Scalp Vein Research Articles

Intravenous catheter flanges as an external nasal stent: a novel technique.

External nasal splints are commonly used for immobilization following nasal fracture reduction or rhinoplasty procedures. The literature documents the use of various materials like thermoplastic materials, aluminum, Orthoplast, fiberglass, plaster of Paris, and polyvinyl siloxane. These materials are bulky, time-consuming, expensive, and cumbersome to use, and have been associated with complications including contact dermatitis and epidermolysis. Furthermore, they cannot be retained if the situation warrants prolonged stabilization and immobilization. We introduce a new technique using readily available scalp vein catheter flanges as an external nasal stent. The technique is easy to master, inexpensive, and limits edema and ecchymosis, while stabilizing the reconstructed nasal skeleton in position during the healing period.

Peripherally Inserted Central Venous Catheter in newborns admitted to the Intensive Care Unit: adverse events

Objective: To analyze factors associated with the occurrence of Adverse Events (AE) related to the Peripherally Inserted Central Catheter (PICC) in Newborns (NB). Method: cross-sectional, descriptive and analytical study, carried out in the Neonatal Intensive Care Unit of a reference hospital, from January to March 2019. The sample consisted of 225 PICCs. The occurrence of AEs was considered as an outcome, and the hierarchical variables were considered explanatory: distal (sociodemographic) and proximal (NB clinics). Wald's chi-square was used for the initial selection of variables (p<0.20) and Poisson regression, with robust variance, for model adjustment (p<0.05). The t test was used to compare the mean occurrence of AE with the insertion of the PICC, at the 5% level. In the final model, the insertion site, scalp vein (p<0.001), and reason for removal (p<0.001) of the PICC were significant for the occurrence of AE. Comparing the averages between occurrences and non-occurrences of AEs, it was verified that only the weight of the NBs was significant (p=0.002), due to prematurity. Conclusion: AEs are related to inadequate management of PICC maintenance and choice of vein.

Application of checklist-based nursing in management of pediatric intravenous infusion via scalp vein set

Application of checklist-based nursing in management of pediatric intravenous infusion via scalp vein set

Scalp vein set for venous cannulation in transfusion dependent thalassaemia major – A safe and effective long-term measure

Scalp vein set for venous cannulation in transfusion dependent thalassaemia major – A safe and effective long-term measure

Transcaruncular medial orbitotomy: A globe sparing intervention in management of COVID associated mucormycosis [CAM

To describe a novel method of transcaruncular medial orbitotomy, local debridement and amphotericin B irrigation into orbit for COVID-19-associated rhino-orbital mucormycosis. Also to evaluate its its outcome in controlling the disease, increasing the survival rate and as a globe-sparing intervention in them. A total of ten COVID-19-associated mucormycosis patients with clinical and radiological evidence of orbital involvement with necrotic tissue localized in medial orbit were considered for our study. A transcaruncular modified medial orbitotomy with medial and inferomedial orbit debridement was done along with placement of scalp vein catheter by a single surgeon. Postoperatively 3.5 mg/ml liposomal amphotericin B irrigation through the catheter was done for 5 sittings. Correction of underlying systemic conditions and intravenous antifungals were given. Clinical response to the procedure was noted on postoperative week 1, week 4, and 3rd month (week 12). The mean age group was noted to be 49.9 years with a male: female ratio of 2.3:1. All patients were diabetics with 5 being newly detected diabetes after COVID infection. All the ten patients showed significant clinical improvement at the first follow-up (week 1). Five patients at 1st month showed clinical and radiological improvement, while one patient had worsening of orbital disease for which exenteration was done. Three patients succumbed to the disease due to altered cardiopulmonary status and 1 patient was lost to follow-up. All 6 survived patients were stable till the last follow-up. Hence, mortality rate accounted to 30% and globe survival of 40% in the current study. Transcaruncular approach to orbit for adequate debridement combined with amphotericin irrigation is a novel technique that can be considered for compartmental involvement of orbit in mucormycosis. Debridement removes the necrotic tissue, while local amphotericin irrigation directly reaches the target tissues that effectively halts the disease progression and hence can be considered an effective globe-sparing intervention without affecting the disease outcome.

