Establishment and comparison of two methods to produce a rat model of mammary gland hyperplasia with hyperprolactinemia

Abstract This study aimed to establish and compare models of mammary gland hyperplasia (MGH) with hyperprolactinemia (HPRL) using two different methods. The models provide information on the relationship between mammary gland hyperplasia and associated hormones. Model A was constructed using intramuscular injections of estradiol benzoate injection (EBI), followed by progesterone (P), and then metoclopramide dihydrochloride (MDI). Model B was designed by administering MDI, follow by EBI, and then P intramuscularly. Model B showed higher MGH progression compared with model A. Notably, increase in estradiol (E2) was negatively correlated with prolactin (PRL) secretion. However, PRL levels in model B were significantly higher compared with the levels in model A. Estrogen (ER), prolactin receptor (PRLR), and progesterone receptor (PR) mRNA and protein expression levels in model B rats were positively correlated with changes in the corresponding hormone levels. However, E2, P, and PRL levels in model A showed no direct relationship with levels of the mRNAs of related hormones and protein expression levels. Our results suggest that model B is an appropriate model of MGH with HPRL that can be used to perform further studies about the interactions of the E2, P, and PRL hormones in this disorder.

Los Riesgos para Mujeres Asociados a la Dispensación de Cyclofem en Droguerías de Bogotá D.C. Revisión de Alcance / The Risks for Women Associated with the Dispensation of Cyclofem in Pharmacies of Bogotá D.C. A Scope Review

La normatividad legal en Colombia exige que la dispensación y administración de Cyclofem en droguerías esté apoyada por una prescripción médica. Cyclofem es un anticonceptivo inyectable de combinación de vía intramuscular (AIC) que contiene medroxiprogesterona acetato y cipionato de estradiol y presenta un 99,7% de efectividad. Este medicamento produce sangrados abundantes, prolongados e irregulares, náuseas, mareos, aumento de peso, dolor de cabeza, osteoporosis y aumenta la tolerancia a la glucosa y la resistencia a la insulina. En la ciudad de Bogotá, D.C. sólo el 0,4% de las droguerías exigen la prescripción médica para la dispensación y administración de dicho medicamento(AU)

The legal regulations in Colombia require that the dispensing and administration of Cyclofem in drugstores be supported by a medical prescription. Cyclofem is an injectable intramuscular combination contraceptive (CCI) that contains medroxyprogesterone acetate and estradiol cypionate with an effectiveness of 99.7%. This medication causes heavy, prolonged and irregular bleeding, queasiness, dizziness, weight gain, headache, osteoporosis and increases glucose tolerance and insulin resistance. Only 0.4% of the pharmacies in Bogotá D.C. demanded the presentation of the medical prescription for dispensing and intramuscular administration (I.M) of Cyclofem in accordance with the current legal regulations(AU)

Dolor al administrar medicamento por inyección intramuscular: ventroglútea vs dorsoglútea / Pain in the administration of drugs by intramuscular injection: ventrogluteal vs dorsogluteal / Dor na administração intramuscular de drogas: ventroglúteo vs dorsogluteal

ResumenIntroducción. La inyección intramuscular es una técnica que causa dolor e incomodidad a las personas. Con el objetivo de determinar la zona de punción menos dolorosa para la administración de medicamentos intramusculares en glúteo, se realizó una revisión de literatura en busca de la evidencia de mayor calidad. Método. Se empleó el método propuesto por el enfoque de la Práctica Clínica de Enfermería Basada en la Evidencia. Se recopiló estudios de EBSCOhost, Google, Google Académico, Cochrane Library y PubMed. Se aplicó los filtros propuestos para la selección: se sometió los dos artículos seleccionados a lectura crítica mediante la plataforma FLC 2.0 con la cual se valoró la calidad de los estudios. El riesgo de sesgo se valoró con The Cochrane Collaboration's tool for assessing risk of bias. A través del sistema de clasificación GRADE se determinó la calidad de la evidencia y la fuerza de la recomendación de la intervención.Resultado. Los artículos incluidos en el estudio respondieron parcialmente a la pregunta clínica planteada. La percepción de dolor durante la administración de inyectables en el sitio ventroglúteo es menor que en el dorsoglúteo, los hallazgos tuvieron un nivel de evidencia moderado y la fuerza de recomendación fue 1B.Conclusión. No hay evidencia contundente para preferir la elección del sitio ventroglúteo sobre el dorsoglúteo para disminuir el dolor asociado a la administración intramuscular de analgésicos antiinflamatorios, aunque el primer sitio posee mayores ventajas en comparación con el segundo.

