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BACKGROUND & AIMS: Wilson disease (WD) is a genetic disease with systemic accumulation of copper that leads to symptoms from the liver and brain. However, the underlying defects in copper transport kinetics are only partly understood. We sought to quantify hepatic copper turnover in patients with WD compared with heterozygote and control subjects using positron emission tomography (PET) with copper-64 (64 Cu) as tracer. Furthermore, we assessed the diagnostic potential of the method.METHODS: Nine patients with WD, five healthy heterozygote subjects, and eight healthy controls were injected with an intravenous bolus of 64 Cu followed by a 90-min dynamic PET scan of the liver and static whole-body PET/CT scans after 1.5, 6, and 20 hours. Blood 64 Cu concentrations were measured in parallel. The hepatic copper retention and redistribution were evaluated by standardized uptake values (SUV).RESULTS: At 90 min, the hepatic SUVs were similar in the three groups. In contrast, at 20 hours post injection, the SUV in WD patient (Mean±SEM 31±4) was higher than in heterozygotes (24±3) or controls (21±4), (p < 0.001). An SUV-ratio of the hepatic 64 Cu concentration at 20 and 1.5 hours completely discriminated between the WD patients and control groups (p < 0.0001; ANOVA). By Patlak-analysis of the initial 90 min of the PET scan, the steady-state hepatic clearance of 64 Cu was estimated to be slightly lower in the patients with WD than in controls, (p = 0.04).CONCLUSIONS: 64 Cu PET imaging enables visualisation and quantification of the hepatic copper retention characteristic for WD patients. This method represents a valuable tool for future studies of WD pathophysiology, which may assist the development of novel therapies, and accurate diagnosis.

99mTc nitrido-Levetiracetam was prepared using the 99mTc nitrido core for labeling. The reaction conditions were optimized to get the highest radiochemical purity (98%): substrate amount 2 mg, Sn(II) (reducing agent) amount 50 µg, pH 7, 30 min, ambient temperature. The biodistribution studies revealed high brain uptake of 99mTc nitride-Levetiracetam, reaching a maximum of 9% ID/g at 30 min post injection (p.i.). The complex deserves further analysis as a candidate brain imaging agent.

Purpose Fibroblast activation protein (FAP), which has high expression in cancer-associated fibroblasts of epithelial cancers, can be used as a theranostic target. Our previous study used 64Cu and 225Ac-labelled FAP inhibitors (FAPI-04) for a FAP-expressing pancreatic cancer xenograft imaging and therapy. However, the optimal therapeutic radionuclide for FAPI needs to be investigated further. In this study, we evaluated the therapeutic effects of beta-emitter (177Lu)-labelled FAPI-46 and alpha-emitter (225Ac)-labelled FAPI-46 in pancreatic cancer models. Methods PET scans (1 h post injection) were acquired in PANC-1 xenograft mice (n = 9) after the administration of [18F]FAPI-74 (12.4 ± 1.7 MBq) for the companion imaging. The biodistribution of [177Lu]FAPI-46 and [225Ac]FAPI-46 were evaluated in the xenograft model (total n = 12). For the determination of treatment effects, [177Lu]FAPI-46 and [225Ac]FAPI-46 were injected into PANC-1 xenograft mice at different doses: 3 MBq (n = 6), 10 MBq (n = 6), 30 MBq (n = 6), control (n = 4) for [177Lu]FAPI-46, and 3 kBq (n = 3), 10 kBq (n = 2), 30 kBq (n = 6), control (n = 7) for [225Ac]FAPI-46. Tumour sizes and body weights were followed. Results [18F]FAPI-74 showed rapid clearance by the kidneys and high accumulation in the tumour and intestine 1 h after administration. [177Lu]FAPI-46 and [225Ac]FAPI-46 also showed rapid clearance by the kidneys and relatively high accumulation in the tumour at 3 h. Both [177Lu]FAPI-46 and [225Ac]FAPI-46 showed tumour-suppressive effects, with a mild decrease in body weight. The treatment effects of [177Lu]FAPI-46 were relatively slow but lasted longer than those of [225Ac]FAPI-46. Conclusion This study suggested the possible application of FAPI radioligand therapy in FAP-expressing pancreatic cancer. Further evaluation is necessary to find the best radionuclide with shorter half-life, as well as the combination with therapies targeting tumour cells directly.

Aims Hyaluronic acid (HA) gel fillers are the most commonly used filler materials for dermal purposes to augment soft tissue due to their superior properties and advantages over other alternative filling materials. One of the key drawbacks associated with the use of fillers is contamination and possible subsequent infection. Methods A prospective cross-sectional study conducted in Renew Cosmetic Clinics and King Abdulaziz University, Faculty of Medicine, female section from November 2019 to March 2020. Results A total of 50 samples with different concentrations (from five different brands) of hyaluronic acid gel fillers were collected. Samples were taken at four different time points: before injection, immediately after injection, one month after injection and three months after injection. The 50 samples were injected into nine different sites and collected from 27 females, aged between 18-55 years. No bacteria were detected in the culture media from any samples from the aerobic and anaerobic culture plates. Conclusion Our study did not find any evidence of contamination associated with the reuse of HA gel fillers regardless of the concentration and the injection site. Applying appropriate sterilization procedure for HA gel fillers extends its usability. There was no correlation between the length of storage time and the risk of contamination.

Background: The frozen shoulder is very common problem in India and usually could occur as idiopathic or trivial injury. Management modality is usually conservative and physiotherapy because of self-limiting nature of disease. Role of corticosteroid injection are usually effective for short period time but newer Orthobiologic agent like PRP injection are equally effective and minimal and no side effect. Material and method: In our study, total 50 patients were taken of adhesive capsulitis in period October 2018 to February 2020 and divided into groups randomly and PRP injection and corticosteroid injection was given and clinical outcome was recorded. Result: In our study, female are more affected then male, usually occur in age 40 to 60-year age group. The final outcome at 3 month post injection 20% patients with excellent, 48% with good and 32% with poor outcome with PRP injection group and for CS injection group this was found as 16% excellent, 36% good and 48% poor outcome. Conclusion: We concluded PRP and MPS showed efficacy and strong evidence in support significant effect of PRP, where steroid contraindicated or refused by patient in the treatment of frozen shoulder. However, inj. Methylprednisolone has sudden onset of action because of anti-inflammatory action with respect to inj. PRP, so has better result at 1 week follow up post injection but in long term (at 3 months follow up) inj. PRP has better effect in compared to injection MPS.