Regional Intravenous Anaesthesia (Bier's block) in Black-headed Vulture (Coragyps atratus) Submitted to Digit Amputation

Background: The Coragyps atratus flies long distances in search of food and has a marked behaviour of food competition. Since they are frequently found in areas of recent human occupation, they are subject to trauma, which may require surgical interventions. Locoregional blocks are used as part of a balanced-anaesthesia protocol and are currently being evaluated in birds, with brachial plexus block being the main technique described in the literature. However, to our knowledge, this is the first description of intravenous regional anaesthesia (Bier's block) in a vulture. Thus, we aim to report the use of Bier's block with 1% lidocaine, in a black-headed vulture submitted to digit amputation. Case: A black-headed vulture (Coragyps atratus), weighing 2 kg, was rescued and referred to the Veterinary Hospital due to its inability to fly. Physical examination revealed a swollen digit in the right pelvic limb. Radiographic examination confirmed the intermediate phalanx fracture of the 4th digit of the right pelvic limb with signs suggestive of advanced osteomyelitis. The animal was referred to surgery for amputation of the affected digit. Before surgery, water and food were withdrawn for 12 h. Pre-anaesthetic medication consisted of 1 mg/kg midazolam and 0.5 mg/kg morphine intramuscularly (IM). Anaesthetic induction was performed through face mask with isoflurane, followed by orotracheal intubation with a 3 mm-endotracheal tube. Anaesthesia was maintained with isoflurane through a non-rebreathing circuit in 100% oxygen. Using a multiparametric monitor, heart rate (HR), respiratory rate (RR), end-tidal CO2 (EtCO2), oxyhemoglobin saturation (SpO2), electrocardiography (ECG), systolic blood pressure (SBP) and core temperature (CT) were evaluated. Antisepsis of the right pelvic limb was performed and an elastic band was applied around the distal region of the affected tibia to serve as a tourniquet. A scalp vein set was used to access the lateral saphenous vein in the region distal to the tourniquet, and 5 mg/kg lidocaine 1% was injected intravenously. The patient remained stable during the procedure, with no need for analgesic rescue. The tourniquet was gradually released 40 min past its application, being completely removed after 45 min of surgery. The anaesthetic supply was interrupted, with extubation after 4 min; the patient had satisfactory anaesthetic recovery. Discussion: The present report describes the success in using the technique of intravenous regional anaesthesia with 1% lidocaine for digit amputation performed on a specimen of black-headed vulture. The pre-anaesthetic medication provided analgesia, satisfactory sedation for venoclysis, and anaesthetic induction without complications. Anaesthetic induction and maintenance in birds are preferably performed with inhaled anaesthetics, thus the choice of mask induction. Despite the reduction in RR soon after induction, the patient remained on spontaneous ventilation. Bier's block using 5 mg/kg lidocaine showed to be an easy and safe technique in vultures, but doses up to 6 mg/kg lidocaine are not associated with adverse effects in birds. The intravenous regional anaesthesia technique described in this manuscript promoted adequate analgesia for the digit amputation procedure in black-headed vultures and allowed hemodynamic stability without significant anaesthetic complications. Thus, the present report points to the potential use of this locoregional block in other birds. Keywords: locorregional block, lidocaine, anaesthesia. Título: Anestesia regional intravenosa (bloqueio bier) em urubu-de-cabeça-preta (Coragyps atratus) submetido à amputação de dígito. Descritores: bloqueio locorregional, lidocaína, anestesia.

