Search results for “Injection

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24 articles

Iatrogenic Extra-Capsular Extension of Knee Septic Arthritis Via Intra-Articular Joint Injection

May 2025 DOI 10.14302/issn.2694-2283.jsem-25-5529
Al-saeed NawafCorresponding author

Background Septic arthritis is a potentially limb or life-threatening joint infection that requires prompt recognition and intervention to reduce morbidity and mortality. While intra-articular joint injections are commonly performed for osteoarthritis and other arthropathies, they carry a rare but significant risk of iatrogenic infection, particularly when performed in the presence of unrecognized joint or periarticular infection. Case Presentation We report a case of a 52-year-old female with a history of traumatic brain injury and chronic right knee pain who developed severe knee swelling, pain, and systemic symptoms following an intra-articular corticosteroid injection performed without ultrasound evaluation/guidance. Post-procedure, she presented with fever, elevated inflammatory markers, and purulent knee effusion. Operative washout revealed a purulent tract extending from the knee joint capsule to the lateral thigh. Cultures from joint aspiration and intraoperative samples grew Streptococcus dysgalactiae. Blood cultures were negative. The patient reported frequent cat scratches to the affected knee and described an unusual sensation of the injection needle tracking laterally during the joint injection. She was treated with surgical drainage and a four-week course of amoxicillin, with full clinical recovery. Discussion This case highlights an unusual presentation of septic arthritis with extra-capsular extension likely due to iatrogenic needle tracking during joint injection. The causative organism, S. dysgalactiae, is an uncommon pathogen in septic arthritis, and the presumed source was contiguous spread from untreated cellulitis, possibly related to cat scratches/bites. The absence of predisposing comorbidities and negative blood cultures further support a local rather than hematogenous source. The case emphasizes the importance of thorough clinical evaluation and consideration of infection prior to joint injections, as well as the potential benefits of ultrasound guidance to minimize procedural complications. Conclusion Careful history, physical examination, and appropriate imaging are essential prior to joint interventions to avoid iatrogenic complications. This case illustrates the rare but serious risk of extra-capsular extension of septic arthritis following intra-articular injection and emphasizes the need for vigilance in identifying underlying infection before proceeding with invasive procedures.

The Useful Conclusion in our Experience Regarding the Sacral Injection

Jan 2024 DOI 10.14302/issn.2694-1201.jsn-23-4829
Sayed Issa AbdulhamidCorresponding author

Caudal injection is a type of epidural injection that is administered to the lower back to reduce pain and inflammation. The injection contains a steroid medication that is injected into the lower part of the epidural space, which surrounds the nerve roots in the lower back. The procedure is usually performed on an outpatient basis, and most patients experience relief from back pain within a few days. The sacral injection is another name for a caudal epidural injection. It is a type of spinal epidural injection that is administered to the sacral hiatus, which is the opening at the base of the spine near the tailbone. The injection is used to treat nerve pain and inflammation caused by conditions such as spinal canal stenosis, herniated disks, degenerative disk disease, sciatica, or radiculopathy.

Retrograde Amnesia and Disorientation after Intraocular Injection of Anti-VEGF Agents

Aug 2018 DOI 10.14302/issn.2470-5020.jnrt-18-2258
Meyer Peter-WolfgangCorresponding author Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany

We present a case of a 77-year-old male patient who was treated in our outpatient clinic for memory disorders because of episodic confusion and retrograde amnesia. The patient reported having symptoms repeatedly following intraocular treatment with Anti-Vascular Endothelial Growth Factor Agents (Ranibizumab and Bevacizumab) as a treatment for wet macular degeneration. EEG showed a localized deceleration that intensified under prolonged voluntary hyperventilation. Symptoms resolved after the intraocular Anti-Vascular Endothelial Growth Factor treatment was stopped and anticonvulsive treatment with lamotrigine was begun. This case is important in that it describes a potential association between intraocular treatments with Anti-Vascular Endothelial Growth Factor Agents and seizures. Symptoms occurred in temporal correlation with intraocular treatment. Clinicians should be aware of this potential side effect on intraocular treatment with Anti-Vascular Endothelial Growth Factor Agents in patients with high risk for seizures.  

Drawbacks of Long-Acting Intramuscular Antipsychotic Injections

Jul 2017 DOI 10.14302/issn.3070-5835.jcpn-17-1562
V. Seeman MaryCorresponding author Professor Emerita, Department of Psychiatry, University of Toronto, 260 Heath Street W. Toronto, Ontario, Canada M5P 3L6.

Second-generation antipsychotics have relatively recently become available in long-acting intramuscular formulations (LAIs) and have been receiving a substantial amount of pharmaceutical industry promotion on the grounds that they improve treatment adherence in patients with psychotic illness. LAIs do have some drawbacks, however, which is the topic area covered by this review. A Global Scholar search of the nursing and medical literature reveals several factors that can negatively impinge on the clinical efficacy of LAIs: 1. The extent of training of injection personnel 2. The quality of surveillance of patient symptoms and side effects 3. The skilled use of the full range of injection techniques 4. The extent of drug accumulation over time 5. The potential loss of drug dose flexibility 6. The impact of exercise and temperature on drug distribution 7. The burden of the medication routine and the social burdens of LAIs 8. The safety of LAIs during pregnancy 9. The perceived coerciveness of LAIs 10. Issues of overdose and polypharmacy 11. Issues of cost 12. The important issue of responsibility for self-management of illness. Although the evidence is clinical and anecdotal, LAIs appear to work well for many patients, but their drawbacks are not negligible. Clinicians need to weigh individual risks and benefits when making treatment decisions.