Introduction Extravasation or partial extravasation of the positron emission tomography (PET) tracer negatively effects image quality in PET and the accuracy of the standard uptake value (SUV). A commercially available topical sensor has been validated using a number of metrics to characterise injection quality. This evaluation explores contributing factors for extravasation and refines metrics to predict extravasation based on the time-activity-curves (TAC) of the topical sensor device. Methods A multi-site, multi-national pooling of 18F FDG PET/CT data was undertaken with 863 patients from 6 sites in the USA and 2 sites in Australia. A number of dose migration metrics determined with topical application of Lara sensors were retrospectively analysed using conventional statistical analysis. Deeper insights into the complex relationship between variables was further explored using an artificial neural network. Results Extravasation was independently predicted by the time taken for the injection sensor counts to reach double the counts of the reference sensor (tc50), the normalised difference between injection and reference sensors counts at 4 min post injection (ndAvgN), or the ratio of injection sensor counts to reference sensor counts at the end of data collection (CEnd ratio). The algorithm developed using the artificial neural network produced 100% sensitivity and 100% specificity against grounded truth for detecting extravasation by weighting and scaling these 3 key metrics; CEnd ratio, ndAvgN and tc50. Conclusion Partial extravasation of a PET dose is readily detected and differentiated using TAC metrics and these metrics could provide deeper insight into the impact of partial extravasation on image quality or quantitation. Further validation of key metrics developed in this study are recommended in a larger and more diverse cohort. Implications for practice Partial extravasation undermines image quality and accuracy of quantitation, impacting efficacy of outcomes for patients. Characterisation of extravasation informs decision making to optimise protocol and procedure, enhancing patient outcomes. Awareness provides the opportunity for education and training to minimise impact. The information can be used to drive policy and regulations to support improved techniques in practice.

A multicenter study was conducted to assess the radiation exposure of relatives and caregivers of patients suffering from castration resistant prostate cancer with bone metastases and treated with Ra-223 dichloride in an outpatient setting. As Ra-223 and most of its progeny emit alpha particles, especially the internal exposure of persons in the patient's vicinity had to be evaluated. METHODS The external radiation was measured in distances of 1 m and 2 m. Wipe-tests were taken in the patients' homes to identify significant contaminations and evaluated by liquid scintillation counting. Samples of saliva and sweat were taken and measured using gamma spectrometry. RESULTS The external exposure from the patients measured 10-20min post injection (p. i.) was

Positron emission tomography (PET)/computed tomography (CT) using 18F-fluoromisonidazole (FMISO) has been used as an imaging tool for tumour hypoxia. However, it remains unclear whether they are useful when scanning is performed earlier, e.g. at 2-h post-injection with a high sensitivity PET scanner. This study aimed to investigate the relationship between quantitative values in 18F-fluoromisonidazole (18F-FMISO)-PET obtained at 2- and 4-h post-injection in patients with head and neck cancer. We enrolled 20 patients with untreated locally advanced head and neck cancer who underwent 18F-FMISO-PET/CT scan between August 2015 and March 2018 at our institute. Image acquisition was performed 2 h and 4 h after 18F-FMISO administration using a combined PET/CT scanner. The SUVmax, SUVmean, SUVpeak, tumour-to-blood ratio (TBR), tumour-to-muscle ratio (TMR), metabolic tumour volume (MTV), and total lesion hypoxia (TLH) were measured in the region of interest of the primary tumour. We evaluated the between-image Spearman’s rank correlation coefficients and percentage differences in the quantitative values. The locations of the maximum uptake pixel were identified in both scans, and the distance between them was measured. The mean (SD) SUVmax at 2 h and 4 h was 2.2(0.7) and 2.4(0.8), respectively. The Spearman’s rank correlation coefficients (ρ) and mean (SD) of the percentage differences of the measures were as follows: SUVmax (0.97; 7.0 [5.1]%), SUVmean (0.97; 5.2 [5.8]%), SUVpeak (0.94; 5.3 [4.7]%), TBR (0.96; 14.2 [9.8]%), TMR (0.96; 14.7 [8.4]%), MTV (0.98; 39.9 [41.3]%), and TLH (0.98; 40.1 [43.4]%). There were significant between-scan correlations in all quantitative values. The mean (SD) distance between the two maximum uptake pixels was 7.3 (5.3) mm. We observed a high correlation between the quantitative values at 2 h and 4 h. When using a combined high-quality PET/CT, the total examination time for FMISO-PET can be shortened by skipping the 4-h scan.

The efficacy of progestagen injection for synchronising oestrus in West African Dwarf (WAD) does was evaluated. The progestagen injections used were 50mg Progesterone; 100mg Progesterone; 25mg Medroxyprogesterone acetate, MPA, 50mg MPA; 25mg Progesterone plus 0.04mg Ethinyl oestradiol combination and 50mg progesterone plus 10i.u oxytocin. The highest oestrous response of 84.6% was obtained with 100mg of Progesterone injection while the MPA groups did not show: oestrus for upward of 50days post injection. A degree of synchrony >50% was obtained only in those treatments containing above 50mg progesterone. Conception rate (Fertility) at first oestrus was above 75% in'all the responding groups except the 50mg progesterone where only 20% of the 71.4% does in oestrus and mated conceived. A single intramuscular injection of 100mg progesterone to postpartum does between 21 and 28days post-kidding led to significant (p

To show that an immediate vitrectomy with an intravitreal injection of antibiotics can be an effective approach for the treatment of acute endophthalmitis following intravitreal injections. We reviewed all cases of clinical endophthalmitis caused by an intravitreal injection that were treated in our department between March 2012 and November 2019. Only patients that underwent a vitrectomy within 6 h after presentation to the clinic and with a documented visual acuity shortly before the causative event were included. Baseline best-corrected visual acuity (BCVA) before the causative event was compared to BCVA measured within a follow-up period of 8 months (up to 14 months). In total, 30 eyes of 30 patients were included. The BCVA before the intraocular infection was a mean value of 0.55 logMAR, and the BCVA on the day of the endophthalmitis decreased significantly to 1.66 logMAR. Within 2 months following the pars plana vitrectomy (PPV), the mean BCVA improved to 0.83 logMAR. Eight months following PPV (mean value, 8.20 months; SD, 3.59 months), the mean BCVA was 0.63 logMAR. In the last follow-up interval most of the eyes recovered, and the BCVA did not differ significantly from baseline. Two eyes underwent further pars plana surgery during the follow-up period. No enucleation was required. In this study, we have shown that an immediate vitrectomy with subsequent intravitreal injection of antibiotics is an effective option for treating post-injection endophthalmitis and frequently results in recovery of vision; thus, it should be performed as early as possible, where available.

An experimental study was carried out to analyze the influence of different post-injection strategies on the regulated and unregulated emissions from a heavy-duty compression ignition (CI) diesel engine. FTIR (Fourier transform infrared spectroscopy) was used to measure and analyze the exhaust emissions which include regulated such as NOx, soot, and unregulated emissions including acetaldehyde, formaldehyde, methane, ethane, propane, ethylene, propylene, and ethyne. Experimental results manifested that the post-injection technique can notably minimize the regulated and unregulated emissions as compared to a single main injection. Under different post-injection conditions, a trade-off relation was also found between soot and NOx emissions. In soot mitigation, the start of injection (SOI) at 40° crank angle (CA) incorporate with 5–15 mg post-injection fuel mass was proved very effective and about 26% lower soot emissions were recorded than single main injection. At SOI 20°CA, with 15 mg post-injection fuel mass, a reduction in the NOx emissions was observed up to 20% and in THC up to 60%. Unregulated emissions (other than formaldehyde and acetaldehyde) were found lower with 5, 10, and 15 mg post-injection fuel mass at 20, 40, 100, and 120°CA but increased at SOI of 60°CA than single main injection. In addition, light HCs, and THC emissions at SOI 60°CA were found to increase which could be beneficial for after-treatment devices.