AbstractIntroduction. Intramuscular injection is a technique that causes pain and discomfort to people. In order to determine the least painful puncture site for the administration of intramuscular gluteal medications, a literature review was conducted in search of the highest quality evidence.Method.The method used in this research was the Evidence-Based Nursing approach. The studies were collected from EBSCOhost, Google, Google Scholar, Cochrane Library and PubMed. Filters of the selection criteria were applied to the papers and then were subjected to critical appraisal using the web platform FLC 2.0 leaving 2 articles remaining. The Cochrane Collaboration's tool for assessing risk of bias was applied and afterwards the GRADE approach was used to determine the quality of the evidence and strength of recommendation.Result. Papers included in the study responded partially the clinical question posed. The ventrogluteal IM injection site seems to be less painful than in the dorsogluteal site during the administration of analgesic antiinflammatory drugs, the findings had a moderate level of evidence and strength of recommendation was 1B. Conclusion. No strong evidence was found to prefer the ventrogluteal site rather than the dorsogluteal site in order to reduce pain associated with intramuscular administration of anti-inflammatory analgesics drugs. Although the first injection site has major advantages compared to the second

ResumoIntrodução: A injeção intramuscular é uma técnica que causa dor e desconforto para as pessoas. Com o objetivo de determinar o local da punção menos doloroso para a administração de medicamentos intramusculares no glúteo, realizou-se uma revisão de literatura em busca de evidência de maior qualidade.Materiais e método: Empregou-se o método proposto pelo enfoque de Prática Clínica de Enfermagem Baseada em Evidência. Realizaram-se estudos de EBSCOhost, Google, Google Acadêmico, Cochrane Library e PubMed. Aplicaram-se os filtros propostos para a seleção: foram submetidos dois artigos selecionados para a leitura crítica mediante a plataforma FLC 2.0 com a qual se estabeleceu um valor para a qualidade dos estudos. O risco de inclinação se determina com The Cochrane Collaboration's tool for assessing risk of bias. Através do sistema de classificação GRADE se determinou a qualidade de evidência e a necessidade da recomendação da intervenção. Resultados: Os artigos incluídos no estudo responderam parcialmente a pergunta clínica planteada. A percepção da dor durante a administração de injetáveis no local ventroglúteo é menor que no dorsoglúteo, as descobertas tiveram um nível de evidência moderado e a necessidade de recomendação foi 1B.Conclusões:Não há evidência contundente para preferir a escolha do local ventroglúteo sobre o dorsoglúteo para diminuir a dor associada a administração intramuscular de analgésicos antiinflamatórios, embora o primeiro local possua maiores vantagens em comparação com o segundo.

Síndrome de Nicolau por la administración de la vacuna séxtuple intramuscular en un lactante de 6 meses / Nicolau syndrome induced by intramuscular injection of a hexavalent vaccine in a 6-month-old girl

El síndrome de Nicolau, también conocido como embolia cutis medicamentosa o dermatitis livedoide, es una reacción cutánea infrecuente, caracterizada por una necrosis de la piel y los tejidos blandos de aparición súbita luego de la aplicación intramuscular de algunas drogas. Presentamos a un bebé de 6 meses de edad que, al recibir la tercera dosis de la vacuna séxtuple intramuscular, desarrolló una lesión necrótica con reticulado violáceo periférico en el sitio de aplicación. Se destaca la importancia del diagnóstico precoz a fin de instaurar un adecuado tratamiento y seguimiento para evitar complicaciones secundarias a la isquemia.