Ophthalmic Science Open Access

Persistent Neovascular Exudation in Patients with Exudative Age-Related Macular Degeneration who have Choroid Imaging Biomarkers of Non-Neovascular Choroidal Pathology: Simultaneous Choroidal Hyperpermeability and Angiogenesis

Nov 2025 DOI 10.14302/issn.2470-0436.jos-25-5503
H. Nelson MarkCorresponding author

Purpose Create a new diagnostic and therapeutic framework for patients with Exudative Age-Related Macular Degeneration (ARMD) and choroid imaging biomarkers of non-neovascular choroidal pathology who have persistent neovascular exudation during the course of monotherapeutic interventions. Methods Retrospective, longitudinal case series study of 25 eyes from 23 patients with the referral diagnoses of treatment resistant Exudative ARMD who had persistent neovascular exudation despite various monotherapies. Inclusion criteria required choroidal imaging biomarkers of non-neovascular pathology including a thickened subfoveal choroid (greater than 300 microns) and vessels (subjectively dilated choroidal vessels in Haller’s layer) on Optical Coherent Tomography (OCT), choroidal neovascularization on IVFA and OCT Angiography (OCTA), as well choroidal leakage noted on indocynanine green videoangiography (ICG). Treatment consisted of OCTA and ICG - Directed Photodynamic Therapy (PDT) Triple Therapy, hereafter described as Combination Therapy, to areas of choroidal hyperpermeability and choroidal neovascularization. Combination therapy consisted of an anti-Vascular Endothelial Growth Factor (VEGF) intravitreal injection on Day 0 followed by half-fluence PDT and 2 mg intravitreal triamcinolone acetonide on Day 3-14. Results All study patients had treatment resistant Exudative ARMD defined as persistent subretinal and/or intraretinal fluid during their course of monotherapeutic interventions. Complete resolution of all exudation occurred in 23 eyes (92.0%) at 8 weeks. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. The mean vision at baseline was 0.46 ± 0.42 LogMAR, best corrected visual acuity (BCVA). 8 weeks after treatment, the vision was 0.35 ± 0.38 LogMar, an improvement of over one line, and this was maintained at one year. The baseline central subfield thickness (CST) was 296.4 ± 136.1 microns and improved by 111.4 ± 105.4 microns at 8 weeks after treatment. Treatment duration was negatively associated with the Caucasian race. Conclusions Patients with subretinal and/or intraretinal fluid secondary to Exudative ARMD should have a complete baseline multimodality imaging study to confirm the presence of neovascularization and whether choroidal hyperpermeability coexists. This study shows that patients with Exudative ARMD and persistent neovascular exudation despite monotherapuetic interventions often have choroidal biomarkers of non-neovascular choroidal pathology and that ICG and OCTA-directed PDT Triple Therapy resulted in complete resolution of all exudation in 92.0% of patients at 8 weeks with a reduction in central subfield thickness (CST) of 111.4 microns. The vision improvement at 8 weeks was 0.11 ± 0.38 LogMar and was sustained over 1 year. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. Additionally, this study shows that the treatment that addresses both pathological processes is successful and should be considered as a primary protocol when the biomarkers are present at baseline or as a secondary protocol if indeed the neovascular leakage is persistent despite monotherapy. Summary Patients with an Exudative ARMD with persistent neovascular exudation despite anti-VEGF monotherapy and who have imaging biomarkers of non-neovascular choroidal pathology often have two pathophysiological processes: choroidal hyperpermeability and angiogenesis. A proposed framework provides the rationale for OCTA and ICG-directed PDT Triple Therapy which successfully resolves 92% of the leakage that was persistent after various monotherapeutics.

Zoological Research Open Access

Study of Anti-Inflammatory Effects of Black Cumin (Nigella Sativa) and Honey on Mice (Mus Musculus)

Aug 2023 DOI 10.14302/issn.2694-2275.jzr-23-4642
Zahoor TayyabaCorresponding author

The study was conducted to determine the effect of Nigella sativa (Kalonji) and Honey as an anti-inflammatory agent for humans and animals. The study was carried out on 20 Albino Mice of almost equal size and weight. All the mice were given 5% solution of formalin in a dose of 0.5ml injection in their right hind paw to produce artificial inflammation. The mice were divided into four groups of five animals in each and were randomly allotted to four treatments as Group A (Control) where no Nigella sativa extract and honey were given, Group B where the mice were given only the ethanolic extract of Nigella sativa in the dose of 0.05ml injection as a remedy of inflammation, Group C where the mice were given only the honey orally in a dose of 0.05mg and Group D where mice were given 50% (0.025ml) intraperitoneally of Nigella sativaextract and 50% (0.75mg) of honey as an anti-inflammatory agents. The data was statistically analyzed by the Analysis of Variance (ANOVA) and the results showed that the inflammation was significantly (p<0.05) reduced in mice given treatments compared to untreated control group and among treated groups. The mice given the extract of Nigella sativa (Group B) showed better results (p<0.05) in reducing the inflammation compared to other groups (C and D), Group D where the mice were given 50% (0.025ml) Nigella sativa extract and 50% (0.75mg) honey showed better results (p<0.05) than mice given only honey. Overall, both the extract of Nigellasativa and the honey were almost equally successful in reducing the inflammation in mice which showed that these two agents can successfully be used as anti-inflammatory drugs in humans and animals.