In this study, we developed a saccharin (SAC)‐based radiopharmaceutical (68Ga‐NOTA‐SAC) and evaluated the possibility of its application as a PET tracer in the diagnosis of carbonic anhydrase IX (CA IX)‐overexpressed tumors. We did a water‐soluble tetrazolium assay and flow cytometry analysis to identify the cell viability decrease by SAC. The radiochemical purity and stability of 68Ga‐ NOTA‐SAC in human and mouse serum was greater than 98%. The small animal PET image‐based radioactivity distribution of all organs decreased over time.68Ga‐NOTA‐SAC presented the highest tumor‐to‐muscle ratio at 90 min post injection (p.i). The growth rates of tumor‐to‐muscle ratios of 68Ga‐NOTA‐SAC were 88% at 60 min and 220% at 90 min, compared to 30 min p.i. The potential of 68Ga‐NOTA‐SAC as a PET tracer is expected to contribute to the diagnostic research on CA IX‐overexpressed tumors with the advantages of a relatively simple synthesis method., We developed a new 68Ga‐NOTA‐SAC as a saccharin‐based PET tracer for diagnosis of CA IX‐overexpressed tumors and quantitatively assessed the targeting ability of 68Ga‐NOTA‐SAC using micro‐PET imaging with in vitro experiments. These 68Ga‐NOTA‐SACs demonstrated a high uptake ratio of the tumor region as well as rapid excretion, allowing a high‐contrast PET image of the targeted tumor region.

Thidiazuron (TDZ) was reported to possess anti-cancer activity against Human cervical carcinoma cell line, so that this study has been conducted for the radiolabeling of TDZ with Technetium-99m. The conditions of the radiolabeling process were optimized and a high radiochemical yield of 93.1 ± 0.35% has been obtained. Molecular docking study illustrated that [99mTc]technetium bisthiadiazuron (99mTc-TDZ) complex has the ability to bind with Caspase-3 protein that over expressed in cancers. Its in-vivo biodistribution on solid tumor bearing mice showed comparatively high T/NT ratio of 6.87 ± 0.14 at 60 min post injection. These promising characteristics make our new designed labeled conjugate a very suitable candidate for molecular imaging of solid tumors, particularly in the cervix.

Background: Periorbital hyperpigmentation is a commonworldwide problem, which makes a person appear tired, sad,and aged. A number of factors can cause dark circles aroundthe eyes including excessive pigmentation, thin and translucentlower eyelid skin overlying the orbicularis oculi muscle, andshadowing due to skin laxity and tear trough. Although anumber of treatment options are available, autologous fattransplantation is an effective method for the treatment oflower lid dark circles, but irregularities caused by leavingvisible lumps of the fat can occur. Mechanical emulsificationof harvested fat achieves much more finer fat particles thanmicro-fat called nano-fat which acts primarily by the plentythe active transplanted stem cells the purpose of this study isto evaluate the effectiveness of the nanofat grafting techniquein correcting infraorbital dark circles.Pateints and Methods: Nanofat grafting was performedin 10 female patients for dark lower eyelids. The grafts wereinjected into intra-dermal and sub-dermal layers using sharp27G needle and were harvested from different sites accordingto the ease of accessibility and to improve the patient's bodycontours. The mean follow-up period was 4.6 months, rangingfrom 2 to 8 months. All patients were clinically evaluatedusing standardized serial digital photographs by two plasticsurgeons, who were blinded to the type of procedure performedat each of the follow-up visits.Results: In this study, there was significant improvementof the peri-ocular dark halos in 5 cases (50%), moderateimprovement was encountered in 2 cases (20%), 2 cases (20%)showed mild improvement and no improvement in one case(10%). As regards patient satisfaction, 8 cases (80%) weresatisfied with the final result, while 2 patients (20%) werenot satisfied. Post-operative edema and ecchymosis wereminimal in 5 cases (50%) and mild in 5 cases (50%). No caseswere presented with either post injection infection or lumpsand contour irregularities during the follow-up period.Conclusion: In conclusion, nano fat injections for thetreatment of infra orbital dark circles is a simple, cost effectiveprocedure. In addition, nanofat grafting technique provideda significant improvement in skin quality. Our results suggestthat the stem cell activity of the nanofat grafting techniquehas great potential as a treatment modality for dark circles aswell as for skin rejuvenation in general.

BACKGROUND: Our objectives were (1) to report the post-injection endophthalmitis rate over 18 months, and (2) to determine any difference in the incidence of endophthalmitis in patients treated with reduced or no 5% povidone-iodine (PI) due to self-reported PI sensitivity. METHODS: We performed a retrospective cohort study of all patients who received intravitreal injections (IVIs) from January 1st, 2018 to June 26th, 2019. Information on patients’ age, gender visual acuities, the number of injections, drug administered, self-reported iodine sensitivity and injection protocols were obtained from electronic and paper records. For endophthalmitis cases, vitreous culture results and treatment were also noted. Patients were divided into three cohorts based on the injection protocol used for statistical analysis. RESULTS: During the study period 22,046 IVIs were administered to 3332 eyes of 2709 patients. Intolerance to PI was reported by 2.4% of patients. The incidence of endophthalmitis was 0.02% (4/21,185) with the standard 5% PI protocol, 0.78% (6/769) with a reduced PI protocol involving fewer drops of 5% PI and chlorohexidine 0.05% for periorbital skin cleansing, and 1.09% (1/92) without any PI use. Receiving the standard PI protocol was associated with significantly lower rates of endophthalmitis compared to both the reduced PI and no PI protocols (p

The surgical correction of the cleft lip is a challenging one and obtaining consistently good esthetic outcomes sometimes can be elusive. Primary correction of cleft lip often results in secondary deformities requiring re intervention. Chemoimmobilsation with Botulinum Toxin A post-secondary cheiloplasty can help obtain favourable esthetic results. Aims: To evaluate the esthetic value of Botulinum Toxin A injection in secondary cleft lip surgeries and to assess the role of Botulinum toxin A in secondary cleft lip scars. Materials and Methods: 30 systemically healthy unilateral cleft lip patients reporting for secondary cheiloplasty procedure were taken up for the study. 10-12 units of Botulinum Toxin A was injected along pre-determined points on the lip. Objective (Photographic evaluation) and subjective (Patient questionnaire method) evaluation was carried out after one year post injection of Botulinum Toxin A. Results: Photographic evaluation revealed that the outcomes were mostly excellent or good. Subjective evaluation conducted showed that majority of patients were either happy or very happy with the esthetic results. Keywords: Botulinum Toxin A, cheiloplasty scars, esthetic evaluation, secondary cheiloplasty, secondary cleft lip, subjective evaluation, unilateral cleft lip.