To study the incidences of needle stick injury among critical care nurses working in rural tertiary care hospital

Needle-stick injuries (NSIs) are a hazard for nursing staff and public health. Nursing workers are at high risk for occupational exposure to blood-borne pathogens via sharp injuries of the needle-stick. Needle-stick injuries (NSIs) are described as penetrating wounds caused by a device that is contaminated with another person’s body fluids. Needle-stick injuries are injuries acquired by needles like -scalp vein needles, hypodermic needles, blood sample collection needles, intracath stylets, lumbar puncture needles used to connect parts of IV delivery systems. Needle-stick injuries (NSIs) form a medium for the transmission of bloodborne infections. Strict use of personnel protective equipment while working in the hospital should be made compulsory. To study incidences of needle stick injury among nurses working in Rural tertiary care Unit, Loni. Ethical approval for this study was obtained from the Institutional Ethical Committee. Seventy-six nurses, who fulfilled inclusion criteria were included and data was obtained through survey. This study involves 76 nursing staff. Of them all, 27(35.5%) nursing staff experienced NSIsThe administration of medication was common action that caused most of needle-stick injuries mentioned by 14 (18.4%) nursing staff. IV cannula was the device that caused many needle-stick injuries reported by 17 (21.1%) nursing staff. Thenursing professionals are the main key players in both elective and emergency situations. There is a quite higher incidence of needle stick injury among critical care nurses. This might be due to handling of emergency cases and attempting to secure the intravenous line or to deliver the medications. Creating awareness and training appropriately is mandatory for critical care nurses.

Ovarian suspension loop: an assembled device for ovarian lifting and immobilization during laparoscopic cystectomy

The mobility and smooth surface of the ovaries can pose a challenge during laparoscopic cystectomy, with difficulties in manipulation and visualization. We describe assembling a device for ovarian lifting and immobilization that utilizes a nylon suture and a “scalp vein set” to create a loop. The loop can be passed into the pelvic cavity and then slid beneath the ovary, elevating and stabilizing it during surgery without the need to puncture the ovarian tissue or grabbing and damage the utero-ovarian infundibulopelvic ligaments. This device is inexpensive, and its components are easily accessible. This assembled device prevents repetitive falling of the ovary into the pelvic cavity, facilitates laparoscopic ovarian cystectomy, and saves operative time.

Influencing factors of neonatal peripherally inserted central venous catheter (PICC)-related phlebitis: a systematic review, meta-analysis and network meta-analysis

A peripherally inserted central venous catheter (PICC) plays an important role in the security of newborns, especially very low birth weight infants and extremely very low birth weight infants. However, PICC-related phlebitis can seriously affect the normal use of catheters and even cause unplanned removals of catheters. In this review, we systematically reviewed and explored the influencing factors of neonatal PICC-related phlebitis. The PubMed, Embase, CENTRAL, CINAHL, CBM, Wanfang and CNKI databases were searched to collect relevant studies on influencing factors of neonatal PICC-related phlebitis. Review Manager software version 5.3 (RevMan; the Cochrane Collaboration 2012, The Nordic Cochrane Center, Copenhagen, Denmark) and GeMTC software version 0.14.3 (Gert van Valkenhoef, Groningen, The Netherlands ) were used for the meta-analysis and network meta-analysis. A total of 32 studies were included, including 14 randomized controlled trials (RCTs), 2 case-control studies, and 16 cohort studies, involving a total of 8278 neonates. The meta-analysis results showed that the influencing factors of neonatal PICC-related phlebitis were catheter malposition (OR (Odds Ratio) = 5.53, 95% CI (Confidence Interval) (1.22, 25.15)), catheter occlusion (OR = 7.18, 95% CI (3.54, 14.56)), gestational age (OR = 2.51, 95% CI (1.35, 4.66)), using a dexamethasone solution to infiltrate the catheter (OR = 0.26, 95% CI (0.17, 0.41)), and innovative nursing interventions (OR = 0.17, 95% CI (0.07, 0.42)). The network meta-analysis results showed that, compared with lower limb veins, the use of scalp veins (OR = 3.57, 95% CI (1.39, 10.18)) and upper limb veins (OR = 1.89, 95% CI (1.08, 3.37)) had a statistically significant difference in the incidence of phlebitis, while there was no statistically significant difference in the incidence of phlebitis between scalp veins and upper limb veins (OR = 0.53, 95% CI (0.20, 1.26)). PICC puncture of the lower limb veins was most likely to lead to phlebitis, followed by upper limb vein puncture, followed by scalp vein puncture. Catheter malposition, catheter occlusion and being small for gestational age were risk factors for PICC-related phlebitis, while dexamethasone solution infiltration of catheters and innovative nursing interventions were protective factors. Venipuncture of the lower limbs is the most likely location to cause PICC-related phlebitis.