New Approach in Treatment of Cancer & Viral Infection by Apis Mellifera L Venom Extracts (Honeybees Venom)

Feb 2022
Ahmed Kamal SamiaCorresponding author Professor Dr. Virology department, Animal Health Research Institute, Egypt

Cancer cells need strong drug to be eliminated. Cancer lesions cure could achieve by topical application of crude bee venom. Bee venom medication used to prevent malignancies in groups most at risk (predisposing factors). Bee venom crosses the blood brain barriers because its components are very small. However, Bee venom contraindicated administered by intravenous injection because it’s hemolytic substance, mellitin which is powerful anticoagulant. However, the cationic peptides mellitin govern the mode of action of bee venom as anticancer and antiviral in vivo; 1 there is a negative charge on cancer cells, viral infected cells, diseased cells, and generally any cells that contain toxins or damage, and viruses are carrying negative charge even when it is outside the living body. 2Bee venom component (melittin) carries a positive charge, it destruct negatively charged cancer cells. 3 The role that the herpes virus is likely to play in increasing the severity of cancerous diseases, worsen the conditions: herpes viruses are opportunistic viruses that strike the body whose immunity is weakened for any reason. Therefore, the role of herpes virus must be neutralized when you planning to treat a cancer patient. Fortunately, bee venom is a powerful antiviral, and thus we hit three birds with one stone, that is, we kill cancer cells, kill opportunistic viruses, and improve tissue immunity to participate in the fight against cancer and get rid of toxic exudates more efficiently.

Characterization of the Vaccine Abdala

Dec 2021 DOI 10.14302/issn.2691-8862.jvat-21-3999
Pino Marrero KatiaCorresponding author Holguin's university of medical sciences, Cuba.

Vaccines symbolize the main pandemic control tool in the world, which is why they are the object of study in many investigations. In this work, the Abdala vaccine was characterized in terms of adverse reactions by conducting a survey and statistical processing of the data taken through distribution graphs of the same, developed in the Minitab software 16. Of the people involved, 47.67% presented Symptoms that were mild to moderate with the presence of pain in the area of the injection, drowsiness and decay, mainly. Based on the distribution of the data in histograms, the duration of these symptoms was approximately 1 day. Likewise, it was observed that the symptoms occur mainly in females, for 33.72% of the cases in the first dose and 23.26% after the second dose was applied.

RETRACTED: Non-Surgical Removal of Basal Cell Carcinoma by Apis Mellifera L Venom

Dec 2020
Ahmed Kamal SamiaCorresponding author Ph.D. ARC, Egypt.

This article has been retracted on March 01, 2021. VIEW THE RETRACTION NOTICE (https://openaccesspub.org/jsce/article/2243) Background Apis Mellifera L venom (Honeybees) is potent and safe anticancer drug. The present case is Basal Cell Carcinoma (SBCC), recurrent and invasde the skin of head (upper right, in front of the right ear). The patient was 65 years old in time of first intervention and the origin of BCC was primarily seen as abnormal growths and changes in birth mole on right side of head. Materials & Methods Preparation Bee Venom solution: Bee venom powder (crude) of dose 1gm was dissolved in 1000 ml of sterile distilled water then filtered by 0.22 micron syring filter. That final concentration of the stock bee venom become 1 ug /ml (i.e. 1ul=1 ug), and kept at -20◦C. (1mg (dried BV) + 1ml (water) = Final concentration (1ug/1 ul)). Before this novel intervention, allergy test performed by subcutaneous injection of small dose of bee venom (0.1 ml) and wait for at least one hour. The patient was not hypersensitive to honeybees’ venom. First stage of treatment: 1- Syringe of 1ml volume was used for direct local injection of cancer area by 0.3 ml from prepared Honeybees venom (0.1 % conc.). 2- At the same time, subcutaneous injection of 0.5 ml of bee venom solution infiltrated around the affected ear. 3- Topical application of the bee venom ointment 2% (bee venom in Vaseline) inside affected ear to protect the ear drum. This process repeated daily with cleaning of the ear every time by suitable safe and sterile saline solutions. 2nd stage: daily S/C injection in axillary area upper lymph nodes of 0.3 ml / bee venom ‘total doses 0.6 ml BV’ (left & right). 3rd stage: bee venom dissolved in sterile Clove oil was applied on inner ear above the drum. 4th stage: Management of healing process was enhanced by ascorbic acid solution as topical application on dead cancer cells and to help in removal of exudates and debris. Results The complete removal of malignant growths in affected ear achieved after 1 month from first bee venom injections. However; the cancerous areas under the second surgical intervention were treated during the next month. Conclusions Apis Mellifera L venom as anticancer drug is totally different from using direct stings as a method of Apitherapy, that because collection of bee venom lead to evaporating of most allergic substance that present in bees stings, also it can be used per os in people who exhibit different degrees of allergy against the drug safely.