Objective: This study was designed to compare different doses of cis-atracurium (2×ED95, 4×ED95, 6×ED95) in regarding onset time, condition of intubation , duration of action, hemodynamic effects, and signs of histamine release. Methods: Sixty ASA I and II adult patients undergoing abdominal surgery under general anesthesia were included in this prospective, randomised, double blind study. Patients were allocated to one of three groups: Group 1:Patients in this group received with initial dose of 0.1 mg/kg (2×ED95) of cis- atracurium. Group 2:Received initial dose of 0.2 mg/kg (4×ED95). Group 3:Received initial dose of 0.3 mg/kg (6×ED95). Result: All the demographic parameters were comparable.There was a statistically significant increase in HR, MABP post intubation when compared to baseline and post injection of 2× ED95 dose of cis-atracurium in group 1. Higher doses of cisatracurium (4×ED95 and 6×ED95) showed onset time that was significantly lower than cisatracurium (2×ED95). Regarding the duration of action, higher doses of cisatracurium (4×ED95 and 6×ED95) showed statistically significant longer duration of action than lower doses of cisatracurium.4×ED95 and 6×ED95 doses of cisatracurium were significantly better than 2×ED95 dose of cisatracurium. Only 6×ED95 dose of cisatracurium was statistically significant with higher percentages of patients with excellent condition of intubation. Conclusion: We can conclude that the higher doses of cisatracurium provide more effective, more rapid neuromuscular blocking with longer duration of action, stable hemodynamic status, and no associated signs of histamine release clinically.

Objective: To evaluate the safety and efficacy of Suprachoroidal Triamcinolone Acetonide (SCTA) injection in patients with treatment resistant Diabetic Macular Edema (DME). Methods: This was a prospective non randomized interventional study conducted in the vitreoretinal department of Al Ehsan Welfare Eye Hospital, Lahore, Pakistan from March 2018 to September 2018. A total of 24 eyes of 24 patients were included. Baseline Best Corrected Visual Acuity (BCVA), Intra Ocular Pressure (IOP) and Central Subfield Thickness (CST) was recorded. After SCTA, patient was followed up at one and three months and same clinical parameters were recorded again and results analyzed. Results: Out of 24 patients, 11(45.83%) were males and 13(54.16%) were females. Mean pre injection CST was 636.5 ± 200.11 um. Mean pre injection BCVA was 0.8 ± 0.24 on ETDRS chart. Mean post injection CST at one and three months was 304.54 ± 67.43 and 302.66 ± 66.93 um. Mean post injection BCVA at one and three months was 0.47 ± 0.3 and 0.45 ± 0.27 on ETDRS chart. The results were statistically significant for pre and post injection CST at both one and three months (p-value < 0.00001). Pre and post injection BCVA was also statistically significant (p-value < 0.05). Conclusion: Preliminary evidence suggests that SCTA is well tolerated and may help in improving functional and structural outcomes of treatment resistant DME. doi: https://doi.org/10.12669/pjms.36.1.1194 How to cite this:Tayyab H, Ahmed CN, Sadiq MAA. Efficacy and safety of suprachoroidal triamcinolone acetonide in cases of resistant diabetic macular edema. Pak J Med Sci. 2020;36(1):---------. doi: https://doi.org/10.12669/pjms.36.1.1194 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

There is increasing interest in the use of adipose‐derived mesenchymal stromal cells (ASCs) for wound repair. As the fate of administered cells is still poorly defined, we aimed to establish the location, survival, and effect of ASCs when administered either systemically or locally during wound repair under physiological conditions. To determine the behavior of ASCs, a rat model with wounds on the dorsal aspect of the hind paws was used and two treatment modes were assessed: ASCs administered systemically into the tail vein or locally around the wound. ASCs were transduced to express both firefly luciferase (Fluc) and green fluorescent protein to enable tracking by bioluminescence imaging and immunohistological analysis. Systemically administered ASCs were detected in the lungs 3 hours after injection with a decrease in luminescent signal at 48 hours and signal disappearance from 72 hours. No ASCs were detected in the wound. Locally administered ASCs remained strongly detectable for 7 days at the injection site and became distributed within the wound bed as early as 24 hours post injection with a significant increase observed at 72 hours. Systemically administered ASCs were filtered out in the lungs, whereas ASCs administered locally remained and survived not only at the injection site but were also detected within the wound bed. Both treatments led to enhanced wound closure. It appears that systemically administered ASCs have the potential to enhance wound repair distally from their site of entrapment in the lungs whereas locally administered ASCs enhanced wound repair as they became redistributed within the wound bed., Adipose‐derived mesenchymal stromal cells were administered either systemically or locally in a rat model of wound repair under physiological conditions. It appears that systemically administered adipose‐derived mesenchymal stromal cells have the potential to enhance wound repair distally from their site of entrapment in the lungs whereas locally administered adipose‐derived mesenchymal stromal cells enhanced wound repair as they became redistributed within the wound bed.

Background: Contrast leakage after arthrography is common. We sought to investigate if immobilization could prevent it. Purpose: The purpose of this study was to determine the effects on contrast extravasation and image quality produced by strict immobilization of the shoulder between arthrography puncture and subsequent MR imaging. Material and methods: Fifty patients underwent shoulder MR arthrography using a standard shoulder puncture in the anteroinferior quadrant. Ten milliliters of contrast mixture of saline, iodinated contrast, and gadolinium contrast was injected by a senior musculoskeletal (MSK) radiologist using a 21G needle. Half of the patients were immediately immobilized using a shoulder sling, and the other half were allowed to move their shoulder and arm freely during the time before MR imaging. MR arthrography was performed with a 3 T system using standard T1 and PD weighted sequences. The MR images were reviewed independently by 2 MSK radiologists and graded for extravasation using a five-point scale (1: none, 2: less than 2 cm, 3: 2-5 cm, 4: 5-10 cm, 5: more than 10 cm) and for image quality using a 5 point scale (1: poor, 5: good). The Pearson correlation was calculated to assess the correlation between leakage and image quality. Results: There was no significant difference in amount of leakage between both groups, and global image quality was found equal in both groups. A negative correlation was found between leakage and quality assessment. Conclusion: This study shows that it cannot be avoided by strict shoulder immobilization and that it negatively affects image quality and interpretation.

Previously Injection of corticosteroids was thought to be the gold standard treatment in lateral epicondylitis. The autologus blood injection and different types of open and arthroscopic operative treatment are also advised for lateral epicondylitis recently. At present, platelet rich plasma (PRP) is considered as an ideal biological autologous blood derived component. All patients seen and clinically diagnosed as lateral epicondylitis and satisfying the inclusion criteria are selected. After obtaining written consent by simple random sampling alternatively patient received steroid injections and platelet rich plasma injections under strict aseptic precautions and were divided into group A group B respectively. In this study PRP and Corticosteroid treated groups had pre injection GRIP STRENGTH of 26.7 and 26.8 respectively with P=0.9. Post injection at 1 month follow up GRIP STRENGTH showed a significant increase in Corticosteroid group (30) as compared to PRP group (29).