Emergency Dynamic Central Venous Cannulation in Preterm Neonates- A Case Series

Neonatal venous cannulation is one of the challenges faced by Anaesthesiologists in routine practice. Neonatal cannulation is extremely difficult and time consuming and it has become an inevitable procedure in neonatal intensive care unit, because of the small vessel diameter and sometimes it is impossible to differentiate between artery and vein. Routinely umbilical vein, scalp vein and peripherally inserted central catheters cannulation are done during initial neonatal period. Central vein cannulation is needed in sick neonates for nutrition, antibiotics, venous sampling, and inotropic support and enables haemodynamics monitoring. Even with the point of care ultrasound, neonatal cannulation is technically challenging in well-experienced hands. Cannulation in a preterm neonate is highly demanding and nightmarish for all intensivists. The present case series aimed to show the successful placement of ultrasound guided supraclavicular subclavian cannulation in a very low birth preterm (less than 1500 gm) in three septic neonates. All three cannulations were done bedside in Neonatal Intensive Care Unit (NICU) with close monitoring of heart rate, pulse oximeter and electrocardiogram. Venipuncture was done under ultrasound guidance. After identifying the anatomic landmarks, subclavian cannulation was done using Seldinger technique. Subclavian cannulation was preferred because of easy accessibility, comfortable fixation and low infection rate

Multislice Spiral CT Imaging Localization and Nursing Care of Catheter Fracture of Scalp Vein Indwelling Needle.

In order to improve the success rate of scalp venous indwelling needles in infants, image positioning and nursing of scalp venous indwelling needle catheters broken with multislice spiral CT were discussed. In this method, three-dimensional reconstruction of multislice spiral CT was used to diagnose and locate the broken catheter according to the anatomical morphology of the indwelling needle, and the treatment and related nursing were carried out. The results showed that the body temperature was 38.7°C, the pulse was 106 times/min, the respiration was 30 times/min, and the body weight was 15 kg. Laboratory examination: the percentage of leukocytes was 10.00 × 10/L, the percentage of lymphocytes was 24.8%, and the percentage of neutrophils was 63.7%. Head CT examination: no obvious abnormalities were observed. 31.9% of children diagnosed with hyperfebrile convulsions had good image quality after treatment with MSCT for catheter fracture of scalp vein indwelling needle; good quality was 52.8%, and barely diagnosed was 12.1%. Multiple post-treatment functions of MSCT have important value in the application of three-dimensional localization of foreign bodies in soft tissues in children and play a more important role in the diagnosis and preoperative evaluation of foreign bodies. Appropriate nursing care for children in the image location examination has very important guiding significance.

Assessment of post-operative analgesia in modified radical mastectomy patients using surgical wound irrigation with 0.25% bupivacaine

Modified Radical Mastectomy is the widely followed treatment for operable breast cancers. Among the methods used to alleviate pain, irrigation of wound with 0.25% Bupivacaine is one of the under-utilized methods with good efficiency compared to other drugs.To evaluate the role of local irrigation of 0.25% bupivacaine in alleviating the post-operative pain. This observational study was conducted among 60 female patients who underwent Modified Radical Mastectomy in a tertiary care teaching hospital between January 2017 and July 2018. Thirty (30) patients were randomly allotted to control group, where the routine post-operative pain management was followed. Another 30 were randomly allotted to study group where, before closure of the wound, a 20G scalp vein set was used along the length of the incision with multiple punctures in it for continuous irrigation with 0.25% Bupivacaine. Post operatively Visual analogue scale was used to measure the pain sensation at every six hours for 24 hours. The adverse effects like pain, hematoma, wound dehiscence, infection was noted on all the post-operative days.Both the groups were similar with respect to basic parameters measured. There was a significant reduction in need for rescue analgesia in the study group. There was a significant difference in mean VAS score between both groups from 6 hour of surgery. Post-operative nausea and vomiting was significantly less in the study group. Irrigation of wound with 0.25% Bupivacaine is found to reduce the pain sensation with minimal side effects without systemic compromise.