Ophthalmic Science Open Access

Compression between Combined Anti-VGEF with Steroids Versus Pure Anti-VEGF in Retinal Vein Occlusion

Sep 2020 DOI 10.14302/issn.2470-0436.jos-20-3400
Abo Taleb EmanCorresponding author Regional hospital for vitreo. Retina and eye care at Sana'a, Yemen

Aim To compare the efficacy of combined anti-VGEF (IVB) with steroids versus pure anti-VEGF for the treatment of macular edema secondary to retinal vein occlusion (RVO). Methods In this prospective study, 51 eyes were randomized into 2 groups according to treatment of clinically identified macular edema secondary to retinal vein occlusion within 4 weeks of onset: Group 1 (19 eyes) was given intravitreal Bevacizumab (IVB) (1.25mg/.05ml) + Triamcinolone (IVTA) (2mg/.05ml); Group 2 (22 eyes) was given pure intravitreal Bevacizumab (IVB) (1.25mg/.05ml) at baseline, at month 1, and at month 2. The outcome of the study represented the EDRTS letters gain, IOP change and (CRT) by using Spectral domain optical coherence tomography (OCT) at month 1, 2, 3 and 6 in each group. Both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) patients with at least 6 months FU were enrolled in the study. Results EDRTS letters gain was (20.37±15.28, 28.05±16.68, 35.16±17.12, 36.47±18.17) in group1 and (14.50±14.56, 18.41±14.56, 20.59±16.13, 21.06±15.72) in group2 at month 2,3 and 6 p value (0.18, .04, 0.004, 0.002). Mean IOP pre-injection (14.00±2.67) in group 1 and (13.5±5.89) in group 2. Group 1 has transient increase in IOP at month 1 and then return to baseline over 6 months. CRT from baseline to final FU decrease by 264.82 (µm) ±147.66 in group 1 and 308.42(µm) ±226.78 in group 2 with no significant difference between two group p value 0.57. There was no significant difference in EDRTS letters gain between CRVO patients and BRVO patients at month 1, 2, 3 and 6 p values (0.83, 0.23, 0.29, 0.13). Conclusion Early treatment macular edema in RVO patients by combined anti-VGEF+ steroid effectively improve functional outcome better than pure anti-VGEF injection.

Assessment of Prescribing and Dispensing Practices Based on WHO Core Prescribing Indicators in Hospital and Community Pharmacies in Khartoum State - Sudan

Jul 2020 DOI 10.14302/issn.2641-5526.jmid-20-3493
I. Kheder SalahCorresponding author Faculty of Pharmacy, National University, Khartoum, Sudan

Background Rational drug management has become an increasingly important topic in order to make optimal use of the drug budget to offer health services of the highest possible standard. It is important that continuous assessment for rational prescribing and use of drug have to be carried. Objective of this study was to gather data on existing drug prescription and dispensing practices and to evaluate the prescribing and dispensing indicators as described by the WHO. Method Observational, cross-sectional, prospective study was designed and conducted to evaluate the performance of hospital and community pharmacies in Khartoum state, related to rational drug use and prescribing and dispensing practices during the period from November 2018 to March 2019. 297 Hospital and community pharmacies from public and private sectors were contacted for carrying out this study survey and the collected data were analysed against WHO standards for core drug use indicators. Results The average number of drugs per encounter was 3.98 drugs. Hospital pharmacies had a higher (4.18±1.516) number of drugs prescribed than community pharmacies (3.87±1.331) with significance difference between mean of two types of pharmacies (P = 0.015). The percentage of antibiotic per prescription was (53.7%). Antibiotic prescribing was much higher (54.0%) in the hospital pharmacies compared to (48.6 %) in community pharmacies. The average percentage of injections per prescription at the facilities was found to be (57.6%). The percentage of prescription with written diagnosis was (26%.0) and the percentage of prescriptions with written dose was (78%.0). The average dispensing time was (1.75) minutes, The Percentage of drugs actually dispensed was (55.99%), the average adequacy of labelling of drugs was (30.4%). Overall prescribing and dispensing indicators were higher than WHO standard. Conclusion The degree of poly pharmacy was greater than of WHO criteria. The completeness and rationality of prescription was found suboptimal and components were missed.

Ophthalmic Science Open Access

Resveratrol Prevents Cataract Formation by Inhibiting Pro-inflammatory Mediator-induced Dysregulation of Lens Calcium

Apr 2020 DOI 10.14302/issn.2470-0436.jos-20-3303
Manikandan R.Corresponding author Department of Zoology, University of Madras, Guindy Campus, Chennai-600025 

