post-vaccination. These results demonstrate the local and systemic effects caused by the foot-and-mouth disease vaccine, evidenced by reduced levels of milk production and the occurrence of vaccine reactions, implying significant economic losses.

Hindquarters Paralysis of a Pure Friesian Female Calf : A Case Report

A 25-days old pure Friesian female calf was admitted with flaccid paralysis of the hind limbs. Paralysis was extended to the bladder and anus sphincter muscle as it was concomitant with urinary and fecal incontinence. She was kept loose in a deserted backyard with a tethered donkey. Pin bricking using a sterile disposable needle along the lateral and median aspect of both limbs revealed intact deep (osseous) sensation while, superficial sensation was found lost. She was diagnosed as acute spinal cord injury due to trauma caudal to the 4th lumber vertebrae. Treatment protocol consisting of drugs and physiotherapy was applied immediately on the same day of admission. Full recover was achieved in 33 days PA.

Access to Breast Cancer Diagnostic Devices in the East African Community: Moving the Needle

PURPOSE Globally, two million women develop breast cancer each year. Low-income countries bear a disproportionate burden as a result of systems strapped by limited resources. Inadequate access to diagnostic services is widely recognized as a driver of unfavorable outcomes, yet baseline data on supply, use, and pricing for breast cancer diagnostic devices are scant. The purpose of this study was to assess access to cancer biopsy devices in Burundi, Kenya, Rwanda, South Sudan, Tanzania, and Uganda, and to ascertain related pricing, procurement, and payment models. METHODS We conducted an observational online survey to capture institution-based data that address demographics, facility capacity, human capital, pathology systems, device sourcing and pricing, supply chains, and workarounds. Additional manufacturer information was obtained through public sources and communication with industry. RESULTS We received 58 survey responses from the 6 East African Community countries, most representing urban public hospitals (68%). Pathology laboratory capacity varied drastically: Although basic histopathology was consistently performed (92% of respondents), hormone receptor, human epidermal growth factor receptor 2, and genetic studies were not (63%, 53%, and 11%, respectively). Training varied among practitioners performing biopsies—for example, surgeons or nurses—and most practitioners did not have ultrasound guidance (80%). Both disposable and reusable core needle devices were in use, and stockouts were reported by most respondents (69%). Workarounds included reuse of disposable devices, alternative procedures (eg, surgical excision or fine-needle aspiration), patient rescheduling, and referral. Most patients received results at follow up, but one fifth of all respondents reported that some patients never received results. Of importance, there was no observable pattern to procurement channels or pricing. CONCLUSION Reliable, accurate, and timely diagnosis is vital to improving outcomes for patients with breast cancer in low-income countries. Significant variation related to operations, human capital management, product mix, procurement methods, and pricing was observed between and within the East African Community countries. Additional investigation is needed to identify opportunities for applying best practices and leveraging regional synergies for impact.

Development and Application of One Separation-Free Safety Tube on the Disposable Infusion Needle.

Objective To develop a new type infusion set and apply it to the clinic, as well as explore its effectiveness in the prevention from needle stick injuries. Methods A total of 200 inpatients who were in need of intravenous infusion with a disposable infusion needle were included and randomly divided into two groups: intervention group and control group. Disposable infusion needles with a separation-free safety tube were used in the intervention group, whereas conventional ones were used in the control group. Then, effects of the two types of infusion sets were observed and compared. Results As for the operation time for infusion, it was (82.19 ± 1.80) seconds in the intervention group and (83.02 ± 1.83) seconds in the control group, with the difference statistically significant (P < 0.05). Besides, the exposure time of the needles after infusion in the intervention group was (3.36 ± 0.17) seconds while (18.85 ± 1.18) seconds in the control group; the difference between which was statistically significant (P < 0.05). In terms of the time for needle disposal, (18.60 ± 0.84) seconds was required in the intervention group, while for the control group, it took (18.85 ± 1.18) seconds, and the difference between two groups was of statistical significance as well (P < 0.05). Nevertheless, there was no statistically significant difference in the accidental slip rate of the needles as that turned out 0% in both groups (P > 0.05). It was worth noting that the block rate of the disposed needles in the intervention group was 100%. Conclusion The separation-free safety tube on the disposable infusion needle could instantly block the sharp needle after infusion, which reduces the needle exposure time and lowers the risk of needle stick injuries. In the meantime, the safety tube is convenient to use, and its application can shorten the time for infusion and needle disposal, consequently improving the working efficiency of nurses. As the new type safety tube has above advantages and would not raise the risk of needle slippage, it is worthy of clinical promotion.