Nicolau syndrome, also known as embolia cutis medicamentosa or livedo-like dermatitis, is a sudden tissue necrosis, a rare complication of intramuscular injection of some drugs. We report a case of a 6-month-old girl who received intramuscularly the third dose of hexavalent vaccine (DTaP-HVB-IPV/HIb), and immediately presented a livedoid lesion around the injection site, progressing to necrosis. We reinforce the importance of early diagnosis to perform a suitable treatment and clinical follow-up to avoid ischemic secondary complications.

Tratamiento anticoagulante y vasodilatador para el síndrome de Nicolau tras la administración de una inyección de bencilpenicilina benzatínica intramuscular a un niño de cuatro años de edad / Anticoagulant and vasodilator therapy for Nicolau syndrome following intramuscular benzathine penicillin injection in a 4 year old boy

El síndrome de Nicolau (SN) es una complicación rara de la inyección de ciertos fármacos por vía intramuscular, intrarticular o subcutánea, que produce necrosis isquémica de la piel, las partes blandas y el tejido muscular circundante. La bencilpenicilina benzatínica es uno de los antibióticos más ampliamente empleados para las infecciones de las vías respiratorias altas y raramente se ha notificado que produzca SN. En este artículo presentamos el caso de un niño de sexo masculino de cuatro años de edad diagnosticado con SN tras la inyección de bencilpenicilina benzatínica tratado satisfactoriamente con heparina fraccionada (enoxaparina) y pentoxifilina. Los médicos deben estar atentos al uso innecesario de bencilpenicilina benzatínica para evitar las probables complicaciones.

Nicolau syndrome (NS) is a rare complication of intramuscular, intraarticular or subcutaneous injection of particular drugs leading to ischemic necrosis of the surrounding skin, soft tissue and muscular tissue. Benzathine penicilin one of the most widely used antibiotic for upper respiratory tract infections and has been rarely reported to cause NS. Here we describe a 4 year old boy with diagnosis of NS after the injection of benzathine penicillin who was successfuly treated with unfractionized heparin (enoxaparine) and pentoxifylline. The practitioners should pay attention for unnecessary use of benzathine penicillin to avoid from probable complications.

Post-injection embolia cutis medicamentosa - Nicolau Syndrome: case report and literature review / Embolia cutis medicamentosa pós-injeção - Síndrome de Nicolau: relato de caso e revisão de literatura

We report on the case of a 40-year-old male who was admitted to the clinic with a large ulcer on his left buttock, 3 days after an intramuscular benzathine penicillin injection. The patient was diagnosed with Nicolau syndrome, a rare vascular complication in which a lesion develops after intramuscular injection. Symptoms are intense pain at the injection site, erythema, and livedoid dermatitis, which leads to necrosis of skin, subcutaneous tissue and muscle tissue. It was described by Nicolau after intramuscular injections of bismuth salt for syphillis therapy. Nicolau syndrome is rare, but its symptoms are devastating and healthcare professionals must be aware of this clinical entity, since intramuscular injections are common procedures for administration of drugs.

Relatamos o caso de um homem de 40 anos apresentando uma grande úlcera na nádega esquerda 3 dias após receber injeção intramuscular de penicilina benzatina. O paciente foi diagnosticado com síndrome de Nicolau, uma rara complicação vascular com lesão após injeções intramusculares. Os sintomas incluem dor intensa no local da injeção, eritema e dermatite livedoide, o que leva a necrose da pele, do tecido subcutâneo e do tecido muscular. Foi descrita por Nicolau após injeções intramusculares de sal de bismuto para o tratamento de sífilis. A síndrome de Nicolau é incomum, mas seus sintomas são devastadores. Portanto, os profissionais de saúde precisam conhecer essa entidade clínica, uma vez que as injeções intramusculares são procedimentos comuns para a administração de drogas.