The effect of resveratrol, a free radical scavenger, during cataract development was evaluated in the Wistar rat pup model. This study investigated the possible free radical scavenging potential of resveratrol at 40 mg/ kg body wt dose in selenite-induced cataract in rat pups. Intraperitoneal injection of sodium selenite (15 µm mol/ kg body wt) in 8 to 10 day old rat pups lead to severe oxidative stress in the tissues evidenced by decreased antioxidants and increased lipid peroxidase, nitric oxide, superoxide anion, hydroxyl radical generation, inducible nitric oxide synthase (iNOS) as well as nuclear factor kappa B (NF-kB) expression levels that probably led to cataract formation. Selenite exposure also caused an increase in total calcium in the eye lens and significantly inhibited the activity of Ca2+ ATPase but not Na+/ K+ ATPase or Mg2+ ATPase. However, both pre- and co-treatments with resveratrol, but not post-treatment, led to an increase in antioxidant levels with a concomitant reduction in oxidative stress and also rescued the selenite-mediated increase in lens Ca2+ and inhibition of Ca2+ ATPase activity in the eye lens. The results of this study demonstrate antioxidants decrease and increase in free radical generation triggered by selenite causes the inactivation of lens Ca2+ ATPase leading to a rise in intracellular Ca2+ level. Resveratol treatment was able to prevent selenite-induced oxidative stress and in turn the inhibition of lens opacification. Thus, resveratrol has the potential to function as an anti-cataractogenic agent, possibly by preventing free radical-mediated accumulation of Ca2+ in the eye lens.

Successful Cascade of Care and Cure HCV in 5382 Drugs Users: How Increase HCV Treatment by Outreach Care, Since Screening to Treatment

May 2019 DOI 10.14302/issn.2574-4526.jddd-19-2770
Remy Andre-JeanCorresponding author Mobile Hepatitis Team, Perpignan Hospital, France

Introduction In France 33% of patients didn’t take care of hepatitis C because there were no diagnosed. Drug injection was main contamination route of hepatitis C virus (HCV) in France. French guidelines were to treat all inmates and drug users, even fibrosis level. Access of HCV screening, care and treatment in drugs users, prisoners and homeless was low in France. They were considered as difficult to treat populations. All these patients need specific support. Hepatitis Mobile Team (HMT) was created in July 2013 to increase screening care and treatment of hepatitis B and C patients. HMT was composed of hepatologist, nurses, social workers and health care worker. Objective increase outreach screening care treatment access and cure of our target population. Patients and methods Target population was drugs users, prisoners, homeless, precarious people, migrants and psychiatric patients. We proposed part or all of our services to our 42 medical and social partners: HCV HBV screening by DBS (dried blood test); outside DBS and FIBROSCAN in converted van; Outreach open center; Drug users information and prevention, Free blood tests in primary care;, Staff training; Social screening and diagnosis; Mobile liver stiffness Fibroscan in site; Advanced on-site specialist consultation; Easy access to pre-treatment commission; Low cost mobile phones for patients; Individual psycho-educative intervention sessions; Collective educative workshops; Peer to peer educational program; Specific one day hospitalizations. All services were free for patients and for partners. Results from 2013 July to 2018 December, we did 8382 DBS for 5382 people (3053 HCV DBS) and 2302 Fibroscan*. HCV new positive rate was 21.3%. Our HCV active file was 651patients included these 24.8% new patients screened by DBS; 98% realized HCV genotype, HCV viral load and FIBROSCAN. DAA treatment was proposed to 96%; 95% started treatment, 4% were lost follow up or refused treatment. After treatment, there was 7 relapse and 3 reinfections by drug injection and cured rate of 94%. Sociological evaluation showed that 4 program qualities for patients: free access, closeness (outside hospital), speed (of the results) and availability (of nurse and social workers). Conclusions:  Specific follow-up of drugs users and other HCV high-risk patients including screening, early detection, diagnosis and treatment increase rate of treated and cured patients, with low rate of relapse and reinfections.

Excellent Completion Rate of 8-Weeks Hepatitis C Treatment in Prison; Results of French National Study.

May 2019 DOI 10.14302/issn.2328-0182.japst-19-2738
BARON AuroreCorresponding author USMP Fleury Merogis, CH Sud Francilien

Rationale Prisons are major reservoirs of hepatitis C virus (HCV) in which a therapeutic approach has been particularly difficult so far. Prevalence of viral hepatitis C (HCV) is higher in prison environment in France than in the general population and is estimated to be 4,8%. The impact in prison environment is little-known as based on local studies.  Inmate health care falls under USMP (prison setting medical unit), hospital specific units as by the january 18, 1994 law. Access to antiviral c treatment for inmates has always been difficult in France, would it be for interferon and ribavirin or use of protease inhibitors, with less than 20% of treated patients. French recommendations for HCV screening recommend systematic screening of inmates. The arrival of all oral therapies by direct antiviral agents (DAA) with shorter treatment times was an opportunity for doctors to propose a treatment and the patient to accept it. In 2014, the French guidelines recommended that HCV carriers in prison should systematically be treated independently of the stage of fibrosis. Objective of the Study PH8 Our objective was to evaluate the completion rate of an 8-week antiviral C treatment by sofosbuvir / ledipasvir regimen in non-cirrhotic genotype 1 patients in deprivation of liberty and achieve sustained virological response (SVR) and to measure the effectiveness of an 8-week treatment (by protocol analysis). Methodology prospective non-interventional multicenter trial among inmates with chronic hepatitis C genotype 1 with METAVIR fibrosis score F0 to F2 and who will receive a daily combination of sofosbuvir / ledipasvir for 8 weeks. Results 6 prison medical units included 115 consenting patients: there were 81% men, mean age 41 years (21 to 64 years). Route contamination was drug injection for 85%. HCV genotype was 1a for 74%, 1b for 24% and 2% none differenciated 1. Fibroscan mesure was available in 89 patients (mean score 3,5 KPa). Fibrotest was available in 37 patients with mean value 0.21. Eleven patients had Fibroscan and Fibrotest; 69% of patients were F0, 22% F1 and 9% F2. Average time between diagnosis and start of treatment was 3 weeks. We are sure that 109 patients (95%) completed DAA 8 weeks treatment; only 2 stopped DAA treatment before 8 weeks and 4 had no follow up after end of detention. HCV viral load was measured at W2 for 90 patients (78%), at W4 for 92 patients (78%), at end of treatment for 92 patients (78%), one month after treatment for 90 patients (78%) and 3 months after for 95 patients (93%). Only one viral load was positive, one month after treatment. Patient was retreated by sofosbuvir / velpastasvir. All HCV viral load 3 months after treatment negative; one patient took DAA only 6 weeks was cured. Conclusions In these study PH8, we observed completion rate of 94% for included patients in patient with 8 weeks ledipasvir/sofosbuvir regimen; data missed for only 4 patients and one relapsed. Short DAA treatment was efficient in prisoners and could be preferred in specific population.