Background Studies to determine gender response to transcutaneous electrical nerve stimulation (TENS) application on individuals who presented with post-injection sciatic pain (PISP) following gluteal injection is not common. A total of 40 subjects comprising 20 males and 20 females who were purposively recruited and conveniently assigned to group A (male) and group B (female) completed the study. Acupuncture-like TENS (AL-TENS) was applied on the 20 male and 20 female subjects, 1 h per session, 3 times per week for the 10 weeks the study lasted. Result The pre-intervention baseline scores for the two groups were 8.80 + 1.05 (Female) and 8.60 + 1.27 (Male). The result revealed that after 10 weeks of intervention the VAS scores were 2.60+ 3.28 (p < 0.001) and 2.40 + 3.28 (p < 0.001) for the female and male subjects, respectively. The mean comparison of the female mean VAS scores (2.60 + 3.28) and male VAS scores 2.40 + 3.25 after 10 weeks of AL-TENS intervention shows no statistically significant difference (p > 0.85) in pain intensity (pain perception). Conclusions There was no gender variation in pain perception in subjects with post-injection sciatic pain (PISP) following gluteal muscle injection after 10 weeks of AL-TENS application. Therefore, gender-based variation should not be considered when applying AL-TENS as an instrument of intervention in subjects with PISP. Trial registration PACTR2018050034082

The accumulation of Tc-PIPIDA in breast tissue of a 21-year eld male, associated with gynomastia, is reported. An increased uptake of both Gallium and Iron was observed with both treatments and from the potassium determinations it was concluded that this was associated with an increase in the ionic permeability of the cell membrane. In comparison with normal subjects it was noted that the plasma clearance of labelled fibrinogen was faster as well as the build up and subsequent clearance from the extra vascular space. All of the derivatives examined showed some degree of localisation in the kidneys, liver and intestines Tumour to non-tumour ratios of 6-8 were reached at 6 huors post injection. The use of quantitative measurements of gallium uptake in tumours and normal lung tissue to differentiate the prescence of small lesions and to distinguish benign lesions from malignant is described.

We included all 74,960 olanzapine LAI dispensings listed in the Pharmaceutical Benefits Schedule (PBS) database from the introduction of olanzapine LAI in January 2010 until the end of January 2020. Adverse event reports for all olanzapine formulations (and the subset of olanzapine LAI) were drawn from Australian Therapeutic Goods Association Database of Adverse Event Notifications (DAEN).

Purpose: To study the difference in the both safety and efficacy of Intravitreal (IVTA)versussubtenon (STTA ) triamcinolone acetonide injection as a treatment approach of diabetic macularedema (DME). Patients and Methods: 50 eyes of 38 diabetic patients diagnosed DMEaccording to the ETDRS criteria were divided into two groups; each group consists of twentyfive eyes. Group A were injected IVTA with 4 mg (0.1ml). Group B were injected STTA with 40mg (1ml). Results: In group Awe found that the mean central macular thickness (CMT) reducedfrom 465.6 u ± 170.8 u at the baseline level to 285.9 u ± 83.2 u,267.5 u ± 79 u and 288.4u±169.8uat 1,3 and 6 months post injection respectively. In group B we found that the mean CMTreduced from 327.65u ± 68.4 u at the baseline level to 273.2 u ± 77.9, 257.8u ± 83.6u and264.9u ±104.3uat 1.3 and 6 months post injection respectively. In group A we found that themean visual acuity (VA) was improved from 0.2 at the baseline to 0.4, 0.3 and 0.4 at 1, 3 and 6months post injection respectively. In group B we found that the mean VA was improved from0.3 at the baseline to 0.5, 0.7 and 0.7at 1.3 and 6 months post injection respectively. In group Awe found that the mean intra ocular pressure (IOP)was changed from 16.2 mmHg ±1.2 mmHgat the baseline to20.9 mmHg ±6.9 mmHg, 17.4 mmHg ±1.6 mm Hg and 17.4 mmHg ±1.6 mmHgat 1,3 and 6 months post injection respectively. In group B we found that the mean IOP waschanged from15.15mmHg ±1.8 mmHg at the baseline to15.6 mmHg ±1.8 mmHg, 15.8mmHg±1.8 mmHg and15.7 mmHg ±1.8mmHg at 1.3 and 6 months post injection respectively.Conclusion: STTA can achieve clinical results comparable to IVTA as regards the reduction ofCMT and the improvement of VA although it achieves this effect somewhat slower.

Purpose: The aim of this work was to assess the outcome of subconjunctival bevacizumab(Avastin) injection in patients with corneal neovascularization (NV). Methods: Twenty eyes oftwenty patients (13 male and 7 female) with corneal neovascularization resulted from variableocular surface disorders were included in this prospective, non-controlled study. All eyesreceived a single subconjunctival injection of 2.5 mg (0.1 ml) bevacizumab using 1 ml syringe27 Guage needle. Morphological changes in the major and minor vessels were studied by slitlamp biomicroscopy and corneal photography pre-injection and one week, 2 months and 6months post injection. Results: Obvious recession of minor vessels of Corneal NV was noticedin most eyes at first week post-injection. The extent of corneal neovascularization of the majorvessels was significantly decreased 1weeks post-injection. This decrease continued noticeablyfor 6 months. Conclusions: Bevacizumab can be safely and effectively used in corneal NVtreatment. It can be considered in the treatment of both minor and major vessel NV resultedfrom long standing chronic inflammation (trachoma), long-standing corneal ischemia (followingcontact lens wear) and other different causes. Bevacizumab was well tolerated over themonitoring period in this research. Further controlled and long term studies are required to fullyevaluate the long term effects of this recent treatment.

Introduction The current standard-of-care protocol for OnabotulinumtoxinA (BoNTA) injections consists of fixed-site injections every 12 weeks. This pattern is based on clinical practice and extrapolated from BoNTA injections for other, non-migraine-related indications. It is unclear if this protocol is optimal for chronic migraine. In clinical practice, migraine patients frequently describe a period of increased headache frequency and intensity in the few weeks preceding their next injections. In order to evaluate the duration of the clinical effect of BoNTA injections in chronic migraine, we studied the variation in headache frequency on a weekly basis during the 12-week period following treatment in a cohort of migraine patients. Method 38 consecutive subjects were enrolled from an outpatient headache clinic, and asked to keep daily headache journals. 24 completed headache journals were analyzed. Headache frequency, duration and severity, as well as intake of symptomatic headache medications were recorded and compared among the different weeks. Results The time-response plot following BoNTA injection was roughly U-shaped, with 3 distinct phases: an induction phase, a maximum efficacy phase, and a wear-off phase. The time-response plot revealed that the wear-off commenced around the eighth week post injection. The mean difference in the number of headache days per week between the first and the eighth week was 1.8 (95% CI [0.670–2.830], p = 0.003). Conclusion The effect of BoNTA injections on chronic migraines was not uniform throughout a 12-week period. A window of vulnerability to migraine attacks exist in the beginning and end of each cycle.

The aim of this study is to investigate the impact of walls on soot processes of a post-injection strategy at different dwell times. The experiments were performed in an optically accessible consta...