The parietal foramen anatomy: studies using dry skulls, cadaver and in vivo MRI.

The aim of this study was to describe the anatomical features encountered in the parietal foramen in a series of 178 human bones and 123 head MRI examinations. A cadaveric specimen was also dissected to demonstrate the trajectory of a superficial scalp vein through the parietal foramen as far as the dura mater. A literature review was performed regarding prevalence of parietal foramen in different populations. Totally, 178 paired adult bones were used to investigate the presence, shape and number of the parietal foramina. In addition, 123 brain MRI examinations were also studied. The parietal foramina were encountered in 75/89 (84.3%) skulls [32/38 (84.2%) in women vs. 43/51 (84.3%) in men, p > 0.05]. The parietal foramen was present bilaterally in 44.73% of females and 54.9% of males. Regarding unilateralityof the parietal foramen, a right or left laterality was observedin female 21% right versus 18% left; and 16% versus 14% (left) in males (p > 0.05). The accessory parietal foramen was present in the right parietal in 2.6% and in 7.9% on the left side of the females, while 5.9% and 3.9% of the males on the right or left sides, respectively. The parietal foramina located in the proximity of the sagittal suture (male 7.1 ± 2.5mm vs. female, 7.4 ± 2.7mm). There was a positive correlation between the right and left parietal foramina regarding the distance from the median line. The distance from a foramen to the contralateral one was 16 ± 4mm in men and 18 ± 5mm in women, respectively (p > 0.05). No major differences were encountered between sexes regarding the anatomical features of parietal foramen.

Successful use of topical nitroglycerine and warm compress for peripheral ischemia following arterial blood sampling in a neonate

Although arterial catheter insertion is undertaken easily and safely, some serious complications like vasospasm, obstruction of the artery by thrombus or emboli have been reported. In the present study, a hospitalized case was reported with peripheral ischemia secondary to the brachial artery catheterization that successfully was treated with topical nitroglycerin 2% and warm compress. An early term neonate was born by the cesarean section with the first minute Apgar score 9. Immediately after birth, the subject was transferred to the NICU because of respiratory distress syndrome and subcostal retractions. Determining arterial blood gas, arterial blood sampling was ordered. Simultaneously with inserting a scalp vein in the right cubital fossa of the upper extremity, 4 fingers discolored to pale and white. Immediately scalp vein needle was removed and topical nitroglycerin 2% ointment was used while a warm compress was applied to the contralateral upper extremity. Gradual improvement in color and blood perfusion was observed in the fingers. One hour later, the white discoloration completely disappeared. Nitroglycerine 2% and warm compress to the contralateral extremity as safe and convenient measures could improve blood flow to peripheral ischemic tissues. However, in some cases more invasive pharmacological managements may be needed.

A clinical rule for the difficulty prediction on scalp intravenous access in infants (SIAI) from emergency room

Infant intravenous access poses a significant challenge to the operator. Scalp vein is the ideal location for emergency medical staff to perform intravenous access for administration of fluids or medications. To tackle this challenge, we developed a clinical rule for the difficulty prediction on scalp intravenous access in infants (SIAI) conducting a prospective cohort study in a pediatric emergency room. A total of 658 infant patients who underwent SVI from January 2017 to September 2018 were recruited in this study. The failure rate of SIAI on the first attempt was 20.2%. Five variables, including dehydration condition, obesity, vein invisibility, vein impalpability and hyperactive status of infant, were independently and statistically associated with failure rate of SIAI. Furthermore, we indicated that any one alone of the above five variables did not significantly lead to greater than 50% failure rate of indwelling needle SIAI (p > 0.05). However, summary effects of more than one of these five variables were statistically significant associated with greater than 50% failure rate of SIAI (p < 0.05). When employing the five-variable model, validation cohort subjects displayed dehydration, obesity, vein invisibility, vein impalpability and hyperactive status had a 67.5% likelihood of failed first attempt on SIAI (C = 0.675; 95% CI: 0.622–0.727; p < 0.001). For the first time, we developed the difficult model for SIAI. We found that dehydration, obesity, vein invisibility, vein impalpability and hyperactive status of the infant patients are the independent and significant predictors associated with SIAI failure. Our predicted model indicates that infant patients with combination of more than one of the five variables contribute to greater than 50% failure rate of indwelling needle in SIAI.