Síndrome de Nicolau posterior a la inyección de penicilina intramuscular / Nicolau's syndrome after benzathine penicillin intramuscular injection

El síndrome de Nicolau se produce por la inyección intra-arterial accidental de sustancias de aplicación intramuscular. Se caracteriza por dolor inmediato en el sitio de la inyección, seguido de alteraciones cutáneas locales y posterior desarrollo de embolias en las extremidades que generan daño isquémico tisular pudiendo llevar a la necrosis. En general se ha adjudicado a la penicilina G benzatínica intrmuscular, aún con técnica de aplicación adecuada, como responsable de este síndrome. Este fármaco sigue siendo de elección en una gran cantidad de enfermedades infecciosas; dentro de sus efectos advesos no alérgicos se destacan las complicaciones vasculares como las más frecuentes. Reportamos un paciente con sífilis tratado con penicilina G benzatínica intramuscular que presentó efectos adversos neurovasculares.

Nicolau's syndrome occurs as a result of intra-arterial accidental injection of intramuscular drugs. The clinical presentation includes immediate pain followed by skin local changes and extremities embolism that may lead to necrosis. Intramuscular Benzathine penicillin has been associated with this syndrome, even with adequate injection technique. This drug is of choice for a wide variety of infectious diseases; the most common non-allergic adverse events are vascular. We report here a syphilitic patient who suffered neurovascular adverse effects after intramuscular penicillin G benzathine application.

Pain from intramuscular vaccine injection in adults / Percepción de dolor después de una inyección intramuscular en adultos

Background: Vaccine use has been increasing worldwide, and adult populations are presented with more opportunities to experience pain from vaccine injection. The insertion of a needle through the skin is the most common source of iatrogenic pain, and needle phobia is a major concern in medical practice. However, it is unclear which factors play major roles in the perception of pain from vaccine injection in adults. Aim: To evaluate the influences of patient characteristics on pain perception due to intramuscular vaccine injection in healthy adult volunteers. Material and Methods: The injection of hepatitis B vaccine using a 24 mm, 24-G needle was performed as a uniform stimulus, and the intensity of injection pain was measured immediately after the injection using a 100-mm visual analogue scale (VAS). The influences of patient characteristics on pain intensity were investigated. Results: One hundred sixty volunteers (65 males, 95 females) were enrolled in this study. The average VAS score was 20.8 ± 17.1 (range 0 to 67) in males and 34.4 ± 19.7 (range 2 to 76) in females (P < 0.001). However, there were no correlations between VAS score and age, body mass index or maximal pain score from previous painful experiences. The VAS score was also not affected by the experience of previous vaccine injections, a history of childbirth in females, or religion. Conclusions: Gender appears to be the only major factor that influences the pain of intramuscular vaccine injection. Therefore, pain-reducing methods will be needed when performing injection procedures, particularly in women.

Antecedentes: La inserción de una aguja para inyecciones es la forma más común de inducción de dolor iatrogénico. No se sabe qué factores afectan la percepción del dolor. Objetivo: Evaluar la influencia de características propias de los pacientes en la percepción de dolor después de una inyección intramuscular. Material y Métodos: Se utilizó como estímulo, la inyección intramuscular de vacuna de hepatitis B, mediante una aguja de 24 mm (24 G). La intensidad del dolor fue evaluada inmediatamente después de la inyección utilizando una escala visual análoga de 100 mm (VAS). Se evaluó la influencia de las características de los pacientes en la intensidad del dolor. Resultados: Participaron 160 voluntarios (65 hombres). El puntaje VAS fue 20,8 ± 17,1 (rango 0 a 67) en hombres y 34,4 ± 19,7 (rango 2 a 76) en mujeres (p < 0,01). No hubo asociación entre el puntaje VAS y edad, índice de masa corporal, haber experimentado previamente dolor, haber dado a luz en mujeres o religión. Conclusiones: El género es la única variable que se asocia con la percepción de dolor después de una inyección intramuscular.