Abscess formation is one of the most common complications of intramuscular injections, a procedure routinely performed in the hospital settings. Though the incidence of such complications is low among the overall recipients of intramuscular injections, it may cause considerable morbidity among those who suffer such complications. In our study, all patients with post intramuscular injection abscess at gluteal and deltoid region were compared for a difference in the patterns of the causative organisms at these two sites. Thus a retrospective analysis of cases was done in reference to the past seven years. It was observed that Staphylococcus aureus was the most common organism at the two sites. However Escherichia coli was isolated only from the gluteal region. Keywords: Gluteal abscess, Deltoid abscess, Complications, Intramuscular injection.

The present study investigated clinical and immunological modulations due to intramuscular injection of Escherichia coli LPS in 49-wk-old laying hens over 48 h post injection (p.i.). LPS induced characteristic sickness behavior but no significant body temperature alterations ( P > 0.05). During experimental period decreases in blood albumin, calcium, phosphorus and tryptophan concentrations, hyperglycemia, increased plasma nitrite concentrations, leucopenia, decreased thrombocyte counts, lymphopenia, heterophilia and an increased heterophilic granulocyte/lymphocyte (H/L) ratio were observed after LPS administration. Time-dependent effects were shown on T and B cell subsets in caecal tonsils (CT) and on splenic CD3+/CD4+/CD8+ proportions, on IL-1β and -10 and inducible NO synthase mRNA expression in peripheral blood lymphocytes (PBL), liver, spleen and CT, and on the mRNA expression of the TLR4 in PBL, liver and spleen p.i. ( P

Labetalol was labeled with 188Re. The reaction conditions (amounts of stannous chloride and substrate, pH, time) were optimized, and the radiochemical yield as high as 95 ± 0.4% was reached. Biodistribution in mice was studied. 188Re-Labetalol showed excellent initial heart uptake and good retention. The heart/liver ratios were 5.16, 2.70, and 2.15 at 30, 60, and 120 min post injection, respectively.

Introduction In 2012, Subcutaneous Trastuzumab (TSC) was introduced as an alternative to Intravenous Trastuzumab (TIV) for HER2+ breast cancer. The pivotal HannaH study demonstrated that TSC was non-inferior to TIV, was preferred by patients, and serious administration related reactions (ARRs) were not reported. However, the Summary of Product Characteristics (SPC) advises that patients be observed for ARRs for 6 hours post-first administration (and 2 hours post-subsequent administrations), similar to TIV. Aim To assess the frequency and tolerability of ARRs during the 6-hour observation period post first administration of TSC in patients with HER2+ breast cancer. Method: A retrospective audit of TSC was conducted in Southwest Ireland across five centers from 2014-2016. Patient charts were reviewed to record ARRs reported on the first-administration or at subsequent visit. In addition a subset of patients were interviewed regarding their recollection of ARRs with first or subsequent injections. Results: The study is ongoing having identified 192 patients. These centers have administered 2111 TSC injections in total, associated with 4998 hours of observation as per SPC. From the 385 injections given over the first two TSC administrations, 13 injections (3.4%) were associated with ARRs within 24 hours. Nine patients (2.3%) experienced injection site reactions immediately post injection, one injection site pain (0.3%), and one experienced petechiae on subsequent exposure (0.3%). Three patients experienced pyrexia and dry cough 24 hours post-injection and were hospitalized for respiratory tract infection. There were no reactions experienced between 2 and 6 hours post-first injection. There were no serious ARRs. Telephone interviews are ongoing and these results will be reported. Conclusion: ARRs related to TSC are usually immediate, mild and self-limiting. Observing patients for 6 hours post-first injection and 2 hours post-subsequent injections represents an inefficient use of healthcare resources. Citation Format: Karmali S, Hughes N, Kinneally A, Kroes J, Cook J, Killian M, Shafiq T, O'Mahony D, Bird B, O'Connor M, O'Reilly S, Galiauskas R, Murphy CG. A regional audit of 6-hour monitoring for administration related reactions during the first administration of subcutaneous trastuzumab [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-16-08.

PURPOSE: To report the outcome of repeated botulinum toxin-A (BTA) injections in the lacrimal glands in patients with epiphora. METHODS: We performed retrospective chart review of patients who were injected with 2.5 units of BTA in the lacrimal gland. Epiphora and tear production were assessed by the Munk score and Schirmer-1 test, respectively, pre-injection and at 1 and 3 months post injection. Regarding repeated injections, the effects of the first were compared to those of the second and third injections. RESULTS: Forty-six eyes of 35 patients had an average of 2.3 injections per eye (range, 1–6). The mean Munk score significantly decreased from 3.72 to 1.87 at 1 month (p 0.05 for each comparison). There was a significant correlation between the difficulty in exposing the lacrimal gland for injection and the risk of complication (p = 0.017). CONCLUSION: BTA injection in the lacrimal gland showed favourable outcomes; repeated injections did not compromise efficacy. BTA injection can be safely repeated for epiphora, especially in patients whose lacrimal gland can be easily exposed.

Purpose: To determine the effect of ultra-widefield fluorescein angiography (UWFFA)-guided targeted retinal photocoagulation (TRP) in branch retinal vein occlusion (BRVO) with macular edema after intravitreal Ranibizumab (RBZ). Methods: 33 eyes of 32 treatment naïve patients diagnosed as BRVO with macular edema were prospectively randomized to 0.5 mg Ranibizumab only (RBZ group) (n = 17) or Ranibizumab with UWFFA-guided laser (RBZ + TRP group) (n = 16). Both groups received three injections at monthly intervals and PRN henceforth. RBZ + TRP group additionally underwent UWFFA-guided TRP of peripheral capillary nonperfusion areas 1 week post injection. Outcome measures included improvement in visual acuity, central subfoveal thickness (CST), and the number of injections required with a minimum follow-up of 9 months. Results: Both groups showed significant improvement in mean BCVA (25.7 ± 8.19 letters, P < 0.001 vs. 23.38 ± 7.56 letters, P < 0.001; in RBZ and RBZ + TRP group, respectively) and reduction in mean central subfoveal thickness (379.12 ± 242.7 μm, P < 0.001 vs. 253.75 ± 137.9 μm, P < 0.001 in RBZ and RBZ + TRP group, respectively) at 9 months. The number of injections in the RBZ group (5.76 ± 1.3) was significantly greater than RBZ + TRP (4.06 ± 0.99) (P < 0.001). Both groups had significant improvement in contrast sensitivity and mean deviation on visual fields; however, the difference between the groups was not significant (P = 0.62 and P = 0.79, respectively). Conclusion: UWFFA-guided TRP reduced the number of injections of Ranibizumab in patients having BRVO with macular edema, while maintaining similar benefits in the improvement of BCVA, central subfoveal thickness without deleterious effect on the visual field, and contrast sensitivity.