Prevalence of Hepatitis C Virus Infection in a Surgical Population of Southeast China: A Large-Scale Multicenter Study.

Background Chronic HCV infection affects 80 million people globally and may progress to advanced liver disease. The present study aims to investigate the present epidemiology of HCV infection in a southeastern Chinese surgical patient cohort. Methods Blood samples obtained from 78,484 surgical patients from 18 different city and county hospitals were enrolled. The incidence of serum HCV antibody positivity, HCV RNA load, and HCV genotyping, as well as demographics and relevant clinical history, were investigated. Data were stratified using the multistage cluster random sampling method and further analyzed using the SPSS-20 package. Results HCV antibody positivity was detected in 0.15% of the population (95% confidence interval (CI): 0.12%–0.18%). Genotype 1b (55.74%) was the dominant type. The HCV infection peaked in the age groups of 16–20, 41–50, and 61–65 years, and it was higher in males than in females (0.19% vs. 0.13%, P < 0.05). The geographical distribution of infection rates differed: 0.19% (95% CI: 0.14%–0.24%), 0.18% (95% CI: 0.13%–0.23%), and 0.06% (95% CI: 0.03–0.09%) in plain areas, islands, and valley regions, respectively. Patients with transfusion history and urban residence were associated with high HCV RNA levels (adjusted odds ratio = 11.24 and 6.20, P < 0.05). Conclusion The prevalence of HCV infection in this cohort from southeast China was 0.17%, which is lower than the reported 0.43% infection rate in China in 2006. This result can be (partially) explained by the improvement of blood donor screening and the successful campaign for the use of disposable syringes and needles.

Human cremaster muscle and cremasteric reflex: A comprehensive review

ObjectiveHuman research on the cremaster muscle (CM), cremasteric reflex (CMR) and genitofemoral nerve (GFN) and reports on their clinical applications using electrophysiological and histological techniques are rare. We aimed to present a detailed review of the human CM and CMR based on our earlier publications and relevant literature. MethodsElectromyography (EMG) of the CM was recorded using disposable needle electrodes. CMR was obtained with tactile and/or electrical stimulation of the inner thigh. Transcranial magnetic stimulation (TMS) and magnetic stimulation of the upper lumbar roots were applied; GFN was stimulated using a surface electrode at the anterior superior iliac spine. ResultsCM striated fibers comprised multiple motor end plates. CM needle EMG results were similar to those of the limb muscles in chronic neurogenic disorders. TMS produced clear-cut evoked motor responses from CM. GFN motor conduction time to CM was absent or delayed in patients with inguinal hernia. EMG of CM was abnormal in 40% of patients with premature ejaculation. ConclusionCM is different from other skeletal muscles both morphologically and physiologically. Intersegmental sacrolumbar reflexes are useful for evaluating ejaculatory dysfunction. SignificanceCM is an important muscle for testis thermoregulation and sexual reflexes. Neurophysiological techniques are available for physiological and clinical studies.