Randomized clinical trial to assess pain and bruising in medicines administered by means of subcutaneous and intramuscular needle injection: Is it necessary to have needles changed? / Ensaio clínico randomizado para avaliação de dor e hematoma em administração de medicamentos por via subcutânea e intramuscular: há necessidade de troca de agulhas? / Ensayo clínico aleatorio para evaluación del dolor y hematoma durante la administración de medicamentos por vía subcutánea e intramuscular: ¿Es necesario cambiar las agujas?

This clinical trial aimed at comparing the intensity of pain and bruising by subcutaneous and intramuscular injections using and retractable fixed syringes and needles and syringes with no needles combined, at a public hospital in Sao Paulo, for six months. We evaluated the perception of pain in case of intramuscular (n=1000) and subcutaneous injections (n=240). In subcutaneous application, bruise formation was also verified. Pain and bruising scores were higher in the group with no needles combined (p<0.001) and (p<0.029), respectively. The test power in relation to the pain scale of was 0.98. The use of retractable fixed needles is recommended in the application of subcutaneous and intramuscular injections. Clinical trial registration number: NCT01271608.

Este ensaio clínico teve como objetivo comparar a intensidade da dor e hematoma consequentes a injeções por via subcutânea e intramuscular, utilizando seringas e agulhas fixas retráteis e seringas com agulhas não conjugadas, em hospital público na cidade de São Paulo, durante seis meses. Foi avaliada a percepção da dor na injeção intramuscular (n=1.000) e na subcutânea (n=240). Na aplicação por via subcutânea, verificou-se também a formação de hematoma. A pontuação de dor e hematoma foi maior no grupo com agulhas não conjugadas (p<0,001 e p<0,029, respectivamente). O poder do teste em relação à escala de dor foi de 0,98. Recomenda-se o uso de agulha fixa retrátil na aplicação de injeções intramusculares e subcutâneas. Registro de ensaio clínico nº NCT01271608.

Este ensayo clínico tuvo como objetivo comparar la intensidad del dolor y hematoma de inyecciones por vía subcutánea e intramuscular utilizando jeringas y agujas fijas retráctiles y jeringas con agujas no conjugadas, en un hospital público en la ciudad de Sao Paulo, durante seis meses. Fue evaluada la percepción del dolor de la inyección intramuscular (n=1000) y la subcutánea (n=240). En la aplicación por vía subcutánea se verificó también la formación de hematoma. La puntuación del dolor y hematoma fue mayor en el Grupo con agujas no conjugadas (p<0,001) y (p<0,029), respectivamente. El poder de la prueba en relación a la escala de dolor fue de 0,98. Se recomienda el uso de aguja fija retráctil en la aplicación de inyecciones intramusculares y subcutáneas. Registro de ensayo clínico nº NCT01271608.

Scanning electron microscopy and histopathological study of the effect of estriol on the endometrium of women using long acting injectable contraceptives with irregular uterine bleeding