Veterinary Healthcare Open Access

Effect of Oxytetracycline Treatment on Postpartum Reproductive Performance in Dairy Buffalo-Cows with Retained Placenta in Egypt

Jun 2018 DOI 10.14302/issn.2575-1212.jvhc-18-2146
A Elmetwally MohammedCorresponding author Department of Theriogenology, Veterinary Medicine Faculty, Mansoura University, Mansoura 36615, Egypt

Retained fetal membrane (RFM) is a crucial calving related disorder that affects economic for the farmer and herd health. Retention of Placenta (ROP) is the condition in which the fetal membranes are not expelled within a period of 12 hours after parturition. Buffalo cows (n=34) aged 4-9 years old with 2-6 lactation season were used in the present study. The Experimental buffaloes were divided into either with (n=25) or without (n=9) fetal membrane retention. The objective of this study was to evaluate the effect of oxytetracycline treatment on reproductive performance of buffalo-cows with retained fetal membranes. All buffaloes in treated group received systemic infusion of oxytetracyclin Hcl injection 5% and 10 mg/kg oxytetracycline for 3 days intrauterine. Reproductive performance parameters for all experimental buffaloes were days to first estrous, number of service per conception, days open and pregnancy diagnosis. All reproductive parameters demonstrated significant changes between treated and non-treated animals (P < 0.05). Altogether, the obtained results indicated that retained placenta in buffaloes could be treated successfully by intrauterine infusion of oxytetracycline

Energy Conservation Open Access

The Study on Dual Fuel Spray and Characteristics of Combustion of Diesel, Natural Gas and Dual Fuel

Jun 2018 DOI 10.14302/issn.2642-3146.jec-18-2135
Wang QianCorresponding author School of Energy and Power Engineering, Jiangsu University, 301 Xuefu Rd., 212013 Jiangsu, China.

Combustion of fossil fuels provides around 88% of total energy supply for modern society, and meanwhile causes many environ mental problems and social problems such as air pollution and energy crisis. Therefore,both at home and abroad are focusing on the research and development of natural gas engine recently. However, the mass production and application of this kind of engine are restricted by some unsolved technical difficulties. This paper explored the injection, combustion and emission processes of diesel/ natural gas and dual fuel engine based on Chemkin II, Fire software and Schlieren method. The experimental study on the mixing process of dual fuel jet was carried out by using high-speed Schlieren method in a constant volume bomb. Based on the Fire software, and then applied to Chemkin II software to analyze the effect of the initial temperature and pressure on the net heat production and combustion emissions. The results show that Dual fuel mechanism is capable of producing different heat production behaviors when varying the initial pressure and temperature CO2 emissions are minimized by changing the initial pressure above or below the atmospheric value. However, CO emissions are peaked when diesel fuel is used. The dual fuel engine minimizes the CO emissions amount caused by diesel fuel. Increasing the initial pressure eliminates dual fuel CO2 combustion emissions. The research of this paper is important to optimize the in cylinder combustion processes of natural gas engine, and have a certain important meaning to guide the development of diesel ignition dual fuel engine.

Veterinary Healthcare Open Access

Lipopolysaccharide Prompts Oxidative Stress and Apoptosis in Rats’ Testicular Tissue

Mar 2018 DOI 10.14302/issn.2575-1212.jvhc-18-2013
A Halawa AmalCorresponding author Department of Forensic Medicine and Toxicology, Faulty of Veterinary Medicine, Mansoura University, Mansoura, Egypt

Lipopolysaccharide (LPS) is a component of the outer membrane of gram negative bacteria. LPS challenging allows switching transcription of proinflammatory cytokines on via over stimulation of Toll-like receptors (TLRs) signaling pathway with subsequent pathogenic inflammatory response. We investigated the possible reproductive toxicity of LPS in male Wister albino rats. Oxidative stress markers, antioxidant status and caspase-3 activity were analyzed in testicular tissues of rats exposed to either saline or LPS (4 mg/kg BW, ip; 0.18 of the LD50). The samples were collected at 6 h and 72 h after injection of LPS. A significant reduction in testicular reduced glutathione (GSH), glutathione-S-transferase (GST) and superoxide dismutase (SOD) was observed at 72 h compared to control group. Total antioxidant capacity was decreased at 6 h with additional significant reduction at 72 h. Catalase activity was reduced significantly at both 6 and 72 h. Malondialdehyde (MDA) was increased (P ≤ 0.05) in LPS injected rats without variation between 6 and 72 h. A significant increase in nitric oxide (NO) was observed at 72 h after injection. A time-dependent increase in LPS-treated groups was observed in the concentration of caspase-3.Histopathological analysis revealed degenerative changes and necrosis of seminiferous tubules after 6 h with further accumulation of eosinophilic edematous transudate in its lumen after 72 h. In conclusion, by increasing time of exposure, LPS induced lipid peroxidation, oxidative stress, reduced testicular antioxidant capacity and encouraged testicular apoptosis which could be possible mechanisms for impairment of testicular function.