SAT-384 RENAL BIOPSY AT OPD LEVEL WITHOUT ADMISSION

Renal biopsy is an essential procedure for diagnosis and prognosis of the glomerular diseases, however it needs a lot of skill and experience to do and usually requires admission for a couple of days, unless sometimes needs an embolization, transfusion, nephrectomy etc. We have an experience of more than 3,000 cases of renal biopsy without major complications such as bleeding, embolization, nephrectomy etc. however all patients were admitted for a couple of days. Recently we performed 928 cases of renal biopsies at the OPD level without complications since last 5 years. Before renal biopsy, we checked bleeding tendencies and blood thinning agents were hold for more than 1 week. Kidney biopsies were done at prone position under local lidocaine anesthetic at biopsy site to numb the entry site or IV ketamine for small children. Disposable kidney biopsy needle was inserted under the ultrasound guide(GE LogiQ E9) at the lower pole of the kidney between lower pole of the kidney and lower medulla while after taking a deep breath and hold at the exhaled state within 10 seconds. We checked renal hematoma, AV-fistula formation etc. by ultrasound 3 times every one hour until go home. Biopsy materials were sent to H.S.Lee’s pathology lab. All patients went home in 4 to 6 hours after procedure. As far as we know, our clinic is the world’s first time try doing kidney biopsy and pathology together although some kidney pathology reading centers are available. IF results were reported by on-line on the same day of kidney biopsy after 5 hours and LM and EM were reported by on-line within two days. All cases went home after 4 to 6 hours of procedure. Three patients took airplane after procedure without any problems. We performed 928 cases of renal biopsy at OPD level without major complications but slight local pain tenderness and all patients went home after 4 to 6 hours after procedure. Male to female ratio was 1.21. Age distribution was from 2 year old to 80 (mean 34.2). Biopsy results were as follows: IgA nephropathy 346 cases (37.3%), mesangial proliferative glomerulonephritis 153 cases (16.5%), FSGS 109 cases (11.7%), Nonspecific glomerulonephritis 84 cases (9.1%), HSP nephritis 36 cases (3.9%), podocyte disease 31 cases (3.3%), membranous nephropathy 22 cases (2.4%), minor glomerular change 20 cases (2.2%), Alport’s syndrome 14 cases (1.5%), MPGN 11 cases (1.2%), Lupus nephritis 9 cases (1.0%), advanced diabetic nephropathy, C1q nephropathy, C3 nephropathy, obesity related nephropathy were 35 cases respectively and others include amyloidosis, acute PSGN, chronic tubulointerstitial nephritis. OPD level percutaneous renal biopsy is no more a dangerous procedure if performed exactly at lower pole of the kidney and close follow up for 4 hours after procedure by ultrasound examination.

A Novel Intermediate Attachment to Reduce Contamination in Reusable Core Needle Biopsy Devices

Abstract One barrier to breast cancer diagnosis in low-resource settings is that devices for core needle biopsy (CNB) are either disposable and expensive, or reusable and susceptible to internal contamination. Through interviews with field workers and verification experiments, we identified that a common, commercially available, reusable CNB device allows contaminants to enter the driver chamber during firing, necessitating laborious cleaning of the entire device after every use. We introduce a novel CNB device attachment that eliminates this contamination mode and interfaces with existing commercial reusable drivers and low-cost disposable needles. This attachment repositions the driver–needle connection to the exterior of the driver, preventing retrograde flow of blood. Using an unmodified commercial CNB, we replicate chamber contamination by firing into a body fluid-mimicking glycerol solution. Prototypes were tested for their performance in eliminating this contamination. We tested the effectiveness of a cleaning procedure to reduce trace contamination by using a fluorescent dye and measuring the intensity of fluorescence after cleaning. The device's ability to reliably and consistently biopsy tissue with the novel attachment was evaluated using breast tissue models. In these tests, a reusable CNB with our attachment exhibited no measurable internal contamination, and maintained full biopsy functionality as measured by tissue sample weight and length. Minimizing internal device contamination would simplify the cleaning process for reusable biopsy devices. This would improve the accessibility of breast cancer biopsies in low- and middle-income countries (LMICs).

Effects of hospital-community-family trinity health education model on household disposal of insulin waste needles