Hormonal contraceptives are female sex steroids, synthetic estrogen and synthetic progesterone [pro gestin], or pro gestin only. They can be administered in the form of oral contraceptives "OC", implants, and injectables. A large part of the modem medical research has focused on studying the effect of different forms of the hormonal contraception on the human endometrium whether by the conventional dilatation and curettage or by outpatient pipelle to study the endometrial histopathological changes either by light microscope or scanning electron microscope; and to correlate the findings detected by both modalities, in order to develop an effective method for diagnosis and treatment of different forms of eridometrial pathology. The aim of the present study was to evaluate the effect of estrogen treatment on the endometrium of women using pogestational injectable contraceptive [Depo-provera] [R]and complaining of irregular uterine bleeding using: Clinical assessment, transvaginal ultrasound and studying endometrial samples by: The ordinary light microscope and the scanning electron microscope. In this study 30 women using depo provera as a contraceptive method and all of them complaining of irregular uterine bleeding were randomly categorized into 2 groups; group A included 15 cases who received estriolfor 3 months, and group B included 15 cases who received Diosmine for the same period. Both groups were subjected to endometrial sampling by an out patient pippelle before and after treatments then the endometrial tissues were examined by the ordinary light microscope and the scanning electron microscope, results were then tabulated and statistically analyzed using the standard statistical tests. Microscopic examination of-the endometrial biopsies from all women receiving depot inedroxyprogesterone acetate revealed variable degrees of endo, netrial atrophy. The glandular architecture was cystic in cases and budded in the others. The glands were lined by mitotically inactive bland-looking cuboidal or flattened cells with rare pseudostratfication. The glands were embedded' in a mitotically inactive spindled stroma that exhibited varying degrees of collagenation. The ratio of glands to stroma was near one with predominant stroma. in many foci. Microscopic examination of the endometrial biopsies of the 15 patients that received Diosmine for 3 months didn't reveal any proliferative change in 12 of them and only weak prohferative changes were noted in 3 of them. All atrophic endometria examined with the SEM revealed inconsistency in cell size and shape, cellular loss and separation, infrequency of ciliated cells and absence of uterodomes. Epithelial surface was usually flattened, with cells often displaying raised cell borders; Microvillous cells were thinly populated with very low, blebbed microvilli. Afew to moderate number of glands with large openings were observed. Pitted cells were observed in 2 of the specimens that were treated with Diosmine. Number of injections and time lapse since the last injection had a role in the endometrial changes but age, gravidity and parity had no role. Depotmedroxyprogesterone acetate [DMPA] is one of the most effective hormonal iontraceptive methods used by women in reproductive age to prevent pregnancy. Discontinuation of DMPA is mainly due to menstrual irregularities including unpredictable bleeding or spotting; this bleeding is mainly due to endometrial atrophy. Estriol is considered the friendly estrogen and can he used in treatment of vaginal bleeding during DMPA use by changing the endometrium front vrophic to prolfirative so it causes building up of a new endometrium without evident side effects Endometriutn either under effect of DMPA or estriol is easy to be studied by combined scanning electron microscopy and ordinary light microscopy cfter endometrial sampling by outpatient pipelle

[Sciatic neuropathy induced with gluteal intramuscular injections in children]

Study the cases of sciatic neuropathy induced with gluteal intramuscular injections in children, a widespread phenomena in medical practice in Syria. I studied the cases that referred to Damascus University children hospital during 6 years [2000-2005]. The diagnosis was done according to the history, clinical examination and the electro myogram which was done after 1 and 3 months after the event. up were followed for 6 months or more. We had 60 cases. 85% of children were less than 5 years old, the injections were done by doctors [41, 6%] and pharmacists [23.3%]. The site of injection was incorrect in 88.2% 0f cases that presented early with obvious site of injection, and it was correct in 11.7%, the antipyretics drugs were the injected materials in 75% of cases and the main antipyretic was Na+ Diclofenac. The peroneal branch of the sciatic nerve was affected 81.6% of the cases and the both branches 8.3% of the cases. after 1 year follow up, Catastrophic sequellae, were noted in 87% of cases [foot drop, foot deformation]

Nicolau syndrome following intramuscular benzathine penicillin.

Nicolau syndrome (NS) is a rare complication of an intramuscular injection characterized by severe pain, skin discoloration, and varying levels of tissue necrosis. The case outcomes vary from atrophic ulcers and severe pain to sepsis and limb amputation. We describe a case of a seven-year-old boy with diagnosis of NS after intramuscular benzathine penicillin injection to the ventrolateral aspect of the left thigh. Characteristic violaceous discoloration of skin and immediate injection site pain identified it as a case of NS. The case was complicated by rapid progression of compartment syndrome of the lower limb, proceeding to acute renal failure and death. Associated compartment syndrome can be postulated as a poor prognostic factor for NS.