A smile plays an important role in determining a person's initial impression.This study aims to evaluate the effectiveness of both injection botulinum toxin type A (botox) and surgical lip repositioning in the correction of the gummy smile due to hyperactive upper lip according to the resulting smile and the patients' satisfaction.The study consisted of 24 patients: 12 received the BTX-A (botulinum toxin type-A) injection and the remaining 12 underwent the surgical procedure (lip repositioning). The patients rated their satisfaction according to their gingival display that was defined as the difference between the lower margin of the upper lip and the superior margin of the right incisor, and patients were followed at 2 weeks, 2 months, and 6 months. Post injection and post-surgery with changes documented by photographs. Both groups answered a questionnaire addressing the overall appearance and they were asked to rate the improvement of their smile according to a 5-point aesthetic scale.The patients rated the effects of BTX-A as highly favorable if we take into consideration that BTX-A had a temporary effect while the surgical procedure (lip repositioning) had a relapse likelihood of more than 80% because the lip reverted back to its original position with almost complete relapse after 6 months and not to mention the risks affiliated with the surgical procedures.BTX-A injection exhibits better results than those of surgery and had given safer and more satisfactory results and achieved the required cosmetic patient requirement than lip repositioning.Улыбка играет важную роль в формировании первоначального впечатления о человеке, поэтому многие пациенты прибегают к коррекции линии улыбки по психологическим и социальным причинам.Оценка эффективности инъекции ботулинического токсина типа А (ботокс; BTX-A) и хирургической коррекции десневой улыбки, возникающей из-за гиперактивности верхней губы, на основании удовлетворенности пациента результатами вмешательства.В исследование были включены 24 пациента: 12 из них была проведена инъекция BTX-A, а остальные 12 перенесли хирургическую операцию коррекции верхней губы. Пациенты оценивали свое состояние в соответствии с изменением степени обнажения десны, которое определялось как расстояние между нижним краем верхней губы и верхним краем правого резца. Повторные осмотры пациентов проводились через 2 нед, 2 и 6 мес, как после введения ботулотоксина, так и после проведения хирургической операции; все изменения, происходившие с пациентами после вмешательства, были задокументированы клиническими и фотоматериалами. Обе группы испытуемых заполнили анкету, касающуюся удовлетворенности своим внешним видом, в которой их попросили оценить результат вмешательства по 5-балльной эстетической шкале.Пациенты оценили эффект от введения BTX-A как очень благоприятный, если принять во внимание, что введение BTX-A давало непродолжительный эффект, в то время как хирургическая операция репозиции верхней губы в 80% случаев требовала повторных корригирующих операций в связи с тем, что верхняя губа вернулась в исходное положение с почти полным рецидивом через 6 мес. При этом возникали риски, связанные с выполнением любых хирургических вмешательств.Результаты введения BTX-A лучше, чем при хирургическом вмешательстве; данная процедура безопаснее и легче переносится пациентами.

The purpose of this study was to compare the scan time, image quality and radiation dose of CT urograms (CTU) using a split vs. single bolus contrast media injection technique. A total of 241 consecutive CTUs performed between August 2019-February 2020 were retrospectively reviewed. There were three study groups: Group 1, &lt, 50 years old, 50/80 cc split-bolus administered at 0 and 700 s post initiation of injection, with combined nephrographic and excretory phases, group 2, ≥50 years old, same split-bolus protocol, and group 3, ≥50 years old, 130 cc single bolus injection, with nephrographic and excretory phases acquired at 100 s and 460 s post injection initiation. The recorded data elements were scan time, number of excretory phases, imaging quality based on opacification of the urinary collecting system (&lt, 50%, 50–75%, 75–100%), and dose-length product (DLP). Associations between group and categorical variables were assessed (Chi-square), mean scan time and DLP were compared (one-way ANOVA). Following analysis, proportionally fewer CTUs required a repeat excretory phase in group 3 (32/112, 28.6%) than in groups 1 (25/48, 52.1%) and 2 (37/80, 46.3%) (p = 0.006). Mean scan time was significantly lower in group 3 (678 s) than in groups 1 (1046 s) and 2 (978 s) (p &lt, 0.0001). There was no association between groups and image quality (p = 0.13). DLP was higher in group 3 (1422 ± 837 mGy·cm) than in groups 1 (1041 ± 531 mGy·cm) and 2 (1137 ± 646 mGy·cm) (p = 0.003). In conclusion, single bolus CTU resulted in significantly fewer repeat phases and faster scan time at the expense of a slightly higher radiation dose.

Simple Summary Local tissue reactions after injection are known in animals and humans. This study analysed the local tissue reaction after injection of the so-called immunologic castration in pigs using magnetic resonance imaging to achieve insight into the reaction site. Long-lasting reactions, which can be traced to inflammatory reactions, were detected. Further studies are needed to evaluate the impact of these reactions on animal well-being and carcass quality. Abstract This study aimed at evaluating the local tissue reaction of an anti-GnRF product, which is used for the so called “immunocastration” in male pigs. A total of 34 pigs were injected two times (including a booster injection) with an anti-GnRF product. Injection was performed using the prescribed safety vaccinator. Injection sites were evaluated three times post injection using magnetic resonance imaging. Two examinations were performed after the first injection and one after the booster. The local tissue reaction was evaluated three-dimensionally by semi-automatic analyses, by linear measurements of injection depth and length, and by scoring the kind of tissue affected. Results showed a long-lasting reaction in affected muscle tissue. Therefore, needle length should be discussed, and an evaluation of the injection site after slaughter should be performed include behavioural scorings post injection to evaluate the impact on animal well-being and carcass quality.

In this research, as the first stage, the effects of the ethanol on engine performance and emissions under the fumigation and emulsion method were experimentally investigated under part load and various engine speed conditions. Diesel-ethanol blend containing 5% ethanol by volume was used as the mixture fuel. In the fumigation method, ethanol was used at the same rate and 99.9% purity as the emulsion method. As the second stage, the effects of ethanol post injection on engine performance and pollutant emissions were investigated in the experimental engine modeled in AVL Boost simulation program and compared with the experimental results. Simulation post injection tests were performed separately after the main injection at 3° CA (P1) and 7° CA (P2). In the experimental studies, NOx emission decreased with the emulsion method (E5) at low and high engine speeds. In post injection strategies, NOx emission in general increased due to improved combustion and increased in-cylinder temperature with P1 (first post injection) and P2 (second post injection) strategies. Soot emission decreased significantly with E5. This improvement in soot emissions was approximately 87% in post injection strategies. © 2021 Society of Thermal Engineers of Serbia Published by the Vinča Institute of Nuclear Sciences, Belgrade, Serbia. This is an open access article distributed under the CC BY-NC-ND 4.0 terms and conditions

Acute lung injury (ALI) is a critical illness but have not effective therapeutic modalities currently where recent studies have revealed anti-inflammatory pleiotropic effects and plaque stabilizing effects of statins so the purpose of this work is preparation of simvastatin loaded nanostructured lipid carriers (simvastatin-NLCs) and investigation of its efficacy in lung injury mice. The simvastatin-NLCs was prepared by thermal melting-low temperature curing method and the quality evaluation was performed with particle size distribution, encapsulation efficiency, and drug loading. Sixty C57BL/6 mice were divided into three experimental groups: blank group model group and simvastatin treated group. Simvastatin was administered intraperitoneally immediately after the LPS injection in animals of the treated group at a dose of 20 mg/kg/day. Lung injury degree and the protective effects of simvastatin against LPS-induced lung injury were assessed at the time-points of 24, 48, and 72 h post injection, and the in vivo efficacy of simvastatin-NLCs on mice was investigated. The average particle size of simvastatin-NLCs was (102.1±42.2) nm, the encapsulation efficiency was (94.6±2.5)%, and the drug loading was (5.78±0.57)%. After 24 hours of administration, the data shows that simvastatin-NLCs inhibit the levels of IL-6 and TNF-α inflammatory factor in the lungs of mice.