Is Paget Disease of Bone more Common in South India? Clinical Characteristics, Therapeutic Outcome and follow-up of 66 Patients from Tamil Nadu.

Introduction:Paget disease of bone (PDB) is a disorder of altered bone remodeling mainly characterized by increased osteoclastic activity. While the exact Indian prevalence remains unknown, a clustering of published cases suggests South Indian predominance.Objective:To study the clinico-biochemical profile and therapeutic response of patients with PDB and briefly review the epidemiology of PDB from an Indian perspective.Materials and Methods:Retrospective data was collected from the charts of patients who have been seen in endocrine out-patient clinics in Tamil Nadu over a 12-year period. Published literature on PDB from India was reviewed.Results:A total of 66 patients (71% males) predominantly from Tamil Nadu were studied. The mean age at presentation was 67 ± 8 years. Polyostotic involvement was seen in 89% and familial occurrence of PDB in 5 patients. Symptoms at presentation mainly included bone pain (51%) and skeletal deformities (18%). Scalp vein sign (21%) and sensorineural hearing loss (64%) were also noted. Incidental PDB detection by raised serum alkaline phosphatase (SAP) levels was observed in 17% and by abnormal fluorodeoxyglucose-positron emission tomography (FDG-PET) scan in 6% of cases. Mean SAP at presentation was 606 ± 438 IU/L (Normal, 76–140). Major skeletal site involvement includes pelvis (62.1%) and spine (34.8%). Mean (range) follow-up of the cohort was 3.4 yrs (1–12 yrs). In all, 64 subjects received zoledronate and two received alendronate, and mean (SD) SAP at 1-year was 73 ± 42 IU/L. All but two showed remission at the end of 1 year. Two had pathological fractures and two had sarcomas. A review of epidemiology of PDB in Indian literature clearly showed a South Indian predilection for unclear reasons.Conclusion:In our cohort of PDB, male gender, polyostotic involvement, and hearing impairment were noted in more than two-thirds of patients and single-dose intravenous zoledronate was effective in normalizing SAP in almost all patients. PDB is intriguingly more common in South India and this needs more exploration.

Tourniquet and adrenaline use in hypospadias surgery: a survey on the current practice in Turkey.

Aim of the study is to determine the hemostatic techniques among pediatric urologists in Turkey. Questionnaire forms were sent to 459 pediatric urologist by e-mail. Ninety eight of 459 participants answered the questionnaire forms. Eighty-one (84.4%) of the participants were using tourniquet. The participants who didn't use tourniquet stated their justifications as follows: lack of need (n=10: 66.7%), development of edema, ischemia, delay of wound-graft healing and fistula risk (n=5: 33.3%). The indications of tourniquet use were stated as follows: penile (91.4%: n=74), distal (72.8%: n=59), penoscrotal (55.6%: n=45) hypospadias; fistula repair (33.3%: n=27), cripple hypospadias (33.3%: n=27), repair with flaps (30.9%: n=25), repair with grafts (27.2%: n=22), and isolated penile curvature (21%: n=17). Most commonly used tourniquet material (49.9%) was latex glove. Erection test was applied by 43.8% of participants. Scalp vein set was the most commonly (54.8%) used injector during erection test. Only 9.4% of participants were using adrenaline. Adrenaline dosages used at 1/100.000 dilution by 55.6%, lidocaine with 1/100.000 adrenaline by 44.4% of participants. Beside a few experimental ones there is a paucity of studies that can serve as a guideline for using these techniques in the literature. There is a necessity of realizing prospective, randomized studies with long-term follow up to evidence that postoperative complications could develop secondary to hemostatic techniques and also to facilitate safe use of these techniques.