Objective To conduct the integrated management of hospital, community and family for patients with insulin injection at home, in order to explore the influence of this trinity health education model on the knowledge of medical waste and the standard disposal of discarded needles. Methods The self-designed questionnaire was used to investigate the knowledge and disposal of medical waste in outpatients, and the causes were analyzed carefully after the problems were found. The hospital, community and family were timely communicated and fed back to the ward and community. After 1, 3 and 6 months of educational intervention, the disposal of insulin needles, the knowledge of medical waste and the recovery of sharp instrument boxes were observed. Results After 1, 3 and 6 months of health education, the final rate of insulin needles mixed into domestic waste was 51.8% (144/278), 15.1% (42/278) and 4.7% (13/278), respectively. Compared with the first result of 99.6% (277/278), the difference was statistically significant (χ2=173.046, 406.136, 502.346, P<0.01); The first survey found that the correct rate of responding to medical waste knowledge items was low. After health education for 1, 3 and 6 months, the correct rate of medical waste related knowledge items was significantly higher than that of the first survey, and the difference was statistically significant (OR=3.016-3 548.810; 95%CI 2.108-917.869, 4.315-19 777.062; χ2=25.180-524.895; P<0.01) ; After 1, 3 and 6 months of health education, the qualified rate of medical waste knowledge was 82.4% (229/278),75.9% (211/278) and 97.1% (270/278), respectively, which was significantly higher than the first result of 6.5% (18/278). The difference was statistically significant (χ2=324.328, 273.712, 453.832, P<0.01). The sharp box recovery of hepatitis B patients was relatively good. Conclusion Hospital-community-family Trinity health education model can improve the breadth and depth of education objects, not only can improve the knowledge of medical waste related to insulin injection patients at home, but also can improve the standardized disposal ability of insulin waste needles. With the passage of time, the effect of health education continues to be good. This integrated health education model is worth popularizing in clinic. Key words: Health education; Medical waste; Standard disposal

Bone Marrow Aspirate and Trephine Biopsy Procedure in a Teaching and Referral Hospital in Kenya

Introduction: Bone marrow aspiration and biopsies are carried out principally to permit cytological assessment of marrow. The procedure is also indicated for immunophenotypic, cytogenetic, molecular and other specialized investigations. The skill to perform bone marrow aspirate and biopsy is usually acquired by the medical personnel through apprenticeship during their training. The training includes performing the procedure, indications, contraindications, and associated hazards. Moi Teaching and Referral Hospital (MTRH) being a specialized Hospital in Western Kenya has several staff trained on performing the procedure. Objective: To assess the performance of bone marrow procedure by clinicians at a teaching and referral hospital. Materials and methods: A descriptive cross-sectional study was done involving 40 clinicians working in the hematology clinic and medical wards from June to December 2019. A structured questionnaire was used to collect the data and data analysis was done using frequency tables. Approval to carry out the study was sought from the institutional IRB. Results: Patients attended to were predominantly adults 33 (83%). The superior posterior iliac crest was the commonest site for the procedure and disposable needles were routinely used in 33 (83%) of the patients. Pain and excessive bleeding 18 (45%) were the commonest complications associated with the procedure. Conclusion: Most of the clinicians involved doing the procedure were residents/registrars. Most of the patients attended to were adults (83%) and majority of the clinicians performed the procedure on the posterior iliac site (96%) using disposable needles (83%). Local anesthesia was commonly used during the procedure (88%). The common complications associated with the bone marrow procedure were pain and excessive bleeding (45%).

Disposal of Used Pens and Needles from Diabetes Patients` Perspective

Introduction:Diabetes as lifelong chronic disease requires pharmacological treatment using plastic pens and needles. Proper disposal of used pens and needles have impact not just on health but environment as well. In 2020 there will be 3.2 million pens used and disposed in Bosnia and Herzegovina resulting in over 600 tons of this waste. Worldwide problem is related to proper disposal of used insulin pens and sharps.Aim:To investigate and evaluate what are the attitudes, knowledge and practices on insulin pens and needles disposal among diabetes patients in Bosnia and Herzegovina.Methods:The research was conducted in five cities in Bosnia and Herzegovina in period December 2019–January 2020 using questionnaire consisted of 28 questions distributed among patients with diabetes through their local patient associations.Results:Total 250 diabetes patients participated. 40.4% inject medicines for 2 times per day and 37.6% for three and more times a day. Patients have not been instructed on proper disposal of used pens or needles in 67.6% and 66% respectively. The most appropriate place to dispose used pens is pharmacies and 90% of respondents would participate in program of collecting used pens if one exists. 75.6% of respondents consider improper disposal of pens and needles as healthcare problem, 18.8% see this as ecological problem and for 4% of them this is not a problem at all.Conclusion:Current practice of disposing used insulin pens and sharps is improper. Patients are aware of health and environmental risk. There is a huge opportunity for pharmacists and other healthcare provides to provide better information and counseling diabetes patients on this topic.