Ibandronate was successfully labeled by using technetium-99m with maximum radiochemical yield (98.6%). The process is achieved by adding (25 µg) from stannous chloride in addition to (300 µg) of Ibandronate at room temperature in pH=7 for 15 min., we obtain a radiochemical yield (98.6%) and the radiolabeled complex was purified by high performance liquid chromatography (HPLC). The radiochemical yield was affected by many factors such as: Ibandronate amount, stannous chloride amount, reaction time, temperature of the reaction and pH of the reaction mixture. The in-vitro stability of 99mTc-Ibandronate was determined along (8 hours). The data obtained approve that 99mTc-Ibandronate complex was stable along (6 hours) without detection of any by-products in the reaction mixture.Biodistribution study showed high uptake and long retention of 99mTc-Ibandronate in bone was (44.32 % ID/organ) at (1 hour) post injection. Thus, 99mTc–Ibandronate could be used as a selective potential imaging agent for diagnosis of bone diseases

Purpose To investigate the safety of pharmaceutically compounded syringes for intravitreal administration of anti-vascular endothelial growth factor (anti-VEGF) drugs. Methods Single center, retrospective chart review. From 2015 to 2019, Oslo University Hospital, Norway gradually implemented pharmaceutical compounding and splitting of bevacizumab, ranibizumab, and aflibercept vials into multiple prefilled syringes for intravitreal use. Medical records of all post-injection endophthalmitis (PIE) cases in this 5-year period were reviewed. The incidences of PIE associated with compounded and clinician-withdrawn syringes were compared. Results In 5 years, the total number of anti-VEGF injections was 112,926; 68,150 procedures (60%) utilized compounded syringes, and 44,776 procedures (40%) utilized clinician-withdrawn syringes. A total of 11 PIE cases were identified (incidence 0.10 per 1000; 95% CI 0.05–0.17). Five PIE cases were associated with compounded syringes (incidence 0.07 per 1000; 95% CI 0.03–0.17); 3 of these were culture positive. Six PIE cases were associated with clinician-withdrawn syringes (incidence 0.13 per 1000; 95% CI 0.06–0.29); 2 of these were culture positive. The relative risk of PIE following procedures utilizing compounded versus clinician-withdrawn syringes was 0.55 (95% CI 0.17–1.79; p = 0.32). Conclusion Use of compounded anti-VEGF drugs in a large clinical setting was not associated with an altered risk of PIE. The finding adds to the evidence that splitting of vials into prefilled syringes for intravitreal injections is safe, provided that an appropriate pharmaceutical compounding procedure is strictly followed.

Background: Managing patients with severe diabetic neuropathy is a great challenge, many lines of treatment are available but there are many patients that cannot tolerate large doses of these medications or not responding or contraindicated to use these lines. Recent experimental evidence suggests that botulinum toxin type A (BTX-A) may have role in management of neuropathic pain. Methods:42 patients with diabetes(22 patients injected Botox and 20 patients placebo) were enrolled in this study. Patients were assessed using VAS and PSQI scale at 0,1,4,12 weeks. Results: significant reduction in VAS 1,4- and 12-weeks post injection in patients injected with Botox in comparison to patients injected with placebo p (.047,.001 and .000) respectively. No significant improvement in PSQI in patient injected with Botox as compared to patients injected with placebo. Conclusion: Botulinum Toxin (A) is effective in sever diabetic neuropathy and may be an alternative way in management of severe diabetic neuropathy.

Our case is about a 30-year-old woman who consults for neck pain, a cervical MRI with and without contrast was performed who objectified a thin centro-medullary cavity measuring 2 mm located at the junction of the anterior third and the posterior two thirds (A), extends from C6 to D1 (B), who appears as high intense on T2-weighted without an enhancement on a post-contrast characteristic of a persistent central canal (PCC). The PCC is defined as a persistence of a focal distension of the ependymal canal, generally discovered during a radiological exploration presents 1 to 2% of cases of exploration of the spinal cord, often of thoracic location. The clinic is poor, sometimes an atypical pain symptomatology with a generally normal neurological examination. Medullary MRI is a reference examination which shows a filiform or fusiform centromedullary cavity appears as high intense on T2-weighted less than 3 mm in diameter located at the junction between the anterior third and the posterior two thirds of the antero-posterior diameter of the spinal cord, The post injection sequences are necessary to eliminate the differential diagnosis, in particular tumor-related syringomyelia.

Tuberculin skin tests remain widely used in the control of bovine tuberculosis (bTB) in cattle. Little is known about the rate of regression of tuberculin reactions after the comparative intradermal cervical test (CICT) in cattle. This study aimed to collect data to describe tuberculin regression in reactors following the CICT at 72 ± 4 h post injection. Reactors were also tested using the interferon gamma (IFN-γ) assay to establish if any pattern existed between these results and the CICT reaction regression. The data were derived from 108 herds, 112 herd-level CICTs and 1008 animals. A multivariable linear mixed model was built to explore the regression of the bovine tuberculin reaction over time and the influence of potential predictors. The results confirmed a proportional decline in the bovine tuberculin reaction occurred over time. The predictors in the final model demonstrated that regression of the tuberculin reaction differed between reactors according to their IFN-γ test results and whether visible lesions were present at slaughter. Follow-up measurement of tuberculin reactions and the serial use of the IFN-γ assay in large breakdowns has the potential to provide both a mechanism for quality assurance of the current CICT bTB surveillance and the identification of atypical breakdowns or reactors requiring further investigation.

In previous study, post injection has shown a significant benefit in the reduction of soot emissions. Among them, the close post injection which only has short dwell between the main injection is supposed to be able to increase the thermal efficiency. The reduction of the cooling loss due to the main flame impingement is considered as the reason to the increase of thermal efficiency. However, there is a lack of study related to the influence of post injection timing and quantity on the combustion characteristics. Therefore, in this study, the engine performance and emission characteristics of injection strategy with close post injection was investigated. The post injection timing was modified from near zero interval to around 4.5°CA from the end of main injection. In addition, the post injection quantity was modified from 3, 9, to 15 mm3/cycle and the intake pressure was modified from 170, 200, to 220 kPa while maintaining the total injection quantity at 39 mm3/cycle. In order to clarify the mechanism of cooling loss by applying post injection and the effect of injection dwell to the cooling loss and combustion characteristics, an optical engine was used to observe the combustion process. As a result, a certain dwell is needed to fully exploit the effect of cooling loss reduction by post injection.