Comparison between the effects of propofol and midazolam on pentylenetetrazole kindled convulsions in rats

Propofol, a short acting intravenous anesthetic which is wildly used for induction and maintenance of anesthesia. In addition, propofol has been successfully used in the management of status epileptics. However, sporadic reports of the occurrence of seizures or seizure like phenomena in epileptic and non‐epileptic patients continue to appear. The purpose of the present study is to examine the effects of intravenous (IV) administration of various doses of propofol and midazolam on pentylentetrazole (PTZ) kindled convulsions in rat.Experiments were conducted in adult females Sprague–Dawley rats (230–250 g). PTZ kindling was induced by intraperitoneal (IP) injection of a subconvulsivant dose of PTZ (35 mg/kg) every alternate day. After each injection of PTZ rats were placed in plexy glass cages and were monitored for 30 minutes for the occurrence of behavioral seizures. Severity of behavioral seizures and seizure score was rated according to Racine scale (Racin, 1972). An animal was considered fully‐kindled when it has had stage 4–5 seizure score on two consecutive trials. To examine the effects of propofol on PTZ kindled convulsions, fully kindled rats (8–10 animals per group) were injected with various doses of propofol (2.5, 5, 10 mg/Kg) prior to PTZ challenge. The drug was administered IV as a single dose through the dorsal tail vein via a 25G butterfly scalp vein cannula. Control animals received an equal volume of saline. Few minutes following drugs or saline injection, rats were challenged with a subconvulsant dose of PTZ (35 mg/Kg) and seizure score for individual animals was recorded. To compare the effects of midazolam on PTZ kindled seizures with these of propofol, the same animal groups were administered various doses of midazolam (2.5, 5, 10 mg/Kg). A period of a two weeks washout was allowed prior to midazolam treatment.The result of our study shows that both anesthetic agents suppressed PTZ kindled seizures in a dose dependent manner indicating that both agents protects against PTZ kindled seizures. However, the effects of midazolam were more profound. Dose response analysis of percent inhibition of kindled seizures shows that the ED50 for midazolam was 1.85 mg/Kg with 95 % CI of (1.71–2.05), whereas the estimated ED50 of propofol was 5.36 mg/kg with 95 % CI of (4.85–5.96).The data of the present study shows that propofol is an effective anticonvulsant against PTZ kindled seizures and provides further support of the anticonvulsant properties reported in different experimental seizures models.Support or Funding InformationThe research was supported by a grant from Arabian Gulf University.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Nosocomial Infections from Intravenous Catheter

The subjects of the study consisted of 164 sick newborn infants (97 boys and 67 girls) who had no signs or symptoms of infections. The intravenous fluid drip (at scalp vein or saphenous vein) was put on soon after taking blood culture. Removal of venous catheters was indicated when the patients condition. No longer needed their use or there was sign of local infection. This study showed that the lower the birth weight or the gestational age, the higher the incidence of infection. The most prominent nosocomial infection in this study was phlebitis (16.5%) followed by infiltration (14.6%), and bacteremia (7 ,9%). The predominant microorganism was E. coli (59.7%). The overall incidence of nosocomial infection was 44.5% and the mortality was 24.7%.

Frazier Metallic Suction Tube: An Adjunct in Irrigation of Deep Fascial Spaces.

Once incision and drainage of fascial space abscess is performed, irrigation of deep spaces with saline and antibiotic solution should be done daily for effective elimination or reduction of infection. Various advocated aids for irrigation into deeper areas are: small pediatric nasogastric feeding tubes, French catheter, polyethylene irrigation tubes and scalp vein infusion set. All these aids have major inherent disadvantages like, they tend to kink inside the deep spaces limiting the reach of irrigating solution into deeper spaces, are not readily available in dental departments and have to be discarded after every use. Overcoming these disadvantages, a simple yet an effective method is proposed here-use of a Frazier suction tube.