[Comparing the pain severity caused by muscular injection of Tramadole in Z and bulb methods]

Pain, rather than any other problems, would persuade people to pursue remedy and treatment. Muscular injections are among pain producing factors. This technique of prescription can be followed by some complications from which pain is the most prevalent one. This study was performed to compare the pain severity caused by muscular injection of Tramadole in Z and Bulb methods. This is a clinical trial study in which 90 women who referred to the emergency ward of Shahid Beheshti hospital in Yasooj in 2006 were randomly selected. Data collection instrument was questionnaire. The pain severity was evaluated by visual scale. Data were analyzed by descriptive statistical method, independent T and chi square test using SPSS software. Mean of pain severity in bulb method was 2.84 +/- 1.242 and in Z method was 4.56 +/- 1.659. The independent T test indicated that the differences in pain severity in two injection methods were statistically significant [p=0.036]. No significant differences were found between age, educational level, job, marriatal status, number of previous injections and BMI of samples between two groups. Bulb method injection induces less pain in comparison with Z method; therefore it is an ideal method for muscular injections. As such, health care workers, especially nurses, can, through this method, minimize the patients' pain, which is one of the most important injection complaints

[Nicolau syndrome: report of a case]

Nicolau syndrome or embolia cutis medicamentosa is a rare complication of intramuscular injection of some drugs. This syndrome has been reported after injection of NSAIDS, corticosteroids and antibiotics. Here we report a 16-year-old boy who developed this syndrome after intramuscular injection of benzathine penicillin

Estudio toxicológico de un inyectable apócrifo conteniendo hierro como principio activo / Toxicological study of a counterfeit medicinal product containing iron sorbitol

Una mujer embarazada murió luego de la administración parenteral de un preparado de hierro (sorbitol),producto que fue identificado por la Autoridad Sanitaria Argentina como un medicamento apócrifo. Su análisis químico determinó que el contenido de hierro era 3.5 veces mayor al rotulado. Los estudios toxicológicos demostraron que su administración representa un riesgo sanitario y podría ser el causante de la muerte.

After the injection of an iron sorbitol preparation a pregnant woman died. Its chemical analysis determined a hugeamount of iron (3.5-fold higher than the labeled). Results obtained by toxicological studies show that such medicinal product represents a sanitary risk and probably it could be presumed as the cause of death.

Sciatic nerve injury due to buttock injection and the necessity of limited gluteal injection

The sciatic nerve injury due to buttock injection is a serious complication. This study is assessment of sciatic nerve injury after glouteal injection and results of measures taken by government and medical centers for prevention in Mashhad. This is a descriptive study in electrodignostic center of imarn Reza Hospital and hassan Abady clinic. During 72 months [1999.3.21-2005.3.21], which was divided into four stages [18 months x4], there were 83 injection-induced sciatic nerve injuries.Diagnostic tests were E.M.G and N.C.V. Data was analyzed by chi and T tests and utilizing SPSS software. The most common medicines for injection were unknown for patient [40%] Diclofenac and Piroxicam [38%] and 33.5% of patients were below 5 years old. 56.5% in left side and 62.5% in males. The damage 'was severe in 53% and in 60% proneal branch was affected. The number of patients from first to 4th stage was: 30-25-16-12. Significant decrease of damage for all ages specially in children under 5 years old was seen. The continuation of instruction by government and prevention of gluteal injection in children less than 5 years is necessary

Lesão do nervo axilar causada pela injeção intramuscular no deltóide: relato de caso / Axillary nerve injury caused by deltoid muscle intramuscular injection: case report

A injeção intramuscular no deltóide é procedimento freqüente. Ocasionalmente, pode causar complicações, tais como contraturas musculares e lesões neurológicas. Aventa-se que a injeção em local impróprio é, em geral, o fator responsável por essas intercorrências. Recentemente, foi encaminhado aos autores um paciente com lesão causada por injeção intramuscular no deltóide. A lesão comprometeu os ramos do nervo axilar que se dirigem às suas porções anterior e média, que se encontravam paralisadas