A study on PEI among private dentists in Mashhad, Iran.

Aim:We aimed to identify the percutaneous exposure incident (PEI) by private dentists in Mashhad, Iran.Methods:Subjects included 199 dentists enrolled in this study. A questionnaire consisting of 11 questions was sent to the dentists for data collection. Information was collected on knowledge about dangers of PEI, a history of needlestick or sharps injuries over the past 12 months, types of devices causing the needlestick or sharps injuries, HBV vaccination, knowledge about PEI protective and therapeutic protocol, and reporting PEI to the specialist. The first ten questions were corrected and each sheet received a score ranging from 0 to 10.Result:95 women (47.7%) and 104 men (52.3%) participated in this study aged between 27–72 years old. The findings showed that a total of 132 dentists (66.3%) had experiences with PEI. 45 (22.6%) of them had experiences with PEI in the past year. Files and needles were found to be the most frequent tools causing PEI, each with 29.7% of frequency. 16.6%, 8.6, 5.7, and 9.7% were obtained for dental burs, band, and surgical baled, respectively as other tools responsible for injuries. Results of the question about causes of needlestick injuries showed that personal carelessness is the most frequent reason (53.8%) followed by inappropriate disposal of the needles (7.6%).Conclusion:The personal carelessness and inappropriate disposal of needles were reported as the most common reasons for PEI injuries. It is suggested to educational programs for dentists should focus on preventing the PEI.

Relationship between fasting blood glucose and body mass index among students of a medical college

Background: Obesity is one of the most important modifiable risk factors in the pathogenesis of lifestyle diseases like atherosclerosis, hypertension and type 2 diabetes mellitus. Overweight or obese adolescents are at an increased risk of developing diabetes and hypertension in future. A study was done to determine the relationship between body mass index and fasting blood glucose among students of a tertiary care teaching hospital.&#x0D; Materials and methods: A cross sectional analytical study was carried out among all medical students in a tertiary care teaching hospital in Kerala who consented to participate after obtaining approval from Institutional Research and Ethics Committee. The study tools used were standardized weighing machine, stadiometer, Accu-check glucometer and strips, disposable needles and pre-designed questionnaire.&#x0D; Results: Among the 254 study participants, 67% were females. The prevalence of impaired fasting glucose is 18.11% in the study population. No significant correlation was found between fasting blood glucose and body mass index. There was an increase in median FBS as the BMI increases, though not statistically significant (p=0.08). In the linear regression model, the statistic R2 explains that 7.9% of the variability in fasting blood glucose is explained by body mass index.&#x0D; Conclusion: The prevalence of prediabetes among the study participants was very high and it was higher among those who were overweight. The need of the hour is to identify the high-risk group in the community right from the young age and initiate trials or intervention studies to prevent or delay the onset of diabetes.