Benzoate Concentration and Cooperativity by a Substrate for Benzoate 1,2-dioxygenase from Benzoate-Degrading Rhodococcus Opacus 1CP

Dec 2017 DOI 10.14302/issn.2576-6694.jbbs-17-1860
P. Solyanikova InnaCorresponding author Laboratory of enzymatic degradation of organic compounds, G.K. Skryabin Institute of Biochemistry and Physiology of Microorganisms of the Russian Academy of Sciences, Pushchino, Russia.

We explored the effect of a change in substrate-benzoate (as sole carbon and energy source) concentration in growth medium on the activity of benzoate 1,2-dioxygenase (BDO) of R.opacus 1CP cells, where BDO is the enzyme mediated the initial attack of benzoate. The activity of the enzyme was estimated by a change of respiration of whole freshly harvested bacterial cells (growth of the cells on benzoate) in response to injection of benzoate. It was shown that when concentration of growth substrate-benzoate decreased from 6 g/L to 250 mg/L, the curves of the dependency of the response rate to benzoate on the initial concentration of benzoate demonstrated that kinetics of the process changes from hyperbolic saturation kinetics, or typical Michaelis-Menten kinetics, to sigmoidal dependency of V on S. The semisaturation constant as a characteristic of the strength of substrate binding with BDO changed simultaneously. These changes were accompanied by the increase in the Hill coefficient from 1.02 up to 3.06, hence positive kinetic cooperativity by a substrate was observed for BDO of R.opacus 1CP cells. The influence of this type of cooperativity on viability of rhodococcus in natural environment and causes of the changes mentioned are discussed. It was hypothesized that an increase in substrate concentration in the medium for the growth of the bacterium not only stimulated synthesis of the inducible enzyme (BDO) in the cell but also led to the change in BDO conformation followed by the change in interaction between substrate-binding active sites of enzymes.

Suboccipital Decompression for Occipital Neuralgia

Aug 2017 DOI 10.14302/issn.2694-1201.jsn-17-1527
Trescot AndreaCorresponding author Pain and Headache Center, 12836 Old Glenn Hwy, Eagle River, AK 99654

Cervicogenic headaches are a significant cause of head and neck pain, and occipital neuralgia is a common component of these cervicogenic headaches. Occipital injections are commonly performed at the occipital ridge, but this site does not address more proximal entrapments of the nerve in the suboccipital region. Because of the potentially dangerous structures in this region, clinicians have tended to avoid the suboccipital region, despite the pathologies seen in this region. This article discusses the pathology of the region, the alternative techniques, and the novel interventional approach developed for this region, specifically the “Stealth” approach of occipital decompression.

Fertility Biomarkers Open Access

The Clinical Significance of a Low Percentage of Mature Oocytes Retrieved Using Common Ovarian Stimulation Protocols.

May 2017 DOI 10.14302/issn.2576-2818.jfb-17-1435
Wiesak TeresaCorresponding author Abington Reproductive Medicine, Toll Center for Reproductive Science, Abington, PA, USA;

The objective of this study was to investigate whether percentage of mature oocytes retrieved from ovaries stimulated with long agonist or multi-dose antagonist protocols affect the implantation, clinical pregnancy and live birth of ICSI (Intracytoplasmic sperm injection) cycles. The 654 cycles of agonist (long lupron) and 610 cycles of multi-dose flexible antagonist (antagon) were analyzed after stratification according to the percentage of the mature oocytes retrieved. The clinical pregnancy of the groups with less than 30 % mature oocytes retrieved, both antagonist and agonist protocol was statistically lower (at least p< 0.05) compared to the groups with more than 30% mature oocytes retrieved. In the agonist protocol, the implantation and live births for this group were significantly (p<0.009) lower than in the group with ≥70% mature oocytes retrieved. The live births in groups with more mature oocytes retrieved (30-69% and ≥70 %) of the antagonist protocol were lower (22.2% vs. 35.9% and 23.9% vs. 41.5%, p<0.0001, respectively) compare to the agonist protocol. The results of our study showed that a very low percentage of mature oocytes retrieved impacts the clinical outcome of antagonist and long agonist protocols.

Cervical Medial Branch Blocks For The Diagnosis Of Somatosensory Tinnitus. A Pilot Study.

Dec 2016 DOI 10.14302/issn.2379-8572.joa-16-1369
Klessinger StephanCorresponding author Department of Neurosurgery, nova clinic Biberach, Eichendorffweg 5, 88400 Biberach, Germany.