107 Follicular wave synchronization and FSH stimulation prior to ovum pickup for invitro embryo production

Invitro embryo production (IVP) has become a reliable alternative for genetic improvement in beef and dairy herds. Maximizing embryo yield and pregnancy per donor are key factors. The aim of this study was to compare ovum pickup (OPU) yields, developmental competence of cumulus-oocyte complexes (COCs), and pregnancy rates from Angus donors in a commercial IVP setting. Donors (&amp;gt;4-year-old pluriparous open dry cows) were handled under the same feeding and environmental conditions. Treatment groups were organised as follows: Group 1: no synchronization (SYNCH; n=5); Group 2: SYNCH with no superstimulation (SOV; n=5); Group 3: SYNCH + SOV (n=5) and OPU 36h after last FSH injection; Group 4: SYNCH + SOV (n=5) and OPU 48h after last FSH injection; and Group 5: SYNCH + SOV (n=5) and OPU 72h after last FSH injection. Follicular waves in groups 2, 3, 4, and 5 were synched by gonadotrophin-releasing hormone (GnRH), prostaglandin F2α (PGF), and controlled internal drug release (CIDR). No pre-synch was used. Injections of FSH (pFSH=180mg, Folltropin) were performed IM twice a day, for three days. A minimum of three replicates were performed for each donor. A Mindray DP30V equipped with a micro-convex transducer 5.0-8.5MHz probe, disposable 20-gauge needle, and a flow rate of 15mL min−1 were used for OPU. All visible follicles (Foll) were punctured and retrieved into a 50-mL 36°C warmed tube with media (phosphate-buffered saline, bovine serum albumin (BSA), and heparin). Viable oocytes were classified according to IETS guidelines. The COCs were matured in 100µL of M199 medium supplemented with ALA-glutamine (0.1mM), Na pyruvate (0.2mM), gentamicin (5µgmL−1), epidermal growth factor (50ngmL−1), oFSH (50ngmL−1), bLH (3μgmL−1), cysteamine (0.1mM), and 10% fetal bovine serum (FBS) for 22 to 24h. Fertilization (Day 0) was carried out using highly fertile sires selected by discontinuous 40%/80% layers (PureSperm) and diluted to a final concentration of 1×106 spermmL−1. Matured oocytes were fertilized in 50µL of modified synthetic oviductal fluid (SOF) media supplemented with fructose (90µgmL−1), penicillamine (3µgmL−1), hypotaurine (11µgmL−1), and heparin (10µgmL−1). After 18h, presumptive zygotes were denuded and cultured under low oxygen tension in 50-µL drops of SOF-BSA for 7 days. On Day 3.5, 2% of FBS was added. On Day 7, fresh transferable (grade 1 and 2, IETS standards) blastocysts were implanted into synchronized recipient cows. Around Day 30, ultrasound diagnosis was performed to determined pregnancy rate (PR). We used ANOVA for comparisons of mean values and X2 test for proportions, α=0.05 (Table 1). In conclusion, synchronization, FSH stimulation, and 48-h coasting before OPU in Angus cows increased the number of collected viable oocytes and embryo development rates. More transferrable embryos and higher rates of PR per OPU were obtained using 36- and 48-h coasting, respectively. Table 1.Follicles (Foll), viable oocytes, cleavage, blastocysts, and pregnancy rates (PR) in Angus cows after ovum pickup (OPU) or invitro embryo production (IVP) SYNCH1 FSH Coasting Foll/OPU Oocytes/OPU Viable oocytes Cleavage,% Embryos,% Embryos/OPU PR,% PR/OPU NO NO NO 10.8a 9.0a 8.9a 63a 25a 2.3a 45a 1.0a YES NO NO 10.1a 8.4a 8.1a 73b 27b 2.2a 51b 1.1a YES YES 36H 16.5b 13.8b 13.6b 70c 29b 4.0b 46a 1.8b YES YES 48H 16.1b 13.4b 13.3b 69c 28b 3.8c 52b 2.0b YES YES 72H 15.6b 13.0b 12.6b 64a 22c 2.8d 55b 1.6c a-dValues with different superscripts in the same column differ (P&amp;lt;0.05). 1SYNCH=synchronized.

Influence of electroacupuncture stimulation on skin temperature, skin blood flow, muscle blood volume and pupil diameter.

To examine the effect of electroacupuncture (EA) stimulation on multiple physiological indices and to evaluate both local and systemic physiological responses induced by the stimulation. 15 healthy male college students participated in an experimental crossover study. They received two kinds of interventions: one with EA stimulation and one without EA stimulation on different days. Two disposable acupuncture needles were inserted at two traditional acupuncture points (ST36 and ST38), located along the anterior tibialis muscle. EA stimulation was administered for 10 min. Skin temperature (ST), skin blood flow (SBF) and muscle blood volume (MBV) were recorded near the stimulation sites, while the pupil diameter (PD) was measured before, during and after the interventions. ST, SBF and MBV increased significantly following EA stimulation. PD of the right and left eyes decreased significantly following EA stimulation. There was a significant difference in ST responses between the groups (P=0.001). For SBF, MBV and PD, no significant differences were demonstrated between the groups. Our study showed that 10 min of EA stimulation increased ST, SBF and MBV, and decreased PD, compared to baseline, while no significant change was observed in the control group. This suggests that EA stimulation alters local blood flow and ST, and these responses are likely mediated via segmental spinal reflexes, supraspinal reflexes involving parasympathetic activation, and other mechanisms.