The purpose was to discover if medial branch blocks (MBBs) of the cervical spine can be used as a diagnostic tool to identify patients with somatosensory tinnitus. MBBs are a diagnostic tool to confirm the diagnosis facet joint pain in patients with neck pain. It is not known, if MBBs are also suitable for testing other symptoms than pain. However, the existence of neural connections between the auditory system and the cervical region can be assumed. Included were 22 consecutive patients presenting with tinnitus, who had received MBBs in a ten years’ period. Patients were tested with a MBB with bupivacaine and triamcinolone. Injections were performed with fluoroscopic visualization using established techniques. The mean follow-up time was 6.2 weeks. Tinnitus was analyzed through the global clinical impression of the patient. Seven patients (31.8 %) experienced a significant improvement of the tinnitus. In one patient a thermal radiofrequency neurotomy was done after positive response to two MBBs. The pain relief and a significant reduction of the tinnitus sustained at the follow-up examination 20 weeks after the denervation. No statistically significant difference was found in age, gender, duration of symptoms, additional neck pain or vertigo, or side or level of the intervention. This pilot study shows the feasibility to identify patients with somatosensory tinnitus with MBBs. Further studies with the primary intention on tinnitus are necessary to prove the significance of MBBs. After a positive response to MBBs, treatment with radiofrequency neurotomy is the rational consequence.

Ophthalmic Science Open Access

Idiopathic Macular Telangiectasia Associated with Large Soft Drusen and Retinal Angiomatous Proliferation

Apr 2016 DOI 10.14302/issn.2470-0436.jos-15-710
Campa ClaudioCorresponding author Sant’Anna University Hospital, Ferrara, Italy

Idiopathic macular telangiectasia type 2 is a rare retinal condition usually characterized by parafoveal telangiectatic vessels, hyperplastic pigment plaques and seldom a full thickness macular hole or a retinal neovascularisation. Herein we describe an atypical presentation of this disease. Methods Review of the patient’s clinical and angiographic records. Results A 87-year-old white man was diagnosed with idiopathic macular telangectasia type 2. Ophthalmological and angiographic examination disclosed telangiectasia of the parafoveal capillaries together with extensive bilateral granular soft drusen and unilateral retinal angiomatous proliferation (RAP). Initially photodynamic therapy with verteporfin (PDT) and subsequently intravitreal injections of bevacizumab were used to treat RAP lesion. This approach provided visual acuity stabilization up to 24 months. Conclusion This case of ours shows that drusen may be a feature of macular teleangiectasia type 2. It also emphasizes that PDT and anti-VEGF therapy are both safe and effective for treating neovascular complications of this disease.

Nephrology Advances Open Access

The Toxicity of Iodinated Radiographic Contrast Agents in the Clinical Practice

May 2015 DOI 10.14302/issn.2574-4488.jna-14-601
Andreucci MicheleCorresponding author Nephrology Unit, Department of “Health Sciences”, Campus “Salvatore Venuta”, “Magna Graecia” University, Viale Europa, loc. Germaneto, I-88100 Catanzaro, Italy ([email protected])

Iodinated radiographic contrast agents (IRCA) are pharmaceutical agents used to improve the visibility of internal organs and structures in X-ray based imaging techniques. However, IRCA may have adverse unwanted effects, ranging from a mild inconvenience, such as itching, to a life-threatening emergency. The adverse effects of IRCA include delayed allergic reactions, anaphylactic reactions, and/or cutaneous reactions. But exposure to IRCA may be associated also with the development of either hyperthyroidism or hypothyroidism, presumably due to the effect of free, biologically active elemental iodine ions present in these agents. Among the side effects associated with the use of intravascular injection of IRCA, Contrast-induced nephropathy (CIN) is undoubtedly their most important and frequent well known adverse reaction. The pathogenesis of CIN is discussed in detail including the factors that increase the incidence of CIN, the main ones being pre-existing renal impairment, particularly when associated with diabetes mellitus. Finally, the measures to reduce the nephrotoxicity of IRCA are suggested beginning with monitoring renal function, discontinuation of potentially nephrotoxic drugs, use of either iodixanol or iopamidol at the lowest dosage possible. The main procedure for prevention of CIN is an adequate hydration of the patient with either isotonic sodium chloride or sodium bicarbonate solutions. A long list of references is provided that will enable readers a deep appreciation of the topic.

Partner Violence and Condom Use in HIV-Discordant Heterosexual Partnerships

Jul 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-168
Eaton AbigailCorresponding author University of California, Berkeley, School of Public Health

This paper examines the association between intimate partner violence and the consistency of condom use in a US urban cohort of HIV-serodiscordant couples. It uses both male and female data from the California Partners Study II of a lower-income ethnically mixed cohort of 145 such couples in the San Francisco Bay Area. We observed a significant association between inconsistent condom use and physical abuse: the risk of inconsistent condom use was double for those experiencing physical abuse (OR, 2.2; 95% CI, 1.1, 4.1). Injection drug use and a history of bisexual behavior were also associated with inconsistent condom use. Physical abuse tended to be reciprocal between partners (OR, 3.2; 95% CI, 1.9, 5.6). Our findings suggest that interventions effective in reducing intimate partner violence, and/or reducing the use of injection drugs in HIV-serodiscordant couples could lead to less transmission of HIV.

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